Table of Content

15 April 2022, Volume 28 Issue 8

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Special Column of Urology and Reproduction

Observation of clinical efficacy of early electrophysiological technology intervention in restoring urine control function after laparoscopic radical resection of prostate cancer

Wei Jianwen, Yin Wenjun, Chen Zekai, Ling Muan, Chen Jie, Pan Bin

2022, 28(8):  1038-1041.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.001

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Objective　To investigate the clinical efficacy of early electrophysiological technology intervention in restoring urine control function after laparoscopic radical resection of prostate cancer. Methods　Five patients aged (63.20±6.14) years with prostate cancer enrolled in the Department of Urology of The First Affiliated Hospital of Jinan University from July to December 2021 received electrophysiological intervention on the third day after laparoscopic radical resection of prostate cancer. The laparoscopic radical resection of prostate cancer was performed between pelvic fascia and prostatic fascia. Tension-free anastomosis was made between the bladder and proximal urethra, and then the anterior wall of the bladder neck and the pubic prostate ligament were stitched up. On the third day, a medical infrared thermal imaging instrument (PRISM 640A/PRISM 384A) was used to visualize the electrophysiological diagnosis, the individual electrophysiological parameters were selected, and then the precise electrophysiological treatment was conducted (low-frequency neuromuscular therapy instrument model: BioStim pro and BioStim ble Foshan Shanshan Datang Medical Technology Co., LTD.). Electrophysiological treatment parameters and electrode tablet adhesive locations: BB8: 10 Hz/300 µs for arterial circulation, BB16: 2 Hz/280 µs for venous circulation, BB27: 48 Hz/180 µs for arterial circulation, BB30: 10 Hz/480 µs for lymphatic circulation; EE21: 36 Hz/300 µs for vascular smooth muscle; electrode tablets were affixed at "curved bone, triple Yin" acupoints. DD1: 8 Hz/500 µs, 20 Hz/350 µs for classⅠ skeletal muscle, DD211: 25 Hz/500 µs for classⅠ skeletal muscle, DD297: 36 Hz/350 µs for class Ⅱ skeletal muscle, DD211 and DD297 alternatively; electrode tablets were attached to the pelvic floor muscles. CC16: 25 Hz/300 µs for pudendal nerves, CC39: 96 Hz/150 µs for sympathetic nerves, electrode tablets were affixed to the "curved bone, sacral eight points" acupoints, consecutive treatment for 5-9 times. After treatment, International Incontinence Advisory Committee Incontinence Questionnaire (ICI-Q-SF) score, Quality of Incontinence Questionnaire (I-QOL) score, and 24 h urinary pad usage in the five patients were recorded. Results　All the patients completed the operation successfully, with the operation time of (5.92±1.35) h, the bleeding volume of (42.00±10.95) ml, and the pelvic drainage tube duration of (4.20±1.10) d. One patient had fever and was cured according to the symptoms. Two weeks later, all the 5 patients had a little urine leakage when coughing vigorously after urinary catheters were removed. Only one patient applied 1 urinary pad on the very day of the extraction of urine tube, and the urinary pad utilized by the patient was less than or equal to 1 piece within 24 hours; another 4 patients did not use the urinary pad after extraction of urine tube, whom were evaluated as the postoperative early recovery of urine control function. The treatment cycle was (7.40±1.52) d, the ICI-Q-SF score was (2.80±1.64), and the I-QOL score was (94.00±3.08). Conclusion　The early electrophysiological technology intervention in restoring urine control function after laparoscopic radical resection of prostate cancer is safe and effective, and it might be expected to become a standard adjuvant therapy in the future.

Assessment of coronary artery calcification and its relationship with cardiovascular events in patients with end-stage renal diseases

Xie Yingye, Zhong Haowen, Chen Li, Zhang Mengbi, Xie Na, Chen Jianhua, Liu Yufeng, Lai Yanhong, Su Xiaoyan

2022, 28(8):  1042-1046.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.002

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Objective　To analyze the assessment method of coronary artery calcification (CAC) in patients with end-stage renal diseases (ESRD) and its relationship with major adverse cardiovascular events (MACE). Methods　From May 2018 to October 2020, 228 patients with ESRD from TungWah Hospital of Sun Yat-sen University were enrolled. The clinical characteristics of ESRD patients with CAC were analyzed. Logistic regression analysis was used to evaluate the assessment and forecast the efficiencies of CAC integral [Agatston (AS) integral, volume integral (VS integral), and mass integral (MS integral)] in CT reconstruction technique for the occurrence of MACE in the ESRD patients. Independent sample t test was used for inter-group comparison of the measurement data conforming to normal distribution, rank sum test was used for inter-group comparison of the measurement data conforming to abnormal distribution, and χ² test was used for inter-group comparison of the count data. Results　According to the occurrence of CAC, the ESRD patients were divided into a CAC group [164 cases, 108 males and 56 females, aged 61.00 (50.00, 71.00) years] and a non-CAC group [64 cases, 43 males and 21 females, aged 38.00 (31.00, 45.00) years]. The incidence of MACE in the CAC group was significantly higher than that in the non-CAC group [60.98% (100/164) vs. 21.87% (14/64)], with a statistically significant difference (P<0.001). In the CAC group, the three CAC integrals of the MACE subgroup were significantly higher than those of the non-MACE subgroup (AS integral: 4 267.0 vs. 725.3, P<0.001; MS integral: 3.2 vs. 2.7, P<0.001; VS integral: 4 732.0 vs. 881.9, P<0.001). Logistic regression analysis showed that AS integral, MS integral, VS integral, and albumin were all risk factors for MACE in the ESRD patients, among which MS integral and albumin were independent risk factors for MACE in the ESRD patients (all P<0.05). Conclusions　ESRD patients with CAC have a high incidence of MACE. MS integral is an independent risk factor of MACE occurrence in ESRD patients, and might be applied to clinical monitoring of the occurrence and development of MACE in ESRD patients.

Association between ApoE gene polymorphism and ADMA level in patients with chronic kidney disease

Mei Jiahui, Lou Huankun, Wang Xun, Han Cuimin, Li Peng, Xing Tuanjie, Wang Minglang, Wang Yilian

2022, 28(8):  1047-1052.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.003

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Objective　To investigate the association between apolipoprotein E (ApoE) gene polymorphism and asymmetric dimethylarginine (ADMA) expression in patients with chronic kidney disease. Methods　A total of 300 patients with chronic kidney disease hospitalized in the departments of cardiology and nephrology of Lianyungang Second People's Hospital from January 2018 to January 2020 were selected. The glomerular filtration rate (GFR) was calculated by the chronic kidney disease epidemiology collaboration (CKD-EPI) method, and 300 patients were stratified according to the GFR: group I with GFR >60 ml/min (86 cases), group Ⅱ with GFR >15 ml/min and ≤60 ml/min (119 cases), and group III with GFR ≤15 ml/min or hematodialysis (95 cases). The ApoE gene polymorphism was detected by polymerase chain reaction (PCR) amplification method, and the ADMA level was detected by double antibody sandwich enzyme-linked immunosorbent method (ELISA). The alleles and genotypes of each group were compared. ANOVA was used for comparison of the measurement data between groups, and χ² test was used for comparison of the count data. Results　The 300 patients were (61.9±13.1) years old, with 151 males (50.33%), body mass index (BMI) of (28.0±5.1) kg/m², including 88 cases (29.33%) of diabetes and 174 cases (58.00%) of cardiovascular diseases. There were statistically significant differences in the proportions of diabetes and coronary heart disease and the levels of low density lipoprotein, triglyceride, creatinine, and ADMA among the three groups (all P<0.05). There were 35 cases (11.67%) of ApoEε2 allele, 287 cases (95.67%) of ApoEε3 allele, and 58 cases (19.33%) of ApoEε4 allele. Based on the renal function, allele distribution was uniform among the three groups (all P>0.05); based on the ADMA level, the distribution of ApoE gene polymorphism was different in different ADMA level groups (all P<0.05). Conclusions　With the decrease of the GFR, the plasma ADMA level increases significantly. The distribution of ApoE alleles is uniform among different renal function groups. The distribution of ApoE alleles is not uniform in different ADMA level groups. The presence of clinical variables such as renal dysfunction limits the expression of ApoEε4 allele.

