Table of Content

15 March 2022, Volume 28 Issue 6

Previous Issue   

Scientific Research

Relationships between protein phosphatase 1 and its dephosphorylation and depression

Ma Xiangxian, Jiang Yuting, Wang Sanwang, Cui Minghu

2022, 28(6):  741-744.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.001

Asbtract ( )  

References | Related Articles | Metrics

In recent years, it has been found that the biological regulation of protein phosphatase family in different brain regions has attracted much attention in depression research. Serine / Threonine protein phosphatase 1 (PP1) controls synaptic plasticity by catalyzing the dephosphorylation of most phosphoserine and phosphothreonine in cells at synapses. Although PP1 and its dephosphorylation are involved in many key biological processes, there is a relative paucity of studies on their relationships with depression. This paper reviews various evidences to support that PP1 and its dephosphorylation may play an important role in the pathogenesis and disease progression of depression.

Effect of modified phalloplasty on common external genital malformations in adolescent males

Zhang Lifeng, Su Quanxin, Gao Shenglin, Lu Chao, Yue Chuang, Wu Xingyu, Mao Weijiang, Zuo Li

2022, 28(6):  745-748.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.002

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the clinical effects of two kinds of modified phalloplasty in adolescent males with common external genital malformations. Methods　The clinical data of 77 adolescent males with common external genital malformations who underwent modified phalloplasty in The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University from January 2018 to March 2020 were retrospectively reviewed. Among them, 56 patients with redundant prepuce and phimosis were (17.8±2.3) years old, and 21 patients with concealed penis were (14.6±2.6) years old. The operative procedure, operative time, blood loss, postoperative complications, and follow-up were reviewed to summarize the application effect. Results　Fifty-six patients with redundant prepuce and phimosis underwent modified circumcision, and 21 patients with concealed penis underwent modified phalloplasty. The operation process of all patients was smooth. In 56 patients with redundant prepuce and phimosis, 4 patients had edema of varying degrees, which resolved spontaneously within 2 weeks. In 21 patients with concealed penis, 5 patients developed edema of varying degrees, which all resolved spontaneously within 3 weeks; 1 patient had postoperative retropubic infection, which improved within 1 week after active symptomatic treatment. After follow up of 6-12 months, the penises of both groups were well straightened and naturally esthetic in appearance, and the patients and their parents were satisfied. Conclusions　Both modified surgical methods have good surgical results and postoperative appearance. For patients with redundant prepuce and phimosis, modified circumcision has the advantages of less bleeding, lower cost, and aesthetic incision. For patients with concealed penis, the incision of modified phalloplasty is smaller, penile release is more adequate, and fixation is stronger. Besides, modified phalloplasty is not only suitable for pediatric patients with concealed penis, has a high application value in young patients.

Research progress on evaluation and risk factors of cognitive frailty in hypertensive patients

Zhao Yang, Zhou Jie, Geng Zhaohui

2022, 28(6):  748-752.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.003

Asbtract ( )  

References | Related Articles | Metrics

This paper expounds the definition, assessment, and influencing factors of cognitive frailty, in order to provide references for standardized assessment of cognitive frailty and long-term care plan of hypertensive patients. It is suggested that there is a lack of specific assessment tools for cognitive frailty in hypertensive patients. In the future, we need to actively carry out researches on cognitive frailty in hypertensive patients, in order to better identify and intervene the cognitive frailty in hypertensive patients, and improve their quality of life.

Effects of sirolimus-containing quadruple immunosuppressor on renal function, T lymphocyte subsets, and prognosis in patients after renal transplantation

Suo Jingjun, Yang Qingyan, Li Tao, Han Jianle, Yang Junwei, Wang Changan, Yang Shuaiping

2022, 28(6):  752-755.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.004

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effects of sirolimus-containing quadruple immunosuppressor on renal function, T lymphocyte subsets, and prognosis in patients after renal transplantation. Methods　A total of 115 patients undergoing renal transplantation in Zhengzhou Seventh People's Hospital were enrolled as the research objects between January 2017 and January 2021. According to different treatment regimens, they were divided into group A [29 males and 37 females, aged (47.6±14.3) years] and group B [23 males and 26 females, aged (45.2±14.7) years]. Group A was treated with triple immunosuppressor, and group B was treated with sirolimus-containing quadruple immunosuppressor on the basis of group A. The renal function indexes [serum creatinine (Scr), β2-microglobulin (β2-MG), and cystatin C (CysC)] and T lymphocyte subsets before and 6 months after surgery, and occurrence of postoperative acute rejection, transplanted kidney loss, lung infection, and death were compared between the two groups. Independent sample t test was used for the measurement data, and χ² test was used for the count data. Results　Before treatment, there were no statistically significant differences in the levels of Scr, β2-MG, and CysC between the two groups (all P>0.05); after treatment, the levels of Scr, β2-MG, and CysC in group B were (104.39±30.91) μmol/L, (2.94±1.71) mg/L, and (0.79±0.15) mg/L, respectively, which were lower than those in group A [(128.54±37.21) μmol/L, (3.57±1.29) mg/L, and (0.86±0.12) mg/L], with statistically significant differences (all P<0.05). Before treatment, there were no statistically significant differences in the levels of CD3⁺, CD8⁺, and CD4⁺/CD8⁺ between the two groups (all P>0.05); there was no statistically significant difference in the CD4⁺ level between the two groups before and after treatment (both P>0.05); after treatment, the levels of CD3⁺, CD8⁺, and CD4⁺/CD8⁺ in group B were (60.90±10.15)%, (20.06±6.69)%, and (1.21±0.14), respectively, which were lower than those in group A [(65.29±10.58)%, (22.65±6.94)%, and (1.27±0.17)], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions within 6 months after renal transplantation between the two groups (P>0.05). Conclusion　The application of sirolimus-containing quadruple immunosuppressor after renal transplantation can better regulate immune function, without aggravating renal function injury.

Establishment and application of a management model for non-dialysis patients with chronic kidney disease based on 5A chronic disease model

Tang Fang, Fu Lizhe, Li Minqing, Wu Yifan, Lu Huijuan, Jiang Sufang, Zou Tao, Deng Lili

2022, 28(6):  756-758.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.005

Asbtract ( )  

References | Related Articles | Metrics

Review on the diagnosis of medullary sponge kidney

Liang Yanbing, Chen Jinlan, Su Zhengming

2022, 28(6):  759-761.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.006

Asbtract ( )  

References | Related Articles | Metrics

 Medullary sponge kidney (MSK) is a kidney malformation, usually characterized by nephrocalcinosis and recurrent kidney stones, and requires an expensive and time-consuming intra-venous urography (IVU) for diagnosis. Although IVU is still the gold standard for diagnosing MSK, other methods such as multi-detector computed tomography (MDCT), magnetic resonance imaging (MRI), and even biomarkers are rapidly emerging, providing hope for early detection and diagnosis of MSK. In this paper, the latest imaging examination of MSK and the study of diagnostic methods of biomarkers are reviewed.

Clinical effects of different doses of levofloxacin in the treatment of rifampicin-resistant pulmonary tuberculosis

Han Zhangqin, Wang Tongsheng

2022, 28(6):  762-765.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.007

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the clinical effects of different doses of levofloxacin in the treatment of rifampicin-resistant pulmonary tuberculosis. Methods　A total of 90 patients with rifampicin-resistant pulmonary tuberculosis were selected from Xinyang Fifth People's Hospital from May 2019 to September 2020, and were divided into a high-dose group and a low-dose group according to the random number table method, with 45 cases in each group. In the high-dose group, there were 25 males and 20 females, aged (42.16±5.05) years, and they were given levofloxacin 0.6 g/d; in the low-dose group, there were 23 males and 22 females, aged (43.27±5.12) years, and they were given levofloxacin 0.4 g/d. The clinical efficacies, focal absorption rates, quality of life, incidences of adverse reactions of the two groups were compared. Independent sample t test was used for the measurement data, and χ² test was used for the count data. Results　The effective rate in the high-dose group [95.56% (43/45)] was higher than that in the low-dose group [75.56% (34/45)], with a statistically significant difference (χ²=7.283, P<0.05). The focal absorption rate in the high-dose group [91.11% (41/45)] was significantly higher than that in the low-dose group [66.67% (30/45)], with a statistically significant difference (χ²=8.073, P<0.05). The scores of social function, material life, physical function, and psychological function in the high-dose group were (81.25±9.46) points, (81.82±9.39) points, (89.05±8.26) points, and (88.03±9.96) points, which were significantly higher than those in the low-dose group [(67.34±7.56) points, (64.31±7.42) points, (65.58±7.47) points, and (61.81±7.63) points], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.080, P=0.777). Conclusion　The clinical effect of high-dose of levofloxacin in the treatment of rifampicin-resistant pulmonary tuberculosis is significant, which can significantly promote the absorption of lesions and improve the patients' quality of life, without increasing adverse reactions, with high safety, worthy of further clinical application.

