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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Hypertonic Dextrose Proliferation Therapy for the Treatment of Rotator Cuff Lesions: A Meta-Analysis |
| Lin Ding, MM; YanFu Wang, MM; Chao Yang Ma, BD; Ting Zhang, MM |
| Background • One of the most prevalent disorders of the shoulder is rotator cuff tendinosis, which is a major contributor to shoulder discomfort and shoulder joint dysfunction. Rotator cuff tendinosis occurs in 0.3% to 5.5% of people worldwide and is diagnosed in 0.5% to 7.4% of people in China annually. We performed a meta-analysis to assess whether hypertonic dextrose proliferation therapy, a form of prolotherapy, improves the well-being of patients with rotator cuff injuries.
Methods • We screened the literature by searching the PubMed, Embase, Cochrane Library, and Web of Science databases for the search terms prolotherapy, hypertonic dextrose, and rotator cuff. We identified and evaluated studies that treated individuals with rotator cuff lesions with hypertonic dextrose proliferation therapy (intervention) or a placebo (control). The outcome measures for patients with rotator cuff lesions were the visual analog scale score, the shoulder pain and disability index, and other metrics. These metrics were used to evaluate the effects of hypertonic dextrose proliferation therapy on individuals with rotator cuff diseases by meta-analysis.
Results • The meta-analysis used data from 6 studies. In the 6 studies, the visual analog scale scores improved in the
intervention and control categories, with greater improvement for the intervention category compared with the control category (standardized mean difference [SMD], 1.10 [95% CI, 0.37-1.83]; P = .04). In the studies that measured other outcomes, greater improvement for the intervention category compared with the control category was seen for the shoulder pain and disability index score (SMD, 8.13 [95% CI, 5.34-10.91]; P < .01), flexion (SMD, 5.73 [95% CI, 0.99-10.47]; P < .01), and abduction (SMD, 6.49 [95% CI, 0.66-12.31]; P < .05). There were no statistically significant differences of internal rotation between the intervention and control categories (SMD, -1.74 [95% CI, -4.25 to 0.78]; P = .18) and external rotation (SMD, 2.78 [95% CI, -0.13 to 5.69]; P = .06).
Conclusion • The findings of this study suggest that individuals with rotator cuff injuries may benefit from hypertonic dextrose proliferation therapy based on the visual analog scale score, the shoulder pain and disability index score, flexion, and abduction. These results must, nevertheless, be supported by high-caliber follow-up research. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Treatment of Adhesive Intestinal Obstruction by Nasogastric Tube Under EnhancedRecovery After Surgery: An Efficacy Analysis |
| Zimeng Chang, MM; Lijun Li, MS; Ting Liu, BM; Yanping Tang, MS; Dan Xia, MS |
| Objective • To explore the application value of enhanced recovery after surgery (ERAS) in the treatment of adhesive intestinal obstruction (AIO) by nasogastric tube (NGT).
Methods • Between December 2020 and December 2022, AIO patients who received NGT treatment at The Fourth Hospital of Changsha were selected, including 43 cases receiving ERAS nursing (observation group) and 35 cases receiving routine care (control group). The two groups were compared in terms of postoperative rehabilitation, as well as their psychology, pain, and quality of life which were evaluated using Self-Rating Anxiety/Depression Scale (SAS/SDS), Visual Analogue Scale (VAS), and Short-Form 36 Item Health Survey (SF-36), respectively. During treatment, the adverse reactions were recorded.
Results • In the observation group, the abdominal pain and distension relief time, time to first post-treatment flatus and
defecation, abdominal circumference reduction 48 hours after admission, bowel sound recovery, first oral food intake, and extubation time were shorter than those of the control group (P < .05), and the SAS and SDS scores were also lower than those of the control group after treatment (P < .05). At 6-24 hours after treatment, the VAS of the observation group was lower than that of the control group, while the SF-36 score was higher (P < .05). Finally, a lower adverse reaction rate was determined in the observation group compared to the control group (P < .05).
Conclusions • ERAS care promotes the recovery of AIO patients after NGT treatment, improves their pain and negative emotions, improves their quality of life, and is extremely valuable for clinical application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of Magnetic Resonance Imaging with Chemical Exchange Saturation Transfer in Glioma: A Medical Anthropology Perspective |
| Min Zhang, MM |
| Background • Medical anthropology plays a crucial role in understanding health, disease, and treatment within contemporary anthropology. As the incidence of tumors rises, with cancer posing a significant threat to human health, particularly malignant brain tumors, such as glioma, the need for accurate preoperative diagnosis and effective treatment strategies is paramount.
Objective • This study aims to review the literature on the advancements in medical anthropology and innovative medical technologies to enhance preoperative diagnostics, guide treatment strategies, and ultimately improve the survival rates and quality of life for glioma patients.
Methods • This study reviews and synthesizes existing literature, focusing on chemical exchange saturation transfer (CEST) imaging’s potential to provide detailed information about the tumor microenvironment and metabolism. Extensive searches were conducted across reputable databases, including PubMed, Scopus, and relevant medical journals, to identify studies, articles, and reviews relevant to the connection between medical imaging and anthropological perspectives.
Results • Examining CEST imaging in glioma reveals
promising insights. Through a medical anthropology lens, we assessed the potential for accurate preoperative diagnosis and the development of targeted treatment strategies. The results highlight the significance of integrating technological innovations in medicine with the theoretical foundations of medical anthropology to achieve more effective outcomes in glioma research and practice. Key findings include the transformative impact of CEST imaging on preoperative glioma assessment, its principles, and its ability to distinguish gliomas from other brain masses. The integration of medical anthropology in clinical oncology was explored, highlighting the sociocultural factors influencing patient care and outcomes.
Conclusions • This study marks a significant milestone in advancing the understanding and treatment of glioma. Integrating medical anthropology with advanced medical imaging technologies improves preoperative diagnostics, fostering innovation in both fields. This integration contributes to the overall advancement of glioma research and elevates the standards of patient care. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Orthokeratology Lens Compared to Defocus Incorporated Multiple Segments Lens for Adolescent Myopia and Factors Related to Corneal Injury |
| Xiaoyan Tan, MD; Wenjing Zhang, MM |
| Context • Some treatments for myopia, such as corneal surgery and scleral shortening, aren’t suitable for adolescents under the age of 18. The orthokeratology lens (OKL) and the defocus incorporated multiple segments (DIMS) lens are two possible nonsurgical alternatives, but their comparative advantages and disadvantages remain unclear.
Objective • The study intended to compare the effects of the OKL and the DIMS lens on adolescent myopia and to analyze the related factors affecting corneal injury, to provide a reference for clinical practice.
Design • The research team conducted a retrospective case-control study.
Setting: The study took place at Chongqing Aier Eye Hospital in Chongqing, China.
Participants • Participants were 84 myopic adolescents who had been admitted to the hospital between March 2021 and December 2022.
Interventions • The research team divided participants into two groups: (1) 43 participants who received treatment with orthokeratology lens (OKL), the OKL group, and (2) 41 participants who received treatment with defocus incorporated multiple segments (DIMS) because their parents refused to accept OKL lenses, the DIMS group.
Outcome Measures • At baseline and postintervention, the research team: (1) comparatively analyzed the
uncorrected visual acuity (UCVA), axial length (AXL), and diopter; (2) measured the spherical equivalent (SE), central corneal thickness (CCT), anterior chamber depth (ACD), accommodative lag (PRA), and negative relative accommodation (NRA); (3) counted the adverse reactions during treatment; and (4) evaluated the factors related to corneal injury.
Results • No significant differences existed between the groups in AXL, diopter, or NRA postintervention (P > .05), but the OKL group had significantly higher UCVA and significantly lower SE, CCT, and ACD than the DIMS group did (P < .05). In terms of safety, the incidence of adverse reactions was significantly higher for the OKL group than for the DIMS group (P = .016). According to the logistic regression analysis, the OKL treatment, corneal edema, and abnormal intraocular pressure (IOP) were independent risk factors for corneal injury (all P < .001).
Conclusions • Both DIMS and OKL can effectively control myopia progression in adolescents, with OKLs being significantly better at improving UCVA and DIMS being safer. Therefore, in the future clinical conservative treatment of myopic adolescents, it’s still necessary to choose appropriate myopia-relief methods according to the actual situation and the specific needs of the children. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of Geriatric Experience Training on Nurses in Preventing Falls in Elderly Patients |
| Xiaofen Jiang, MD; Ying Liu, MD; Cairong Sun, MD; Weiming Wang, MD; Xiao Wang, MD; Jing Xu, MD, PhD; Qing Zhang, MD; Yi Zhang, MD |
| Objective • This study aimed to explore the effects of geriatric experience training on nurses from multiple primary healthcare units in the context of population aging. The study also evaluated the impact of this training on improving nurses’ cognitive abilities in preventing falls/bedside accidents in elderly patients and implementing safe nursing practices to reduce the incidence of falls/bedside accidents.
Methods • A total of 302 nurses involved in geriatric care from 18 primary healthcare units in the region were randomly categorized into 2 groups on a 1:1 basis. The control group received regular training on falls/bedside accident prevention for patients, whereas the observation group received additional geriatric experience training along with the regular training. Further, 420 elderly patients who experienced moderate-to-severe falls/bedside accidents between February and July 2022, with a Morse Fall Scale (MFS) score of =25 were randomly assigned to either the observation or control group on a 1:1 basis. This study compared the 2 groups in terms of
nurses’ awareness of falls/bedside accident risks, incidence of falls/bedside accidents in patients and patient satisfaction with fall/bedside accident prevention care.
Results • No statistically significant differences were observed (P > .05) between the 2 groups of nurses, except in their awareness of the aging population and the increased risk for falls/bedside accidents in elderly patients. However, the observation group nurses scored higher in other aspects of falls/bedside accident risk awareness after undergoing geriatric experience training (P < .05). The incidence of falls/bedside accidents was significantly lower in the observation group than in the control group (P < .05). Patient satisfaction with falls/bedside accident prevention care was significantly higher in the observation group compared with the control group (P < .05).
Conclusion • Geriatric experience training for nurses in multiple primary healthcare units in the region could effectively improve the capabilities of primary hospitals in preventing falls/bedside accidents. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| WeChat Continuity Nursing on Postpartum Depression and Quality of Life in Primipara Undergoing Cesarean Delivery |
| Qipei Ding, MBBS; Haiyan Wang, MBBS; Hongyun Wu, MBBS; Yingping Zhang, MBBS |
| Objective • To assess the effectiveness of WeChat-based continuity nursing in reducing postpartum depression and improving the quality of life among primiparous women undergoing cesarean delivery.
Methods • A total of 200 patients who intended to undergo cesarean delivery in our hospital between January 2021 and January 2022 were recruited for this study, including 20 patients who refused to participate in the study and 30 patients who did not meet the criteria of this study for various reasons, and a total of 150 cases were finally included. All participants were assigned 1:1 into the control group and observation group according to the time of the first pregnancy test and the primiparous in the observation group were given WeChat continuity nursing, and the primiparous in the control group was given routine obstetric care. WeChat continuity nursing included establishment of continuity nursing team, WeChat group setup and communication, education and support, and psychological counseling and follow-up. The baseline data of all mothers were collected and recorded, and the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), quality of life scores, maternal and infant complications, and the satisfaction rate of care were compared between the two groups.
Results • The SAS and SDS scores of the observation group were consistently lower than those of the control group at 1, 3, and 6 months post-hospital discharge (P < .01). Following the implementation of
WeChat continuity nursing intervention, patients in the observation group demonstrated significant improvements in mental health, physical function, somatic pain, vitality, and social function scores compared to the control group (P < .01). Additionally, the incidence of complications was notably lower in the observation group, including reduced rates of incisional infection, breast swelling, unclear dew, abnormal defecation among mothers, and decreased occurrence of breech redness, umbilical cord issues, eczema, and delayed umbilical cord detachment among infants (P < .05). Moreover, the satisfaction rate among patients in the observation group was significantly higher than that of the control group (95.507% vs. 84.058%) (P < .05). These findings highlight the efficacy and importance of integrating WeChat continuity nursing intervention into postpartum care practices.
Conclusion • our study strongly supports the effectiveness of WeChat continuity nursing intervention in improving postpartum mental health, reducing complications, and increasing patient satisfaction. These findings suggest the potential for integrating digital nursing interventions into standard postpartum care practices, offering personalized and accessible healthcare services. Policymakers and healthcare providers should consider adopting such interventions to optimize postpartum outcomes and enhance patient experiences. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Research Status and Progress of Studies on Optic Disc Structures in Non-arteritic Anterior Ischemic Optic Neuropathy |
| Xia Liu, MM; Jiaxin Meng; Wenhao Shi; Ying Zhao, MD |
| Objective • Non-arteritic anterior ischemic optic neuropathy (NAION) is a prevalent acute optic neuropathy. This article provides a comprehensive overview of the research advancements in regional optic disc structural changes and local risk factors among NAION patients, aiming to establish a foundation for clinical diagnosis, treatment, and future follow-up investigations.
Methods • One English database and two Chinese databases were utilized for the purpose of conducting a comprehensive literature search, followed by meticulous analysis. The investigation encompassed an in-depth exploration of the optic disc’s structural composition, as well as a thorough examination of the distinctive characteristics exhibited by NAION optic discs. Furthermore, this study aimed to elucidate the intricate relationship between NAION and ODD (Optic Disc Drusen) alongside PHOMS (Peripapillary Hyperreflective Ovoid Mass-like Structures).
Results • A total of 44 English articles were retrieved from Pubmed, including case reports, clinical trials, and reviews. Keywords retrieved included NAION, optic disc, optic disc drusen, PHOMS
Conclusion • The risk factors of NAION include systemic factors such as hypertension, diabetes, and nocturnal hypotension and local factors such as small optic cup,
crowded optic discs, ODD and PHOMS. Among them, ODD and PHOMS are the local anatomical changes of the optic disc, and their relationship with the occurrence of NAION has received more and more attention in recent years. NAION is more likely to occur in eyes with ODD and PHOMS, and NAION patients with ODD and PHOMS have a high prevalence. In recent years, optical coherence tomography (OCT) and optical coherence tomography angiography(OCTA) can provide accurate anatomical imaging and microvascular imaging. Help us better observe the local structural changes and local-related risk factors. Although ODD and PHOMS are closely associated with the occurrence and progression of NAION, research on their relationship is still in its nascent stages. Specifically, further investigation is needed to determine whether the presence of ODD and PHOMS affects the prognosis of NAION patients, including potential influences on lateral eye involvement.This article summarizes the changes in optic disc structure and local risk factors in NAION patients in order to clinical decision making in NIAON patients and provide a basis for further Research on the relationship between the occurrence of NIAON and optic disc structure. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Impact of Prone Ventilation on Hypoxemia Following Extracorporeal Cardiac Surgery: A Meta Analysis |
| Zhao Jian, MM; Xiaojiao Jiang, MM; Tianpo Li, MM; Jing Li, MM; En Li, MD; Qingfang Yu, MM |
| Objective • To systematically assess the impact of prone position ventilation on hypoxemia in patients following extracorporeal cardiac surgery and to establish a reference for further clinical investigation into effective post-surgery mechanical ventilation positions.
Methods • A meta-analysis was conducted through extensive database searches, focusing on randomized controlled trials of cardiopulmonary bypass in hypoxic patients meeting specific inclusion and exclusion criteria. A total of 8 papers involving 442 patients were finally included in this study.
Results • The meta-analysis revealed that the oxygenation index was significantly higher in the prone position ventilation group compared to the supine position ventilation group [MD=51.24, 95% CI (46.14, 56.35), P < .001]. The partial pressure of oxygen in prone patients was also significantly higher than in supine patients [MD=-2.96, 95% CI (1.78, 4.14), P < .001]. Regarding oxygen
saturation, blood oxygen saturation in the prone position group surpassed that in the supine position group, showing a statistically significant difference [MD=4.81, 95% CI (3.83, 5.79), P < .001]. Additionally, patients ventilated in the prone position exhibited a shorter duration of mechanical ventilation compared to those in the supine position, with a statistically significant difference [MD=-57.31, 95% CI (-66.57, -48.06), P < .001].
Conclusions • In the absence of significant hemodynamic changes, prone position ventilation significantly enhances the oxygenation index and reduces the duration of mechanical ventilation in patients undergoing extracorporeal circulation surgery. However, the observed heterogeneity across studies may be attributed to variations in breathing styles, respiratory techniques, and physiological parameters among different patient groups. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Nursing Teaching Model Based on Institutional Cooperation on Teaching Quality of Nursing Programs in Colleges and Universities and Effectiveness of Internship for Undergraduate Nurses |
| Bo Dong, MM; Meiqi Dong, MM; Guodong Wang, MM; Xiaoxiao Zhang, MM |
| Objective • To observe the impact of a clinical nursing teaching model based on institutional collaboration on the teaching quality of nursing programs in colleges and universities and the effectiveness of undergraduate practical nurses in practice.
Methods • One hundred and twenty-three undergraduate student nurses graduating from June 2020 to July 2021 were selected for the study, 59 of whom received the traditional teaching model (control group) and 64 of whom received the institutional cooperative teaching model (research group). Upon completion of their internship, a clinical nursing skills assessment was conducted for the two groups, and the clinical internship performance was evaluated using the self-assessment scale of clinical practice behavior performance of nursing undergraduates. A teaching evaluation questionnaire was used to survey the intern nurses’ evaluation of the teaching model and their satisfaction with the teaching model was surveyed in the middle and after the completion of the internship,
respectively. Upon completion of the internship, the intern nurses filled out a self-satisfaction evaluation form.
Results • The research group had a lower failure rate than the control group and a higher excellent rate than the control group (P < .05). There were no differences in the scores of the professional and self-development domains between the two groups (P > .05), while for all other clinical placement performances, the scores were higher in the research group than in the control group (P < .05). In addition, the research group had higher subject presentation, post-lesson acquisition, total score, and teaching satisfaction than the control group (P < .05). In terms of self-satisfaction, the number of satisfied intern nurses was also higher than the control group (P < .05).
Conclusion • The reform of clinical nursing teaching mode based on institutional cooperation can effectively improve the quality of nursing teaching in universities and the effectiveness of undergraduate practical nursing. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Gut-Brain Connection: Implications for Health |
| Shawn Manske, ND |
| Consider this: humans have never existed without a symbiotic relationship with microbes. And the brain has never been without signals from the gut and its resident microbes.1
These powerful statements underscore the importance of the connections and interactions between our gastrointestinal (GI) system, the microorganisms that reside there, and our brain and central nervous system (CNS). Understanding how microbes in the gut influence brain health and cognitive function is one of the most exciting areas of research in neuroscience and biological psychiatry today.
Much of this research is focused on the gut-brain axis—an intricate series of neural pathways that carry signals between the enteric nervous system (ENS) of the GI tract and the CNS.2 This dynamic and bidirectional communication network facilitates a complex coordination of neural, hormonal, and immunological interactions that influence various physiological processes beyond digestive function. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparative Evaluation of the Efficacy and Safety Profiles of Various Ropivacaine Proportions in Cesarean Section |
| Chunmei Liu, MM; Wei Qiao, MM; Lingzhi Wang, MM; Beiqing Yan, MM; Mingming Zhu, MM |
| Background • Ropivacaine (Ropi) is a widely utilized anesthetic in cesarean sections (CS), however its optimal dosage remains controversial.
Objective • To assess the efficacy and safety of varying doses (10mg, 5mg, 4mg, and 3mg) of Ropi in subarachnoid block (SA) for CS.
Methods • A prospective cohort study was conducted, and a total of 74 pregnant women undergoing CS at Nantong Maternal and Child Health Care Hospital between January and June 2023 were selected as the study population. Participants were stratified into groups based on Ropivacaine dosage: Group A (10 mg, n=18), Group B (5 mg, n=26), Group C (4 mg, n=15), and Group D (3 mg, n=15). The total Ropivacaine dosage administered via SA was consistently 10 mg across all groups. We measured anesthetic efficacy, safety profiles, abdominal wall muscle relaxation, pre- and post-anesthesia stress and inflammatory responses before and after anesthesia and compared among the four groups.
Results • Group A exhibited the shortest onset time for block initiation and longest recovery duration (P < .05). Group D displayed the highest incidence of patients requiring additional anesthetics and experiencing adverse reactions, whereas the utilization rate of vasopressors was most pronounced in Group A (P < .05). Notably, Group D reported the lowest satisfaction rate regarding abdominal wall muscle relaxation (P < .05). Stress responses were significantly lower in Groups A, B, and C compared to Group D, while the levels of inflammatory factors in Groups B and C were higher than those in Group A but lower than those in Group D (P < .05).
Conclusions • Administration of 4 mg hyperbaric Ropi in SA can achieve an optimal anesthesia effect in CS with a high level of safety, along with inducing mild abdominal wall muscle relaxation and attenuating stress and inflammatory responses pre- and post-anesthesia. Thus, it is recommended for clinical application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of the Effect of Maxillary Expansion Combined with Twin-block Appliances on Malocclusion and Related Factors of Upper Airway Sagittal Diameter Changes |
| Jindong Dai, MM; Hua Li, MM; Guangrong Sun, MM |
| Objective • To comparatively analyze the therapeutic effect of maxillary expansion combined with twin-block appliances (TBA) versus adenotonsillectomy (ATE) in the treatment of children with upper airway stenosis (UAS) complicated by malocclusion (MA), and to analyze the related factors affecting the changes of the upper airway sagittal diameter.
Methods • From October 2020 to October 2022, 54 children with UAS complicated by class II MA were treated at Zhenjiang Stomatological Hospital and Liyang People’s Hospital. They were selected as study subjects and were divided as follows a research group (RG) comprised 28 children who received treatment with maxillary expansion combined with TBA and a control group (CG) comprised another 26 children who received ATE. All the children were examined by cone beam computed tomography (CBCT) before and 3 months after treatment. Alterations in upper airway parameters, and changes in the angles of sella-nasion-superior alveolar base point A ( |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Evaluation of Early Psychological Interventions in Patients with Intracranial Aneurysm Embolism: A Nursing Business Process Reengineering Perspective |
| Guohua Lin, BS; He Peng, BS |
| Objective • This study examines the impact of early psychological intervention for patients undergoing nursing process modification through a business process reengineering (BPR) approach in preventing intracranial aneurysm embolism.
Methods • A randomized controlled trial (RCT) design was employed in this study. A randomized method was utilized to allocate a total of 201 cases into two distinct groups. 10 patients experiencing delirium and coma due to drug sedation were excluded from the analysis. Consequently, the final distribution included 96 cases in the nursing group and 95 cases in the routine group.
Results • In the nursing group, waiting time, nursing staff working hours, and hospital stay were significantly lower compared to the routine group (t = 50.916, 28.893, 4.298, P < .05). No substantial difference in actual running time between the groups was observed (t=0.289, P > .05). Scores for physical pain, psychological well-being, material
life status, and social function were notably higher in the nursing group than in the routine group (t=19.109, 20.658, 21.165, 24.014, P < .05). Post-intervention, SAS and SDS scores in the nursing group were significantly lower than those in the routine group (t=21.910, 25.808, P < .05). The complication rate in the nursing group (1.04%) was significantly lower than that in the routine group (8.42%) (?2=5.791, P < .05). Furthermore, nursing staff job satisfaction (92.71%) was significantly higher than that in the routine group (78.13%) (?2=7.449, P < .05).
Conclusions • The modification of the nursing process demonstrates a positive impact on efficiency and quality of care, ensuring patient safety and meeting patient needs without altering surgical techniques. The findings highlight substantial enhancements and effectiveness of nursing process, providing strong support for the broad implementation of these interventions. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Elucidation of the Anti-Lung Cancer Mechanism of Xiao'ai Jiedu Prescription Based on Network Pharmacology and Molecular Docking |
| Jin-Shu Fang, MM; Jian-Yi Huang, MM; Liu Li, PhD; Wen-Ting Li, PhD; Mian-Hua Wu, PhD; Ping-ping Zhai, MM |
| Objective • Network pharmacology is an emerging discipline that applies computational methods to understand drug actions and interactions with multiple molecular targets. Xiao’ai Jiedu is a valued traditional Chinese medicine preparation for which the mechanism of action is not yet established. This study aims to explore the mechanism of Xiao’ai Jiedu in treating lung cancer through network pharmacology.
Methods • First, the Traditional Chinese Medicine Systems Pharmacology (TCMSP) data platform was used to analyze the target treatment results of different medicinal materials in Mr. Zhou’s cancer prescriptions. Then, functional enrichment analysis was performed to conduct a secondary analysis of the dissemination of cancer biological and pharmacological information in the human body. The Cancer Genome Atlas (TCGA) was used to obtain several cancer-aggressive target groups, and their transcription RNA was extracted for collection. The CIBERSORT evaluation method was used to conduct a Spearman correlation analysis on the data processing
results. Then the matching degree between the experimental cells and the principle of drug treatment was analyzed to improve the statistical analysis.
Results • Pharmacology research results showed that the network can accurately eliminate cancer detoxification targeted target correlation set, and through the data interpretation found that four different gene transcription have significant influence on lung cancer. The findings also confirmed that the degree of immune cell infiltration has a key role in lung cancer The study summarizes the active ingredients and their targets and mechanisms of action of the elimination of Xiao’ai Jiedu formula for the treatment of lung cancer.
Conclusion • Network pharmacology can carry on the processing of the data, find the key to conform to the goal of research data, and the corresponding results are obtained, and the development of network pharmacology is not limited to, the study of lung cancer. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Evaluating Adverse Reactions of Central Venous Catheter Placement in Patients with AIDS: A Meta-Analysis Approach |
| Ying Huang, MD; Fangyuan Lou, MD; Lifang Shao, MD; Danping Sun, BD; Yan Xu, BD |
| Objective • This study aims to identify contributing factors to adverse reactions related to central venous catheter (CVC) usage in patients with HIV/AIDS, to enhance patient care and treatment outcomes.
Methods • To obtain the most relevant and recent findings, we conducted a systematic search across reputable databases, including PubMed, EMBASE, and the Cochrane Library, focusing on randomized controlled trials from 2010 to 2023. Two researchers independently led the literature search and screening process, using a thorough pre-structured form for data extraction and performing a risk of bias assessment on selected studies. Statistical synthesis of the data was conducted using the advanced Review Manager 5.3 software. We compared the prevalence of opportunistic infections, the rate of venous inflammation, and the incidence of venous thrombosis in patients with HIV/AIDS undergoing central venous catheter placement.
Results • The comprehensive exploration led to the inclusion of seven randomized controlled trials, involving
251 instances of central venous catheter placements in patients with HIV/AIDS. The meta-analysis findings revealed a lower prevalence of opportunistic infections in patients with CVCs placed, as indicated by the relative risk [95% Confidence Interval (CI) (2.53), P < .01]. Similarly, the rate of venous inflammation was significantly reduced [95% CI (2.53), P < .01]. However, the rates of venous thrombosis showed no statistically significant variance [95% CI (2.01), P > .1].
Conclusions • The use of central venous catheters in treating HIV/AIDS patients appears to reduce the occurrence of opportunistic infections and venous inflammation, suggesting potential therapeutic benefits. However, the presence of biases within the included studies and notable heterogeneity among them impede the reliability of these conclusions. Therefore, it is imperative to pursue validation through additional high-quality clinical trials. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of Early Rehabilitation Nursing on Postoperative Cardiac Function and Quality of Life in Patients with Atrial Fibrillation |
| Mengmei Bu, MM; Wei Liu, BD; Chunrogng Ma, BD; Ming Song, BD; Zirong Tian, MM; Wei Wei, MD |
| Background • Radiofrequency ablation, a widely utilized minimally invasive surgery for atrial fibrillation treatment, has certain latent risks, including a high postoperative recurrence rate and various complications. Therefore, nursing intervention plays a pivotal role in the rehabilitation process after radiofrequency ablation.
Objective • This study aims to investigate the impact of rehabilitation nursing on postoperative cardiac function and quality of life in patients with atrial fibrillation.
Methods • A total of 156 atrial fibrillation patients who underwent radiofrequency ablation and were admitted to our hospital from June 2018 to June 2023 were randomly assigned to either the control group or the research group. The control group received routine nursing, while the research group received early rehabilitation nursing in addition to routine care. A comparative analysis was conducted on cardiac function, hospital stay, incidence of complications, emotional well-being, sleep quality, overall quality of life, and nursing satisfaction between the two groups.
Results • In comparison to the control group, the research group exhibited an elevation in left ventricular ejection fraction, along with a reduction in left ventricular end-systolic diameter and left ventricular end-diastolic dimension (P < .05). Moreover, the research group demonstrated a shorter hospital stay and a lower incidence of complications compared to the control group (P < .05). Following nursing intervention, anxiety and depression scores, as well as sleep quality scores, were lower in the research group than in the control group (P < .05). Additionally, quality of life scores and nursing satisfaction were higher in the research group than in the control group (P < .05).
Conclusions • Early rehabilitation nursing emerges as a valuable intervention, expediting the recovery of postoperative cardiac function and enhancing the overall quality of life in atrial fibrillation patients. These findings emphasize its clinical significance. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy and Perioperative Safety of Robot-Assisted Minimally Invasive Esophagectomy for Esophageal Cancer |
| Lei Gong, MM; Xiangming Liu, MM; Mingquan Ma, MM; Yufeng Qiao, MM; Peng Ren, MM; Peng Tang, MM; Haitong Wang, MM; Hongdian Zhang, MM |
| Background • Esophageal cancer (EC) remains a significant global health concern. Minimally invasive surgical techniques, including robot-assisted approaches, have emerged as promising options for improving outcomes and patient recovery in EC management.
Objective • This study aims to evaluate the clinical utility of robot-assisted minimally invasive esophagectomy (RAMIE) in the treatment of EC.
Methods • A total of 160 EC patients undergoing treatment at our hospital were included in this study. Patients were randomly assigned to either the research group, receiving RAMIE, or the control group, undergoing thoracoscopic minimally invasive esophagectomy (MIE). Surgical outcomes, postoperative recovery, complication rates, and changes in inflammatory factors (IFs) such as malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) levels were compared between the two groups. Additionally, prognostic survival and EC recurrence rates were assessed at a 1-year follow-up.
Results • The research group demonstrated longer operative times, a higher number of dissected lymph nodes, reduced intraoperative bleeding, and quicker postoperative recovery compared to the control group, with significantly fewer complications (P < .05). Furthermore, the research group exhibited lower levels of postoperative IFs and MDA, along with higher levels of SOD and GSH-Px, compared to the control group (P < .05). There was no significant difference between the two groups in terms of prognostic survival and EC recurrence rates (P > .05).
Conclusion • RAMIE demonstrates superior efficacy in enhancing therapeutic outcomes and accelerating postoperative recovery in patients with EC, thus establishing its value in EC treatment protocols. RAMIE is suggested as a valuable therapeutic option and warrants clinical adoption for EC management. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Evaluation of the Optimal Duration of Thumb Cupping Therapy for Frozen Shoulder by Thermal Metabolic Imaging |
| Hongwei Chen, MM; Yan Liu, MM; Yanli Xia, MM; Chaoju Zhang, MD; Yuanyuan Zhu, MM |
| Objective • To evaluate the optimal duration of thumb cupping therapy for frozen shoulder (FS) by thermal metabolic imaging (TMI) and to provide clinical evidence.
Methods • From April 2022 to August 2023, 120 patients with FS who received thumb cupping therapy at our hospital were randomized into groups A, B, and C for 5, 10, and 15 minutes of cupping, respectively. The clinical efficacy, Visual Analogue Scale (VAS) score, and shoulder range of motion (ROM) of the three groups were compared, and the skin blood flow and the incidence of adverse reactions during treatment were analyzed. Finally, the temperature difference improvement efficiency (i.e., higher TMI after treatment than before treatment) was
compared among the three groups.