Investigation and analysis of the demands for popular science and health information in patients with chronic kidney disease

Wei Feiyuan, Guo Junjun, Gu Juan, Wu Dongming, Xue Leyi, Wang Lingzhen, Tang Fang, Deng Lili

2022, 28(8):  1052-1057.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.004

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Objective　To investigate the demands for popular science and health information in patients with chronic kidney disease (CKD), and provide a reference for formulating CKD popular science and education prescriptions. Methods　From December 2020 to January 2021, the convenience sampling method was used to survey 332 CKD patients from Guangdong Hospital of Traditional Chinese Medicine, Chinese Medicine Hospital of Hainan Province, and The People's Hospital of Xiangtan County. The survey included general conditions and nephropathy knowledge demands. χ² test was used for comparison of the count data and rank sum test was used for comparison of the grade data. Results　Among the 332 patients, 54.2% (180/332) were male, 45.8% (152/332) were female, 27.1% (90/332) were under 45 years old, 30.4% (101/332) were 45-60 years old, and 42.5% (141/332) were over 60 years old. The three items with high demand for nephropathy health information were diet management knowledge [82.2% (273/332)], nephropathy course and basic knowledge [61.4% (204/332)], and drug management knowledge [61.1% (203/332)]. The demand for popular science carriers was higher in text [85.8% (285/332)] and video animation [73.8% (245/332)]. Doctors (87.0%) and nurses (66.3%) were in high demand for personnels who were wished to impart popular science knowledge. There were statistically significant differences between the patients' current way of obtaining popular science and their expected way of online and offline face-to-face medical education (all P<0.001). Conclusions　Most CKD patients share the common demands for dietary health information, and dietary health education for CKD patients should be strengthened. The text and video animation led by doctors and nurses for health education are more popular in CKD patients. Reasonably combining Internet technology to conduct online science popularization can improve the efficiency and quality of health education for CKD patients.

Correlation between regular follow-up and complications in peritoneal dialysis patients 

Su Caihong, Huang Liqiu, Li Hongyan, Lei Ying, Yang Shen, Zhang Yunfang

2022, 28(8):  1057-1061.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.005

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Objective　To study the correlation between regular follow-up and complications in peritoneal dialysis patients, and to provide basis for clinical diagnosis and treatment and patient management. Methods　A single-center retrospective analysis method was used. The data of 212 peritoneal dialysis patients who were followed up in Huadu District People's Hospital of Guangzhou from January to October 2020 were collected. Among them, 156 patients themselves were followed up once a month, as a regular follow-up group, and other 56 patients with poor regular follow-up as an irregular follow-up group. The basic and clinical data of the two groups were analyzed. χ² test was used for the count data, independent sample t test or Wilcoxon rank sum test was used for the measurement data, and Spearman rank correlation analysis was used for correlation analysis. Results　In the irregular follow-up group, the time of dialysis was 44.50 (22.00, 77.50) months, the education level above middle school accounted for 53.57% (30/56), the systolic blood pressure was (147.84±19.79) mmHg (1 mmHg=0.133 kPa), the incidence of cardiovascular events was 28.57% (16/56), and the incidence of respiratory diseases was 10.71% (6/56), which were higher than those in the regular follow-up group (all P<0.05). In the irregular follow-up group, the complete self-care accounted for 73.21% (41/56), the fluid change by patients themselves accounted for 71.43% (40/56), the residual urine volume was 100.00 (0.00, 300.00) ml, and the serum albumin level was (33.65±5.14) g/L, which were lower than those in the regular follow-up group (all P<0.05). The 56 patients in the irregular follow-up group had 53 cases of complications, accounting for 94.64% (53/56); among the causes of complications, cardiovascular events accounted for 26.32% (35/133). Correlation analysis showed that regular follow-up was negatively correlated with self-care ability, fluid change operators, time of dialysis, systolic blood pressure, cardiovascular events, respiratory disease, and other diseases (r=-0.176, -0.272, -0.167, -0.196, -0.195, -0.218, -0.159; P=0.011, 0.001, 0.015, 0.004, 0.004, 0.001, 0.021); regular follow-up was positively correlated with education level, residual urine volume, and serum albumin level (r=0.141, 0.204, 0.165; P=0.041, 0.003, 0.016). Conclusion　During the long-term maintenance peritoneal dialysis treatment, it is of great significance to strengthen the regular follow-up for patients to reduce complications, especially the occurrence of cardiovascular and cerebrovascular events.

Analysis of pathogenic bacteria and their drug sensitivities of urinary tract infection after resection of bladder cancer

Cheng Peng, Zhang Qingqing, Ma Yajun

2022, 28(8):  1062-1065.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.006

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Objective　To retrospectively analyze the pathogenic bacteria and their drug sensitivities of urinary tract infection after resection of bladder cancer, and to provide references for clinicians to select antibiotics. Methods　From January 2017 to September 2021, 277 patients with urinary tract infection after resection of bladder tumor in Tengzhou Central People's Hospital Affiliated to Xuzhou Medical University were selected, including 126 males and 151 females, with an age of (66.7±8.7) years old, and their midstream urine samples were collected for routine culture. The identification and drug sensitivity test were carried out on pathogenic bacteria. Results　The main pathogens of urinary tract infection after resection of bladder tumor were Gram-negative bacilli [77.62% (215/277)], mainly Escherichia coli [42.24% (117/277)] and Klebsiella pneumoniae [15.16% (42/277)]; the second was Gram-positive cocci [21.30% (59/277)], mainly Enterococcus faecalis D group [8.66% (24/277)] and Streptococcus agalactiae B group [4.69% (13/277)]; fungi accounted for 1.08% (3/277). The drug-sensitive test results showed that the more sensitive antibiotics of Escherichia coli and Klebsiella pneumoniae were mainly ertapenem, imipenem, and meropenem (all >96%), and the antibiotics with high resistance rate were mainly ampicillin, cefazolin, and ciprofloxacin (all >60%); Enterococcus faecalis D group and Streptococcus agalactiae B group showed higher sensitivity to ampicillin, linezolid, penicillin, daptomycin, nitrofurantoin, tigecycline, teicoplanin, and vancomycin (all >94%), Enterococcus faecalis D group was more resistant to clindamycin, tetracycline, and erythromycin (all >66%), and Streptococcus agalactiae B group was more resistant to clindamycin, erythromycin, levofloxacin, and moxifloxacin (all >80%). Conclusions　The main pathogens of urinary tract infection after resection of bladder cancer are gram-negative bacilli, mainly Escherichia colicancer and Klebsiella pneumoniae, and the Gram-positive cocci are mainly Enterococcus faecalis D group and Streptococcus agalactiae B group. The resistance rates of pathogenic bacteria to some antibiotics are high, so clinicians should pay attention to monitoring and drug sensitivity test results of pathogenic bacteria, and apply antibiotics rationally.

