Table of Content

01 November 2024, Volume 30 Issue 21

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Cerebrovascular Disease

Risk factors in high-risk people of ischemic stroke

Li Cuicui, Zhong Guangzhi, Cai Donghao, Mei Chuangchuang

2024, 30(21):  3522-3526.  DOI: DOI: 10.3760/cma.j.issn.1007-1245.2024.21.001

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Objective　To explore the influence of different risk indicators on ischemic stroke and to identify the risk factors for high-risk people of ischemic stroke. Methods　One hundred and six patients with ischemic stroke treated at Guangdong Second Traditional Chinese Medicine Hospital from May 2023 to January 2024 were selected as an observation group, including 62 males and 44 females. One hundred and six healthy examinees during the same period were selected as a control group, including 52 males and 54 females. Their clinical data, including age, gender, and concomitant diseases, of both groups were collected. All the objects were taken blood to detect blood lipids and coagulation indicators. The data were compared between the two groups by the independent sample t test and χ² test. The independent risk factors for cerebral infarction were analyzed using the logistic regression model. The receiver operating characteristic curve (ROC) was used to analyze continuous variables with statistical significance in univariate analysis. Results　The observation group were (64.42±10.74) years old, and the control group (39.37±12.75) years old, with a statistical difference between the two groups (P<0.05). The proportions of the ones with hypertension, diabetes, and heart disease and the levels of fibrinogen (FIB), D-dimer and triacylglycerol (TG) in the observation group were higher than those in the control group [77.4% (82/106) vs. 0, 48.1% (51/106) vs. 0, 16.0% (17/106) vs. 0, (4.07±1.22) g/L vs. (2.84±0.38) g/L, (1.25±0.98) mg/L vs. (0.25±0.11) mg/L, and (1.65±0.69) mmol/L vs. (1.07±0.35) mmol/L]; the levels of total cholesterol (TC), high density lipoprotein (HDL), and low density lipoprotein (LDL) in the observation group were lower than those in the control group [(3.54±0.74)mmol/L vs. (4.71±0.59) mmol/L, (0.98±0.17) mmol/L vs. (1.53±0.19) mmol/L, and (2.01±0.65) mmol/L vs. (3.14±0.64) mmol/L]; there were statistical differences (all P<0.05). The logistic regression analysis showed that age, hypertension, diabetes, TG, and D-dimer were independent risk factors for ischemic stroke, and the HDL decrease was closely related to ischemic stroke (all P<0.05). The results of ROC showed that the areas under the curves (AUC) of TG, HDL, D-dimer, and their combination were 0.708, 0.969, 0.870, and 0.998. Conclusion　Age, hypertension, diabetes, TG, D-dimer, and HDL are closely related to the occurrence and development of ischemic stroke, and combined detection can help identify the high-risk people of ischemic stroke.

Correlations between diffusion tensor imaging parameters and brain edema in patients with acute cerebral infarction

Chen Xiaoxue, Li Kefeng, Han Haisen, Li Yiming

2024, 30(21):  3526-3531.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.002

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Objective　To explore the correlations of magnetic resonance diffusion tensor imaging (DTI) parameters, serum small and dense low-density lipoprotein cholesterol (sd LDL-C), and the level of homologous domain protein (Beclin-1) of bcl-2 with the degree of neurological deficits and the severity of cerebral edema in patients with acute cerebral infarction (ACI). Methods　One hundred and five patients with ACI treated at Shangqiu Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were selected as an observation group, including 62 males and 43 females who were (63.29±3.28) years old. Thirty-five healthy volunteers during the same period were selected as a control group, including 20 males and 15 females who were (64.11±3.02) years old. The DTI parameters [anisotropy index (FA) and mean diffusion coefficient (DCavg)] and serum levels of sd LDL-C and Beclin-1 were compared between the two groups. According to the scores of National Institutes of Health Stroke Scale (NIHSS), the observation group were divided into mild injury (39 cases), moderate injury (34 cases), and severe injury (32 cases); according to the severity of brain edema, they were divided into mild (68 cases) and severe (37 cases). The DTI parameters and serum levels of sdLDL-C and Beclin-1 were compared. The data were compared between the two groups by the independent-sample t test and between 3 or more than 3 groups by one-way analysis of variance. The count data were compared by χ² test. The Spearman correlation analysis was used to investigate their correlations with the degree of neurological deficit and severity of brain edema. The receiver operating characteristic curve (ROC) was used to evaluate the value of DTI parameters, sd LDL-C, and Beclin-1 in assessing the severity of brain edema. Results　The FA and DCavg in the observation group were lower than those in the control group [(0.19±0.04) vs. (0.35±0.06) and (5.03±1.07) vs. (8.62±1.28)]; the serum levels of sd LDL-C and Beclin-1 in the observation group were higher than those in the control group [(1.24±0.31) mmol/L vs. (0.45±0.11) mmol/L and (3.29±0.85) μg/L vs. (1.09±0.29) μg/L]; there were statistical differences (all P<0.05). As the degree of neurological deficit increased, FA and DCavg showed a downward trend, while the serum levels of sd LDL-C and Beclin-1 showed an upward trend (all P<0.05). The FA and DCavg in the patients with severe brain edema were lower than those in the patients with mild brain edema(both P<0.05); the serum levels of sd LDL-C and Beclin-1 in the patients with severe brain edema were higher than those in the patients with mild brain edema (both P<0.05). FA and DCavg were negatively correlated with the degree of neurological deficit and severity of brain edema (r_FA=-0.528 and -0.627; r_DCavg=-0.559 and -0.603; all P<0.05); the serum levels of sd LDL-C and Beclin-1 were positively correlated with the degree of neurological deficit and severity of brain edema (r_{sd LDL-C}=0.485 and 0.501; r_Beclin-1=0.449 and 0.621; all P<0.05). The areas under the curves (AUC) of FA, DCavg, sd LDL-C, Beclin-1, and their combination for evaluating the severity of brain edema were 0.740, 0.763, 0.788, 0.811, and 0.908, respectively; and the combination's AUC was superior to those of the individual indicators (P<0.05). Conclusions　In patients with ACI, FA and DCavg decrease, while the serum levels of sd LDL-C and Beclin-1 increase; they are closely related to the degree of neurological deficits and the severity of brain edema. Combined detection of their levels has certain evaluation value for the degree of brain edema.

Impact of escitalopram combined with repetitive transcranial magnetic stimulation on cognitive function and negative emotions in elderly patients with post-stroke depression

Song Haiying, Liu Yi, Gao Pengju

2024, 30(21):  3531-3536.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.003

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Objective　To evaluate the effectiveness of escitalopram and repetitive transcranial magnetic stimulation (rTMS) for elderly patients with post-stroke depression. Methods　One hundred and six elderly patients with post-stroke depression treated at Xingyuan Hospital of Yulin from January 2021 to December 2023 were selected for the randomized controlled trial, and were divided into a control group and an observation group, with 53 cases in each group. In the control group, there were 29 males and 24 females who were (64.38±7.24) years old. In the observation group, there were 27 males and 26 females who were (64.63±7.36) years old. The control group took escitalopram, while the observation group took escitalopram and rTMS. Four weeks was one treatment cycle, and both groups were treated two cycles. The levels of monoamine neurotransmitters and neurotrophic factors, cerebral blood flow status [mean cerebral artery flow velocity (Vm), peak systolic flow velocity (Vs), pulsatility index (PI)], and changes in white matter structure were compared between the two groups before and after the treatment. Their cognitive functions, negative emotions, and quality of life were assessed using the Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Stroke-Specific Quality of Life Scale. t and χ² tests were used. Results　After the treatment, the levels of monoamine neurotransmitters and neurotrophic factors and score of white matter injury in the observation group were better than those in the control group; the Vm, Vs, and PI in the observation group were (57.88±6.95) cm/s, (96.67±8.32) cm/s, and (0.68±0.19), and those in the control group (50.17±6.03), (90.14±7.83) cm/s, and (0.87±0.26); the scores of MoCA, life quality, HAMA, and HAMD in the observation group were better than those in the control group [(24.18±3.01) vs. (20.04±2.93), (159.15±24.26) vs. (130.52±20.18), (12.26±2.09) vs. (17.45±2.43), and (13.81±2.13) vs. (18.69±2.34)]; there were statistical differences in the above indicators between the two groups (all P<0.05). Conclusion　Escitalopram combined with rTMS for elderly patients with post-stroke depression can improve their cognitive function and reduce their negative emotions.

Clinical efficacy of pentoxifroline combined with edaravone dexcanol in treatment of elderly patients with acute progressive cerebral infarction

Xue Ping, Gao Yongmei, Cui Xiaoli

2024, 30(21):  3537-3541.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.004

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Objective　To investigate the effect of pentotheobromine combined with edaravone dexcanol in the treatment of elderly patients with acute progressive cerebral infarction. Methods　A total of 82 elderly patients with acute progressive cerebral infarction treated at Hancheng People's Hospital from January 2021 to November 2023 were selected as the study objects, and were divided into a study group and a control group by the random number table method, with 41 cases in each group. There were 23 males and 18 females in the control group; they were (70.98±5.14) years old. There were 25 males and 16 females in the study group; they were (71.74±5.05) years old. The control group took conventional treatment and edaravone dexcanol. The study group took conventional treatment, edaravone dexcanol, and pentoxifylline. Both groups were treated for 2 weeks. The degrees of neurological impairment, clinical efficaceis, cerebral circulation-related indicators, hemorheology, and incidences of adverse reactions were compared between the two groups. t and χ² tests were used. Results　After 2 weeks' treatment, the scores of National Institutes of Health Stroke Scale and modified Rankin Scale in the study group were lower than those in the control group [(4.13±0.64) vs. (5.32±0.75) and (1.02±0.18) vs. (1.19±0.21)], with statistical differences (both P<0.05). The total effective rate of the study group was higher than that of the control group [95.12% (39/41) vs. 80.49% (33/41)], with a statistical difference (P<0.05). After 2 weeks' treatment, the middle cerebral artery peak velocity, average velocity, and cerebral vascular reserve capacity of the study group were higher than those of the control group [(70.03±5.41) cm/s vs. (66.25±5.03) cm/s, (38.24±3.35) cm/s vs. (34.69±3.12) cm/s, and (38.69±3.36)% vs. (35.27±3.15)%], with statistical differences (all P<0.05). After 2 weeks' treatment, the fibrinogen level, hematocyte volume, and plasma viscosity of the study group were lower than those of the control group [(3.19±0.49) g/L vs. (3.75±0.58) g/L, (37.68±2.63)% vs. (40.03±3.04)%, and (1.33±0.21) mPa/s vs. (1.61±0.24) mPa/s], with statistical differences (all P<0.05). There was no difference in the incidence of total adverse reactions between the two groups [12.20% (5/41) vs. 9.76% (4/41); P>0.05]. Conclusion　Pentotheobroline combined with edaravone dexcanol in the treatment of elderly patients with acute progressive cerebral infarction is effective, can improve their neurological function, brain circulation, and blood rheology, and is safe and reliable.

