Table of Content

01 December 2024, Volume 30 Issue 23

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Colunm of Stomatology

Clinical effects of movable dentures versus fixed dentures in repair for patients with periodontal disease and dental defect

Xia Bingbing, Zhou Feng, Xu Shan, Xing Yali, Ye Hongqiang

2024, 30(23):  3886-3890.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.001

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Objective　To compare the clinical effects of movable dentures and fixed dentures in the treatment of patients with periodontal disease and dentition defect. Methods　Ninety patients with periodontal disease and dentition defect treated at Department of Stomatology, Nanyang Central Hospital from March 2022 to February 2024 were selected for the randomized controlled trial, and were divided into a reference group and an experimental group by the random number table method, with 45 cases in each group. There were 22 males and 23 females in the reference group; they were (46.52±8.14) years old; their disease course was (3.06±1.05) years. There were 24 males and 21 females in the experimental group; they were (46.81±8.33) years old; their disease course was (3.11±1.12) years. The reference group were treated with movable dentures, while the experimental group with fixed dentures. The masticatory function, temporomandibular function, oral function before and after the treatment and therapeutic effects were compared between the two groups. t and χ² tests were applied. Results　Before the treatment, there were no statistical differences in the masticatory function, temporomandibular function, and oral function between the two groups (all P>0.05). After the treatment, the maximum occlusal contact area, bite force, and masticatory efficiency in the reference group were higher than those in the experimental group [(231.05±21.52) mm² vs. (205.49±20.03) mm², (140.05±14.32) Ibs vs. (131.01±13.92) Ibs, and (86.72±7.23)% vs. (80.80±6.81)%]; the asymmetry index of bite force and scores of clinical dysfunction index, temporamandibular joint disturbance index, oral pain, oral health, tooth mobility, and gingival bleeding in the experimental group were lower than those in the control group [(14.05±1.32)% vs. (20.01±2.92)%, (4.21±1.06) vs. (5.85±1.56), (0.08±0.02) vs. (0.14±0.03), (3.66±1.01) vs. (4.31±1.16), (16.08±1.72) vs. (22.72±2.23), (4.48±1.02) vs. (7.31±1.71), and (1.16±0.51) vs. (1.81±0.66)]; there were statistical differences (t=5.832, 3.036, 3.998, 12.476, 5.833, 7.442, 2.834, 15.816, 9.534, and 5.227; all P<0.05). The effective rate of the experimental group was higher than that of the control group [95.56% (43/45) vs. 77.78% (35/45)], with a statistical difference (χ²=6.153; P=0.013). Conclusions　In the treatment of patients with periodontal disease and dentition defect, fixed dentures can more effectively restore their chewing function, provide more balanced force distribution, and help reduce periodontal tissue damage. Moreover, fixed dentures are more effective in improving symptoms of temporomandibular joint disorders, oral comfort, overall health status, and clinical treatment effect, so it is worth being generalized.

Effect of iRoot SP combined with single pointed root canal filling in treatment of patients with retrograde pulpitis

Cao Baiyu

2024, 30(23):  3891-3895.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.002

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Objective　To analyze the effect of iRoot SP combined with single pointed root canal filling in the treatment of patients with retrograde pulpitis. Methods　A total of 120 patients with retrograde pulpitis who were treated in Department of Stomatology, Fujian Provincial Hospital from January 2022 to May 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 60 cases in each group. There were 35 males and 25 females in the control group; they were (58.65±4.89) years old; their disease course was (4.12±1.36) years. There were 32 males and 28 females in the observation group; they were (59.34±5.27) years old; their disease course was (4.51±1.49) years. The control group received root canal filling using iRoot SP by the cold lateral pressure method. The observation group used iRoot SP and did single pointed root canal filling. The therapeutic effects, filling effects, periodontal indices [probing depth (PD), probing bleeding index (BOP), tooth mobility (TM), and clinical attachment level (CAL)], and levels of inflammatory factors [hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β)] in gingival crevicular fluid were compared between the two groups. t and χ² tests were applied. Results　The total effective rate of the observation group was higher than that of the control group [96.67% (58/60) vs. 86.67% (52/60)], with a statistical difference (χ²=3.927; P<0.05). The good filling rate of the observation group was higher than that of the control group [96.67% (58/60) vs. 75.00% (45/60)], with a statistical difference (χ²=11.582; P<0.05). Before the treatment, there were no statistical differences in the PD, BOP, TM, CAL, and levels of hs-CRP, TNF-α, and IL-1β between the two groups (all P>0.05). After the treatment, the PD, BOP, TM, CAL, and levels of hs-CRP, TNF-α, and IL-1β in the observation group were lower than those in the control group [(1.97±0.23) mm vs. (2.76±0.26) mm, (0.84±0.19) vs. (1.31±0.23), (0.12±0.05) mm vs. (0.27±0.08) mm, (0.94±0.37) mm vs. (2.10±0.42) mm, (0.78±0.06)mg/L vs. (1.03±0.09) mg/L, (0.48±0.09) mg/L vs. (1.01±0.10) mg/L, and (56.68±2.34) ng/L vs. (63.16±2.57) ng/L], with statistical differences (t=17.628, 12.203, 12.316, 16.053, 17.903, 30.515, and 14.441; all P<0.05). Conclusion　iRoot SP combined with single pointed root canal filling treatment for patients with retrograde pulpitis has good root canal sealing effect and can improve their periodontal status and inflammatory factor levels in gingival crevicular fluid of affected teeth, with significant overall therapeutic effect.

Prognosis analysis of percutaneous acupoint electrical stimulation combined with root canal therapy for patients with acute pulpitis

Jin Yingzhe, Yi Yuanping, Dong Yu, Feng Lei

2024, 30(23):  3895-3899.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.003

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Impact of multimodal physical therapy combined with extracorporeal shock wave therapy on patients with temporomandibular joint disorders

Song Wei, Chen Jingtao, Chen Xinzhao, Wang Yan, Li Baodong

2024, 30(23):  3900-3905.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.004

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Objective　To explore the effect of multimodal physical therapy combined with extracorporeal shock wave therapy (ESWT) on patients with temporomandibular joint disorders. Methods　This prospective controlled study included 240 patients with temporomandibular disorders treated at Second Hospital, Air Force Military Medical University from January 2021 to January 2023. The patients were randomly divided into a control group and an observation group by the random number table method, with 120 cases in each group. There were 68 males and 52 females in the control group; they were (39.25±4.14) years old; their disease course was (61.59±8.54) d. There were 70 males and 50 females in the observation group; they were (39.37±4.28) years old; their disease course was (61.71±8.62) d. The control group took multimodal physical therapy. The observation group took multimodal physical therapy and ESWT. The clinical efficacies and the scores of temporomandibular joint function [Mandibular Function Impairment Questionnaire (MFIQ)], pain [Visual Analogue Scale (VAS)], temporomandibular joint disorder degree [pain index (PI), dysfunction index (DI), and comprehensive mandibular index (CMI)], oral health quality [Oral Health Impact Profile-14 (OHIP-14)], and Fricton index [joint noise (JN), mandibular movement (MM), muscle palpation (MP), and joint palpation (JP)] and maximum mouth opening before and after 2 weeks' treatment were compared between the two groups. t and χ² tests were applied. Results　The effective rate in the observation group was higher than that in the control group [95.83% (115/120) vs. 82.50% (99/120)], with a statistical difference (χ²=11.042; P<0.001). Before the treatment, there were no statistical differences in the scores of MFIQ, VAS, PI, DI, CMI, OHIP-14, JN, MM, MP, and JP and maximum mouth opening between the two groups (all P>0.05). After the treatment, the scores of MFIQ, VAS, PI, DI, CMI, OHIP-14, JN, MM, MP, and JP in the observation group were lower than those in the control group (9.64±1.59 vs. 19.57±2.68, 2.62±0.62 vs. 3.90±0.78, 0.35±0.07 vs. 0.58±0.09, 0.26±0.06 vs. 0.44±0.08, 0.20±0.07 vs. 0.31±0.11, 11.23±2.17 vs. 22.16±3.04, 1.36±0.35 vs. 3.12±0.64, 2.01±0.57 vs. 4.66±1.03, 6.37±1.46 vs. 9.28±2.54, and 1.34±0.46 vs. 3.45±0.87); the maximum mouth opening in the observation group was bigger than that in the control group [(3.25±0.68) mm vs. (2.02±0.51) mm]; there were statistical differences (t=34.908, 14.072, 22.098, 19.718, 9.242, 32.056, 26.431, 24.660, 10.881, 23.487, and 15.852; all P<0.05). Conclusion　Multimodal physical therapy combined with ESWT for patients with temporomandibular disorders is effective and can improve their joint function and oral health, reduce their pain and disorder levels, and increase their maximum mouth opening.

Application of invisible appliances without brackets in patients with periodontitis and malocclusion deformity

Liu Qian, An Nana, Hou Zhenting

2024, 30(23):  3905-3909.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.005

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Objective　To investigate the effect of invisible appliances without brackets on periodontal health in patients with periodontitis and malocclusion deformity. Methods　A total of 100 patients with periodontitis and malocclusion deformity treated at Hospital of Stomatology, Air Force Military Medical University from January 2022 to January 2024 were selected for the randomized controlled trail. The patients were divided into a control group and an observation group by the random number table method, with 50 cases in each group. There were 28 males and 22 females in the control group; they were (32.15±3.94) years old; their disease course was (25.45±4.16) months. There were 30 males and 20 females in the observation group; they were (32.52±3.88) years old; their disease course was (25.62±4.08) months. The control group were treated with straight wire appliances, and the observation group with invisible appliances without brackets. The therapeutic effects, periodontal health indicators [probing depth (PD), clinical attachment level (CAL), plaque index (PLI), and sulcus bleeding index (SBI)], gingival crevicular fluid inflammatory factors [interleukin-1β (IL-1β), interleukin-6 (IL-6), human matrix metalloproteinase 8 (MMP-8), and tumor necrosis factor-α (TNF-α)], appearance and function satisfaction, and incidence rates of complications were compared between the two groups. t and χ² tests were applied. Results　The total effective rate in the observation group was higher than that in the control group [96.00% (48/50) vs. 80.00% (40/50)], with a statistical difference (χ²=6.222; P=0.012). Before the treatment, there were no statistical differences in the PD, CAL, PLI, SBI, and levels of IL-1β, IL-6, MMP-8, and TNF-α between the two groups (all P>0.05). After the treatment, the PD, CAL, PLI, SBI, and levels of IL-1β, IL-6, MMP-8, TNF-α in the observation group were lower than those in the control group [(2.28±0.26) mm vs. (2.60±0.32) mm, (3.72±0.45) mm vs. (4.38±0.62) mm, (2.38±0.44) vs. (2.84±0.50), (1.80±0.27) vs. (2.12±0.34), (10.62±2.06) ng/L vs. (17.15±3.84) ng/L, (5.75±1.42) ng/L vs. (8.45±2.14) ng/L, (2 008.62±50.12) ng/L vs. (2 416.71±56.15) ng/L, and (15.55±2.12) ng/L vs. (25.87±3.17) ng/L], with statistical differences (t=5.487, 6.091, 4.883, 5.211, 10.596, 7.433, 38.339, and 19.135; all P<0.05). After the treatment, the aesthetic satisfaction of the observation group was higher than that of the control group [98.00% (49/50) vs. 82.00% (41/50)], with a statistical difference (χ²=7.111; P=0.008). The incidence rate of complications in the observation group was lower than that in the control group [2.00% (1/50) vs. 16.00% (8/50)], with a statistical difference (χ²=4.395; P=0.036). Conclusion　Invisible appliances without brackets for patients with periodontitis and malocclusion deformity can improve the therapeutic effect and their periodontal health, control the inflammatory factors in gingival crevicular fluid after treatment, reduce the occurrence of complications, and obtain satisfactory appearance, so it is worth being generalized.