Scientific Research

Changes of serum zinc, copper, and selenium concentrations in children and adolescents with myopia

Xin Jifu, Wuren Tuya, Qingge Letu

2022, 28(8):  1066-1069.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.007

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Objective　To investigate the changes of serum zinc, copper, and selenium concentrations and copper/zinc ratio in children and adolescents with myopia and the clinical significance. Methods　From January 2018 to December 2020, 166 children and adolescents with myopia [110 boys and 56 girls, aged (13.78±4.21) years] from Department of Ophthalmology, The Affiliated Hospital of Inner Mongolia Medical University and 150 children and adolescents with normal vision [87 boys and 63 girls, aged (12.37±4.82) years] were chosen as subjects. The serum zinc, copper, and selenium concentrations were detected by atomic absorption spectrometry, and the copper/zinc ratio which reflected the oxidative stress level of the body was calculated accordingly. Student's t test was used to compare the measurement data between groups, Chi-square test was used for the count data, and correlation analysis was performed by Pearson correlation coefficient method. Results　The levels of serum zinc and selenium in the children and adolescents with myopia were lower than those in the control group [(0.83±0.27) mg/L vs. (1.06±0.32) mg/L, (41.05±9.07) µg/L vs. (47.19±8.36) µg/L], and the copper/zinc ratio was higher than that in the control group [(1.18±0.32) vs. (0.98±0.26)], with statistically significant differences (all P<0.05); there was no statistically significant difference in the serum copper level between the two groups (P>0.05). There were no correlations among serum trace elements in the children and adolescents with myopia (all P>0.05). Conclusions　The serum levels of anti-oxidant trace elements zinc and selenium in children and adolescents with myopia have reduced, and the copper/zinc ratio has increased, which suggests that the process of myopia in children and adolescents may be related to the state of oxidative stress.

Calf muscle growth after Onabotulinum toxin A injection in children with spastic cerebral palsy: a prospective study

He Lu, Li Jinling, Yang Xubo, Zheng Yun, Xu Kaishou

2022, 28(8):  1070-1076.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.008

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Objective　To investigate the muscle growth of gastrocnemius, soleus, and tibialis anterior after Onabotulinum toxin A injection and intensive physiotherapy program in children with cerebral palsy. Methods　From December 2014 to March 2016, 24 children with spastic cerebral palsy aged 2-7 years from Guangzhou Women and Children's Medical Center participated in this prospective study, including 14 boys and 10 girls. Their lower limbs were divided into a diplegia cerebral palsy group (DCP group, 28 lower limbs in 14 children with diplegia cerebral palsy), an affected side of hemiplegia cerebral palsy group (aHCP group, 10 affected lower limbs in 10 children with hemiplegia cerebral palsy), and a control group (uHCP group, 10 unaffected lower limbs in 10 children with hemiplegia cerebral palsy). Interventions included Onabotulinum toxin A injection and intensive physiotherapy program. Assessments were applied at baseline and 12 and 24 weeks after Onabotulinum toxin A injection and physiotherapy. Ultrasound measurement parameters were muscle thickness, fascicle length, and growth rate. Clinical measurement parameters were gross motor function measure, modified Ashworth scale, and modified Tardieu scale. Independent sample t test or one-way ANOVA was used for the measurement data conforming to normal distribution, rank sum test was used for the measurement data conforming to abnormal distribution, Chi-square test was used for the count data, and the Pearson correlation analysis was used. Results　The gross motor function, spasticity, and most muscle architecture were improved in the three groups after Onabotulinum toxin A injection and intensive physiotherapy (all P<0.05). The average growth rates of gastrocnemius muscle thickness and fascicle length of the affected legs were 6.24% and 7.99% after 24 weeks. For the internal/lateral gastrocnemius muscle thickness and fascicle length and soleus muscle thickness in the DCP group, the lateral gastrocnemius fascicle length in the aHCP group, and the internal gastrocnemius fascicle length in the uHCP group, the growth rates from baseline to 12 weeks after intervention were better than those from 12 weeks to 24 weeks after intervention (all P<0.05); the soleus muscle growth rate of the DCP group from baseline to 24 weeks after intervention was better than those of the aHCP group and uHCP group (both P<0.05); the growth rates of soleus fascicle length in the DCP group and uHCP group from 12 weeks to 24 weeks after intervention were better than that in the aHCP group (both P<0.05). Conclusion　Children aged 2-7 years with spastic cerebral palsy might undergo longitudinal and cross-sectional growth in calf muscles after single Onabotulinum toxin A injection and physiotherapy.

Analysis of risk factors of cervical insufficiency in patients with polycystic ovary syndrome and late abortion undergoing pregnancy-assisted therapy 

Liu Caixia, Zhou Xinhua, Guo Baozhi, Guo Huanhuan

2022, 28(8):  1077-1080.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.009

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Objective　To analyze the influencing factors of cervical insufficiency (CI) in patients with polycystic ovary syndrome (PCOS) complicated with late abortion who receive pregnancy-assisted therapy. Methods　A total of 102 patients with PCOS with late abortion receiving pregnancy-assisted therapy were selected from Women & Infants Hospital of Zhengzhou between January 2019 and December 2020. The patients' age was (32.39±6.54) years old, and there were 78 cases of singleton pregnancy and 24 cases of multiple pregnancy. According to whether CI occurred, the patients were divided into a control group (without CI, 88 cases) and an observation group (with CI, 14 cases). The general conditions of the two groups were compared by univariate analysis (independent sample t test and χ² test), multivariate logistic regression analysis was performed on the data with statistically significant differences in the univariate analysis to screen the influencing factors of CI. Results　Multivariate logistic analysis showed that average uterine diameter, pre-pregnancy body mass index (BMI), multiple pregnancy, and preterm birth history were the influencing factors for CI in PCOS patients with late pregnancy-assisted abortion (OR=2.678, 2.918, 2.872, and 3.792; all P<0.05). Conclusions　The average uterine diameter, pre-pregnancy BMI, multiple pregnancy, and preterm birth history are the influencing factors for CI in PCOS patients with late pregnancy-assisted abortion. It is necessary to take corresponding measures according to the above factors to reduce the probability of CI.

Correlation between vitamin D level and cognitive dysfunction in elderly patients with cerebral small vessel disease

Gong Chen, Shen Xiaozhu, Bao Qinwen, Zhao Xiaofei

2022, 28(8):  1081-1085.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.010

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Objective　To investigate the correlation between serum 25-hydroxyvitamin D [25(OH)D] level and cognitive dysfunction in elderly patients with cerebral small vessel disease (CSVD). Methods　From December 2019 to December 2020, 97 patients with CSVD in The Second People's Hospital of Lianyungang City including 56 males and 41 females, aged 65-85 years were selected and were divided into a CSVD with normal cognition group (50 cases) and a CSVD with cognitive dysfunction group (47 cases) according to the Montreal Cognitive Assessment Scale (MoCA) score, and other 30 elderly healthy people were selected as a control group. The clinical data and serum 25(OH)D levels of the three groups were collected. One way ANOVA was used for comparison of the measurement data between groups, χ² test was used for comparison of the count data between groups. Multivariate logistic regression analysis was used to analyze the risk factors for cognitive dysfunction in CSVD patients, and Pearson correlation analysis was used to explore the relationship between the MoCA score and 25(OH)D level in the cognitive dysfunction group. Results　The 25(OH)D levels of the CSVD with normal cognition group [(23.36±2.10) μg/L] and the CSVD with cognitive dysfunction group [(15.66±1.47) μg/L] were lower than that of the control group [(34.03±2.17) μg/L] (F=13.764, P<0.05), and the level of 25(OH)D in the CSVD with cognitive dysfunction group was significantly lower than that in the CSVD with normal cognition group (P<0.05). Compared with those in the CSVD with normal cognition group and the control group, the scores of visual space and execution, attention and computation, abstraction, delayed recall, and orientation and the total score of MoCA were decreased in the CSVD with cognitive dysfunction group (all P<0.05). Multivariate logistic regression analysis showed that 25(OH)D level was a protective factor for cognitive dysfunction in elderly patients with CSVD (OR=0.491, P=0.005). In the CSVD with cognitive dysfunction group, the level of 25(OH)D was positively correlated with the total score of MoCA and the scores of visual space and execution, attention and computation, delayed recall, and orientation (r=0.74, 0.63, 0.59, 0.74, 0.53; all P<0.05). Conclusion　The decline of serum 25(OH)D level is a risk factor for cognitive dysfunction in elderly patients with CSVD, and patients with low serum 25(OH)D level have more obvious cognitive dysfunction.