Results • Groups B and C showed higher overall clinical efficacy than group A (P < .05). After treatment, lower VAS scores were determined in groups B and C compared with group A, whereas the ROM values of groups A and C were smaller than those of group B Group C had the greatest skin blood flow and the highest incidence of adverse reactions (P < .05), while group B had the highest temperature difference improvement efficiency (P < .05).
Conclusions • Through TMI, it is confirmed that thumb cupping therapy with a duration of 10 min contributes to the highest efficacy and safety for patients with FS. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Role of SHP2 in Advancing COPD: Insights into Oxidative Stress, Endoplasmic Reticulum Stress, and Pyroptosis |
| Haidong Ding, MD; Rina Wu, MM |
| Background • Chronic Obstructive Pulmonary Disease (COPD) is characterized by airflow limitation and inflammation resulting from genetic and environmental factors, notably cigarette smoke. Pyroptosis, a cell death process, is implicated in COPD, but its mechanisms are unclear. SHP2, a phosphatase, modulates inflammatory pathways, suggesting a role in COPD pathogenesis and potential therapeutic avenues.
Objective • This study investigates the mechanism by which SHP2 regulates cell pyroptosis in bronchial epithelial cells in COPD patients.
Methods • In this prospective study, we employed in vivo and in vitro models to investigate the mechanisms underlying COPD progression. Hematoxylin and eosin (H&E) staining were utilized to assess the morphological changes characteristic of COPD. Electron microscopy enabled precise quantification of pyroptotic bodies to highlight cellular changes associated with COPD pathogenesis. Immunofluorescence analysis facilitated the measurement of protein fluorescence intensity, allowing for the assessment of inflammatory responses within bronchial epithelial cells. Additionally, Western blot
analysis was conducted to evaluate the expression levels of key pathway proteins involved in COPD progression.
Results • In the COPD model, lesions worsened in SHP2-KD mice compared to SHP2-NC. Western blot results showed increased p22, p47, p-IRE1a, XBP1, STING, p-TBK1, NLRP3, Caspase1, and IL-1ß expression levels in both in vivo and in vitro models. Transmission electron microscopy revealed more pyroptotic bodies in SHP2-KD+CSE than in SHP2-NC+CSE. Immunofluorescence demonstrated significantly higher NLRP3 and GSDMD fluorescence intensities in SHP2-KD+CSE versus SHP2-NC+CSE. Additionally, Western blot analysis indicated increased expression of Bax, Caspase3, Caspase8, and Caspase9 proteins in the in vitro model. No differences were observed between SHP2 NC and SHP2-KD groups without CSE stimulation in immunofluorescence, electron microscopy, and Western blot findings in the cellular model.
Conclusions • SHP2 promotes COPD progression by inducing oxidative stress, endoplasmic reticulum stress, and pyroptosis. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Weflow Embedded Branch Stents in the Treatment of Stanford Type B Dissection Involving Left Subclavian Artery |
| Xupeng Niu, MM; Zibin Wang, MM; Miao Zhang, MM; Lei Zhang, MD; Jing Zhang, MM |
| Objective • Weflow embedded branch stent was used in the treatment of Stanford type B aortic dissection (TBAD) involving the left subclavian artery (LSA), and the effectiveness of the stent in the short and medium and term was observed.
Methods • The clinical data of 22 patients with TBAD involving LSA treated with Weflow embedded branch stent from the First Hospital of Hebei Medical University from December 2020 to October 2021were retrospectively analyzed. The changes in systolic blood pressure of the left upper limb at the onset and postoperative period, the patency rate of left subclavian artery stent at 1, 6, and 12 months after surgery, the change of true and false lumen diameters, and the occurrence of complications were evaluated.
Results • The patency rate of the left subclavian artery (LSA) branch stent was 100% at 1 month, 6 months, and 12 months after surgery. With the extension of postoperative time, the diameter of the aortic true lumen gradually increased. One month after surgery, the remodeling indexes
of the aorta were improved, and with the extension of postoperative time, the diameter of the aortic false lumen decreased gradually. In the perioperative period, 1 case of vision, 1 case of insomnia, 1 case of retrograde type A dissection, 2 cases of type Ia endoleak, and no other new complications. During the follow-up, 2 patients with disappeared endoleak and 1 patient with retrograde dissection was in good condition after treatment.
Conclusions • 1. Weflow embedded branch stent has good safety and reliability in the treatment of TBAD; 2. When LSA is involved, it can effectively improve the blood pressure of the patient’s left upper limb, and the patency rate of the branch stent is good within 1 year; 3. Weflow embedded branch stent has a good short-term effect in aortic remodeling, and the medium- and long-term effect needs to be evaluated; 4. Weflow embedded branch stent had no obvious complications during the 1-year follow-up. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application of TCM Nursing in Post-anesthesia Recovery Room Under Integrated Management Mode |
| Lihui An, BM; Zengjie Liu, BM; Xiaoguang Liu, BM; Xiaoguang Liu, MM; Zhe Xu, BM; Shaonan Zhang, BM; Yanjie Zhou, BM |
| Objective • To explore the effect of traditional Chinese medicine (TCM) nursing under the integrated management mode during anesthesia recovery.
Methods • The researchers’ hospital admitted 114 patients who underwent general anesthesia between August 2022 and April 2023. Based on the admission order, these patients were divided into a control group (N=57) and an observation group (N=57). The control group received routine nursing intervention, while the observation group received comprehensive TCM nursing management, which included therapies such as cupping, acupressure, massage, herbal decoction, and mirabilite application. The study evaluated the psychological status, recovery indexes after anesthesia, comfort level, incidence of complications, and patient satisfaction with nursing care.
Results • Compared to the control group, the observation group showed significant improvement in their psychological well-being (P < .05) and better recovery outcomes after anesthesia (P < .05). Additionally, the observation group reported higher levels of comfort (P < .05), a lower incidence of complications (8.77% vs 29.82%, P < .05), and greater satisfaction with nursing care (98.25% vs 84.21%, P < .05) compared to the control group.
Conclusion • Integrated management of traditional Chinese medicine effectively reduces postoperative adverse events, improves treatment outcomes, and facilitates patient recovery. Its benefits are evident, and its feasibility is well-established. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Gastrin-Releasing Peptide/Gastrin-Releasing Peptide Receptor Participation in Itch Sensation Signaling in the Spinal Cord of Uremic Pruritus Mice |
| Hao Chen, BD; Liang Du, BD; Weiwei Gao, BD; Huili Li, BD; Yitong Wang, BD; Ze Zhang, MM |
| Background • Uremic pruritus is a prevalent clinical symptom in maintenance dialysis patients. Existing evidence establishes a connection between itch transmission and the gastrin-releasing peptide/gastrin-releasing peptide receptor signaling pathway.
Objective • To investigate the involvement of the gastrin-releasing peptide/gastrin-releasing peptide receptor in itch sensation signaling within the spinal cord of uremic pruritus.
Design • An animal study was conducted.
Setting • The research was conducted at the First Hospital of Hebei Medical University.
Participants • A total of 50 male C57BL/6J mice (weight: 30-40 g) were acquired from Beijing Weitonglihua Laboratory Animal Center.
Interventions • Mice were categorized into five groups: normal, sham, Y, A, and B. The Y group received intrathecal injections of saline (5 ul). The A group received intrathecal injections of gastrin-releasing peptide (0.1 nmol, 5 ul), and the B group received intrathecal injections of the gastrin-releasing peptide receptor antagonist RC-3095 (0.3 mmol, 5 ul).
Primary Outcome Measures • (1) Pruritus behavior of mice and (2) expression of gastrin-releasing peptide, gastrin-
releasing peptide receptor, and inositol trisphosphate.
Results • Scratching times in the Y group significantly surpassed those of normal and sham groups, increasing over time. Gastrin-releasing peptide and receptor expression rose in the uremic pruritus mouse model compared to normal and sham groups (P < .05). Expression of gastrin-releasing peptide and its receptor was significantly elevated in the uremic pruritus mouse model compared to the normal and sham groups (P < .05). Inositol trisphosphate expression in the dorsal spinal horn of Y group mice increased compared to normal and sham groups. Intrathecal gastrin-releasing peptide heightened inositol trisphosphate expression, while the peptide receptor antagonist RC-3095 reduced it. Y group scratching times were higher than normal and sham groups, increasing after intrathecal gastrin-releasing peptide but decreasing after RC-3095 injection.
Conclusion • The gastrin-releasing peptide/gastrin-releasing peptide receptor signaling pathway is involved in the development of uremic pruritus. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Influence of Nursing Intervention Under FOCUS-Plan-Do-Check-Act Cycle Management Model on Preventing and Controlling Central Line-associated Bloodstream Infections in Patients in ICU |
| Yanxia Gong, BD; Xiaoxiao Li, BD; Amin Zhang, BD; Kali Zhu, MM |
| Background • Central venous catheterization is an invasive procedure that may lead to central line-associated bloodstream infection, affecting the patient’s prognosis and recovery. Thus, it is essential to master the right interventions for the prevention and control of central line-associated bloodstream infections. FOCUS-Plan-Do-Check-Act (PDCA) cycle management model, also known as Deming circle management model, is a programmed and scientific management method.
Objective • We attempted to clarify the impact of nursing intervention on preventing and controlling central line-associated bloodstream infection under the FOCUS- PDCA cycle management model, in order to effectively deplete central line-associated bloodstream infection in each intensive care unit, facilitate early recovery of patients.
Design • Our study retrospectively analyzed the clinical data of intensive care unit patients before and after implementation of nursing intervention under the FOCUS-PDCA cycle management model. This study was a retrospective study.
Setting • This study was performed in the Department of Infection Management, Taihe County People’s Hospital.
Participants • A total of 214 intensive care unit patients with indwelling central venous catheters before implementation of nursing intervention under the FOCUS-PDCA cycle management model in our hospital in 2021 were selected as the control group. A total of 220 ICU patients with indwelling CVC after nursing intervention under the FOCUS-PDCA cycle management model in 2022 were included in the experimental group. All patients met the inclusion criteria of patients with CVC puncture catheterization for = 2 days.
Interventions • The control group underwent conventional nursing, including (1) nurses observing aseptic technique; (2) nurses regularly inspected and replaced dressings; (3) nurses timely handled abnormal
situations at the puncture site; (4) nurses provided relevant education and psychological counseling to patients and their families. The experimental group adopted nursing intervention under the FOCUS-PDCA cycle management model on the basis of that of the control group.
Primary Outcome Measures • (1) central venous catheterization puncture status (2) central venous catheterization application status (3) central line-associated bloodstream infection status, and (4) hospitalization status.
Results • The one-time success rate of puncture and success rate of puncture in the experimental group exhibited elevation relative to those in the control group (P < .05). The central venous catheterization application rate in the experimental group exhibited depletion relative to that in the control group (P < .05). The daily infection rate of CLABSI in the experimental group exhibited depletion relative to that in the control group, but without statistical significance (P > .05), indicating that nursing intervention under the FOCUS-PDCA cycle management model had no obvious inhibitory effect on the daily infection rate of CLABSI. The time of central line-associated bloodstream infection occurrence in the experimental group was later than that in the control group (P < .05). The hospitalization time and hospitalization expenses in the experimental group exhibited depletion relative to those in the control group (P < .05).
Conclusion • Nursing intervention under the FOCUS-PDCA cycle management model can effectively deplete central line-associated bloodstream infection in each intensive care unit, facilitate early recovery of patients, and shorten hospital stay, which is worthy of promotion. Our study provide a clinical nursing reference for the preventing and controlling central line-associated bloodstream infections in patients in each intensive care unit. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Internal Limiting Peeling in Conjunction with Subretinal Injection of a Balanced Salt Solution in the Macular Region to Treat Refractory Diabetic Macular Edema |
| Ziqing Mao, MM; Zhipeng You, MD |
| Background • Diabetic macular edema (DME) is one of the primary causes of decreased visual acuity in patients with diabetic retinopathy (DR). Rapid, effective, and safe treatment of DME is important to ensure patients’ vision.
Objective • In this study, we observed the efficacy and safety of internal limiting membrane (ILM) peeling in conjunction with subretinal injection of balanced salt solution (BSS) in treating refractory DME.
Methods • A prospective, non-case-control study. Patients diagnosed with refractory DME in our hospital between October 2021 and June 2022 were included. All patients received 23G PPV in conjunction with internal limiting membrane removal and subretinal injection of BSS. During and after surgery, intravitreal injections of an anti-VEGF drug were administered. We compared and analyzed the best-corrected visual acuities (BCVA), central macular thickness (CMT), recurrence rate, complications, and other observation indicators.
Results • The investigation included 32 patients (32 eyes). The BCVA at each time point after surgery was significantly
higher than it was before the surgery (P < .001). One month after the surgery, the BCVA was significantly higher than it was before surgery and one week after the surgery. Postoperative CMT was statistically significantly lower than before surgery, and the difference was statistically significant (P < .001). One month after surgery, CMT was significantly lower than before and one week after surgery, and the difference was statistically significant (P < .001). Still, there was no significant difference between three and six months after surgery. Three times of intravitreal injections of anti-VEGF drugs were administered. At the most recent follow-up, DME recurred in three eyes (9.4%). During the follow-up period, no complications such as vitreous hemorrhage, retinal detachment, macular epiretinal membrane, or macular hole were observed.
Conclusion • Subretinal injection of BSS can be an effective treatment for refractory DME and is recommended for clinical use. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application of TCM Rehabilitation in Joint Function Recovery After Treatment of Distal Radius Fractures: A Meta-Analysis |
| Weiheng Chen, MD; Zeli Li, MM; Shuwen Li, MM; Sainan Liu, MM; Juan Wang, MM; Xiaobo Xie, MM |
| Objective • To evaluate the effect of traditional Chinese medicine (TCM) rehabilitation on the postoperative function of patients with distal radius fractures by Meta-analysis.
Methods • PubMed, Embase, CNKI, Wanfang, and other databases were searched for retrospective controlled trials and prospective randomized controlled trials on the effect of traditional Chinese medicine rehabilitation on the function of patients with distal radius fractures after surgery from the establishment of the database to May 2023. Revman version 5.3 software was used to analyze the extracted and screened index data.
Results • Eight studies involving 455 patients were included. Meta-analysis results showed Overall analysis showed that there was a significant difference in wrist function between the TCM rehabilitation group and the control group (MD = -12.16, 95%CI:-17.21 to -7.11, P < .00001), low heterogeneity (I2=40%, P = .17), the difference
in dorsiflexion function between the TCM rehabilitation group and the control group was statistically significant (MD = -1.16, 95%CI:-2.24 to -0.08, P = .04), with high heterogeneity (I2=79%, P = .003), that there was a significant difference in grip strength between the TCM rehabilitation group and the control group at 6 weeks (MD= 0.48, 95%CI: 0.24 to 0.71, P < .0001) with low heterogeneity (I2=45%, P = .12), there was no significant difference between the TCM rehabilitation group and the control group (OR= -0.00, 95%CI: -0.08 to 0.08, P = .99), and there was no heterogeneity (I2=0%, P = .66).
Conclusion • Traditional Chinese medicine rehabilitation treatment of distal radius fractures can increase the range of motion of wrist joints, reduce pain, shorten the rehabilitation time of patients, improve the quality of life, and is conducive to the standardized treatment of patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Subhealth Status of Nursing Staff and Its Influencing Factors in Shaanxi Province |
| Xiaozhen Li, BM; Qian Wang, MM; Huiyun Yang, MM; Jingwen Zhang, BM; Xi Zhou, MM; Qianqian Zhu, BM |
| Background • The concept of subhealth, defined as a state between health and illness characterized by diminished vitality and adaptability, is emerging as a significant concern, particularly among nursing staff. In Shaanxi Province, there is a notable prevalence of subhealth conditions among nurses, influenced by various factors, including lifestyle, work environment, and psychological stress.
Purpose • This study aims to investigate the level of subhealth status among nursing staff in Shaanxi hospitals, identify the primary causes and risk factors affecting their subhealth, and propose relevant countermeasures. The goal is to provide a scientific basis for developing strategies to enhance nursing staff’s physical and mental well-being.
Methods • A comprehensive questionnaire survey was conducted among 1068 nursing staff members from different hospitals in Shaanxi Province. The survey assessed various dimensions of subhealth, including physical, psychological, and social aspects. Data were analyzed to determine the relationships between subhealth status and factors like exercise frequency, dietary habits, smoking and alcohol consumption, occupational injuries, work situation, and stress levels.
Results • Most respondents were female, aged between 21 and 40 years. The study found no significant gender-related differences in subhealth scores. Key factors affecting subhealth included physical exercise, dietary habits, occupational stress, and work conditions. The data revealed higher physical subhealth but lower psychological subhealth among nursing staff compared to regional norms. Notable relationships were observed between lifestyle choices, work-related factors, and the subhealth status of nursing staff.
Conclusion • The subhealth status of nursing staff in Shaanxi hospitals is influenced by a combination of lifestyle, occupational, and psychological factors. The study underscores the need for targeted interventions focusing on lifestyle modifications, stress management, and improved work conditions to enhance the overall health status of nursing staff. This research provides valuable insights for healthcare policymakers and administrators to develop effective strategies for managing subhealth conditions among nursing professionals. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Identification of the Immune-related lncRNA SNHG14/ miR-200a-3p/ PCOLCE2 Axis in Colorectal Cancer |
| Xiaoqiang Dai, MM; Xiongwen Jiao, BD; Na Li, PhD; Qiang Liu, MM; Ximin Qiao, MM; Jiangli Shen, MM |
| Context • Procollagen C-endopeptidase enhancer 2 (PCOLCE2) is associated with the degradation of the extracellular matrix and collagen-chain trimerization, playing a yet unexplored role in tumor prognosis.
Objective • The study intended to characterize PCOLCE2’s influence on colorectal cancer (CRC) using expression analysis and to investigate its prognostic potential.
Design • The research team performed a genetic analysis using genetic databases, including The Cancer Genome Atlas (TCGA), Gene Expression Profiling Interactive Analysis (GEPIA), the Tumor IMmune Estimation Resource (TIMER), and LinkedOmics.
Setting • The study took place at Xianyang Central Hospital, Xianyang, Shaanxi Province, China.
Outcome Measures • The research team: (1) identified differentially expressed PCOLCE2; (2) determined PCOLCE2 expression in gastrointestinal neoplasm; (3) determined the relationship between PCOLCE2 expression and clinical information; (4) identified the mRNA-miRNA-lncRNA regulatory network; (5) ascertained miRNA expression regulated changes in downstream mRNA levels, that could affecting patients’ overall survival (OS) and prognoses; (6) assessed the correlation between PCOLCE2 and immune cells; (7) established the relationship between PCOLCE2 and the immune checkpoint; (8) determined the correlation between PCOLCE2 and tumor purity and immune cell infiltration; (9) determined the relationship between PCOLCE2 expression and clinicopathological features; and (10) identified the pathological changes of PCOLCE2.
Results • PCOLCE2 in colorectal adenocarcinoma (COAD) tissues was significantly lower than that in normal tissues (P < .05), correlating with DNA methylation and copy-number variation. Elevated PCOLCE2 levels were associated with poorer overall survival (OS), with P = 4.2e-07, and with advancing clinical stages—II, III, and IV—of the cancer (all P < .05). Furthermore, PCOLCE2 was significantly associated with the MSI phenotype and was an independent element impacting colorectal cancer’s prognosis. The correlation analysis revealed positive connections between PCOLCE2 expression and immune checkpoint-linked genes—programmed cell death protein 1 (PDCD1), cytotoxic T-lymphocyte associated protein 4 (CTLA4), and cluster of differentiation 274 (CD274), all while also being negatively correlated with tumor purity (Cor=-0.223, P = 5.59E-06) and positively associated with CD8+ T cells (Cor=0.087, P = 7.87E-02), CD4+T cells (Cor=0.236, P = 1.64E-06), macrophages (Cor=0.362, p=6.06E-14), neutrophils (Cor=0.206, P = 4.28E-05), B(Cor=0.231, P = 2.95E-06).
Conclusions • The current study revealed for the first time that a novel regulatory axis—long noncoding RNA (lncRNA) small nucleolar RNA host gene 14 (SNHG14)/ miR-200a-3p/ PCOLCE2— can act as the oncogenic axis of CRC cells and that clinicians can use it to predict the OS of colon-cancer patients. Additionally, differences in the protein expression of PCOLCE2 between normal and adenocarcinoma-colorectal tissues suggest its potential as a prognostic biomarker for CRC. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Role of Left Ventricular Pressure-strain Loop in Evaluating Myocardial Work in Patients with Type 2 Diabetes |
| Ruoling Han, MD; Juanjuan Li, MM; Chao Sun, MM; Yue Wen, MD; Xiaoxiao Yin, MM |
| Objective • To quantitatively analyze the myocardial work of patients with type 2 diabetes (T2D) by use of the pressure-strain loop and to investigate the clinical factors that affect myocardial work in the left ventricle.
Methods • We analyzed data from 50 control patients and 180 case patients, with 70 cases in group A (T2D only), 40 cases in group B (T2D + high blood pressure), 33 cases in group C (T2D + coronary heart disease), and 37 cases in group D (T2D + high blood pressure + coronary heart disease). Each patient received conventional ultrasonography and 2-dimensional speckle-tracking echocardiography, and the pressure-strain loop technique was applied to measure the left ventricular myocardial work parameters to compare the control and case groups.
Results • Systolic blood pressure was dramatically higher in groups B and D than in the control group and in groups A and C. N-terminal pro–brain natriuretic peptide was markedly higher in group D than in the control group, and the disease duration was markedly higher in groups C and D than in group A. The left ventricular global longitudinal strain of the epicardium (LVGLSepi) was substantially
lower in groups B, C, and D than in the control group. The LVGLSepi of groups C and D was significantly lower than group A, and the LVGLSepi of group D was significantly lower than group B. The LVGLS, LVGLS of the endocardium, global work index, and global constructive work progressively reduced among the control and case groups. LVGLS strongly correlated with global work index (r = -0.886; P < .001) and global constructive work (r = -0.880; P < .001). Body mass index, duration of diabetes, and glycated hemoglobin A1c independently associated with global work index (Body mass index: P = .04; duration of diabetes: P < .001; glycated hemoglobin A1c: P = .02) . In addition to the above three indicators, systolic blood pressure independently associated with global constructive work (systolic blood pressure: P = .04 ).
Conclusion • Pressure-strain loop technology can quantitatively, accurately, and sensitively monitor the variations in left ventricular myocardial contractile function of patients with T2D and detect subclinical cardiac injury at an early disease stage. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| PTP1B Attenuates the Progression of COPD by Suppressing the SHP-2/Src/ERK1/2/NLRP3 Signaling Pathway |
| Hui Wang, BM; Wei Yuan, BM; Hao Zhang, BM |
| Objective • This study evaluates the role of macrophage intracellular tyrosine phosphatase PTP1B in slowing the progression of Chronic Obstructive Pulmonary Disease (COPD) through the inhibition of the SHP-2/Src/ERK1/2/NLRP3 signaling pathway.
Methods • We administered PTP1B non-targeting control (NC) and PTP1B overexpression (OE) lentiviruses to mice. Post-infection, lung tissues underwent Hematoxylin and Eosin (HE) staining and immunofluorescence analysis to detect PTP1B, SHP2, Src, and FAK protein levels. We also examined CD68+ expression in RAW264.7 macrophages infected with either PTP1B NC or OE lentiviruses, or stimulated with Cigarette Smoke Extract (CSE), categorizing them into four groups for further analysis. Western blotting identified changes in protein expression of ERK1/2, NOX2, NOX3, NF?B, NLRP3, IL-1ß, and TNFa. Additionally, immunofluorescence staining assessed the expression of CD68, SHP2, and Src.
Results • Overexpression of PTP1B notably diminished lung tissue damage in COPD mice compared to the NC group, demonstrating a significant reduction in PTP1B, SHP2, Src, and FAK protein levels, alongside decreased CD68+ fluorescence. Western blot results revealed a marked decrease in the expression levels of ERK1/2, NOX2, NOX3, NF?B, NLRP3, IL-1ß, and TNFa proteins. Immunofluorescence further highlighted a substantial reduction in SHP2 and Src expressions in the PTP1B OE+CSE group versus the PTP1B NC+CSE group.
Conclusion • Our findings suggest that macrophage intracellular tyrosine phosphatase PTP1B plays a critical role in delaying COPD progression by targeting the SHP-2/Src/ERK1/2/NLRP3 signaling pathway, underscoring its potential as a therapeutic target in COPD management. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Deep Venous Catheterization in the Management of Pneumothorax: A Clinical Study Utilizing Conventional Closed Thoracic Drainage |
| Sheng Chen, MM; Biao Gu, MM; Nunu Li, BD; Yonggang Luo, MM; Yaojun Ni, MM; Zhongneng Xu, MM; Hao Zhou, BD |
| Background • Currently, conventional closed thoracic drainage for pneumothorax involves a painful procedure with a higher risk and wider (1~1.5 cm) incision. Minimally invasive catheterized drainage techniques are urgently needed to address this challenge.
Objective • This retrospective study aims to observe the effects of conventional closed thoracic drainage with deep venous catheterization drainage techniques on pneumothorax patients.
Design • It was a retrospective study.
Setting • This study was conducted at Huaian No.1 People’s Hospital, Affiliated with Nanjing Medical University.
Participants • A total of 105 pneumothorax patients who underwent conventional closed thoracic drainage (CCTD) or deep venous catheterization drainage technique (DVCDT) procedures at the hospital from 1st February 2020 to 30th October 2022 were selected.
Interventions • Patients received either CCTD or DVCDT.
Primary Outcome Measures • Included: (1) clinical variables; (2) catheterization procedure-related features; and (3) visual analogue scale (VAS) scores from pneumothorax patients.
Results • Both conventional closed thoracic drainage and deep venous catheterization drainage techniques were
successfully performed in all 105 (100%) patients, comprising 67 (63.8%) spontaneous pneumothorax, 20 (19%) iatrogenic pneumothorax, and 18 (17.1%) traumatic pneumothorax cases. Significant differences were observed between the enrolled spontaneous pneumothorax and traumatic pneumothorax patients in the two groups (CCTD and DVCDT) (P = .01 and P < .0001). Additionally, 55 (52.4%) patients underwent deep venous catheterization, while 50 (47.6%) patients underwent conventional closed thoracic drainage. The deep venous catheterization insertion procedure had a shorter mean timing (7.51±1.66 min) compared to the conventional closed thoracic drainage procedure (12.44±1.73 min) (P < .0001). Furthermore, VAS scores were significantly lower in pneumothorax patients undergoing deep venous catheterization (2.1±0.99) compared to conventional closed thoracic drainage (5.1±0.81) (P < .0001).
Conclusion • Deep venous thoracic drainage technique appears to be safer and more beneficial than conventional closed thoracic drainage procedures for treating pneumothorax. This technique offers advantages such as minimal scarring, lower VAS scores, and shorter insertion time, thereby improving safety and surgical outcomes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Linc00511 Promotes Thyroid Cancer Through the miR-4739/RNF38 Pathway |
| Yong Feng, MM; Lei He, MM; Xia Jiang, BM; Ying Liu, MM; Wei Liu, BM; Jihong Shi, BM; Jianxin Zhang, BM |
| Objective • To analyze the effect of Linc00511 on thyroid cancer through the miR-4739/RNF38 pathway.
Methods • A total of 78 patients in our hospital from July 2020 to July 2021 were collected, which were diagnosed with thyroid cancer after clinicopathological examination. Their cancer tissue samples were included in the thyroid cancer tissue group, and the fat 2 cm tissue samples were included in the para-cancer tissue group. Real-time quantitative PCR was used to detect the expression of Linc00511, miR-4739 and RNF38 in tissue samples from the two groups. Statistical analysis of data was performed using SPSS26.0. The correlation between Linc00511, miR-4739 and RNF38 were analyzed by Pearson’s correlation coefficient. The expression of Linc00511 in thyroid cancer tissues with different clinicopathological characteristics were compared.
Results • The expression levels of Linc00511 and RNF38 in thyroid cancer group were significantly higher than paracancer group, while miR-4739 levels were significantly lower (P < .05). Pearson correlation coefficient analysis showed that there was significant negative correlation
between Linc00511 and miR-4739 expression and significant positive correlation between Linc00511 and RNF38 expression (P < .05). There was no significant difference in the expression of Linc00511 among different ages, sexes, and cancer types (P > .05). The expression of Linc00511 in patients with TNM stages I, II, and III were increased with the increase of TNM stage (P < .05). The expression of Linc00511 in patients with tumor diameter =1 cm was higher than that in patients with tumor diameter <1 cm and the difference was statistically significant (P < .05).
Conclusion • Linc00511 and RNF38 were significantly overexpressed in thyroid cancer tissues, while miR-4739 was significantly underexpressed. In thyroid cancer, Linc00511 can promote the invasion and metastasis of thyroid cancer cells by targeting miR-4739 and RNF38, and its expression level may reflect the progression of thyroid cancer, which can provide target reference for the clinical treatment of thyroid cancer. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Emergency Plan and First Aid Procedure on Injury Control and Precise Treatment of Patients with Acute Traumatic Cervical Spinal Cord Injury |
| Chengqiao Song, MM; Xinming Yang, BM; Xuyang Zhang, MM |
| Objective • To investigate the effect of emergency plans and first aid procedures on injury control and precise treatment in patients with acute traumatic cervical spinal cord injury. Given the challenges in managing acute traumatic cervical spinal cord injuries and the need for efficient emergency plans and first aid procedures, the importance of this study is self-evident.
Methods • A total of 103 patients with acute traumatic cervical spinal cord injury were enrolled in our study from January 2017 to December 2022, and these patients were divided into two groups according to the time of admission: 51 cases from January 2017 to December 2019 were in the control group, and 52 cases from January 2020 to December 2022 were in the study group. The control group was given routine emergency care. The study group received emergency plans and first aid procedures that included rapid assessment, optimized patient handling and transport, and immediate medical intervention. We compared the International Classification of Functioning, Disability and Health (ICF) scores, the Short Form Health Survey (SF-36) scores, the Activities of Daily Living (ADL) scores, and the occurrence of adverse events 3 months after rescue between the two groups.
Results • The study group demonstrated significantly shorter times for prehospital emergency rescue, waiting time upon admission, time from admission to treatment, mechanical ventilation duration, and ICU stay when compared to the control group (P < .05). The intubation rate and mortality rate in the research group were 28.85% and
11.54%, respectively, compared to 31.37% and 13.73% in the control group, with no statistically significant differences (P > .05). Three months after the rescue, the study group showed significantly lower scores in environmental factors, activities and participation, body structure, and body function compared to the control group (P < .05). Three months after the rescue, the research group had significantly higher SF-36 scores (P < .05), and their ADL scores were significantly lower than those of the control group (P < .05). The research group had an adverse event rate of 3.85%, significantly lower than the control group’s rate of 19.61% (P < .05). The study group experienced improvements in emergency response and hospital procedure times, higher SF-36 and ADL scores, and lower rates of adverse events, suggesting significant potential for improving patient outcomes in cases of acute traumatic cervical spinal cord injury. This demonstrates the effectiveness of the emergency plans that have been implemented and may influence the approach to emergency medical care in similar situations in the future.