Effects of one-time root canal filling using AH-Plus canal sealer and iRoot SP canal sealer in patients with chronic apical periodontitis

Wang Xiaomin, Guo Fang, Tian Ying

2024, 30(23):  3910-3914.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.006

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Objective　To compare the therapeutic effects of using epoxy resin-based canal sealer (AH-Plus) versus bioceramic iRoot SP in the root canal treatment for patients with chronic apical periodontitis. Methods　Ninety patients with chronic apical periodontitis treated in Department of Conservative Dentistry and Endodontics, Hospital Affiliated to Yan'an University from May 2021 to October 2022 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 45 cases in each group. There were 24 males and 21 females in the control group; they were (28.14±6.02) years old; their disease course was (3.26±0.92) months. There were 22 males and 23 females in the observation group; they were (26.55±5.78) years old; their disease course was (3.45±0.79) months. The control group took root canal treatment with AH-Plus sealer and warm vertical compaction of gutta-percha, while the observation group were treated with iRoot SP sealer and took warm vertical compaction of gutta-percha. The efficacies, pain scores [Visual Analog Scale (VAS)], masticatory function (masticatory efficiency and absorption values in masticatory tests) before and after the treatment, and patient satisfaction were compared between the two groups. t and χ² tests were applied. Results　The total effective rate in the observation group was higher than that in the control group [97.78% (44/45) vs. 73.33% (33/45)], with a statistical difference (χ²=10.879; P<0.001). The scores of VAS 12, 24, and 72 h after the treatment in the observation group were lower than those in the control group (1.52±0.19 vs. 2.35±0.26, 2.65±0.31 vs. 3.80±0.29, and 3.29±0.20 vs. 4.15±0.23), with statistical differences (t=15.142, 18.173, and 18.928; all P<0.05). There was no statistical difference in the mastication efficiency between the two groups before the treatment (P>0.05). After the treatment, the mastication efficiency in the observation group was higher than that in the control group [(85.21±11.22)% vs. (72.76±10.23)%], with a statistical difference (t=5.500; P<0.05). The total satisfaction rate with the treatment in the observation group was higher than that in the control group [95.56% (43/45) vs. 77.78% (35/45)], with a statistical difference (χ²=6.154; P=0.013). Conclusion　Compared with AH-Plus root canal sealer, iRoot SP canal sealer in root canal treatment for patients with chronic apical periodontitis is more effective and can reduce post-operative pain, and improve masticatory function and patient satisfaction.

Orthodontic treatment for children with traumatic tooth dislocation

Liu Zhenxia, Dong Yu, Yang Yifan

2024, 30(23):  3914-3918.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.007

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Objective　To analyze the effects of orthodontic treatment and manual reduction combined with arch splint fixation for children with traumatic tooth dislocation. Methods　Sixty children with traumatic tooth dislocation treated at Department of Stomatology, Xi'an Third Hospital from October 2021 to October 2022 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 30 cases in each group. There were 17 boys and 13 girls in the control group; they were (10.12±2.12) years old. There were 16 boys and 14 girls in the observation group; they were (10.76±1.98) years old. The control group took manual reduction combined with dental arch splint fixation, and the observation group orthodontic treatment. The treatment efficacies, incidence rates of complications, periodontal indicators [plaque index (PLI), gingival index (GI), and bleeding index (BI)], treatment satisfaction, and recurrence rates were compared between the two groups. t and χ² tests were used. Results　The total effective rate in the observation group was higher than that in the control group [96.7% (29/30) vs. 80.0% (24/30)], with a statistical difference (χ²=4.043; P=0.044). The incidence rate of complications in the observation group was lower than that in the control group [6.7% (2/30) vs. 26.7% (8/30)], with statistical difference (χ²=4.320; P=0.038). Before the treatment, there were no statistical differences in PLI, GI, and BI between the two groups (all P>0.05). After the treatment, the PLI, GI and BI in the observation group were lower than those in the control group (1.24±0.52 vs. 1.83±0.61, 0.73±0.33 vs. 1.21±0.52, and 0.73±0.33 vs. 1.21±0.40), with statistical differences (t=4.032, 4.269, and 5.070; all P<0.05). The scores of fixation quality, aesthetics, and comfort in the observation group were higher than those in the control group (8.13±1.56 vs. 6.34±1.45, 8.12±1.13 vs. 6.33±1.23, and 7.88±1.11 vs. 5.21±1.34), with statistical differences (t=4.603, 5.870, and 8.405; all P<0.05). The recurrence rates 3 months after the treatment in both groups were 0; the recurrence rates 6 months and 1 year after the treatment in the observation group were lower than those in the control group [3.3% (1/30) vs. 20.0% (6/30) and 6.7% (2/30) vs. 26.7% (8/30)], with statistical differences (χ²=4.043 and 4.320; both P<0.05). Conclusion　Orthodontic treatment for children with traumatic tooth dislocation is effective and can reduce the incidence of complications, maintain periodontal health, and improve the satisfaction, so it is worth being generalized.

Literature Analysis

Risk prediction model of perioperative hypothermia in patients with general anesthesia: a systematic review

Li Zimeng, Jiang Yaxin, Wei Tingyu, Jiang Weiting, Chen Bizhen

2024, 30(23):  3919-3924.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.008

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Objective　To systematically evaluate the model for predicting the risk of perioperative hypothermia in patients undergoing general anesthesia. Methods　The studies related to perioperative hypothermia risk prediction models for patients taking general anaesthesia were searched from China National Knowledge Infrastructure, China Biomedical Literature Database, Wanfang Database, Wikipedia Journal Library, PubMed, Web of Science, Embase, Cochrane Library, and Medline from their establishment to 12 March 2024. The investigators screened the literatures according to the inclusion and exclusion criteria, and 2 researchers independently carried out data extraction and quality assessment based on the Data Extraction Form for Predictive Modelling Studies and the Risk of Bias Assessment Tool. Results　A total of 22 studies containing 22 models were included; the area under the receiver operating characteristic curve (AUC)/C-index of 21 studies was 0.709-0.898; 1 study did not report the AUC. Age, body mass index, infusion volume/rehydration volume, operation time, operation room temperature, anesthesia time, and basal body temperature were the independent predictors reported repeatedly by the predictive model. 22 articles overall present a high risk of bias and good applicability. Conclusions　The existing prediction models for hypothermia risk in patients taking general anesthesia have good predictive performance, but there are methodological deficiencies and high bias risks. In the future, it is recommended to validate and update the existing models, refer to different legal studies to construct standardized risk prediction models for different populations.

New Medical Advances

Correlation between dry eyes and depression

Wang Lei, Gao Honglian, Zhang Fengyi, Sun Ruiting, Zhang Lei

2024, 30(23):  3925-3928.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.009

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Dry eye is a multifactorial ocular surface disease with tear film instability as its core feature. Its incidence rate is increasing year by year. The eye discomfort and visual impairment caused by dry eyes have a serious impact on the patients' work and life. Depression is a common affective disorder, and its incidence rate is also on the rise. Depression has become an important health and social problem at present. Depression is more common in patients with dry eyes than in general population, and dry eyes is also more common in depressed patients. At the same time, antidepressants are also related to the occurrence and development of dry eyes. Therefore, this article summarizes and analyzes these possible related factors, so as to study the correlation between dry eyes and depression and make a brief review.

Application and research progress of proton-pump inhibitors in stress ulcer after craniocerebral injury

Shi Shanping, Yan Qinqin, Qin Zhao, Wu Xue

2024, 30(23):  3929-3932.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.010

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Stress ulcer is a common complication of severe craniocerebral injury. Its incidence rate is high. It affects the treatment effectiveness and prognosis. This article reviews first-line proton-pump inhibitors in the prevention and treatment of stress ulcer after craniocerebral injury in recent years, summarizes the shortcomings and risk of researches on its prevention by proton pump inhibitors, so as to provide references for clinical reasonable medication and further research.

TATI comprehensive treatment mode for patients with advanced hepatocellular carcinoma

Wang Shan, Hao Jianbin, Zhao Jie, Hao Yanzhang

2024, 30(23):  3933-3936.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.011

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Hepatocellular carcinoma (HCC) is one of the common malignant tumors. Currently, the main treatment methods for HCC include liver transplantation, surgical resection, various percutaneous modalities, such as transarterial chemoembolization (TACE) and ablation, and systemic treatments, such as tyrosine kinase inhibitors (TKIs) and immune-checkpoint inhibitors (ICIs). The TATI comprehensive treatment mode is a new therapy that sequentially applies TACE, ablation, TKIs, and ICIs to patients with advanced HCC. Reviewing and analyzing the latest treatment advances for patients with advanced HCC in recent years, this article explores the feasibility and safety of the TATI comprehensive treatment mode, so as to provide references for clinical physicians.