Efficacy of Pinggan Huoxue powder in adjuvant treatment of patients with acute cerebral infarction of wind-phlegm-stasis obstruction type and its influence on cerebral blood perfusion

Qu Yang, Hu Shirui

2024, 30(21):  3542-3547.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.005

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Objective　To explore the efficacy of Pinggan Huoxue powder in the adjuvant treatment of patients with acute cerebral infarction of wind-phlegm-stasis obstruction type and its influence on cerebral blood perfusion. Methods　One hundred and eight patients with acute cerebral infarction of wind-phlegm-stasis obstruction type treated at Ankang Hospital of Traditional Chinese Medicine from July 2021 to June 2023 were selected for the randomized controlled trial, and were divided into a western medicine group and a traditional Chinese medicine group by the random number table method, with 54 cases in each group. There were 33 males and 21 females in the western medicine group; they were (64.25±6.12) years old. There were 30 males and 24 females in the traditional Chinese medicine groups; they were (64.71±6.35) years old. The western medicine group orally took butyphthalide soft capsules for 2 weeks on the basis of routine fluid rehydration, reduction of intracranial pressure, and dilatation; in addition, the traditional Chinese medicine group orally took Pinggan Huoxuxue powder for 2 weeks. The clinical efficacies, scores of traditional Chinese medicine syndromes, neurological function [neuron-specific enolase (NSE), brain-derived neurotrophic factor (BDNF), and glial fibrillary acidic protein (GFAP)], cerebral blood perfusion [perfusion index (PI) and bilateral arterial mean flow velocity], and inflammatory response [C-reactive protein (CRP) and interleukin-10 (IL-10)] before and 2 weeks after the treatment, and incidences of adverse reactions were compared between the two groups by t test, χ² test, Fisher's precision probability test, and rank sum test. Results　The total effective rate in the traditional Chinese medicine group was higher than that in the western medicine group [88.89% (48/54) vs. 72.22% (39/54)], with a statistical difference (χ²=4.788; P=0.029). After 2 weeks' treatment, the scores of NIHSS, primary syndromes, and secondary syndromes and levels of NSE, GFAP, PI, and CRP in the traditional Chinese medicine group were lower than those in the western medicine group (t=3.855, 4.284, 2.894, 5.949, 3.889, 2.852, and 8.424; all P<0.05). The BDNF level, bilateral arterial mean flow velocity, and IL-10 level after 2 weeks' treatment in the traditional Chinese medicine group were higher than those in the western medicine group (t=3.661, 2.803, and 4.203; all P<0.05). There was no statistical difference in the total incidence of adverse reactions between the two groups [16.67% (9/54) vs. 12.96% (7/54); χ²=0.293; P=0.588]. Conclusion　Pinggan Huoxue powder in the adjuvant treatment of patients with acute cerebral infarction of wind-phlegm-stasis obstruction type is effective, can relieve their clinical symptoms, improve their neurological function and cerebral blood flow perfusion, and alleviate their inflammatory response, and does not increase adverse reactions.

Effect of early intervention based on risk management on neurological function and activities of daily living in patients with acute cerebral infarction undergoing interventional therapy

Wu Lanyan, Zhao Jun, Zhang Jiuxia

2024, 30(21):  3547-3552.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.006

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Objective　To observe the effect of early intervention nursing based on risk management on neurological function and activities of daily living in patients with acute cerebral infarction (ACI) undergoing interventional therapy. Methods　A total of 86 patients with ACI who underwent interventional therapy in Hubei Province Third People's Hospital, Jianghan University from January 2020 to September 2023 were selected as the research objects, including 47 males and 39 females who were (56.85±5.62) years old. Among them, there were 43 cases with anterior circulation occlusion and 43 cases with posterior circulation occlusion. The patients were divided into a control group and an observation group using the random number table method, with 43 cases in each group. The control group received routine nursing, while the observation group received early intervention nursing based on risk management. Both groups received intervention till 1 month after discharge. The neurological function [National Institutes of Health Stroke Scale (NIHSS)], self-care ability [Exercise of Self-Care Agency (ESCA)], activities of daily living [modified Barthel index (MBI)], fall risk [Chinese version Falls Efficacy Scale (FES)], nursing satisfaction (self-made nursing satisfaction scale), and incidences of complications during nursing and follow-up within 3 months after discharge in the two groups were evaluated. Results　One month after discharge, the score of NIHSS in the observation group was lower than that in the control group [(7.84±3.29) vs. (10.28±4.63); t=2.817; P<0.05]; the scores of the 4 items of ESCA, MBI, and FES and nursing satisfaction rate in the observation group were higher than those in the control group [(27.64±3.72) vs. (24.16±2.15), (15.04±3.55) vs. (12.06±2.84), (19.72±4.56) vs. (14.74±3.59), (62.63±7.33) vs. (56.29±6.75), (70.11±5.05) vs. (64.27±5.43), (48.28±5.05) vs. (42.16±5.43), and 97.67% (42/43) vs. 83.73% (36/43); t=5.311, 4.298, 5.627, 4.172, 5.164, and 5.412; χ²=4.962; all P<0.05]. The total incidence of complications in the observation group was lower than that in the control group [6.98% (3/43) vs. 23.26% (10/43)], with a statistical difference (χ²=4.441; P<0.05). Conclusion　Early intervention nursing based on risk management can promote neurological function recovery in patients with ACI undergoing interventional therapy, improve their self-care ability and activities of daily living, reduce the risks of complications and falls, and improve the satisfaction with nursing.

Effect of balance cupping therapy combined with traditional Chinese medicine nursing on life quality of patients with hemiplegia after stroke of Fengtan Zuluo type

Li Bei, Diao Tongyan

2024, 30(21):  3553-3557.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.007

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Objective　To explore the effect of balance cupping therapy combined with traditional Chinese medicine nursing on the life quality of patients with hemiplegia after stroke of Fengtan Zuluo type. Methods　This was a retrospective study. Seventy-eight patients with hemiplegia after stroke of Fengtan Zuluo type treated at Shaanxi Hospital of Traditional Chinese Medicine from January to December 2023 were selected. They were divided into an experimental group and a control group according to the treatment methods, with 39 cases in each group. There were 19 males and 20 females in the experimental group; they were (57.68±9.34) years old; their disease course was (4.52±1.21) months. There were 18 males and 21 females in the control group; they were (57.74±9.34) years old; their disease course was (4.56±1.13) months. The control group took traditional Chinese medicine nursing, and the experimental group traditional Chinese medicine nursing and balance cupping therapy. All the patients were treated for 3 weeks. The neurological deficits [National Institute of Health Stroke Scale (NIHSS)], motor function [Fugl-Meyer Functional Assessment Scale (FM)], and scores of Chronic Disease Self-Efficacy Scales (CDES) were compared between the two groups by t and χ² tests. Results　Before the intervention, the scores of NIHSS, FM, and CDES in the control group were (44.01±4.98), (57.05±6.09), and (52.91±4.81), and those in the experimental group (43.26±5.21), (58.23±5.16), and (53.37±5.11), with no statistical differences between the two groups (all P>0.05). After the intervention, the scores of NIHSS, FM, and CDES in the control group were (35.46±5.17), (60.34±3.11), and (42.35±5.11), and those in the experimental group (23.34±6.48), (63.35±3.45), and (32.25±4.25), with statistical differences between the two groups (all P<0.05). Conclusion　Balance cupping therapy combined with traditional Chinese medicine nursing for patients with stroke of Fengtan Zuluo type can reduce their nerve deficit, and improve their motor function and self-management ability

Diabetic Oculopathy

Research progress on effect of phacoemulsification on corneal endothelial cells in patients with diabetic cataract

Huang Ju, Li Shiyi, Zhang Ao, Wang Kang, Zhang Peipei, Xie Yingbin

2024, 30(21):  3558-3564.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.008

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Diabetic cataract is one of the leading causes of vision loss and blindness in diabetic patients. Phacoemulsification is a common clinical treatment for cataracts. Both diabetes and phacoemulsification are risk factors for corneal endothelial cell damage. Corneal endothelial cell damage by phacoemulsification can be effectively mitigated by protecting corneal endothelial cells in diabetic patients before, during, and after surgery. This article reviews the effects and possible mechanisms of diabetes and phacoemulsification on corneal endothelial cells, as well as measures to protect corneal endothelial cells in diabetic patients before, during, and after phacoemulsification.

Yidian Eryuan adaptive nursing for patients with early diabetic retinopathy

Shen Yan, Wang Liping, Wang Qiaoli

2024, 30(21):  3564-3568.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.009

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Objective　To explore the role of Yidian Eryuan adaptive nursing in blood sugar control and visual rehabilitation in patients with early diabetic retinopathy. Methods　Eighty-six patients with early diabetic retinopathy treated at from January 2022 to January 2024 were selected for the randomized controlled trial, and were divided into an experimental group and a control group by the random number table method, with 43 cases in each group. There were 24 males and 19 females in the control group; they were (57.63±7.23) years old; their diabetic course was (5.34±1.17) years. There were 21 males and 22 females in the experimental group; they were (56.92±7.19) years old; their diabetic course was (4.97±1.23) years. The control group took routine nursing care. The experimental group took routine nursing care and Yidian Eryuan adaptive nursing. Before and after the intervention, the blood glucose levels [fasting plasma glucose (FPG), 2-hour postprandial glucose (2hPG), and glycosylated hemoglobin (HbA1c)], visual rehabilitation outcomes [best-corrected visual acuity (BCVA), mean defect (MD) in visual field, and mean sensitivity (MS)], self-efficacies [Diabetes Self-Efficacy Scale (DSES)], and quality of life [National Eye Institute Visual Function Questionnaire (NEI-VFQ-25)] were compared between the two groups by t and χ² tests. Results　Before the intervention, there were no statistical differences in FPG, 2 hPG, HbA1c, BCVA, MD, MS, and scores of DESE and NEI-VFQ-25 between the two groups (all P>0.05). After the intervention, the HbA1c, FPG, 2 hPG, and MD in the experimental group were lower than those in the control group [(5.14±0.62)% vs. (5.81±0.74)%, (5.64±1.04)mmol/L vs. (6.39±1.12)mmol/L, (6.32±1.13)mmol/L vs. (7.49±1.04)mmol/L, and (8.37±1.13) vs. (10.34±1.17)]; the BCVA, MS, and scores of DESE and NEI-VFQ-25 in the experimental group were higher than those in the control group [(0.85±0.21) vs. (0.72±0.24), (17.89±1.03) vs. (17.08±0.91), (91.37±8.28) vs. (81.26±8.46), and (46.34±7.09) vs. (41.06±6.48)]; there were statistical differences (t=4.551, 3.218, 4.996, 7.942, 2.673, 3.865, 5.600, and 3.605; all P<0.05). Conclusion　Yidian Eryuan adaptive nursing for patients with early diabetic retinopathy can improve their glycemic control, visual function recovery, self-efficacy, and quality of life.

