Table of Content

01 April 2022, Volume 28 Issue 7

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Postgraduates

Relationship of acute cerebral infarction with Hcy, NF-κB, and MCP-1

Wang Yao, He Wen

2022, 28(7):  889-893.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.001

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Ischemic stroke seriously endangers human health and is the primary cause of death or disability in China. The early treatment is very important for the prognosis of ischemic stroke patients. Thrombolytic and intravascular therapies are the most effective treatment for vascular recanalization, and can save cerebral ischemic penumbra to the greatest extent, but cerebral reperfusion injury is still inevitable. The mechanism of inflammatory injury is an important part of cerebral ischemia-reperfusion injury; therefore, it is of great significance to actively reduce the excessive inflammatory reaction of ischemic brain tissue. Evidences have shown that homocysteine (Hcy), nuclear factor-κB (NF-κB), and monocyte chemotactic protein-1 (MCP-1) are closely related to acute cerebral infarction and inflammatory injury after ischemic stroke. This article reviews the research progress on the relationship of acute ischemic stroke with Hcy, NF-κB, and MCP-1, so as to provide new ideas for alleviating cerebral ischemia-reperfusion injury and improving the patients' prognosis.

Exercise compliance in patients with type 2 diabetes mellitus

Zhu Yingyi, Wang Hui, Lyu Weibo, Cheng Kangyao

2022, 28(7):  894-897.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.002

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Exercise is one of the important means to prevent the occurrence and progression of type 2 diabetes mellitus. Exercise compliance is affected by a variety of controllable or uncontrollable factors, and intervention and management tools are gradually developing in the direction of digitalization. This study reviews the current status of exercise compliance in patients with type 2 diabetes mellitus, analyzes exercise compliance and its influencing factors, and proposes intervention strategies to improve exercise compliance from a nursing perspective and to provide references for exercise behavior promotion in patients with type 2 diabetes mellitus.

Research progress of semaglutide in treatment of obesity

Xing Guoqing, Yu Suguo

2022, 28(7):  898-901.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.003

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Obesity has become a serious public health crisis in the whole world, and its incidence is increasing. Obesity and a series of concurrent diseases bring huge burden to the health care system. How to lose weight more effectively has become a hot spot in today's society, and it is difficult to control body weight only by life intervention. Therefore, anti-obesity drugs as an auxiliary means have received widespread attention, but relatively few drugs have been approved for weight loss. Semaglutide, a new glucagon-like peptide-1 receptor agonist (GLP-1RA), has the advantages of long half-life and high stability as compared with traditional GLP-1RA. This article focuses on the research progress of semaglutide in the treatment of obesity, which provides a new choice for reducing obesity.

Scientific Research

Effect of type 2 diabetes mellitus on leptomeningeal collateral circulation in patients with acute cerebral infarction

Chen Jianjun, Chen Qiaoqiong, Mei Zhizhong, Huang Xiaoyun, Yu Yingli, Lin Han, Huang Yihong, Liao Wang

2022, 28(7):  902-907.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.004

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Objective　To investigate the effect of type 2 diabetes mellitus on leptomeningeal collateral circulation in patients with acute cerebral infarction. Methods　Ninety-four type 2 diabetes patients with acute ischemic cerebral infarction and occlusion or over 85% stenosis of anterior cerebral artery, middle cerebral artery, and internal carotid artery treated at Houjie Hospital from March 1, 2020 to June 30, 2021 were selected as a diabetes and cerebral infarction group, including 51 males and 43 females, and they were (65.02±14.15) years old. Ninety-four patients with acute ischemic cerebral infarction of similar occlusion or stenosis and of similar age were selected as a control group, including 48 males and 46 females, and they were (68.20±12.63) years old. Regional leptomeningeal collateral (rLMC) score was used as an indicator to evaluate the leptomeningeal collateral circulation. The scores of National Institute of Health Stroke Scale (NIHSS) and Alberta Stroke Program Early CT Score (ASPECTS) of the two groups were evaluated. The related factors, such as the age of onset, blood pressure, blood glucose, cholesterol, low-density lipoprotein cholesterol (LDL-C), smoking history, drinking history, and histories of cerebral infarction and coronary heart disease, were compared and analyzed. The correlation regression analysis was carried out. Results　The rLMC score, NIHSS score at admission, and ASPECTS score were (11.55±5.22), (11.99±8.57), and (5.26±2.45) in the diabetes and cerebral infarction group, and were (14.02±4.88), (10.03±8.75), and (6.27±2.53) in the control group, with statistical differences (P=0.001, 0.123, and 0.006). There were statistical differences in blood glucose, smoking history, and drinking history but not in the other indicators at admission between the two groups. Spearman correlation analysis of rLMC score showed that rLMC was significantly correlated with NIHSS score (r=-5.790, P<0.001) and ASPECTS score (r=0.556, P<0.001). Systolic pressure (r=0.207, P=0.045) and diastolic pressure (r=0.213, P=0.040), cholesterol (r=0.244, P=0.018), and LDL-C (r=0.215, P=0.037) were all statistically significant. Age (r=-0.089, P=0.392) and blood glucose (r=-0.292, P=0.120) were not statistically significant. Multiple regression showed that only ASPECTS and NIHSS scores were statistically associated with rLMC. Conclusions　Type  2  diabetes not only significantly affects the establishment of leptomeningeal collateral circulation in patients with acute ischemic cerebral infarction, but also affects the volume of cerebral infarction and the disease severity. In addition to the effects of type  2  diabetes on leptomeningeal collaterals, it is possible that arterial blood pressure (systolic and diastolic pressures), cholesterol, and LDL-C are associated with perfusion of leptomeningeal collateral circulation.

Correlation between traditional Chinese medicine syndromes of Wangbi disease and pro-inflammatory factors

Zhang Yuqiong, Cui Hongwei, Yu Lei, Li Guohua, Lyu Xingliang

2022, 28(7):  907-911.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.005

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Wangbi disease was first proposed by the modern physician Professor Jiao Shude. It is a further embodiment of rheumatoid arthritis in the field of traditional Chinese medicine after the "Bizheng", "Lijie", and "Hexifeng". From the earliest record of the disease in the Huang Di Nei Jing to the present, after more than two thousand years, Wangbi disease is still one of the diseases recognized by the medical community that it is difficult to completely cure. Major doctors constantly improve the syndrome types of this disease based on their own clinical experiences. It was not until 2018 that Guidelines for the Diagnosis and Treatment of Rheumatoid Arthritis had the most comprehensive eight types of syndromes. Among them, five kinds of empirical evidences are cold and wet bi syndrome, rheumatism syndrome, hot and humid bi resistance certificate, blood stasis syndrome, and sputum stasis syndrome, and three kinds of deficiency evidences are Qi Yin deficiency certificate, Qi and blood deficiency certificate, and liver and kidney deficiency certificate. From a macro perspective, traditional Chinese medicine has achieved remarkable results under the guidance of the principles of syndrome differentiation and treatment. Western medicine believes that the occurrence and development of this disease are closely related to pro-inflammatory factors from a microscopic view, and the expressions of many pro-inflammatory factors vary in the different types of traditional Chinese medicine syndromes. This article summarizes the relationship between traditional Chinese medicine syndromes and pro-inflammatory factors in the pathogenesis of Wangbi, discusses the role of traditional Chinese medicine in the treatment of Wangbi disease development on inflammatory factors, in order to have a guiding effect on traditional Chinese medicine syndrome differentiation and combined traditional Chinese medicine and western medicine, and further improve the patients' survival quality.