Anesthetic effect of dexmedetomidine hydrochloride in interventional treatment for intracranial aneurysms 

Zhao Zhenzhen

2022, 28(6):  765-768.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.008

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the anesthetic effect of dexmedetomidine hydrochloride in interventional treatment for intracranial aneurysms. Methods　This is a retrospective analysis. A total of 60 patients with intracranial aneurysms who received interventional treatment in Zhengzhou Cardiovascular Hospital from January 2020 to August 2021 were selected as the research objects. According to the different anesthesia schemes, the patients were divided into a control group (30 cases, receiving conventional general anesthesia) and a study group (30 cases, receiving general anesthesia with dexmedetomidine). In the control group, 17 males and 13 females were (57.21±6.33) years old; in the study group, 18 males and 12 females were (57.38±6.42) years old. The time of eye opening, extubation time, stay time in recovery room, bispectral index (BIS) when recovery, and anesthetic complications were compared between the two groups, as well as systolic blood pressure (SBP), heart rate (HR), and mean arterial pressure (MAP) before induction of anesthesia (T₀) and 15 min (T₁) and 30 min (T₂) after maintenance. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison of the measurement data, and χ² test was used for the count data. Results　At T₀, there were no statistically significant differences in the HR, SBP, and MAP between the two groups (all P>0.05). At T₁, the MAP of the study group was (99.35±10.62) mmHg (1 mmHg=0.133 kPa), which was higher than that of the control group [(87.45±4.80) mmHg], with a statistically significant difference (P<0.05); there were no statistically significant differences in the HR and SBP (both P>0.05). At T₂, the HR, SBP, and MAP of the study group [(69.52±6.27) beats /min, (146.33±5.67) mmHg, and (98.12±7.69) mmHg] were higher than those of the control group [(66.43±5.29) beats /min, (143.77±3.57) mmHg, and (89.38±4.62) mmHg], with statistically significant differences (all P<0.05). The time of eye opening, stay time in recovery room, and extubation time in the study group were (16.37±2.03) min, (35.20±10.07) min, and (12.28±2.38) min, respectively, which were shorter than those in the control group [(24.28±4.95) min, (54.43±12.86) min, and (24.20±6.71) min], with statistically significant differences (all P<0.05). There was no statistically significant difference in the BIS between the two groups when recovery (P>0.05). There was no statistically significant difference in the incidence of anesthetic complications between the two groups (χ²=0.577, P=0.448). Conclusion　Dexmedetomidine hydrochloride has a good anesthetic effect in interventional surgery for intracranial aneurysms, with stable patients' vital signs during the operation, high quality of postoperative recovery, and a low incidence of complications.

Application of pain nursing pathway under mind mapping in elderly patients undergoing cholecystectomy

Liu Xiaoli

2022, 28(6):  769-772.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.009

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of pain nursing pathway under mind mapping on postoperative pain perception, psychological status, and sleep quality of elderly patients undergoing cholecystectomy. Methods　Eighty-nine elderly patients treated in department of hepatopancreatobiliary surgery of Affiliated Cancer Hospital of Zhengzhou University between March 2020 and January 2021 were selected as the research subjects. All of them received cholecystectomy and were divided into a control group and an observation group with the random number table. The 44 patients in the control group were given routine nursing, including 23 males and 21 females, with an age of (70.83±3.65) years old; the 45 patients in the observation group were given pain nursing pathway intervention under mind mapping on the basis, including 23 males and 22 females, with an age of (71.34±3.21) years old. The differences in pain perception [Pain Belief and Perception Inventory (PBPI)], psychological status [World Health Organization (WHO) Profile of Mood States (POMS)], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were compared between the two groups 3 d after surgery. The measurement data were compared between groups by independent sample t test and within groups by paired t test, and the count data were tested by χ² test. Results　Three days after surgery, the PBPI, POMS, and PSQI scores of the observation group were (32.77±5.18), (56.63±6.47), and (23.87±4.39) points, respectively, which were significantly lower than those of the control group [(37.64±6.12), (64.16±6.81), and (27.44±4.78) points], with statistically significant differences (t=4.055, 5.349, and 3.671; all P<0.001). Conclusion　Pain nursing pathway intervention under mind mapping can effectively alleviate the postoperative pain perception, enhance the psychological status, and improve the sleep quality in elderly patients undergoing cholecystectomy.

Application effect of graded psychological nursing intervention system in improving anxiety and depression in hospitalized children and adolescents 

Peng Hong, Tao Li, Gu Jing, He Juan, Tang Mei

2022, 28(6):  773-776.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.10

Asbtract ( )  

References | Related Articles | Metrics

Objective　To verify the application effect of graded psychological nursing intervention system in improving anxiety and depression in hospitalized children and adolescents. Methods　Totally 80 children and adolescents hospitalized in Deyang People's Hospital from June 2020 to June 2021 were randomly selected as the research objects and were divided into an experimental group and a control group with 40 cases in each group with the random number table. The control group received routine nursing intervention, and the experimental group received graded psychological nursing intervention. At the time of discharge, the scores of children's self-rating depression scale, children's anxiety disorder screening scale, and satisfaction evaluation scale were compared. Independent sample t test was used for the measurement data conforming to normal distribution, rank sum test was used for the measurement data conforming to abnormal distribution, and χ² test was used for the count data. Results　There were 40 children finally included in the experimental group and 39 children in the control group. In the experimental group, there were 21 males and 19 females, aged 10.0 (9.0, 17.0) years; there were 22 males and 17 females in the control group, aged 10.5 (8.0, 18.0) years. After intervention, there were statistically significant differences between the two groups in the scores of each item of children's self-rating depression scale except "liking to go out to play" and "stomach pain" (all P<0.05). After intervention, there were statistically significant differences in the scores of each item of children's anxiety disorder screening scale between the two groups (all P<0.05); the total score of the experimental group was lower than that of the control group [(14.33±1.93) points vs. (17.13±1.98) points] (P<0.05). After intervention, the total score of satisfaction evaluation scale in the experimental group was higher than that in the control group [(86.08±5.83) points vs. (73.28±14.65) points] (P<0.05). Conclusion　Graded psychological nursing intervention system can improve the anxiety and depression in hospitalized children and adolescents and improve their satisfaction, which is worthy of reference.