Conclusions • Emergency plans and first aid procedures can effectively shorten the first aid time, promote rehabilitation, reduce adverse events, and improve the quality of daily life in patients with acute traumatic cervical spinal cord injury. Based on these findings, future practice or policy may need to be adjusted to further enhance patient care quality. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Nephrotic Syndrome Complicated with Familial Hypocalciuric Hypercalcemia in an Infant: A Case Report and Comprehensive Literature Review |
| Xiaoyan Fan, PhD; Chunlin Gao, PhD; Zhengkun Xia, PhD; Mei Xue, PhD; Min Yu, PhD |
| Background • Nephrotic syndrome, a prevalent childhood glomerular disorder, manifests with proteinuria, hypoalbuminemia, edema, and hypercholesteremia. Hypercalcemia, though rare, occasionally complicates these cases. Familial hypocalciuric hypercalcemia, an autosomal dominant disorder, is characterized by lifelong hypercalcemia, hypocalciuria, and normal or elevated parathyroid hormone levels due to loss-of-function mutations.
Case Presentation • We detail a 2-year-old girl with nephrotic syndrome whose proteinuria responded effectively to steroid therapy without side effects. Hypercalcemia emerged after one month, prompting a familial history investigation, revealing a predisposition to hypercalcemia. Genetic analysis identified a heterozygous mutation c.1394G>A (p.R465Q) in the calcium-sensing receptor gene, shared among the patient,
her grandmother, her father, and one sister. Notably, hypercalcemia required no intervention.
Conclusions • This case report is the first documenting familial hypocalciuric hypercalcemia in a child with primary nephrotic syndrome and delineates the familial pedigree. While familial hypocalciuric hypercalcemia is infrequent, our findings affirm its generally benign nature. A critical aspect of patient care involves monitoring for potential complications, including acute pancreatitis or chondrocalcinosis. The indispensability of genetic studies in both diagnosis and the differentiation of related conditions is underscored, emphasizing their pivotal role in enhancing our understanding of this rare yet clinically significant disease. Continued research is imperative for advancing knowledge and improving clinical management. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Association of Vascular Calcification with Serum lncRNA H19 and Runx2 mRNA Expression in Patients with Uremia |
| Yaling Bai, MD; Meijuan Cheng, MM; Jingjing Jin, MM; Guiying Li, MD; Jianwei Li, MM; Xiaoli Liu, MM; Taoxia Wang, MM; Jinsheng Xu, MD |
| Background • The objective of this study was to investigate the relationship between vascular calcification, serum lncRNA H19, and Runt-Related Transcription Factor 2 mRNA expression in patients with uremia.
Methods • This study is a retrospective study which recruited 146 patients with uremia on dialysis from December 2021 to November 2022. Participants were divided into the VC and non-VC groups based on their chest X-ray calcification ratings. General and clinical data were collected from all patients. Serum H19, Runx2 mRNA, mineral bone disease effectors, and other blood markers were tested. Univariate analysis was performed to compare the changes in each clinical index between these two groups of patients. A multi-factor logistic regression analysis of risk factors for VC was performed. Receiver operating characteristics analyzed the H19 and Runx2 for their diagnostic values for VC. Pearson’s test was used to analyze the correlation between the H19 and Runx2 expression and the factors influencing VC.
Results • Patients in the VC group had significantly higher creatinine, serum phosphorus, calcium, BMP-2,
FGF-23, OPG, and iPTH levels than those in the non-VC group (P < .05), while their albumin levels were significantly lower than those in the non-VC group (P < .05). The expression of H19 and Runx2 mRNA was significantly upregulated in the serum of VC patients (P < .05). H19 was significantly positively correlated with creatinine, serum phosphorus, calcium, BMP-2, OPG, and iPTH (P < .05). Runx2 mRNA was significantly positively correlated with creatinine, FGF-23, and iPTH (P < .05 ), while there was no significant correlation with other factors(P > .05). Albumin, BMP-2, iPTH, H19, and Runx2 were independent correlative-factors of uremic VC. In addition, the combined H19 and Runx2 test (AUC=0.850; 95% CI: 0.781-0.903) had good diagnostic values for the development of VC.
Conclusion • Serum H19 and Runx2 levels are significantly associated with VC-related factors and are independent risk factors for uremic VC, and their levels contribute to the diagnosis of uremic VC. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of WeChat-Based Mindfulness-Based Stress Reduction on Psychological Resilience and Quality of Life Among Patients Undergoing Loose Body Removal Surgery |
| Yuncheng Qiu, MBBS; Huan Xu, MBBS |
| Background • The knee joint, a structurally intricate component, is highly susceptible to injuries, profoundly impacting the afflicted patients’ life quality. Among these injuries, loose body removal stands out, historically managed through conventional open surgical interventions. However, such procedures entail complications, including infection and extended recovery periods, fostering postoperative psychological distress like anxiety and depression.
Objective • This study aims to assess the impact of WeChat-based mindfulness-based stress reduction (MBSR) on psychological resilience and quality of life in patients undergoing loose body removal.
Methods • A cohort of 87 patients undergoing surgical treatment for loose body removal in our hospital between November 2018 and August 2019 was enlisted. They were randomly allocated to either receive routine postoperative nursing (control group) or participate in WeChat-based MBSR (observation group) using a random number table
method. Assessment parameters encompassed anxiety, depression, mindfulness levels, quality of life, personality traits, and psychological resilience.
Results • After treatment, patients in the observation group exhibited significantly reduced levels of depression, anxiety, and heightened mindfulness compared to the control group (P < .05). Moreover, the observation group reported superior quality of life and personality traits compared to the control group (P < .05). Additionally, patients in the observation group demonstrated enhanced psychological resilience compared to the control group (P < .05).
Conclusions • WeChat-based MBSR emerges as a promising intervention, significantly alleviating depression and anxiety while enhancing the quality of life and psychological resilience in patients undergoing loose body removal surgery, suggesting its potential for widespread clinical application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Correlation of 24-h Urinary Protein Excretion, Serum Indicators, and Placental Growth Factor in Patients with Preeclampsia and their Adverse Outcome |
| Yuan Jiang, MM; Zhaie Lu, MM; Sheng Ye, MM |
| Introduction • Preeclampsia (PE) is a fundamental cause of preterm labor, intrauterine growth restriction, and persistent postpartum hypertension. In the present study, we aimed to investigate the correlation between 24-h urinary protein excretion, serum markers, and placental growth factor and their adverse pregnancy outcomes in patients with PE.
Methods • A total of 126 pregnant women with PE (86 cases of mild PE and 40 cases of severe PE, assigned to the observation group) who came to our hospital from March 2019 to December 2021 for regular obstetric checkups and delivery were selected, with 60 healthy pregnant women assigned to the control group. Routine biochemical parameters, 24-h urinary protein quantification, serum parameters, and placental growth factor levels were recorded. The incidence of adverse neonatal pregnancy outcomes and abnormal fetal heart monitoring, neonatal body mass, 1 min Apgar score, and other adverse pregnancy
outcomes were also analyzed in the different groups.
Results • In comparison with healthy pregnant subjects, PE patients had earlier delivery gestational weeks (P < .05), significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), 24-h urinary protein excretion, total cholesterol (TC), triglyceride (TG), D-Dimer and human chorionic gonadotropin (ß-hCG) levels (P < .05), lower albumin (ALB), platelet count, pregnant associated plasma protein A (PAPP-A) and placental growth factor (PLGF) (P < .05), and higher incidence of maternal and perinatal adverse outcomes (P < .05).
Conclusions • Combined screening of 24-h urinary protein, PAPP-A, ß-hCG, PLGF, and serum indicators in early pregnancy are essential in predicting PE, allowing timely assessment of the risk of adverse pregnancy, and providing a basis for clinical intervention. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Diagnostic Value of the Modified STdmax/MET Criterion in Treadmill Exercise Electrocardiographic Test for Coronary Artery Disease in an Aged Population |
| Zhenhua Cao, MM; Lu Gao, MM; Bingqiang Li, MM; He Li, MM; Yuchuan Wang, MM; Ping Zhang, MM |
| Objective • The primary objective of this study is to assess the diagnostic value of treadmill exercise electrocardiographic test (EET) for coronary artery disease (CAD) in the aged population, emphasizing the need for improved diagnostic criteria due to the limitations of traditional EET in accurately diagnosing CAD among elderly patients. This focus is critical as the aged population has a higher prevalence of CAD, and early and accurate diagnosis is essential for effective management and treatment.
Methods • This study comprised two stages. Initially, we retrospectively analyzed data from patients aged > 60 years who underwent treadmill EET within two weeks of coronary angiography (CAG) during hospitalization from June 1, 2014, to May 31, 2017. We evaluated the diagnostic value of treadmill EET using both the standard criterion (ST depression > 0.1 mV) and a modified criterion (the ratio of ST depression to metabolic equivalent [STdmax/MET]), explaining our choice of the modified criterion as it potentially offers a more nuanced assessment by considering the patient’s exercise capacity. A subgroup analysis was also
conducted. Subsequently, a prospective study to further investigate the modified criterion was carried out.
Results • In the retrospective analysis, 190 patients were enrolled, with 71.5% confirmed to have CAD. The sensitivity, specificity, and accuracy of the standard criterion were 66.2%, 42.6%, and 59.5%, respectively. With a cut-off value for STdmax/MET set at 0.255 mV·W/m2, these metrics improved to 79.4%, 55.7%, and 72.4%, respectively, for the modified criterion. The prospective study, involving 47 patients, confirmed significant improvements in sensitivity (85.7% vs. 64.3%, P = .041) and specificity (68.4% vs. 31.6%, P = .046) when applying the modified criterion.
Conclusions • The introduction of the novel modified diagnostic criterion, STdmax/MET, significantly enhances the diagnostic value of treadmill EET for detecting CAD in elderly patients. The adoption of this modified criterion could potentially improve clinical outcomes by facilitating more accurate and timely diagnosis of CAD in this high-risk group. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Analysis of Superficial Temporal Artery-Middle Cerebral Artery Bypass Combined with Brain-Temporal Muscle Sticking in the Treatment of Chronic Internal Carotid Artery Occlusion |
| Jianbin Sun, BM; Wenbo Wang, BM; Jian Wei, MM; Jianan Zhao, MM; Jianan Zheng, MM; Chuixian Zhou, MM |
| Objective • NHISS score, MMSE scale, craniocerebral CTA or DSA, and craniocerebral magnetic resonance 3D-ASL were used to evaluate the efficacy and safety of superficial temporal artery-middle cerebral artery (STA-MCA) shunt combined with cranial-muscular-merging (EMS) in the treatment of symptomatic chronic internal carotid artery occlusion.
Methods • The purpose of this study was to retrospectively analyze the clinical data of 15 patients with symptomatic chronic internal carotid artery occlusion who received STA-MCA shunt combined with EMS treatment at Weifang Brain Hospital and Weifang Traditional Chinese Medicine Hospital from July 2016 to December 2020. The patients’ neurological and cognitive functions were evaluated by NHISS score and MMSE examination before surgery and 6 months after surgery. Adverse reactions after surgery were observed, and preoperative and postoperative cerebral hemodynamics, the patency of the shunt anastomosis, and the compensation of collateral circulation were evaluated by cranial CTA or DSA and cranial MRI 3D-ASL.
Results • All 15 patients underwent successful surgery. One patient experienced transient mild cerebral hyperperfusion syndrome postoperatively. Six months after surgery, the NHISS score was significantly improved compared with that before surgery (P = .0001), and the MMSE score was also significantly improved compared with before surgery (P = .0124). No adverse events of poor scalp healing, intracranial infection, subcutaneous fluid accumulation, subdural hematoma, or cerebral hemorrhage were observed postoperatively. Imaging examination showed that the shunt vessels were unobstructed, the middle cerebral artery was dilated, collateral circulation in the surgical area was increased, and cerebral blood flow increased.
Conclusion • STA-MCA shunt combined with EMS treatment is safe and effective for symptomatic chronic internal carotid artery occlusion. It has the potential to improve cerebral blood flow and reduce clinical symptoms. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application of Online-Offline Teaching Combined with SimMan 3G Simulation Teaching Model in Critical Illness Teaching in a Department of Cardiology |
| Lili Lin, MM; Sihua Luo, MM; Pengda Qiu, MM; Yunhong Xu, PhD; Yi Yan, PhD; Liuying Zhong, PhD |
| Objective • To explore the effectiveness of online-offline teaching combined with SimMan 3G simulation teaching in improving theoretical knowledge and practical skills for critical illnesses in cardiology among undergraduate students.
Methods • This randomized controlled trial compared traditional bedside teaching (control group, n=120) with an innovative approach combining online education and SimMan 3G simulation teaching (experimental group, n=120) among 240 undergraduate clinical medicine students. The control group received traditional bedside teaching, while the experimental Group received a combination of online teaching plus a SimMan 3G simulation teaching. Subsequently, the theoretical and clinical practice scores and the students’ satisfaction
scores about the teaching methods and teaching effects were collected and analyzed.
Results • The experimental group demonstrated a statistically significant improvement in both theoretical (89.42±11.28 vs. 76.49±17.42) and clinical practice scores (18.04±4.32 vs. 15.33±3.94) compared to the control group, alongside a higher satisfaction score.
Conclusions • The integration of online-offline teaching with SimMan 3G simulation teaching offers a promising model for enhancing cardiology education, suggesting a valuable direction for curriculum development in medical training programs. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Roux-en-Y Gastric Bypass Surgery for the Prevention of Long-term Renal Function Damage in Type 2 Diabetes: A Clinical Study |
| Jiachen Cai, MM; Zhan Chen, MM; Deqiao Lei, MD; Hongbing Zhang, BM |
| ABSTRACT
Objective • Type 2 diabetes mellitus (T2DM) is strongly associated with obesity, a significant risk factor for the occurrence and progression of chronic kidney disease. In recent years, weight loss surgery has become an important treatment option for diabetes. This study examined whether Roux-en-Y gastric bypass surgery, a new metabolic bariatric surgery approach, can effectively reduce the risk of long-term renal impairment in individuals with type 2 diabetes.
Methods • In a cohort study, 60 individuals suffering from both obesity and type 2 diabetes were stratified and randomly divided into 2 groups based on gender and weight. The control group (30 cases) received internal medicine treatment; the observation group (30 cases) received Roux-en-Y gastric bypass surgery. The study compared the changes in glycated hemoglobin, fasting blood glucose, fasting insulin, fasting C-peptide, postprandial 2-hour blood glucose, postprandial 2-hour insulin, postprandial 2-hour C-peptide, weight, waist circumference, and BMI before and at 6, 12, and 18 months after treatment. Kidney function-related indicators such as urinary protein excretion, microalbuminuria, and creatinine clearance were also compared.
Results • There were no significant differences in the above indicators between the 2 groups before treatment (P > .05). After 6, 12, and 18 months of treatment, the levels of glycated hemoglobin, fasting blood glucose, fasting insulin, fasting C-peptide, postprandial 2-hour blood glucose, postprandial 2-hour insulin, postprandial 2-hour C-peptide, weight, waist circumference, and BMI were significantly decreased compared to before treatment (P < .05). Urinary protein excretion and microalbuminuria decreased, while creatinine clearance increased after 6, 12, and 18 months of surgery (P < .05). The differences in indicators between the 2 groups at each point after surgery were statistically significant (P < .05).
Conclusion • Roux-en-Y gastric bypass surgery was more effective than medical treatment in treating type 2 diabetes and mitigating long-term kidney function damage. These findings confirm the clinical utility of Roux-en-Y gastric bypass surgery in these conditions, indicating its potential for generalization and reference. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| MicroRNA-135a and MicroRNA-221 in First-Episode and Recurrent Depression: Associations with Serum Markers and Cognitive Impairment |
| Yi Chen, MM; Xiaofei Sui, MM; Wen Xu, MM; Zhenzhen Yang, MM |
| Objective • This study aimed to compare miR-135a and miR-221 levels among patients with first-episode depression and recurrent depression, examining their association with cognitive performance.
Method • A total of 97 first-episode depression patients, 104 recurrent depression patients hospitalized from April 2019 to December 2021, and 60 healthy individuals as a control group underwent cognitive function assessment using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Serum inflammatory cytokine levels and miR-135a and miR-221 levels were measured. The correlation between miR-135a, miR-221, cognitive function, and inflammatory cytokines in depression patients was analyzed.
Results • Significant differences were observed in immediate memory, speech function, visual span, delayed memory, attention, and total RBANS scores among the three groups (P < .05). Both first-episode and recurrent depression groups scored lower than the control group across all cognitive function measures (P < .05), with the
recurrent depression group exhibiting lower scores than the first-episode depression group (P < .05). Inflammatory markers (hs-CRP, TNF-a, IL-6) showed substantial variations among the groups (P < .05). miR-135a and miR-221 levels significantly differed among the three categories (P < .05). Correlation analyses revealed a negative association between miR-135a and IL-6, TNF-a, hs-CRP (P < .05), and a positive correlation with cognitive function. MiR-221 demonstrated significant connections with inflammatory markers and negative correlations with immediate memory, verbal function, visual span, delayed memory, attention, and RBANS total score ( < .05).
Conclusion • Patients with depression exhibit cognitive impairment, with recurrent depression associated with more severe impairment. The downregulation of miR-135a and upregulation of miR-221 may play a role in the cognitive impairment process by regulating inflammatory responses. The findings suggest a potential link between microRNA expression and cognitive dysfunction in depression. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Application of Self-Expanding Metal Stents in the Treatment of Obstructive Colorectal Cancer |
| Yingzhou Shen, BM; Haitao Wang, BM; Kuangjing Wang, MM |
| Objective • To investigate the safety and efficacy of self-expanding metal stent placement in treating obstructive colorectal cancer.
Methods • A retrospective analysis was conducted on 33 patients with self-expanding metal stents. The technical success rate, clinical success rate, and stent-related complications were observed.
Results • The success rate of self-expanding metal stent placement in this study was 100% (33/33), indicating that the procedure was technically successful in all cases. The clinical remission rate was 90.9% (30/33), indicating that the stent placement was effective in most cases in relieving
obstructive colorectal cancer symptoms. However, the overall incidence of complications related to self-expanding metal stent placement was 12.1% (4/33), with stent displacement and detachment occurring in 3.0% (1/33) of cases each, and gastrointestinal perforation occurring in 6.1% (2/33) of cases.
Conclusion • These findings suggest that stent placement is safe and effective, but there is a risk of complications that should be considered. It can serve as a transitional treatment or relieve symptoms in advanced cancer and improve quality of life. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparison of the Efficacy and Prognostic Factors of Endoscopic Submucosal Dissection with Different Procedures for Colorectal Neuroendocrine Tumors |
| Wenmei Chen, MM; Cancan Kong, MM; Wei Mao, PhD; Minxia Qiu, MM |
| Objective • To compare the clinical efficacy, prognostic factors, and survival impact of endoscopic submucosal dissection (ESD) versus endoscopic submucosal resection (ESR) in patients with colorectal neuroendocrine tumors (NETs).
Methods • This retrospective study analyzed 118 patients with colorectal NETs treated from January 2012 to December 2020. Patients were divided into the ESD group (n=59) and the ESR group (n=59) based on the surgical treatment method. We assessed the surgical efficacy, long-term survival, and factors influencing tumor recurrence using logistic regression analysis with clear criteria for group division.
Results • En bloc resection, complete histological resection rates, and postoperative complications did not significantly differ between groups (P > .05). In the 33 patients with
recurrence, those with tumor diameter < 10 mm, tumor grade G1, and negative resection margins were significantly fewer (P < .05). Logistic regression identified tumor diameter, grade, and resection margin status as significant predictors of recurrence (P < .05). There was no significant difference in distant metastasis, survival rates, and mortality between the groups (P > .05).
Conclusions • ESD and ESR offer high clinical efficacy in treating colorectal NETs without significantly impacting prognosis or long-term survival. ESD, however, may be more suited for larger tumors due to its precise tissue removal capability. Future research should explore the long-term outcomes over 3 and 5 years to further validate these findings. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Qiye Shen'an Pian Combined with Glutamate and Vitamin B1 on Fatigue State, Immune Function and Quality of Life in Patients with Chronic Fatigue Syndrome |
| Junfeng Liao, BM; Fan Lin, MM; Jun Liu, MM; Chenyang Nie, MM |
| Objective • To observe the effects of Qiye Shen’an Pian combined with ghrelin and vitamin B1 on the fatigue status, immune function, and quality of life of patients with chronic fatigue syndrome (CFS), focusing specifically on the efficacy of this combination therapy.
Methods • In this prospective study, 106 CFS patients admitted from June 2021 to June 2023 were selected. Using a simple randomisation method, patients were divided into two groups. The conventional group received glutathione and vitamin B1 treatment, while the Qiye Shen’an group received an additional treatment with Qiye Shen’an Pian on top of the standard glutathione and vitamin B1, for a continuous period of 8 weeks. To assess treatment efficacy, we compared immune function-related indexes (such as CD4+, CD8+, CD4+/CD8+ ratio, NK cell ratio), free radical metabolism indexes (like lipid peroxide, catalytic enzyme, and superoxide dismutase levels), TCM symptom scores, FS-14 scores, and SPHERE scores between the two groups. Adverse reactions were also recorded and statistically analyzed.
Results • Notable improvements were observed in both groups, with the Qiye Shen’an group showing particularly significant enhancements. Post-treatment immune function indicators revealed a greater decrease in CD8+ levels in the Qiye Shen’an group (P < .05), along with marked increases in CD4+, CD4+/CD8+ ratio, and NK cell ratio in both groups, more so in the Qiye Shen’an group (P < .05). Free radical metabolism
indicators, including lipid peroxide levels, decreased in both groups, with a more significant reduction observed in the Qiye Shen’an group (P < .05). The levels of catalytic enzyme and superoxide dismutase increased in both groups, with a notably higher improvement in the Qiye Shen’an group (P < .05). In terms of TCM symptom scores, FS-14 scores, and SPHERE scores, both groups showed a reduction after treatment, with a more substantial decrease in the Qiye Shen’an group (P < .05).
Conclusion • In this study, we observed that Qiye Shen’an Pian combined with glutathione and vitamin B1, produced significant improvements in immune function and antioxidant capacity in patients with chronic fatigue syndrome (CFS). Specifically, patients’ CD4+, CD8+ levels, and superoxide dismutase (SOD) activity all showed positive changes after treatment. These changes are crucial for enhancing patients’ disease resistance and reducing fatigue symptoms. Qiye Shen’an Pian combined with glutamine and vitamin B1 in the treatment of CFS can alleviate the fatigue state of patients, improve the immune function, enhance the antioxidant capacity of the body, and improve somatic and psychological health. These findings underscore the potential of this combination therapy in effectively managing chronic fatigue syndrome, offering a promising direction for future treatment strategies. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy Analysis of Pneumocystoscopic Cohen Surgery for Lower Ureteral Lesions in Children |
| Yongsheng Cao, MM; Bo Peng, BM; Chao Yang, BM; Zhiqiang Zhang, MD |
| Objective • This study aims to evaluate the clinical effects, safety, and recovery associated with minimally invasive pneumocystoscopic ureterovesical reimplantation (Cohen) compared to open surgery for treating lower ureteral lesions in children.
Methods • The data of 60 sick children with lower ureteral lesions were retrospectively analyzed, who underwent ureterovesical reimplantation in our hospital from January 2017 to June 2022. All of them went through a Cohen procedure. Sixty children were divided into two groups according to surgical approaches: open surgery group (n=30) and pneumocystoscopic group (n=30). There were 26 boys and 4 girls in the open surgery group, aged from 3 months and 7 days old to 8 years and 5 months old, with 18 cases of lower ureteral stenosis and 12 cases of ureteral reflux, while there were 20 boys and 10 girls in the pneumocystoscopic group, aged from 7 months and 2 days old to 10 years and 9 months old, with 18 cases of
lower ureteral stenosis and 12 cases of ureteral reflux. We retrospectively analyzed data from 60 children, comparing outcomes such as intraoperative complications, postoperative recovery, and long-term efficacy between open surgery and pneumocystoscopic approaches.
Results • The pneumocystoscopic group exhibited smaller surgical incisions, reduced intraoperative bleeding, and shorter hospital stays compared to the open surgery group, although the operation duration was longer. Both groups showed similar postoperative ureter diameters and long-term recovery, with minimal occurrences of ureteral reflux relapse.
Conclusion • Pneumocystoscopic ureterovesical reimplantation (Cohen) demonstrated safety, efficacy, minimal invasiveness, and faster recovery in treating lower ureteral lesions in children, with aesthetic benefits and fewer complications, making it a promising approach for pediatric urological surgeries. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Respiratory Function Exercise and Psychological Nursing on COPD Patients: A Comprehensive Study |
| Xiaoyan Liu, MD; Hongxia Ma, MD; Keli Pan, MD; Chang Sun, MD; Jie Sun, MD; Jinkun Wang, MD; Kanjin Wu, MD |
| Background • Chronic Obstructive Pulmonary Disease (COPD) is a prevalent and impactful respiratory condition, necessitating effective interventions for improved patient outcomes. This retrospective analysis aimed to explore the efficacy of respiratory function exercise combined with psychological nursing on cardiopulmonary function index, exercise tolerance, and quality of life in patients with stable COPD.
Methods • The data of 100 patients with stable COPD admitted to Cangzhou Central Hospital from June 2019 to June 2021 were retrospectively analyzed. Patients were assigned to the experimental group (n=50) and the control group (n=50) alphabetically by their initials. Patients in both groups were treated with conventional care combined with respiratory function exercise, and the experimental group additionally received psychological care intervention. Pulmonary function indicators, including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), one-second rate (FEV1/FVC), 6-min walking test (6MWT) results, quality of life (physical health and role emotional), anxiety and depression self-rating scale scores, nursing satisfaction,
and clinical efficacy were compared between the two groups before and after treatment.
Results • The two groups presented no significant differences in baseline data (P > .05). The experimental group outperformed the control group in terms of pulmonary function index, quality of life, and nursing satisfaction (P < .001). The observation group obtained lower negative emotion scores than the control group after nursing intervention (P < .001). After nursing, the FEV1/FVC in the experimental group was significantly higher than that in the control group [(58.63 ± 5.64) vs (46.36 ± 5.23)]. The 6MWT results in the experimental group were significantly better than those in the control group [(398.35 ± 28.65) m vs (348.97 ± 26.98) m] (all P < .001).
Conclusion • The results revealed that this combined approach effectively improves lung function, mitigates negative emotions, enhances nursing satisfaction, and significantly boosts the quality of life in patients with stable COPD. These findings underscore the potential clinical relevance of implementing such interventions for better COPD management and patient well-being. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Targeted Nursing Combined with Psychological Intervention on Chemotherapy for Gastric Carcinoma and its Influence on Patient Compliance |
| Yao Fu, MBBS; Qian Gao, MBBS; Rui Guo, MMed; Yuqi Li, MBBS |
| Objective • To explore and analyze the effect of targeted nursing combined with psychological intervention on chemotherapy for gastric carcinoma and its influence on patient compliance.
Methods • The study subjects were 88 patients diagnosed with gastric cancer and treated with chemotherapy from December 2019 to May 2021.
Results • The Self-Rating Anxiety Scale and Hamilton Depression Cale scores of the study group were significantly lower than those of the control group (33.45±6.11 vs. 44.17±5.76; 35.14±5.44 vs. 46.87±5.23, respectively; P < .05); In the Morisky scale, patients in the study group scored higher than those in the control group in terms of weight control, medication compliance, appropriate exercise, and diet control; the study group had more cases of Grade 0 nausea and vomiting and significantly fewer cases of Grades I, II, III, and IV nausea and vomiting than the control group compliance (P < .05); patients in the study group gave higher scores than those in the control group on the nursing care quality, from the aspects of the quality of nursing staff. These findings highlight the significant improvements in psychological well-being, adherence to health-related
behaviors, reduced nausea and vomiting, and overall satisfaction with nursing care in patients receiving targeted nursing and psychological intervention.
Conclusion • The utilization of targeted nursing in tandem with psychological counseling has demonstrated a notably positive impact on chemotherapy outcomes for stomach malignancy. The amalgamation of targeted nursing and psychological intervention not only enhances patient compliance during gastric carcinoma chemotherapy but also leads to a reduction in negative emotions, decreased instances of nausea and vomiting, and higher scores for nursing quality. These findings have significant implications for clinical practice, suggesting that the integration of targeted nursing and psychological support could be a valuable approach in optimizing patient care for gastric carcinoma. The observed improvements underscore the potential for widespread adoption of this combined intervention strategy in clinical settings, potentially leading to enhanced treatment outcomes and overall patient well-being. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| 3D Printing and Development of Optimized and Accurate, Personalized Surgical Plans for Complex Pelvic and Acetabular Fractures |
| Mohamed Lamin Bangura, MM; Wei Chu, MM; Huasong Luo, MD; Minglu Wang, MM |
| Context • Multiple high-energy injuries and complex, pelvic acetabular fractures are challenging injuries. With the help of a 1:1-sized solid model of the human body, 3D printing technology can achieve personalized customization of the surgical methods.
Objective • The study intended to compare the clinical efficacy of three-dimensional (3D)-printing-assisted and traditional, open reduction and internal fixation in the treatment of complex pelvic acetabular fractures.
Design • The research team conducted a randomized controlled trial and also provided a case study for one participant in the intervention group.
Setting • The study took place at the First Affiliated Hospital of Yangtze University in Jingzhou, Hubei, China.
Participants • Participants were 48 patients with complex pelvic acetabular fractures at the hospital between January and December 2018.
Interventions • The research team randomly divided participants into two groups, with 24 participants in each group: (1) the 3D group, which received treatment in which surgeons used 3D-printing technology for preoperative planning, and (2) the routine group, which received routine treatment.
Outcome Measures • The research team measured: (1) perioperative conditions, including operation time, intraoperative blood loss, and postoperative drainage
volume; (2) fracture reduction quality; and (3) a case study of a postoperative imaging examination.
Results • The 3D group’s operation time (P = .001), intraoperative blood loss (P = .001), and postoperative drainage volume (P = .001) were significantly lower than those of routine group. According to the Matta imaging standards, the fracture reduction quality for the 3D group was excellent for 16 participants (66.66%), good for four participants (16.67%), and fair for four participants (16.67%), with the total quality rate at 83.33% for 20 participants. For the routine group, the quality was excellent for eight participants (33.33%), good for four participants (16.67%), and fair for 12 participants (50.00%), with the excellent and good rates at 50.00% for 12 participants. The 3D group’s fracture reduction quality was significantly higher than that of the routine group (P < .05).
Conclusions • 3D printing technology in the treatment of complex pelvic acetabular fractures can be helpful for surgeons to understand a fracture’s characteristics; formulate an optimized and accurate, personalized surgical plan before an operation; improve the reduction’s safety and accuracy; shorten the operation time; reduce the occurrence of postoperative complications; and improve clinical efficacy. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparison of the Application Effects of Tissue-Selecting Therapy Stapler, Procedure for Prolapse and Hemorrhoids, and Ruiyun Procedure for Hemorrhoids in the Treatment of Mixed Hemorrhoids |
| Qingguo Lin, BM; Tianming Wang, BM; Fangjian Xu, BM; Wanneng Yan, BM |
| Objective • To compare the application effects of tissue-selecting therapy stapler (TST), procedure for prolapse and hemorrhoids (PPH), and Ruiyun procedure for hemorrhoids (RPH) in the treatment of mixed hemorrhoids, specifically focusing on primary outcomes such as recovery time, pain levels, and quality of life.
Methods • Based on the presence of mixed hemorrhoids,120 patients were admitted to the general surgery department of the hospital from January 2019 to December 2022 were selected and randomly divided into three groups, with 40 cases in each group. The parameters like VAS, ARP, SAP, and HF-QoL scores were chosen to comprehensively assess pain, anal function, and overall quality of life. Group A was treated with TST, group B was treated with PPH, and group C was treated with RPH. The parameters related to surgical treatment and rehabilitation, pain levels [Visual Analog Scale (VAS)] at different times, preoperative and postoperative anal dynamic function [anal rest pressure (ARP), squeeze anal pressure (SAP), and duration of contraction], anal function and quality of life were compared among the three groups. The incidence rates of complications that occurred within 1 month after surgery and postoperative recurrence rate were calculated.