Effect of ginsenoside Rg3 on hepatocellular carcinoma

Tang Linlin, Li Hongying, Liu Wenshan, Ding Chuanhua

2022, 28(7):  912-916.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.006

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According to the GLOBOCAN data in 2018, liver cancer ranked fourth in the number of malignant tumors and second in the number of deaths. It is recommended that patients with advanced hepatocellular carcinoma are treated with traditional Chinese medicine. Ginsenoside Rg3 is a rare ginsenoside of tetracyclic triterpenoid damarane type, and has 20 (R) and 20 (S) enantiomers. Shenyi capsule, a new anticancer drug with ginsenoside Rg3 monomer as the main component, was marketed in 2003, and is mainly used in the adjuvant treatment of lung cancer and liver cancer. Ginsenoside Rg3 has been proved to have good anti-liver cancer activity in vitro and in vivo. The mechanism of ginsenoside Rg3 against hepatocellular carcinoma is multiplex, including inducing apoptosis of hepatocellular carcinoma cells, inhibiting invasion and metastasis of hepatocellular carcinoma cells, inhibiting angiogenesis, reversing drug resistance, regulating autophagy, and enhancing immune function. In this review, the preclinical and clinical research progress of ginsenoside Rg3 in the treatment of hepatocellular carcinoma was reviewed so as to provide references for the subsequent research.

Clinical experience of treating fever

Liu Zhilong, He Jing, Li Chongyu

2022, 28(7):  916-919.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.007

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Fever refers to the temperature ≥37.3 ℃, beyond the normal range; and although the body temperature is within the range < 37.3 ℃, but one has conscious body heat or hotness and other uncomfortable performance. This paper systematically summarized the experience of applying traditional Chinese medicine in the diagnosis and treatment of fever. Based on the clinical syndromes high and low fevers and on the main concomitant symptoms, the syndrome basis is provided for syndrome differentiation and treatment, and the efficient prescription mainly based on traditional Chinese medicine is applied.

Application of evidence-based case study in standardized training of residents

Bie Fengjie, Lai Milin, Xu Biao, Wang Lei, Liu Xiaoyan

2022, 28(7):  920-923.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.008

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Objective To explore the application effect of evidence-based case study in the standardized training of clinical residents in a department of mammary gland. Methods  A total of 24 regular trainees in Department of Mammary Gland, Second Affiliated Hospital of Guangzhou University of Chinese Medicine from April to December 2021 were divided into a control group and an experimental group according to when they started to worked at this department. The control group had 11 ones, including 4 males and 7 females, and took the traditional teaching method. The experimental group had 13 ones, including 6 males and 7 females, and did the teaching of evidence-based case study. The teaching effects of the two groups were evaluated through the questionnaire survey and graduation examination results. The measurement data of normal distribution were compared between these two groups by independent-sample t test, and the count data by χ² test. Results  There were no statistical differences in the scores of graduation examination, subjective questions, and objective questions (all P>0.05). The experimental group had higher praise on the teaching of evidence-based case study than the control group on the traditional teaching; the scores of study interest, clinical thought, achieving information, self-evidence in receiving patients, and questioning in the experimental group were higher than those in the control group [(6.08±2.02) vs. (4.00±1.55), (6.62±1.66) vs. (4.00±1.34), (7.00±1.35) vs. (5.00±1.48), (6.23±1.92) vs. (3.45±1.37), and (6.23±1.92) vs. (4.00±1.90)], with statistical differences (all P<0.05). Conclusion  The teaching of evidence-based case study for regular trainees in a department of mammary gland can improve their self-teaching and problem-solving abilities.

Detection of allergens in patients with allergic diseases at a traditional Chinese hospital in Guangzhou

Deng Chao, Shen Sujing, Liang Ming, Zhu Zhuojun

2022, 28(7):  924-928.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.009

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Objective　To analyze the allergens in patients with allergic diseases. Methods　The allergen specific immunoglobulin E (IgE) antibodies in 507 patients treated at Department of Pediatrics, Department of Respiratory Medicine, and Department of Otolaryngology at Guangdong Second Hospital of Traditional Chinese Medicine from November 2019 to October 2020 were detected by the immunoblotting. The allergen distribution and statistical differences were analyzed by χ². Results　Among the 507 patients, there were 267 males and 240 females, and they were 2-90 years old. Four hundred and two patients were positive in the allergen detection, with a positive rate of 79.4% (212/267) in the male and a positive rate of 79.2% (190/240) in the female, and there was no statistical difference between the male and the female (χ²=0.82, P>0.05). There were statistical differences in the positive rate between the age groups (χ²=36.92, P<0.05) and between seasons (χ²=45.60, P<0.05). The positive rate of inhaled allergens was higher than that of ingested allergens; the main inhaled allergens were household dust mites [62.2% (250/402)] , dust mites [56% (225/402)], and cockroaches [50% (201/402)], and the main ingested allergens were egg white [22.9% (92/402) and milk [19.9% (80/402)]. Conclusions　The main allergens in patients at Guangdong Second Hospital of Traditional Chinese Medicine are household dust mites , dust mites, milk, egg white, and cockroaches. There are differences between age groups, and seasons.