Treatises

Exploring mechanism of Xihuang pills in treatment of gastric cancer based on network pharmacology and machine learning

Wang Lizhi, Chen Hongxi, Zhu Kanglian

2024, 30(23):  3937-3946.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.012

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Objective　To explore the potential mechanism of Xihuang pills in the treatment of gastric cancer (GC) based on network pharmacology and machine learning. Methods　All the data collection and analysis were conducted between November 2023 and August 2024. The study involved various stages, including data collection, gene target prediction, network model construction, and statistical analysis. The chemical composition data of Xihuang pills were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). The active ingredient targets were predicted using the Swiss Target Prediction and HERB databases. The disease-related targets were collected from GeneCard, and differential targets were filtered. The disease target genes were further filtered using the support vector machine (SVM) machine learning algorithm. The potential targets of Xihuang pills for gastric cancer were identified as the intersection of disease targets and active ingredient targets. Gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of the potential targets were performed using the clusterProfiler package. The active ingredients and potential targets were imported into the Cytoscape 3.10.0 software to construct a "drug-active ingredient-target" network. The topological analysis was performed to identify the core components of Xihuang pills in the treatment of gastric cancer. The LASSO regression was used to screen the core targets of Xihuang pills for gastric cancer. The Cibersort algorithm was employed for immune infiltration analysis of the core targets. The data were processed using the R 4.2.1 software, and statistical tests were conducted using t test and one-way analysis of variance. Results　A total of 41 active ingredients and 182 related targets were identified, with 2 410 gastric cancer-related genes and 119 intersecting genes. The GO enrichment analysis identified 2 049 GO terms (P<0.05); the KEGG pathway enrichment analysis revealed 177 KEGG signaling pathways (P<0.05). The network analysis of the "drug-active ingredient-target" revealed that quercetin might be a potential core component of Xihuang pills for gastric cancer. The LASSO regression identified CD36, GJA1, and SERPINE1 as potential core targets for Xihuang pills in the treatment of gastric cancer. The data analysis revealed that compared to normal samples, GJA1 and SERPINE1 genes were highly expressed in patients with gastric cancer (both P<0.01), while CD36 showed a trend of low expression (P<0.001); all the three had good diagnostic efficacy. The prognostic analysis indicated that higher expression levels of core targets were negatively correlated with patients' prognosis, meaning that the higher the expression levels of the core targets, the worse the prognosis. The immune infiltration analysis suggested that the development of gastric cancer is associated with the dysregulation of multiple immune cells. The core targets, CD36, GJA1, and SERPINE1, may alleviate the progression of gastric cancer regulating the infiltration of various immune cells. Conclusion　Xihuang Pills may exert therapeutic effects on gastric cancer through anti-inflammatory mechanisms and by regulating immune cell functions.

Mechanism of peony skin for improving hectic fever in rats with perimenopause syndrome based on hemorheology and calcitonin gene related peptide

Chen Wenjia, Wang Jie, Wang Yingzheng, Wang Yinghao, Huang Meixia

2024, 30(23):  3946-3950.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.013

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Objective　To explore the mechanism of peony skin for improving hectic fever in rats with perimenopause syndrome based on hemorheology indicators and calcitonin gene related peptide (CGRP). Methods　From September to December 2022, the basic research was did at Experimental Animal Center, Fujian University of Traditional Chinese Medicine. Forty female rats were divided into a sham operation group, a model group, a peony skin group, and a Qinggusan-positive group, with 10 in each group. Except for the sham operation group, the other 3 groups underwent bilateral ovariectomy; L-thyroxine(92 mg/kg) was given once a day, for 7 consecutive days starting on the 7th day after the operation to establish Yin-deficient perimenopause syndrome models. The sham operation group and the model group were orally administered an equal amount of distilled water; the peony skin group and the Qinggusan-positive group were orally administered peony skin (2.2 g/kg) and Qinggusan (7.3 g/kg), respectively, once a day, for a total of 14 d. One hour after the last administration, the rats were anesthetized, and their blood was collected; the hemorheology indicators were detected; the serum CGRP was detected by enzyme-linked immunosorbent assay (ELISA); the expression of receptor activity-modifying protein 1 (RAMP1) and calcitonin receptor-like receptor (CLR) mRNA in the rats' hypothalamuses were detected by reverse transcription-polymerase chain reaction (RT-PCR). The one-way analysis of variance was used for the statistical analysis. Results　The erythrocyte sedimentation rate, hematocrit, low-,medium-, and high-shear whole blood viscosities, content of serum CGRP, and the expression levels of hypothalamic RAMP1 and CLR mRNA in the model group were higher than those in the sham operation group (all P<0.05), and were significantly reversed by peony skin, with statistical differences (all P<0.05). Conclusion　Peony skin can improve the levels of CGRP, its receptor, and hemorheology in rats with perimenopause syndrome.

Value of contrast-enhanced ultrasound, DWI, and serum MAGEA3 and MAGEA4 in diagnosis of papillary thyroid carcinoma

Qi Li, Li Hao, Wu Bao

2024, 30(23):  3951-3956.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.014

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Objective　To investigate the value of contrast-enhanced ultrasound (CEUS), diffusion-weighted imaging (DWI), and serum melanoma-associated antigen A3 (MAGEA3) and melanoma-associated antigen A4 (MAGEA4) in the diagnosis of papillary thyroid carcinoma (PTC). Methods　This was a retrospective study. Eighty patients pathologically confirmed with PTC treated at Imaging Center, Ankang Hospital of Traditional Chinese Medicine between January 2022 and March 2024 were selected as a PTC group, including 32 males and 48 females who were (45.84±8.51) years old. Eighty patients with benign thyroid tumors were set as a control group, including 35 males and 45 females who were (44.62±7.50) years old. The serum levels of MAGEA3 and MAGEA4, CEUS characteristics, and apparent diffusion coefficient (ADC) values were compared between the two groups. The consistency of serum MAGEA3 and MAGEA4, CEUS, and DWI with pathological diagnosis was evaluated. t and χ² tests were used for the statistical analysis. Results　The serum levels of MAGEA3 and MAGEA4 in the PTC group were higher than those in the control group [(43.68±10.24) ng/L vs. (31.40±6.85) ng/L and (33.57±8.94) ng/L vs. (28.56±6.20) ng/L], with statistical differences (t=8.92 and 4.12; both P<0.05). The proportions of the patients with lymph node enlargement, calcification, heterogeneous echogenicity, unclear boundaries, and irregular shapes in the PTC group were higher than those in the control group [20.00% (16/80) vs. 3.75% (3/80), 60.00% (48/80) vs. 21.25% (17/80), 58.75% (47/80) vs. 35.00% (28/80), 47.50% (38/80) vs. 18.75% (15/80), and 72.50% (58/80) vs. 28.75% (23/80)], with statistical differences (χ²=10.09, 24.90, 9.06, 14.93, and 30.63; all P<0.05). Blood flow grading in the PTC group was mainly Ⅱ-Ⅲ, and that in the control group was mainly I-Ⅱ, with a statistical difference between the two groups (Z=44.91; P<0.05). The ADC value in the PTC group was significantly lower than that in the control group [(1.26±0.33)×10^-3mm²/s vs. (1.93±0.64)×10^-3mm²/s], with a statistical difference (t=8.32; P<0.05). The results of the receiver operating characteristic curve analysis showed that the sensitivities of CEUS, ADC, MAGEA3, and MAGEA4 in the diagnosis of PTC were 83.8%, 93.8%, 68.8%, and 53.7%, respectively; the specificities were 90.0%, 66.2%, 91.2%, and 85.0%, respectively; the areas under the curves (AUC) were 0.937, 0.819, 0.839, and 0.690, respectively. These findings demonstrate the high diagnostic accuracy of these indicators for PTC. When CEUS, ADC, MAGEA3, and MAGEA4 were combined, the sensitivity, specificity, AUC were 96.3%, 93.8%, and 0.990, respectively. Conclusions　Serum levels of MAGEA3 and MAGEA4 are elevated in patients with PTC. The combination of CEUS, DWI, and serum MAGEA3 and MAGEA4 has high clinical application value in the diagnosis of PTC and can improve diagnostic accuracy.

Influencing factors of effect of vitrectomy combined with scleral buckling for patients with open eyeball injury

Dong Youhui, Zhang Chengxia, Yu Meixia, Xu Kai

2024, 30(23):  3956-3961.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.015

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Objective　To analyze the influencing factors of the effect of vitrectomy combined with scleral buckling in the treatment of patients with open eyeball injury. Methods　A total of 167 patients with open eyeball injury treated at Department of Ophthalmology, Lianyungang First People's Hospital from January 2020 to July 2023 were selected as the study objects, including 176 males and 38 females. They were 25-59 (42.04±8.10) years old. All the patients underwent vitrectomy and scleral buckling surgery, and were divided into an effective treatment group and an ineffective treatment group based on the treatment effect. χ² test and t test were used for the statistical analysis. Ｍultivariate logistic regression was used to analyze the influencing factors of vitrectomy combined with scleral buckling in the treatment of the patients with open eyeball injury. Results　Among the 167 patients, 106 were effectively treated, with an effective rate of 63.47% (106/167). They were included in the treatment effective group. The rest 61 patients were ineffective, with an ineffective rate of 36.53% (61/167). They were included in the treatment ineffective group. The proportion of preoperative best corrected visual acuity (BCVA) <0.1, the proportion of injury zone Ⅲ, the proportion of injury type of intraocular foreign bodies, and the incidence  rate of endophthalmitis in the treatment ineffective group were higher than those in the effective treatment group [68.85% (42/61) vs. 49.06% (52/106), 26.23% (16/61) vs. 12.26% (13/106), 52.46% (32/61) vs. 33.02% (35/106), and 54.10% (33/61) vs. 33.96% (36/106); the proportion of surgery timing between 7-14 d in the treatment ineffective group was lower than that in the treatment effective group [77.05% (47/61) vs. 91.51% (97/106)]; the length of the wound in the treatment ineffective group was longer than that in the treatment effective group [(4.21±0.42) mm vs. (3.96±0.36) mm]; there were statistical differences (χ²=6.17, 6.92, 7.02, 6.48, and 6.83; t=4.06; all P<0.05). The multivariate logistic regression analysis showed that preoperative BCVA <0.1 (OR=2.174, 95%CI 1.012-4.672), wound length (OR=5.224, 95%CI 1.936-14.100), injury zone Ⅲ (OR=4.064, 95%CI 1.517-10.884), injury type of intraocular foreign bodies (OR=3.236, 95%CI 1.425-7.350), and endophthalmitis (OR=2.879, 95%CI 1.346-6.161) were the risk factors for the effect of vitrectomy combined with scleral buckling in the treatment of the patients with open globe injury; the surgery timing between 7-14 d (OR=0.225, 95%CI 0.064-0.788) was a protective factor for the effect of vitrectomy combined with scleral buckling in the treatment of the patients with open eyeball injury (all P<0.05). Conclusion　Preoperative BCVA, wound length, injury zone, injury type, endophthalmitis, and surgery timing are the influencing factors for the effect of vitrectomy combined with scleral buckling in the treatment of patients with open eyeball injury.