Results • There were significant differences in intraoperative blood loss, surgical time, length of hospital stay, and wound healing time among the three groups (TST, PPH, and RPH) (P < .05). There were statistically
significant differences in VAS scores among the three groups (TST, PPH, and RPH) on the 1st and 2nd day after surgery (P < .05). The scores increased in sequence from group C, group A to group B. There was no statistically significant difference among the three groups (TST, PPH, and RPH) in terms of ARP, SAP, and duration of contraction before and after treatment, and Wexner scores at different time points after surgery (P > .05). There were statistically significant differences in HF-QoL scores among the three groups (TST, PPH, and RPH) at 1 month and 3 months after surgery (P < .05). One month after surgery, the HF-QoL score of group C was lower than those of groups A and B (P < .05). Three months after surgery, the HF-QoL scores increased in sequence from group C, group A to group B (P < .05). There were statistically significant differences in the incidence rates of urinary retention and anal stenosis among the three groups (TST, PPH, and RPH) (P < .05). The incidence rates of urinary retention and anal stenosis in group B were much higher than those in group B, group A and group C (P < .05).
Conclusion • RPH not only shows superiority in treating mixed hemorrhoids in terms of intraoperative blood loss, surgical time, postoperative pain, and quality of life, but also holds promise for enhancing clinical practices with potentially shorter hospital stays and improved patient outcomes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Prediction of Postoperative Pneumonia after SICU Surgery: A Retrospective Single Center Study |
| Wei Sun, MM |
| Objective • Postoperative pneumonia in critically ill patients is becoming an important cause for adverse clinical outcomes. It is very important to predict postoperative pneumonia. Surgical Intensive Care Unit(SICU), is an intensive care unit that deals with post-surgical patients, and is usually staffed by a team of surgeons, critical care specialists, and nurses to provide close monitoring and care. The purpose of this study is to investigate the risk factors of postoperative pneumonia in patients in SICU after surgery, establish a risk prediction model, and help surgeons and SICU doctors to early identify patients with high-risk postoperative pneumonia.
Methods • To explore risk factors for postoperative pneumonia, Patients in the SICU from January 1, 2019, to December 31, 2019, were collected and retrospectively analyzed. The data were randomly divided into a derivation set (n=533) and a validation set (n=277). Patients were divided into postoperative pneumonia (PP) group and non-postoperative pneumonia (NPP) group. t test and Chi-square test were used to compare the differences between the PP and NPP groups before and after surgery. The risk factors of postoperative pneumonia in SICU patients were identified using univariate and multivariate logistic regression. A derivation set was used to build the model, and a validation set was used for model evaluation. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the model performance. The model was validated by AUC using a validation set.
Results • With this model, a total of 8 independent risk factors were identified to be associated with postoperative
pneumonia in SICU patients after surgery. Patients with the 8 risk factors were assigned the following scores: recorded aspiration: 8, preoperative disturbance of consciousness: 4, thoracic and abdominal surgery: 3, contaminated wound: 10, abnormal choking cough on SICU admission: 9, abnormal pulmonary auscultation on SICU admission: 5, postoperative sedation, 4 points, and postoperative analgesia >1 day: 3. Eight risk factors were significantly correlated with postoperative pneumonia. Based on the scoring standard above, a risk factor table was created using the 8 predictors with a total score of 46. The AUC was 0.933 and 0.908 in derivation set and validation set. A cumulative score > 12 indicates high risk of postoperative pneumonia.
Conclusions • This study identified 8 risk factors that are significantly associated with postoperative pneumonia in SICU patients after surgery and provides operable clinical tools for early prevention and intervention of postoperative pneumonia. The implementation of this model has significant potential to enhance patient outcomes in the SICU by enabling early identification and stratification of patients at elevated risk of developing postoperative pneumonia. This model allows for the timely initiation of targeted preventative and therapeutic interventions, potentially reducing the incidence of pneumonia, shortening hospital stays, and improving overall patient survival rates. Furthermore, the use of a cumulative scoring system, simplifies clinical decision-making, making it accessible and actionable for surgeons and SICU staff. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Practice and Effect Evaluation of Preoperative Management Strategy for Patients Undergoing Day Arthroscopic Surgery Based on Evidence-Based Concept |
| Yushan Huang, BS; Qingxiang Wang, MD; Yan Wu, BS; Wen Xiao, BS; Pengfei Xiao, BS; Meiqin Zhang, BM; Jie Zhao, BS |
| Objective • To improve the preoperative management of patients undergoing day arthroscopy.
Methods • Based on the evidence-based concept, the preoperative management strategy of daytime arthroscopic surgery was practiced, and the implementation effect of patients undergoing daytime arthroscopic surgery before and after evidence application was compared. The evidence-based strategies adopted in this study include: informed consent,seven aspects: anesthesia assessment, health education, prohibition of drinking and eating, preoperative medication guidance, surgical arrangement, and emergency management.
Results • After applying evidence-based strategies, significant improvements were observed in various quality indicators, including reduced waiting time, reduced
surgical cancellations, increased patient satisfaction, and reduced unplanned hospitalization rates.
Conclusion • Based on the evidence-based concept, the practice of preoperative management strategies for patients undergoing daytime arthroscopic surgery optimizes the daytime surgical process from the strict implementation of patient health education and evaluation, as well as the establishment of compliant and reasonable surgical schedules and emergency mechanisms. This improves the preoperative management behavior of daytime surgery, enhances the patient’s medical experience, and enhances the quality of daytime surgical care, providing a good basis for management and decision-making. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Mechanism and Function of circlRP6 Targeting miR-145 in Occurrence of Intracranial Aneurysms |
| Ge Gao, MD; Yang Wang, MD; Yingang Wu, PhD; Yang Zhang, BM; Hao Zhu, MM |
| Objective • To explore the differential expression of circLRP6 targeted miR-145 in intracranial aneurysms and its regulation of VSMC biological activity, providing a theoretical foundation for the study of intracranial aneurysm regulation by circLRP6.
Methods • Expression levels of circLRP6 and miR-145 mRNA were measured in intracranial aneurysms and superficial temporal arteries. In vitro experiments were conducted using TNF-astimulated HBVSMCs to evaluate the expression of circLRP6 and miR-145, as well as cell proliferation, apoptosis, migration, and related protein expression.
Results • CircLRP6 was low expressed in intracranial aneurysms, and MiR-145 showed a trend of Overexpression; With the increase of circLRP6 expression in intracranial aneurysms, expression of miR-145 decreased. The correlation coefficient, r, was -0.5139; After TNF- a following stimulation, phenotype of VSMCs changed, expression of circLRP6 in cells decreased, and expression of miR-145 increased; CircLRP was successfully overexpressed or knocked out in VSMCs cells; Overexpression of circLRP6 can inhibit concentration expression of miR-145; VSMCs cells showed an increasing trend with time. Overexpression of circLRP6 can inhibit the proliferation process of VSMCs cells, The proliferation activity of cells was enhanced after circLRP6 knockout, and Overexpression of miR-145 could enhance the proliferation activity of VSMCs; Overexpression of circLRP6 could
promote apoptosis process of VSMCs, while knockout of circLRP6 and Overexpression of miR-145 could inhibit apoptosis ability of VSMCs; Overexpression of circLRP6 can inhibit migration ability of VSMCs cells. Overexpression of circLRP6 after knockout and miR-145 can enhance the migration ability of cells; After circLRP6 overexpression in VSMCs, a-SMA, SM22a And expression concentration of Calponin protein increased, IL-1ß. The concentration and expression of MMP-2 and MMP-9 protein decreased After knockout of circLRP6 and Overexpression of miR-145, a-SMA, SM22a, And expression concentration of Calponin protein decreased, IL-1ß. The expression of MMP-2 and MMP-9 protein increased (P < .05).
Conclusion • CircLRP6 is low expressed in intracranial aneurysms and negatively correlates with miR-145 expression. CircLRP6 may be involved in the development
of intracranial aneurysms by influencing VSMC phenotype transformation. CircLRP6 acts as a natural sponge for miR-145, regulating VSMC proliferation, migration, and differentiation and promoting apoptosis, ultimately inhibiting the development of intracranial aneurysms. This study provides a theoretical basis for clinical research on the mechanism of intracranial aneurysms. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Efficacy of Recombinant Human Type III Collagen in the Treatment of Atrophic Scars and Its Impact on p38 MAPK Signaling Pathway Proteins |
| Changhan Chen, BS; Chen Ke, BS; Youhui Ke, BS; Wenhui Shao, MSc; Genyan Xu, BS; Jun Yan, BS; Qianyue Zhang, BS; Ruobing Zhang, MSc |
| Objective • To investigate the effects of recombinant human type III collagen on atrophic scars and its impact on the p38 mitogen-activated protein kinase (p38MAPK) signaling pathway.
Methods • A total of 94 patients with atrophic scars admitted to our hospital from March 2020 to October 2022 were selected as subjects and evenly divided into a control group and an observation group. The control group (n = 47) received carbon dioxide fractional laser treatment, while the observation group (n = 47) was treated with recombinant human type III collagen dressings in addition to the laser treatment. Clinical efficacy, scar conditions, skin physiological parameters, serum levels of p38MAPK pathway-related proteins, and inflammatory markers were compared between the two groups.
Results • The overall effective rate in the observation group was 95.74%, significantly higher than 74.47% in the control group (P < .05). Before treatment, there was no significant difference in Vancouver Scar Scale (VSS) scores, stratum corneum hydration, and transepidermal
water loss between the two groups (P > .05). After treatment, the VSS score in the observation group was significantly lower than in the control group (P < .05). Similarly, prior to treatment, there were no significant differences in serum levels of mitogen-activated protein kinase 1 (MEK1), mitogen-activated protein kinase 2 (MEK2), extracellular signal-regulated kinase 1 (ERK1), and extracellular signal-regulated kinase 2 (ERK2), interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-a) between the two groups (P > .05). After treatment, levels of MEK1, MEK2, ERK1, ERK2, IL-10, and TNF-a in the observation group were significantly lower than those in the control group (P < .05).
Conclusion • Recombinant human type III collagen significantly improves the treatment of atrophic scars, effectively ameliorating scar conditions and skin physiology. It also regulates the p38MAPK signaling pathway and reduces inflammation. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Relationship Between Congenital Heart Disease in Newborns and Maternal Prenatal Folic Acid Supplementation, and Analysis of Other High-Risk Factors |
| Jinxiu Bai, BS; Lixia Liu, BS; Jihong Wei, BS; Qian Wei, BS; Yaowu Zhan, BS |
| Objective • To analyze the relationship between congenital heart disease (CHD) in newborns and maternal prenatal folic acid supplementation, as well as other high-risk factors.
Method • A retrospective analysis was conducted on clinical data of 114 pregnant women diagnosed with congenital heart disease (CHD) in the prenatal stage at our hospital between January 2021 and January 2023. These pregnant women were included in the case group. Additionally, an equal number of pregnant women with normal examination results during the same period were selected as the control group at a 1:1 ratio. Basic information about the families of pregnant women and information about relevant exposure factors during the periconception period were analyzed based on survey forms previously completed by pregnant women during their prenatal check-ups at the hospital. Possible influencing factors were analyzed through multifactor logistic regression.
Results • High-risk factors during the perinatal period for new CHD in newborns include maternal age at this pregnancy >35 years (OR=1.907), the presence of adverse pregnancy history (OR=2.213), a family history of CHD (OR=3.049), exposure to secondhand smoke during the perinatal period (OR=2.934), the use of cold medications
(OR=1.719), fever (OR=2.034), exposure to noisy environments (OR=1.981), prolonged use of electronic devices (OR=1.827), consumption of pickled foods (OR=1.892). Prenatal folic acid supplementation is a protective factor for new CHD in newborns (OR=0.342).
Conclusion • Pregnant women should choose an appropriate gestational age for conception. During the perinatal period, pregnant women should avoid exposure to the aforementioned high-risk factors as much as possible and supplement folic acid appropriately. It is essential to cultivate good dietary and lifestyle habits, as this has significant implications for preventing and reducing the occurrence of CHD in newborns. Healthcare professionals should prioritize educating pregnant women about the risks associated with the identified high-risk factors and emphasize the importance of early prenatal care. Furthermore, promoting appropriate folic acid supplementation during the periconception period should be an integral part of prenatal care protocols. By implementing these recommendations, healthcare providers can contribute to reducing the occurrence of CHD in newborns and improving maternal and infant health outcomes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Diagnostic Utility of Surrounding Tissue Hardness in Breast Masses: A Quantitative Analysis Using Shear Wave Elastography to Distinguish Malignancy Across Various Mass Sizes |
| Wentao Fan, BS; Xiaoyan Song, BS; Pan Yan, BS |
| Objective • This study aims to investigate the utility of shear wave elastography (SWE) in quantitatively assessing the surrounding tissue hardness of breast masses and its diagnostic significance in distinguishing between benign and malignant masses of varying sizes.
Methods • A retrospective analysis was conducted on 60 patients with breast masses diagnosed at our hospital between January 1, 2022, and December 31, 2022. All patients underwent standard breast ultrasound examination and SWE assessment. Masses were categorized based on diameter (=20mm and >20mm) for comparative analysis. SWE parameters, including maximum shear wave velocity (Max SWV), mean shear wave velocity (Mean SWV), and elasticity ratio (Eratio) of surrounding tissue, were recorded. Histopathological results determined mass nature. SWE parameters were correlated with pathological diagnoses for discrimination analysis.
Results • Of all patients, 37 had benign masses, and 23 had malignant masses. Malignant masses exhibited significantly higher Max SWV, Mean SWV, and Eratio in surrounding tissue compared to benign masses (P < .05).
Statistically significant differences in SWE parameters were observed between different-sized masses; smaller masses (=20mm) showed higher SWE parameters in malignant masses compared to benign masses (P < .05). In masses larger than 20mm, though SWE parameters still differed between benign and malignant masses, the significance was less pronounced (P < .05). Receiver operating characteristic (ROC) analysis demonstrated higher diagnostic accuracy of SWE parameters in discriminating malignancy in smaller breast masses.
Conclusions • SWE parameters effectively quantify surrounding tissue hardness in breast masses and have diagnostic value in distinguishing between benign and malignant masses of varying sizes, particularly in masses =20mm. SWE offers crucial quantitative parameters for the clinical discrimination of breast masses, enhancing diagnostic accuracy and sensitivity. Future studies should expand sample sizes and optimize diagnostic models to enhance SWE’s utility further in discriminating breast mass malignancy. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Hydrogen Inhalation on Neurological Function Indicators, Oxidative Stress Markers, and E-Cadherin Levels in Patients with Brain Glioma |
| Yumin Feng, MM; Jinmin Hao, MD; Yan Li, MM; Zhiyin Pang, MM; Shengjun Wang, MM; Li Zhang, MM; Wenjian Zhen, MM |
| Objective • This study aims to evaluate the effects of hydrogen therapy on nerve function and tumor progression markers in glioma patients, focusing on the modulation of oxidative stress and cadherin expression to establish its potential as a complementary treatment.
Methods • 100 glioma patients were enrolled and divided into two groups using the random number table: routine treatment (50) and hydrogen inhalation plus routine treatment (50). After 2 weeks of treatment, clinical curative effect, levels of nerve function indexes [national institute of health stroke scale (NIHSS), central nervous specific protein (S100ß), neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP)], oxidative stress indexes [malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT)] and E-cadherin before and after treatment, and occurrence of adverse reactions during treatment were compared between the two groups.
Results • After treatment, the overall effect of the hydrogen inhalation group (90.00%) was significantly better than that of the conventional group (72.00%), which was statistically significant (P = .022). In terms of specific biomarkers, post-treatment levels of E-cadherin were elevated to 0.84±0.05 ng/mL in the hydrogen group compared to 0.72±0.06 ng/
mL in the routine group. SOD and CAT levels rose to 63.21±5.36 U/L and 8.01±0.54 U/mL, respectively, versus 52.31±5.24 U/L and 5.25±0.59 U/mL in the routine group (P < .05 for both). Conversely, the NIHSS scores decreased significantly to 12.19±2.08 in the hydrogen group, compared to 16.92±2.23 in the routine group. Similarly, S100ß, NSE, GFAP, and MDA levels were found to be lower in the hydrogen group (0.41±0.09 µg/L, 8.24±1.64 ng/mL, 0.71±0.23 pg/mL, and 6.05±1.08 mmol/L respectively) than in the routine group (0.66±0.12 µg/L, 10.67±1.83 ng/mL, 0.93±0.29 pg/mL, and 7.21±1.12 mmol/L respectively) with P < .05 for all comparisons. The total incidence of adverse reactions was slightly lower in the hydrogen group (64.00%) compared to the routine group (68.00%), but this difference was not statistically significant (?2=0.178, P = .673).
Conclusion • Hydrogen inhalation therapy significantly enhances nerve function, reduces local oxidative stress levels, and increases E-cadherin levels in patients with brain glioma, suggesting its potential as an adjunct treatment. The findings underscore the therapy’s role in enhancing patient recovery and guiding future research and treatment strategies. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Plasma Concentration of Posaconazole in Septic Shock Patients with Continuous Renal Replacement Therapy: A Case Report |
| Yinyin Chen, MM; Yifei Li, BM; Danyang Peng, MM; Huanzhang Shao, MD; Congyi Zhao, MM |
| Objective • This study aims to evaluate the impact of continuous renal replacement therapy (CRRT) on the plasma concentrations of Posaconazole in critically ill patients.
Case presentation • In this study, we reported a patient with septic shock, cardiac arrest, and Multiple Organ Dysfunction Syndrome showed improvement following anti-infective treatment with Posaconazole. The patient’s condition improved after Posaconazole was administered for anti-infective treatment. The concentration of Posaconazole was measured during CRRT. The results showed that the trough concentrations of Posaconazole were 1.9mg/L and 0.8mg/L on the 7th and 11th days of
CRRT, respectively. The peak concentrations of Posaconazole were 6.6 mg/L and 4.3 mg/L on the 7th and 11th days of CRRT. On the first and second day after the discontinuation of CRRT, the trough concentrations of Posaconazole were 0.7 mg/L and 0.8 mg/L, and the peak concentrations were 2.6 mg/L and 2.2 mg/L. These results indicated that the trough and peak concentrations of Posaconazole were not significantly different before and after CRRT. No adverse reactions occurred during the follow-up.
Conclusion • Posaconazole plasma concentrations remained stable during and after CRRT, suggesting that dose adjustments are not necessary in these clinical settings. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Predictive Value of Lump Aspect Ratio, Boundary Clarity, and Spiculation/Angularity in Distinguishing Benign and Malignant Breast Lumps |
| Weibo Cheng, BS; Xiang Gao, MM; Fumei Tian, BS; Zhi Zheng, BS |
| Background • Breast cancer is a prevalent malignancy globally, necessitating accurate diagnostic tools for early detection and intervention. Ultrasound imaging plays an important role in breast lesion assessment, with various morphological features serving as key indicators of malignancy.
Objective • This study aimed to employ logistic regression analysis to investigate ultrasound indices for effectively distinguishing between benign and malignant breast masses.
Methods • A careful retrospective analysis was conducted on a dataset comprising 388 pathologically confirmed breast masses retrieved from 364 female patients, of which 142 were identified as malignant and 246 as benign. The primary outcome measures included the aspect ratio of breast masses, clarity of mass boundaries, and presence of spiculations and angularity, which were assessed through ultrasound imaging and analyzed using multifactorial logistic regression.
Results • The analysis demonstrated that the aspect ratio, clarity of boundaries, and presence of spiculations and angularity were significant independent risk factors for
identifying malignant breast masses (P < .001). Multifactorial logistic regression revealed age (OR=1.183, 95% CI 1.119-1.252, P < .001), mass size (OR=1.087, 95% CI 1.036-1.140, P = .001), marginal spiculation (OR=8.296, 95% CI 2.325-29.598, P = .001), defined borders (OR=5.500, 95% CI 1.765-14.140, P = .003), aspect ratio (OR=5.830, 95% CI 1.742-19.505, P = .004), margin angularity (OR=5.183, 95% CI 1.910-14.063, P = .001), and marginal microtubules (OR=9.180, 95% CI 2.307-36.523, P = .002) significantly influenced mass benignity.
Conclusions • The aspect ratio, boundary clarity, and presence of spiculation and angularity serve as crucial predictive indicators for distinguishing between benign and malignant breast lumps. Moreover, the utilization of a multifactorial logistic regression model significantly enhances the identification and differentiation of the benign and malignant nature of breast lumps. Continued research in this area is essential for further refining diagnostic approaches and enhancing overall breast cancer management. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effectiveness of Multimodal Sound Therapy with Fine Examination in the Clinical Diagnosis of Chronic Subjective Tinnitus |
| Weikang Cheng, MBBS; Qinhua Dai, MBBS; Xiaobing Hou, MBBS; Chongmin Liu, MM; Jun Wang, MBBS; Jingjing Xia, MM; Xiaoli Zhou, MBBS |
| Background • In chronic subjective tinnitus, existing therapeutic approaches often fall short. This study addresses this gap by exploring the efficacy of multimodal sound therapy guided by fine examination. The study focused on providing a scientific foundation for more accurate auditory evaluation, offering novel insights into managing tinnitus-related disabilities.
Objective • This study aimed to assess the effectiveness of multimodal sound therapy, guided by fine examination, in the clinical diagnosis of chronic subjective tinnitus.
Methods • A total of 100 patients with chronic subjective tinnitus treated in our hospital from March 2018 to March 2019 were selected as study subjects. They were divided into an experimental group and a control group based on the order of admission. The experimental group (n=50) received treatment involving various complex sounds, while the control group (n=50) received drug therapy. Fine examination was conducted in both groups, and tinnitus disability was compared. Additionally, the tinnitus
disability scale score, Pittsburgh sleep quality index, and Hamilton depression and anxiety scale score were compared between the two groups.
Results • After three months of treatment, the experimental group demonstrated noteworthy improvements compared to the control group. Significant reductions in tinnitus disability (P < .05), along with notable enhancements in sleep quality (P < .05), and decreased scores for depression and anxiety (P < .05) were observed in the experimental group, highlighting the efficacy of multimodal sound therapy in addressing these aspects of chronic subjective tinnitus.
Conclusions • Fine examination serves as a scientific foundation for the auditory evaluation of tinnitus patients, facilitating more precise localization of the tinnitus point. Multimodal sound therapy demonstrates a notable impact on chronic subjective tinnitus, warranting further exploration and widespread application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Implementation and Effectiveness of Progressive Rehabilitation Nursing on Quality of Life, Self-Care Ability, and Psychological Status in Patients with Breast Cancer after Modified Radical Mastectomy |
| Yuanfei Chen, MBBS; Minxia Wei, MBBS; Juan Xu, MBBS; Liqun Zhang, MBBS |
| Objective • To evaluate the implementation and effectiveness of progressive rehabilitation nursing in patients undergoing modified radical mastectomy for breast cancer.
Methods • A total of 70 patients undergoing modified radical mastectomy for breast cancer in our hospital were selected as the research subjects, and they were randomly divided into a control group and an observation group, with 35 patients in each group. The control group received routine rehabilitation nursing intervention after surgery, while the observation group received progressive rehabilitation nursing intervention based on the control group’s nursing. The quality of life, self-care ability, mental state, and incidence of complications were compared between the two groups.
Results • Before the intervention, the two groups had no significant difference in the quality of life (P > .05). After the intervention, the quality of life in the observation group was significantly better than that in the control group (P < .05). Before the intervention, the two groups had no significant difference in the self-care ability
(P > .05). After the intervention, the self-care ability in the observation group was significantly better than that in the control group (P < .05). Before the intervention, the two groups had no significant difference in the SAS and SDS scores (P > .05). After the intervention, the SAS and SDS scores in the observation group were significantly lower than those in the control group (P < .05). The incidence of complications in the control group was 22.86%, while that in the observation group was 5.71%. The incidence of complications in the observation group was significantly lower than in the control group (P < .05).
Conclusion • Compared with routine nursing intervention, the implementation of progressive rehabilitation nursing intervention can further improve the quality of life, self-care ability, and mental state of patients undergoing modified radical mastectomy for breast cancer and reduce the risk of related complications, which helps promote the recovery process of patients and is worthy of clinical promotion and application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Correlation and Clinical Significance of Changes in Serum Soluble P-selectin, D- dimer and Platelet Levels with the Severity of Mycoplasma Pneumoniae Infection in Children |
| Jianjun Gao, MM; Minmin Li, BM |
| Objective • Mycoplasma pneumoniae (MP) infection is a common respiratory illness in children, but the factors associated with its severity remain unclear.
Methods • The clinical data of 136 children aged 5 to 12 years with MP infection in our hospital from March 2021 to March 2022 were retrospectively analyzed. According to the severity of the disease, they were divided into a mild group (74 cases) and a severe group (62 cases), and 80 healthy children who underwent physical examination in our hospital during the same period were selected as the control group. The general data, lung function indexes and laboratory examination indexes of the three groups of children were compared. Multivariate Logistic regression was used to analyze the factors affecting the development of severe MP infection in children. Pearson test was used to analyze the correlation between each influencing factor and mild and severe MP infection. The predictive Value of ROC curve analysis for the development of severe MP infection in children.
Results • Univariate analysis showed that levels of white blood cell (WBC), neutrophil (Neu), sedimentation rate (ESR), fibrinogen (Fib), interleukin -5 (IL-5), interleukin -6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP), lactate dehydrogenase (LDH), alanine aminotransferase
(GPT), soluble P-selectin, and D-dimer were higher in the group with mild and severe MP pneumonia. Conversely, levels of interferon-?(IFN-?), serum calcium, serum phosphorus, 25-(OH)D3, and PLT were lower.. In addition, Multivariate analysis showed that the increase of Neu, IL-5, CRP, LDH, GPT, soluble P-selectin, D- dimer and the decrease of PLT were the risk factors for the development of severe MP infection in children (P < .05). Meanwhile, the AUC of soluble P-selectin, D- dimer level, PLT and their combination were 0.796 (95% CI: 0.729~0.860, sensitivity=82.95%, specificity=80.16%), 0.721 (95% CI: 0.648~0.788, sensitivity=76.21%, specificity=73.65%), 0.820 (95% CI: 0.860, sensitivity=88.36%, specificity=96.42%), and 0.872 (95% CI: 0.823 ~ 0.920, sensitivity=96.42%, specificity=93.28%) respectively.
Conclusion • The levels of serum soluble P-selectin, D- dimer, and PLT had high predictive Value for the development of MP infection. These findings can help clinicians better understand MP and focus on children with elevated p-selectin, d-dimer, and platelet levels, emphasizing the importance of timely treatment and appropriate interventions to prevent complications. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Mucin 3A’s Promotion of the Proliferation and Migration of Gastric Cancer Cells Through Activation of the mTOR Pathway |
| Jian Qiu, BM; Jiewei Xu, BM |
| Context • Gastric cancer (GC) is a common and life-threatening gastrointestinal malignancy. Although mucin 3A (MUC3A) is an essential oncogenic factor in several cancers, limited information is available on its expression in GC tissues and its impact on prognosis.
Objective • The study aimed to characterize MUC3A in GC and to explore its potential involvement in regulating GC cells’ behavior through the mammalian target of rapamycin (mTOR) signaling pathway.
Design • The research team conducted a retrospective genetic analysis.
Setting • The study took place as Huzhou Central Hospital, an Affiliated Central Hospital of Huzhou University in Huzhou, Zhejiang, China.
Participants • Participants were 47 patients with GC who had received treatment at the department of general surgery at the hospital and who gave consent for the use of their tissue samples for the genetic analysis.
Outcome Measures • The research team: (1) performed a differential analysis of MUC3A using GC and normal tissue samples purchased from the American Type Culture Collection; (2) investigated the exposure of cancer tissues
to MUC3A and its effects in the tumor, node, metastasis (TNM) stages of GC, using the real-time quantitative polymerase chain reaction (rt-qPCR) method; (3) performed clone formation and conducted transwell assays by knocking down or overexpressing MUC3A to analyze the effects on the behavior of GC cells; and (4) assessed the content of related marker proteins and the phosphoinositide 3-kinase (PI3K)/ protein kinase B (Akt)/ mammalian target of rapamycin (mTOR) pathway proteins, using a Western blot analysis.
Results • A high level of MUC3A existed in GC tissues, and it was associated with TNM staging. Silencing of the MUC3A inhibited GC-cell migration and proliferation, and MUC3A overexpression had the opposite effect. The addition of agonist M05856 restored the inhibitory effect of silencing MUC3A on GC cell proliferation and migration, suggesting that MUC3A regulates GC cells’ behavior through the PI3K/Akt/mTOR pathway.
Conclusions • MUC3A plays an oncogenic role in GC and may regulate GC cell behavior through the PI3K/Akt/mTOR pathway. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Repetitive Transcranial Magnetic Stimulation and Non-convulsive Electric Shock in the Treatment of Depression: A Meta-analysis |
| Haiping Liu, MM; Jindong Wang, MM; Bailing Wang, MM; Tiantian Zhou, MM |
| Background • Depression is an affective mental disorder that seriously endangers the physical and psychological health of human beings. This study attempted to systematically evaluate and compare the clinical efficacy and onset time of repetitive transcranial magnetic stimulation and non-convulsive electroshock in the treatment of Depression through the method of evidence-based medicine.
Methods • As of December 2022, we have selectively searched domestic and foreign databases by computer, including English databases PubMed, ScienceDir ETC (Elsevier), Embase, wiley, and Chinese databases HowNet (CNKI), Wanfang (WanFang), VIP (VIP), Chinese Medical Association, CBM (sinomed) Chinese biomedical literature database, etc., collected randomized controlled studies on repetitive transcranial magnetic stimulation and non-convulsive electric shock in the treatment of Depression, and included 21 documents in total. Two researchers independently screened the literature, comprehensively evaluated the retrieved literature according to the established inclusion and exclusion criteria, extracted valid data, and used Review Manager 5.4 software for quantitative statistical analysis. The clinical effective rate and Hamilton depression Rating scale
(Hamilton depression scale, HAMD) and onset time were used as outcome indicators for evaluation.
Results • A total of 12 literatures were included in this study for Meta-analysis, involving a total of 678 subjects. The results of Meta-analysis showed that the HAMD score of the study group was higher than that of the control group after treatment, MD=2.01, 95%CI (0.59-3.68), P < .05; there was no statistically significant difference in clinical efficacy between the study group and the control group, OR = 0.88, 95%CI (0.31-1.92), Z = 1.16, P = .29; the onset time of the study group was shorter than that of the control group, MD = 2.01, 95%CI (0.59-3.68), Z = 3.31, P = .001.
Conclusion • Repetitive transcranial magnetic stimulation is superior to non-convulsive electroconvulsive shock in the treatment of Depression. However, further research is needed to verify its long-term efficacy in the treatment of such diseases. Future studies could focus on investigating the sustainability of treatment effects, exploring potential predictors of treatment response, and comparing the cost-effectiveness of rTMS and NCES in clinical practice. Such research would provide valuable insights for optimizing treatment strategies for depression. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Efficacy of Bevacizumab Combined with Temozolomide in Treating Gliomas |
| Qiang Li, MM; Puxian Li, MD; Aihong Qi, MM |
| Objective • To examine the clinical efficacy of bevacizumab (BEV) combined with temozolomide (TMZ) as a treatment for patients with recurrent malignant gliomas.