Effect of laparoscopic exercise combined with body position therapy in relieving non-incision pain after laparoscopic surgery

Wen Guixiang, Fan Cailian, Huang Suchang

2022, 28(7):  929-933.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.010

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Objective　To investigate the clinical effect of laparoscopic exercise combined with body position therapy in relieving non-incision pain after laparoscopic surgery. Methods　This was a clinical intervention study. The subjects were 90 patients who completed laparoscopic surgery in Department of Gynecology, Guangdong Second Traditional Chinese Medicine Hospital from July 2019 to July 2021. The 90 patients with non-incision pain after laparoscopic surgery were divided into a control group, an observation group 1, and an observation group 2 by the random number talbe method, with 30 cases in each group. The control group was (34.36±4.25) years old, the observation group 1 was (35.41±3.26) years old, and the observation group 2 was (34.48±3.56) years old. The control group was routinely given dietary guidance, exercise guidance, psychological care, etc.; the observation group 1 took knee-chest lying position on the basis of the control group; and the observation group 2 did laparoscopic exercise under instruction on the basis of observation group 1. The differences in pain score, pain duration, and nursing satisfaction after non-incision pain intervention after laparoscopic surgery were compared between the three groups. ANOVA , χ² ,and rank sum test were applied. Results　There were statistical differences in the pain scores 6, 24, and 48 h after the intervention between the 3 groups (F=26.824, 28.577, and 43.037; all P<0.001). There were statistical differences in the pain duration between the control group and the observation group 1 (χ²=7.460, P=0.024), between the observation group 1 and the observation group 1 (χ²=0.543, P=0.762), and between the control group and the observation group 2 (χ²=11.416, P=0.003). The nursing satisfaction was 90.0% (27/30) in the control group, 96.7% (29/30) in the observation group 1, and 100.0% (30/30) in the observation group 2, with statistical differences between the control group and the observation group 1 (Z=-2.065, P=0.039) and between the observation group 1 and the observation group 2 (Z=-2.051, P=0.040). Conclusions　Laparoscopic exercise combined with body position therapy can significantly relieve non-incision pain after laparoscopic surgery, shorten the duration of pain, and improve patients' nursing satisfaction. The operation is simple, costs no money, and has no side effects, so it is worthy of widespread clinical application and promotion.

Effects of different trigger methods on pregnancy outcomes of IVF-ET in patients with polycystic ovary syndrome

Liu Wei, Xu Dandan, Tong Jie, Ren Jianzhi

2022, 28(7):  933-936.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.011

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Objective　To compare the effects of different trigger methods on the pregnancy outcomes of in vitro fertilization and embryo transfer (IVF-ET) in patients with polycystic ovary syndrome. Methods　Two hundred and fifty-five patients with polycystic ovary syndrome who took IVF-ET assisted fertilization in Reproductive Medicine Center, Hospital of 73rd Army Group of Land Force, People's Liberation Army of China were retrospectively analyzed. According to the trigger methods, they were divided into a human chorionic gonadotropin (HCG) trigger group (HCG trigger group; 81 cases) and a gonadotropin releasing hormone agonist (GnRH-a) combined with a low dose of HCG trigger group (combined trigger group; 174 cases). The general data, numbers of eggs obtained, numbers of available embryos, rates of MⅡ eggs, clinical pregnancy rates, sustained pregnancy rates, early abortion rates, and incidences of ovarian hyperstimulation syndrome (OHSS) were compared between the two groups.t and χ² tests were applied. Results　There were no statistical differences in the number of eggs obtained, the number of available embryos, the rate of MⅡ eggs, the rate of clinical pregnancy, the rate of sustained pregnancy, and the rate of early abortion between the two groups (all P>0.05). The total incidence of OHSS of the combined trigger group was 6.17% (5/81), which was lower than that of the HCG trigger group (0), with a statistical difference (χ²=10.956，P=0.001). Conclusion　In patients with polycystic ovary syndrome undergoing a fresh cycle IVF-ET, GnRH-a combined with a low-dose HCG trigger is relatively better, and can reduce the occurrence of OHSS.

Randomized controlled study of disease activity assessment of rheumatoid arthritis based on Smart System of Disease Management

Pan Deng, Wang Hao, Wu Henglian, Chen Tengyun, Deng Yunming

2022, 28(7):  937-941.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.012

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Objective　To explore the impact of the Smart System of Disease Management (SSDM) on the psychological status, self-efficacy, and mobility of patients with rheumatoid arthritis. Methods　One hundred and fifteen patients with rheumatoid arthritis who were treated in Dongguan Tungwah Hospital from May to December 2019 were selected. Three patients were removed from the group, and 112 patients were finally included, including 60 males and 52 females who were 23-76 years old. They were divided into a control group and a research group by the random number table method. The control group took routine education and telephone follow-up education. On this basis, the research group applied SSDM to manage the patients. The scores of Disease Activity Score 28 (DAS28), Health Assessment Questionnaire (HAQ), health survey brief table (SF-36), Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA), morning stiffness times, disease remission rates, follow-up rates, and relapse rates in these two groups were observed. SPSS 20.0 was used for the data analysis. χ² and t tests were applied. Results　After the intervention, the scores of DAS28, HAQ, HAMD, and HAMA were lower, the score of SF-36 was higher, and the morning stiffness time was shorter in the research group than in the control group (all P<0.05). The remission rate, the follow-up rate, and the recurrence rate were 98.21% (55/56), 96.43% (54/56), 1.79% (1/56) in the research group, and were 83.93% (47/56), 80.36% (45/56), and 16.07% (9/56) in the control group, with statistical differences (χ²=6.245, 6.527, and 10.721; P=0.008, =0.006, and <0.001). Conclusions　The SSDM for patients with rheumatoid arthritis is more effective in the course of disease treatment. It can effectively improve the patients' quality of life, adjust their poor psychological conditions, effectively reduce the disease activity, and increase the disease remission rate and follow-up rate, and reduce the disease recurrence rate, so it is worthy of promotion and application in the disease management of patients with rheumatoid arthritis.

Application of N-terminal pro-B-type natriuretic peptide in cardiovascular diseases

Luo Wei, Zhang Yuanqi (Proofreading)

2022, 28(7):  942-946.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.013

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The application of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in cardiovascular diseases has been widely noticed, especially in the diagnosis, risk classification, and prognosis evaluation of heart failure, coronary heart disease, hypertension, diabetes, and other diseases, and remarkable achievements have been made. In this paper, the research progress in the above aspects is reviewed.

Effects of different enzyme-linked immunosorbent assays in detecting hepatitis C antibody

Wu Feifei

2022, 28(7):  946-949.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.014

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Objective　To study the effects of different enzyme-linked immunosorbent assays (ELISA) in detecting hepatitis C antibody. Methods　Eighty male hepatitis C patients who were 20-65 years old and who were admitted to hospitals at Luohu District from June 2019 to June 2021 were selected. According to the detection methods, they were divided into a conventional group (40 cases), detected by the indirect ELISA, and an experimental group (40 cases), detected by the double antigen sandwich ELISA. The test results of the two groups were compared and analyzed. The independent-sample t and χ² test were applied. Results　There were 8 anti-viral hepatitis C (HCV) positive samples, and the positive detection rate was 87.50% (7/8) in the experimental group, and was 25.00% (2/8) in the conventional group; there were 72 anti-HCV negative samples, and the negative detection rate was 97.22% (70/72) in the experimental group, and was 83.33% (60/72) in the conventional group; there were statistical differences between these two groups (χ²=6.349 2 and 7.912 1; P=0.011 7 and 0.004 9). The sensitivity, specificity, and positive and negative predictive values in the experimental group were higher than those in the conventional group, with statistical differences (all P<0.05). Conclusion　The double antigen sandwich ELISA has high specificity and sensitivity in the detection of hepatitis C antibody, so it can provide reference data for disease treatment and prognosis improvement, and is worth being generalized.