Clinical Research

Effect of Sanshen Jiangxiao capsules combined with metformin in treatment of patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease

Wang Lulu, Qi Haiyan, Wang Gaolei, Hang Cheng, Ke Ting, Shi Hanfei, Xiao Yang

2024, 30(23):  3962-3966.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.016

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Objective　To study the effects of Sanshen Jiangxiao capsules combined with metformin on glucose and lipid metabolism and liver function in patients with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD). Methods　Ninety-four patients with type 2 diabetes mellitus and NAFLD treated at Shaanxi Provincial Hospital of Traditional Chinese Medicine from October 2022 to October 2023 were selected as the study objects, and were divided into a control group and a study group by the random number table method, with 47 cases in each group. There were 27 males and 20 females in the control group; they were (49.04±3.63) years old; their diabetic course was (5.35±0.74) years; there were 12 cases of mild fatty liver and 35 cases of moderate fatty liver. There were 23 males and 24 females in the study group; they were (50.41±3.04) years old; their diabetic course was (5.14±0.75) years; there were 17 cases of mild fatty liver and 30 cases of moderate fatty liver. The control group took metformin, once a day; the initial oral dose was 0.5 g; the blood glucose was detected every week; if the blood glucose was still high, the dose could be gradually increased; the highest dose was 1.0 g per time, twice a day; after the blood glucose was under control, the dose was reduced to 0.5 g per time, twice a day and maintained. On the basis of the control group, the study group orally took 6 Sanshen Jiangxiao capsules per time, 3 times/d. Both groups were treated for 3 months. The clinical efficacies, changes of blood glucose indicators (glycosylated hemoglobin, fasting blood glucose, and 2-hour postprandial blood glucose), blood lipids (high density lipoprotein cholesterol, low density lipoprotein cholesterol, triacylglycerol, and total cholesterol), liver function (aspartate aminotransferase, alanine aminotransferase), and quantitative parameters of liver ultrasound (liver echo failure coefficient and liver-kidney echo ratio) before and after the treatment, and safety were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　The total effective rate of the study group was higher than that of the control group [85.11% (40/47) vs. 69.96% (31/47)], with a statistical difference (χ²=4.663; P=0.031). There were statistical differences in glucose and lipid metabolism, liver function, and quantitative parameters of liver ultrasound in both groups between before and after the treatment (all P<0.05). After the treatment, the levels of the glycated hemoglobin, fasting blood glucose, 2-hour postprandial blood glucose, low-density lipoprotein cholesterol, triglyceride, total cholesterol, and high density lipoprotein in the study group were better than those in the control group [(7.02±0.73)% vs. (7.64±0.78)%, (5.49±0.81) mmol/L vs. (6.08±0.73) mmol/L, (8.04±1.14) mmol/L vs. (9.28±1.17) mmol/L, (1.37±0.16) mmol/L vs. (2.41±0.36) mmol/L, (1.24±0.27) mmol/L vs. (1.86±0.35) mmol/L, (4.10±0.63) mmol/L vs. (5.17±0.74) mmol/L, and (1.18±0.24) mmol/L vs. (1.03±0.21) mmol/L], with statistical differences (all P<0.05); the levels of aspartate aminotransferase, alanine aminotransferase in the study group were lower than those in the control group [(33.42±4.12) U/L vs. (40.87±5.14) U/L, (34.18±4.05) U/L vs. (38.56±5.73) U/L], with statistical differences (all P<0.05); the attenuation coefficient of liver echo and the ratio of liver and kidney echo in the study group were lower than those in the control group [(1.01±0.11) dB vs. (1.20±0.17) dB and 1.14±0.15 vs. 1.29±0.27], with statistical differences (both P<0.05). No adverse reactions occurred in both groups during the treatment. Conclusion　Sanshen Jiangxiao capsules combined with metformin for patients with type 2 diabetes mellitus and NAFLD is effective and safe, and can reduce blood glucose and lipids and protect liver function.

Value of contrast-enhanced ultrasound combined with MSCT in diagnosis of liver cirrhosis complicated with small liver cancer

Ma Hongjuan, Zhang Tianci, Zhong Yuqin

2024, 30(23):  3967-3972.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.017

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Objective　To evaluate the value of contrast-enhanced ultrasound (CEUS) combined with multi-slice spiral CT (MSCT) in the diagnosis of cirrhosis complicated with small liver cancer. Methods　The clinical data of 97 patients with cirrhosis and focal lesions treated at Xincheng District Hospital of Traditional Chinese Medicine from October 2021 to October 2023 were retrospectively analyzed. According to the pathological results, they were divided into an observation group (52 patients with cirrhosis and small liver cancer) and a control group (45 patients with cirrhosis hyperplasia nodules). In the observation group, there were 30 males and 22 females; they were (45.87±6.74) years old; their lesion size was (1.95±0.37) cm; Child liver function classification: 43 cases were grade A, and 9 cases were grade B. In the control group, there were 27 males and 18 females; they were (46.91±7.62) years old; their lesion size was (1.89±0.35) cm; Child liver function classification: 40 cases were grade A, and 5 cases were grade B. All the patients underwent CEUS examination and MSCT examination. Pathological examination was used as the gold standard to analyze the consistency of CEUS, MSCT, and their combination with the gold standard in the diagnosis of cirrhosis complicated with small liver cancer. The diagnostic values of CEUS, MSCT, and the combination of CEUS and MSCT for diagnosing cirrhosis complicated with small liver cancer were analyzed. t test and χ² test were used for the statistical analysis. Results　CEUS was consistent with the gold standard in the diagnosis of cirrhosis complicated with small liver cancer in some degree (Kappa=0.628; P<0.05). CEUS combined with MSCT was consistent with gold standard in the diagnosis of cirrhosis complicated with small liver cancer (Kappa=0.855; P<0.05). The regional blood volumes (RBV) in the delayed stage and portal vein stage in the observation group were lower than those in the control group [(472.68±49.83)ml vs. (745.21±78.16) ml and (1 257.61±138.94)ml vs. (1 485.79±186.27)ml; both P<0.05]. The arterial regional blood flower (RBF) and RBV in the arterial stage in the observation group were higher than those in the control group [(65.96±7.67)ml vs. (46.12±4.83)ml and (3 472.97±458.21)ml vs. (1 526.58±272.30)ml; both P<0.05]; there were no statistical differences in RBF in the delay stage and portal vein stage between the two groups (both P>0.05). The peak intensity (PI) in the observation group was higher than that in the control group (64.81±7.62 vs. 53.20±5.45; P<0.05); the time to peak (TTP) and arrival time (AT) in the observation group were shorter than those in the control group [(28.19±4.65) s vs. (63.41±7.93) s and (14.26±4.82) s vs. (19.78±5.84) s; both P<0.05]. There were no statistical differences in the CT values in the delayed stage and plain scan stage between the two groups (both P>0.05). The CT value in the portal vein stage in the observation group was lower than that in the control group (62.45±6.74 vs. 83.21±8.95; P<0.05). The CT value in the arterial stage in the observation group was higher than that in the control group (108.49±11.92 vs. 65.38±7.21; P<0.05). The areas under the curves (AUC) of CEUS, MSCT, and their combination in the diagnosis of cirrhosis complicated with small liver cancer were 0.815, 0.845, and 0.928, respectively; the AUC of their combination was higher (P<0.05). Conclusion　CEUS and MSCT have some value in the diagnosis of cirrhosis complicated with small liver cancer, and their combination has higher diagnostic value.

Changes and clinical significance of serum levels of miR-135b-5p and miR-126-3p in pregnant women with preeclampsia

Tong Lajuan, Xu Weiwei, Ma Meng, Wang Jing

2024, 30(23):  3972-3977.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.018

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Objective　To investigate the changes of the serum levels of microRNA-135b-5p (miR-135b-5p) and microRNA-126-3p (miR-126-3p) in pregnant women with preeclampsia (PE) and their clinical significance. Methods　Adopting a retrospective study. From February 2020 to February 2022, 89 patients with PE treated at Second Hospital, Shaanxi University of Chinese Medicine were selected as a study group who were (27.28±2.94) years old and whose body mass index (BMI) was (22.72±2.45) kg/m²; 89 normal pregnant women were selected as a control group who were (26.49±2.76) years old and whose BMI was (22.84±2.12) kg/m². The patients were divided into a mild group (58 cases) and a severe group (31 cases) according to the severity of the disease. The patients were divided into a good group (52 cases) and a adverse group (37 cases) according to the adverse pregnancy outcomes a such as intrauterine distress, premature delivery, neonatal asphyxia, fetal death, low weight infants, macrosomia, etc. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was applied to detect the expression levels of miR-135b-5p and miR-126-3p. t and χ² tests were performed to compare the data between the two groups. Pearson correlation was carried out to analyze the correlation of the serum levels of miR-135b-5p and miR-126-3p with systolic blood pressure, diastolic blood pressure, and proteinuria in the patients. Multivariate logistic regression was used to analyze the factors affecting PE degree. The diagnostic value of the patients with severe PE and the predictive value of adverse pregnancy outcomes in the patients were analyzed using the receiver operating characteristic curve (ROC). Results　The serum levels of miR-135b-5p and miR-126-3p in the study group were lower than those in the control group (0.69±0.14 vs. 1.07±0.23 and 0.65±0.13 vs. 1.08±0.25), with statistical differences (both P<0.05). The serum levels of miR-135b-5p and miR-126-3p in the study group were lower than those in the mild group (0.49±0.11 vs. 0.79±0.15 and 0.53±0.12 vs. 0.71±0.14), with statistical differences (both P<0.05). The serum levels miR-135b-5p and miR-126-3p in the good group were lower than those in the adverse group (0.53±0.12 vs. 0.81±0.18 and 0.52±0.11 vs. 0.75±0.15), with statistical differences (both P<0.05). The Pearson correlation analysis showed that of miR-135b-5p was negatively correlated with systolic blood pressure, diastolic blood pressure, and proteinuria (r=-0.492, -0.612, and -0.522; all P<0.05); miR-126-3p was negatively correlated with systolic blood pressure, diastolic blood pressure, and proteinuria (r=-0.519, -0.481, and -0.626; all P<0.05). Multivariate logistic regression analysis revealed that low levels of miR-135b-5p and miR-126-3p were risk factors for severe PE (both P<0.05). According to the ROC analysis, the areas under the curves (AUC) of the combination of miR-135b-5p and miR-126-3p for the diagnosis of the patients with severe PE and the prediction of adverse pregnancy outcomes were 0.948 and 0.952, respectively, which were higher than those of either indicator (both P<0.05). Conclusion　The expression levels of miR-135b-5p and miR-126-3p in the serum of patients with PE decrease, and are related to the development of PE and adverse pregnancy outcomes. The combination of the two has high diagnostic value for patients with severe PE and predictive value for adverse pregnancy outcomes.