Effects of continuous nursing on postoperative recovery, bad moods, and complications in patients with malignant obstructive jaundice

Gao Tingting, Wu Liping, Li Hui

2022, 28(6):  777-780.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.011

Asbtract ( )  

References | Related Articles | Metrics

Therapeutic effect of methylprednisolone combined with lidocaine for refractory sudden deafness with tinnitus

Li Fuyun, Xue Maifu

2022, 28(6):  780-783.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.012

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the therapeutic effect of methylprednisolone combined with lidocaine in refractory sudden deafness with tinnitus, and its influence on the mean value of pure tone hearing threshold and adverse reactions. Methods　In the retrospective analysis, 160 patients with refractory sudden deafness with tinnitus admitted to Maternity and Child Health Hospital of Jiaozuo City from January 2020 to September 2021 were selected as the research objects. According to the random number table method, they were divided into a control group (80 cases) and an observation group (80 cases). In the control group, there were 45 males and 35 females, with an age of (50.52±3.82) years old; there were 41 males and 39 females in the observation group, with an age of (50.98±3.99) years old. Both groups received conventional treatment, and the observation group was given methylprednisolone and lidocaine for combined treatment. The improvement of ear function, adverse reactions, and medication effects of the two groups were compared. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison of the measurement data, and χ² test was used for the count data. Results　Before treatment, there were no statistically significant differences in the mean pure tone threshold and Tinnitus Handicap Inventory (THI) score between the two groups (both P>0.05); after treatment, the mean pure tone threshold and THI score of the observation group were (40.03±3.55) dB and (13.85±2.01) points, respectively, which were lower than those of the control group [(51.95±4.14) dB and (19.95±2.75) points], with statistically significant differences (both P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.826, P=0.363). The total effective rate of the observation group was 98.75% (79/80), which was higher than that of the control group [90.00% (72/80)], with a statistically significant difference (χ²=4.238, P=0.040). Conclusion　The combined use of methylprednisolone and lidocaine in the clinical treatment of patients with refractory sudden deafness with tinnitus can promote the improvement and recovery of symptoms such as hearing loss and tinnitus, and can reduce the occurrence risk of adverse reactions in patients and improve the efficacy of patients' medication, which is worthy of promotion and application.

Effects of different types of adhesives on the strength and durability of dentin bonding

Zhang Wenhao, Wei Dixin, Ye Qi, Zhuang Yuan, Li Yanfen

2022, 28(6):  784-787.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.013

Asbtract ( )  

References | Related Articles | Metrics

Objective　To compare the effects of different types of adhesives on the strength and durability of dentin bonding, so as to provide references for clinical selection of adhesives. Methods　A total of 50 patients were selected from the Department of Stomatology of Shenzhen Baoan Women's and Children's Hospital Affiliated to Jinan University from January 2019 to June 2020, including 25 males and 25 females, aged (42.21±8.27) years. Fifty complete caries-free human discrete third molars were removed for treatment, which were divide into group A, B, C, D, and E by the random number table method, 10 tooth in each group. Group A was treated by total acid corrosion adhesive, group B was treated by two-step self-acid corrosion adhesive, group C was treated by one-step acid corrosion adhesive, group D was treated by general adhesive, and group E was treated by total acid corrosion + general adhesive. Each group shall conduct resin bonding operation strictly according to the instructions, and 60 dentine-resin strips were cut out in each group, which were further subdivided into two subgroups according to the storage time, 30 in each group. After storing in artificial saliva for 24 h and 12 months, the specimens were cut and made, and the bonding strength of each specimen was tested. The fracture mode of the specimens was analyzed by stereomicroscope, and the bonding strength and fracture mode of 5 kinds of dental adhesives were compared. Univariate ANOVA was used for multiple-group comparison of the measurement data, SNK-q test was used for pairwise comparison between groups, paired t test was used for intra-group comparison, and rank sum test was used for the ranked data. Results　There was no statistically significant difference in the bonding strength between group A and group B after 24 h of storage [(30.73±2.56) MPa vs. (31.42±9.17) MPa] (P>0.05); the bonding strength of group A and group B were higher than those of group C [(22.22±5.67) MPa], group D [(25.04±1.87) MPa], and group E [(24.54±2.09) MPa] (P<0.05); the bonding strength of group D was higher than that of group C (P<0.05). The bonding strength of each group after 12 months of storage was: group B [(30.56±2.54) MPa] >group A [(28.35±3.25) MPa] > group D [(24.91±6.46) MPa] > group E [(20.18±3.08) MPa] > group C [(17.43±1.28) MPa], with a statistically significant difference (P<0.05). The bonding strength of group A, group C, and group E after 12 months of storage were higher than those after 24 h of storage, with statistically significant differences (all P<0.05); there was no statistically significant difference in the bonding strength of group B or group D (both P>0.05). After storage for 24 h and 12 months respectively, the number of mixed fractures was always the largest in each group, and there was no statistically significant difference in the constituent ratio of fracture structure among each group (P>0.05). Conclusions　The bonding strength of dentin treated with two-step self-acid corrosion adhesive and total acid corrosion adhesive are the highest; the bonding strength of one-step self-acid corrosion adhesive is the lowest. As time goes on, the bonding strength of dentin treated with two-step self-acid corrosion adhesive is still the highest, and that of dentin treated with one-step self-acid corrosion adhesive decreases most obviously.

Application of component analysis of urinary calculi in Pingshan area

Luo Linbin, Zhu Bin, Zhao Meixiang

2022, 28(6):  788-791.  DOI: 2022001982

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the composition of urinary calculi in Pingshan area. Methods　The retrospective analysis selected 200 adult patients with urinary calculi in Pingshan District People's Hospital from December 2019 to April 2021 as the research objects. The patients were divided into an observation group and a control group according to the random number table method with 100 cases in each group. There were 58 males and 42 females in the observation group, with an age of (55.56±10.33) years old; they were treated with lithotripsy (extracorporeal lithotripsy, ureteroscopic lithotripsy, and percutaneous nephroscopic lithotripsy), and the calculi were collected for calculus composition analysis and dietary guidance after lithotripsy. There were 60 males and 40 females in the control group, with an age of (56.14±10.57) years old; they only received lithotripsy (extracorporeal lithotripsy, ureteroscopic lithotripsy, and percutaneous nephroscopic lithotripsy) and regular follow-up observation after surgery. The postoperative recurrence rate, mastery degree of health knowledge, and quality of life of the two groups were counted, and the calculus composition of the observation group was analyzed. Independent sample t test and χ² test were used to compare the measurement data and count data between groups. Results　The postoperative recurrence rate of the observation group was 4.0% (4/100), lower than that of the control group [18.0% (18/100)], with a statistically significant difference between the two groups (χ²=10.010, P=0.002). The scores of pathogenesis, dietary status, disease recurrence, and knowledge of complications in the observation group were (92.85±3.69) points, (93.16±4.15) points, (94.15±3.85) points, and (95.10±3.99) points, respectively, higher than those in the control group [(83.18±4.15) points, (84.65±5.22) points, (85.67±4.11) points, and (86.34±4.62) points], with statistically significant differences (all P<0.05). The scores of social function, emotional function, psychological function, and physiological function in the observation group were (94.15±4.11) points, (94.26±4.00) points, (95.10±3.95) points, and (94.97±4.10) points, respectively, higher than those in the control group [(85.67±3.97) points, (86.15±3.97) points, (84.67±4.96) points, and (85.16±4.99) points], with statistically significant differences (all P<0.05). Analysis of stone components in the observation group showed that there were many types of stone components, including 20 cases of simple stone and 80 cases of mixed stone. In the observation group, the detection rates of calcium oxalate stones, infectious stones, uric acid stones, and other stones in male patients were 69.70% (46/66), 75.00% (15/20), 87.50% (7/8), and 100.00% (6/6), respectively, higher than those in female patients [30.30% (20/66), 25.00% (5/20), 12.50% (1/8), and 0.00% (0/6)], with statistically significant differences (all P<0.05). The age in patients with calcium oxalate stones was (53.54±13.54) years old, lower than that in patients with non-calcium oxalate stones [(62.57±13.91) years old], and the age in patients with uric acid stones was (62.32±13.57) years old, higher than that in patients with non-uric acid stones [(50.95±13.15) years old], with statistically significant differences (both P<0.05). Conclusions　The clinical characteristics of patients with urinary calculi in Pingshan area were analyzed, and targeted treatment was given. After treatment, in order to prevent the recurrence, the composition of calculi was analyzed, and the dietary guidance was provided, which played a positive role in reducing the postoperative recurrence rate, improving patients' health knowledge and quality of life, and was worthy of promotion.