Different drugs combined with macular laser photocoagulation for macular edema after diabetic retinopathy in elderly patients

Yu Meixia, Zhang Chengxia, Dong Youhui, Xu Kai

2024, 30(21):  3569-3574.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.010

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Objective　To explore the clinical efficacy of triamcinolone acetonide or conbercept combined with laser photocoagulation in the treatment of macular edema after diabetic retinopathy (DR) in elderly patients. Methods　Seventy elderly patients with macular edema after DR (82 eyes) treated at Department of Ophthalmology, Lianyungang First People's Hospital from June 2020 to June 2023 were selected for the prospective study, and were divided into an observation group (35 cases and 42 eyes) and a control group (35 cases and 40 eyes) by the random number table method. There were 19 males and 16 females in the observation group; they were (73.26±4.89) years old. There were 17 males and 18 females in the control group; they were (72.87±5.11) years old. The observation group took conbercept and macular laser photocoagulation. The control group took macular laser photocoagulation. The improvement and regression times of symptoms, visual function-related indicators [subfoveal choroidal thickness (SFCT), best corrected visual acuity (BCVA), and central macular thickness (CMT)], disease-related biochemical indicators [vascular endothelial growth factor (VEGF) and stromal cell-derived factor-1 (SDF-1)], macular blood flow densities [superficial capillary plexus (SCP) and deep capillary plexus (DCP)], and disease-related indicators [choroidal vascular index (CVI) and serum complement 1q/tumor necrosis factor-associated protein 9 (CTRP9)] before the treatment and after 3 months' treatment, and incidences of adverse reactions were compared between groups by t and χ² tests. Results　The macular edema improvement time, fundus bleeding absorption time, and effusion absorption time in the observation group were shorter than those in the control group [(4.36±0.21) weeks vs. (5.42±0.38) weeks, (2.39±0.23) weeks vs. (3.42±0.33) weeks, and (10.36±0.81) weeks vs. (12.25±1.15) weeks], with statistical differences (t=15.733, 16.463, and 8.637; all P<0.05). After 3 months' treatment, the CMT, VEGF, SDF-1, and CVI in the observation group were lower than those in the control group [(339.56±31.24) μm vs. (398.69±27.29) μm, (138.72±16.73) ng/L vs. (276.19±15.92) ng/L, (415.23±24.80) mg/L vs. (526.16±22.93) mg/L, and (63.86±0.94)% vs. (64.97±0.61)%]; the levels of BCVA, SCP, DCP, and CTRP9 in the observation group were higher than those in the control group [(0.49±0.08) vs. (0.34±0.07), (39.92±2.84)% vs. (38.16±2.79)%, (45.96±2.71)% vs. (43.39±2.39)%, and (113.36±14.65) μg/L vs. (102.45±13.29) μg/L]; there were statistical differences (t=10.180, 30.080, 21.034, 6.420, 9.018, 2.830, 4.546, 3.575; all P<0.05). There was no statistical difference in SFCT between the two groups (t=0.302; P=0.763). During the treatment, 1 case of dry eyes (single eye) occurred in observation group, and 1 case of conjunctival congestion (single eye) occurred in control group; the rest had no obvious adverse reactions (χ²=0.001; P=0.972). Conclusions　Compared with macular laser photocoagulation combined with triamcinolone acetonide, macular laser photocoagulation combined with conbercept has better clinical efficacy for elderly patients with macular edema after DR, and the latter one can better promote the recovery of visual function. In addition, it has a positive effect on the visual acuity, and can alleviate the clinical symptoms.

Walnut moxibustion combined with syndrome differentiation nursing care for patients with diabetic retinopathy during proliferative stage

Wang Junjie, Wu Min, Yang Yi

2024, 30(21):  3574-3579.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.011

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Objective　To investigate the effect of walnut moxibustion combined with syndrome differentiation nursing care for patients with diabetic retinopathy (DR) during proliferative stage. Methods　One hundred and eighty-four patients with DR during proliferative stage treated at Department of Traditional Chinese Medicine Ophthalmology, Jinan Second People's Hospital from January 2022 to December 2023 were selected for the randomized controlled trial, and were divided into a control group, a syndrome differentiation group, a walnut moxibustion group, and syndrome differentiation+walnut moxibustion group by the random number table method, with 46 cases in each group. There were 28 males and 18 females in the control group; they were (52.19±8.06) years old; their diabetic course was (6.92±1.15) years; their DR course was (8.22±1.30) years. There were 25 males and 21 females in the syndrome differentiation group; they were (55.09±9.22) years old; their diabetic course was (6.69±1.08) years; their DR course was (8.41±1.36) years. There were 27 males and 19 females in the walnut moxibustion group; they were (53.37±10.14) years old; their diabetic course was (7.13±1.28) years; their DR course was (8.70±1.42) years. There were 28 males and 18 females in the syndrome differentiation+walnut moxibustion group; they were (53.95±9.16) years old; their diabetic course was (6.85±1.20) years; their DR course was (8.59±1.44) years. All the 4 groups took routine care; in addition, the syndrome differentiation group took syndrome differentiation nursing care, the walnut moxibustion group took walnut moxibustion, and the syndrome differentiation+walnut moxibustion group took syndrome differentiation nursing care and walnut moxibustion, for 3 months. The intervention effects, best corrected visual acuity (BCVA), visual acuities (MS), central macular thicknesses (cMT), anxiety levels [Self-rating Anxiety Scale (SAS)], and quality of life [Chinese-version Low Vision Quality of Life Questionnaire (CLVQOL)] before and after the intervention, and incidences of complications were compared between the two groups by one-way ANOVA, t test, χ² test, Fisher exact test, and rank sum test. Results　The total effective rate in the syndrome differentiation+walnut moxibustion group was higher than those in the syndrome differentiation group, walnut moxibustion group, and control group [95.56% (43/45) vs. 80.43% (37/46), 81.40% (35/43), and 61.36% (27/44)], with a statistical difference (P<0.05). Before the intervention, there were no statistical differences in BCVA, MS, cMT, and scores of SAS and CLVQOL between the four groups (all P>0.05). After the intervention, the BCVA, MS, and score of CLVQOL in the syndrome differentiation+walnut moxibustion group were higher than those in the syndrome differentiation group, walnut moxibustion group, and control group [(0.69±0.11) vs. (0.52±0.10), (0.50±0.08), and (0.36±0.06); (22.90±3.95) dB vs. (19.78±3.76) dB, (20.04±3.53) dB, and (17.22±3.14) dB; (85.53±14.65) vs. (73.11±12.50), (69.39±11.72), and (60.48±10.26)]; the cMT and score of SAS in the syndrome differentiation+walnut moxibustion group were lower than those in the syndrome differentiation group, walnut moxibustion group, and control group [(229.17±29.96) μm vs. (339.05±52.27) μm, (354.92±56.43) μm, and (434.11±63.89) μm; (30.59±5.15) vs. (36.65±5.77), (37.83±5.62), and (40.91±6.08)]; there were statistical differences (all P<0.05). The incidence of complications in the syndrome differentiation+walnut moxibustion group was lower than those in the syndrome differentiation group, walnut moxibustion group, and control group [4.44% (2/45) vs. 17.39% (8/46), 20.93% (9/43), and 25.00% (11/44)], with a statistical difference (P<0.05). Conclusion　Walnut moxibustion combined with syndrome differentiation nursing care can effectively improve the intervention effect and vision level of patients with DR during proliferative stage, relieve their anxiety, improve their quality of life, and reduce the incidence of complications.

Effect of mind map-based individualized nursing on visual acuity in patients with diabetic retinopathy

Ye Jianli, Liu Huina, Huan Juju

2024, 30(21):  3580-3584.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.012

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Objective　To explore the effect of individualized nursing based on mind map on improving the vision of patients with diabetic retinopathy, and to provide a more targeted intervention strategy for clinical nursing. Methods　Ninety patients with diabetic retinopathy treated at Department of Ophthalmology, Yulin Hospital, First Hospital, Xi'an Jiaotong University from April 2020 to June 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 45 patients in each group. There were 24 males and 21 females in the control group; they were (55.81±2.56) years old; their diabetic course was (8.08±4.09) years. There were 23 males and 22 females in the observation group; they were (56.28±2.64) years old; their diabetic course was (8.04±3.37) years. The control group took conventional nursing care; in addition, the observation group took individualized nursing care guided by mind map. Before and after the nursing care, the blood glucose levels [fasting blood glucose (FPG) and 2-hour postprandial glucose (2h FPG)], visual recovery (naked eye visual acuity and corneal curvature), self-care ability [Self-Care Ability Evaluation Scale (ESCA)], and quality of life [Quality of Life Assessment Scale (SF-36)] were compared between the two groups by t and χ² tests. Results　Before the nursing care, there were no statistical differences in the FPG, 2 h FPG, naked eye visual acuity, corneal curvature, self-care ability, and quality of life between the two groups (all P>0.05). After the nursing care, the levels of FPG and 2 h FPG in the observation group were lower than those in the control group [(6.53±0.60) mmol/L vs. (7.40±0.75) mmol/L and (8.72±1.47) mmol/L vs. (9.88±1.76) mmol/L]; the naked eye visual acuity, corneal curvature, and scores of self-care responsibility, health knowledge, self-care skills, self-concept, body state, social communication function, psychological state, and role function in the observation group were higher than those in the control group [(0.53±0.10) vs. (0.46±0.09), (43.86±3.14) D vs. (42.51±3.09) D, (26.28±3.18) vs. (21.44±3.06), (37.24±4.17) vs. (29.77±3.02), (18.44±2.63) vs. (13.73±1.96), (20.60±2.94) vs. (17.68±2.53), (74.16±8.29) vs. (70.15±7.18), (72.08±7.59) vs. (68.35±7.26), (71.02±7.13) vs. (67.32±6.85), and (75.34±8.15) vs. (71.93±7.05)]; there were statistical differences (t=5.800, 3.239, 3.490, 2.056, 7.357, 9.732, 9.633, 5.050, 2.395, 2.382, 2.510, and 2.123; all P<0.05). Conclusion　Individualized nursing based on mind map for patients with diabetic retinopathy can improve their visual acuity, blood glucose control, self-care ability, and quality of life, providing an effective nursing mode for clinical practice.