Risk factors of carbapenem-resistant Pseudomonas aeruginosa infection in critically ill elderly patients

Liu Qibo, Cai Donghao, Mei Chuangchuang, Li Xiaojun

2024, 30(23):  3978-3982.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.019

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Objective　To investigate the risk factors of carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection in critically ill elderly patients, and to establish a prediction model and validate it. Methods　The demographic and clinical data of 148 critically ill patients with CRPA infection treated at Guangdong Provincial Second Hospital of Traditional Chinese Medicine from January 2018 to December 2023 were collected, including the patients' gender, age, whether they were complicated with respiratory failure, cardiac insufficiency, hypertension, cerebral infarction, and other underlying diseases, and calcitoninogen, D-dimer, white blood cell count, hemoglobin, platelet count, blood urea, blood creatinine, blood glucose, glutamine transaminase, total protein, total bilirubin, and other laboratory data within 24 h after infection. The patients were divided into a young group (44 cases) and an old group (104 cases) according to their age. The young group was 18-65 (51.0±13.0) years old, and the old group ≥65-103 (79.8±8.0). The risk factors for the prognosis of CRPA infection were determined by univariate and multivariate logistic regression analyses using χ² test, t test, etc. The variables were screened by the LASSO regression, and were constructed into a nomogram prediction model. The model was evaluated using the area under the receiver operating characteristic curve (AUC), the standard curve, and the decision curve analysis (DCA). Results　Complicated with cardiac insufficiency and cerebral infarction, decreased hemoglobin and platelet count during infection, blood urea, blood creatinine, blood glucose, and calcitonin were the risk factors for CRPA infection in the critically ill elderly patients (all P<0.05). Complicated with cerebral infarction (OR=5.537; 95%CI 2.226-13.769) and decreased platelet count (OR=0.994; 95%CI 0.991-0.998) were the independent risk factors for CRPA infection in the critically ill elderly patients. Complicated with cerebral infarction and platelet count were screened according to LASSO regression to construct a nomogram prediction model. The model's AUC was 0.784; the calibration curve showed a 45° angle, so it had a good calibration ability; the clinical decision curve showed that the model had high net benefit in the range of 60%-90% treatment threshold probability. Conclusions　The variables used to construct the model are simple and effective. The constructed model has good differentiation and accuracy, and has good predictive value for CRPA infection in critically ill elderly patients. Timely intervention for high-risk groups within a certain range can result in good clinical benefits.

Effect of general anesthesia with nalbuphine and fentanyl for patients undergoing radical gastric cancer surgery

Ma Yafang, Chen Zhifu, Yan Anjun

2024, 30(23):  3983-3987.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.020

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Objective　To investigate the effect of general anesthesia with nalbuphine and fentanyl for patients undergoing radical gastric cancer surgery. Methods　A total of 120 patients undergoing radical gastrectomy for gastric cancer at Baoji People's Hospital from January to December 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 60 cases in each group. There were 37 males and 23 females in the control group; they were (61.56 ± 4.21) years old; there were 12 cases of TNM stage I, 35 cases of stage Ⅱ, and 13 cases of stage Ⅲ; there were 14 cases of grade I of American Society of Anesthesiologists (ASA), 31 cases of grade Ⅱ, and 15 cases of grade Ⅲ. There were 31 males and 29 females in the observation group; they were (60.49 ± 4.37) years old; there were 18 cases of TNM stage I, 32 cases of stage Ⅱ, and 10 cases of stage Ⅲ; there were 19 cases of grade I of ASA, 30 cases of grade Ⅱ, and 11 cases of grade Ⅲ. The control group was anesthetized with fentanyl and normal saline, and the observation group with nalbuphine and fentanyl. The stress response indicators, vital signs, pain severities at different time points, sleep quality, and adverse events were compared between the two groups.χ² test, t test, and analysis of variance were used for the statistical analysis. Results　Forty-eight hours after the operation, the levels of superoxide dismutase, aldosterone, cortisol, and renin in the observation group were lower than those in the control group [(95.71±5.30) U/ml vs. (97.95±5.52) U/ml, (86.18±5.26) ng/L vs. (88.36±5.43) ng/L, (22.41±2.35) pg/L vs. (23.38±2.49) pg/L, and (0.75±0.17) μg/L vs. (0.83±0.26) μg/L], with statistical differences (t=2.267, 2.234, 2.194, and 1.995; all P<0.05); the mean arterial pressure, heart rate, and saturation of peripheral oxygen in the observation group were higher than those in the control group [(82.67±3.34) mmHg (1 mmHg=0.133 kPa) vs. (81.43±3.25) mmHg, (82.89±3.32) beats/min vs. (81.67±3.21) beats/min, and (90.32±3.43)% vs. (89.09±3.31)%], with statistical differences (t=2.061, 2.046, and 1.999; all P<0.05); the scores of the 7 items of Pittsburgh Sleep Quality Index in the observation group were better than those in the control group, with statistical differences (t=2.534, 2.263, 2.254, 2.383, 2.401, 2.214, and 2.509; all P<0.05). The postoperative analgesic effect of the observation group was better than that of the control group (F=21.701, P_{between groups}<0.001; F=67 557.071, P_time<0.001; F=7.953, P_interaction<0.05). The incidence rate of adverse events in the observation group was lower than that in the control group [3.33% (2/60) vs. 15.00% (9/60); χ²=4.904; P<0.05]. Conclusion　General anesthesia with nalbuphine and fentanyl during radical gastric cancer surgery can not only stabilize the patients' vital signs and reduce the stress response, but also can achieve good analgesic effect and improve their sleep quality, and is safe.

Xiaochaihu decoction for patients with mild recurrent oral ulcer of Shaoyang Shishu type

Liu Qiliang, Li Bi'e, Shao Haibin, Leng Chang'e, Xia Changpu, Mai Xi

2024, 30(23):  3988-3991.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.021

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Objective　To assess the clinical effect of Xiaochaihu decoction in the treatment of patients with mild recurrent oral ulcer (ROU) of Shaoyang Shishu type. Methods　A total of 120 patients with mild ROU of Shaoyang Shishu type treated at Huadu District Maternity and Child Health Hospital 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 60 cases in each group. There were 20 males and 40 females in the control group; they were (41.42±0.41) years old; their disease course was (2.53±0.26) years. There were 22 males and 38 females in the observation group; they were (39.78±0.66) years old; their disease course was (2.11±0.71) years. Both groups were treated with Kangfuxin liquid; in addition, the observation group took Xiaochaihu decoction. The efficacies, ulcer healing time after 7 days' treatment, irritation pain duration, changes of the scores of traditional Chinese medicine (TCM) symptoms, and recurrence rates within six months after the treatment were compared between the two groups. t and χ² tests were applied. Results　The total effective rate in the observation group was higher than that in the control group [88.3% (53/60) vs. 71.7% (43/60)], with a statistical difference (χ²=5.208; P=0.022). The irritation pain duration and ulcer healing time in the observation group were shorter than those in the control group [(2.67±0.34) d vs. (4.55±0.61) d and (4.24±0.21) d vs. (7.68±0.87) d], with statistical differences (t=20.852 and 29.773; both P<0.05). After 7 days' treatment, the difference of TCM score in the observation group was lower than that in the control group (5.66±0.82 vs. 8.41±1.21), with a statistical difference (t=14.573; P<0.001). The recurrence rate within six months after the treatment in the observation group was lower than that in the control group [41.67% (25/60) vs. 80.00% (48/60)], with a statistical difference (χ²=18.502; P<0.001). Conclusion　Xiaochaihu decoction for patients with mild recurrent oral ulcer of Shaoyang Shishu type can relieve their local and systemic symptoms, and decrease the recurrence rate.

Relationship of serum levels of GDF-15 and PPARγ with coagulation indicators and prognosis in patients with early-onset preeclampsia

Tang Mingbo, Pan Yongheng, Lan Zhaoyang

2024, 30(23):  3992-3996.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.022

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Objective　To explore the relationship of serum levels of growth differentiation factor 15 (GDF-15) and peroxisome proliferator-activated receptor γ (PPARγ) with coagulation indicators in patients with early-onset preeclampsia and their impact on prognosis. Methods　Seventy-six patients with early-onset preeclampsia treated at Ankang Maternal and Child Health Hospital from May 2020 to May 2023 were selected as a study group, and 75 healthy pregnant women during the same period a control group. The serum levels of GDF-15 and PPARγ were measured using the enzyme-linked immunosorbent assay. The coagulation function indicators [activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), and fibrinogen (FIB)] were detected. The patients were followed up for their prognosis. The correlation of the levels of GDF-15 and PPARγ with coagulation function was analyzed by the Pearson product coefficient. The predictive values of GDF-15, PPARγ, and coagulation indicators for the severity of preeclampsia were analyzed using the receiver operating characteristic curve (ROC). χ² and t tests were used for the statistical analysis. Results　The levels of GDF-15, PPARγ, and FIB in the severe group, the preeclampsia group, and the control group sequentially decreased, while the APTT, TT, and PT sequentially increased, with statistical differences (all P<0.05). The levels of GDF-15 and PPARγ were significantly correlated with coagulation indicators (all P<0.05). The area under the curve of the combination of these indicators was 0.779, with a sensitivity of 75.0% and a specificity of 80.0%. The levels of GDF-15 and PPARγ in the patients with good prognosis were lower than those in the patients with poor prognosis (both P<0.05). Conclusion　Serum levels of GDF-15 and PPARγ are elevated in patients with early-onset preeclampsia and are related to abnormal coagulation function, making them potential biomarkers for early diagnosis and prediction of adverse outcomes.