Special Column of Pediatrics

Etiologic and epidemiologic characteristics of respiratory pathogenic bacterial infection in 5 938 children from Changzhi City in Shanxi Province 

Feng Ruijie, Li Xiaoze

2022, 28(6):  793-799.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.015

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the epidemiological and etiological characteristics of respiratory tract infection in 5 938 children in Changzhi City of Shanxi province, and to provide scientific basis for the formulation of prevention strategies and clinical treatment for children. Methods　The samples of 5 938 hospitalized children with respiratory diseases in Changzhi Maternal and Child Health Hospital from December 2017 to February 2020 were collected, and 13 pathogenic bacteria were detected by loop mediated isothermal amplification technique (LAMP). χ² test was used for the count data, and Pearson correlation coefficient was used for correlation analysis. Results　Among the 5 938 cases, 3 394 (57.16%) were boys and 2 544 (42.84%) were girls, all ≤12 years old, with a total positive rate of 65.66% (3 899/5 938). The top three positive detection rates were 33.06% (1 963/5 938) of Streptococcus pneumoniae, 29.74% (1 766/5 938) of Haemophilus influenza, and 9.90% (588/5 938) of methicillin-resistant staphylococci. The detection rate of mixed infection was 25.60% (1 520/5 938), 2.73% (162/5 938) of severe pneumonia, 1.01% (60/5 938) of neonatal pneumonia, and 3.57% (212/5 938) of cerebrospinal fluid infection. Conclusions　Respiratory tract infection of children in Changzhi City of Shanxi Province is mainly caused by Haemophilus influenzae and Streptococcus pneumoniae. The composition of pathogenic bacteria varies with time, symptoms, sampling sites, population characteristics, and other factors, some of which have typical distribution characteristics.

Effects of alveolar lavage combined with dexamethasone on pulmonary function and serum inflammatory factors in children with lobar pneumonia

Sun Shuangshuang

2022, 28(6):  800-804.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.016

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the effects of alveolar lavage combined with dexamethasone on pulmonary function and serum inflammatory factors in children with lobar pneumonia. Methods　A total of 50 children with lobar pneumonia in Children's Hospital Affiliated to Zhengzhou University from July 2017 to February 2021 were selected retrospectively and were divided into two groups according to the treatment plans. In the control group (24 cases), there were 10 females and 14 males, aged (6.97±1.02) years; in the combined group, there were 11 females and 15 males, aged (7.27±1.28) years. The control group was treated with dexamethasone, and the combined group was treated with alveolar lavage on the basis of the control group. The treatment effect, symptom relief time, length of hospital stay, and pulmonary function and serum inflammatory factors levels before and after treatment were compared between the two groups. The measurement data were compared between groups by independent sample t test, paired t test within groups, and the count data by χ² test. Results　There was no statistically significant difference in the total effective rate between the combined group and the control group [92.31% (24/26) vs. 70.83% (17/24)] (P>0.05). The antipyretic time [(4.18±1.67) d], cough relief time [(7.22±2.50) d], lung wet rales disappearance time [(8.53±1.84) d], large patchy shadow dissipation time [(8.11±2.34) d], and length of hospital stay [(9.18±2.37) d] in the combined group were shorter than those in the control group [(7.25±3.84) d, (10.38±4.25) d, (12.20±3.78) d, (11.95±3.62) d, and (12.69±4.05) d] (all P<0.01). After 7 days of treatment, the forced expiratory volume in one second (FEV₁) [(1.38±0.30) L], peak expiratory flow (PEF) [(4.09±0.96) L/s], and forced vital capacity (FVC) [(1.55±0.28) L] in the combined group were higher than those in the control group [(1.13±0.25) L, (3.35±0.85) L/s, and (1.26±0.32) L] (all P<0.01); the serum soluble intercellular adhesion molecule 1 (sICAM-1) [(15.31±3.29) μg/L], interleukin 6 [(5.19±1.37) pg/ml], and high mobility group protein B1 (HMGB1) levels [(60.35±15.62) μg/L] in the combined group were lower than those in the control group [(24.11±5.82) μg/L, (8.64±3.06) pg/ml, and (73.84±20.67) μg/L] (all P<0.05). Conclusion　Alveolar lavage combined with dexamethasone is helpful to reduce inflammatory reaction in children with lobar pneumonia, improve pulmonary function, and shorten symptom relief time and length of hospital stay.

Research progress of plastic bronchitis in children

Tian Jie, Jin Yu, Liu Suqin

2022, 28(6):  805-808.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.017

Asbtract ( )  

References | Related Articles | Metrics

Plastic bronchitis is a multisystem clinical syndrome that causes severe respiratory distress in children. This disease is more common in infection related diseases at home. Its clinical manifestations are varied and the severity of the disease varies. Diagnosis depends on the removal of endogenous foreign bodies by cough or bronchoscopy. At present, there is no effective treatment has been introduced, bronchoscopy intervention and control of primary diseases are the key of treatment. Its prognosis mainly depends on the severity of primary diseases and whether the treatment is timely and effective.

Clinical application value of level of neutrophil extracellular traps in the severity evaluation of sepsis in children

Ren Chong, Chen Nan, Chen Ning

2022, 28(6):  808-811.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.018

Asbtract ( )  

References | Related Articles | Metrics

Objective　To study the clinical application value of level of neutrophil extracellular traps (NETs) in the severity evaluation of sepsis in children. Methods　A total of 53 children with sepsis in Children's Hospital Affiliated to Zhengzhou University from October 2019 to June 2021 were selected as a sepsis group [29 males and 24 females, with an age of (2.07±0.68) years old], and 53 children with healthy physical examination were selected as a healthy group [33 males and 20 females, with an age of (1.83±0.59) years old] in a 1:1 ratio. Blood samples were collected and tested for NETs level. The levels of NETs in the two groups, the levels of NETs in children with different degrees of sepsis, at different time points, in different periods, and with different prognosis, and the correlation were analyzed. χ² test was used for the count data, independent sample t test was used for the measurement data, and Spearman correlation analysis was used. Results　The level of NETs in the sepsis group was significantly higher than that in the healthy group [(42.41±4.34)% vs.(0.26±0.04)%], with a statistically significant difference (P<0.001). The levels of NETs in 6 children with severe sepsis were significantly higher than that in 43 children with general sepsis [(57.82±6.19)% vs.(40.11±4.08)%], with a statistically significant difference (P<0.001). On the first day and the seventh day, the level of NETs in children in infection stage was significantly higher than that in children in infection dissipation stage (both P<0.001). The level of NETs in the 14 dead cases was significantly higher than that in the 39 survivors [(59.56±5.35)% vs.(33.56±3.46)%], with a statistically significant difference (P<0.001). Spearman analysis showed that the level of NETs was significantly positively correlated with infection stage (r=0.581) and death (r=0.623) (both P<0.001). Conclusions　Timely monitoring of NETs level during the treatment of children with sepsis can identify the stage of disease, and the effectiveness of treatment regimens can be determined according to the trend of changes in NETs level, which is convenient for clinicians to adjust medication regimens in time and improve clinical efficacy. In addition, NETs level detection can also predict the risk of prognosis to provide individualized preventive measures, which has a high application value.

Analysis of 56 cases of missed or misdiagnosed autism spectrum disorder

Wu Manhong, Xu Ning, Chang Yanqun, Wen Jian, Yu Chulan, Huang Shuangmiao, Feng Jiaxin, Deng Haiyin

2022, 28(6):  811-814.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.019

Asbtract ( )  

References | Related Articles | Metrics

Evaluation of interest-oriented floor play therapy combined with multimedia sensory and speech training in the treatment of children with autism spectrum disorder 