Effect of pembrolizumab for advanced lung adenocarcinoma patients with high PD-L1 expression

Li Yixuan, Zhao Min, Chen Na, Ma Jing

2022, 28(8):  1086-1088.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.011

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Two cases of Chlamydia psittaci pneumonia and literature review

Song Xiaobo, Wu Tingting, Li Fan

2022, 28(8):  1089-1092.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.012

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Chlamydia psittaci is an atypical pathogen, and is an intracellular parasitic Gram-negative bacterium. Birds are the main hosts and it is zoonotic. This paper reported two cases of pneumonia caused by Chlamydia psittaci infection in Shanghai Songjiang District Central Hospital. One case was complicated with respiratory failure and liver dysfunction, the pathogen was confirmed after next-generation gene sequencing for bronchoscopic alveolar lavage fluid, and the pulmonary inflammation was absorbed and improved after anti-infection. Through case sharing, it can provide references for clinicians in the clinical process of diagnosis and treatment of pneumonia, so that clinicians can accurately evaluate the severity of the disease, identify the pathogen as soon as possible, timely adjust the medication plan, achieve accurate treatment, and get valuable time for the treatment of the disease.

Immunogenicity and influencing factors of measles-mumps-rubella combined vaccine and cognition of vaccination in recruits

Xie Xiaobo, Yu Dexian, Liu Wenyi, Yang Yang

2022, 28(8):  1093-1098.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.013

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Objective　To evacuate the immunogenicity of measles-mumps-rubella combined vaccine (MMR), explore its influencing factors, and survey the attitude to vaccination in recruits. Methods　The cluster sampling method was used to select recruits from two boot camps stationed in Guangdong in September 2017 as the research objects. A total of 396 people from the boot camp 1 were selected to study the immunogenicity and influencing factors of MMR, and a cognitive survey of vaccine was conducted in 473 people from the boot camp 2. The recruits' antibody titers before and after MMR vaccination were tested, and a questionnaire survey was conducted. χ² test was used to analyze the difference of antibody positive rate before and after vaccination. After data transformation, normality test, and homogeneity test of variance, the antibody geometric mean concentration (GMC) was statistically analyzed by independent sample t test or F test. Results　After MMR vaccination, the antibody positive conversion rates of measles, mumps, and rubella in the 396 people from the boot camp 1 were 100.00%, and the antibody GMC of measles, mumps, and rubella were 1 191.67 mIU/ml, 1 663.62 U/ml, and 144.59 IU/ml respectively, which were 1.73 times, 4.79 times, and 4.09 times of those before vaccination. The antibody levels after vaccination were significantly higher than those before vaccination (all P<0.05). After vaccination, the antibody GMC of the soldiers with negative antibody before vaccination was lower than those with positive antibody before vaccination, and the difference was statistically significant in the mumps and rubella (both P<0.05). The study found that age, nationality, education background, place of enlistment, family economic status, smoking, drinking, work before enlistment, intimate contact with the opposite sex, and chronic gastroenteritis had no significant effects on the antibody concentration after MMR vaccination. According to the survey, the vast majority of people in the boot camp 2 wanted to know the knowledge related to the vaccine [97.25% (460/473)] and believed that vaccination could effectively prevent the corresponding diseases [90.49% (428/473)], but only 72.52% (343/473) were willing to inoculate vaccine. The main reason for their reluctance was vaccine safety (53.85%). Conclusions　Domestic MMR can produce good immunogenicity in recruits. Vaccine security events make a negative influence on vaccination willingness, and the publicity and education of vaccination in troops should be strengthened.

Risk factors of intraoperative massive hemorrhage in children undergoing brain tumor removal

Zhang Na, Wei Wei, Xu Xinke, Chen Cheng, Sun Guifang, Tan Yonghong

2022, 28(8):  1099-1103.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.014

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Objective　To analyze the risk factors of intraoperative massive hemorrhage in children undergoing brain tumor removal and explore its effect on postoperative recovery. Methods　The clinical data of 290 children who underwent elective brain tumor resection in Guangzhou Women and Children's Medical Center from October 2014 to December 2020 were analyzed retrospectively, including 172 males. According to the ratio of intraoperative blood loss to estimated blood volume (BL/EBV), they were divided into a small amount of bleeding group (BL/EBV≤0.5) and a large amount of bleeding group (BL/EBV>0.5). The influence of massive hemorrhage on postoperative recovery was analyzed, and the related factors of massive hemorrhage were analyzed by univariate analysis and multivariate logistic regression analysis. Independent sample t test or Wilcoxon rank-sum test was used for comparison between groups of the measurement data, and χ² test was used for comparison between groups of the count data. Results　There were 199 cases in the small amount of bleeding group and 91 cases in the large amount of bleeding group, with a massive hemorrhage rate of 31.38%. Body mass was a protective factor for intraoperative hemorrhage (OR=0.786, P=0.011), and maximum tumor diameter was an independent risk factor for intraoperative hemorrhage (OR=1.506, P<0.001). The incidence of postoperative infection-related complications in the large amount of bleeding group was significantly higher than that in the small amount of bleeding group, and the duration of postoperative mechanical ventilation and postoperative hospital stay were also significantly longer (all P<0.05). Conclusion　The preoperative body weight and maximum tumor diameter are influencing factors for intraoperative massive hemorrhage in children undergoing brain tumor resection, and massive hemorrhage will increase the risk of postoperative complications.

Study on the correlation between the degree of paralysis and the thickness of cortical bone in adolescents with cerebral palsy

Huang Fang, Wang Liyuan, Yang Jiewen

2022, 28(8):  1104-1106.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.015

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Objective　The bone development in adolescents with different degrees of cerebral palsy was investigated by measuring the thickness of cortical bone. Methods　Fifty-one adolescents (29 males and 22 females) aged from 10 to 18 years were randomly selected for the cortical examination of the humerus from Guangzhou Social Welfare Institute from July to December 2020, including 30 cases with normal motor function, 8 cases with mild cerebral palsy, 6 cases with moderate cerebral palsy, and 7 cases with severe cerebral palsy. The radiographs of the right humerus were taken to measure the cortical bone thickness of the humerus. One-way ANOVA was used for overall comparison of the measurement data, and SNK-q test was used for pairwise comparison. Results　The cortical bone thickness of the normal motor function group, the mild cerebral palsy group, the moderate cerebral palsy group, and the severe cerebral palsy group were (4.04±0.82) mm, (4.50±0.82) mm, (3.57±0.99) mm, and (2.97±0.49) mm, respectively, with a statistically significant difference (F=5.067, P=0.004). SNK-q results showed that there was no statistically significant difference in the cortical bone thickness among the normal motor function group, the mild cerebral palsy group, and the moderate cerebral palsy group (P=0.058), and there was no statistically significant difference between the moderate cerebral palsy group and the severe cerebral palsy group (P=0.139). Conclusion　Humeral cortical bone thickness gradually thins as the degree of cerebral paralysis increases to moderate and severe degree.