Effect of dexmedetomidine on inflammatory response, myocardial injury, and insulin resistance in elderly patients with diabetes mellitus

Zhang Borui, Chen Baoyu, Fan Long, Chang Jianhua, Shan Bing, Liu Shengnan

2024, 30(23):  3996-4000.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.023

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Objective　To investigate the effect of dexmedetomidine on inflammatory response, myocardial injury, and insulin resistance in elderly patients with diabetes mellitus. Methods　Eighty-four elderly diabetic patients taking selective orthopedic lower limb surgical treatment at Shaanxi Provincial People's Hospital from July 2022 to April 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 42 cases in each group. There were 23 males and 19 females in the observation group; they were (71.84±4.01) years old; 24 cases had surgery on the left sides, and 18 the right sides. There were 25 males and 17 females in the control group; they were (71.44±4.05) years old; 22 cases had surgery on the left sides, and 20 the right sides. All the patients took intravenous-inhalation combined anesthesia. The observation group took injection of dexmedetomidine after anaesthesia induction, and the control group equal volume of saline. The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), phosphocreatine kinase isoenzymes (CK-MB), and troponin I (cTnI) and insulin sensitive indexes (ISI) before using tourniquets (T0), 30 min after using tourniquets (T1), and 15 (T2) and 60 min (T3) after loosening tourniquets, extubation times, ICU stays, and hospital stays were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　At T1, T2, and T3, the levels of TNF-α, IL-6, CK-MB, and cTnI were higher than those at T0 in both groups; the levels of TNF-α [(26.25±3.36) ng/L vs. (29.96±4.07) ng/L, (28.25±3.69) ng/L vs. (34.46±4.42) ng/L, and (26.94±3.24) ng/L vs. (30.05±4.12) ng/L], IL-6 [(318.65±36.63) ng/L vs. (354.27±41.69) ng/L, (352.45±42.42) ng/L vs. (414.49±46.68) ng/L, and (369.77±45.54) ng/L vs. (440.52±58.18) ng/L], CK-MB [(26.22±3.25) U/L vs. (30.11±4.06) U/L, (30.09±3.22) U/L vs. (48.87±5.52) U/L, and (45.54±5.09) U/L vs. (58.59±6.12) U/L], and cTnI [(0.04±0.02) μg/L vs. (0.06±0.02) μg/L, (0.08±0.02) μg/L vs. (0.12±0.03) μg/L, and (0.11±0.04) μg/L vs. (0.22±0.05) μg/L] in the observation group were lower than those in the control group, with statistical differences (t=4.555, 6.989, 3.845, 4.159, 6.374, 6.205, 4.847, 19.045, 10.624, 4.582, 7.189, and 11.133; all P<0.05). At T1, T2, and T3, the ISI's were lower than those at T0 in both groups; the ISI's in the observation group were higher than those in the control group (0.006±0.002 vs. 0.004±0.001, 0.004±0.001 vs. 0.002±0.001, and 0.011±0.005 vs. 0.004±0.001), with statistical differences (t=5.796, 9.165, and 8.896; all P<0.05). The extubation time, ICU stay, and hospital stay in the observation group were shorter than those in the control group [(2.75±0.62) h vs. (4.19±0.94) h, (16.88±2.27) h vs. (22.26±3.63) h, and (15.22±2.63) d vs. (20.19±4.46) d], with statistical differences (t=8.287, 8.143, and 6.220; all P<0.05). Conclusion　Pretreatment with dexmedetomidine in orthopedic lower limb surgery for elderly diabetic patients can inhibit their inflammatory response and oxidative stress, reduce tourniquet-related myocardial injury, control blood glucose and insulin resistance, and promote their postoperative recovery, so it is worthy of promotion.

Effect of fumigation with Shire Duqing decoction combined with diphenyl cream for patients with perianal eczema

Lin Wanlin, Chen Wenping, Qin Yue, Huangfu Ruirui

2024, 30(23):  4001-4005.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.024

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Objective　To explore the effect of fumigation with Shire Duqing decoction combined with diphenyl cream for patients with perianal eczema. Methods　One hundred and ninety-six patients with perianal eczema treated at Xi'an Daxing Hospital from January 2022 to July 2023 selected for the randomized controlled trial, and were divided into an observation group and a control group by the random number table method, with 98 cases in each group. There were 51 males and 47 females in the control group; they were (39.15±5.26) years old; their disease course was (5.78±1.62) weeks. There were 46 males and 52 females in the observation group; they were (37.82±5.08) years old; their disease course was (5.41±1.38) weeks. The control group were treated with diphenyl cream. The observation group were treated with diphenyl cream and fumigation with Shire Duqing decoction. After 3 weeks' treatment, the severities of eczema, scores of traditional Chinese medicine syndromes, levels of inflammation and immune factors [interleukin-4 (IL-4), interferon gamma (INF-γ), and immunoglobulin E (IgE)], quality of life and psychological resilience, efficacies, adverse reactions, and recurrence rates were compared between the two groups. χ² and t tests were used. Results　The treatment effective rate of the observation group was higher than that of the control group [94.90% (93/98) vs. 83.67% (82/98)], with a statistical difference (χ²=6.453, P=0.011). After the treatment, the scores of anal itching, eczema area, perianal exudate, main symptoms, and secondary syndromes, the levels of IL-4, INF-γ, and IgE, and the scores of Dermatology Life Quality Index (DLQI) and Connor-Davidson Resilience Scale (CD-RISC) in the observation group were better than those in the control group [1.44±0.31 vs. 1.61±0.33, 1.47±0.21 vs. 1.59±0.34, 1.39±0.29 vs. 1.52±0.41, 6.21±1.83 vs. 7.59±1.73, 2.57±0.43 vs. 3.16±0.51, 2.07±0.35 vs. 2.41±0.29, (30.62±4.83) ng/L vs. (34.91±5.27) ng/L, (35.14±5.71) ng/L vs. (32.56±4.95) ng/L, (561.34±79.62) U/ml vs. (584.28±61.37) U/ml, 6.04±1.51 vs. 7.72±1.39, and 67.34±7.21 vs. 62.48±6.05], with statistical differences (all P<0.05). The recurrence rate of the observation group was lower than that of the control group [14.29% (14/98) vs. 29.59% (29/98)], with a statistical difference (χ²=6.703, P=0.010). No serious adverse reactions were observed in both groups. Conclusion　Shire Duqing decoction combined with diphenyl cream for patients with perianal eczema can alleviate their symptoms, such as itching and skin lesions, inhibit inflammatory reactions, improve therapeutic effect, and reduce the recurrence rate.

Modified Xiao Jianzhong decoction in treatment of patients with centrally mediated abdominal pain syndrome of spleen and stomach deficiency-cold type

Huang Jinhong, Li Weizhi

2024, 30(23):  4006-4009.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.025

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Objective　To observe the clinical efficacy of modified Xiao Jianzhong decoction for patients with centrally mediated abdominal pain syndrome (CAPS) of spleen and stomach deficiency-cold type. Methods　Sixty-eight patients with CAPS of spleen and stomach deficiency-cold type treated at Baoji Chencang Hospital from September 2021 to August 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 34 cases in each group. There were 18 males and 16 females in the control group; they were (49.97±9.35) years old; their disease course was from 6 months to 8 years. There were 15 males and 19 females in the observation group; they were (51.68±11.83) years old; their disease course was from 6 months to 10 years. The control group were given routine clinical treatment, such as regulating intestinal function, antispasmodic, probiotics to regulate intestinal flora, etc. and took doxorubicin for anxiolytic treatment. The observation group took Xiao Jianzhong decoction. The scores of pain scale and Hamilton Anxiety Scale (HAMA), life quality, therapeutic effects, and adverse reactions were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　After 4 weeks' treatment, the scores of pain scale and HAMA in the observation group were lower than those in the control group (2.47±0.83 vs. 4.03±1.00 and 6.26±2.26 vs. 9.21±2.19; both P<0.05). The effective rate in the observation group was higher than that in the control group [94.12% (32/34) vs. 73.53% (25/34); P=0.021]. The incidence rate of adverse reactions in the observation group was lower than that in the control group [17.65% (6/34) vs. 76.47% (26/34); P<0.05]. The score of life quality in the observation group was higher than that in the control group (88.94±1.59 vs. 79.56±2.05; P<0.05). Conclusion　Modified Xiao Jianzhong decoction for patients with CAPS of spleen and stomach deficiency-cold type can effectively alleviate their symptoms, improve their life quality, with better overall effectiveness and a lower incidence rate of adverse reactions.

Efficacy of daglipzin combined with insulin degludec and liraglutide injection in treatment of patients with diabetic nephropathy and poor blood glucose control

Chen Ying, Duan Shuangli, Li Li

2024, 30(23):  4009-4014.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.026

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Objective　To observe the effect of dagliprazin combined with insulin degludec and liraglutide injection in the treatment of patients with diabetic nephropathy (DN) and poor blood glucose control. Methods　A total of 167 patients with DN and poor blood glucose control treated at Hanzhong Nanzheng District People's Hospital from February 2022 to February 2024 were selected for the randomized controlled trial, and were divided into a study group (83 cases) and a control group (84 cases) by the random number table method. There were 47 males and 36 females in the study group; they were (57.39±8.16) years old; their disease course was (12.51±2.23) years; there were 48 cases of DN stage Ⅱ and stage 35 cases of stageⅢ. There were 50 males and 34 females in the control group; they were (56.47±8.23) years old; their disease course was (12.36±2.19) years; there were 51 cases of DN stage Ⅱ and 33 cases of stage Ⅲ. The study group were treated with dagliprazin and insulin degludec and liraglutide injection, and the control group with dagaglizin and insulin glargine, for 3 months. The clinical efficacies, renal function, blood glucose, markers of renal injury, peripheral blood cytokines, and the incidence rates of adverse drug reactions were compared between the two groups by t and χ² tests. Results　Before the treatment, there were no statistical differences in the levels of serum creatinine (Scr) and blood urea nitrogen (BUN) and urine albumin-to-creatinine ratio (UACR) between the two groups (all P>0.05). After the treatment, the levels of Scr and BUN and UACR in the study group were lower than those in the control group [(65.24±8.93) μmol/L vs. (76.12±10.43) μmol/L, (6.23±1.12) mmol/L vs. (8.04±1.41) mmol/L, and (92.32±14.26) mg/g vs. (106.21±18.35) mg/g], with statistical differences (all P<0.05). Before the treatment, there were no statistical differences in the levels of fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPBG), and glycosylated hemoglobin (HbA1c) between the two groups (all P>0.05). After the treatment, the levels of FBG, 2hPBG, and HbA1c in the study group were lower than those in the control group [(6.14±0.76) mmoL/L vs. (7.01±0.89) mmoL/L, (8.16±1.49) mmol/L vs. (9.32±1.73) mmol/L, and (5.21±0.59)% vs. (5.82±0.68)%], with statistical differences (all P<0.05). Before the treatment, there were no statistical differences in the levels of N-acetyl-β-D-glucosidase (NAG), retinol-binding protein (RBP), and neutrophil gelatinase-associated lipocalin (NGAL) between the two groups (all P>0.05). After the treatment, the levels of NAG, RBP, and NGAL in the study group were lower than those in the control group [(15.12±2.54) U/L vs. (18.84±3.01) U/L, (1.08±0.21) mg/L vs. (1.37±0.26) mg/L, and (51.26±8.13) μg/L vs. (62.13±10.28) μg/L], with statistical differences (all P<0.05). Before the treatment, there were no statistical differences in the levels of free fatty acid (FFA) and peroxisome surge activator receptor γ (PPARγ) between the two groups (both P>0.05). After the treatment, the levels of FFA and PPARγ in the study group were lower than those in the control group [(9.03±1.76) μg/L vs. (11.26±2.51) μg/L and (1 306.49±201.43) ng/L vs. (1 148.52±159.47) ng/L], with statistical differences (both P<0.05). The total effective rate of the study group was higher than that of the control group [85.54% (71/83) vs. 70.24% (59/84); P<0.05]. The incidence rates of adverse drug reactions in the study group and the control group were 6.02% (5/83) and 4.76% (4/84), respectively, with no statistical difference (P>0.05). Conclusion　Dagliprazin combined with insulin degludec and liraglutide injection in the treatment of patients with DN and poor blood glucose control is effective, can improve their renal function, blood glucose, markers of kidney injury, and peripheral blood cytokines, and does not increase adverse drug reactions.