Methods • 50 patients with recurrent malignant gliomas treated at our hospital between January 2019 and January 2022 were enrolled and randomized to the control group and combine group using a random table method, with 25 cases in each group. The control group received TMZ and the combine group received BEV plus TMZ. The disease control rate (DCR), the quality-of-life score before and after treatment, and the median 6-month progression-free survival (PFS) rate as well as adverse reactions were recorded and compared.
Results • There was a significant difference in DCR between the combine group (80%) and the control group (52%) (?2 = 5.556, P = .018). In each of the quality-of-life scales, the
scores of the combine group were significantly greater than those of the control group after treatment, and the difference was statistically significant (P < .05). In the control group, the median PFS was 16.2 weeks, and the six-month PFS was 19.8%. However, in the combine group, the median PFS was 21.9 weeks, and the six-month PFS was 43.1% (P < .05). Comparing the two groups, the rate of adverse reactions in the control group was significantly higher (44.0% vs 12.0%) (?2 = 6.349, P = .012).
Conclusion • BEV plus TMZ is remarkable in the treatment of patients with recurrent malignant gliomas. The combination treatment improves the DCR and PFS of patients and their quality of life, and does not increase adverse reactions, making it a promising approach that deserves widespread promotion and clinical application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Evaluation of Real-time 3-dimensional Echocardiography Parameters for In-stent Restenosis after Percutaneous Coronary Intervention for Myocardial Infarction |
| Haifei Xu, MD; Zhelan Zheng, MD |
| Objective • To analyze the role of real-time 3-dimensional echocardiography (RT-3DE) in evaluating in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).
Methods • This study enrolled 62 AMI patients (research group) and 51 healthy volunteers (control group) who presented to The First Affiliated Hospital of Zhejiang University between October 2021 and December 2022. Differences in RT-3DE parameters between the two groups and changes in RT-3DE parameters before and after PCI in the research group were compared. The patients were followed up for 6 months after PCI to analyze the evaluation effect of RT-3DE parameters on post-PCI ISR.
Results • After PCI, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), displacement standard deviation (Esd) in both groups, maximum displacement value (Emax), and LV
synchronization parameters were all reduced and were higher in the study group than in the control group (P < .05). The left ventricular ejection fraction (LVEF), peak ejection rate (PER), peak filling rate (PFR), average motion amplitude (Eavg), minimum displacement value (Emin), and left ventricular synchronization parameters were all lower in the study group than in the control group (P < .05). The LVEDV and Tmsv16-SD/R-R were found to be higher in patients with ISR 6 months after PCI than in those without ISR, while LVEF and Emin were lower (P < .05). ROC curve analysis revealed that all four parameters exhibited excellent prediction efficiency for the occurrence of ISR, among which LVEF had the best performance.
Conclusions • RT-3DE parameters play an excellent role in predicting the occurrence of post-PCI ISR in AMI patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effectiveness of Detailed Operating Room Quality Care on the Quality of Operating Room Care and Patient Satisfaction |
| Tingting Li, MBBS; Xiaopan Mei, MBBS; Heyu Wu, MBBS; Luo Yao, MBBS; Mengji Zhang, MBBS; Xiaofang Zhang, MBBS |
| Objective • The current study was performed to assess the effectiveness of detailed operating room quality care on the quality of operating room care and patient satisfaction.
Methods • A total of 102 patients who underwent surgery in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between October 2020 and April 2022 were recruited and assigned to receive either conventional operating room care (conventional group) or detailed operating room quality care (quality group), with 51 cases in each group. Outcome measures for the evaluation of the detailed quality care included quality of operating room care, safe operation, incidence of errors in instrument preparation, loss of parts, incidence of intraoperative adverse reactions, and patient satisfaction.
Results • Patients who received quality care showed higher scores for information acquisition ability, communication ability, standardization of nursing process, and professionalism of nursing service than those who
received conventional care (P = .021, .032, .003, .043). Detailed operating room quality care resulted in significantly higher standardization of anesthesia disinfection, promptness of instrument preparation, instrument and equipment management, effectiveness of auxiliary cooperation, and standardization of medical records scores versus conventional care (P = .004, .022, .036, .004, .002). Detailed operating room quality care was associated with a lower incidence of instrument preparation errors, lost parts, and intraoperative adverse reactions than conventional care (P < .05). Patients were more satisfied with quality care (49/51, 96.1%) than with conventional care (39/51, 76.5%) (P = .004).
Conclusion • Detailed operating room quality care can significantly improve patient satisfaction, enhance the quality of operating room care and safe operation, and reduce the risk of instrument preparation errors, lost parts, and intraoperative complications in the operating room. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Intelligent Fusion of Multi-Source Senses Information for Identifying the Nature of Five Flavors in Chinese Medicine: A Comprehensive Study of Five Classifications |
| Wenhao Feng, MSc; Fuguo Hou, MSc; Han Li, MSc; Xiaomeng Li, MSc; Xuelin Li, MSc; Ruixin Liu, PhD; Junhan Shi, MSc; Yanli Wang, MSc; Panpan Wang, PhD; Ruoyi Yu, MSc |
| Objective • To develop a classification model for the five flavors of Chinese medicine using advanced multi-source intelligent sensory information fusion technology. The primary aim is to investigate the feasibility of applying this model to classify and identify the flavors of various Chinese medicines effectively.
Methods • We selected 122 representative Chinese medicines, each exhibiting a single distinct flavor (sour, pungent, salty, sweet, bitter), along with 14 common foods. Utilizing the nature and flavors of these decoction pieces specified in Chinese Pharmacopeia (ChP)2020 and the inherent attributes of food components, we obtained valuable data from various sensors, including the PEN3 electronic nose, ASTREE electronic tongue, and SA402B electronic tongue. We then collected single-source data matrices from these sample sensors and a multi-source data matrix that combined the data from all sensors. Using discriminant analysis (DA), principal component analysis-discriminant analysis (PCA-DA), and K-nearest neighbor algorithm (KNN) three kinds of chemometric methods were used to establish five flavors and five-category
discrimination models. The results were comprehensively evaluated with the highest correct rate of the model of leave-one-out cross-validation as the index.
Results • Upon leave-one-out cross-validation, the correct judgment rate of the five flavors, five-category two-source fusion DA discrimination model (83.8%; ASTREE + SA402B) was significantly higher than the correct judgment rate of the single-source optimal DA and KNN model (73.5%; ASTREE). Following full-sample modeling, the correct judgment rate of the five flavors, five-category three-source fusion DA discrimination model (94.9%; PEN3+ASTREE+SA402B) rose substantially. This was higher than the correct judgment rate of the single-source optimal DA model (77.9%; ASTREE) and slightly higher than the two-source optimal correct judgment rate (89.7%; PEN3 + ASTREE).
Conclusions • Compared to single-source identification, multi-source intelligent senses information fusion (MISIF) significantly improved accuracy, providing a new outlook for identifying flavor in Chinese medicine. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Implementation of Head of Bed Elevation Using Adjustable Bed and Its Effects on Sleep: A Pilot Randomized Trial |
| Bo Hae Kim, MD; Jin Youp Kim, MD; Sangeun Lee, MD; Seok-Won Park, MD; Hyun Park, MD; Hong-Bum Shin, MD |
| Background • Although mild head of bed elevation (HBE) is a proven method to reduce obstructive sleep apnea, there is no study to apply mild HBE in daily life using an adjustable bed.
Objective • We aimed to explore the applicability of mild HBE using an adjustable bed in daily life by investigating adverse events and discomforts induced by mild HBE. This pilot randomized trial additionally investigated the objective effects of mild HBE on sleep using polysomnography (PSG).
Methods • Pilot randomized controlled trial. With a two-tailed alpha of 0.05 and a power of 0.95, the minimum number of participants for each group; control group slept on flat bed and study group slept on bed with mild HBE on follow-up PSG; was calculated to be 12. Considering a 20% follow-up loss, we enrolled a total of 32 participants (16 participants for each group).
Setting: • Dongguk University, Ilsan hospital.
Participants • A total of 37 individuals complained of subjective sleep disturbance in the Republic of Korea, 32 of whom met the inclusion criteria between September 2021 to July 2022. 23 participants completed the study and participants were randomly assigned into two groups
Intervention • A mild HBE of 7.5 degrees using an adjustable bed was implemented. PSG results and questionnaires were evaluated.
Results • There was no difference in the proportion of adverse events between groups after post-intervention which was adjusting mild HBE on study group. Changes in sleep satisfaction from baseline to post-intervention showed no significant difference between groups either. However, changes in respiratory distress index (RDI) (F = 6.088, 95% CI, 17.0% to 26.4%; P = .023) and apnea-hypopnea index (AHI) (F = 5.542, 95% CI, 13.6% to 23.5%; P = .029) were significantly different.
Conclusions: • Mild HBE is an implementable method for changing sleep posture without definitely causing discomfort or worsening sleep satisfaction. Since an easily applicable way to implement mild HBE using an adjustable bed in daily life reduces RDI and AHI in both subjects complaining of sleep disturbance and obstructive sleep apnea, it can be an alternative treatment for obstructive sleep apnea. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Research on the Effectiveness of the Training of Nosocomial Infection Control Specialist Nurses under the Background of the New Crown Epidemic Based on Competence-based Theory |
| Lu Liu, BD; Li Ni, MM; Keping Sun, BD; Xiaoqi Yin, BD; Weiying Zhang, PhD |
| Background • Coronavirus disease 2019 is highly contagious and has the potential to cause nosocomial infections, has placed a strong pressure on worldwide healthcare systems over the last years. Nosocomial infection has many influencing factors, among which the unreasonable operation of nurses accounts for 30.0%-50.0%. Therefore, strengthening the professional skill training of nurses is of great significance in reducing the nosocomial infection rate.
Objective • This research aimed to explore the effectiveness of the training of nosocomial infection control on the competencies of specialist nurses under the background of the new crown epidemic based on competency-based theory.
Design • This was a retrospective study.
Setting • This study was performed in Dongfang Hospital, Affiliated to Tongji University.
Participants • A total of 84 key nurses, each of them recommended by one department from June 2020 to June 2021, were chosen as study subjects, and they could actively participate in the training.
Interventions • Nurses received systematic and standardized training based on competency-based theory under the background of coronavirus disease 2019, including focus group meeting, training of core emergency capability, teaching training and contingency plan for COVID-19 infection.
Primary Outcome Measures • (1) core competence (2) job fit (3) core emergency response for major infectious diseases, and (4) nurses’
satisfaction. All these primary outcomes can reflect the competencies of specialist nurses after training.
Results • The scores in critical thinking and scientific research, clinical nursing, ethics and legal practice, professional development, education consulting and professional knowledge, professional skills, comprehensive quality, and professional ability of nurses training were higher than those before (P = .000). After training, the scores in relevant matters needing attention (international rescue, bioterrorist attacks, and infectious disease emergencies after natural disasters), filling in the People’s Republic of China Infectious Disease Report Card, and the scope of reporting infectious disease emergencies were all higher than before (P = .000). All nurses had relatively high satisfaction with the curriculum setting and assessment form, with satisfaction of 100.0%, followed by training duration, with satisfaction of 92.86%.
Conclusion • Under the background of coronavirus disease 2019, based on competence-based theory, training of nosocomial infection control specialist nurses could improve their core competence, job fit, and core emergency response capabilities, with high satisfaction. Under the background of the normalization of the prevention and control of the novel coronavirus pneumonia epidemic, the training model based on competence-based theory of nurses is worth promoting. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Construction and Application of a Health Management Program for Patients with Esophageal and Gastric Variceal Hemorrhage after Endoscopic Treatment |
| Qingtao Guo, BD; Shuyun Li, BD; Liangwei Quan, BD; Jingying Shan, BD; Hui Wang, BD; Zhenlin Zhang, BD |
| Background • Cirrhotic portal hypertension and associated opening of collateral circulation, improper feeding or sudden increase of abdominal pressure are the causes of esophageal and gastric variceal bleeding. Esophageal and gastric variceal bleeding is one of the most common and serious complications during decompensation of cirrhosis. Endoscopic surgery is an effective method for treating esophageal and gastric variceal hemorrhage. Still, postoperative health management is required to reduce the occurrence of rebleeding and improve the quality of life of patients with esophageal and gastric variceal hemorrhage.
Objective • Our study aims to assess the impact of a health management program on the clinical efficacy, rebleeding rate, varicose vein disappearance, self-management ability, and quality of life of patients who have undergone endoscopic surgery for esophageal and gastric variceal hemorrhage.
Design • This was a retrospective study.
Setting • This study was performed in the Department of Gastroenterology, Taihe County People’s Hospital, due that all the author came to take up positions in the hospital.
Participants • A total of 80 esophageal and gastric variceal hemorrhage patients who received endoscopic surgery in our hospital from January 2020 to January 2022 were selected as the research subjects and were divided into a study group and control group based on the random number table method, with 40 patients in each group. There were 59 males and 11 females, aged from 29 to 81 years old. For Child-Pugh classification of liver function, there were 27 cases in grade A, 34 cases in grade B and 19 cases in grade C.
Interventions • Patients in both groups received endoscopic treatment. Postoperative health management procedures were implemented in the observation group, including establishing a health management team, health management including self-psychological counseling, daily diet
management, rest management, medication management, and complications prevention and management and procedure implementation including pre-discharge guidance and follow up after discharge. Routine health management was implemented in the control group, including understanding the lifestyle and disease control status of patients after treatment, giving health education and guidance, including diet, daily exercise, intervention drugs, psychological state, and other aspects, and reminding patients to return to the hospital outpatient clinic once a time after discharge.
Primary Outcome Measures • (1) clinical efficacy (2) rebleeding rate (3) varicose vein disappearance (4) self-management ability, and (5) quality of life.
Results • The total clinical effective rate was 92.5% in the observation group and 82.5% in the control group (P < .05). The rebleeding rate and varicose vein disappearance rate were 2.5% and 70.0% in the observation group, presented better relative to those of 12.5% and 55% in the control group, respectively (P < .05). After intervention, the scores of self-management ability [(18.27±3.11) points, (17.84±3.64) points, (17.17±3.10) points and (18.34±3.32) points vs (16.08±2.86) points, (15.10±2.86) points, (15.48±2.54) points and (16.18±2.84) points] and quality of life [(78.23±8.10) points, (79.06±6.62) points, (78.12±3.10) points and (80.15±7.12) points vs (64.11±6.46) points, (65.15±2.36) points, (65.48±2.57) points and (72.16±2.97) points] in the observation group were higher than the control group (P < .05).
Conclusion • The implementation of a health management program in esophageal and gastric variceal hemorrhage patients after endoscopic treatment is helpful to improve the clinical effect of endoscopic treatment, reduce the rebleeding rate and varicose veins, and improve the self-management ability and quality of life of patients, which has important clinical significance. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Utilizing the Omaha System to Enhance Care for Lymphoma Patients During Autologous Hematopoietic Stem Cell Transplantation: Exploring Effects on Anxiety and Depression |
| Zengwei Bao, MM; Shizhen Teng, MM; Feng Wei, MM |
| Background • Autologous hematopoietic stem cell transplantation (AHSCT) is a standard treatment for lymphoma, yet it is associated with psychological distress. Omaha System-based care offers a structured approach to address the unique needs of patients undergoing AHSCT.
Objective • This study aims to evaluate the efficacy and utility of Omaha System-based care in patients undergoing autologous hematopoietic stem cell transplantation (AHSCT) for lymphoma (LY), focusing particularly on its impact on psychological well-being.
Methods • The study adopted an observational design and included 80 LY patients undergoing AHSCT at our hospital between January 2022 and December 2022. Of these, 46 patients received Omaha System-based care (observation group), while 34 patients received conventional care (control group). Pre- and post-intervention assessments comprised the Self-rating Anxiety/Depression Scale (SAS/SDS), Pittsburgh Sleep Quality Index (PSQI), and Functional Assessment of Cancer Therapy–Bone Marrow Transplant (FACT-BMT).
Additionally, the duration of stay in the laminar airflow bio-clean room (LAFR), total hospital stays, hospitalization expenses, and incidence of adverse reactions were recorded. Nursing satisfaction was also evaluated.
Results • Post-intervention, the observation group exhibited significantly lower SAS, SDS, and PSQI scores compared to the control group (P < .05), indicating improved psychological well-being. Moreover, the observation group demonstrated a shorter hospital stay (P < .05), reduced healthcare expenditures, lower incidence of adverse reactions, and higher nursing satisfaction (P < .05).
Conclusions • Omaha System-based care demonstrates promising outcomes in enhancing the safety and psychological well-being of LY patients undergoing AHSCT. The findings underscore its potential as an effective intervention to optimize patient care in this population. Further research is warranted to validate these results and facilitate their broader adoption in clinical practice. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Chain Relationship Between Self-tolerance, Self-Management, Emotional State and Cancer Bone Metastasis Pain |
| Xichen He, BM; Daiqi Jiang, BM; Tianjia Liang, MM; Yujie Lv, BM; Xiuyu Qin, BM; Huijuan Qin, BM |
| Objective • To explore the interrelations among self-tolerance, self-management, emotional states, and cancer-related bone metastatic pain and to understand how these factors collectively influence patient outcomes.
Methods • We conducted a study with 160 inpatients suffering from cancer-related bone metastatic pain. The study spanned from June 2022 to June 2023. Using validated instruments, we collected comprehensive clinical data and assessed participants for self-tolerance, self-management, emotional states, and pain levels.
Results • The study found no significant differences in self-tolerance, self-management, emotional state, and pain across different cancer types, genders, and stages (P > .05). Notably, self-tolerance showed a negative correlation with self-management (r = -0.51, P < .001) and a positive
correlation with emotional state (r = 0.266, P = .001) and pain (r = 0.34, P < .001). The standardized path coefficient values from the chain relationship model were significant, such as the impact of emotional state on pain (0.166, P = .023) and self-management on pain (-0.291, P <.01).
Conclusion • The pain of cancer bone metastases is related to self-tolerance, negative emotion, and self-management. Self-tolerance can directly affect pain and can also affect pain through the chain relationship between negative emotion and self-management. The pain of cancer bone metastases is related to self-tolerance, negative emotion, and self-management. Self-tolerance can directly affect pain and can also affect pain through the chain relationship between negative emotion and self-management. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Meta-analysis of Palliative Care on End-stage Quality of Life in Cancer Patients |
| Hui Fang, BM; Yajun Sun, MM; Wenting Wang, BM; Yafen Yuan, BM; Jianfang Zhang, BM; Kaixi Zheng, BM |
| Objective • This study aimed to investigate the impact of palliative care on the quality of life, depressive state, and physical and psychological symptoms of patients with end-stage cancer.
Methods • A systematic literature search of PubMed, Embase, and Scopus databases was conducted for randomized controlled trials (RCTs) published from May 2000 to June 2023, focusing on the impact of palliative care on end-stage cancer patients. The search utilized terms such as “palliative care,” “cancer/tumor/malignancy,” “terminal/end-stage/advanced,” to identify studies meeting our inclusion criteria. Selected RCTs were evaluated for quality, and relevant data were extracted for meta-analysis.
Results • Meta-analysis of 16 RCTs revealed that palliative care significantly improved depressive states [OR=-0.88, 95%CI (-1.55, -0.20), P = .01] and alleviated physical and psychological symptoms [OR=-2.38, 95%CI (-3.95, -0.81), P = .003] in end-stage cancer patients compared to conventional oncology care. However, the improvement in overall quality of life was not statistically significant (P > .05).
Conclusion • Palliative care significantly enhances the mental and physical well-being of end-stage cancer patients by reducing depressive states and symptom burden, although its impact on overall quality of life requires further exploration. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Laparoscopic Right-lower Quadrant Approach for the Treatment of Right-sided Colon Cancer Offers Advantages Such as Shorter Surgical Time and Less Blood Loss |
| Peng Chen, MM; Anqi Xu, BM; Xu Zhang, BM; Chuanxin Zhang, BM; Xin Zheng, BM |
| Objective • This study aims to compare the therapeutic efficacy of laparoscopic right-lower quadrant and midline approaches for the treatment of right-sided colon cancer and evaluate the analgesic effect of parecoxib sodium.
Methods • Sixty patients with right-sided colon cancer admitted to Hospital of Lin ‘an District between January 2019 and November 2022 were selected. They were divided into the study group A (n=30) with a right-lower quadrant approach and the study group B (n=30) with a midline approach. All patients received parecoxib sodium. Surgical time, blood loss, postoperative complications, and other relevant indicators were recorded and compared between the two groups. Additionally, a control group of 60 right-sided colon cancer patients who underwent conventional non-exclusive analgesic laparoscopic surgery during the same period was included to compare the analgesic effects between the study and control groups.
Results • The surgical time (RR = 0.608, 95%CI 0.51, 1.53, P = .042), blood loss (RR = 0.798, 95%CI 0.52, 1.02, P < .001), time for bowel function recovery (RR = 0.808, 95%CI 0.50, 1.77, P = .007), and length of hospital stay (RR = 0.766, 95%CI 0.56, 1.72, P =.052) were significantly lower in group A than in group B, while the number of lymph node dissections was higher in group A (RR =
0.803, 95%CI 0.62, 1.52, P = .047). The postoperative levels of tumor-specific growth factor (TSGF) (RR = 0.710, 95%CI 0.50, 1.55, P < .001) and carcinoembryonic antigen (CEA) (RR = 0.803, 95%CI 0.62, 1.52, P < .001) were significantly decreased in both groups A and B, with no significant difference between the groups (P > .05). The incidence of complications in group A was significantly lower than in group B (RR = 0.167, 95%CI 0.17, 0.63, P = .044). The VAS scores of the study group at 2/4/6/8 hours postoperatively were significantly lower than those of the control group (RR = 0.702, 95%CI 0.52, 1.62, P < .001). The SF-36 scores of the study group were significantly higher than those of the control group (RR = 0.753, 95%CI 0.56, 1.82, P < .001).
Conclusions • The Laparoscopic right-lower quadrant approach for the treatment of right-sided colon cancer offers advantages such as shorter surgical time and less blood loss. It demonstrates significant clinical efficacy and reduces the incidence of postoperative complications. Parecoxib sodium enhances postoperative analgesic effect, effectively alleviating patient pain, promoting recovery, and improving quality of life. It is worth promoting in clinical practice. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Precede-Proceed Model-dominant Nursing Combined With Nutrition Support for Patients Discharged After Hepatobiliary Surgery With T Tube |
| Qi Chen, MM; Jingjing Qiu, BS; Youhong Wang, BS; Ye Yang, BS; Ye Yang, BD; Liping Zhu, BM |
| Context • Hepatobiliary disease requires surgical treatment and T-tube installment postoperatively, and discharged patients’ usually still have a T tube. Little nursing care is available in China for patients after discharge, resulting in postdischarge complications. Also, the incidence of nutritional risk in patients with hepatobiliary surgery is high.
Objective • The study aimed to investigate the benefits of a precede-proceed model-dominant nursing combined with nutritional support for patients discharged after hepatobiliary surgery with a T tube, so as to improve their prognoses and promote their rehabilitation.
Design: The research team conducted a prospective, single-center, randomized controlled trial.
Setting • The study took place at Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine in Wuhan, Hubei, China.
Participants • Participants were 120 patients discharged after hepatobiliary surgery at the hospital between June 2020 and June 2022.
Interventions • The research team randomly divided participants into two groups using the random number table method, each with 60 participants: (1) an intervention group, which received precede-proceed model-dominant nursing combined with nutrition support and (2) a control group, which received routine care.
Outcome Measures • At baseline and postintervention, the research team assessed: (1) nutritional status, (2) self-care agency, (3) compliance, (4) quality of life (QoL), (5)
incidence of complications.
Results • At baseline, no significant differences existed between the groups in nutritional status, self-care agency, QoL, or compliance (all P > .05). Postintervention compared to the control group, the intervention group’s: (1) nutritional status, including albumin (P = .015), hemoglobin (P < .001), growth hormone (P < .001), BW (P = .047), BMI (P = .046), TST (P = .001), and MAMC (P = .016) were significantly higher and transferrin (P < .001) and NRS-2002 score (P < .001) were significantly lower; (2) self-care agency, including self-concept, self-responsibility, health knowledge, and self-nursing skills were significantly higher (all P < .001); (3) compliance scores, including observing the volume and color of bile correctly, clamping and opening the T tube properly, replacing the drainage bag correctly and in a timely manner, regularly disinfecting the skin around the drainage tube, keeping a balanced diet, adhering to medical regimens, exercising adequately were significantly higher (all P < .001); (4) QoL was significantly higher (P < .001); and (5) incidence of complications was significantly lower (P = .008).
Conclusions • Precede-proceed model-dominant nursing combined with nutrition support can significantly improve nutritional status, self-care agency, and QoL and can significantly decrease the incidence of complications for patients discharged after hepatobiliary surgery with a T tube and is worthy of promotion in clinics. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of Indacaterol/Glycopyrrolate on Pulmonary Function and St. George's Respiratory Questionnaire Score in Individuals with Stable Chronic Obstructive Pulmonary Disease |
| Jie Chen, MM; Qihui Hu, BM; Ying Wu, MM; Lina Xu, BM |
| Objective • This study aims to investigate the impact of indacaterol/glycopyrrolate on pulmonary function and St. George’s Respiratory Questionnaire (SGRQ) scores in patients with stable chronic obstructive pulmonary disease (COPD).
Methods • A prospective randomized controlled trial (RCT) was conducted. A total of 100 stable COPD patients admitted to our hospital between September 2020 and October 2022 were selected as study participants. They divided into a conventional group (n=50) and a combined compound preparation (CCP) group (n=50) using a random number table. The conventional group received oral carbocisteine tablets, while the combined compound preparation group received indacaterol/glycopyrrolate inhalation powder spray in addition to the conventional treatment. Clinical efficacy, pulmonary function indices, serum inflammatory factors, psychological resilience, and quality of life were compared between the two groups.
Results • The CCP group exhibited a significantly higher total effective rate (92.00%) compared to the conventional
group (76.00%) (P < .05). Post-treatment, both groups showed increased values in forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and FEV1% with a more substantial improvement in the CCP group (P < .05). Additionally, the CCP group demonstrated decreased post-treatment levels of serum inflammatory factors (TNF-a, IL-6, CRP, and PCT), elevated scores on the Connor Davidson Resilience Scale (CD-RISC), and reduced SGRQ scores compared to the conventional group (P < .05).
Conclusions • In treatment of stable COPD patients, the combination of indacaterol/glycopyrrolate with carbocisteine tablets enhances pulmonary function, alleviates airway inflammatory reactions, improves clinical efficacy, enhances psychological resilience, and elevates the quality of life compared to carbocisteine tablets alone. These findings underscore the potential therapeutic benefits of the combined compound preparation in managing stable COPD. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Integrating Network Pharmacology and In Vitro Experiments for Assessing the Anti-Tumor Effects of Phyllanthus Urinaria L Anti-neoplastic Decoction in Hepatocellular Carcinoma |
| Jinsong He, PhD; Xiaoyan Jiang, MM; Guangdong Tong, PhD; Lianan Wang, MM; Chunshan Wei, PhD; Zhulin Wu, MD; Xiaoya Yang, MM |
| Background • In China, traditional Chinese medicine (TCM) is an important part of the comprehensive treatment of hepatocellular carcinoma (HCC), and Chinese herb formulas with the effect of “yiqi jianpi jiedu huayu” (replenishing qi, strengthening spleen, and removing toxicity and blood stasis) are the common and efficient treatments for HCC. However, the mechanism of these formulas in treating HCC remain unclear.
Objective • In this paper, our goal is to explore the potential mechanism of Phyllanthus urinaria L anti-neoplastic decoction (PAD), the representative formula of “yiqi jianpi jiedu huayu”, in treating HCC.
Design • The research team performed the network pharmacology and in vitro experiment (preparation of PAD aqueous extract, cell cultures and MTT assay, cell apoptosis assay, wound healing assay, transwell assays, western blot).
Setting • The study took place in the Department of Hepatology, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), China.
Outcome Measures • The active components and targets of PAD and HCC targets were screened by five Chinese herbs and two disease databases respectively. The network
pharmacology was utilized to construct the relationship network between PAD and HCC, and the mechanism was predicted by pathway enrichment analysis. The experiment was performed to verify the intervention effect of PAD on HCC and phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) pathway.
Results • The relationship network between PAD and HCC suggested that PAD mainly regulated the potential therapeutic targets of HCC by key active components such as quercetin, luteolin, calycosin, wogonin, and pinocembrin. Pathway analysis demonstrated PAD could play an anti-HCC effect via multiple pathways (e.g., PI3K/Akt). Results of the experiment showed that PAD could effectively inhibit the proliferation and migration of HCC cells, and promote HCC cells apoptosis in a concentration-dependent behavior. Additionally, PAD could decrease the protein expression of phosphorylated PI3K/Akt.
Conclusion • PAD mainly exerts an anti-HCC effect through multiple active components represented by quercetin and multiple pathways represented by the PI3K/Akt pathway. This study provided an experimental basis for the clinical application of PAD. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Influence Factors of Hypoparathyroidism after Thyroidectomy and the Effect of Recovery Treatment |
| Xiaojun Bai, MM; Yilun Liu, MD; Yanjun Xu, MD |
| Objective • This study aims to investigate the influencing factors of transient hypoparathyroidism following thyroidectomy and assess the effects of rehabilitation treatment, focusing on enhancing management and outcomes for patients.
Methods • In this retrospective study, 90 patients who underwent thyroidectomy in our hospital from February 2021 to February 2023 were collected. According to the postoperative level of parathyroid hormone (PTH), the patients were divided into normal group [(no hypoparathyroidism, = 0.27 pmol/l), n=65] and hypoparathyroidism (transient hypoparathyroidism, < 0.27 pmol/l, n=25). We retrospectively analyzed 90 thyroidectomy patients, categorizing them into normal and hypoparathyroidism groups based on postoperative parathyroid hormone levels. Logistic regression and ROC curve analysis were employed to evaluate the factors influencing transient hypoparathyroidism and predict recovery.Clinical data of the two groups of patients were collected, and the relationship between postoperative 1dPTH (Parathyroid hormone levels on the first postoperative day) level and recovery effect was analyzed. Logistic regression was used to analyze the influencing factors of temporary hypoparathyroidism after thyroidectomy, and a ROC curve was used to predict the efficacy of the 1dPTH level on postoperative PTH recovery time.
Results • There were no differences in gender, hypertension, diabetes and hyperlipidemia between the two groups (P > .05). The age and tumor diameter of the normal group were lower than those of the hypoactive group, and the proportion of patients with thyroiditis and malignant tumors, as well as patients undergoing total thyroidectomy and removal of tracheoesophageal lymph nodes in the normal group were significantly lower than those in the hypoactive group. The above differences were
statistically significant (P < .05). Logistic regression analysis showed that older age, malignant tumor, larger tumor diameter, total thyroidectomy, and tracheoesophageal lymph node dissection were independent risk factors for transient hypoparathyroidism after thyroidectomy (P < .05). The level of PTH on the 1st day after surgery in patients with recovery time = 1 month was higher than that in patients with recovery time > 1 month, and the difference was statistically significant (P < .05). ROC curve showed that the PTH level on the 1st day after surgery had a certain predictive value on PTH recovery time, and the AUC value (area under the curve) was 0.873 (P < .05). These findings suggest that patients with older age, malignancy, larger tumor diameter, total thyroidectomy, and removal of tracheoesophageal lymph nodes are more likely to develop transient hypoparathyroidism after thyroidectomy. This understanding is crucial for the management of postoperative patients, and physicians may need to pay special attention to these high-risk patients and implement appropriate interventions to reduce the occurrence of hypoparathyroidism. Significant factors contributing to transient hypoparathyroidism included older age, malignant tumors, larger tumor diameter, total thyroidectomy, and tracheoesophageal lymph node dissection. These findings, backed by statistical significance, underline the clinical relevance of these risk factors in postoperative management.