Correlation between serum albumin level and severity in COVID-19 patients

Lin Youfei, Wang Jiaojiao, Wu Di, Liu Yiping, Chen Xiaohong, Chen Lizhou

2022, 28(8):  1107-1111.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.016

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Objective　To investigate the relationship between serum albumin level and severity in patients with coronavirus disease 2019 (COVID-19). Methods　The clinical data of 70 COVID-19 patients in Fuzhou Pulmonary Hospital of Fujian Province from January 23, 2020 to March 5, 2020 were analyzed retrospectively. According to the initial serum albumin level, the enrolled patients were divided into a normal albumin group (43 cases) and a hypoalbuminemia group (27 cases). Then, the differences in both groups were analyzed about serum albumin levels and chest imaging scores on the 1^st, 7^th, and 14^th day after admission, as well as nucleic acid turning negative time. Independent sample t test was used to compare the measurement data between groups, and χ² test or Fisher's exact probability method was used to compare the count data between groups. Results　Among the 70 patients, 36 were male and 34 were female, aged (43.53±14.91) years. The patients in the hypoalbuminemia group were older (t=3.117, P=0.003) and had a higher incidence of underlying diseases (χ²=9.807, P=0.002) and cough (χ²=7.396, P=0.007) than those in the normal albumin group. The serum albumin levels in the hypoalbuminemia group were (39.66±3.77) g/L, (32.58±4.00) g/L, and (36.20±2.27) g/L on the 1^st, 7^th, and 14^th day after admission, which were lower than those in the normal albumin group [(43.55±5.67) g/L, (41.18±6.16) g/L, and (41.82±4.87) g/L], with statistically significant differences (all P<0.05). The chest imaging scores in the hypoalbuminemia group were (6.88±2.80) points, (6.57±2.98) points, and (4.88±2.47) points on the 1^st, 7^th, and 14^th day after admission, which were higher than those in the normal albumin group [(4.85±2.76) points, (4.58±3.21) points, and (3.45±1.74) points], with statistically significant differences (all P<0.05). The nucleic acid turning negative time in the hypoalbuminemia group was (22.68±4.60) d, longer than that in the normal albumin group [(19.50±5.36) d], with a statistically significant difference (t=-2.329, P=0.023). Conclusions　The serum albumin level in COVID-19 patients is closely related to the severity of patients' condition. The lower the serum albumin level in patients, the more severe the chest image and the longer the nucleic acid turning negative time.

Practice of setting up a protection supervisor post in COVID-19 isolation ward

Li Mengmeng, Liu Yu, Xu Jianying, Wu Qiaomei

2022, 28(8):  1111-1114.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.017

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Objective　To explore and evaluate the operation effect of the post of protection supervisor in the COVID-19 isolation ward. Methods　A retrospective collection of staff who entered and exited the COVID-19 isolation ward of Fangcun Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine within 40 days from May 29, 2021 to July 9, 2021 was conducted. A total of 105 people were studied, including 27 males and 78 females, with an age of (36.35±3.82) years old. The post of protection supervisor was set up in the isolation ward, and the job responsibilities were formulated, including on-site supervising and assisting staff in and out of the ward to put on and take off protective clothing, avoiding improper protection and pollution when taking off protective clothing, and preventing personnel from infection; maintaining and supervising the overall epidemic prevention affairs in the ward to prevent the occurrence of nosocomial infections. Results　Within 40 days of the temporary establishment of the isolation ward, the protection supervisors supervised, guided, and assisted 3 354 people entering and exiting the isolation wards, supervised the overall epidemic prevention affairs of the ward 117 times, prevented 117 cases of incorrect putting on or taking off protective clothing, the correct rate of putting on and taking off protective clothing was 100.0%, and the rate of nosocomial infection in the isolation ward was 0. Conclusion　The establishment of a protection supervisor post has important supervisory and guiding significance for avoiding the personnel infection and reducing the nosocomial infections.

A mixed research scheme on job stressors in nurses from the transitional isolation ward under emergency in the epidemic containment area of Guangzhou 

Wang Jing, Liu Yu, Xu Jianying, Yang Liming, Lin Jingxia, Wu Qiaomei, Deng Lili

2022, 28(8):  1114-1118.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.018

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Objective　To understand the job stressors in nurses from the transitional isolation ward under emergency in the epidemic containment area of Guangzhou, to clarify the practical problems and difficulties in their work process, and to formulate effective intervention measures. Methods　Using the combination of quantitative and qualitative methods, 67 nurses in the transitional isolation ward of Guangdong Hospital of Traditional Chinese Medicine from June to July 2021 were surveyed by Nurse Job Stressor Scale (NJSS) in the form of questionnaire. Semi-structured interview was conducted on 2 male nurses and 13 female nurses aged 23 to 39 years. Golaizzi 7-step analysis was used to sort out, summarize, and analyze the interview contents. Research software Nvivo12 was used to analyze the interview materials. Results　The score of job stressors in the nurses from the transitional isolation ward was (2.549±0.758) points, among which the main stressor was workload and time distribution [(2.878±0.838) points]. Four themes were extracted: nursing workload, worry about lack of working ability and knowledge, psychological state fluctuation, and concern for family members during the epidemic containment. Conclusion　In the future, nursing managers should carry out all-round, diversified, and continuous knowledge training, timely pay attention to and ease nurses' psychological pressure, reduce the workload of transitional isolation ward, and take targeted intervention measures to help them cope with it positively.

Application effect of poly-L-lactic acid absorbable internal fixation system in jaw fractures

Xiao Bin, Huang Zicheng, Li Jianmin, Yang Yiming, Kuang Rong

2022, 28(8):  1118-1122.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.019

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Objective　To observe the application effect of poly-L-lactic acid absorbable internal fixation system in jaw fractures. Methods　A prospective study was used to select 120 patients with jaw fractures who received treatment in Yuebei People's Hospital from January 2020 to July 2021. They were divided into an observation group and a control group by the random number table method. The control group included 23 males and 37 females, aged (30.25±2.37) years; the observation group included 24 males and 36 females, aged (30.49±2.28) years. The control group was given micro titanium plate and screw fixation, while the observation group was given poly-L-lactic acid absorbable internal fixation system treatment. The occlusal forces, chewing efficiencies, and fixation forces before and after treatment, fracture healing time, operation time, incidence of complications, and treatment effect were compared between the two groups. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison of the measurement data, and χ² test was used for the count data. Results　After treatment, the occlusal force, chewing efficiency, and fixation force in the observation group were (160.92±4.18) lbs, (0.75±0.22), and (4.58±0.32) N, respectively, which were higher than those in the control group [(100.28±4.46) lbs, (0.61±0.17), and (3.58±0.29) N], with statistically significant differences (all P<0.05). There was no statistically significant difference in the operation time between the two groups (P>0.05); the fracture healing time of the observation group was (1.28±0.27) months, which was shorter than that of the control group [(3.20±0.46) months], with a statistically significant difference (P<0.05). The incidence of complications in the observation group was 10.00% (6/60), which was lower than that in the control group [31.67% (19/60)], with a statistically significant difference (P<0.05). The effective rate of treatment in the observation group was 93.33% (56/60), which was higher than that in the control group [70.00% (42/60)], with a statistically significant difference (P<0.05). Conclusion　The poly-L-lactic acid absorbable internal fixation system can significantly improve the occlusal relationship in patients with jaw fractures, significantly reduce the fracture healing time, and avoid the complications caused by metal residues, with high stability of fixation and reduction and good effect.

Research status of nasal high flow humidification oxygen therapy for patients with chronic obstructive pulmonary disease

Xu Hong, Li Mingmin, Sun Wei

2022, 28(8):  1123-1126.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.020

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Chronic obstructive pulmonary disease poses an increasing threat to human health, so it has received increasing clinical attention. In clinic, oxygen therapy is often used to treat chronic obstructive pulmonary disease, which can help patients improve their quality of life and reduce the probability of complications by inhibiting the deterioration of the disease. However, the treatment effect of the traditional oxygen therapy on chronic obstructive pulmonary disease is relatively poor. As a novel oxygen therapy model, nasal high-flow oxygen therapy can improve the patients' state of hypoxia through a high flow rate, relieve their carbon dioxide retention conditions, and at the same time improve their comfort level during the disease treatment process due to stable humidification and heat preservation effects. It greatly shortens patients' treatment time and reduces the probability of respiratory tract infection and bronchospasm. This study focused on the main working principle, clinical performance, application in stable chronic obstructive pulmonary disease patients and acute exacerbation chronic obstructive pulmonary disease patients management of high flow oxygen therapy humidification therapeutic apparatus, and made the following review.