MPR versus VR of multi-slice CT scans in diagnosis of subtle and occult fractures 

Chen Bin, Leng Zhixin, Tian Hong'an

2022, 28(7):  950-953.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.015

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Objective　To analyze the clinical values of multi-slice CT (MSCT) with multiplanar reformation (MPR) and volume rendering (VR) in the diagnosis of subtle and occult fractures. Methods　The clinical data of 126 patients with suspected fractures in plain X-ray examination and confirmed as subtle and occult fractures by MSCT scan in Xianning Central Hospital from January 2020 to January 2021 were retrospectively analyzed. Of the 126 patients, 66 were male and 60 female, and they were 16-63 years old, with a total of 145 suspected fracture joints. The MPR and VR were used to diagnose subtle and occult fractures, and the effects of the different techniques in the diagnosis of occult fractures were compared. The count data were expressed as cases or percentages, and the χ² and McNemar tests were performed. The sensitivity, specificity, and accuracy of MSCT in the diagnosis of subtle and occult fractures were calculated. Results　A total of 115 occult fracture sites and 30 fracture-free sites out of 145 osteoarticular injuries in the 126 cases were confirmed by surgery and post-operative follow up. The fractures were consisted of 26 pelvic and hip fractures, 20 knee fractures, 21 spine fractures, 31 ankle fractures, 11 elbow fractures, and 6 wrist fractures. With the results of surgery and post-operative follow-up as the gold standard, the McNemar test indicated that the sensitivity, specificity, and accuracy of MSCT in the diagnosis of occult fractures were 98.26% (113/115), 100.00% (30/30), and 98.62% (143/145), respectively. The accuracy rate of MPR in identifying occult fractures was 94.78%(109/115), with 6 missed diagnoses; the accuracy rate of VR in identifying occult fractures was 99.13% (114/115), with 1 missed diagnosis; the values of MPR and VR in the diagnosis of occult fractures yielded no statistical difference (P>0.05). Both MPR and VR were able to correctly identify the un-fractured area, and the accuracies of the two techniques in the diagnosis of occult fractures were not statistically different (χ²=3.684, P>0.05). Conclusion　MSCT scan and its post-processing techniques MPR and VR can effectively show subtle and occult fractures and are of great value in the diagnosis of subtle and occult fractures.

Ultrasound in diagnosis and treatment of tendon diseases of lower extremities

Zhao Jing, Zheng Aiping

2022, 28(7):  953-956.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.016

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In recent years, the incidence of tendon diseases has increased gradually in professional sportsmen and sports amateurs. Tendon diseases can lead to pain and dysfunction of affected tendons. At present, the clinical diagnosis of tendon diseases usually depends on imaging methods. In recent years, ultrasonic diagnosis and adjuvant therapy have been widely used in patients with tendon diseases. This review briefly summarizes the research progress of ultrasound as an imaging diagnostic tool and auxiliary treatment of tendon diseases of lower extremities. Ultrasound imaging mainly obtains the diagnosis by evaluating tendon thickness, echo, and neovascularization. Ultrasound has good sensitivity and specificity in the diagnosis of tendon diseases, but there are still deficiencies in the identification of the development stage of tendon diseases. Ultrasound guided clinical treatment is also used in the treatment of many tendon diseases, and is an important direction for further research in the future.

Changes of intestinal flora in elderly patients with postoperative delirium after hip arthroplasty

Liang Jiamin, Yang Zijian, Yang Jiwu, Liang Peiwen, Hu Shunqing

2022, 28(7):  957-961.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.017

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Objective　To investigate the changes of intestinal flora in elderly patients with postoperative delirium (POD) after hip arthroplasty. Methods　This was a case control study. The patients who took hip arthroplasty under combined spinal and epidural anesthesia in The Third Affiliated Hospital of Guangzhou University of Chinese Medicine from September 2019 to August 2021 were recruited; among whom, 13 patients with POD (POD group), including 7 males and 6 females who were (72.62±3.25) years old, and 20 patients without POD (non-POD group), including 13 males and 7 females who were (73.00±4.19) years old, were randomly selected. The 16S rRNA sequencing technology was used to analyze the changes of intestinal flora 12 hours before and 48 to 60 hours after the operation. The count data were compared by χ² test, and the measurement data by t test. Results　The postoperative Chao1 index and Shanon index of the POD group were significantly lower than those of the non-POD group [(333.32±97.86) vs. (455.20±153.50) and (3.27±0.79) vs. (5.05±1.06); both P<0.05]. The relative abundances of postoperative proteobacteria and firmicutes were higher and the relative abundances of postoperative bacteroides, actinomycota, and bacteroidetes were lower in the POD group than in the non-POD group after the surgery [(21.45±4.73)% vs. (16.42±3.55)%, (52.45±7.38)% vs. (46.70±6.94)%, (12.68±3.78)% vs. (21.37±4.17)%, (32.35±8.60)% vs. (42.75±9.43)%, and (12.68±3.78)% vs. (21.37±4.17)%], with statistical differences (all P<0.05). The relative abundances of postoperative sartorella, staphylococcus, proteus, and clostridia were higher and the relative abundances of bifidobacterium, clostridium tenuis, and bacteroides were lower in the POD group than in the non-POD group after the surgery [(16.45±3.74)% vs. (10.18±2.40)%, (21.38±4.60)% vs. (14.92±2.94)%, (15.33±3.22)% vs. (9.48±1.67)%, (28.55±4.90)% vs. (14.70±2.92)%, (29.41±5.80)% vs. (45.24±7.08)%, (10.18±2.04)% vs. (13.50±2.31)%, and (27.65±3.59)% vs. (34.76±4.72)%], with statistical differences (all P<0.05). Conclusions　The diversity of intestinal flora is decreasing; structural changes on the phylum and genus levels of intestinal flora may be involved in the occurrence of POD after hip arthroplasty.