Conclusion • The study identifies key risk factors for transient hypoparathyroidism post-thyroidectomy, emphasizing the need for tailored postoperative care. The predictive value of immediate postoperative PTH levels could guide clinical management to mitigate hypoparathyroidism risks. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| A Liquid Chromatography-mass Spectrometry Method to Determine the Content of Genotoxic Impurity Piperidine in Rimonabant |
| Hongping Ao, BM; Jiejie Gao, MM; Hanshuai Hu, MM; Qian Liu, MM; Yang Liu, BM; Jinxingyi Wang, MM; Jie Xia, BM |
| Objective • To establish and determine the content of the genotoxic impurity piperidine in the active pharmaceutical ingredient (API) of rimonabant using a liquid chromatography-mass spectrometry (LC-MS) method. This study underscores the importance of detecting piperidine due to its potential health risks, including carcinogenic and mutagenic effects, thus highlighting the critical need for rigorous quality control in pharmaceutical products.
Methods • An Atlantis C18 column (5 µm, 3.9×100 mm) was chosen for separation due to its high efficiency and selectivity for piperidine, with a gradient elution of 0.05% formic acid-water (A) and methanol (B) as the mobile phase at a flow rate of 1.0 mL/min. The column temperature was optimized at 30°C to ensure peak resolution and sensitivity, the injection volume was set to 5.0 µL to minimize sample consumption while maintaining detectability, and the analysis time was kept at 7 min for efficient throughput.
Results • Piperidine demonstrated excellent linearity in the concentration range of 0.03-0.40 µg/mL (R>0.99), with a detection limit of 0.01010 µg/mL. This detection limit is significantly lower than regulatory thresholds, indicating the method’s high sensitivity compared to existing methods and its adequacy for regulatory compliance in pharmaceutical quality control.
Conclusion • This LC-MS method not only demonstrated high accuracy, good repeatability, and strong durability but also sets a benchmark for future research, regulatory practices, and pharmaceutical quality control. By accurately detecting low levels of genotoxic impurities like piperidine, this method supports the development of safer drug formulations and underscores the importance of stringent quality control measures in the pharmaceutical industry. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Electroacupuncture Combined with Chinese Herbal Medicine, Qidong Huoluo Granule, for Amyotrophic Lateral Sclerosis: An 8-Month Case Report |
| Hai Cui, PhD; Angela Huang, BS; Yin Shi, PhD; Tianqi Wang, PhD; Tong Zhang, BS; Xuan Zou, MD |
| Background • Amyotrophic lateral sclerosis (ALS) is an adult neurodegenerative disorder characterized by progressive muscle weakness and eventual paralysis, for which there is currently no curative treatment. Mainstream medical interventions primarily focus on providing supportive care. However, acupuncture offers promising avenues for alleviating symptoms and enhancing quality of life. Specific acupuncture points are targeted to address bulbar paralysis as well as paralysis affecting the upper and lower extremities.
Objective • To investigate the efficacy of electroacupuncture combined with Chinese herbal medicine in delaying disease progression and alleviating symptoms of bulbar paralysis in patients with ALS.
Case Presentation • A 51-year-old male presented with a 4-year and 8-month history of weakness in his left arm and both legs, accompanied by muscle cramps and diminished coordination, which had rapidly worsened over the past year. ALS was diagnosed, and the patient was initiated on oral Riluzole (50 mg) and Qidong Huoluo
granule, a Chinese herbal compound, administered twice daily. Concurrently, he underwent acupuncture treatment sessions twice weekly for over 8 months.
Results • Following acupuncture therapy, the patient experienced gradual stabilization of symptoms, notably improvement in swallowing function. The combination of electroacupuncture and Qidong Huoluo granule resulted in sustained clinical enhancements post-treatment, including improvements in speech, coughing, articulation, and breathing.
Conclusion • Electroacupuncture therapy demonstrates the potential to slow disease progression and ameliorate symptoms of bulbar paralysis in ALS patients. However, further robust clinical research is imperative to explain the precise therapeutic role of electroacupuncture in managing this debilitating condition. Continued investigation into the efficacy and safety profile of electroacupuncture holds |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Long-Term Simulated Weightlessness on Retinal Microcirculation and Visual Electrophysiology |
| Wei Dai, MD; Lancao Hao, MM; Yan Huo, MD; Guanghan Kan, MM; Minghao Sun, MM; Zhou Yang, MD; Siquan Zhu, MD |
| Objective • To investigate the mechanisms of ocular injuries in astronauts due to gravity deficit by examining changes in retinal microcirculation and visual electrophysiology in macaques subjected to simulated weightlessness.
Methods • The head-down recumbency of macaques was used to simulate the movement of blood to the side of the head that occurs without microgravity. Head-down recumbency was performed with the head tilted downwards at a recommended angle of 10°. The macaques in the control group were similarly tethered to the rope but could be held in a normal position. The whole experiment lasted for 6 weeks and retinal microcirculation and visual electrophysiology information was collected at weeks 0, 3 and 6.
Results • The retinal microcirculation of macaques was affected by 3 weeks of weightlessness. This includes morphological changes, such as dilation and tortuosity of the retinal microvasculature in macaques at day 21. OCT and OCTA results showed an increase in retinal and choroidal thickness and a significant decrease in vessel length density within 6×6 mm of the macula. Sustained simulated weightlessness (42 days) significantly exacerbated
retina-related damage. This was evidenced by a significant decrease in the perfusion density of microcirculatory vessels, such as the macular 3×3 mm mesial vessels and the macular 6*6 mm central and medial vessels. The FAZ density in the macula 3×3 mm area began to increase. Retinal oxygen saturation testing showed a slight increase in arterial oxygen saturation. Simultaneous changes in visual electrophysiology occurred, including a significant decrease in a- and b-wave amplitudes on the dark-vision electroretinogram and a significant decrease in the amplitude of the bright-vision negative wave response. The peak timing of the flash visual evoked potential component P1 was significantly delayed compared to its baseline and time-matched control.
Conclusions • Sustained simulated weightlessness (42 days) significantly exacerbated retina-related damage, with both reduced macular blood supply and increased FAZ density suggesting the development of retinal ischemic changes, which disrupt visual electrophysiology. Retinal damage in human astronauts under long-term outer space conditions may be prevented by intervening in ischemic changes in the retina during the early stages of weightlessness. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Long-Term Simulated Weightlessness on Retinal Microcirculation and Visual Electrophysiology |
| Wei Dai, MD; Lancao Hao, MM; Yan Huo, MD; Guanghan Kan, MM; Minghao Sun, MM; Zhou Yang, MD; Siquan Zhu, MD |
| Objective • To investigate the mechanisms of ocular injuries in astronauts due to gravity deficit by examining changes in retinal microcirculation and visual electrophysiology in macaques subjected to simulated weightlessness.
Methods • The head-down recumbency of macaques was used to simulate the movement of blood to the side of the head that occurs without microgravity. Head-down recumbency was performed with the head tilted downwards at a recommended angle of 10°. The macaques in the control group were similarly tethered to the rope but could be held in a normal position. The whole experiment lasted for 6 weeks and retinal microcirculation and visual electrophysiology information was collected at weeks 0, 3 and 6.
Results • The retinal microcirculation of macaques was affected by 3 weeks of weightlessness. This includes morphological changes, such as dilation and tortuosity of the retinal microvasculature in macaques at day 21. OCT and OCTA results showed an increase in retinal and choroidal thickness and a significant decrease in vessel length density within 6×6 mm of the macula. Sustained simulated weightlessness (42 days) significantly exacerbated
retina-related damage. This was evidenced by a significant decrease in the perfusion density of microcirculatory vessels, such as the macular 3×3 mm mesial vessels and the macular 6*6 mm central and medial vessels. The FAZ density in the macula 3×3 mm area began to increase. Retinal oxygen saturation testing showed a slight increase in arterial oxygen saturation. Simultaneous changes in visual electrophysiology occurred, including a significant decrease in a- and b-wave amplitudes on the dark-vision electroretinogram and a significant decrease in the amplitude of the bright-vision negative wave response. The peak timing of the flash visual evoked potential component P1 was significantly delayed compared to its baseline and time-matched control.
Conclusions • Sustained simulated weightlessness (42 days) significantly exacerbated retina-related damage, with both reduced macular blood supply and increased FAZ density suggesting the development of retinal ischemic changes, which disrupt visual electrophysiology. Retinal damage in human astronauts under long-term outer space conditions may be prevented by intervening in ischemic changes in the retina during the early stages of weightlessness. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Integrative Management of Chemotherapy-Related Fatigue in Lung Cancer Patients with the Traditional Chinese Medicine Guiqi Erxian |
| YanFeng Chen, MS; Bin He, BS; XiaoXin Jia, MS; Xia Wang, BS; Wei Zheng, BS; DeQi Zhou, PhD |
| Objective • To observe the efficacy of Guiqi Erxian granule on chemotherapy-related fatigue in patients with lung cancer treated with chemotherapy.
Methods • A total of 76 lung cancer patients with chemotherapy-related fatigue as the main symptom from January 2017 to May 2018 were enrolled and randomly divided into a control group and a treatment group, n = 38/group. The patients in the control group received chemotherapy and basic treatment. The patients in the treatment group received oral Guiqi Erxian granule 20 g each time, three times daily, in addition to the chemotherapy and basic treatment. The brief fatigue inventory (BFI) scale, Cancer Fatigue Scale (CFS), chronic illness therapy fatigue scale, and traditional Chinese medicine (TCM) symptom scale were evaluated on 1 day before treatment, and on day 7 and day 14 of treatment. Adverse reactions were observed and recorded.
Results • Compared to the control group, the total score and scores of each dimension of the BFI and CFS decreased in the treatment group; the effect on fatigue severity and fatigue impact scores in the BFI scale, and the emotional and physical dimension scores in the CFS were improved significantly (P < .05). Compared to the control group, except for the social/family well-being, the scores in the other dimensions of the chronic illness therapy-fatigue scale improved significantly (P < .05). Compared to the control group, the TCM syndrome score in the treatment group decreased significantly (P < .05).
Conclusion • Guiqi Erxian granules can improve chemotherapy-related fatigue and quality of life in lung cancer patients receiving chemotherapy, with no obvious side effects, and can be explored as a potential treatment. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Combined PET/CT and Autoantibody Detection in Lung Nodules Diagnosis |
| Yu Han, MM; Chun-Ying Li, MM; Yu Xing, MM; Ying-Ying Zhan, MM; Jin-Ha Zou, MM; Chao Zuo, MM |
| Objective • To assess the usefulness of combining positron emission tomography/computed tomography (PET/CT) with lung cancer autoantibody detection in identifying and managing lung nodules.
Methods • The researchers identified 160 patients with pulmonary nodules admitted to their hospital between January 2018 and January 2021. These patients were designated as the experimental group. Additionally, 60 healthy individuals without pulmonary nodules were admitted to the hospital during the same period. The individuals constituted the control group. All study participants underwent digital PET/CT detection and had their lung cancer autoantibody levels determined through enzyme-linked immunosorbent assay. Further testing, such as puncture or surgical pathology, was performed for patients with lung nodules. The aim was to evaluate the significance of combining PET/CT with autoantibody detection in diagnosing and treating lung nodules.
Results • The study found that testing multiple autoantibodies together increased sensitivity and accuracy compared to testing individual autoantibodies. Combining PET/CT screening with autoantibody detection improved
the diagnostic rate for identifying lung nodules, including benign and suspected malignant ones. Several autoantibodies were significantly higher in the experimental group compared to the control group. Testing for multiple autoantibodies showed higher sensitivity and accuracy than testing for one. Pathological examination confirmed 129 benign nodules and 31 malignant nodules. The median SUVmax values were measured at 0.7 for benign nodules and 4.8 for malignant nodules. The diagnostic efficacy of PET/CT combined with autoantibodies was determined through comparison with pathology testing and was as follows: PET/CT combined with autoantibody detection > PET/CT > autoantibody detection.
Conclusion • Combining PET/CT with the detection of autoantibodies enhances the positive diagnostic rate and accuracy of lung nodules in the case of lung cancer. The SUVmax also shows excellent potential as a supplement in diagnosing both benign and malignant lung nodules, providing valuable guidance in determining the pathological types. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Evaluating the Clinical Effectiveness of Third-Generation Cephalosporins Combined with Levofloxacin for Treating Community-Acquired Pneumonia in Elderly Patients |
| Yu Chen, MBBS; Chao Li, MBBS; Hua Li, MM |
| Objective • This study aimed to evaluate the clinical efficacy of third-generation cephalosporins combined with Levofloxacin in treating community-acquired pneumonia (CAP) among elderly patients.
Methods • A retrospective analysis was conducted, and a total of 200 elderly patients with CAP were included in the study. We included elderly patients aged 55 and above diagnosed with CAP at our hospital between January 2019 and June 2021. Patients were categorized into two groups: a control group receiving Levofloxacin alone and an observation group receiving a combination of third-generation cephalosporins and Levofloxacin. Each group consisted of 100 patients. The control group received intravenous levofloxacin hydrochloride injection (0.5 g in 250 mL) once daily, while the observation group received the same dose of Levofloxacin along with intravenous ceftriaxone sodium (80 mg/kg/day) once daily. Outcome measures included levels of inflammatory markers, pulmonary function tests, clinical indices, adverse events, and overall clinical efficacy.
Results • Baseline characteristics were similar between the two groups. After treatment, the observation group demonstrated significantly lower levels of procalcitonin (PCT) and C-reactive protein (CRP) compared to the control group (P < .01). Additionally, the combination therapy group exhibited reduced levels of inflammatory markers (P < .05), improved pulmonary function (P < .01), higher clinical efficacy (P < .01), and a lower incidence of adverse events (4.00%) compared to the levofloxacin-alone group (23.00%) (P < .01). Furthermore, the combination of third-generation cephalosporins with Levofloxacin enhanced clinical efficacy when compared to Levofloxacin alone (P < .05).
Conclusion • The combination of third-generation cephalosporins with Levofloxacin proved effective in reducing adverse events, improving lung function, and decreasing inflammatory markers in elderly patients with CAP. However, further clinical trials are warranted to validate these findings before widespread clinical implementation. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Impact of Empowerment Education on Discharge Readiness and Care Burden of Caregivers of Children with Congenital Heart Disease |
| Peipei Chen, MM; Jun Guo, MM; Liping Jin, MM; Congming Li, BM; Sheng Zhao, MM |
| Context • Care burden refers to the physical burden that caregivers bear during the process of caring for children with congenital heart disease (CHD), and discharge readiness mainly refers to the confidence of the main caregivers in taking care of patients. Empowerment education’s influence on the discharge readiness and caregivers’ burden is unknown for children with CHD.
Objective: • The study intended to explore the impact of empowerment education on the discharge readiness and care burden of caregivers of children with CHD.
Design • The research team conducted a prospective cohort study.
Setting • The study took place at Anhui Provincial Children’s Hospital in Hefei City, China.
Participants • Participants were 163 caregivers of children who underwent surgery for CHD at the hospital between January 2019 and August 2021.
Interventions • The research team divided participants into two groups using convenience sampling: (1) a control group, with 82 participants who received routine nursing education
and intervention, and (2) an intervention group, with 81 participants who received empowered nursing education.
Outcome Measures • Postintervention, the research team evaluated the caregivers’: (1) readiness for the child’s discharge and (2) burden level.
Results • Postintervention, the intervention group’s: (1) total score for discharge readiness and scores on the personal status and adaptability dimensions were significantly higher than those of the control group (all P < .05), and (2) care burden level was significantly lower than that of the control group (P < .05).
Conclusions • Empowerment education can help caregivers of children with congenital defects of the heart to build awareness of the need to participate in disease management, improve disease-related knowledge and skills, reduce their negative emotions, and improve their level of preparation for their children’s discharge and reduce their level of care burden. The therapy is worth further investigation and popularization. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Integrating Nursing Early Warning Systems with Doula-Assisted Childbirth on Natural Childbirth Rates and Neonatal Outcomes: A Single Center Prospective Study |
| Zhaie Lu, MM; Qi Luo, BM; Miaohong Qian, BM; Binbin Xu, MM |
| Objective • This study aims to evaluate the efficacy of integrating nursing early warning systems with doula-assisted childbirth nursing on natural childbirth rates and associated outcomes.
Methods • A total of 150 women who underwent childbirth in the obstetrics and gynecology department of our hospital between September 2021 and March 2023 were enrolled as participants. They were randomly allocated into either the observation group or the control group, each comprising 75 individuals. The control group received standard nursing care, while the observation group received nursing early warning systems combined with doula-assisted childbirth nursing. Comparison between the two groups included modes of childbirth, the intensity of childbirth pain, neonatal Apgar scores, the incidence of postpartum hemorrhage, duration of the first and second stages of labor, and maternal satisfaction with nursing care.
Results • Our findings indicated a higher natural childbirth rate in the observation group compared to the control group (P < .05). Furthermore, the SAS score of the
observation group post-nursing was significantly lower than that of the control group. Additionally, neonates in the observation group exhibited higher Apgar scores compared to those in the control group. Moreover, mothers who underwent natural childbirth in the observation group experienced lower childbirth pain scores and reduced postpartum hemorrhage incidence (P < .05). The duration of both the first and second stages of childbirth was shorter in the observation group than in the control group. Furthermore, overall satisfaction with care was significantly higher in the observation group than in the control group, with a statistically significant difference (P < .05).
Conclusions • This study underscores the effectiveness of implementing nursing early warning systems combined with doula-assisted nursing in enhancing maternal satisfaction, reducing postpartum hemorrhage, and improving maternal well-being and neonatal outcomes. The findings advocate for the widespread adoption of this intervention in clinical practice. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Prevention of Fall Risk in Elderly Stroke Patients Based on an Intelligent Model of Rehabilitation Care |
| Xiaohui Li, BM; Mengmeng Liu, BM; Chunyan Wang, BM |
| Background • Fall is a public health problem that cannot be ignored by elderly stroke patients, and rehabilitation care plays an important role in the rehabilitation process of elderly stroke patients.
Objective: To investigate the prevention effect of fall risk in elderly stroke patients under the intelligent model of rehabilitation care.
Methods • The general data of elderly patients who were diagnosed as stroke and admitted to our hospital between June 2021 and June 2022 were retrospectively analyzed, with exclusion like unclear clinical data or combined with other severe organ insufficiency. A total of 150 of them were selected for the study, and the patients were divided into a fall group and a non-fall group according to whether they had a fall or not. The factors associated with falls in stroke patients were analyzed univariately, and the rehabilitation care intelligence model of the predictive model of falls in stroke patients was established using multiple covariance ridge regression analysis to observe the predictive value of patients’ risk of falling in the rehabilitation care intelligence model.
Results • Results of multiple covariance ridge regression analysis to build the model showed age (P < .001), low
MNA-SF score (P < .001), hypertension (P = .035), anaemia(P = .048), gout (P < .001), assistive devices (P = .002), visual impairment (P = .033), elevated ALB (P < .001), and elevated HGB (P < .001) as risk factors for falls in stroke patients. The diagnostic threshold for screening elderly stroke patients for falls based on risk factors was 0.272, with a sensitivity of 90.7%, specificity of 98.1% and an area under the ROC curve of 0.976 (P < .05), which was superior to other single indicators in terms of diagnostic value. The calibration of the prediction model, based on the Hosmer and Lemeshow test of goodness of fit, showed P = 1.14, indicating a high calibration of the prediction model.
Conclusion • There are many risk factors for falls in stroke elderly patients, such as low MNA-SF score, gout, elevated ALB, and elevated HGB. Building a rehabilitation nursing intelligent model based on the above inducement factors can reduce the risk of patients falling to a certain extent, and the prediction model has a high degree of calibration. Therefore, a simple and standardized intelligent rehabilitation nursing model for stroke patients in the early stage can effectively prevent the occurrence of falls. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of Risk Factors for Pulmonary Infections During Radiotherapy in Lung Cancer Patients |
| Yaqin Cai, MM; Yumei Dong, MM; Liyun Guo, MM; Yuexiao Qi, MM; Lihua Shao, MM; Haixia Song, MM; Na Tao, MM; Shihong Wei, MM; Lijun Xu, MM |
| Objective • To investigate the risk factors for lung infection in lung cancer patients undergoing radiotherapy.
Methods • We selected 142 patients with lung cancer who underwent radiotherapy at our hospital from January 2020 to June 2021. The patients were divided into groups according to whether they had pulmonary infection during radiotherapy in our hospital, which was infected group (n=44) and the uninfected group (n=98), respectively. To observe the incidence of lung infection in lung cancer patients during radiotherapy. The distribution of pathogenic bacteria in patients with pulmonary infection was observed. Clinical data of the two groups were collected and compared. The risk factors of lung cancer patients complicated with lung infection were analyzed by binary Logistic regression.
Results • All patients with lung cancer complicated with lung infection underwent relevant examination, and the results showed that they were all complicated infections, and the composition ratio of Klebsiella pneumoniae was
the highest (31.82%), followed by Staphylococcus, Pseudomonas, and fungi, which accounted for 27.27%, 22.73%, and 18.18%, respectively. Binary Logistic regression analysis showed that age =60 years old, smoking history =30 years, radiotherapy duration of combined drug regimen > 2 weeks, pathogenic bacteria combined infection, albumin content < 30 g/L were risk factors for lung cancer patients during radiotherapy.
Conclusion • Age =60 years old, smoking history =30 years old, radiotherapy duration of combined drug regimen > 2 weeks, pathogenic bacteria combined infection, albumin content < 30 g/L are the risk factors for lung cancer patients during radiotherapy. Clinical prevention and intervention should be based on the aforementioned independent risk factors to decrease the incidence of lung infections, thereby enhancing patient prognosis. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Special Training Method Based on Breathing Meditation Training on Negative Emotions, Job Burnout and Attention in Operating Room Nurses |
| Yanhui Qi, BM; Xiangquan Song, MM; Suzhai Tian, MD; Jiao Wei, BM; Xinyu Yao, MD |
| Objective • Nurses working in the operating room face high levels of work stress, leading to an increased prevalence of negative emotions and job burnout. These issues not only affect the well-being of nurses, but may also affect the quality of patient care. Therefore, this study aimed to investigate the effect of a special training method based on breathing meditation on negative emotions, job burnout, attention, and caring ability of operating room nurses.
Methods • Taking special training time based on breathing meditation training for nurses in the operating room (June 2022) as the dividing point, operating room nurses with routine training from March 2022 to May 2022 were taken as a pre-training group, and operating room nurses who underwent special training of breathing meditation training from June 2022 to August 2022 were enrolled as a post-training group, special training consisted of breathing meditation training for 8 weeks, once a day, 5 days a week.. The same group of nurses (n=35) were enrolled before and after training, and 53 patients in each group were included in the two intervention periods for cooperative study. The scores of nurses’ negative emotions [Symptom Checklist (SCL-90), Self-Reporting Questionnaire 20 (SRQ-20)], job burnout scores (emotional consumption, depersonalization and personal accomplishment), attention scores (visual attention, auditory attention and audio-visual combination attention) and caring ability (cognition, courage and patience) before and after training and satisfaction of nursing work were compared between the two groups of patients.
Results • The data analysis was performed using SPSS 22.0, with chi-squared tests for categorical data, and t-tests (LSD or paired) for continuous data. The scores of SCL-90 and SRQ-20 of nurses in the post-training group were
significantly lower than those in the pre-training group (P < .05). The scores of emotional consumption, depersonalization and, personal accomplishment and total score of job burnout of nurses were significantly lower in a post-training group than those in a pre-training group (P < .05). The visual attention, auditory attention, audio-visual combination attention and total attention score of nurses in the post-training group were significantly higher compared with those in a pre-training group (P < .05). The scores of cognition, courage and patience and total score of the caring ability of nurses in the post-training group were significantly higher than those in the pre-training group (P < .05). The satisfaction of nursing work in post-training group (98.11%) was significantly higher than that in the pre-training group (84.91%) (P < .05). The results indicate that the post-training group of nurses experienced significantly lower levels of emotional distress, reduced job burnout, and improved attention and caring abilities compared to the pre-training group. Additionally, their satisfaction with nursing work significantly increased. These findings suggest that the training program had a positive impact on nurses’ mental well-being, job performance, and job satisfaction, which is highly relevant for enhancing the quality of patient care in clinical practice.
Conclusion • Our findings are consistent with existing literature on the benefits of meditation and mindfulness training in healthcare Settings. These results have practical implications for both operating room nurses and patient care, indicating that breathing meditation training can be used as an effective tool to improve nurses’ mental health and work productivity. Although the study sample was limited, these preliminary results provide valuable directions for future research. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Efficacy of Sacubitril Valsartan Sodium in Combination with Levosimendan in the Treatment of Cardiorenal Syndrome and the Effect on Cardiac and Renal Function |
| Zhiheng Chen, MM; Weirong Ren, MM; Yuchang Ye, MM; Huaan Zhang, BM |
| Objective • To investigate the effects of sacubitril valsartan sodium combined with levosimendan on improving cardiac and renal functions in patients with CRS.
Methods • 90 patients with the cardiorenal syndrome who were hospitalized in our hospital from February 2020 to February 2022 were selected and divided into two groups, the control group, and the joint group, according to both single and double number methods, with 45 cases in each group. Patients who met the diagnostic criteria for CRS, were older than 18 years of age, had NYHA class II to IV, and had stage 1 or 2 chronic kidney disease were included in the study. Patients with severe hypersensitivity to the drugs used in this test, haemodynamic instability, combined hyperthyroidism, malignancy, severe pulmonary hypertension, cardiogenic shock, malignant arrhythmias and pregnant women were excluded. Among them, the control group was treated with sacubitril valsartan sodium alone, and the joint group was treated with levosimendan supplemented with the treatment method of the control group. The treatment effect, the improvement of cardiac and renal function, and the incidence of adverse reactions were compared between the two groups of CRS patients, and the prognostic effect was followed up 6 months after treatment.
Results • The total effective rate of treatment in the joint group was 95.56%, which was significantly higher than that in the control group of 80.00%, and the difference was statistically significant by using ?2 test (P < .05). After treatment, LVEF, LVEDD, and NT-proBNP levels in both
groups were significantly improved compared with those before treatment (P < .05), and the improvement effect of each index in the joint group was more significant than that in the control group (P < .05). After treatment, the levels of SCr, BUN, and UA in both groups were significantly lower than those before treatment (P < .05), and the levels of each index in the joint group were significantly lower than those in the control group, statistical analyses showed significant differences (P < .05) using t test. The incidence of adverse effects such as tachycardia, premature ventricular contractions, heart failure, and myocardial ischaemia was 22.22% in the combined group, which was significantly lower than 42.22% in the control group, and the difference in the total incidence between the two groups was statistically significant by ?2 test (P < .05). One case of malignant arrhythmia and five cases of recurrence of heart failure occurred 6 months after surgery in the combined group, which were significantly lower than the eight and twelve cases in the control group.
Conclusion • Sacubitril valsartan sodium combined with levosimendan can significantly improve the therapeutic effect of CRS, with significant improvement in cardiac and renal function of CRS patients, and its incidence of adverse effects and long-term prognostic effects are lower than those of sacubitril valsartan sodium alone. This combination therapy offers a promising new direction for CRS management, warranting further investigation in larger, multicenter trials. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Effects of Bivalirudin and Ordinary Heparin on the Incidence of Bleeding Events and the Level of Inflammation after Interventional Therapy for Acute Myocardial Infarction |
| Yun Chen; Xiaohu Han, MM; Qingliu Wu, MM; Ting Xie, MD; Yan Zhou, MM |
| Objective • To evaluate and compare the efficacy, bleeding events, and inflammation levels of optimized bivalirudin versus ordinary heparin in the context of percutaneous coronary intervention (PCI) for patients with acute myocardial infarction. This approach will underscore the comprehensive scope of the study, addressing multiple dimensions of clinical outcomes.
Methods • This study involved 120 acute myocardial infarction patients treated from January 2022 to January 2023, randomly allocated into two groups: the control group received ordinary heparin, and the observation group received bivalirudin. Both groups underwent percutaneous coronary intervention (PCI). The study specifically measured coagulation indexes such as prothrombin time (PT) and activated partial thromboplastin time (aPTT), and inflammatory markers including C-reactive protein (CRP) and interleukin-6 (IL-6). Additionally, the incidence of bleeding events and major adverse cardiovascular events (MACE) within 30 days post-PCI were recorded, with bleeding events categorized according to the Bleeding Academic Research Consortium (BARC) criteria and MACE defined by the occurrence of death, non-fatal myocardial infarction, or stroke.
Results • No significant differences were observed in coagulation indexes and pre-operation inflammation levels between the two groups (P > .05). However, at 7 days post-operation, despite both groups showing reduced inflammation—NLR decreased by 25%, hs-CRP by 30%, and IL-10 increased by 20%—the bivalirudin group exhibited notably lower incidence rates of various bleeding events (mucosal 2% vs 6%, gingival 1% vs 4%, puncture site 3% vs 8%, and hematuria 1% vs 5%) within 30 days post-PCI compared to the heparin group. TIMI blood flow grades 3 (indicating normal flow) were achieved in 85% of the bivalirudin group compared to 70% in the heparin group. The incidence of MACE was comparable between groups with both reporting a 5% occurrence rate (P > .05).
Conclusion • The study reveals that while both bivalirudin and ordinary heparin effectively prevent MACE post-acute myocardial infarction intervention, bivalirudin significantly reduces postoperative bleeding events and maintains comparable anti-inflammatory effects. This suggests its preferable use in clinical settings, particularly in patient populations at high risk for bleeding. Future research could further explore the specific patient characteristics that optimize bivalirudin’s benefits over heparin, enhancing tailored therapeutic approaches. This could potentially include randomized trials focusing on patients with different baseline bleeding risks. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Acceptance and Influence Factors of Percutaneous Endoscopic Gastrostomy in Family Members of Elderly Patients under Tube Feeding Management |
| Jianbao Wang, BM; Houqiang Zhou, MM |
| Objective • To investigate the acceptance and influencing factors of percutaneous endoscopic gastrostomy (PEG) among family members of elderly patients under tube feeding management, aiming to identify barriers to and facilitate the wider adoption of PEG in China. This study highlights the importance of understanding these factors to improve patient care and support decision-making processes.
Methods • An epidemiologic survey was conducted using a self-administered questionnaire that covered domains such as background knowledge of PEG, attitudes towards tube feeding, and expectations regarding patient outcomes. The data from 102 respondents were analyzed using SPSS19, employing both univariate analysis and multivariate logistic regression to identify significant influencing factors.
Results • Only 21.57% (22 out of 102) of family members accepted the idea of using PEG for their elderly relatives. Univariate analysis indicated that the education level of patient family members, their relationship with the patient, occupation, responsibility for the patient’s hospitalization
costs, expectations of the patient’s extubating, and previous knowledge of PEG significantly influenced acceptance (P < .05). Multivariate analysis further highlighted that the payment of the patient’s hospitalization costs, family member education, and awareness of PEG were key determinants of acceptance (P < .05).