Wan Kai, Shang Qing, Li Jingjie, Ma Caiyun, Lyu Nan

2022, 28(6):  815-818.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.020

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the efficacy of interest-oriented floor play therapy combined with multimedia sensory and speech training in the treatment of children with autism spectrum disorder (ASD). Methods　A total of 82 children with ASD in Children's Hospital Affiliated to Zhengzhou University from November 2018 to December 2020 were selected and were divided into a study group (41 cases) and a control group (41 cases) according to the random number table method. There were 20 males and 21 females in the control group, aged (6.87±1.49) years; there were 23 males and 18 females in the study group, aged (6.02±1.35) years. The control group was given routine rehabilitation, and the study group was given interest-oriented floor play therapy combined with multimedia sensory and speech training on the basis of the control group. The efficacy, Autism Behavior Checklist (ABC) score, Childhood Autism Rating Scale (CARS) score, Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) [comprehensive response control quotient (FRCQ) and comprehensive attention quotient (FAQ)], Pediatric Evaluation of Disability Inventory (PEDI), and language developmental delay test (S-S) were compared between the two groups. Independent sample t test was used for the measurement data and χ² test was used for the count data. Results　Compared with 68.29% (28/41) of the control group, the total effective rate of the study group [87.80% (36/41)] was higher (P<0.05). After treatment, the ABC and CARS scores of the study group were (31.56±8.45) points and (28.16±5.59) points, respectively, which were lower than those of the control group [(39.04±9.61) points and (33.48±6.15) points] (both P<0.05). After treatment, the FRCQ and FAQ scores of the study group were (109.12±17.16) points and (97.54±16.38) points, respectively, which were higher than those of the control group [(98.25±16.46) points and (86.19±14.37) points] (both P<0.05). After treatment, the PEDI and S-S scores of the study group were (82.23±11.32) points and (56.64±5.41) points, respectively, which were higher than those of the control group [(75.16±10.64) points and (43.79±4.85) points] (both P<0.05). Conclusion　Interest-oriented floor play therapy combined with multimedia sensory and speech training in the treatment of children with autism spectrum disorder can improve the treatment effect, improve their language disorder, reduce the severity of the disease, and improve the body function and language function.

Effect of early sensory integration training on convalescent children with severe viral encephalitis 

Wang Lin, Li Xiaoxia, Wan Kai, Shang Qing

2022, 28(6):  819-821.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.021

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of early sensory integration training in convalescent children with severe viral encephalitis. Methods　From June 2020 to June 2021, 78 children with severe viral encephalitis in convalescence in Children's Hospital Affiliated to Zhengzhou University were selected and were divided into two groups according to the random number table method, with 39 cases in each group. There were 23 males and 16 females in the observation group, aged (7.25±1.03) years; there were 22 males and 17 females in the control group, aged (7.22±1.01) years. The control group received routine nursing, and the observation group received intervention combined with early sensory integration training on this basis. After training for 3 months, the motor function, intellectual development, and sensory integration scores of the two groups were compared. χ² test was used for the count data, independent sample t test was used for inter-group comparison of the measurement data, and paired t test was used for intra-group comparison of the measurement data. Results　The scores of motor function and intelligence development in the observation group after nursing were (78.96±6.12) and (96.43±8.75) points respectively, which were higher than those in the control group [(66.75±8.13) and (89.74±7.43) points]; the sensory integration score in the observation group was (40.52±8.44) points, which was lower than that in the control group [(51.43±8.10) points]; the differences were statistically significant (all P<0.05). Conclusion　Early sensory integration training can improve motor function and intelligence level of children in the convalescent stage of severe viral encephalitis, and improve their sensory integration ability.

Progress on biological agents in the treatment of pediatric rheumatic diseases

Zhang Bing, Liu Li

2022, 28(6):  822-824.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.022

Asbtract ( )  

References | Related Articles | Metrics

In recent decades, biological agents have been widely used in the treatment of rheumatic diseases in children and have achieved good therapeutic effects. However, the indications approved are different in China and at abroad, and there are fewer approved indications for children. According to the different mechanisms of drug, biological agents can be divided into four types: for cytokines, for B cells, for T cells, and for signal transduction. In this paper, the mechanisms of action and indications of biological agents are summarized according to the above four types.

Analysis of clinical features and prognosis in neonates with Ommaya reservoir placement

Chi Xiufang, Zhang Yong

2022, 28(6):  825-828.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.023

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the possible factors affecting complications and prognosis after Ommaya reservoir placement, and to study the preventive measures. Methods　Children with intracranial hemorrhage or hydrocephalus after intracranial hemorrhage who were admitted to neonatal intensive care unit (NICU) of Guangdong Women and Children Hospital from August 2020 to July 2021 and underwent Ommaya reservoir placement were selected. The general information, clinical manifestations, postoperative complications, and prognosis were retrospectively analyzed. Results　Eight cases met the inclusion criteria, including 4 males and 4 females, and 1 case was full term and 7 cases were premature. Six cases had good surgical results, who had no postoperative bleeding, difficulty in puncture, blocking the tube, displacement of Ommaya reservoir, or liquid leakage, but among whom 2 cases had postoperative intracranial infection; 2 cases had poor surgical results. Conclusions　Intracranial hemorrhage or hydrocephalus after intracranial hemorrhage is common in premature infants, and is more than grade Ⅲ. Ommaya reservoir placement is an extremely effective method for hydrocephalus, and its most common postoperative complication is intracranial infection. Ommaya reservoir placement is not recommended when combined with intracranial infection.

Clinical efficacy of triptorelin for girls with idiopathic central precocious puberty and its effect on bone age 

Xu Liqin, Hong Qingrong, Fang Yuan

2022, 28(6):  829-832.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.024

Asbtract ( )  

References | Related Articles | Metrics

Objective　To study the clinical effect of triptorelin for girls with idiopathic central precocious puberty. Methods　The clinical data of 68 girls diagnosed with idiopathic central precocious puberty in Zhenjiang First People's Hospital from January 2018 to December 2020 were retrospectively analyzed, whose age was (8.21±1.55) years old and the course of disease was (13.42±2.97) months. All the 68 girls were treated with triptorelin for injection, and the related data before and after 12 months of treatment were compared and analyzed. Paired t test was used to compare the measurement data before and after treatment. Results　After 12 months of treatment, the body weight, height, and predicted adult height (PAH) in girls with idiopathic central precocious puberty increased, the growth rate tended to be normal, the bone age progression was delayed, and the bone age/age decreased (all P<0.05). After 12 months of treatment, the baseline values of follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E₂) and uterine and ovarian volumes in girls with idiopathic central precocious puberty decreased (all P<0.05). Before treatment, 31 girls had 4 or more follicles with diameter greater than or equal to 4 mm, which decreased to 12 cases after 12 months of treatment, the secondary sexual characteristics were alleviated, and the adverse reactions were rare. Conclusions　The use of triptorelin for girls with idiopathic central precocious puberty can reduce the levels of sex hormones, delay the display of secondary sexual characteristics in girls, and achieve growth and development consistent with normal age, slow down the premature closure of bones, and make girls develop normally, with few adverse reactions, which is worthy of application and promotion.

Application of video electroencephalogram combined with peripheral blood inflammation indexes in the diagnosis of brain injury in premature infants

Deng Shiyue, Lyu Xiang, Jiang Lijun

2022, 28(6):  832-836.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.025

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the value of video electroencephalogram (VEEG) combined with peripheral blood inflammation indicators [total number of white blood cells (WBC), hypersensitive C-reactive protein (hs-CRP), and procalcitonin (PCT)] in the diagnosis of brain injury in premature infants, and to provide new clinical ideas for the evaluation of brain injury and its short-term prognosis in premature infants. Methods　The premature infants who were admitted to Affiliated Hospital of Yangzhou University from October 2020 to July 2021 and premature infants who were born in the obstetric department of other hospitals in the city with high risk factors of brain injury and transferred to neonatal intensive care unit of Affiliated Hospital of Yangzhou University within 24 hours were selected. According to the results of head magnetic resonance imaging (MRI) at 40 weeks of corrected gestational age, the premature infants were divided into a brain injury group and a non-brain injury group, with 28 cases in each group. In the brain injury group, there were 16 males and 12 females, with a gestational age of (32.83±2.09) weeks; there were 13 males and 15 females in the non-brain injury group, with a gestational age of (32.79±2.14) weeks. All preterm infants were examined by bedside VEEG within 1 week after birth and 2 ml of venous blood was collected on the 1st, 3rd, and 7th day after birth to detect the levels of WBC, hs-CRP, and PCT. The sensitivity and specificity of VEEG in the diagnosis of brain injury in premature infants were analyzed by four-grid table of diagnostic test, and the differences of WBC, hs-CRP, and PCT levels between the two groups at different time points were analyzed by ANOVA for repeated measurement. Results　The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and accuracy of VEEG in the diagnosis of brain injury in premature infants were 78.6% (22/28), 82.1% (23/28), 81.5% (22/27), 79.3% (23/29), 4.4, 3.8, and 80.4% respectively, and the Kappa value was 0.607. On the 1st day after birth, there was no statistically significant difference in the hs-CRP level between the two groups (P>0.05), the WBC and PCT levels in the brain injury group were higher than those in the non-brain injury group (both P<0.05). On the 3rd day after birth, the WBC, hs-CRP, and PCT levels in the brain injury group were higher than those in the non-brain injury group (all P<0.05). On the 7th day after birth, there were no statistically significant differences in the WBC and PCT levels between the two groups (both P>0.05), while the hs-CRP level was higher in the brain injury group (P<0.05). Conclusions　VEEG can be used as a reliable basis for the early diagnosis of brain injury in premature infants. The simultaneous increase of WBC, hs-CRP, and PCT levels on the 3rd day after birth often indicates the risk of brain injury in premature infants.