Evaluation of the effect of chronic disease self-management model in patients with postoperative lymphedema of breast cancer

Yuan Chenye, Li Yuqun

2022, 28(8):  1126-1130.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.021

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Objective　To explore the clinical effect of chronic disease self-management model applied to postoperative lymphedema in breast cancer patients. Methods　A total of 118 patients with lymphedema after breast cancer surgery who were admitted to Wuxi Second People's Hospital from December 2018 to October 2020 were selected and were divided into two groups by the random number table method, with 59 cases in each group. The control group was (43.35±6.50) years old and received routine intervention, and the observation group was (43.57±6.67) years old and received chronic disease self-management model. The self-care ability, upper limb function, and quality of life were compared between the two groups. The measurement data were compared between groups by independent sample t test and within groups by paired t test, and the count data were compared by Chi-square test. Results　Before intervention, there were no statistically significant differences in the scores of self-care ability, upper limb function, and quality of life between the two groups (all P>0.05). After intervention, the scores of self-care ability and quality of life in the observation group were (146.52±5.60) points and (173.04±7.69) points, respectively, which were significantly higher than those in the control group [(128.81±6.57) points and (153.95±5.31) points], and the upper limb function score in the observation group was (65.27±4.20) points, which was significantly lower than that in the control group [(72.94±5.83) points], with statistically significant differences (all P<0.05). Conclusion　The chronic disease self-management model applied to patients with lymphedema after breast cancer surgery can effectively enhance their self-care ability, improve their upper limb function, and significantly improve their quality of life.

Application of a mixed teaching mode of gynecological and obstetric cases co-built by teachers from Guangdong and Macao

Zhang Xueling, Huang Meiling, Liu Chunling, Sun Zhuoran

2022, 28(8):  1130-1134.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.022

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Objective　To cooperate with universities and clinical practice bases in Guangdong and Macao and explore the application effect of reform mode in clinical nursing teaching of nursing students in gynecological and obstetric practice through the combination of "online + offline" teaching mode driven by clinical cases in obstetrics. Methods　A total of 182 nursing students who practiced gynecology and  obstetrics in The Third Affiliated Hospital of Guangzhou Medical University from 2019 to 2020 were selected as the subjects. A non-synchronous control was adopted. Ninety nursing students from June to December 2019 were selected as a control group, including 9 males and 81 females, aged (21.77±1.14) years, and conventional clinical nursing teaching method was adopted; 92 nursing students from June to December 2020 were selected as an observation group, including 7 males and 85 females, aged (21.74±1.05) years, and the "online + offline" mixed teaching mode was adopted. The self-directed learning abilities and clinical decision-making abilities of the two groups were compared. Independent sample t test was used for the measurement data and Chi-square test was used for the count data. Results　The scores of self-directed learning ability and clinical decision-making ability in the observation group were (257.92±37.70) points and (144.68±22.92) points, respectively, which were higher than those in the control group [(234.68±23.04) points and (133.21±13.35) points], with statistically significant differences (both P<0.05). Conclusions　The mixed teaching mode of obstetric cases co-built by Guangdong and Macao nursing teachers can improve the self-directed learning ability and clinical decision-making ability in nursing students. However, this reform mode requires the students' active participation, and has certain requirements on the nursing students' clinical acuity and thinking activity. Moreover, this study only has selected clinical nursing interns from a hospital, and the sample range of future research needs to be further expanded.

Research progress in the application of MEBO in wound healing

Zhang Ying, Cui Guanghuai, Liu Feifei, Huang Xingzi, Dai Shumin, Li Qiongyu, Pei Mengge, Liu Wenming

2022, 28(8):  1134-1137.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.023

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In recent years, the management and treatment of wound has become a hot spot of clinical research. In addition to dressing change of wound and surgical treatment when necessary, drugs promoting wound healing have also been paid more and more attention to. In recent years, more and more literatures have reported that moisture exposed burn ointment (MEBO) has good anti-infection and promoting wound healing effects in the treatment of burns and chronic wounds. Therefore, this paper reviewed the effect of MEBO on wound healing and its anti-inflammatory effect, aiming to provide clinical guidance for optimizing drug use to promote wound healing. In this paper, the components and promoting healing mechanism of MEBO were introduced, then the latest progress on clinical application of MEBO was discussed, and finally, the possible research direction of MEBO in wound treatment in the future was summarized and prospected.

Treatises

Comparative study on clinical symptoms and ultrasonic image features of benign and malignant non-mass-like breast lesions 

Zhuang Shulian, Yang Shuang, Lai Danhui, Ye Siting, Lin Xian, Chen Miao, Zhang Jianxing

2022, 28(8):  1138-1142.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.024

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Objective　To analyze the differences of clinical symptoms and ultrasonic image features between benign and malignant non-mass-like breast lesions and to investigate their diagnostic values. Methods　A total of 229 non-mass-like breast lesions detected by ultrasound in 210 female patients aged (44.3±11.1) years were retrospectively analyzed in The Second Affiliated Hospital, Guangzhou University of Chinese Medicine from June 2017 to July 2019. The differences of clinical symptoms and ultrasonic image features were compared between the benign and malignant groups. The ultrasonic image features included size, orientation, cord-shaped hypoecho in the lesion, echo pattern, posterior features, calcification, associated features, and blood flow signal. Independent sample t test was used to compare the measurement data, and χ² test or Fisher's exact probability method was used to compare the count data. Results　A total of 71 malignant lesions and 158 benign lesions were confirmed by surgery or biopsy. There were statistically significant differences in clinical symptoms, cord-shaped hypoecho in the lesion, echo pattern of lesions, calcification, associated features, and blood flow between the benign group and the malignant group (all P<0.05); in the benign group, the echo pattern of lesions was mainly type Ⅱa and Ⅴ, while in the malignant group, it was mainly type Ⅰb and Ⅱb; there were no statistically significant differences in the size, orientation, and posterior features (all P>0.05). Conclusion　There are some differences in the clinical symptoms and ultrasonic image features between benign and malignant non-mass-like breast lesions, which may be helpful to the differential diagnosis for non-mass-like breast lesions.

Associations between homocysteine and stroke severity and extracranial and intracranial arteriostenosis in stroke patients 

Yang Yingliang, Xu Yingzhi, Liu Guiyan, Wang Quanliang

2022, 28(8):  1142-1146.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.025