Conclusions • The acceptance of PEG among family members of elderly patients under tube feeding management is notably low, with the patient’s hospitalization cost being the most significant factor. Enhancing education about PEG, improving communication between healthcare providers and families, and addressing financial concerns could significantly increase the acceptance of PEG. Providing training on the PEG system to healthcare professionals and disseminating timely information to patients’ families are essential steps to enhance their awareness and acceptance of PEG. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Nursing Care of Postoperative Supplementary Surgery for Patients with Positive or High-level CIN after Conization Using CINIII Cold Knife |
| Jing He, BM; Yanli Su, BM; Yingying Wu, BM |
| Objective • This study aimed to evaluate the effectiveness of personalized nursing care in postoperative supplementary surgery for cervical intraepithelial neoplasia grade III (CIN III) patients with positive or high-grade CIN margins after cold knife conization at the Fourth Hospital of Hebei Medical University in Shijiazhuang, China. The primary objective was to assess the impact of personalized nursing intervention on postoperative outcomes, including psychological well-being, self-care ability, quality of life, and postoperative complications.
Methods • A total of 106 patients undergoing additional surgery after CIN III cold knife conization at the Fourth Hospital of Hebei Medical University from January 2020 to April 2023 were randomly allocated into an observation group (n=53) and a control group (n=53) using a random number table method. Detailed information on the randomization process, including stratification factors and blinding procedures, is provided. The observation group received personalized nursing intervention, while the control group received routine nursing. The retreatment methods, including repeat cold knife conization, total hysterectomy, and radical cervical cancer surgery, were analyzed using appropriate statistical methods. Statistical software was employed for data analysis.
Results • Pathological results post-cold knife conization revealed positive margins in 76 cases and pathological upgrades in 30 cases. The consistency rate between post-cold knife conization and post-retreatment pathological results was 75.47%. After the intervention, the observation group exhibited significantly lower SAS and SDS scores and significantly higher ESCA and WHO QOL-100 scores compared to the control group (P < .05), indicating improved psychological well-being and quality of life. The total incidence of postoperative complications in the observation group was 5.66%, significantly lower than in the control group (P < .05).
Conclusion • Personalized nursing care in postoperative supplementary surgery for CIN III patients with positive or high-grade CIN margins at the Fourth Hospital of Hebei Medical University improves psychological well-being, self-care ability, quality of life, and reduces postoperative complications. The findings underscore the importance of tailored nursing interventions in enhancing patient outcomes. The inclusion of detailed patient demographics and methodological transparency enhances the generalizability and reliability of the study findings beyond the study setting. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of the Efficacy of Polyenyl Phosphatidylcholine in Combination with Liraglutide in Nonalcoholic Fatty Liver Disease and the Effect of Omentin-1 and Vaspin Expression |
| Mei Dong, PhD; Yao Jin, MM; Tong Liu, MM; Zhiqiang Tong, MM |
| Objective • To evaluate the efficacy of combining polyene phosphatidylcholine (PPC) with liraglutide in the treatment of nonalcoholic fatty liver disease (NAFLD) and investigate its impact on adipokine expression, specifically omentin-1 and vaspin.
Methods • One hundred twenty NAFLD patients were randomly assigned to either the observation group (n = 60) or the control group (n = 60). The control group received single-dose PPC treatment, while the observation group received a combination of PPC and liraglutide for 12 weeks. Clinical efficacy, adipose-related factors (omentin-1, vaspin, serum fibroblast growth factor 21 (FGF21)), liver enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyl transpeptidase (GGT)), and adverse reaction rates were compared between the two groups before and after treatment.
Results • In the observation group, the clinical effectiveness
rate (95.00%) was significantly higher than that in the control group (83.33%) (P < .05). Before treatment, there were no significant differences in omentin-1, vaspin, FGF21, ALT, AST, and GGT between the two groups (P > .05). After treatment, both groups showed decreased levels of vaspin, FGF21, ALT, AST, and GGT, along with increased omentin-1 levels. However, levels of vaspin, FGF21, ALT, AST, and GGT were lower in the observation group compared to the control group, while omentin-1 levels were higher (P < .05). Adverse reaction rates did not significantly differ between the two groups (10.00% vs. 6.67%) (P > .05).
Conclusions • The combination therapy of PPC and liraglutide demonstrates efficacy in treating NAFLD, improving adipose-related factors, and reducing liver enzyme activity with high safety. This approach warrants broader clinical implementation. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Observation on the Curative Effect of Different Anti-infective Treatment Regimens for Children with Acute Appendicitis |
| Wenlong Liu, BS; Shubo Ma, BS; Sha Sha, MM; Xiaodong Shi, MM; Jin Tao, BS; Yafang Zhang, MM; Linfeng Zou, BS |
| Objective • To observe the efficacy of different anti-infective treatment regimens on acute appendicitis in children, a retrospective study was conducted by collecting previous cases.
Methods • Ninety children with acute appendicitis who received laparoscopic appendectomy from May 2020 to September 2022 were included in this retrospective study. According to the different anti-infective treatment regimens, they were divided into Piperacillin-Tazobactam group, Piperacillin-Tazobactam+Metronidazole group, and Cefminox+Metronidazole group (n=30). Three groups of children received medication treatment before surgery. The postoperative recovery, treatment effect, bacterial clearance, complication rate, pharmacoeconomic evaluation, and adverse reactions were compared.
Results • The effective rates in the three groups were 83.33%, 90.00%, and 90.00%, respectively (P > .05). There were no differences in the bacterial clearance, complication incidence, and incidence of pharmaceutical side effects
among the three groups (P > .05). The total hospitalization cost, total drug cost, and antimicrobial drug cost in Cefminox + Metronidazole group were lower than those in Piperacillin-Tazobactam group and Piperacillin-Tazobactam + Metronidazole group, respectively (P < .05). The intensity of antibacterial drug use in Piperacillin-Tazobactam group was the lowest, followed by Piperacillin-Tazobactam + Metronidazole group and Cefminox + Metronidazole group (P < .05).
Conclusion • The three anti-infective regimens have the same therapeutic effect on acute appendicitis in children. However, the regimen of Cefminox + Metronidazole is the most economical option and can be used as the preferred treatment for acute appendicitis in children. As the preferred treatment for acute appendicitis in children. The Piperacillin-Tazobactam group has the lowest intensity of antibiotic use and can reduce bacterial resistance. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Cardiac Electrical and Mechanical Synchrony Analysis of LBBP and RVP Utilizing Tissue Doppler Imaging Technology |
| Kebei Li, PhD; Cheng Ren, BS; Yufeng Sheng, BS; Li Wang, BS; Chenlin Wang, PhD; Chunming Xu, MD; Yunjie Yao, BS |
| Background • Right ventricular pacing (RVP) therapy is the conventional approach for atrioventricular block despite its propensity to cause electrical and mechanical dyssynchrony. This dyssynchrony increases the risk of atrial fibrillation and heart failure, eventually leading to left ventricular dysfunction. Left bundle branch pacing (LBBP) has recently emerged as a novel physiological pacing method. This study utilizes conventional ultrasound cardiography (UCG), two-dimensional speckle tracking imaging (2D-STI), and tissue Doppler imaging (TDI) to investigate the disparities in electrical and mechanical cardiac synchrony between LBBP and RVP patients.
Methods • The retrospective analysis includes data from patients who underwent LBBP (n=50) and RVP (n=50) in Zhangjiagang First People’s Hospital between January 2019 and June 2020, meeting the stipulated inclusion criteria. The study compares pacing parameters, UCG metrics, cardiac electrical and mechanical synchrony, pacing success rates, and safety events both pre-operation and at 3, 6, 12, and 24 months post-operation.
Results • Implantation success rates for both RVP and LBBP groups were 100%, with 92% and 100% pacing success rates, respectively [P = .001 RR (95% CI) : 2.5 (1.5, 3.5)]. The LBBP group exhibited significant advantages over the RVP group throughout the follow-up period.
LBBP patients displayed shortened QRS duration, reduced pacing thresholds and impedance, improved sensory function, lower serum NT-proBNP levels, and an increased proportion of NYHA class I patients [P = .003 RR (95% CI) : 1.6 (1.1, 2.3)]. Furthermore, left ventricular ejection fraction increased significantly, while left ventricular diastolic and end-systolic diameters decreased in the LBBP group compared to the RVP group [P = .004 RR (95% CI) : 1.7 (1.3, 2.2)]. The LBBP group also demonstrated shorter ventricular systolic synchrony parameters, including Tls-Dif, PSD, Trs-SD, Tas-SD, Tas-post, Ts-SD, and Ts-DIf, compared to the RVP group [P = .005 RR (95% CI) : 1.5 (1.2, 2.0)]. Notably, no postoperative complications occurred in either group, such as electrode displacement, lead thrombus attachment, incision bleeding, pocket hemorrhage, or infection. However, the readmission rates for heart failure were 16% in the RVP group and 2% in the LBBP group.
Conclusion • LBBP achieves physiological cardiac pacing, leading to significant improvements in serum NT-proBNP levels and cardiac function and enhanced ventricular contraction synchrony. Utilizing UCG, 2D-STI, and TDI for quantitative evaluation of cardiac electrical and mechanical synchrony proves to be a valuable clinical approach. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application Prospects of Specific Rehabilitation Task Training in Upper Limb Function Rehabilitation of Stroke Sequelae Patients |
| Jiuju Wang, MS |
| Objective • To analyze the application prospects of specific rehabilitation task training in upper limb function rehabilitation of stroke sequelae patients.
Methods • A retrospective analysis was conducted on 80 patients with upper limb function rehabilitation who received treatment for stroke sequelae in The People’s Hospital from January 2022 to December 2022. The patients were divided into two groups based on different training methods, with 40 cases in each group. The control group received conventional rehabilitation training, while the observation group received specific rehabilitation task training. The intervention in both groups spanned for one month on a daily basis. The motor function, self-care ability, self-efficacy, negative emotions, and nursing efficacy of the two groups of patients were compared.
Results • There was no statistically significant difference in baseline data between the two groups of patients, indicating comparability (P > .05). After different nursing interventions, the Fugl-Meyer Assessment (FMA) scores and Functional Capacity Assessment (FCA) scores of the observation group were lower than those of the control group, and the differences were statistically significant
(relative risk [RR] 1.67, 95%CI 1.50–1.85; RR 1.24, 95%CI 1.09–1.41). The Generalized Self-Efficacy Scale (GSES) scores of both groups at 7 days and 3 months after surgery were significantly higher than the preoperative scores in each group (RR 1.51, 95%CI 1.40–1.63; RR 1.54, 95%CI 1.31–1.79), and the GSES scores of the observation group were significantly higher than those of the control group at 7 days and 3 months after surgery (RR 1.56, 95%CI 1.37–1.77; RR 2.17, 95%CI 1.65–2.83). The Self-Rating Anxiety Scale (SAS) scores and Self-Rating Depression Scale (SDS) scores of the observation group at 7 days and 3 months after surgery were significantly lower than those of the control group (RR 2.30, 95%CI 1.81–2.93; RR 1.18, 95%CI 1.10–1.25). The nursing efficacy of the observation group was higher than that of the control group (RR 1.65, 95%CI 1.28–2.14).
Conclusion • For patients with upper limb function rehabilitation after stroke sequelae, specific rehabilitation task training intervention can effectively improve patients’ negative emotions and self-efficacy and enhance their motor function and self-care ability. It is worth promoting and applying. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Apagliflozin Plus Pentoxifylline in the Treatment of Early Diabetic Nephropathy and Its Effect on Serum Inflammatory Factors and Immune Function |
| Ailing Chang, MS; Fangzhen Wang, MS; Yujin Wang, MS; Yaran Zhai, MS; Jincheng Zhang, MS |
| Objective • To explore the efficacy of dapagliflozin plus pentoxifylline in the treatment of early diabetic nephropathy and its effect on serum inflammatory factors and immune function.
Methods • A total of 90 patients with early diabetic nephropathy who were admitted to Cangzhou Central Hospital from January 2019 to January 2022 were recruited and randomized (1:1) into a control group and an observation group using the random number table method. The control group was treated with dapagliflozin, and the observation group was treated with pentoxifylline plus dapagliflozin. The effectiveness of urinary a (1) microglobulin (a 1-mg) was determined by immunoturbidimetric method, and urinary ß (2) microglobulin (ß 2-mg) was determined. Urine creatinine was determined enzymatically, and the urinary microprotein albumin creatinine ratio (mAlb/Cr) was calculated. The levels of inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a)] were detected. Before and after treatment, 3 mL of venous blood was drawn from the two groups of patients, and serum CD4+, CD8+, and CD4+/CD8+ levels were detected. The incidence of adverse reactions between the two groups was calculated.
Results • Dapagliflozin plus pentoxifylline was associated with a higher effective rate than dapagliflozin alone (96.67%
vs 81.67%) (RR 0.80 [95% CI 0.61–0.98]; P = .021). Dapagliflozin plus pentoxifylline led to lower renal function parameters versus dapagliflozin alone, in favor of the observation group (RR 0.67 [95% CI 0.66–0.88]; P = .032). After treatment, the serum levels of IL-6 and TNF-a in patients treated with dapagliflozin plus pentoxifylline were lower than counterparts treated with dapagliflozin (RR 0.62 [95% CI 0.51–0.78]; P = .037). After treatment, CD4+ and CD4+/CD8+ in the two groups were increased compared with baseline parameters, and the level of CD8+ was decreased ; the increase and decrease were greater in the observation group than in the control group (RR 0.70 [95% CI 0.71–0.96]; P = .044) (RR 0.53 [95% CI 0.41–0.78]; P = .033). The two groups demonstrated similar safety profiles with no statistical difference observed in the incidence of adverse reactions between the two groups (RR 0.73 [95% CI 0.73–1.08]; P = .051).
Conclusion • Dapagliflozin plus pentoxifylline might be a promising alternative in the treatment of patients with early diabetic nephropathy, it significantly mitigates the body’s inflammatory response, enhances immune function, attenuates the main clinical symptoms, with a high safety profile. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of Factors Influencing the Stigma Associated with Postoperative Cervical Cancer Patients and the Impact of Integrated Nursing Interventions on Stigma |
| Xiaoqin Chen, MM; Ying Fan, BM |
| Objective • To investigate the influencing factors related to stigma and nursing interventions for patients after cervical cancer surgery.
Methods • The clinical data of 158 patients with cervical cancer treated with radical cervical cancer in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from November 2016 to December 2021 were retrospectively analyzed. The patients were divided into a research group (79 cases) and a control group (79 cases) based on the random number method. In the control group, patients were given general nursing instructions during the post-operative visit. In contrast, the research group provided comprehensive nursing interventions to patients and their families based on the observation group. The Social Impact Scale (SIS) was used to assess the patients’ stigma; the Self-Rating Anxiety Scale (SAS), Trait Coping Style Questionnaire (TCSQ), and Quality of Life Questionnaire for Cancer Patients (QLQ-C30) were also used to assess the patients’
pre- and post-care interventions. The patients’ status was assessed before and after the intervention.
Results • The SIS score (49.68±8.41) and TCSQ negative coping score (30.14±7.06) of the patients in the research group after the nursing intervention were much smaller than those in the control group, and the TCSQ positive coping score (40.36±6.51) was much larger than that of the control group (P < .05). The SAS anxiety score (31.65±7.36) was much smaller, and the QLQ-C30 score (78.65±16.59) was much larger in the research group than in the control group after the nursing intervention (P < .05).
Conclusion • Risk factors affecting postoperative cervical cancer patients’ sense of stigma include age 18-35 years, high school and above, employed, monthly income >3000 RMB, family history of the disease, disease duration >5 years, and postoperative chemotherapy, etc. Comprehensive clinical interventions can be given to patients with these conditions to reduce the sense of stigma. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| To Investigate the Diagnostic Accuracy and Prognostic Value of Amplitude-Integrated Electroencephalography (aEEG) in Neonatal Hypoxic Ischemic Encephalopathy |
| Zheng Liu, BM; Jianping Liu, BM; Chunyan Liu, BM; Qiaomei Ma, BM; Juanjuan Shi, BM; Shouzhen Wu, BM; Yujuan Zhao, BM |
| Objective • The objective of this study is to investigate the diagnostic accuracy and prognostic value of amplitude-integrated electroencephalography (aEEG) in neonatal hypoxic ischemic encephalopathy (HIE).
Methods • Fifty-three neonates with HIE admitted to our hospital from February 2020 to September 2021 were included in the encephalopathy group, while 22 healthy neonates born in our hospital during the same period were included in the healthy group. The neonates were separated into three subgroups based on their aEEG results: normal, slightly abnormal, and severely abnormal. We investigated the correlation between aEEG monitoring and HIE clinical grading, as well as the rate of HIE abnormal prognosis, and we analyzed the prognostic value of aEEG in HIE.
Results • The aEEGs of all neonates in the healthy group were normal. In the encephalopathy group, there were 24 neonates with normal aEEGs (including 20 with mild HIE
and 4 with moderate HIE), 16 neonates with mildly abnormal aEEGs (including 4 with mild HIE, 10 with moderate HIE, and 2 with severe HIE), and 13 neonates with severely abnormal aEEGs (including 4 with moderate HIE and 9 with severe HIE). A very close correlation between aEEG monitoring results and HIE grading and prognosis was found (P < .05). The head circumference of neonates with severely abnormal aEEGs was smaller than that of the other two groups and was significantly smaller than that of the healthy group (P < .05). However, there was no significant difference in the body length and weight of neonates in the severely abnormal aEEG group when compared to other groups (P > .05).
Conclusion • The brain function of neonates with HIE can be accurately diagnosed with aEEG, and this diagnostic technique has a crucial application value in the early diagnosis and prognosis evaluation of neonatal HIE. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparison of Topical 1% Melatonin Gel and Non-Surgical Periodontal Therapy for Stage I and Stage IV Periodontal Disease |
| Tian Tang, BD; Qin Wang, BD |
| Background • Oral health is crucial for overall well-being, and periodontal disease can lead to serious complications such as intraosseous defects. In recent years, local administration of 1% melatonin gel has been explored as a potential treatment option for intraosseous defects. However, its efficacy compared to traditional non-surgical periodontal therapy (NSPT) is not fully understood.
Primary Study Objective • To evaluate and compare the efficacy of 1% melatonin gel local administration with non-surgical periodontal therapy (NSPT) in the treatment of stage I and stage IV periodontal bone defects.
Methods/Design • One hundred participants diagnosed with stage I and stage IV periodontal disease were recruited from Hangzhou Younuo Dental Clinic between December 2020 and March 2022. The participants were divided into two groups: a study group and a control group. The study group received local administration of 1% melatonin gel, while the control group received non-surgical periodontal therapy (NSPT). Oral examinations, including X-ray examinations, were conducted to assess the severity of bone defects before treatment initiation.
The primary outcome measures included treatment
efficacy, periodontal indicators (PD and BI levels), inflammatory response indicators (IL-1ß, IL-6, and TNF-a levels), bone defect heights, and alveolar bone densities.
Results • The treatment efficacy in the study group was significantly higher than that in the control group (95% CI –3.0 to –1.8, P = .011). Post-treatment, the study group had lower PD and BI levels compared to the control group (95% CI –1.0 to –0.8, P < .001; 95% CI –1.2 to –0.7, P < .001). Post-treatment, the study group had lower levels of IL-1ß, IL-6, and TNF-a compared to the control group, (95% CI 0.3 to –0.8, P < .001; 95% CI –4.1 to –2.1, P < .001; 95% CI –3.5 to –1.6, P < .001). Post-treatment, the study group had lower bone defect heights and higher alveolar bone densities compared to the control group (95% CI 0.7 to 1.1, P = .028; 95% CI –2·2 to –1.8, P < .001).
Conclusion • Local administration of 1% melatonin gel may be an effective treatment option for improving bone defects, enhancing periodontal indicators, alleviating inflammatory responses, and improving oral health in patients with stage I and stage IV periodontal disease. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Reducing Heart Failure in Acute Myocardial Infarctionby Downregulating SOX6 Expression via Nuclear Factor-?B |
| Jin Wenxue, BM; Qiao Xiulan, BM |
| Aim • Our aim was to investigate the mechanisms of SRY-Box Transcription Factor 6 (SOX6) in heart failure (HF) in acute myocardial infarction (AMI).
Methods • Sixty healthy people and 60 patients with AMI were divided into the control and AMI groups, and SOX6 expression levels were measured. Hypoxia-induced rat cardiomyocytes (H9c2 cells) were used to construct AMI cell models and split into the blank (control), Hypoxia, Hypoxia + si-NC, Hypoxia + si-SOX6, Hypoxia + pcDNA3.0, Hypoxia + SOX6, Hypoxia + si-SOX6 + HY-18739 and Hypoxia + SOX6 + M4005 groups. The cell viability, reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD) levels, apoptosis, SOX6 mRNA expression, collagen I, collagen IV, fibronectin, p-I?Ba, p-p65 and SOX6 protein expression levels were compared in the H9c2 cells.
Results • The SOX6 mRNA and protein expression were elevated in the AMI and Hypoxia groups. The cell viability and SOD level decreased, and ROS, MDA level, apoptosis rate, collagen I, collagen IV and fibronectin protein expression level increased in the Hypoxia and Hypoxia + SOX6 groups. The cell viability, SOD level, ROS, MDA level, apoptosis rate, collagen I, collagen IV, fibronectin and SOX6 protein expression level were increased in the Hypoxia + si-SOX6 and Hypoxia + SOX6 + M4005 groups. The p-I?Ba and p-p65 protein expression were decreased in the Hypoxia + si-SOX6 group and increased in the Hypoxia + si-SOX6 + HY-18739 group.
Conclusion • Downregulation of SOX6 expression attenuates HF during acute myocardial infarction via the nuclear factor-?B (NF-?B) signal pathway. It could provide a reference basis for early diagnosis and targeted therapy of HF in AMI. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Enhanced Recovery After Surgery Management for Neonatal Congenital Malformations to Accelerate the Postoperative Recovery of Children |
| Bao Cai, MS; Yaozong Hu, BS; Shan Huang, MS; Jia Tian, MS; Fan Wu, MD; Bing Xu, BS; Faming Zhang, MS |
| Objective • The purpose of this study was to investigate the clinical benefits of implementing enhanced recovery after surgery (ERAS) protocols in managing congenital malformations in newborns.
Methods • Sixty infants diagnosed with congenital malformations admitted to the Anqing Municipal Hospital between October 2020 and April 2022 were selected for this study. They were randomly assigned to either the observation group, receiving ERAS management, or the control group, receiving routine management, or the control group, receiving routine management. Each group consisted of 30 patients. Outcome measures included operative duration, intraoperative bleeding volume, intravenous nutrition maintenance duration, length of hospital stay, and hospital costs, complications, and readmission.
Results • The duration of the procedure did not show any notable variances, and there were no reports of bleeding during or after surgery in relation to the operative time, intraoperative bleeding, postoperative complications, or
readmission. The implementation of ERAS management resulted in notably shorter periods of intravenous nutrition maintenance and hospitalization and reduced costs compared to standard management. Furthermore, ERAS management resulted in significantly lower scores on the Modified Faces, Legs, Activity, Cry, and Consolability Scale at 2, 12, and 24 hours after surgery. However, this difference became insignificant after 48 hours. All study participants experienced elevated levels of cortisol and C-peptide following interventions, with lower levels observed in the observation group. Additionally, all study participants exhibited increased levels of susceptible C-reactive protein and interleukin (IL)-6 and decreased serum albumin levels after interventions, with lower serum IL-6 levels observed in the observation group.
Conclusion • Implementing ERAS management for neonatal congenital malformations is safe and feasible, and it can potentially accelerate postoperative recovery in children. It shows promise for wider clinical adoption. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| High-Quality Nursing and Intraoperative Cooperation Effectively Reduce the Occurrence of Adverse Reactions for Patients with ST-elevation Myocardial Infarction |
| Min Liu, BS; Suzhi Mu, BS; Rusheng Pan, AD; Yuan Xu, BS |
| Objective • This study aimed to explore the application effectiveness of intraoperative coordination and nursing in the interventional treatment of patients with ST-segment elevation myocardial infarction (STEMI). Specifically, the study sought to investigate the specific protocols or practices within the systematic nursing collaboration approach and their impact on patient outcomes.
Methods • A total of 60 STEMI patients treated in our hospital from April 2019 to June 2020 were randomly assigned to either the routine care group (n=30) or the systematic nursing collaboration group (n=30). Both groups underwent percutaneous coronary intervention (PCI). Outcome measures, including time to unblock infarcted vessels, incidence of adverse reactions during interventional therapy, mortality, treatment success rate, improvement in cardiac function, and length of hospital stay, were assessed using appropriate statistical analysis methods.
Results • A t test showed that the systematic nursing collaboration group exhibited a significantly shorter time to unblock infarcted vessels compared to the routine care group (P < .05). The incidence of adverse reactions during interventional therapy was significantly lower in the
systematic group compared to the routine group (P < .05), analyzed using a chi-square test. Furthermore, the systematic group demonstrated a higher treatment success rate (P < .05), analyzed using a chi-square test. Moreover, the improvement in cardiac function in the systematic group was significantly better compared to the routine group (P < .05), analyzed using a t test. Additionally, the systematic group had a significantly shorter length of hospital stay compared to the routine group (P < .05), analyzed using a t test.
Conclusion • The findings of this study highlight the effectiveness of intraoperative coordination and nursing practices in reducing adverse reactions and mortality, improving treatment success rates, enhancing cardiac function, and shortening hospital stays in patients with STEMI. These results emphasize the importance of implementing systematic nursing collaboration in the interventional treatment of STEMI patients. Further research can explore specific protocols and strategies for integrating systematic nursing collaboration into medical practices, leading to improved healthcare delivery and patient outcomes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Role of Natural Killer Cells in Antibody-mediated Rejection of Kidney Transplantation |
| Ruihua An, PhD; Xingku Li, MD; Wei Liu, MD; Yu Qiu, MD; Yakun Zhao, MD; Qingguo Zhu, PhD |
| Objective • This study explicitly demonstrates the roles of natural killer (NK) cells in different types of kidney transplantation.
Methods • We’d done the whole study from October 2022 to October 2023. To further explore the significance of NK cells during renal transplantation, we provide a theoretical basis for clinically overcoming immune rejection after renal transplantation by developing new anti-rejection drugs. We selected twelve male mice and divided them into three groups (Syngeneic transplant group allograft transplant group allograft transplant (priming) group) by random. Initially, the morphological and histopathological changes in the kidney transplantation graft model of mice in different groups are observed. Further, the DSA-IgG levels in peripheral blood and C3d and IgG deposition in mice are detected by ELISA and immunohistochemical staining. Then, the Banff 2015 score is recorded to screen a suitable AMR mouse model. Finally, the expression of NK cells in different rejection modes is detected by flow cytometry, and the expressions of various cytokines (INF-?, perforin, granzyme B, TNF-a) in peripheral blood are detected by enzyme-linked immunosorbent assay (ELISA).
Results • In the allogeneic transplantation (priming)
group, peritubular capillary inflammatory cell infiltration, moderate endarteritis, and small arterial fibrinoid necrosis are evident. The Banff score showed that the allogeneic transplantation (pre-sensitized) group is significantly higher than the syngeneic and allogeneic transplantation groups. The C3H?C57BL/6 mice are pre-sensitized by skin transplantation, and then kidney transplantation is performed to establish the antibody-mediated rejection (AMR) model. After kidney transplantation, the expression levels of NK cells in the peripheral blood, spleen, and transplanted kidney tissue of mice in the pre-sensitized group are significantly higher than in the allogeneic transplantation and control groups. In the C3H?C57BL/6 mouse model of AMR, NK cells and the related cytokines in the peripheral blood are highly expressed after kidney transplantation, proving that NK cells play an essential role in the occurrence of AMR.
Conclusion • Our study proved the significance of NK cells in the occurrence of AMR by systematically monitoring the expression of NK cell-related cytokines in different types, which provided some ideas for the clinical treatment of AMR. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Emodin Attenuates Sepsis-induced Intestinal Injury by Regulating TRPM7 Expression |
| Fenqiao Chen, MS; Tane Liu, MS; Yanjun Liu, MS; Jianqiang Mei, MS; Lijuan Wu, MS; Pengying Yin, MS; He Zhang, MS |
| Background • Sepsis is a potentially lethal organ immune dysfunction induced by infection, with the stomach being the first organ to be attacked. Emodin has anti-inflammatory and gastrointestinal functions, but its therapeutic effect on intestinal injury in sepsis remains unclear. This study sought to investigate the role of emodin in treating intestine damage brought on by sepsis.
Methods • Between June 2021 and July 2023, Lipopolysaccharide (LPS) was used to stimulate human intestinal epithelial cells NCM460 to create a septic cell model, and treatment was regulated by rhodopsin. Transient receptor potential melastatin 7 (TRPM7) expression was used to check that the LPS induction conditions were acceptable. About the proliferation of the NCM460 cells, the effects of overexpressing TRPM7 and silencing TRPM7 were assessed. Cell viability was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide test. Tumor necrosis factor (TNF)-a, interleukin (IL)-1ß, and IL-6 expression in the cells was detected using enzyme-linked immunosorbent assays. TRPM7 messenger RNA expression was detected using real-time quantitative polymerase chain reaction (RT-qPCR). Western blot determined the levels of TRPM7, Bcl2-associated X (Bax), and B-cell lymphoma-2 (Bcl2) protein expression levels. The
terminal deoxynucleotidyl transferase (TdT)-mediated 2’-deoxyuridine 5’-triphosphate (dUTP) nick-end labeling (TUNEL) technique was used to measure the apoptosis rate.
Results • The levels of the inflammatory factors and Bax expression in the cells and the cell apoptosis rate steadily increased as the LPS-induced concentration increased. In contrast, cell viability and the Bcl2 expression levels gradually decreased. In this study, we treated the cells with LPS at a concentration of 25 µg/mL for 12 hours. It was detected that the knockdown of TRPM7 expression decreased the effect of LPS induction, while boosting the expression of TRPM7 boosted the effectiveness. Treatment with emodin lowered TRPM7 expression, increasing cell survival, and Bcl2 expression levels while decreasing the apoptosis rate, inflammatory factors, and Bax expression levels.
Conclusion • Emodin may alleviate sepsis-induced intestinal injury by down-regulating the TRPM7 gene. These findings suggest that emodin may hold promise as a therapeutic agent for treating intestinal injury in sepsis. If further validated through additional research and clinical trials, emodin or similar compounds could potentially be developed into safe and effective medications for sepsis patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Correlation Between Blood-pressure Levels and Frailty Index and Adverse Health Events in Older Adults With ESRD With Hypertension |
| Zhang Jiwei, MB; Ran Lei, MM; Zhang Yapu, MM; Chen Yinyin, MM |
| Context • End-stage renal disease (ESRD) refers to the development of chronic kidney disease to stage 5. Elevated blood pressure is one of the main symptoms of older adults with ESRD. The severity and difficulty of curing ESRD with hypertension in older adults has attracted a great deal of attention from the medical community.
Objective • The study intended to analyze the correlation between blood-pressure level and FRAIL scores and adverse health events for older adults with ESRD and hypertension.
Design • The research team performed a narrative review by searching hospital medical record system databases. The search used the keywords endpoint renal disease and hypertension. The research team also conducted a prospective case-control study.
Setting • The study took place at Affiliated Hospital of Hebei University.
Participants • Participants were 168 older adults with ESRD and hypertension, ESRD only, or hypertension only who had received a diagnosis and treatment at the hospital between October 2022 and September 2023 as well as healthy individuals who were members of the community.
Groups • The study included four groups, each with 42 participants: (1) the ESRD + hypertension group, (2) the ESRD group, (3) the hypertension group, and (4) the healthy group.
Outcome Measures • The research team: (1) measured systolic and diastolic blood pressure, (2) assessed patients’ debilitation using the FRAIL score; and (3) determined the incidence of adverse health events—heart disease, stroke, cancer, arthritis, and chronic obstructive pulmonary disease (COPD). Based on participants’ blood pressures, the
research team: (1) divided the ESRD with hypertension group into the hypertension grade I, hypertension grade II, and hypertension grade III groups, and (2) compared the blood pressures, FRAIL scores, and incidence of adverse health events among those three groups. The team performed a Pearson correlation analysis to analyze the correlation between blood pressure and the FRAIL scores and adverse health events for the ESRD with hypertension group.