Changes of ultrasonic measurements and correlation of calf motor nerve and its innervation muscles in patients with diabetic peripheral neuropathy

Huo Zhongyuan, Zhao Hongyan, Cheng Chen, Tian Wei, Song Huanhuan

2022, 28(7):  962-966.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.018

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Objective　By analyzing the correlation between the changes in the shear wave hardness of the calf motor nerve and its innervating muscles in patients with type 2 diabetes, to explore the clinical value of high-frequency gray-scale ultrasound and shear wave elastography in the evaluation of the calf motor nerve and muscle lesions in patients with diabetic peripheral neuropathy (DPN). Methods　A case-control study was conducted on 80 inpatients in Department of Diabetes, Lianyungang Traditional Chinese Medicine Hospital Affiliated to Kangda College of Nanjing Medical University from August 2020 to November 2021. There were 40 DPN patients, including 18 males and 22 females, with an age of (58.95±7.08); and there were 40 diabetic patients with no neuropathy, including 18 males and 22 females, with an age of (59.03±8.03). There were 30 normal controls in the same period, with an age of (58.40±6.26). High frequency ultrasound conventional gray-scale mode and shear wave imaging mode were used to collect the cross-sectional areas of the peroneal nerve and tibial nerve and the Young's modulus of gastrocnemius, tibial anterior muscle, and peroneal muscle. We used one way ANOVA to compare the measured values of the 3 groups and analyzed the correlation between the cross-sectional area of the motor nerve of the calf and the Young's modulus of the corresponding innervated muscle. The independent-sample t test and χ² test were used. Kendall W test was used to test the consistency. Pearson correlation analysis was applied. Results　There were statistical differences in the measured values of ultrasonic parameters between the three groups (all P<0.05). The cross-sectional areas of the tibial and peroneal nerves in the DPN patients were the largest, which were (16.29±2.01) mm² and (19.88±2.71) mm², respectively; the shear wave hardness Young's modulus was the lowest in the DPN patients; and the Young's modulus values of the gastrocnemius muscle (maximum plantar flexion), gastrocnemius (maximum dorsiflexion), tibial anterior muscle, and peroneal muscle in the DPN patients were (56.29±10.12) kPa, (79.25±12.86) kPa, (76.84±12.88) kPa, and (67.09±12.55) kPa. The cross-sectional areas of the tibial and peroneal nerves in the DPN patients were negatively correlated with the Young's modulus of the corresponding innervated muscles (all P<0.01). The cross-sectional area of the tibial nerve was correlated with the Young's modulus (maximum dorsiflexion) and (maximum plantar flexion) of the gastrocnemius muscle (r= -0.617 and -0.632). The correlation r value between the cross-sectional area of the peroneal nerve and the Young's modulus of the tibialis anterior muscle (maximum plantar flexion) was -0.622. The correlation r value between cross-sectional area of the peroneal nerve and the Young's modulus of the peroneal muscle (foot inversion) was -0.629. Conclusions　Patients with DPN have reduced leg muscle stiffness. Conventional gray-scale ultrasound can be combined with shear wave elastography to assess the motor nerve and its innervation muscle lesions of the leg, providing more imaging diagnostic evidences for clinical evaluation of DPN patients.

Treatises

Application of cone beam CT combined with six-dimensional bed in cervical cancer radiotherapy and analysis of boundary of target area

Wang Yuliu, Fang Yongwen, Xiao Liangjie, Yao Wenyan, Liu Biaoshui, Lin Xiaosheng, Lin Chengguang, Fang Jianlan

2022, 28(7):  967-970.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.019

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Objective　To study the accuracy of the placement of cervical cancer with intensity-modulated radiation therapy (IMRT) adjusted by cone beam CT (CBCT) and six-dimensional 6D treatment bed and the boundary of the target area. Methods　Thirty-six patients with cervical cancer who were 35-70 years old treated at Sun Yat-sen University Cancer Center from October 2020 to April 2021 were randomly selected. Their Karnofsky score was over 80. After volumetric intensity modulated radiation therapy (VMAT), each patient underwent CBCT scans a total of 714 times before each treatment to obtain a volume CT image, which was then registered with the localization CT image, and performed 6D registration again, and the 6D setup error value was recorded. The body mass index (BMI) of each patient was recorded. The influences of BMI on the coronal plane Rtn, sagittal plane Pitch, transverse plane Roll, and other directions in the 6D registration was analyzed. According to the Van Herk formula M_PTV=2.5∑+0.7σ, the corresponding extrapolation boundary value (MPTV) in the translation direction was calculated. Independent sample t test and paired t test were performed on all the data. Results　The absolute values of the placement errors of 3D registration in the left and right (LR), head-to-foot (SI), and ventral dorsal (AP) directions were (2.1±0.9), (3.2±1.2), and (2.3±1.2) mm, and those of 6D registration were (1.8±0.6), (3.2±1.0), and (2.2±0.8) mm. The paired t test was used for the original data, and there was no statistical difference in the SI direction (P>0.05), and were in the LR and AP directions (all P<0.05). Under the influence of BMI, there were statistical differences in the the rotation and positioning errors in the directions of yaw angle (Rtn), pitch angle (Pitch), and roll angle (Roll) between the normal and obese patients (all P<0.05). The 6D registration was reduced by 1.0, 2.0, and 1.6 mm in LR, SI, and AP as compared with the 3D registration by calculating the extrapolation boundary. Conclusions　For CBCT combined with 6D treatment table online correction, 6D image registration is better than 3D image registration. According to the formula M_PTV=2.5∑+0.7σ, the 6D extension boundary is smaller than the 3D extension boundary; in the clinical radiotherapy for cervical cancer, the use of 6D image registration combined with a six-dimensional bed has more advantages than a single three-dimensional bed, which can reduce the dose of normal tissues around the target area and improve the accuracy of tumor radiotherapy.