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Objective　This study aimed to investigate how plasma homocysteine (Hcy) correlated to stroke severity in patients with large artery atherosclerosis and to evaluate the association between Hcy level and extra- and intra-cranial arterial stenosis. Methods　We enrolled 96 patients with large artery atherosclerosis (LAA) stroke (internal carotid artery and middle cerebral artery supply area) and 57 healthy controls in Shouguang People's Hospital. The LAA stroke patients were divided into two subgroups according to National Institutes of Health Stroke Scale (NIHSS): one group with NIHSS score ≥6 and another group with NIHSS score <6. Based on the intracranial and extracranial artery stenosis, the LAA stroke patients were classified into three groups: a single-vessel group, a double-vessel group, and a multi-vessel lesion group. Independent sample t test was used for comparison between two groups if the measurement data met the normal distribution, one-way ANOVA was used for comparison among three groups, and non-parametric test was used for comparison if the measurement data did not meet the normal distribution. χ² test was used for the count data. Logistic regression analysis was used to find risk factors, and receiver operating characteristic curve (ROC) was used to evaluate the application value of Hcy concentration in predicting the severity of neurological impairment in patients with acute stroke at admission. Results　There were 58 males and 38 females in the LAA group, aged (66.38±10.93) years; there were 27 males and 30 females in the control group, aged (61.84±10.99) years. The plasma Hcy concentration in the LAA group was significantly higher than that in the control group [(28.65±16.49) μmol/L vs. (14.56±10.47) μmol/L] (P<0.05). The plasma Hcy level in the NIHSS score ≥6 group was significantly higher than that in the NIHSS score <6 group [(36.63±14.00) μmol/L vs. (24.27±16.20) μmol/L] (P<0.05). The area under the curve (AUC) of Hcy for evaluating the degree of nerve defect in acute stroke patients at admission was 0.776 (95%CI 0.683-0.868), and the optimal diagnostic value was 21.43 μmol/L (a sensitivity of 91.2% and a specificity of 56.5%). The Hcy concentration in the multi-vessel stenosis group was higher than those in the double-vessel stenosis group and the single-vessel stenosis group successively [(43.25±17.40) μmol/L vs. (25.53±12.47) μmol/L vs. (18.47±7.88) μmol/L], with a statistically significant difference (P<0.05). The higher the number of intracranial and extracranial large vessel stenosis in acute LAA stroke was, the higher the plasma Hcy concentration was. Conclusions　Plasma Hcy concentration is correlated with the neurological deficit severity in stroke patients. The more intracranial and extracranial arterial stenosis the stroke patients have, the higher the plasma Hcy concentration is. Hcy may be an indicator for evaluating the neurological deficit severity and the extent of arterial stenosis in LAA stroke patients.

Study on the related factors of blood glucose change in newborns born to women with gestational diabetes mellitus

Ma Fenfang, Li Xiaoling, Liu Yuchang, Huang Yanqiong

2022, 28(8):  1147-1149.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.026

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Objective　To investigate the related factors of blood glucose change in newborns born to women with gestational diabetes mellitus (GDM). Methods　A total of 200 pregnant women with GDM who delivered in Taishan People's Hospital from January 2019 to April 2021 were collected. Blood glucose was detected 1 h, 3 h, 6 h, 12 h, and 24 h after birth, and the neonatal birth weight and feeding status and maternal gestational age, delivery mode, and lactation status 24 h after birth were collected. Chi-square test was used for the count data, and logistic regression was used for multivariate regression analysis. Results　The lowest blood glucose was (3.42±1.06) mmol/L 1 h after birth, the blood glucose gradually increased after birth, and the neonatal blood glucose levels 3 h, 6 h, 12 h, and 24 h after birth were (3.49±1.05), (3.58±1.14), (4.01±0.52), and (4.39±0.48) mmol/L, respectively. Among them, 46 newborns (23.0%) were still hypoglycemic 24 h after birth. Gestational age ≤38 weeks, neonatal body weight <3 000 g, and lactation 24 h after birth were the independent risk factors of hypoglycemia 24 h after birth (all P<0.05). Conclusions　Gestational age, neonatal body weight, and 24 h lactation volume are the main factors affecting hypoglycemia in newborns born to women with GDM 24 h after birth. We should pay special attention to these factors in clinical practice so as to prevent the occurrence of neonatal hypoglycemia in early stage.

Clinical Research

Comparative analysis of laryngeal mask anesthesia and endotracheal intubation anesthesia in single-hole thoracoscopic bilateral thoracic sympathectomy T3/T4

Wei Wuzhi, Liang Zhu, Lyu Wenqiang, Yang Duo, Lin Xifeng

2022, 28(8):  1150-1154.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.027

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Objective　To compare and analyze the clinical effects of laryngeal mask anesthesia and endotracheal intubation anesthesia in single-hole thoracoscopic bilateral thoracic sympathectomy T3/T4. Methods　It was a case control study. The clinical data of 80 patients with severe palmar hyperhidrosis who underwent minimally invasive surgery in the department of cardiothoracic surgery of Jieyang People's Hospital from January 2017 to October 2021 were retrospectively analyzed. They were divided into two groups, undergoing laryngeal mask anesthesia (group Ⅰ, 40 cases) and endotracheal intubation anesthesia (group Ⅱ, 40 cases) respectively. There were 21 males and 19 females in group Ⅰ, aged (20.8±4.6) years; there were 17 males and 23 females in group Ⅱ, aged (20.9±4.7) years. The total hospital stay, postoperative hospital stay, anesthesia cost, hospitalization cost, visual field exposure score, anesthetic effect score, operation time, anesthesia time, incidence of postoperative complications, and other indicators were compared. Independent sample t test was used for the measurement data conforming to normal distribution, rank sum test was used for the measurement data conforming to abnormal distribution or the grade data, and Chi-square test or Fisher's exact probability method was used for the count data. Results　The total length of stay in group Ⅰ was 2.0 (2.0, 2.0) d, the postoperative length of stay was 1.0 (1.0, 1.0) d, the anesthesia cost was (2 442.9±420.2) Yuan, the total hospitalization cost was (10 848.2±1 238.4) Yuan, and the anesthesia time was (75.1±18.0) min, the total length of stay in group Ⅱ was 3.0 (3.0, 4.0) d, the postoperative length of stay was 2.0 (2.0, 3.0) d, the anesthesia cost was (2 883.7±242.3) Yuan, the total hospitalization cost was (12 739.5±917.1) Yuan, and the anesthesia time was (97.9±23.1) min, the above indexes in group Ⅰ were better than those in group Ⅱ, and the incidence of throat pain in group Ⅰ was significantly lower than that in group Ⅱ, with statistically significant differences (all P<0.05). There were no statistically significant differences in the visual field exposure score, anesthetic effect score, operation time, and incidences of other postoperative complications between the two groups (all P>0.05). Conclusions　Laryngeal mask anesthesia is safe and effective in single-hole thoracoscopic bilateral thoracic sympathectomy T3/T4. It is suitable for accelerated rehabilitation surgery after minimally invasive surgery for palmar hyperhidrosis.

Application of Jinsang Sanjie capsules in patients with reflux pharyngitis

Fan Xiaxia

2022, 28(8):  1154-1158.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.028

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Objective　To explore the effect of Jinsang Sanjie capsules in patients with reflux pharyngitis. Methods　A total of 94 patients with reflux pharyngitis in Qingyang Hospital of Traditional Chinese Medicine from August 2020 to July 2021 were selected for retrospective study. According to different treatment plans, they were divided into a control group and an observation group, with 47 cases in each group. There were 22 males and 25 females in the control group, aged (46.51±8.79) years; there were 19 males and 28 females in the observation group, aged (45.51±7.79) years. The control group was treated with rabeprazole and mosapride, and the observation group was additionally treated with Jinsang Sanjie capsules on the basis of the control group. The total effective rates, clinical symptom scores, serum inflammatory factors levels [interleukin-2 (IL-2), IL-8, and tumor necrosis factor-α (TNF-α)], plasma gastrointestinal hormones levels [vasoactive intestinal peptide (VIP), motilin (MTL), and gastrin (GAS)], and adverse reactions of the two groups were observed. The measurement data were tested by independent sample t test or paired t test and the count data by χ² test. Results　The total effective rate of the observation group was 95.74% (45/47), higher than that of the control group [82.98% (39/47)] (P<0.05). After treatment, the scores of cough, dysphagia, sticky throat, heartburn and acid reflux, and heating in the observation group were (0.51±0.14) points, (0.32±0.17) points, (0.31±0.12) points, (0.42±0.14) points, and (0.61±0.28) points, respectively, lower than those in the control group [(0.66±0.23) points, (0.41±0.22) points, (0.49±0.17) points, (0.71±0.29) points, and (0.81±0.31) points] (all P<0.05). After treatment, the levels of IL-8, TNF-α, and VIP in the observation group were (12.17±1.21) ng/L, (8.31±1.07) ng/L, and (16.88±2.19) ng/L, respectively, lower than those in the control group [(19.31±2.75) ng/L, (13.10±1.26) ng/L, and (20.86±2.31) ng/L], and the levels of IL-2, MTL, and GAS were (8.43±1.96) μg/L, (320.25±46.14) ng/L, and (162.96±23.15) ng/L, respectively, higher than those in the control group [(6.31±1.05) μg/L, (281.29±42.56) ng/L, and (133.57±18.46) ng/L] (all P<0.05). The rate of adverse reactions in the observation group was 4.26% (2/47), and there was no statistically significant difference compared with 8.51% (4/47) in the control group (P>0.05). Conclusion　Jinsang Sanjie capsules combined with rabeprazole and mosapride has a significant effect in the treatment of reflux pharyngitis, which can effectively improve the patients' symptoms and reduce the levels of inflammatory factors.