Clinical study on erythromycin combined with interferon atomization in the treatment of infantile pertussis-like syndrome

Gao Feng, Zhang De􀆳an, Kong Li

2022, 28(6):  837-840.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.026

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the clinical effect of erythromycin combined with interferon atomization in the treatment of infantile pertussis-like syndrome. Methods　A total of 150 infants with pertussis-like syndrome who were admitted to Mengyin County People's Hospital from May 2018 to May 2021 were numbered according to the order of admission, and were divided into an observation group (75 cases) and a control group (75 cases) by the random number table method. The observation group included 50 males and 25 females, aged from 1 to 12 months; the control group included 47 males and 28 females, aged from 1 to 12 months. The control group was treated with erythromycin atomization, and the observation group was treated with interferon on this basis. The clinical effects, relief time of clinical symptoms and signs, laboratory indexes, and immune function were compared between the two groups, and the occurrence of adverse reactions was statistically analyzed. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison, and χ² test was used for the count data. Results　The total response rate in the observation group was significantly higher than that in the control group [92.00% (69/75) vs. 77.33% (58/75)] (P<0.05). The relief time of spastic cough symptom, disappearance time of lung rales, relief time of dyspnea, and hospital stay in the observation group [(7.00±1.28) d, (5.40±1.25) d, (5.13±1.01) d, and (7.72±2.12) d] were shorter than those in the control group [(7.90±1.59) d, (6.69±2.14) d, (6.58±1.32) d, and (9.39±2.59) d] (all P<0.05). After treatment, the white blood cell count, percentage of lymphocytes, and C-reactive protein (CRP) in the observation group [(15.14±4.65) ×10⁹/L, (30.14±12.05)%, and (4.17±1.45) mg/L] were lower than those in the control group [(24.17±7.12) ×10⁹/L, (45.25±10.50)%, and (8.05±2.13) mg/L] (all P<0.05), the levels of immunoglobulin G (IgG), IgA, and IgM [(11.35±2.52) g/L, (1.29±0.18) g/L, and (2.04±0.46) g/L] were higher than those in the control group [(7.55±1.76) g/L, (1.05±0.25) g/L, and (1.80±0.45) g/L] (all P<0.05). No adverse reactions were observed during treatment. Conclusions　Erythromycin combined with interferon atomization is superior to interferon atomization alone in the treatment of infantile pertussis-like syndrome in terms of curative effect and relief of symptoms and signs. The former can improve the immune function more significantly, with good safety.

Analysis of the effect of quality control circle activities in improving the discharge family readiness for preterm infants

Liao Lihua, Chen Songzhu, Liu Fangyun, Cai Shuwan

2022, 28(6):  841-846.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.027

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of quality control circle activities in improving the family readiness for premature infants discharged from hospital. Methods　In April 2020, a quality control circle activity team was set up. A total of 36 premature infants including 4 pairs of twins and 32 premature infants' mothers, were discharged from Department of Neonatology of The Second Affiliated Hospital of Guangzhou Medical University before the quality control circle activities from June to September 2020 as a control group. The present situation of discharge family readiness was investigated, the causes were analyzed, the improvement focus was established, the target value was set, and the countermeasures were formulated. A total of 37 premature infants including 2 pairs of twins and 35 premature infants' mothers, were selected after the implementation of quality control circle activities from November 2020 to March 2021 as an observation group, and the quality control circle activities and continuous quality improvement were carried out for them. The age in premature infants' mothers of the control group was (31.66±5.313) years old, and (31.91±4.705) years old of the observation group. In the control group, there were 17 male and 19 female premature infants, with a gestational age of (34.10±2.19) weeks; in the observation group, there were 21 male and 16 female premature infants, with a gestational age of (33.83±2.00) weeks. The discharge family readiness for preterm infants, maternal anxiety level, and preterm infants' rate of growth and development reaching the standards 2 weeks after discharge were compared between the two groups. Independent sample t test was used for the measurement data, and χ² test was used for the count data. Results　After the implementation of quality control circle activities, the score of discharge family readiness for preterm infants increased from (2.59±1.04) to (4.09±0.70), the maternal anxiety level decreased from (57.66±7.294) to (43.37±4.486), and the preterm infants' rate of growth and development reaching the standards 2 weeks after discharge increased from 61.11% (22/36) to 89.19% (33/37), with statistically significant differences (all P<0.05). Conclusions　Quality control circle activities can effectively improve the family readiness for preterm infants discharged from hospital, reduce the maternal anxiety level, improve the preterm infants' rate of growth and development reaching the standards 2 weeks after discharge, and better help preterm infants to transition smoothly from hospital to family.

Evaluation of the effect of ultrasound-guided dynamic tip positioning technology in radial artery catheterization in children

Li Tiantian, Wen Xiaofang, Yu Meiyang

2022, 28(6):  846-849.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.028

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the influence and safety of ultrasound-guided dynamic tip positioning technology on the quality of radial artery catheterization in children. Methods　A total of 109 children who planned to undergo radial artery catheterization in The First Affiliated Hospital of Henan University of Science and Technology from February 2019 to February 2021 were selected as the study subjects. According to the random number table method, they were divided into two groups, including 54 patients [30 males and 24 females, aged (2.51±0.48) years] in the control group who received radial artery catheterization by touch positioning method, 55 patients [32 males and 23 females, aged (2.53±0.44) years] in the observation group who were given ultrasound-guided dynamic needle tip positioning technique for puncture catheterization. The related indexes of the two groups were compared. χ² test was used for the count data and independent sample t test was used for the measurement data. Results　The first puncture success rate [85.45% (47/55)] and total success rate [96.36% (53/55)] in the observation group were higher than those in the control group [48.15% (26/54) and 64.81% (35/54)] (both P<0.05). The puncture time [(4.12±0.99) min] and puncture times [(1.02±0.31) times] in the observation group were lower than those in the control group [(8.23±1.26) min and (2.18±0.46) times] (both P<0.05). The total incidence of radial artery hematoma and spasm after puncture in the observation group [3.64% (2/55)] was lower than that in the control group [16.67% (9/54)] (P<0.05). Conclusion　Both touch positioning and ultrasound-guided dynamic needle tip positioning can be used in radial artery catheterization in children, but the latter has a higher puncture success rate, better quality control indexes, and higher safety.