New Medical Advances

Progress of multimodal ultrasound in assessment of carotid plaque

Xu Haoyang, Duan Shuhui, Xiong Zhengbiao, Yan Junhong

2024, 30(21):  3585-3588.  DOI: 2024-00931

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Early diagnosis of carotid atherosclerosis is an important means for prevention of cardiovascular and cerebrovascular diseases. Currently, MRI, CT angiography (CTA), digital subtraction angiography (DSA), and ultrasound can detect carotid atherosclerotic plaques. However, ultrasound has been paid more and more attention in clinic due to its advantages of repeatability, non-invasion, and low cost. In addition to conventional ultrasound techniques, new ultrasound techniques have gradually come on the market and play an important role in assessing the vulnerability of carotid plaque and carotid artery elasticity. In this paper, the application of new techniques such as contrast-enhanced ultrasound, superb microvascular imaging, bright-mode blood flow imaging, vector flow mapping, three-dimensional vascular ultrasound imaging, shear wave imaging, and ultrafast ultrasound imaging pulse wave velocity in the diagnosis of carotid atherosclerosis plaque is reviewed.

Treatises

Effects of partial nephrectomy combined with different nutritional support methods for patients with ectopic renal cell carcinoma

Yan Jiawen, Wei Shucen

2024, 30(21):  3589-3593.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.014

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Objective　To explore the effects of different nutritional support methods for patients with translocated renal cell carcinoma undergoing partial nephrectomy. Methods　This prospective study included 74 patients with ectopic renal cell carcinoma who underwent partial nephrectomy at Department of Urology, Shangluo Central Hospital from February 2021 to April 2023. The patients were divided a parenteral nutrition group (37 cases) and an enteral nutrition group (37 cases) by computer coding. There were 11 males and 26 females in the parenteral nutrition group; they were (45.83±4.67) years old. There were 13 males and 24 females in the enteral nutrition group; they (45.57±4.33) years old. The parenteral nutrition group took parenteral nutritional support on the basis of standard care. The enteral nutrition group took enteral nutritional support. The nutritional parameters [hemoglobin (Hb), albumin (Alb), transferrin (TRF), and prealbumin (PA)], immune markers (CD3⁺, CD4⁺, and CD8⁺), and inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-8] before and after the intervention and incidences of adverse reactions during the intervention were compared between the two groups by t and χ² tests. Results　Before the intervention, there were no statistical differences in the levels of Hb, Alb, TRF, PA, CD3⁺, CD4⁺, CD8⁺, TNF-α, IL-6, and IL-8 between the two groups (all P>0.05). After the intervention, the levels of Hb, Alb, TRF, PA, CD3⁺, and CD4⁺ in the enteral nutrition group were higher than those in the parenteral nutrition group [(126.73±11.26) g/L vs. (117.89±11.03) g/L, (37.41±5.88) g/L vs. (32.76±5.92) g/L, (2.98±0.44) g/L vs. (2.67±0.46) g/L, (239.73±23.70) mg/L vs. (217.46±22.54) mg/L, (51.30±5.86)% vs. (42.58±5.07)%, and (42.67±3.46)% vs. (37.34±3.41)]; the levels of CD8⁺, TNF-α, IL-6, and IL-8 in the enteral nutrition group were lower than those in the parenteral nutrition group [(27.57±3.19)% vs. (33.46±3.27)%, (18.46±2.57) ng/L vs. (22.34±2.73) ng/L, (43.26±4.35) ng/L vs. (54.67±4.97) ng/L, and (37.92±4.08) mg/L vs. (42.26±4.31) mg/L]; there were statistical differences (t=3.411, 3.390, 2.962, 4.142, 6.845, 6.674, 7.842, 6.295, 10.508, and 4.448; all P<0.05). There was no statistical difference in the incidence of adverse reactions between the two groups during the intervention (χ²=0.725; P=0.394). Conclusion　Enteral nutritional support can improve the nutritional status, immune function, and inflammatory levels in patients with ectopic renal cell carcinoma after partial nephrectomy.

Impact of individualizedly designed loop electrosurgical excision procedure on margin status and prognosis of patients with cervical squamous intraepithelial lesions

Liu Tingyan, Wang Weijia, Liao Huiming, Mai Bi, Hu Guiying, Luo Xiping

2024, 30(21):  3594-3600.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.015

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Objective　To investigate the relationship of individualizedly designed loop electrosurgical excision procedure with the margin status and prognosis of patients with cervical squamous intraepithelial lesions. Methods　The clinical data of 151 patients with high-grade cervical squamous intraepithelial lesions (HSIL) who took LEEP at Guangdong Women and Children Hospital from January 2015 to December 2019 were retrospectively analyzed. The patients were (35.54±7.29) years old. Sixty cases had fertility requirements, and 91 cases had no fertility requirements. Before the operation, the colposcopists individualizedly designed the LEEP for the patients according to the comprehensive and accurate colposcopic evaluation, cervical cytology, pathology of biopsy, and other factors. The status of the endocervical margin of excised specimens, cervical adhesion, and human papillomavirus (HPV) test results within 2 years after the surgery were statistically analyzed. The multivariate regression analysis was used to analyze the factors influencing the status of the endocervical margin and the relationship of different margin status and surgical procedures with their prognosis. The feasibility and effectiveness of the individualizedly designed LEEP were explored. t, χ², and Fisher's exact probability tests were applied. Results　Among the 151 patients, 131 cases were negative on the margin, and 20 cases positive, with a positive rate of 13.25%. The length and thickness of conization in the patients with fertility requirements were higher than those in the patients with no fertility requirements [(1.18±0.34) cm vs. (0.93±0.21) cm and (1.11±0.45) cm vs. (0.90±0.33) cm]; the proportion of the patients who took LEEP in the patients with fertility requirements was lower than that in the patients with no fertility requirements; there were statistical differences (t=5.680 and 3.459; χ²=6.181; all P<0.05). There was no statistical difference in the margin positive rate between the two groups (P>0.05). The univariate analysis results showed that cervical cytology, the number of quadrants involved in aceto-white epithelium in colposcopy, and lesion grade were correlated with the status of the endocervical margin (all P<0.05). The multivariate logistic regression analysis results showed that the number of quadrants involved in aceto-white epithelium and lesion grade before the surgery and the independent risk factors influencing the endocervical margin after LEEP (both P<0.05). The HPV negative rate within 2 years after the surgery was 82.7%(124/150). There were no statistical differences in cervical stenosis and HPV results 6, 12, and 24 months after the surgery between the patients with different endocervical margin status (all P>0.05). Conclusions　On the premise of patients' fertility requirements, the LEEP designed according to the comprehensive and accurate colposcopic evaluation, cervical cytology, lesion grade, and other factors is clinically feasible and effective, especially for the women with fertility requirements.

Aloe combined with Lianchuang Shenji ointment for nasopharyngeal carcinoma patients with radiation dermatitis

Bai Xiaohui, Cao Hongxin, Wang Shuhong

2024, 30(21):  3600-3604.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.016

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Objective　To evaluate the efficacy and safety of aloe and Lianchuang Shenji ointment for nasopharyngeal carcinoma patients with radiation dermatitis. Methods　Ninety-six nasopharyngeal carcinoma patients with radiation dermatitis treated at Department of Radiotherapy, Yulin Hospital, First Hospital, Xi'an Jiaotong University from January 2020 to May 2023 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 48 cases in each group. There were 23 males and 25 females in the control group; they were (52.84±9.41) years old. There were 26 males and 22 females in the study group; they were (53.66±8.57) years old. The control group took routine treatment. The study group were treated with aloe and Lianchuang Shenji ointment. The radiation dermatitis grades (RTOG), treatment effects, scores of acute radiation dermatitis response (RISRAS), pain scores of Numerical Rating Scale (NRS), scores of Karnofsky Performance Status (KPS), and serum levels of interleukin-6 (IL-6) and C-reaction protein (CRP), before and after the treatment and incidences of adverse reactions were compared between the two groups by t and χ² tests. Results　The total effective rate in the study group was higher than that in the control group [93.8% (45/48) vs. 72.9% (35/48)], with a statistical difference (χ²=5.423; P=0.009). Before the treatment, there were no statistical differences in the radiation dermatitis grade, scores of RISRAS, NRS, and KPS, and levels of IL-6 and CRP between the two groups (all P>0.05). After the treatment, the proportion of the patients with > radiation dermatitis grade Ⅰ, scores of RISRAS and NRS, and levels of IL-6 and CRP in the study group were lower than those in the control group [20.8% (10/48) vs. 45.8% (22/48), (3.22±1.65) vs. (6.17±1.97), (0.47±0.21) vs. (1.11±0.62), (26.13±4.71) μg/L vs. (34.17±5.62) μg/L, and (7.22±1.91) mg/L vs. (10.75±2.13) mg/L]; the score of KPS in the study group was higher than that in the control group [(85.11±12.45) vs. (72.21±11.54)]; there were statistical differences (all P<0.05). No significant adverse reactions were observed in either group. Conclusion　Aloe combined with Lianchuang Shenji ointment for nasopharyngeal carcinoma patients with radiation dermatitis is an effective and safe method, providing a new option for clinical treatment.

Mechanism of Xiaozhong Tang in treatment of hemorrhoids based on network pharmacology and molecular docking

Yuan Wenbei, Zhang Leihong

2024, 30(21):  3605-3613.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.017

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Objective　To investigate the mechanism of the self-formulated traditional Chinese medicine formula Xiaozhong Tang in the treatment of hemorrhoids based on the network pharmacology and molecular docking. Methods　The active ingredients and target proteins of Xiaozhong Tang were obtained from the Traditional Chinese Medicine System Pharmacology and Pharmacokinetics Database and Analysis Platform (TCMSP), and the protein names were corrected using the UniProt database. The disease targets of hemorrhoids were obtained from the GeneCards, OMIM, TTD, DrugBank, and DisGeNET databases, and the intersections of the two target sets were obtained. The protein-protein interaction (PPI) network was established using the STRING database and Cytoscape software, and the core targets were obtained. The shared targets were subjected to the Gene Ontology (GO) function enrichment analysis and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis using the Metascape database. Finally, the core components and core targets were uploaded to the CB-Dock2 platform for molecular docking verification. Results　A total of 136 active ingredients and 233 target proteins were identified from the whole formula, and 638 disease targets were obtained. There were 45 shared targets. After PPI analysis and topological feature analysis, matrix metalloproteinase-9 (MMP9), tumor protein p53 (TP53), etc. were identified as the 9 core targets. The GO and KEGG enrichment analysis showed that Xiaozhong Tang may be related to lipid and atherosclerosis, IL-17 signaling pathway, and HIF-1 signaling pathway in the treatment of hemorrhoids. The molecular docking results showed that the core components, such as α-spinach sterol, baicalin, hanbaicalin, etc., had good binding activity with the MMP9, TP53, and IL1B targets of hemorrhoids. Conclusion　Xiaozhong Tang treats hemorrhoids through multiple components, multiple targets, and multiple pathways, and provides theoretical support for its clinical treatment of hemorrhoids.