Detection of bacterial types and antibiotic susceptivity of genital Candidiasis in Guangzhou 

Li Xiaodong, Song Weizhong, Cao Wenling, Li Ping, Liang Jingyao, Li Huaping, Wang Huanli, Wang Jianqin

2022, 28(7):  971-974.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.020

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Objective　To monitor the isolates of genital Candidiasis in Guangzhou from 2013 to 2019, and to evaluate the susceptibilities of 7 antibioitics. Methods　Six hundred and forty-nine patients with genital Candidiasis infection treated at Clinic of Sexually Transmitted Diseases, Guangzhou Institute of Dermatology from January 2013 to December 2019 were selected, including 116 males and 533 females, and they were 15-84 years old. The ATB ID32C bioMerieux France and Rosco Disk diffusion method was be used to do the typing and drug sensitivity test of Candidiasis. The susceptibilities for all kinds of Candidasis were compared. Results　Among the 649 strains of genital Candidiasis, there were 517 strains of candida albicans (79.66%), 72 strains of candida glabrata (11.09%), 33 strains of candida parapsilosis (5.09%), and 27 strains of other Candidiasis (4.16%). The isolatation rate of candida albicans during these 7 years did not changed obviously (χ²=11.56, P>0.05), that of  candida glabrata increased (χ²=13.72, P<0.05), and those of candida parapsilosis and other candida decreased (χ²=19.28 and 14.76,both P<0.05). The susceptibilities of genital candida to nystatin, ketoconazole, fluconazole, itraconazole, miconazole, and terbinafine were 99.69% (647/649), 85.20% (553/649), 72.57% (471/649), 52.23% (339/649), 34.36% (223/649), 34.98% (227/649), and 8.32% (54/649). Conclusions　The genital Candidiasis is candida albicans. Candidiasis has a high drug-susceptibility rate to polyene antibiotics, and is resistant against azoles. Different kinds of Candidiasis have different antibiotic sensitivities.

Correlation between pathogen distribution and immune indicators in patients with non-lactating mastitis

Zhou Bei, Fan Lichun

2022, 28(7):  975-978.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.021

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Objective　To study the correlation between bacterial infection and immune index in non-lactation mastitis patients. Methods　One hundred patients with non-lactating mastitis treated at Hainan Women and Children's Medical Center from August 2019 to August 2021 were randomly selected as an observation group, and another 100 healthy women who had physical examination at Hainan Women and Children's Medical Center during the same time were randomly selected as a control group. The observation group was (35.29±4.61) years old, and their body weight was (52.35±3.30) kg. The control group was (35.22±4.56) years old, and their body weight was (52.22±3.20) kg. The levels of peripheral blood immune indicators in the two groups were compared, and the correlation was analyzed. The pus samples were collected from the patients in the observation group for bacterial culture and drug susceptibility test, and the resistance of staphylococcus aureus to common antibiotics was analyzed. χ² and t tests were applied. Results　The levels of immunoglobulin (Ig) A and IgM in the peripheral blood were (2.68±1.04) g/L and (1.80±0.77) g/L in the observation group, and were (2.08±0.86) g/L and (1.28±0.46) g/L in the control group, with statistical differences (t=4.446 and 5.797; both P<0.001). Pearson correlation analysis showed that the bacterial infection in the patients with non-lactation mastitis was positively correlated with IgA and IgM (r=0.574 and 0.611, both P<0.05). Staphylococcus aureus was the main pathogen in the pus samples, accounting for 73.00% (73/100). The drug resistance rates of staphylococcus aureus to penicillin, benzoxicillin, clindamycin, gentamycin, furantoin, levofloxacin, tetracycline, and vancomycin were 87.67% (64/73),75.34% (55/73),38.36% (28/73),27.40% (20/73),10.96% (8/73),9.59% (7/73),8.22% (6/73), and 0. Conclusion　There is a close relationship between bacterial infection and immune indicators in patients with non-lactating mastitis, and the main pathogen is Staphylococcus aureus, which has a high sensitivity to vancomycin

Adjuvant intravenous infusion of nalbuphine versus remifentanil in epidural labor analgesia

Huang Yu, Chen Weiming, Wang Shouping

2022, 28(7):  979-985.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.022

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Objective　To compare the clinical efficacies and safety of intravenous nalbuphine and remifentanil combined with epidural block in labor analgesia. Methods　A total of 150 full-term puerperae at Third Affiliated Hospital of Guangzhou Medical University from August to October 2020 were randomly divided into a simple epidural analgesia group (group C), a nalbuphine adjuvant epidural analgesia group (group N), and a remifentanil adjuvant epidural analgesia group (group R), with 50 cases in each group. All the three groups received epidural labor analgesia when their uterine orifices were opened to 3 cm. Within 10 minutes before the epidural puncture, group N was given intravenous injection of nalbuphine 0.1 mg/kg, and group R was given intravenous injection of remifentanil 0.20 μg/kg, then continuous intravenous infusion of remifentanil 0.05 μg/kg·min^-1 until the anesthesia level reached T10 and the infusion was stopped. All the three groups was given 0.065% ropivacaine + 0.4 μg/ml sufentanil epidural continuous infusion. The scores of Visual Analogue Scale (VAS) were recorded before analgesia, at epidural puncture, and each time point after analgesia. The duration of labor, the rate of cesarean section, the rate of instrumental-assisted labor, the utilization rate of oxytocin, and the maternal satisfaction were recorded. The neonates' Apgar scores (1, 5, and 10 min) were recorded, and their umbilical artery blood was extracted for blood gas analysis. The adverse reactions during delivery were observed. The independent-sample t, paired t, and χ² tests were applied. Results　The VAS scores at epidural puncture in group N and group R were significantly lower than that in group C [(5.68±1.13) and (5.61±1.11) vs. (8.10±1.00)], with statistical differences between group N and group C and between group R and group C (both P<0.05) but no between group N and group R (P>0.05). The scores of maternal satisfaction in group N and group R were higher than that in group C [(9.04±0.86) and (9.36±0.74) vs. (8.47±0.84)], with statistical differences between group N and group C and between group R and group C (both P<0.05) but no between group N and group R (P>0.05). The Ramsay sedation scores at epidural puncture in group N and group R was higher than that in group C [(1.75±0.43) and (2.17±0.60) vs. (1.17±0.38)], with statistical differences (both P<0.05). The incidences of dizziness in group N and group R were higher than that in group C [32% (16/50) and 40% (20/50) vs. 12% (6/50)], with statistical differences between group N and group C and between group R and group C (both P<0.05) but no between group N and group R (P>0.05). The incidence of narcolepsy in group R was 10% (5/50), which was statistically different from those in group N (0) and group C (0) (both P<0.05). There were no statistical differences in general data, VAS scores at other time points, improved Bromage scores at all the time points, time of labor, cesarean section rate, instrumental delivery rate, oxytocin utilization rate, Apgar score of newborns, and umbilical artery blood gas analysis between the three groups (all P>0.05). Conclusion　Intravenous infusion of small doses of nalbuphine and remifentanil can significantly relieve the pain level before epidural labor analgesia takes effect and alleviate maternal tension, so that the puerperae can better cooperate with the anesthesiologists' instructions, create more favorable conditions for the anesthesia operation, improve their satisfaction, do not affect the delivery mode, do not prolong the labor process, and do not increase the occurrence of maternal and infant serious adverse reactions.