Treatises

Correlations between changes of serum related cytokines and clinical stage in patients with primary glaucoma

Wang Yali

2022, 28(6):  850-854.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.029

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the correlations between changes of serum related cytokines and clinical stage in patients with primary glaucoma. Methods　A total of 85 patients with primary glaucoma treated in Zhengzhou Second People's Hospital from July 2019 to March 2021 were selected as a study group [40 males and 45 females, aged (56.67±2.12) years], and 50 healthy subjects who underwent physical examination in the hospital during the same period were selected as a control group [23 males and 27 females, aged (57.17±2.33) years]. The levels of interleukin-4 (IL-4), IL-6, and IL-12 were compared between the two groups. According to the clinical symptoms and visual field examination results, the patients in the study group were divided into a mild stage group (29 cases), a moderate stage group (33 cases), and a severe stage group (23 cases). The levels of IL-4, IL-6, and IL-12 in patients with mild stage, moderate stage, and severe stage were compared and analyzed. Logistic regression analysis was used to explore the correlations between the levels of IL-4, IL-6, and IL-12 and the clinical stage in patients with primary glaucoma, and Pearson correlation analysis was used to analyze the correlations between the changes of serum related cytokines and the clinical stage in patients with primary glaucoma. Independent sample t test was used for comparison of the measurement data between two groups, F test was used for comparison of the measurement data among multiple groups, and χ² test was used for the count data. Results　The level of IL-4 in the study group was (236.89±45.36) pg/ml, which was significantly higher than that in the control group [(191.65±50.34) pg/ml], and the levels of IL-6 and IL-12 were (35.42±28.46) pg/ml and (96.94±51.23) pg/ml, respectively, which were significantly lower than those in the control group [(61.18±30.21) pg/ml and (130.21±56.55) pg/ml], with statistically significant differences (all P<0.05). There were no statistically significant differences in the gender, age, blood pressure, and blood glucose among patients with mild stage, moderate stage, and severe stage (all P>0.05); the intraocular pressure (IOP) in the three groups became higher and higher from mild to severe stage, with a statistically significant difference among the three groups (P<0.05). The serum levels of IL-6 and IL-12 in the three groups decreased significantly from mild to severe stage, and the levels of IL-6 and IL-12 in patients with severe stage were significantly lower than those in patients with mild stage (both P<0.05); the serum level of IL-4 in the three groups increased gradually from mild to severe stage, but there was no statistically significant difference among the three groups (P>0.05). Logistic regression analysis showed that IL-6 and IL-12 levels were significantly correlated with the clinical stage of primary glaucoma (both P<0.05); Pearson analysis showed that the changes of serum IL-6 and IL-12 levels were negatively correlated with the clinical stage of primary glaucoma patients (r=-0.450, -0.430). Conclusion　The changes of serum related cytokines have a certain correlation with the clinical stage of primary glaucoma, which can be used to evaluate the severity of primary glaucoma and provide scientific basis for clinical treatment.

Clinical observation on the effect of sodium zirconium cyclosilicate powder on short-term potassium lowering in patients with severe hyperkalemia of chronic kidney disease

Li Rugang, Huang Jieping, Kuang Shuanghong, Liang Zezhi, Zhong Jinghua

2022, 28(6):  854-858.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.030

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the short-term potassium lowering effect of sodium zirconium cyclosilicate powder in patients with severe hyperkalemia of chronic kidney disease. Methods　The clinical data of 11 patients with chronic kidney disease complicated with severe hyperkalemia who refused emergency hemodialysis and took sodium zirconium cyclosilicate powder in Yuebei People's Hospital from November 2020 to May 2021 were retrospectively analyzed, and the short-term treatment effect and drug safety were analyzed. Paired t test was used to compare the measurement data with normal distribution before and after medication. The correlation between potassium reduction range and intravenous potassium level before medication was analyzed by Pearson correlation analysis. Results　Among the 11 patients, 8 cases were male and 3 cases were female, aged (75.5±12.5) years; there were 10 cases (90.91%) with hypertension, 3 cases (27.27%) with diabetes, 1 case (9.09%) with coronary heart disease, and 1 case (9.09%) with heart failure; the estimated glomerular filtration rate (eGFR) was <15 ml·min^-1· (1.73 m²)^-1 in 7 cases (63.64%), and ≥15 ml·min^-1· (1.73 m²)-1 in 4 cases (36.36%). The intravenous potassium level of 11 patients was (7.02±0.54) mmol/L before medication, and (4.62±0.76) mmol/L in morning reexamination on the second day after medication, and the potassium reduction range on the first day was (2.40±0.43) mmol/L, with a statistically significant difference before and after medication (P<0.001). According to the initial intravenous potassium level, 4 patients in the ≥7.00 mmol/L group were decreased by (3.26±0.70) mmol/L on the first day, 7 patients in the 6.50-7.00 mmol/L group were decreased by (1.91±0.64) mmol/L on the first day; there was a statistically significant difference in the potassium reduction range between the two groups on the first day (P=0.024). The potassium reduction range on the first day was positively correlated with the level of intravenous potassium before medication (r=0.318, P=0.047). Hypokalemia occurred in 1 case and vomiting in 2 cases, and no other adverse reactions were found. Conclusion　Sodium zirconium cyclosilicate powder can effectively reduce the blood potassium level in patients with chronic kidney disease and severe hyperkalemia within 24 hours, with high safety.

Clinical effect of Juqin decoction combined with bronchoscopic alveolar lavage on patients with bronchiectasis

Che Qifu, He Lijie

2022, 28(6):  858-862.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.031

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the clinical effect of Juqin decoction combined with bronchoscopic alveolar lavage in the treatment of patients with bronchiectasis. Methods　A total of 80 patients with bronchiectasis in Jiamusi Hospital of Traditional Chinese Medicine from March to July 2021 were divided into a conventional group and a combined group with the random number table with 40 cases in each group. In the conventional group, there were 21 males and 19 females, aged (58.36±8.97) years, were treated with bronchoscopic alveolar lavage. In the combined group, there were 22 males and 18 females, aged (58.40±9.01) years, were treated with Juqin decoction on the basis of the conventional group. The clinical efficacy and adverse reactions were compared between the two groups, as well as sputum characteristics, lung function, and inflammation indexes before and after treatment. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison of the measurement data, and χ² test was used for the count data. Results　The total effective rate of the conventional group was 80.00% (32/40), which was significantly lower than that of the combined group [97.50% (39/40)] (P<0.05). After treatment, the sputum volume, sputum density, and purulent mucus indexes in the combined group were (109.54±10.95) ml, (0.51±0.14) points, and (0.49±0.12) points, which were significantly lower than those in the conventional group [(135.29±13.53) ml, (0.78±0.16) points, and (0.72±0.15) points], with statistically significant differences (all P<0.05). After treatment, the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, and forced mid-expiratory flow rate (PEF25%-75%) in the combined group were (2.21±0.50) L, (2.82±0.43) L, (78.37±11.63)%, and (56.11±3.61), which were significantly higher than those in the conventional group [(1.71±0.41) L, (2.46±0.38) L, (69.51±10.79)%, and (54.06±3.40)], with statistically significant differences (all P<0.05). After treatment, the levels of interleukin-8 (IL-8), tumor necrosis factor -α (TNF-α), soluble intercellular adhesion molecule-1 (sICAM-1), and human secretory phospholipase A2-X (SPLA2-X) in the combined group were (52.11±4.98) pg/ml, (9.54±1.05) pg/ml, (178.44±17.84) ng/L, and (127.85±7.84) ng/L, which were lower than those in the conventional group [(57.25±5.48) pg/ml, (10.98±1.27) pg/ml, (202.55±20.26) ng/L, and (209.51±8.34) ng/L], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.157, P=0.692). Conclusion　The application of Juqin decoction combined with bronchoscopic alveolar lavage in the treatment of bronchiectasis has significant effect, which can significantly improve the sputum characteristics and lung function, reduce the inflammatory indexes, with high safety, which is worthy of promotion.