Expression and significance of regulatory T cells in thymus and extra-thymus in patients with unknown recurrent abortion

Zhang Yidan, Wu Shuteng, Zhou Dan

2024, 30(21):  3614-3618.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.018

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Objective　To investigate the expression and detection significance of regulatory T cells in the thymus and extra-thymus of patients with unknown recurrent abortion (URSA). Methods　Sixty-three patients with URSA treated at Shenzhen People's Hospital from April 2021 to April 2023 were selected as an observation group, and 63 normal pregnant women after partial mastectomy a control group. The observation group were (28.10±2.94) years old; their body mass index was (27.56±2.81) kg/m². The control group were (28.31±2.97) years old; their body mass index was (27.29±2.75) kg/m². The expression levels of thymus and extra-thymus regulatory T cells in the two groups were detected. The expression levels of thymus and extra-thymus CD4⁺ CD25⁺ Tr cells were compared between the two groups. The data were compared between the two groups by the independent-sample t test and χ² test. The receiver operating characteristic curve (ROC) was drawn based on the detection results. The best cutoff values and areas under the curves (AUC) of the two indicators were determined. The prediction values of the two indicators for the occurrence risk of URSA were analyzed. Results　The expression levels of thymus and extra-thymus CD4⁺CD25⁺Tr cells in observation group were lower than those in the control group [(7.92±0.86)% vs. (11.75±1.23)% and (7.18±0.79)% vs. (11.03±1.07)%], with statistical differences (both P<0.05). The AUC's of thymus and extra-thymus CD4⁺CD25⁺Tr cells and their combination in the prediction of URSA were 0.779, 0.760, and 0.875 (P<0.05). The sensitivity, specificity, and accuracy of the combination in the prediction of URSA were 95.24%(60/63), 96.83%(61/63), and 96.03%(121/126), respectively, which were higher than those of thymus CD4⁺ CD25⁺ Tr cells [76.19%(48/63), 79.37%(50/63), and 77.78%(98/126)] and those of extra-thymus CD4⁺ CD25⁺ Tr cells [(73.02%(46/63), 74.60%(47/63), and 73.81%(93/126)] (all P<0.05). Conclusions　The expression levels of thymus and extra-thymus CD4⁺ CD25⁺ Tr cells in patients with URSA decrease. Clinical combined detection of the above two indicators can predict the risk of abortion in pregnant women to a certain extent, and provide data references for subsequent relevant treatment and intervention.

Influencing factors of vaginal delivery failure in women with pre-eclampsia and establishment of a risk prediction nomogram model

Zhao Xiangyang, Tian Yi, Wei Yanan

2024, 30(21):  3618-3623.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.019

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Objective　To screen the influencing factors of vaginal delivery failure in women with pre-eclampsia, and to construct a predictive model for vaginal delivery failure. Methods　The medical records of 137 women with pre-eclampsia who were (32.29±3.16) years old and gave birth in Hanzhong People's Hospital from January 2020 to October 2023 were retrospectively analyzed. According to the 80/20 rule, they were randomly divided into a training set (107 cases) and a validation set (30 cases). According to the delivery modes, the training set were divided into a vaginal delivery group (85 cases) and an intermediate cesarean section group (22 cases). The influencing factors of vaginal trial failure in the women with pre-eclampsia were screened, and a predictive model for vaginal trial failure in the women with pre-eclampsia was constructed and validated. t and χ² tests were used for the statistical analysis. Results　The age, levels of lactate dehydrogenase, 24-hour proteinuria, and Th-22, and proportion of primipara in the intermediate cesarean section group were higher than those in the vaginal delivery group [(33.35±2.71) years vs. (31.29±3.05) years, (302.91±50.24) U/L vs. (259.78±32.61) U/L, (2.41±0.75) g vs. (1.79±0.34)g, (1.27±0.34)% vs. (1.06±0.31)%, and 95.45% (21/22) vs. 76.47% (65/85)]; the plasmacytoid dendritic cell (pDC) in the intermediate cesarean section group was lower than that in the vaginal delivery group [(0.13±0.04)% vs. (0.18±0.06)%]; there were statistical differences (all P<0.05). The logistic regression analysis showed that age (OR=3.601, 95%CI 1.063-12.194), parity (OR=3.725, 95%CI 1.099-12.615), lactate dehydrogenase (OR=4.088, 95%CI 1.207-13.846), 24-hour proteinuria (OR=3.740, 95%CI 1.104-12.667), Th-22 (OR=4.088, 95%CI 1.207-13.846), and pDC (OR=0.223, 95%CI 0.066-0.754) were identified as the influencing factors for vaginal delivery failure in the women with pre-eclampsia (all P<0.05). The sensitivity of the nomogram model in predicting vaginal delivery failure in the 107 women with pre-eclampsia of the training set was 0.804 (95%CI 0.715-0.862), with a specificity of 0.749 (95%CI 0.675-0.816) and an area under the curve of 0.832 (95%CI 0.731-0.899). When validated in the 30 women in the validation set, the nomogram model exhibited a sensitivity of 0.756 (95%CI 0.682-0.825), a specificity of 0.773 (95%CI 0.701-0.851), and an area under the curve of 0.804 (95%CI 0.707-0.881) for predicting vaginal delivery failure in the women with pre-eclampsia. Conclusions　Age, parity, lactate dehydrogenase, 24-hour proteinuria, Th-22, and pDC are associated with vaginal delivery failure in women with pre-eclampsia. Constructing a nomogram prediction model contributes to the early assessment of the risk of vaginal delivery failure in women with pre-eclampsia.

Clinical Research

Correlations of serum levels of amyloid A, high-sensitivity C-reactive protein, and insulin-like growth factor-1 with disease severity of patients with Parkinson's disease

Xu Kemin, Sun Jujun, Zhang Ying, Qi Jiang

2024, 30(21):  3624-3629.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.020

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Objective　To investigate the serum levels of amyloid A (SAA), high-sensitivity C-reactive protein (hs-CRP), and insulin-like growth factor 1 (IGF-1) in patients with Parkinson's disease (PD) and their correlations with disease severity, and to assess the value of these biomarkers in the evaluating disease progression and providing prognostic guidance. Methods　A total of 122 patients with PD treated at Xidian Group Hospital from January 2021 to October 2023 were selected as an observation group, and were divided into an early-stage group (44 cases) and a middle-late stage group (78 cases) according to their disease severities. Among the 122 patients, there were 64 males and 58 females; they were (68.13±8.45) years old; their disease course was (6.06±2.71) years. Fifty healthy examinees during the same period were selected as a healthy control group, including 28 males and 22 females who were (67.25±7.59) years old. The levels of SAA, hs-CRP, and IGF-1 were compared between the 3 groups, and their correlations with the disease severity were analyzed. Multivariate regression analysis was employed to identify the risk factors influencing disease progression. The diagnostic values of SAA, hs-CRP, and IGF-1 in disease progression assessment were evaluated using the receiver operating characteristic curves (ROC). t and χ² tests were applied. Results　The levels of SAA and hs-CRP in the observation group were higher than those in the healthy control group [(9.53±1.50) mg/L vs. (3.71±1.06) mg/L and (5.37±2.74) mg/L vs. (0.82±0.29) mg/L; both P<0.05]; the level of IGF-1 in the observation group were lower than that in the healthy control group [(65.73±15.25) μg/L vs. (84.04±19.72) μg/L; P<0.05]. The disease severity was correlated with the levels of SAA, hs-CRP, and IGF-1 (r=0.587, 0.492, and -0.660; all P<0.05). The multifactorial regression analysis revealed that advanced age, long disease duration, high levels of SAA and hs-CRP, and a low level of IGF-1 were significant predictors of increased disease severity. The combined predictive model of SAA, hs-CRP, and IGF-1 showed an area under the curve (AUC) of 0.967, with a sensitivity of 92.3% and a specificity of 93.2%. Conclusion　The serum levels of SAA, hs-CRP, and IGF-1 are closely associated with the disease progression of patients with PD and can serve as important biomarkers for assessing disease progression.

Application of afentanil and remazolam in painless gastroenteroscopy for elderly patients with cardiopulmonary insufficiency

Wang Kun, Guo Qiang, Lu Kai

2024, 30(21):  3629-3634.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.021

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Objective　To investigate the effects of afentanil combined with remazolam on vital signs and cognitive function in elderly patients with cardiopulmonary insufficiency taking painless gastroenteroscopy. Methods　A total of 84 elderly patients with cardiopulmonary insufficiency who took painless gastroenteroscopy at Xi'an Central Hospital from January 2021 to December 2023 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 42 cases in each group. There were 22 males and 20 females in the control group; they were 65-84 (72.78±4.69) years old. There were 19 males and 23 females in the study group; they were 66-85 (72.80±4.72) years old. The control group were given nalbuphine and remazolam for anesthesia, and the study group afentanil and remazolam. The vital signs 1 min before administration (T0), at putting the scope in (T1), 1 (T2) and 10 (T3) min after starting the operation, and when the operation was over (T4), sedative and analgesic effects 5 and 30 min after recovery from anesthesia, anesthetic indicators, and cognitive function were compared between the two groups. t and χ² tests were applied. Results　The mean artery pressures (MAP), heart rates (HR), and respiratory rates (RR) at T1, T2, T3, and T4 were lower than those at T0 in both groups, and the MAP, HR, and RR in the study group were higher than those in the control group (all P<0.05). There was no statistical difference in the pulse oxygen saturation (SpO₂) between at different time points in the study group (P>0.05); the SpO₂ at T1, T2, T3, and T4 were lower than that at T0 in the control group (P<0.05). The scores of Visual Analogue Scale (VAS) and Ramsay 5 and 30 min after recovery from anesthesia in the study group were lower than those in the control group (all P<0.05). The anesthesia onset time, recovery time, orientation recovery time, and the time from the end of the operation to departure in the study group were shorter than those in the control group [(1.33±0.27) min vs. (1.55±0.34) min, (5.63±1.22) min vs. (9.48±1.31) min, (7.81±0.57) min vs. (10.32±1.15) min, and (8.16±1.26) min vs. (10.25±1.58) min], with statistical differences (t=3.28, 13.94, 12.63, and 6.70; all P<0.05). The incidences of adverse events during the operation and within 60 min after the operation in the study group were lower than those in the control group (all P<0.05). There were no statistical differences in the scores of Montreal Cognitive Assessment (MoCA) and Mini-mental state examination (MMSE) at recovery after the operation between the two groups (both P>0.05). One hour after the operation, the scores of MMSE and MoCA in the study group were higher than those in the control group [(28.75±2.42) vs. (27.06±2.18) and (29.15±2.14) vs. (27.13±2.36)], with statistical differences (t=3.36 and 4.11; both P<0.05). Conclusion　The application of afentanil and remazolam in elderly patients taking painless gastroenteroscopy can effectively maintain their vital signs stable, improve the analgesic and sedative effects, shorten the onset and recovery times of anesthesia, and reduce the risk of adverse events and postoperative cognitive impairment.