Clinical Research

Signs of multi-slice spiral CT and ultrasound for intrahepatic portosystemic venous shunts and misdiagnosis analysis

Feng Yun, Hu Rong, Huo Yaling, Wang Dan

2022, 28(7):  986-988.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.023

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Application effect of chlorhexidine gluconate antibacterial transparent dressing in patients after lumbar cistern catheterization and its influence on infection rate

Fan Yuying, Ma Hongyan, Yu Wenjun, Zhang Yan

2022, 28(7):  989-991.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.024

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Objective　To explore the application effect of chlorhexidine gluconate antibacterial transparent dressing in patients after lumbar cistern catheterization and its influence on infection rate. Methods　A total of 70 patients (39 males and 31 females, with an average age of 38.0) after lumbar cistern catheterization at Guangdong 999 Brain Hospital from January 2019 to May 2020 were selected and divided into a control group and a study group by the random number table method, with 35 patients in each group. The control group took the conventional fixation method, and the study group was fixed with chlorhexidine gluconate antibacterial transparent dressing. The occurrences of tube removal, internal drainage tube obstruction, unplanned extubation, skin allergy symptoms, intracranial infection, and cerebrospinal fluid leakage in the two groups within 48 hours were observed. The χ² was applied. Results　The incidences of tube removal, unplanned extubation, skin allergy symptoms, intracranial infection, and cerebrospinal fluid leakage in the study group were lower than those in the control group [2.9% (1/35) vs. 8.6% (3/35), 2.9% (1/35) vs. 11.4% (4/35), 5.7% (2/35) vs. 45.7% (16/35), 2.9% (1/35) vs. 11.4% (4/35), and 0 vs. 8.6% (3/35); all P<0.05]. Conclusion　The application of chlorhexidine gluconate antibacterial transparent dressing in lumbar cistern catheterization can effectively reduce the incidence of tube removal, internal drainage tube obstruction, unplanned extubation, skin allergy symptoms, intracranial infection, and cerebrospinal fluid leakage within 48 hours, and has high safety and ideal effect, so it is worthy of promotion and application.

Self-efficacy of patients after total hysterectomy and the influencing factors

Cheng Jiehao, Chen Haiping, Lai Leqi

2022, 28(7):  992-995.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.025

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Objective　To investigate the current situation and influencing factors of self-efficacy of patients after total hysterectomy. Methods　Fifty-one patients after hysterectomy treated in a grade 3A hospital in Guangzhou were investigated by the general data questionnaire and self-efficacy scale. The correlation between the self-burden and self-efficacy in the patients were analyzed by Pearson correlation analysis. t test, one way ANOVA, and multiple linear regression were applied. Results　The total score of self-efficacy was (21.76±9.30). There were statistical differences in the scores of offspring number and family per capita monthly income of self-efficacy (F=3.88 and 1.24; P=0.015 and 0.044). Conclusions　Family per capita monthly income and course of disease are important influencing factors of self-efficacy in patients after total hysterectomy. It is suggested that patients with low per capita monthly income and a long course of disease should strengthen postoperative psychological nursing to improve their self-efficacy after total hysterectomy.

Case Report

Primary ovarian carcinoid: a case report

Wang Wen, Tian Xiangyu, Yao Shujuan

2022, 28(7):  996-998.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.026

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Primary ovarian carcinoid is rare, mostly occurring in perimenopausal women. At present, most cases are reported as individual cases. Gynecologists have not much knowledge of it, and it is difficult to diagnose before surgery. Its diagnosis is mainly confirmed by postoperative pathological examination. It could be misdiagnosed easily. The disease should be highly suspected when pelvic mass is found clinically, as well as the occurrence of certain endocrine substances and their causes of skin flushing, telangiectasia, bronchospasm, heart damage, and other symptoms. The surgical scope can be selected individually according to the patients' age, fertility requirements, and other specific conditions. These patients should be strictly followed up after surgery.

Cushing's syndrome with hypokalemia and repeated fracture as the first manifestations: report of one case and literature review

Liu Yingxiao, Lin Wenwen, Zhang Yupan

2022, 28(7):  999-1001.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.027

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Objective　To investigate one case of Cushing's syndrome with atypical signs and with hypokalemia and repeated fracture as the first manifestations. Methods　The clinical data of a case of Cushing's syndrome with hypokalemia and repeated fractures as the first manifestations in Weihai Municipal Hospital, Shandong University were analyzed, and the literatures were reviewed. Results　A 68-year-old female patient was diagnosed as adrenocorticotrophic hormone (ACTH) pituitary tumor in sellar region with hypokalemia and repeated fracture as the first manifestations, and she was improved after surgical treatment. Conclusion　Patients with hypokalemia and repeated fracture are prone to missed diagnosis due to atypical clinical signs, and they should be paid attention to in clinical work.

Nursing Research

Nursing care of senile melanosis coli complicated with advanced rectal cancer

Wang Dianrong, Liu Wei, Wang Lanlan, Wang Qian, Li Xiuju, Zhao Liping

2022, 28(7):  1002-1006.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.028

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Objective　To summarize the perioperative nursing of an elderly patient with melanosis coli (MC) and advanced rectal cancer. Methods　A patient with MC and advanced rectal cancer received perioperative nursing, and the literatures were studied. Results　Preoperative individualized comprehensive evaluation was performed, pulmonary function exercise was strengthened, and effective psychological intervention and adequate intestinal preparation were taken. Reasonable postoperative nutritional support was given, multi-mode analgesic strategy was implemented, pipeline nursing was strengthened, the nursing of melanosis colostomy was paid attention to, the disease changes was closely observed, the complications were actively prevented and treated, and the health education and guidance were strengthened. After 19 days' careful treatment and nursing, the patient recovered and was discharged from the hospital. Conclusions　MC is rare in clinic, and it is rarely reported that it is associated with rectal cancer. The perioperative nursing was summarized for clinical references.

A qualitative study on needs of patients with ischemic stroke and dysphagia for discharge planning services

Liang Weiying, Yin Yushan

2022, 28(7):  1006-1009.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.029

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Objective　To explore the needs of patients with ischemic stroke and dysphagia for discharge planning services, and to provide references for formulating a scientific and standardized discharge plan. Methods　The phenomenological research methods were used in the qualitative research. Ten ischemic stroke patients with dysphagia hospitalized in Neurology Department, The Second Affiliated Hospital of Guangzhou Medical University for 4-24 d from December 2020 to June 2021 were selected for semi-structured interview, including 9 males and 1 female. They were 43-82 years old. Their education level was from elementary school to college. The Colaizzi analysis method was used to code, analyze, classify, and refine the data. Results　The needs for discharge planning services of the stroke patients with dysphagia were summarized into four themes: disease knowledge, swallowing rehabilitation exercise, mental and psychological support, and social support. Conclusions　The needs for discharge planning services of stroke patients with dysphagia are high. The doctors, nurses, technologists, and family members should work together so as to provide individualized multi-disciplinary cooperative discharge planning services for the patients and improve their life quality after discharge.