Clinical Research

Study on 24-hour dynamic electrocardiogram parameters in the evaluation of malignant arrhythmia after PCI in patients with acute myocardial infarction 

Fan Pengyun

2022, 28(6):  863-866.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.032

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the value of 24-hour dynamic electrocardiogram (DCG) parameters in evaluating malignant arrhythmia (MA) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods　A total of 80 AMI patients treated by PCI in Nanyang Second People's Hospital from June 2020 to June 2021 were selected as the research subjects, including 43 males and 37 females, aged (47.24±3.14) years. The occurrence of MA within 72 hours after operation of patients was observed and recorded, and the patients were divided into two groups according to the results. All patients underwent 24-hour DCG examination and the relevant parameters were recorded [standard deviation of R-R interval (SDNN) from 24-hour normal atrial depolarization to ventricular depolarization (R-R), standard deviation of normal R-R interval (SDANN-index) for 5 consecutive minutes in 24 hours, and 24-hour QT interval variability (QTV)]. The value of 24-hour DCG parameters in evaluating MA after PCI in patients with AMI was analyzed. Independent sample t test and χ² test were used to compare the measurement data and the count data between groups. Results　After PCI treatment in 80 patients with AMI, MA occurred in 22 cases (27.50%) within 72 hours after operation. The rate of Killip grade Ⅲ/Ⅳ of cardiac function in the MA group was higher than that in the non-MA group [63.64% (14/22) vs. 36.21% (21/58)], with a statistically significant difference (P<0.05); there were no statistically significant differences in the other data (gender, infarct area, and age) between the two groups (all P>0.05). The SDNN, SDANN-index, and 24 h-QTV values of the MA group were (73.76±10.07) ms, (67.14±6.76) ms, and (18.69±4.15) ms, respectively, which were lower than those in the non-MA group [(84.47±10.75) ms, (73.38±6.84) ms, and (23.53±3.04) ms], with statistically significant differences (all P<0.05). The results of receiver operating characteristic curve (ROC) showed that SDNN, SDANN-index, and 24 h-QTV alone and combined examination all had certain values in evaluating MA after PCI in AMI patients, and the areas under the curve (AUC) were >0.7, among which the combined examination had the highest evaluation value. Conclusion　24-hour DCG parameters have certain values in evaluating the occurrence of MA in AMI patients after PCI.

A comparative study on the diagnostic effects of conventional electrocardiogram and dynamic electrocardiogram for cardiogenic syncope in the elderly

Li Xiuzheng, Ding Lingyan, Liu Yan

2022, 28(6):  867-869.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.033

Asbtract ( )  

References | Related Articles | Metrics

Objective　To compare the effects of conventional electrocardiogram (ECG) and dynamic electrocardiogram (DCG) in the diagnosis of cardiogenic syncope in the elderly. Methods　A total of 110 elderly patients with suspected cardiogenic syncope admitted to Binzhou Central Hospital from June 2020 to May 2021 were selected for conventional ECG and DCG examinations, including 62 males and 48 females, aged (76.07±6.15) years. The diagnostic accuracy, sensitivity, and specificity of the two examinations were compared, as well as the detection rates of arrhythmia in patients with positive and negative cardiogenic syncope. The count data were tested by χ² test. Results　Among 110 elderly patients with suspected cardiogenic syncope, 88 cases (80.00%) were finally diagnosed as positive, and 22 cases (20.00%) were negative. In the diagnosis of elderly patients with suspected cardiogenic syncope, the diagnostic accuracy, sensitivity, and specificity of DCG [90.91% (100/110), 93.18% (82/88), and 81.82% (18/22)] were significantly higher than those of conventional ECG [63.64% (70/110), 72.73% (64/88), and 27.27% (6/22)], with statistically significant differences (all P<0.05). The detection rate of arrhythmia types diagnosed by DCG in elderly patients with cardiogenic syncope was significantly higher than that by conventional ECG, with statistically significant differences (all P<0.05). Conclusions　In the diagnosis of cardiogenic syncope in the elderly, the diagnostic accuracy, sensitivity, and specificity of DCG are higher than those of conventional ECG, the detection rate of arrhythmia is more accurate and efficient, and the clinical diagnosis effect is more ideal.

Case Report

Idiopathic portal hypertension with gastrointestinal bleeding as first manifestation: a case report

Tang Ming, Huang Wei

2022, 28(6):  870-872.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.034

Asbtract ( )  

References | Related Articles | Metrics

Idiopathic portal hypertension (IPH), a diagnosis of exclusion without Clin-eguide Evidence-Based Treatment Guidelines, is rare in clinic. The clinical data, diagnosis, and treatment methods in a patient with IPH who was admitted to The First Affiliated Hospital of Jinan University on August 6, 2021 were analyzed, and the relevant literatures were reviewed to summarize the diagnosis and treatment processes of IPH.

Tumor necrosis factor-α antagonist combined with small-medium dose of glucocorticoids in the treatment of severe drug eruption: two cases report and literature review

Li Lingjia, Hu Jia, Wang Zixi, Tao Shiqin

2022, 28(6):  873-876.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.035

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the effect of tumor necrosis factor-α (TNF-α) antagonist combined with small-medium dose of glucocorticoids in severe drug eruption. Method　We summarized the incidence and outcome of 2 cases of severe drug eruption in Wuxi No.2 People's Hospital Affiliated to Nanjing Medical University. Results　Case 1: a 52-year-old male, took carbamazepine orally for right facial trigeminal neuralgia 31 days before admission, and had fever, systemic rash, and elevated white blood cell (WBC) and C-reactive protein (CRP) levels, accompanied by liver function impairment. He was diagnosed as Stevens-Johson syndrome, was treated with subcutaneous injection of 25 mg (initial dose not doubled) etanercept once every 3 days for 4 times, the corresponding dose of glucocorticoids was 60, 40, 20, and 20 mg, and the patient recovered. Fever was controlled within 6 hours after the first injection; 3 days later, the lesions began to desquamate, and 5 days later, the epidermis regenerated. Levels of WBC, CRP, and transaminase in the peripheral blood began to decrease after the first injection, and returned to normal in 1 week. Case 2: a 68-year-old female, took allopurinol orally due to gout 3 weeks before admission, had high fever, oliguria, and systemic rash, accompanied by liver and kidney function impairment, increased WBC and eosinophils, and lymph node enlargement. She was diagnosed as drug reactions with eosinophilia and systemic symptoms (DRESS), was treated with etanercept with the dose as same as case 1, and the corresponding dose of glucocorticoids was 60, 40, 40, and 20 mg. Fever was controlled within 6 hours after the first injection; 3 days later, the skin began to desquamate, and 7 days later, 80% of the rash subsided. WBC and CRP in the peripheral blood began to decrease after the first injection, transaminase and eosinophils continued to increase, and gradually recovered in 2 weeks. Follow-up up to now showed no recurrence in 2 patients. Conclusion　It is suggested that TNF-α antagonist combined with small-medium dose of glucocorticoids can promote the outcome of severe drug eruption more quickly, safely, and effectively in the early stage.

Nursing Research

Effect analysis of TCM emotional nursing on patients with gastrointestinal tumors

Huang Yufen

2022, 28(6):  877-879.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.036

Asbtract ( )  

References | Related Articles | Metrics

Summary

Research progress of flexible ureteroscopy in the treatment of upper urinary tract calculi

Yang Libin, Xu Hanbiao

2022, 28(6):  880-883.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.037

Asbtract ( )  

References | Related Articles | Metrics

With the continuous innovation and improvement of flexible ureteroscope and its auxiliary equipment in recent years, flexible ureteroscope is more and more widely used in clinic. It has been commonly used for the treatment of upper urinary tract calculi in the past, and now it is also used for ablation of ureteral tumors, incision of ureterostenosis, incision and internal drainage of parapelvic cyst, and so on. Flexible ureteroscope enters the body through the natural cavity to fully realize minimally invasive examination and treatment. At present, the electronic flexible ureteroscope, which is widely used in clinic, has the advantages of clear imaging of surgery field, good flexibility of deflection, and with working channel, thereby has a unique advantage in the treatment of upper urinary tract calculi. Moreover, with the development and application of disposable electronic flexible ureteroscope and robot-assisted flexible ureteroscope system, the safe and rapid development of flexible ureteroscopic surgery is further promoted.

Research progress of uric acid and cardiovascular diseases

Liu Zhen, Sun Jingwu, Zhang Ning, Liu Jingyang, Shi Xinye, Dong Wenjing

2022, 28(6):  884-888.  DOI: 10.3760/cma.j.issn.1007-1245.2022.06.038

Asbtract ( )  

References | Related Articles | Metrics

With the improvement of living standards, people's diet has improved, and uric acid also goes up gradually. Uric acid is the final metabolite of purine decomposition in vivo. Due to the lack of uric acid oxidase (an enzyme responsible for the conversion of uric acid to allantoin), human beings are exposed to 50 times of serum uric acid concentration than other mammals. Recent studies have shown that uric acid is related to cardiovascular diseases, and the relationship between them is complex and not yet clear. This review explains the correlation between uric acid and cardiovascular diseases, and hopes to reduce the prevalence and mortality of cardiovascular diseases.