Relationship of apolipoprotein E genotype with blood lipids and cognitive function in patients with Alzheimer's disease

Gao Yajun, Gao Bo, Zhou Xuan, Liu Feng

2024, 30(21):  3635-3640.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.022

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Objective　To investigate the relationship of apolipoprotein E (ApoE) genotype with blood lipids and cognitive function in patients with Alzheimer's disease (AD). Methods　One hundred and seven patients with AD treated at Yan 'an People's Hospital from March 2022 to May 2023 were selected as a study group. According to the severity of cognitive function, the patients were divided into a severe group (25 cases; the score of Mini-Mental State Examination (MMSE) ≤9) and a mild to moderate group (82 cases; the score of MMSE 10-26). Fifty-two healthy examinees during the same period at Yan 'an People's Hospital were selected as a control group. There were 61 males and 46 females in the study group who were (63.17±8.35) years old. There were 33 males and 19 females in the control group who were (63.86±8.02) years old. The ApoE genotype and allele frequency distribution and blood lipid levels [triglyceride (TG), high density lipoprotein cholesterol (HDL-C), cholesterol (CHO), and low density lipoprotein cholesterol (LDL-C)] in the patients with different ApoE alleles were compared between the control group, the mild to moderate group, and the severe group. The correlation between serum lipid levels and ApoE alleles in the patients was analyzed. The clinical data of the mild to moderate group and the severe group were compared. The influencing factors of severe cognitive dysfunction in the patients were analyzed. χ², t, and F tests were applied. Results　The gene distribution in the control group, the mild to moderate group, and the severe group was consistent with the Hardy-Weinberg equilibrium law (=0.83, 2.46, and 0.50; all P>0.05), indicating population representation. The ApoE 3/4 ε2/4 and ε3/4 genotypes of the severe group were higher than those of the mild to moderate group (both P<0.05). The ApoEε4 allele in the severe group was higher than those in the mild-moderate group and the control group; the ApoEε3 allele in the severe group was lower than those in the mild-moderate group and the control group; the ApoEε3 allele in the mild-moderate group was lower than that in the control group (all P<0.05). There was no statistical difference in ApoEε2 allele between the the severe group and the mild-moderate group (P>0.05), but the ApoEε2 allele in the severe group and the mild-moderate group were higher than that in that in the control group (both P<0.05). The Spearman analysis showed that TG, HDL-C, CHO, and LDL-C were not correlated with ApoE alleles (all P>0.05). The interleukin-6 (IL-6) and lipoprotein phospholipase A2 (Lp-PLA2) in the severe group were higher than those in the mild-moderate group (both P<0.05). The multivariate logistic regression analysis showed that the ApoEε4 allele (OR=3.924, 95%CI 1.725-8.925) and Lp-PLA2 (OR=2.807, 95%CI 1.234-6.385) were the influential factors for severe cognitive impairment in the patients (both P<0.05). Conclusions　ApoE alleles are not associated with lipid levels in patients with AD. AD patients with ApoE epsilon 4 have a higher risk of severe cognitive impairment.

Correlation of serum levels of IRS-1 and CTRP3 with adverse pregnancy outcomes in women with gestational diabetes mellitus

Wang Jing, Li Wenting, Wang Min, Cui Zhangxia, Tian Ting, Zhang Xiaocai, Li Mei

2024, 30(21):  3640-3645.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.023

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Objective　To study and analyze the correlation of the serum levels of insulin receptor substrate-1 (IRS-1) and C1q tumor necrosis factor related protein-3 (CTRP-3) with adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM). Methods　From January 2021 to December 2023, 132 women with GDM who gave birth at Second Hospital, Shaanxi University of Chinese Medicine were selected as a diseased group; they were (28.76±3.18) years old; their body mass index (BMI) was (25.72±2.82) kg/m²; their gestation weeks was (38.06±1.42); among them, there were 66 multiparae; 82 cases took vaginal delivery; they were divided into a good outcome group (80 cases) and an adverse outcome group (52 bases) according to their pregnancy outcomes. One hundred and thirty-two healthy pregnant women who gave birth during the same period were selected as a control group; they were (28.65±3.06) years old; their BMI was (25.31±2.67) kg/m²; their gestation weeks was (38.21±1.33); among them, there were 60 multiparae; 86 women took vaginal delivery. The general clinical data were collected and analyzed for univariate analysis. Multivariate logistic regression was applied to analyze the influencing factors of adverse pregnancy outcomes in the women with GDM. The receiver operating characteristic curve (ROC) was applied to analyze the diagnostic values of IRS-1 and CTRP3 for adverse pregnancy outcomes in the patients with GDM. Pearson method and Spearman correlation analysis were applied to analyze the correlations of IRS-1 and CTRP3 with the clinical indicators and pregnancy outcomes in the women with GDM. χ² test, t test, and Pearson and Spearman correlation analyses were used. Results　The serum levels of IRS-1 and CTRP3 in the diseased group were obviously lower than those in the control group [(1.82±0.21) μg/L vs. (2.33±0.28) μg/L and (353.51±38.14) ng/L vs. (425.95±45.21) ng/L], with statistical differences (t=16.74 and 14.07; both P<0.05). The serum levels of IRS-1 and CTRP3 in the adverse outcome group were lower than those in the good outcome group; the levels of fasting blood glucose (FBG), glycated hemoglobin (HbAlc), and insulin resistance index (HOMA-IR) in the adverse outcome group were higher than those in the good outcome group; there were statistical differences (t=8.61, 7.49, 7.26, 8.40, and 32.73; all P<0.05). The elevated levels of FBG, HbAlc, and HOMA-IR were all risk factors for adverse pregnancy outcomes in the patients [OR (95%CI)=1.498 (1.099-2.042), 1.698 (1.092-2.639), and 2.014 (1.063-3.816); all P<0.05], while IRS-1 and CTRP3 were protective factors for adverse pregnancy outcomes in the patients [OR (95%CI)=0.774 (0.621-0.964) and 0.731 (0.573-0.932); both P<0.05]. The ROC showed that the area under the curve (AUC) of the combination of IRS-1 and CTRP3 for adverse pregnancy outcomes in the patients was 0.899; the AUC of the combination was obviously better than those of IRS-1 and CTRP3 (Z=2.094 and 2.056; both P<0.05). IRS-1 and CTRP3 were negatively correlated with pregnancy outcomes, FBG, HbAlc, and HOMA-IR in the patients (all P<0.05). Conclusions　The serum levels of IRS-1 and CTRP3 decrease in GDM patients with adverse pregnancy outcomes. The combination of the two has certain predictive value for adverse pregnancy outcomes in patients with GDM.

Relationship of IKKε and FABP4 with glucose and lipid metabolism and pregnancy outcomes in patients with gestational diabetes mellitus

Yan Lu, Li Weiling, Yin Ting, Zhang Jinhui

2024, 30(21):  3646-3650.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.024

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Objective　To explore the relationship of nuclear factors-κB inhibitor kinase ε (IKKε) and fatty acid binding protein 4 (FABP4) with glucose and lipid metabolism and pregnancy outcomes in patients with gestational diabetes mellitus (GDM). Methods　One hundred and twenty-five patients with GDM confirmed by prenatal examinations at Xi'an Gaoxin Hospital from June 2020 to December 2023 were selected. They were 22-36 (28.77±3.02) years old and 24-28 (26.14±0.87) weeks pregnant. The serum levels IKKε and FABP4 and glucose and lipid metabolism indicators in all the patients were detected. According to the pregnancy outcomes, the patients were divided into a good pregnancy group (92 cases) and a poor pregnancy group (33 cases). The correlations of serum IKK εand FABP4 with glucose and lipid metabolism in the patients were analyzed using the Pearson's method. The factors influencing the pregnancy outcomes in the patients were analyzed using the logistic regression. The predictive values of serum IKKε and FABP4 on pregnancy outcomes in the patients were analyzed using the receiver operating characteristic curves (ROC). t and χ² tests were applied. Results　The levels of IKKε, FABP4, fasting blood glucose (FBG), glycosylated hemoglobin type A1C (HbAlc), triglycerides (TG), and total cholesterol (TC) in the good pregnancy group were higher than those in the good pregnancy group (all P<0.05). The Pearson's analysis showed that the serum levels of IKK ε and FABP4 were positively correlated with FBG, HbAlc, TG, and TC (r=0.543, 0.621, 0.354, 0.312, 0.705, 0.658, 0.433, and 0.365; all P<0.05). The multivariate logistic regression analysis showed that IKK ε (OR=3.287, 95%CI 1.994-5.418), FABP4 (OR=3.942, 95%CI 1.754-8.856), FBG (OR=2.857, 95%CI 1.416-5.762), and TC (OR=4.133, 95%CI 2.190-7.799) were independent risk factors for adverse pregnancy outcomes in the patients (all P<0.05). The ROC displayed that the sensitivities of serum IKK ε, FABP4, and their combination in predicting pregnancy outcomes in the patients was 72.70%, 75.80%, and 90.90%; the specificities were 73.90%, 71.70%, and 91.30%; the areas under curves (AUC) were 0.802, 0.829, and 0.923 (all P<0.05). Conclusions　Serum IKK εFABP4 in patients with GDM are positively correlated with glucose and lipid metabolism indicators, such as FBG, HbAlc, TG, and TC. Serum IKKε and FABP4 are independent risk factors for adverse pregnancy in patients with GDM. IKKε and FABP4 can effectively predict pregnancy outcomes in patients with GDM.