Clinical application effect of high-low sofa in patients after hip replacement

Zhang Manyin, Tang Shunluan, Xu Yanxing

2022, 28(7):  1010-1012.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.030

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Effect of semiconductor laser combined with 30% supramolecular salicylic acid in treatment of acne curative and nursing experience

Zhang Wenjun, Li Yueming, He Shiqi, Liang Shuhong, Liu Yingxue, Wu Yiling, Gong Yeqing

2022, 28(7):  1013-1016.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.031

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Objective　To explore the effect of semiconductor laser combined with 30% supramolecular salicylic acid in the treatment of acne and the nursing effect. Methods　A total of 100 patients with acne who were treated at the Guangzhou Institute of Dermatology Prevention and Treatment from October 2019 to April 2021 were selected and divided into a control group and a study group using a random number table method, with 50 cases in each group. The control group had 19 males and 31 females who were 14-41 (25.62 ± 8.35) years old, and were given semiconductor laser treatment. The study group had 20 males and 30 females who were 12 to 43 (26.43±8.12) years old, and were treated with semiconductor laser and 30% supramolecular salicylic acid. The changes in skin texture characteristics and adverse reactions were recorded. The clinical efficacies and patient satisfaction were evaluated. t and χ² tests were used for statistical analysis. Results　After the treatment, the counts of stains, pores, erythema, and purple matter in the study group were lower than those in the control group [(35.41±6.22)% vs. (40.16±9.37)%, (25.10±6.83)% vs. (29.65±8.40)%, (21.05±8.42)% vs. (28.02±9.23)%, (29.31±9.02)% vs. (32.60±10.67)%; t=2.986, 2.972, 4.035, and 2.318; all P<0.05]. After the second treatment, the total clinical effective rate was 44.00% (22/50) in the study group, and was 24.00% (12/50) in the control group, with a statistical difference (χ²=4.456, P=0.035). The total effective rate 2 months after the end of the treatment was 54.00% (27/50) in the control group, and was 78.00% (39/50) in the study group, with a statistical difference (χ²=6.417, P=0.011). The total satisfaction with acne was 88.00% (44/50) in the control group, and was 100.00% (50/50) in the study group, with a statistical difference (χ²=8.542, P=0.004). Conclusions　Semiconductor laser combined with 30% supramolecular salicylic acid can significantly improve the symptoms of acne and the clinical treatment effect. At the same time, standardized nursing measures should be used to ensure the clinical treatment effect and patient satisfaction.

Summary

Association of brain-derived neurotrophic factor with post-stroke pain and depression

Tian Jinxiu, Cheng Aixia, Li Haoliang

2022, 28(7):  1017-1020.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.032

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Brain-derived neurotrophic factor (BDNF) is the most abundant neurotrophic factor in human brain, and has remarkable ability to repair brain injury. Recent studies show that BNDF plays an important role in the development of a variety of complications after stroke, and is promising as a late target for the development of novel stroke treatments, but its mechanism is not clear. In this paper, the biological characteristics of BDNF, the action mechanism of complications after stroke, and the latest research progress are reviewed, so as to provide new ideas for the clinical diagnosis and treatment of pain and depression after stroke.

Research progress of sulforaphane in treatment of Helicobacter pylori infection

Wang Hao, Xie Qingzhi

2022, 28(7):  1021-1024.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.033

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The problem of Helicobacter pylori (Hp) infection is still serious in China, and there are still some deficiencies in the current treatment plan based on antibiotics. Studies have found that sulforaphane (SFN), a natural plant active substance, can improve the eradication rate and reduce adverse reactions by enhancing the body's antioxidant ability, inhibiting the growth and colonization of Hp and directly killing Hp infection. This paper reviews the research progress of SFN in the treatment of Hp infection, hoping to provide new ideas for the treatment of Hp infection.

Research new progress of peri-liver-transplantation induced intestinal injury and ferroptosis

Wu Wei, Tan Yongxing, Wang Yongwang

2022, 28(7):  1025-1028.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.034

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Ferroptosis is a newly discovered form of cell death characterized by excessive accumulation of iron-dependent lipid reactive oxygen species (L-ROS) in recent years. It is related to many metabolic regulation pathways, such as iron, lipid, and amino acid metabolisms. This article summarizes the concept, morphological and biochemical characteristics, and regulatory mechanism of ferroptosis, as well as the mechanism of ferroptosis in perioperative intestinal injury induced by liver transplantation and the treatment strategies for ferroptosis, so as to provide theoretical basis for organ protection of liver transplantation.

Research progress in etiology, diagnosis, and treatment of placenta previa

Liu jing, Gai Xinxin, Liang Sen, Wei Xuegong

2022, 28(7):  1029-1033.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.035

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Placenta previa is a common complication in obstetrics, and its etiology is not clear. A large number of studies show that advanced age pregnant women, history of cesarean section, multiple pregnancy, medical assisted reproduction, and history of uterine cavity operation can increase its risk. In recent years, the incidence of placenta previa has continued to rise, and has gradually become the focus of clinicians. Its occurrence is one of the main causes of bleeding in late pregnancy. If it is not handled in time, it can seriously threaten the life safety of mothers and infants. Therefore, clear diagnosis and scientific treatment are of great significance to reduce the occurrence of adverse outcomes of mothers and infants. This paper aims to summarize the new research progress in the etiology, diagnosis, and treatment of placenta previa, so as to provide clinicians with the basis for the diagnosis and treatment of placenta previa, and to reduce the maternal and neonatal mortalities.

Relationship between air pollutants and sepsis

Chen Jing, Shi Fei

2022, 28(7):  1034-1036.  DOI: 10.3760/cma.j.issn.1007-1245.2022.07.036

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Sepsis is a systemic inflammatory response syndrome caused by infection. Sepsis is dangerous and has a high mortality. At present, it is still a serious disease threatening the safety of human lives. After unremitting research, people have gradually deepened their understanding of sepsis, but it is still a dangerous condition. The research history of sepsis renal damage has been decades, and its mechanism has not been fully clarified, which may include renal ischemia-reperfusion injury, inflammatory factors, nitric oxide theory, apoptosis theory, endothelial dysfunction and endothelin effect, endotoxin direct injury, oxidative stress injury, etc. More and more evidences show that air pollution can induce infection and other diseases, so air pollution is likely to be an important risk factor for sepsis. This study discusses the effects of air pollutants on sepsis, and is expected to prevent and control the disease early so as to reduce its incidence.