Efficacy of multi-functional electric ion pretreatment combined with 5-aminolevulinic acid photodynamic therapy for 7 cases of refractory plantar warts and literature review 

An Rongzhen, Zhang Junhua, Ren Na, Sun Hongyun, Ma Lei

2022, 28(8):  1158-1161.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.029

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Objective　To observe the clinical efficacy of multi-functional electric ion pretreatment combined with 5-aminolevulinic acid photodynamic therapy in the treatment of refractory plantar warts. Methods　From July 2020 to August 2021, 7 cases of refractory plantar warts in Binzhou Medical University Hospital were treated by multi-functional electric ion pretreatment in combination with 5-aminolevulinic acid photodynamic therapy for 3 to 6 times, including 5 males and 2 females, aged 11-70 years. The clinical effect was evaluated after 3 months of follow-up. Results　All the plantar warts in the 7 patients were removed completely with dermatoglyph reconstruction after 3-6 times of treatment and no recurrence during the 3-month follow-up visit. Conclusion　Effective pretreatment combined with 5-aminolevulinic acid photodynamic therapy is a recommended treatment for patients with refractory plantar warts and poor effect of conventional treatment.

Case Report

Epilepsy caused by ceftizoxime sodium: one case report and literature review 

Cui Hongxia, Wang Junteng

2022, 28(8):  1162-1163.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.030

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In this paper, a case of chronic nephritis with drug-induced epilepsy induced by ceftizoxime in Weihai Central Hospital Affiliated to Qingdao University in October 2021 was reported. Naranjo probability score was used to determine that the patient's epilepsy was most likely caused by ceftizoxime. The mechanism of ceftizoxime-induced epilepsy in patients with chronic renal insufficiency was discussed through literature review, in order to provide reference for clinical treatment.

Nursing Research

Effect of systematic health education on maternal and infantile health during perinatal period in grass-roots hospitals

Wang Ailing, Xu Lijun

2022, 28(8):  1164-1167.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.031

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Objective　To explore the effect of systematic health education on perinatal maternal and infantile health, so as to provide scientific management basis of perinatal maternal and infantile health in grass-roots hospitals. Methods　A total of 810 pregnant women aged (29.5±13.5) years admitted to Nan 'ao County People's Hospital from January 2019 to December 2020 were randomly taken as an observation group, and planned systematic health education intervention measures were implemented; 956 pregnant women aged (29.0±12.0) years admitted to Nan 'ao County People's Hospital from January 2017 to December 2018 were randomly taken as a control group, and oral routine health education was carried out. The effects of different education methods were compared between the two groups. Independent sample t test was used for the measurement data and Chi-square test was used for the count data. Results　After health education intervention, the pregnant women in the observation group had a comprehensive understanding and mastery on the contents of the questionnaire, and the total effective rate of health education was significantly higher than that in the control group [100.00% (810/810) vs. 92.53% (880/951)], with a statistically significant difference (χ²=67.289, P<0.001). After systematic health education intervention, the spontaneous labor rate [81.0% (656/810) vs. 69.3% (659/951)] and breastfeeding rate [99.0% (802/810) vs. 90.4% (860/951)] in the observation group were significantly higher than those in the control group, with statistically significant differences (χ²=33.507 and 64.859, both P<0.001); the puerperal infection rate in the observation group was lower than that in the control group [0.1% (1/810) vs. 0.8% (8/951)], with a statistically significant difference (χ²=4.413, P=0.036); there were no statistically significant differences in the dystocia rate, postpartum bleeding rate, neonatal asphyxia score, and incidences of neonatal umbilical cord infection, neonatal pneumonia, and neonatal hyperbilirubinemia between the two groups (all P>0.05). Conclusion　Systematic health education for pregnant women in grass-roots hospitals can significantly improve the spontaneous labor rate and breastfeeding rate and reduce the incidence of maternal and infantile complications in perinatal period, so as to ensure the maternal and infantile safety in perinatal period.

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Research progress on the role of miRNA in nasopharyngeal carcinoma

Li Shihua, Zhou Hui, Yao Jun

2022, 28(8):  1168-1171.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.032

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Nasopharyngeal carcinoma is one of the common malignant tumors in China. Its incidence location is hidden and it is not easy to find in the early clinical stage, most of them are already in the middle and late stage when found out. MicroRNA (miRNA) is an endogenous, non-coding single-stranded RNA molecule about 22 nucleotides long. MiRNA can target the expression of a variety of tumor-related genes. With the in-depth research on miRNA at home and abroad, tumor-specific miRNA has become a new target for the treatment of nasopharyngeal carcinoma and a biomarker for prognosis prediction. In this review, the role of miRNA in the pathogenesis, development, diagnosis, treatment, prognosis prediction, and radiotherapy resistance of nasopharyngeal carcinoma was reviewed.

Application progress of speckle tracking echocardiography in arrhythmia

Sun Junming, Kong Xiangjian, Ma Baoxin

2022, 28(8):  1171-1176.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.033

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At present, the incidence of arrhythmia in China is rising rapidly, showing a trend of being younger and increasing, which often causes the occurrence of critical illnesses such as heart failure, cardiogenic shock, and cerebral thrombosis. Arrhythmia is often accompanied by changes in myocardial structure and function. Evaluating the overall and partial myocardial function in patients with arrhythmia is of great significance for selection of treatment options, evaluation of treatment effect, and prediction of long-term treatment outcomes. Speckle tracking echocardiography (STE) is a newly emerging ultrasound technology that can quantitatively assess myocardial function, which has no angle-dependent advantage over conventional echocardiography, can be used to identify subtle myocardial damage, and has applications in multiple aspects of arrhythmia disease alone or in combination with conventional echocardiography. This article reviews its clinical application and research progress in arrhythmia.

Research progress of Actinidia chinensis root against malignant tumors

Zhou Mingxuan, Li Jianchang

2022, 28(8):  1176-1179.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.034

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Actinidia chinensis root is a common traditional Chinese medicine with multiple functions. It has been proved that Actinidia chinensis root has anti-tumor effect and is now widely used in the treatment of various tumors. This paper reviewed the researches on the mechanism of Actinidia chinensis root against various malignant tumors to provide a new research basis for clinical use of Actinidia chinensis root to prevent and treat tumors.

Current situation and research progress of clinical treatment of diabetic retinopathy

Qin Shuipen

2022, 28(8):  1180-1184.  DOI: 10.3760/cma.j.issn.1007-1245.2022.08.035

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Diabetic retinopathy (DR) is a local retinal microangiopaplasia in diabetic patients caused by long-term high blood glucose level, which can cause various degrees of visual impairment and is the main cause of blindness. The occurrence of DR is related to many factors and its pathogenesis is very complicated. At present, the clinical therapeutic methods of DR are varied, but the efficacy is different. With the development of pathogenesis of DR, many therapeutic methods have been proposed. This paper reviews the pathogenesis and clinical treatment status of DR based on previous research reports, aiming to provide references for clinical practice.