Effectiveness of low-dose levothyroxine in treatment of patients with diabetes mellitus and hyperthyroidism

Gao Meng, Hu Wenhua, Li Wei

2024, 30(21):  3651-3656.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.025

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Objective　To observe the effect of low-dose levothyroxine in the treatment of patients with diabetes mellitus and hyperthyroidism. Methods　A total of 136 patients with diabetes mellitus and hyperthyroidism treated at Yangling Demonstration District Hospital from January 2023 to January 2024 were selected for the randomized controlled trial, and were divided into a conventional group and a small-dose group by the random number table method. There were 32 males and 36 females in the conventional group; they were (54.85±9.63) years old; their diabetic course was (7.12±2.05) years; their hyperthyroidism course was (2.56±0.89) years. There were 37 males and 31 females in the small-dose group; they were (55.12±10.14) years old; their diabetic course was (7.08±2.12) years; their hyperthyroidism course was (2.51±0.92) years. The conventional group were treated with methimazole and dagliflozin; in addition, the small-dose group were treated with small-dose levothyroxine. Both groups were treated for 6 months. The blood glucose indicators, insulin function indicators, intestinal flora, and thyroid hormone levels were compared between the two groups by t test. The clinical efficacies and safety of the two groups were compared by χ² test. Results　After the treatment, the fasting blood glucose, insulin resistance index, postprandial 2 h blood glucose, and glycated hemoglobin were lower than those before the treatment in both groups, and those in the small-dose group were lower than those in the conventional group [(6.34±0.78) mmol/L vs. (7.28±1.04) mmol/L, (2.63±0.34) vs. (3.41±0.37), (8.27±1.76) mmol/L vs. (9.54±2.04) mmol/L, and (6.74±1.12)% vs. (8.31±1.65)%; t=5.963, 12.800, 3.887, and 6.492; all P<0.05]; the islet β-cell indices of the two groups were higher than those before the treatment, and the islet β-cell index in the small-dose group was higher than that in the conventional group [(65.75±10.15) vs. (54.86±8.09); t=6.919; P<0.05]. After the treatment, there were no statistical differences in the numbers of Enterobacteriaceae, Enterococci, Bifidobacteria, and Lactobacillus between the two groups (all P>0.05). After the treatment, the levels of free triiodothyronine and free thyroxine were lower than those before the treatment in both groups, and the levels in the small-dose group were lower than those in the conventional group [(4.41±1.33) ng/L vs. (6.89±2.12) ng/L and (10.25±3.77) ng/L vs. (14.56±5.14) ng/L; t=8.172 and 5.576; both P<0.05]; the levels of thyrotropin in both groups were higher than those before the treatment, and the level in the small-dose group was higher than that in the conventional group [(3.32±0.72) ng/L vs. (2.74±0.58) ng/L; t=5.173; P<0.05]. The total effective rate in the small-dose group was higher than that in the conventional group [92.65% (63/68) vs. 79.41% (54/68); P<0.05]. The total incidence of adverse reactions, such as liver injury, secondary hypothyroidism, hypoglycaemia, and gastrointestinal discomfort, in the small-dose group was 11.76% (8/68), and that in the conventional group 8.82% (6/68), with no statistical difference (P>0.05). Conclusion　Small-dose levothyroxine can modulate thyroid hormone expression in patients with diabetes mellitus and hyperthyroidism, facilitate glycaemic control, and improve their insulin function.

Effect of basic treatment, moxibustion on Yiyu point, and Tongluo Ditan Decoction for patients with type 2 diabetic peripheral neuropathy

Zhang Yanfen, Guo Haonan, Wu Hongqun, Ji Hua, Wang Tao

2024, 30(21):  3656-3661.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.026

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Objective　To observe the effect of basic treatment, moxibustion on the Yiyu point, and Tongluo Diitan Decoction for patients with type 2 diabetic peripheral neuropathy. Methods　Ninety-three patients with type 2 diabetic peripheral neuropathy of the phlegm-stasis obstruction type treated at Shangluo Central Hospital from March 2022 to February 2024 were selected as the research objects, and were divided into a control group (46 cases) and an observation group (47 cases) according to the treatment methods. In the control group, there were 26 males and 20 females who were (48.53±6.27) years old. In the observation group, there were 24 males and 23 females who were (49.71±7.34) years old. Both groups received basic treatment. The control group received moxibustion on their Yiyu points, and the observation group took Tongluo Ditan Decoction on the basis of the control group. The scores of traditional Chinese medicine syndromes, nerve conduction velocities, clinical efficacies, blood glucose levels, vascular endothelial function, oxidative stress reaction, and adverse reactions were compared between the two groups. t test and χ² test were used. Results　After the treatment, the total score, score of secondary symptoms, and score of main symptoms of the observation group were lower than those of the control group [(6.28±1.23) vs. (10.12±1.97), (2.17±0.34) vs. (4.09±0.88), and (4.11±0.85) vs. (6.03±1.72)], with statistical differences (all P<0.05). After the treatment, the motor conduction velocity (MNCV) and sensory conduction velocity (SNCV) of the median nerve and common peroneal nerve in the observation group were higher than those in the control group [(47.25±5.76) m/s vs. (43.56±4.54) m/s, (49.31±5.69) m/s vs. (45.82±4.87) m/s, (44.17±5.88) m/s vs. (39.25±4.36) m/s, and (46.51±5.72) m/s vs. (42.69±4.83) m/s], with statistical differences (all P<0.05). The total effective rate of the observation group was higher than that of the control group [93.62% (44/47) vs. 78.26% (36/46); P<0.05]. After the treatment, the levels of glycosylated hemoglobin (HbAlc), 2 h postprandial blood glucose (2hPG), fasting blood glucose (FBG), serum endothelin-1 (ET-1), vascular endothelial growth factor (VEGF), and malondialdehyde (MDA) in the observation group were lower than those in the control group [(6.03±1.25)% vs. (7.28±1.72)%, (7.21±1.24) mmol/L vs. (8.72±1.69) mmol/L, (5.35±0.83) mmol/L vs. (6.72±1.20) mmol/L, (78.32±9.08) ng/L vs. (115.20±12.47) ng/L, (79.85±9.30) ng/L vs. (112.34 ±13.68) ng/L, and (3.65±0.68) mmol/L vs. (4.87±1.02) mmol/L]; the levels of serum nitric oxide (NO) and superoxide dismutase (SOD) in the observation group were higher than those in the control group [(65.41±7.38) μmol/L vs. (49.86±5.94) μmol/L and (165.76±18.40) U/L vs. (108.27±11.34) U/L]; there were statistical differences (all P<0.05). During the treatment, there were no obvious adverse reactions in both groups. Conclusion　Basic treatment, moxibustion on the Yiyu point, and Tongluo Ditan Decoction for patients with type 2 diabetic peripheral neuropathy is effective, can increase nerve conduction speed, reduce oxidative stress reaction, improve vascular endothelial function, and regulate blood sugar level, and is safe and reliable.

Modified Banxia Xiexin Decoction combined with quadruple therapy for Helicobacter pylori-positive patients with peptic ulcer

Hu Shasha, Li Ming, Zhou Min, Gan Huihu, Jin Lianning, Zhou Wenbo

2024, 30(21):  3662-3665.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.027

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Epidemiological characteristics of Mycoplasma pneumoniae infection in children at some hospital in Guangzhou from 2020 to 2023

Chen Shufang, Wang Nan, Cai Donghao

2024, 30(21):  3666-3670.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.028

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Objective　To analyze the epidemiological characteristics of infection rate, gender, age, and incidence season of Mycoplasma pneumoniae (MP) in children at Guangdong Provincial Second Hospital of Traditional Chinese Medicine, and to provide some references for clinical prevention and early differential diagnosis. Methods　The clinical data of 1 953 children with respiratory tract infection, such as bronchitis, pneumonia, cough, headache, fever, runny nose, etc., treated at Guangdong Provincial Second Hospital of Traditional Chinese Medicine from January 2020 to December 2023, were retrospectively analyzed. The results of total antibodies of MP in serum detected by passive agglutination were represented by cases or rates. The IBM SPSS Statistics 22.0 was used for χ² test to compare the differences. If P<0.05, there is a statistical difference. Results　The serological positive rate of MP was 40.35% (788/1 953). The positive rates of MP antibodies from 2020 to 2023 were 39.63% (107/270), 38.40% (134/349), 38.19% (207/542), and 42.93% (340/792), respectively. The positive rate in the girls was higher than that in the boys [47.22% (408/864) vs. 34.89% (380/1 089); χ²=30.420; P<0.05]. The positive rate in the juvenile group (≥13-18 years old) was the highest (51.11%, 92/180), followed by that in the school age group (≥7-13 years old) (50.66%, 308/608), and that in the preschool group (0-7 years old) was the lowest (33.30%, 388/1 165); there was a statistical difference in the positive rate between the age groups (χ²=59.527; P<0.05). The highest positive rate was found in autumn (September-November) (41.63%, 326/783), followed by winter (December-February) (40.12%, 193/481). Conclusions　The outbreak of MP infection at Guangdong Provincial Second Hospital of Traditional Chinese Medicine occurs in autumn and winter, and children of school age and adolescents are susceptible groups. MP infection should be considered in diagnosis and treatment when patients present with symptoms of cough, pneumonia, bronchitis, and bronchoppneumonia. Effective prevention and control measures should be taken according to the characteristics of MP infection in children in Guangzhou.