Component analysis and metabolic evaluation of patients with urinary calculi in Huishui area

Gao Wei, Wang Rujiang, Xiang Ping, Yang Li, Du Xianliang, Yang Ruiji, Luo Xiang, Chen Long

2024, 30(23):  4015-4018.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.027

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Objective　To analyze the components of calculi and metabolic evaluation of patients with urinary calculi in Huishui area. Methods　From January 2023 to July 2024, the components of calculi and 24-hour urine analysis results of 226 patients with urinary calculi in Huishui area were analyzed. Among the 226 patients, there were 148 males and 78 females; they were (48.7±6.9) years old. The χ² test was used for the statistical analysis. Results　Among the 216 cases who took component analysis, 74 cases (34.26%) were identified as calcium oxalate calculi, 17 cases (7.87%) uric acid calculi, and 4 cases (1.85%) calcium phosphate calculi; a total of 121 cases (56.02%) presented various types of mixed calculi. Among the 226 cases who took 24-hour urine analysis, 220 cases (97.35%) had abnormal metabolism; there were 20 cases (8.85%) of hypercalciuria, 179 cases (79.20%) of hypomagnesuria, 35 cases (15.49%) of hypernatriuria, 12 cases (5.31%) of hyperuricosuria, 1 case (0.44%) of hyperphosphaturia, and 76 cases of low urine volume; 94 cases (41.59%) had 1 abnormal metabolism, 71 cases (31.42%) 2, 7 cases (3.10%) 3, and 3 cases (1.33%) 4. Conclusion　The prevalence of urinary calculi in Huishui area is associated with the local environment, water quality, and metabolic disorders.

Case Report

One case of primary alveolar soft part sarcoma of cervix and literature review

Xu Yinghan, Qi Jing, Zhang Jiaqi, Qiao Qi, Yu Ning

2024, 30(23):  4019-4021.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.028

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Primary alveolar soft part sarcoma of cervix is very rare. This article reports one case of primary alveolar soft part sarcoma of cervix and review the related literatures, so as to explore this disease's clinicopathological characteristics, immunophenotype, and differential diagnosis and to improve clinical and pathological doctors' knowledge on it.

One case of primary pulmonary small cell ovarian carcinoma and literature review

Yi Lijun, Fan Wenlan, Li Yunrong, Li Hong

2024, 30(23):  4022-4025.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.029

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This paper reports a case of primary pulmonary small cell carcinoma of the ovary and reviews the relevant literatures. Under the microscope, the cells are small or medium, and round, with sparse cytoplasm, deep nuclear staining, obscure nucleolus, and frequent mitotic images. Neuroendocrine markers, CgA, Syn, CD56, and INSM1, are positively expressed, while Vimentin and WT1 are negatively expressed; it is helpful for the diagnosis and differential diagnosis. The main treatment option is surgery with chemotherapy, but the prognosis is poor, with most patients dying within 2 years after diagnosis.

Nursing Research

Effect of optimized method of Streptomyces proteinolytic on nursing dispensing efficiency before gastroscopy

Rao Ting, Zhang Lihua

2024, 30(23):  4026-4029.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.030

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Objective　To investigate the effect of three different methods on the dissolution of streptomyase protease and improve the efficiency of nursing dispensing before gastroscopy. Methods　In Center of Digestive Endoscopy, Fifth Hospital, Sun Yat-sen University in March 2024, the traditional stirring method, closed container shock method, and electric stirring method were used to dissolve 20 000 U streptomycin + 1 g sodium bicarbonate + 50 ml water mixture, respectively, with 30 experiments in each group. The observation indicator was the time taken for the liquid powder to completely dissolve. t test was used. Results　The electric stirring method was the best method, and was better in time than the traditional stirring method and the closed container shock method. The single part configuration time was (118.3±5.0) s by the traditional stirring method, (40.0±3.5) s by the closed container shock method, and (25.0±4.0) s by the electric stirring method. The average time of the electric stirring method was 93.3 seconds less than that of the traditional stirring method; the average time of the electric stirring method was 15.0 seconds less than that of the closed container shock method; the difference was statistically significant (P<0.001). The 10-person configuration time by the traditional stirring method was (199.8±12.5) s; the time by the closed container shock method was (79.7±5.0) s; the time by the electric stirring method was (39.8±6.0) s. The average time of the electric stirring method was 160.0 seconds less than that of the traditional stirring method; the average time of the electric stirring method was 39.9 seconds less than that of the closed container shock method; the difference was statistically significant (P<0.001). Conclusion　The electric stirring method can effectively reduce the time of dispensing before gastroscopy and improve the efficiency of nursing work.

Psychological capital appreciation of patients with type 2 diabetes mellitus and its influencing factors

Yu Yueqin, Yang Qi

2024, 30(23):  4030-4032.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.031

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Impact of a nurse-led multidisciplinary collaborative management model on postoperative survival quality of patients with laryngeal cancer

Tang Lijun, Chen Jinhui, Liu Liang, Xiao Yili

2024, 30(23):  4033-4037.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.032

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Objective　To explore the impact of the multidisciplinary collaborative management model led by nurses on the postoperative survival quality of patients with laryngeal cancer. Methods　The patients with laryngeal cancer treated at Hunan Provincial People's Hospital from April 2023 to March 2024 were selected as the research objects and divided into two groups according to the admission time. The 30 patients treated from October to September 2023 were set as a control group, including 28 males and 2 females who were (63.47±8.92) years old. The 32 patients treated from October 2023 to March 2024 were set as an experimental group, including 31 males and 1 females who were (63.22±9.08) years old. The control group received routine nursing care for laryngeal cancer surgery; in addition, the experimental group was given a multidisciplinary collaborative management model led by nurses. The survival quality and self-efficacies within 6 months after surgery and the satisfaction one month after surgery were compared between the two groups. The independent sample t test, χ² test, and rank sum test were used. Results　Six months after surgery, the scores of survival quality and self-efficacy in the experimental group were higher than those in the control group (1 029.28±28.17 vs. 915.27±19.63 and 34.28±3.29 vs. 29.67±4.16), with statistically differences (both P<0.05). The satisfaction rate one month after surgery of the experimental group was higher than that of the control group [100.0% (32/32) vs. 93.3% (28/30)], with a statistical difference (P=0.035). Conclusion The nurse-led multidisciplinary collaborative nutritional management model for patients with laryngeal cancer is conducive to improving their survival quality after surgery, self-efficacy, and nursing satisfaction.

Application effect of comprehensive nursing intervention in atomizing inhalation treatment for patients with chronic obstructive pulmonary disease and respiratory failure

Lu Jing, Wang Peipei, Wang Xiaodong, Liang Ying, Yang Meiju

2024, 30(23):  4038-4043.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.033

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Objective　To analyze the application effect of comprehensive nursing intervention for patients with chronic obstructive pulmonary disease (COPD) and respiratory failure treated by atomizing inhalation. Methods　A total of 96 patients with COPD and respiratory failure who received atomization inhalation at Shangqiu First People's Hospital from October 2021 to September 2023 were selected. They were divided into a reference group and an experimental group according to the nursing methods, with 48 cases in each group. There were 20 males and 28 females in the reference group; they were (66.78±9.14) years old; their disease course was (5.06±1.12) years. There were 18 males and 30 females in the experimental group; they were (66.81±9.13) years old; their disease course was (4.95±1.02) years. Both groups took atomization inhalation therapy. The reference group took routine nursing. The experimental group took comprehensive nursing intervention, including psychological nursing, respiratory tract nursing, postural nursing, life management, and rehabilitation guidance. Both groups took drug therapy and nursing intervention for 7 d. Follow-up was 3 months. The lung function, blood gas analysis indicators, and quality of life before and after the intervention, treatment compliance, nursing satisfaction, and incidence rates of complications were compared between the two groups. t and χ² tests were used. Results　After the intervention, the forced vital capacity, forced expiratory volume in first second, and peak expiratory flow in the experimental group were higher than those in the reference group [(3.65±0.52) L vs. (3.21±0.53) L, (2.65±0.32) L vs. (2.31±0.42) L, and (82.72±6.23) L/min vs. (78.80±5.81) L/min, with statistical differences (t=4.105, 4.461, and 3.188; all P<0.05). After the intervention, arterial blood carbon dioxide partial pressure, arterial blood oxygen pressure, and pH value in the experimental group were better than those in the reference group [(50.05±3.52) mmHg (1 mmHg=0.133 kPa) vs. (61.49±4.03) mmHg, (70.05±6.32) mmHg vs. (60.01±5.92) mmHg, and (7.42±0.33) vs. (7.30±0.21)], with statistical differences (t=14.812, 8.032, and 2.125; all P<0.05). The treatment compliance and nursing satisfaction of the experimental group were higher than those of the reference group [100.0% (48/48) vs. 89.58% (43/48) and 97.92% (47/48) vs. 85.42% (41/48)]; the incidence rate of complications in the experimental group was lower than that in the reference group [4.17% (2/48) vs. 20.83% (10/48); there were statistical differences between the two groups (χ²=5.274, 4.909, all 6.095; all P<0.05). Follow-up was 3 months, the scores of physiological function, physiological function, physical pain, general health, vitality, social function, emotional function, and mental health in the experimental group were higher than those in the control group (80.05±6.52 vs. 71.10±5.41, 81.05±6.32 vs. 72.08±5.22, 82.72±6.23 vs. 71.45±5.06, 81.88±6.02 vs. 71.45±4.06, 82.76±6.61 vs. 73.08±5.01, 83.70±6.58 vs. 72.69±5.53, 86.91±6.21 vs. 75.65±5.31, and 85.05±5.52 vs. 76.10±4.41), with statistical differences (t=7.318, 7.581, 9.728, 9.951, 8.085, 8.874, 9.547, and 8.776; all P<0.05). Conclusion　In the treatment of patients with COPD and respiratory failure by atomization inhalation, comprehensive nursing intervention can improve their pulmonary function, arterial blood gas indicators, quality of life, treatment compliance, and satisfaction with nursing service, and reduce the risk of complications.