Intracavitary injection of compound betamethasone combined with extracorporeal shockwave therapy for patients with painful shoulder joint contracture

Gao Jiandong, Sun Fude

2024, 30(21):  3671-3675.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.029

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Effect of total glucosides of paeony capsules combined with probiotic aloe vera fermentation gel in treatment of patients with recurrent aphthous ulcer

Zhang Lin, Gao Ailing, He Xiangyi

2024, 30(21):  3675-3679.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.030

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Objective　To investigate the clinical efficacy of total glucoside of paeony capsules combined with probiotic aloe vera fermentation gel in the treatment of patients with recurrent aphthous ulcer. Methods　Eighty patients with recurrent aphthous ulcer treated at Xi'an Honghui Hospital from January to December 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 22 males and 18 females in the control group; they were (31.88±6.12) years old; their disease course was (11.15±2.70) months. There were 20 males and 20 females in the observation group; they were (31.76±6.00) years old; their disease course was (11.22±2.16) months. The control group were treated with probiotic aloe vera fermentation gel, and the observation group with probiotic aloe vera fermentation gel and total glucoside of paeony capsules, for 2 weeks. The clinical efficacies, pain scores of Visual Analogue Scale (VAS), ulcer areas, levels of inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-2 (IL-2), and interferon-γ (IFN-γ)], and incidences of adverse reactions were compared between the two groups by t and χ² tests. Results　The total effective rate of the observation group was higher than that of the control group [95.00% (38/40) vs. 80.00% (32/40)], with a statistical difference (χ²=4.114; P=0.043). Before the treatment, there were no statistical differences in the score of VAS, ulcer area, and levels of inflammatory factors between the two groups (all P>0.05). After the treatment, the score of VAS and levels of TNF-α and IL-2 in the observation group were lower than those in the control group [(1.30±0.22) vs. (2.20±0.36), (3.58±0.81)g/L vs. (5.35±1.48)g/L, and (0.30±0.07) g/L vs. (0.62±0.10) g/L]; the ulcer area in the observation group was smaller than that in the control group [(0.68±0.12) cm² vs. (1.45±0.28) cm²]; the level of IFN-γ in the observation group was higher than that in the control group [(77.50±12.97) mmol/L vs. (63.68±12.49) mmol/L]; there were statistical differences (t=13.492, 6.635, 16.580, 15.986, and 4.854; all P<0.05). There was no statistical difference in the incidence of adverse reactions between the two groups (χ²=0.263; P=0.608). Conclusion　Total glucoside of paeony capsules combined with probiotic aloe vera fermentation gel in the treatment of patients with recurrent aphthous ulcer can improve the therapeutic effect and reduce their pain, inflammatory reaction, and ulcer area, and does not significantly increase the occurrence of adverse reactions.

Nursing Research

Effect of rehabilitation protocol based on integrated health behavior change theory for patients with upper limb dysfunction after breast cancer surgery

Jiao Yanyan, Liu Rongrong, Chen Bing, Gao Congcong, Yang Hongxing

2024, 30(21):  3680-3684.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.031

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Objective　To investigate the effects of the rehabilitation program based on the integrated health behavior change (ITHBC) theory on shoulder joint mobility and self-management efficacy in patients with upper limb dysfunction after breast cancer surgery. Methods　Eighty female patients with upper limb dysfunction after breast cancer surgery treated at Third Hospital, Zhengzhou University from March 2022 to March 2024 were selected for the randomized controlled trial, and were divided into a conventional group and a study group by the random number table method, with 40 cases in each group. The conventional group were 42-64 (54.12±4.83) years old; there were 19 cases of tumor stage I, 18 cases of stage Ⅱ, and 3 cases of stage Ⅲ. The study group were 43-65 (55.61±5.28) years old; there were 19 cases of tumor stage I, 17 cases of stage Ⅱ, and 4 cases stage of Ⅲ. The conventional group took the regular rehabilitation program, and the study group the rehabilitation program based on ITHBC theory. Both groups were intervened for 8 weeks. The shoulder joint movement, self-management efficacies, post-traumatic growth, and quality of life were compared between the two groups. χ² and t tests were applied. Results　After the intervention, the mobility of shoulder abduction, extension, and flexion in the study group were higher than those in the conventional group [(172.45±7.62)° vs. (145.88±8.64)°, (54.28±5.10)° vs. (40.30±5.23)°, and (168.77±9.20)° vs. (148.66±8.69)°], with statistical differences (t=14.59, 12.10, and 10.05; all P<0.05). After the intervention, the scores of self-efficacy (GSES) and Chinese version Posttraumatic Growth Inventory (PTGI) in the study group were higher than those in the conventional group [(33.41±2.79) vs. (30.88±2.68) and (81.53±5.69) vs. (76.80±4.48)], with statistical differences (t=4.14 and 4.13; both P<0.05). The scores of material function, social function, psychological function, and body function in the study group were higher than those in the conventional group, with statistical differences (t=5.28, 4.57, 6.23, and 5.52; all P<0.05). Conclusion　ITHBC rehabilitation program can effectively promote post-traumatic growth of patients with upper limb dysfunction after breast cancer surgery, and improve their self-management efficacy, shoulder joint movement, and quality of life.

Meridian point therapy combined with ear point pressing for patients taking maintenance hemodialysis

Wei Xiaoyan, Wang Meirong, Zhang Qunfang, Zeng Zhikui

2024, 30(21):  3685-3688.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.032

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Objective　To analyze the effect of meridian point therapy combined with ear point pressing for patients taking maintenance hemodialysis (MHD). Methods　Eighty-four patients taking MHD at Hospital Affiliated to Jiangxi University of Traditional Chinese Medicine from January 2023 to January 2024 were selected, and were divided into a control group and an observation group by the random number table method, with 42 cases in each group. There were 27 males and 15 females in the control group; they were (54.29±3.40) years old. There were 29 males and 13 females in the observation group; they were (54.40±3.26) years old. The control group took routine intervention; in addition, the observation group took meridian point therapy and ear point pressing. Both groups were intervened for 4 weeks. The psychological status, disease-related symptoms, fatigue symptoms, and sleep quality were compared between two groups by χ² and t tests. Results　After the intervention, the scores of the Hamilton Depression Scale, Hamilton Anxiety Scale, symptoms of Dialysis Fatigue Scale, Fatigue Scale-14, and Pittsburgh Sleep Quality Index in the observation group were lower than those in the control group [(9.33±1.26) vs. (13.29±1.59), (8.61±1.02) vs. (12.25±1.53), (1.02±0.16) vs. (1.77±0.25), (1.35±0.19) vs. (2.16±0.20), (0.89±0.16) vs. (1.55±0.21), (1.02±0.18) vs. (1.73±0.24), (0.96±0.19) vs. (1.62±0.25), (4.35±0.69) vs. (6.21±1.25), and (6.80±1.16) vs. (10.31±1.54)], with statistical differences (t=12.650, 12.829, 16.376, 19.029, 16.201, 15.338, 13.622, 8.443, and 11.798; all P<0.05). Conclusion　Meridian point therapy combined with ear point pressing for patients taking MHD can improve their psychological state and life quality, and alleviate their fatigue symptoms.

Application of Ausubel's problem solving mode in nursing care for women with pre-eclampsia

Hui Xinyun, Shi Xiaoting, Wang Yuanli

2024, 30(21):  3689-3693.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.033

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Objective　To study the efficacy of application of Ausubel's problem solving mode in nursing care for women with pre-eclampsia. Methods　Ninety women with preeclampsia treated at Baoji Maternal and Child Health Care Hospital from December 2022 to December 2023 were selected for the randomized controlled trial, and were divided into a control group and a study group by the random number table method, with 45 cases in each group. The control group were (31.19±1.21) years old and (32.19±1.85) weeks pregnant, with a body mass index (BMI) of (27.49±3.29) kg/m². The study group were (31.21±1.19) years old and (32.23±1.92) weeks pregnant, with a BMI of (27.52±3.32) kg/m². The control group took conventional nursing care, and the study group Ausubel's problem solving mode nursing care. The blood pressure control, degrees of gestational stress, and delivery outcomes were compared between the two groups at enrollment and 2 weeks after delivery. t and χ² tests were used. Results　At enrollment, there were no statistical differences in the systolic and diastolic blood pressures between the two groups (both P>0.05); 2 weeks after delivery, the systolic and diastolic blood pressures were lower than those at enrollment in both groups (all P<0.05), and the pressures in the study group were lower than those in the control group [(135.12±6.24) mmHg (1 mmHg=0.133 kPa) vs. (138.52±6.23) mmHg and (98.12±3.52) mmHg vs. (99.97±3.69) mmHg; t=2.587 and 2.434; both P<0.05]. At enrollment, there were no statistical differences in the scores of Pregnancy Pressure Scale (PPS) between the two groups (all P>0.05); 2 weeks after delivery, the scores of PPS were lower than those at enrollment in both groups (all P<0.05), and the scores of the two dimensions and the total score of PPS in the study group were lower than those in the control group [(28.56±3.21) vs. (30.12±3.28), (27.62±3.16) vs. (29.48±3.24), and (56.18±5.26) vs. (59.60±5.19); t=2.280, 2.757, and 3.105; all P<0.05]. The rate of spontaneous delivery in the study group was higher than that in the control group [77.78% (35/45) vs. 57.78% (26/45); χ²=4.121; P<0.05]; the rate of assisted vaginal delivery in the study group was lower than that in the control group [26.67%(12/45) vs. 46.67% (21/45); χ²=3.876; P<0.05]; the rate of cesarean section in the study group was lower than that in the control group [22.22% (10/45) vs. 42.22% (19/45); χ²=4.121; P<0.05]; the incidence of neonatal asphyxia in the study group was 2.22% (1/45), and that in the control group 8.89% (4/45), with no statistical difference (χ²=0.847; P>0.05). Conclusion　Ausubel's problem solving mode nursing care for women with preeclampsia can improve their blood pressures and labour outcomes, and reduce their stress.

Effect of traditional Chinese medicine acupoint application for patients with benign prostatic hyperplasia after electro-prostatectomy

Zhang Chengyi, Xu Bifang, Wang Zijuan, Xu Qingjiang

2024, 30(21):  3693-3696.  DOI: 10.3760/cma.j.issn.1007-1245.2024.21.034

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Objective　To observe the effect of traditional Chinese medicine acupoint application for patients with benign prostatic hyperplasia after electro-prostatectomy. Methods　A total of 122 patients with benign prostatic hyperplasia after electro-prostatectomy at Department of Urology, Provincial Hospital Affiliated to Fuzhou University from February to November 2023 were selected for the randomized controlled trial, and were divided into an observation group and a control group by the random number table method, with 61 cases in each group. The observation group were (66.73±3.38) years old; their disease course was (7.45±1.61) years; their prostate symptom score was (24.08±1.53). The control group were (67.62±3.54) years old; their disease course was (7.21±1.54) years; their prostate symptom score was (23.28±1.41). The control group received routine care, while the observation group received traditional Chinese medicine acupoint application on the basis of the control group, for 5 d. The bladder spasms related indicators, scores of Visual Analogue Scale (VAS) and life quality, and satisfaction degrees were compared between the two groups. t and χ² tests were applied. Results　Seventy-two hours after the surgery, the incidence, frequency, and duration of bladder spasms, bladder extubation time, continuous flushing time, and score of VAS in the observation group were lower than those in the control group, with statistical differences (all P<0.05); the score of life quality and nursing satisfaction in the observation group were higher than those in the control group [(89.90±4.99) vs. (71.00±4.39) and 100.00% (61/61) vs. 93.44% (57/61)], with statistical differences (both P<0.05). Conclusion　Traditional Chinese medicine acupoint application can effectively improve the rehabilitation effect and quality of life of patients with benign prostatic hyperplasia after electro-prostatectomy.