Consistency of two venous thrombosis risk assessment scales for inpatients with tumors

Gan Haili, Shi Limei, Li Lirong, Liang Juan, Ban Zhixin

2024, 30(23):  4043-4046.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.034

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Objective　To explore the consistency of Padua Scale and Khorana Scale in the assessment of venous thromboembolism risk in inpatients with tumors, and to provide references for choosing an appropriate scale for assessing venous thromboembolism risk in inpatients with tumors. Methods　One hundred and thirty-six cancer patients who were admitted to People's Hospital of Guangxi Zhuang Autonomous Region from May to July 2022 were selected for the retrospective analysis, including 76 males and 60 females who were (52.72±15.00) years old. The risk of venous thromboembolism was assessed by both the Padua Scale and the Khorana Scale. The detected rates of thromboembolism risk by the two scales were compared by the χ² test. The consistency of the results of the two scales was analyzed by the Kappa test. Results　The detected rates by the Padua Scale and Khorana Scale on the risk of venous thromboembolism in the patients were 43.38% (59/136) and 41.18% (56/136), respectively, with no statistical difference (P>0.05). The concordance rate of the two scales in the assessment of the risk of venous thromboembolism in the patients was 90.44% (123/136), and the Kappa value was 0.804 (P<0.01), with good concordance. Conclusions　The two scales, Padua and Khorana, have high consistency in the risk assessment of venous thromboembolism in inpatients with tumors. Both can be used as the evaluation criteria for the risk assessment of venous thromboembolism in inpatients with tumors.

Application of peripherally inserted central catheters through different catheterization approaches in premature infants

Chen Jinmei

2024, 30(23):  4047-4050.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.035

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Objective　To explore and analyze the application effects of peripherally inserted central catheters (PICC) through different catheterization approaches (upper and lower limb catheterization) in premature infants. Methods　One hundred and twenty premature infants who took PICC catheterization at Guangdong Maternal and Child Health Hospital from June 2023 to August 2024 were selected for the prospective study. According to the catheterization approaches (upper and lower limb catheterization), they were divided into a study group and a control group, with 60 cases in each group. The study group had 60 males and 21 females; their gestational age was (28.0±2.3) weeks; the catheterization weight was (1.46±0.20) kg. The control group had 60 males and 22 females; their gestational age was (29.0±2.2) weeks; the catheterization weight was (1.35±0.10) kg. The study group took catheterization through lower limb veins, and the control group through upper limb veins. The operation times, bleeding volumes, catheter retention times, incidence rates of complications, success rates of catheterization at one time, one successful puncture rate, and ectopic incidence rates were compared between the two groups by t and χ² tests. Results　The catheterization operation time, puncture point bleeding volume, and catheter retention time in the study group were better than those in the control group [(24.62±2.11) min vs. (32.53±2.29) min, (1.01±0.20) ml vs. (1.98±0.55) ml, and (16.50±4.10) d vs. (14.60±4.20) d], with statistical differences (all P<0.05). The success rate of catheterization and successful puncture rate at one time in the study group were higher than those in the control group [98.33% (59/60) vs. 88.33% (53/60) and 98.33% (59/60) vs. 75.00% (45/60)], with statistical differences (both P<0.05). The incidence rates of complications and the ectopic rate in the study group were lower than those in the control group [5.00% (3/60) vs. 16.67% (10/60) and 3.33% (2/60) vs. 13.33% (8/60)], with statistical differences (both P<0.05). Conclusion　PICC catheterization lower through limb veins has fewer complications, better safety, and a higher success rate, so it the first choice for PICC catheterization.

Auricular beans combined with external application of Chinese medicine Reyanbao for patients with abdominal distension after colorectal surgery

Xu Fen, Deng Changmao, Gao Hefei, Li Wenfang, Jiang Xiaochun

2024, 30(23):  4050-4053.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.036

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Preventive Medicine

Epidemiological characteristics of hand-foot-mouth disease at Panyu District, Guangzhou from 2014 to 2023

Chen Lushan, Huang Guifeng, Yang Yanjun

2024, 30(23):  4054-4058.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.037

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Objective　To analyze the epidemiological characteristics of hand-foot-mouth disease at Panyu District, Guangzhou from 2014 to 2023, and to provide references for formulating prevention and control measures. Methods　The epidemic data and demographic data of hand-foot-mouth disease at Panyu District, Guangzhou were collected from the Chinese Disease Prevention and Control Information System-Surveillance Report Management. SPSS 25.0 was used for the statistical analysis. The χ² test was used for the comparison of categorical variables. Results　From 2014 to 2023, a total of 84 193 cases of hand-foot-mouth disease at Panyu District, Guangzhou were reported, with an average annual incidence rate of 336.04/100 000 and with no case of severe disease and no death case; the incidence rate in 2014 was the highest (509.00/100 000); the incidence rate in 2020 was the lowest (69.20/100 000). There was a statistical difference in the incidence rate between different years (χ²=14 744.597; P<0.001). There were cases reported in each month; the peak incidence mainly occurred from May to July. There was a statistical difference in the average annual incidence rate between different towns and streets (χ²=997.536; P<0.001). The male-to-female ratio was 1.45:1; the reported incidence rates were 422.67/100 000 and 283.38/100 000, respectively (χ²=3 305.453; P<0.001). The top three cases were 55 442 scattered children, 23 778 nursery children and 3 952 students, accounting for 65.85%, 28.24% and 4.69% of the total reported cases, respectively. Most cases were <3 years old [57.01% (47 995/84 193)]. The incidence rates in the 1≤-2 years old group [27.62% (23 257/84 193)], the 2≤-3 years old group [19.01%(16 005/84 193)], and the 3≤-4 years old group [17.92% (15 088/84 193)] were the top three. The incidence rates in the scattered children [65.85% (55 442/84 193)], the children in childcare agencies [28.24% (23 778/84 193)], and students [4.69% (3 952/84 193)] were the top three. From 2014 to 2023, 4.61% of the cases reported the results of pathogenic detection; Enterovirus 71, Coxsackievirus A16, and other enteroviruses accounted for 21.80% (846/3 880), 17.24% (669/3 880), and 60.95% (2 365/3 880), respectively; there was a statistical difference in the detection rate of the three pathogens between different years (χ²=909.414; P<0.001). A total of 6 outbreaks were reported; 125 related cases were reported, accounting for 18.18% of the total number of reported public health emergencies (33 cases) of Class C infectious diseases in the surveyed areas, and all of them occurred in kindergartens. Conclusions　From 2014 to 2023, the incidence of hand-foot-mouth disease at Panyu District, Guangzhou was generally characterized by a high incidence in alternate years, with obvious seasonal and population distribution characteristics. The pathogenic surveillance of preschool children and key areas should be strengthened; correpsonding health education should be carried out to improve the child caregivers' knowledge level of disease prevention and control.

Medical Education

Application of CBL teaching method and online courses in teaching clinical medicine professional masters

Huang Shuai, Linghu Xitao, Huang Weihua, Li Jinjie, Huang Yan, Yin Huinan

2024, 30(23):  4059-4063.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.038

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Objective　To explore the effect of the application of case-based learning (CBL) teaching method and online courses in teaching clinical medicine professional masters. Methods　Sixty clinical medicine professional masters at Guangzhou Medical University from June to September 2023 were selected for the randomized controlled trial, and were divided into a control group, including 14 males and 16 females who were 23-25 years old, and an experimental group, including 15 males and 15 females who were 23-25 years old, by the random number table method, with 30 ones in each group. The control group used the traditional teaching mode, while the experimental group used the CBL teaching method combined with online course mode. After the teaching, the learning satisfaction and clinical and scientific research abilities of the two groups were evaluated. The independent-sample t test and χ² test were used for the statistical analysis. Results　The scores of theoretical knowledge, practical skills, and clinical assessment in the experimental group were higher than those in the control group (85.33±4.72 vs. 7.50±6.12, 83.70±1.51 vs. 77.43±4.85, and 85.90±3.95 vs. 76.10±4.13), with statistical differences (all P<0.05). Conclusion　The application of the CBL teaching method combined with online course mode in teaching clinical medicine professional masters can improve their clinical and scientific research abilities.

An attempt to reform online and offline mixed teaching in medical laboratory continuing education based on 5G mobile network

Chen Bo, Huang Haiying, Zhou Qiang, Ji Tianxing, Lin Zhen, Chen Jingnan

2024, 30(23):  4063-4066.  DOI: 10.3760/cma.j.issn.1007-1245.2024.23.039

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Using the 5G mobile internet network resources and creating a learning multimedia resource network platform, students can learn independently online and interact with teachers. A series of related teaching webpages are created concentrating teaching related content, materials, and after-school tests, and are stored on the school website to carry out various teaching forms of learning and real-time communication. Students can use the school website to preview before class and review after class, conduct self-tests, and engage in online discussions and exchanges with classmates and teachers. Due to the relatively simple production technology and process of teaching webpages, the addition, deletion, and modification of the courseware content are relatively easy to implement. The advantages of online teaching combined with the characteristics of traditional teaching are fully leveraged, and a mixed teaching approach to cultivate clinical operational skills of medical laboratory students is adopted.