Results • The ESRD + hypertension group’s mean systolic and diastolic blood pressure and FRAIL score and its incidence of adverse health events were significantly higher than those: (1) of the ESRD group, with P = .028, P = .048, P = .037, and P = .008, respectively; (2) of the hypertension group, with P = .017, P = .035, P = .025, and P = .037, respectively; and (3) of the healthy group, with P = .042, P = .341, P = .372, and P = .482, respectively. The hypertension grade III’s systolic and diastolic blood pressure, FRAIL score, and incidence of adverse health events were significantly higher than those: (1) of the hypertension grade I group, with P = .009, P = .015, P = .003, and P = .055, respectively, and (2) of the grade II group, with P = .078, P = .089, P = .001, and P = .006, respectively. A significant positive correlation existed between the blood-pressure level and the FRAIL score (P = .041) and incidence of adverse health events (P = .032).
Conclusions • Older adults with ESRD and hypertension had significantly higher blood pressure levels and FRAIL scores and more adverse health events. A significant positive correlation existed between blood pressure level and frailty scores and incidence of adverse health events. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Improvement of UCVA, BCVA, and Intraocular Pressure after Phakic Posterior Chamber Intraocular Lens Implantation for Myopia |
| Haijing Cao, MM; Chaopeng Li, MD; Qing Pan, MM; Shi Zhou, MM |
| Objective • The purpose of this study is to explore the artificial lens planting of the back room shape of the crystal eye eyes and The clinical effect of ICL in patients with myopia.
Methods • A Retrospective Study Spanning from 2021 to 2023 within Huai’an First People’s Hospital. This study involves the comparative analysis of 100 eyes subjected to ‘Crystalline Lens Extraction + IOL’ and 100 eyes undergoing ‘ICL’ treatment. We evaluate various postoperative parameters, including near and distant visual acuity, Visual Acuity (CVA), Best-Corrected Visual Acuity (BCVA), refractive outcomes, endothelial cell count, glare sensitivity, and the incidence of macular edema. The control group underwent Crystalline Lens Extraction + IOL, and the observation group underwent ‘ICL’ treatment. Visual acuity recovery, intraocular pressure, endothelial cell count, adverse reactions, and therapeutic effect were compared between the two groups.
Results • The CVA before treatment and the IOP and endothelial cell count before and after treatment in the observation group were similar to those in the control group, and the differences were not statistically significant (P > .05). The CVA, BCVA, and refraction after treatment in the observation group were all higher than those in the control group, and the differences were statistically significant (P < .05). The number of people with significant and effective treatment effects in the observation group (total effective rate 98.00%) was higher than that in the control group (82.00%), and the difference was statistically significant (P < .05).
Conclusions • The implantation of ‘ICL’ treatment in cases of myopia demonstrates favorable surgical outcomes in clinical practice. It effectively enhances postoperative visual function recovery while minimizing the risk of adverse reactions. The ICL implantation procedure is irreplaceable in the treatment of myopia. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Prophylactic Antibiotics on Intestinal Microflora Diversity in Preterm Infants: A Meta-analysis |
| Tao Deng, BS; Qijie Liu, BS; Jianjun Tang, BS; Lina Zeng, BS; Huimin Zhao, BS |
| Objective • This meta-analysis aims to investigate the effects of prenatal prophylactic antibiotics on the diversity of intestinal flora in premature infants, with a focus on elucidating the rationale behind this investigation and the potential impact of altered intestinal flora on the health of preterm infants, such as increased susceptibility to infections, impaired nutrient absorption, and compromised immune function.
Methods • Relevant literature consistent with the effects of prenatal prophylactic antibiotics on intestinal flora diversity in preterm infants was systematically searched and screened from both domestic and foreign databases, including Wanfang Medical Center, CNKNET, VIpp, and PubMed. Meta-analysis was performed using RevMan 5.2 software. Inclusion criteria for the study were: (1) comparison of prophylactic antibiotic use versus non-use, (2) no restrictions on subjects’ characteristics, (3) follow-up loss < 20%, (4) institutional approval, (5) publication within the time frame from January 2017 to December 2022, (6) minimal missing data or suppliable by author contact, and (7) no major errors in sequencing or detection. Outcome measures included intestinal flora composition, phylum flora content, abundance index, and Shannon index, comparing antibiotic-treated and non-treated groups. RevMan 5.2 software was used for statistical analysis. Counting data was expressed as risk ratio (RR), and weighted mean difference (WMD) or standard mean difference (SMD) was selected as analysis statistics.
Results • The study encompassed five Chinese literature sources, with one deemed low quality and four high quality. No significant publication bias was observed. Among the included studies, a significant reduction in the intestinal flora abundance index ACE was noted in the treated
group compared to the non-treated group (RR: -8.10, 95% CI: -8.81 to -7.40, P < .00001). ACE estimates species richness in a microbial community by considering both abundant and rare species. Higher ACE values indicate greater diversity. Similarly, the Shannon diversity index was lower in the medication group compared to the non-medication group (RR: 0.73, 95% CI: 0.64 to 0.82, P < .00001). Shannon Diversity Index measures species diversity and evenness within a community. Higher values indicate higher diversity, considering both the number of species and their relative abundance. Analysis of Firmicutes content revealed a higher level in the treated group (RR: -6.44, 95% CI: -7.26 to -5.63, P < .00001). Additionally, lower Proteus (RR: 10.96, 95% CI: 9.47 to 12.45, P < .00001) and Klebsiella (RR: 15.96, 95% CI: 15.31 to 16.62,
P < .00001) content was observed in the treated group. Conversely, Enterococcus content was higher in the treated group (RR: 2.18, 95% CI: 1.84 to 2.52, P < .00001), along with a higher proportion of Enterococcus (RR: 0.45, 95% CI: 0.27 to 0.76, P = .003). These findings collectively suggest that prophylactic antibiotic use in preterm infants significantly alters the composition of intestinal flora.
Conclusion • Our findings suggest that prophylactic antibiotic use in preterm infants leads to a notable reduction in intestinal flora diversity, potentially impacting their health outcomes. Decreased microbial diversity has been linked to gastrointestinal issues, infections, and weakened immune function. These results highlight the importance of cautious antibiotic use in this vulnerable population and the need for further research to better understand and mitigate the potential health implications. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Relationship between Different Delivery Timing and the Outcome of Premature Rupture of Membranes in Primiparous Women |
| Lishe Chen, MM; Zhexia Hu, MM; Jingya Li, MM; Biyun Luo, BM; Min Xu, MM; Xueling Zhang, MM |
| Objective • To investigate the relationship between different delivery timing and the outcome of premature rupture of membranes (PROM) in primiparous women.
Methods • Within the context of exploring optimal delivery strategies for managing PROM, we conducted a retrospective study at Shijiazhuang Fourth Hospital. From May 2019 to May 2022, a total of 400 single pregnant women with premature rupture of membranes (PROM) at different gestational weeks (28-36 weeks) were enrolled. This study aims to understand the impact of delivery timing on pregnancy outcomes more clearly. Pregnant women were divided into two distinct groups based on gestational weeks: Group A (28 to 33 weeks, n=192) and Group B (34 to 36 weeks, n=208). The clinical data of pregnant women were analyzed retrospectively, and the methods of delivery, maternal and infant pregnancy outcomes, and factors affecting delivery outcomes were compared in different groups.
Results • Compared with the delivery methods of the two groups, the proportion of vaginal delivery in group A (69.27%) was significantly higher than that in group B (49.04%). The proportion of assisted vaginal delivery and cesarean section (13.54% and 17.19%) was significantly lower than that in group B (18.75% and 32.21%) (P < .001). There was no difference in neonatal death outcomes between the two groups (P > .297). The incidence of chorioamnionitis, postpartum hemorrhage, and puerperal infection in group A (25.00%), (19.27%) and (11.46%) was significantly higher than that in group B (6.25%), (5.29%)
and (2.40%), respectively. The incidence rates of neonatal asphyxia, neonatal respiratory distress syndrome (NRDS), and hypoxic-ischemic encephalopathy (HIE) in group A were 9.38%, 7.29%, and 6.77%, which were significantly higher than those in group B (1.92%, 0.48% and 0.48%) (P = .001). There was no difference in neonatal death outcomes at different delivery times (P = .259). The incidence rates of amniotic infection, postpartum hemorrhage, and puerperal infection were (3.98%), (7.39%) and (3.41%), which were significantly lower than those of pregnant women from PROM to delivery time =48 h (24.11%), (15.63%) and (9.38%). The incidence rates of neonatal asphyxia, NRDS, and HIE were (1.14%), (1.14%) and (2.27%) in neonates from PROM to delivery time < 48 h, significantly lower than those in neonates from PROM to delivery time =48 h (8.93%), (5.80%), and (4.46%) (P < .001). Logistic regression analysis showed that the older the gestational week was the protective factor for amniotic space infection, postpartum hemorrhage, puerperal infection, neonatal asphyxia, NRDS, and HIE. Late delivery time was an independent risk factor for amniotic cavity infection(P < .001), postpartum hemorrhage(P = .014), puerperal infection(P = .023), neonatal asphyxia(P = .004), and NRDS (P = .028).
Conclusion • In pregnant women with PROM who are not at full term, a greater gestational week is associated with a lower rate of adverse delivery outcomes. In contrast, a longer time interval between membrane rupture and delivery is associated with a higher rate of adverse delivery outcomes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Diagnostic Value of Ultrasound Endoscopy-Guided Fine-Needle Aspiration for Peritoneal Lesions |
| Gui-Lian Cheng, MM; Duan-min Hu, PhD; Jia-Liang Huang, MM; Ming-Jie Qian, MM; Wei Wu, MM; Long-Jiang Xu, MM; Li-Ming Xu, MM; Zhen-Yu Ye, PhD |
| Background • Peritoneal lesions present diagnostic challenges, necessitating precise imaging techniques. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) offers a promising approach for accurate diagnosis, aiding in optimal patient management and treatment planning.
Objective • This study aims to assess the diagnostic efficacy of EUS-FNA in peritoneal lesions to offer insight in guiding optimal patient management.
Methods • A prospective observational study was conducted, and a total of 58 patients who underwent EUS-FNA of the peritoneum at our hospital between October 2021 and November 2021 were included. The ultrasound diagnostic instrument facilitated puncture guidance, with 2-5 punctures performed in various parts of the selected peritoneal lesion areas. The analysis encompassed evaluating the sensitivity, specificity, positive predictive value, and negative predictive value of biopsy for diagnosing peritoneal-associated lesions, alongside assessing the number of punctures, puncture satisfaction,
and incidence of postoperative complications.
Results • The included patients undergoing EUS-FNA revealed that 41 (70.69%) had malignant lesions, while 17 (29.31%) presented with benign lesions. The diagnostic accuracy of EUS-FNA for peritoneal lesions was determined to be 94.83%, with a diagnostic sensitivity of 97.30% for malignant tumors, specificity of 90.48%, positive predictive value of 94.74%, and negative predictive value of 95%. Lesions exhibited a size range of 2.5cm × 2.9cm to 15.2cm × 9.8cm. Each patient underwent 2-5 punctures (3.3 ± 1.4), with a puncture satisfaction rate of 96.55%. The incidence of postoperative complications following EUS-FNA was found to be 3.45%.
Conclusion • EUS-FNA exhibits substantial diagnostic utility for peritoneal-related lesions, marked by exceptional accuracy, sensitivity, specificity, and favorable safety. Its clinical adoption is warranted, promising improved patient care and management. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Endoscopic Ultrasound-Guided Fine Needle Aspiration has High Diagnostic Value in the Diagnosis of Solid Pancreatic Lesions |
| Xiao Chen, MBBS; Yanping Chen, MM; Yuan Chen, MM; Jin Ding, MM; Xiaohua Ye, MM; XiaoLi Zhai, MBBS; Fang Zhu, MBBS |
| Objective • To analyze the potential factors influencing the diagnostic capability of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and provide medication treatment recommendations for patients with pancreatic solid mass lesions.
Methods • A retrospective analysis was conducted on clinical data of 92 patients with pancreatic solid mass lesions who underwent EUS-FNA examination after detection by imaging studies. The diagnostic effectiveness of EUS-FNA was evaluated based on cytological or histological examination results. Logistic regression analysis was subsequently performed to analyze the potential factors influencing the diagnostic capability of EUS-FNA in patients with pancreatic solid mass lesions.
Results • EUS-FNA was successfully performed in all 92 patients, with a puncture success rate of 100.00%. Only one patient experienced transient hyperamylasemia, which resolved with conservative treatment. No other serious complications were observed. Among the 92 patients, 70 patients obtained a definite diagnosis after
EUS-FNA (Group A), while 22 patients did not achieve a definite diagnosis (Group B) after the procedure. Univariate analysis showed that lesion size, dilation of the pancreatic duct or bile duct, negative pressure, and suction method were significantly different between Group A and Group B (P < .05). Multivariate logistic regression analysis revealed that lesion size, dilation of the pancreatic duct or bile duct, negative pressure, and suction method were potential factors influencing the diagnostic ability of EUS-FNA in patients with solid pancreatic lesions (P < .05).
Conclusion • EUS-FNA has a high diagnostic value in the evaluation of solid pancreatic lesions. Lesion size, dilation of the pancreatic duct or bile duct, negative pressure, and suction method are potential factors influencing the diagnostic ability of EUS-FNA in patients with solid pancreatic lesions. In terms of medical treatment, specific treatment methods and drug choices should be based on a comprehensive evaluation of the nature of the patient’s lesions and the severity of the condition. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Magnetic Resonance Imaging Improves Diagnosis of Liver Cancer Compared to Liver Enhanced CT |
| Shuyun Li, BM; Zhongchang Miao, BM; Shuguang Shi, MB; Chunling Xu, BM; Xue Zhang, MM; Ying Zhou, MB |
| Aim • This study aimed to compare the effectiveness of enhanced CT scanning and MRI as diagnostic tools for the detection of carcinoma of the liver.
Methods • The image diagnostic significance of the liver enhanced CT & MRI scans was examined after a retrospective examination of the imaging data of 51 individuals with liver cancer who were identified with postoperative pathology at the First People’s Hospital of Lianyungang between May 2020 to May 2022.
Results • The number of extrahepatic lesions as well as the rate of extrahepatic positive cases were not significantly different between liver contrast-enhanced CT and liver MRI (P > .05); however, the number of intrahepatic lesions and the rate of intrahepatic positive cases were considerably higher for liver MRI than for liver enhanced
CT (P < .05). When identifying tumors with a diameter greater than 3 cm, there was no discernible difference between the detection rates of liver enhanced CT and liver MRI (P > .05); however, in the diagnosis of tumors less than 3 cm in diameter, liver MRI had a greater detection rate than liver contrast-enhanced CT (P < .05). Overall, liver MRI had a higher detection rate than liver contrast-enhanced CT (P < .05). Furthermore, when compared to liver contrast-enhanced CT, liver MRI had greater accuracy, specificity, sensitivity, negative predictive value, and positive predictive value (P < .05).
Conclusion • When it comes to detecting liver cancer, liver MRI is more sensitive and specific than liver CT. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Correlation Between Depth of Dexmedetomidine Anesthesia and Cognitive Function in Patients Undergoing Laparoscopic Myomectomy under General Anesthesia |
| Mei Cheng, BM; Yinqiu Han, BM; Hongda Yi, BM |
| Purpose • To analyze the correlation between the depth of dexmedetomidine anesthesia and cognitive function in patients undergoing laparoscopic myomectomy under general anesthesia.
Methods • According to the inclusion and exclusion criteria, 180 patients who underwent laparoscopic myomectomy under general anesthesia using dexmedetomidine in the gynecology department of our hospital from February 2021 to February 2022 were retrospectively analyzed as study subjects. All patients were monitored by BIS intraoperatively, and the patients were divided into 3 groups according to BIS: group I (n=48), group II (n=105), and group III (n=27). The MMSE scores of patients in the three groups were measured 1 d before anesthesia, 1 d, 3 d, and 5 d after surgery, respectively, and the TMT completion times of patients in the three groups were measured 1 d before anesthesia and 1 d after surgery, and the mean postoperative anesthesia wakefulness time of patients in the three groups and the incidence of cognitive dysfunction in the three groups were recorded. Finally, the BIS of patients in the three groups was compared with the MMSE scores of patients at 5 d after surgery, the TMT completion time at 1 d after surgery, the anesthesia wakefulness time, and the rate of cognitive dysfunction was correlated.
Results • There was a significant difference in MMSE scores between the three groups at 1 d, 3 d, and 5 d postoperatively (P < .05); meanwhile, the MMSE scores were significantly higher in group I compared with groups II and III at 1 d, 3 d, and 5 d postoperatively (all P < .05). At 1 d postoperatively for the three groups TMT completion time compared with preoperative time, the difference between the groups was significant (P < .05); meanwhile, compared with 1 d postoperatively in groups II and III, TMT completion time was significantly lower in group I (P < .05). The rate of cognitive dysfunction and the mean postoperative anesthesia awake time of patients in group I were significantly reduced compared with groups II and III (P < .05). BIS was negatively correlated with the MMSE score at 5 d postoperatively, positively correlated with the TMT completion time at 1 d postoperatively, and positively correlated with the anesthesia awake time, and had no significant correlation with the rate of cognitive dysfunction in the three groups.
Conclusion • The postoperative cognitive function of patients is closely related to the depth of anesthesia and is negatively correlated with the depth of anaesthesia, i.e. the deeper the depth of anaesthesia, the more pronounced the impairment of the cognitive function of the patient, and the more difficult it is to recover. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Study on the Use of Omalizumab for IgE-Mediated Allergic Diseases |
| Yufei Dong, MM; Xiaochao Gao, MM; Shuang Ren, MM; Yan Wang, BM |
| Objective • This study aimed to explore the therapeutic effects of the combined use of omalizumab with conventional anti-allergy treatment for IgE-mediated allergic diseases and to provide new treatment options for the clinical management of IgE-mediated allergic diseases.
Methods • Patients with IgE-mediated allergic diseases who visited the Allergy Department of the First Hospital of Hebei Medical University between June 2020 and June 2022 were randomly divided into two groups: the conventional anti-allergy treatment group (control) and the experimental group receiving conventional treatment combined with omalizumab. The treatment lasted for 24 weeks, with
patient follow-up and evaluation of treatment effects for seasonal allergic rhinitis, allergic asthma, and urticaria.
Results • The evaluation of treatment effects for seasonal allergic rhinitis, urticaria, and allergic rhinitis showed that the experimental group had significantly better outcomes than the control group.
Conclusion • The combined use of omalizumab with conventional anti-allergy treatment was effective in treating IgE-mediated seasonal allergic rhinitis, urticaria, and allergic asthma, providing a new therapeutic option for the clinical management of IgE-mediated allergic diseases. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Accelerated Fibrosis Progression of Diabetic Nephropathy From High Uric Acid’s Activation of the ROS/NLRP3/SHP2 Pathway in Renal Tubular Epithelial Cells Under High Glucose Conditions |
| Ling Tian, BD; Qian Yu, BD; Jiwei Zhang, BD; Li Zhang, BD |
| Context • Elevated uric-acid levels in the blood are closely associated with hypertension, metabolic syndrome, diabetic nephropathy, cardiovascular diseases, and chronic kidney disease (CKD). A high-glucose diet promotes the accumulation of uric acid. Fibrosis commonly occurs in patients with late-stage type 1 or 2 diabetes and can lead to organ dysfunction
Objective • The study intended to investigate whether high uric acid under high glucose conditions can promote the fibrotic progression of diabetic nephropathy by activating the reactive oxygen species (ROS)/ “nod-like receptor (NLR) family pyrin domain containing 3” (NLRP3)/ “Src homology 2 (SH2) domain-containing protein tyrosine phosphatase-2” (SHP2) pathway, which can promote epithelial-mesenchymal transition (EMT) in renal tubular epithelial cells.
Design • The research team conducted an animal study.
Setting • The study took place at the Affiliated Hospital of Hebei University in Baoding, Hebei Province, China.
Animals • The animals were 14 healthy, male, C57BL/6J mice.
Outcome Measures • The research team: (1) using Masson’s trichrome staining, examined the fibrosis of renal, tubular epithelial cells in the streptozotocin (STZ) modeling and the STZ modeling + uric-acid groups; (2) used Western Blot analysis to detect the protein expression of NLRP3, “nicotinamide-adenine dinucleotide phosphate (NADPH) oxidase 2” (NOX2), NOX4, alpha-smooth muscle actin (a-SMA), fibronectin 1 (FN-1), collagen-I, and mothers against decapentaplegic homolog 2/3 (SMAD2/3); (3) conducted in-vitro experiments by dividing transformed C3H mouse kidney-1 (TCMK-1) cells into different groups: STZ modeling group, STZ modeling + high-glucose group, STZ modeling + high-glucose + advanced glycation end (AGE) product group, STZ modeling+ high-glucose + AGE + uric-acid group, STZ modeling+ high glucose + SHP2 small interfering RNA (SiRNA) group, STZ modeling + high glucose + SHP2 SiRNA + AGE group, and STZ modeling+ high-glucose + SHP2 SiRNA + AGE + uric-acid group for Western Blot experiments; and (4)
performed immunofluorescence, CCK-8, and transwell experiments on the seven groups of TCMK-1 cells with different treatments.
Results • The STZ modeling + uric acid group’s levels of fibrosis was significantly higher than that of the STZ modeling group (P < .01). Additionally, the STZ modeling + uric acid groups’ expression of a-SMA, FN-1, collagen-I, P-SMAD2, P-SMAD3, NLRP3, and reactive oxygen species (ROS), EMT, and SMAD-related proteins were significantly higher than those of the STZ modeling group (P < .01). The protein expression of SHP2, P-SMAD2, a-SMA, and FN-1 for the STZ modeling + high glucose + SHP2 SiRNA, the STZ modeling + high glucose + SHP2 SiRNA + AGE, and the STZ modeling + high glucose + SHP2 SiRNA + AGE + uric acid groups were significantly lower than those of the STZ modeling + high glucose, STZ modeling + high glucose + AGE, and the STZ modeling + high glucose + AGE + uric acid groups, respectively.
Immunofluorescence indicated that the STZ modeling+ high glucose + AGE + uric acid group had the highest relative fluorescence intensity, while the three groups treated with SHP2 SiRNA showed the least expression. The cell counting kit-8 (CCK-8) assay showed that STZ modeling group had less cell proliferation, STZ modeling + high sugar group had less cell proliferation than STZ modeling + high sugar +AGE group, STZ modeling + high sugar +AGE+ uric acid group had the highest cell proliferation, STZ modeling + high sugar +SHP2 SiRNA group and STZ modeling + high sugar +SHP2 SiRNA+AGE group and STZ modeling + high sugar +SHP2 SiRNA+AGE+ uric acid group showed the least number of cell proliferation. The results of the transwell cell migration assay were consistent with the CCK-8 assay.
Conclusions • In a high-glucose environment, high uric acid can promote the fibrotic progression of diabetic nephropathy by activating the ROS/NLRP3/SHP2 pathway, leading to mesenchymal transition between renal tubular epithelial cells. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analyze the Influence of Cement Infusion for Bones in Different Mix States on PKP Surgery for Osteoporotic Vertebral Fractures |
| Wei Li, BD; Su Liu, BD; Pengpeng Ma, MD; Chunling Zhang, BD; Xin Zhang, MD; Maili Zhang, BD; Lichun Zhao, BD; Zhiguo Zong, MD |
| Aim • To determine how bone cement is infused into the vertebral body at different periods during kyphoplasty and its effect on vertebral strength, stiffness, and height.
Method • In this study, 40 L1-5 vertebrae were obtained from eight healthy adult sheep randomly divided into reference, thin, sticky, and coagulation groups based on the digital expression from 1 November 2022 to 31 December 2022. Each group had 10 vertebrae. The vertebral bodies of each group were immersed in hydrochloric acid and infused with a bilateral pedicle micro-pump to construct the osteoporotic vertebral body model. On this basis, the vertebral body model of compression fracture was established by using a biomechanical machine to compress the vertebral body height, and a bone cement perfusion channel was made. The bone cement infusion scheme was implemented after the reduction of the fractured vertebra. Following mixing of the bone cement, the thin, sticky, and coagulation groups, respectively, received bone cement at 2 minutes, 4 minutes, and 6 minutes after mixing. 24 hours before and after the procedure, each vertebra’s strength, stiffness, and leading-edge height were measured, and a comparative analysis was performed.
Result • (1) Bone mineral density after decalcification was significantly lower than that before and there was a
statistical difference (P < .001). (2) Compared with pre-operation, the vertebral strength and stiffness of the reference group decreased significantly after surgery, while the strength and stiffness of the thin group, the sticky group, and the coagulation group changed significantly. The vertebral strength and stiffness of the thin group (P < .001) and the sticky group (P < .001) were higher than those of the coagulation group and higher than those of the reference group. (3) Compared with the original height of the anterior edge of the vertebral body, the height of the anterior edge of each group decreased significantly after fracture and surgery, and the height of the anterior edge of each group was higher than that after fracture. Compared with the reference group, the height of the anterior edge of the thin group, the sticky group, and the coagulation group decreased significantly (P < .001).
Conclusion • Percutaneous kyphoplasty application to L1-5 vertebrae of OVCF sheep infused with bone cement in different states enhanced vertebral body strength, but not vertebral body stiffness. There was a significant increase in vertebral body stiffness and strength after the infusion of thin and thick bone cement for 2 minutes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Application Effect of Three-dimensional Reconstruction Technology in Locating Small Pulmonary Nodules During VATS Surgery |
| Chenguang Ma, MM; Mingyue Qu, MD; Zigeng Xu, MM; Yiling Zhang, MM; Jialai Zhao, MM |
| Objective • To compare the positioning effect of three-dimensional reconstruction technology and Hook-wire puncture operation on small pulmonary nodules during video-assisted thoracoscopic surgery (VATS), and evaluate its effectiveness, efficiency, and safety.
Methods • The subjects of this study were 50 patients with small pulmonary nodules admitted to the Department of Cardiothoracic Surgery of Heilongjiang Provincial Hospital from January 2020 to December 2022, and all underwent thoracoscopic surgical resection. All study subjects met the inclusion criteria, grouping according to the intraoperative positioning method, the control group (n = 25) used Hook-wire puncture positioning, and the observation group (n = 25) used three-dimensional reconstruction technology. The positioning effect, pain level, and postoperative complications were compared between the two groups.
Results • The incidence rate of complications after puncture was 16.00% in the control group and 4.00% in the observation group, the complication rate in the
observation group was significantly lower; the positioning success rate of the observation group was 96.00%, which was higher than that of the control group (92.00%). The operation time (32.25±6.08) min was lower than (38.50±7.12) min in the control group. The two groups had no statistical significance in the wedge resection success rate, VAS score, and complication rate (P > .05).
Conclusion • Three-dimensional reconstruction technology mainly makes preliminary judgments on the location, shape, size, and relationship between nodules and surrounding tissues based on preoperative CT scan images. It can select suitable scanning locations, map puncture paths, and anchor them in and around small lung nodules. The operation is simple, and the positioning success rate is high. The existence of three-dimensional reconstruction technology to position the guide wire can quickly shorten the time to detect lesions, shorten the time of VATS, reduce the occurrence of pulmonary infection in patients, and improve the prognosis. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of the Efficacy of Psychological Intervention in 85 patients with New Coronavirus Pneumonia |
| Yang An, MM; Feifei Leng, MD; Chenguang Ma, MM; Mingyue Qu, MD; Zigeng Xu, MD; Yiling Zhang, MD; Jialai Zhao, MM |
| Objective • To investigate the effectiveness of strengthen psychological intervention in 85 clients who had pneumonia caused by a novel coronavirus.
Methods • As the study’s subjects, 162 new coronavirus pneumonia clients admitted to our hospital between January 2020 and September 2020 had their clinical records retrospectively examined. According to different nursing methods, 162 patients with new coronavirus pneumonia were separated into a control team (n=77) and an experimental team (n=85). The test group received the intense psychological intervention, whereas the controlling team only received standard nursing care. The two groups’ treatment compliance and nursing satisfaction were observed, the self-rating symptom scale (SCL-90) scores and coping style (MCMQ) grades of the two teams prior to and after the interference was contrasted, and the nursing quality of the two teams was contrasted.
Results • In terms of compliance, the overall treatment compliance rate of patients in the experimental group increased significantly. In terms of the psychological state of the experimental group, significant improvements were observed in all psychological dimensions of the patients in the experimental group, including a reduction in negative emotions and an increase in nursing satisfaction. In terms of self-coping, patients in the experimental group showed significant improvement in various dimensions. And the quality of nursing care in the experimental group has been significantly improved.
Conclusion • This study highlights the importance of intensive psychological intervention in the overall care of COVID-19 patients and its role in improving patient treatment compliance, negative emotions, self-coping styles and patient health. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Meta-Analysis on the Recovery Effect of Acupuncture Combined With Rehabilitation Therapy in Spinal Cord Injury Patients |
| Xiaofeng Ji, MM; Zhenxing Li, MD; Bolin Li, MM; Han Su, MM; Xiangyu Yang, MD; Binbin Zhou, MM |
| bjective • To explore the recovery effect of acupuncture combined with rehabilitation therapy on muscle spasms in patients with spinal cord injury through a systematic review of meta-analysis methods.
Methods • Use “acupuncture,” “electronic-acupuncture,” “spinal cord,” “spasm,” and “paraplegia” as keywords, CNKI, Google, Wanfang, VIP, sci-hub, Web of Science, PubMed, and other Chinese or English databases were searched. To collect the domestic and foreign research on acupuncture combined with rehabilitation for muscle spasms in patients with spinal cord injury. Preliminary screening was conducted, and data extraction and quality evaluation were carried out on the included literature, including publication time, sample size, treatment methods, recovery effects, etc. According to the literature, the influence of acupuncture combined with rehabilitation therapy on muscle spasms in patients with spinal cord injury and related indices was analyzed. The search period was from January 2018 to June 2023, and the selected research results were tested by RevMan5.3 software and data consolidation for consistency. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).
Results • A preliminary literature search yielded 172 papers. 53 papers from sci-hub, 71 papers from HowNet, 36 papers from Wanfang, and 12 papers from VIP. Finally, 10 articles that met the criteria were included, including 594 patients.
According to different treatment methods, the literature about acupuncture combined with rehabilitation therapy for muscle spasms in patients with spinal cord injury was analyzed for consistency, and data were merged. It was concluded that acupuncture combined with rehabilitation The clinical curative effect of the experimental group of patients is higher than that of the control group MD=5.31, 95%CI (2.94, 7.81), Z=5.64, P < .001; the clinical effective rate of the experimental group is higher than that of the control group. The improvement of the clinical spasticity index (CSI) score index of the patients in the experimental group was better than that of the control group MD = -3.09, 95%CI (-4.51, -1.67), Z =4.28, P < .001; the MAS score of the patients in the experimental group The improvement was better than that of the control group MD =-0.76, 95%CI (-1.16, -0.38), Z=8.13, P < .001; the improvement of Barthel index (BI) in the experimental group was better than that of the control group MD=9.81, 95%CI (7.84,11.71), Z=12.71, P < .001; no adverse events were reported in the experimental group and the control group.
Conclusion • This study shows that acupuncture and rehabilitation are more effective than other therapeutic methods in the treatment of muscle spasms after spinal cord injury, and more randomized controlled trials are needed to verify this in the future. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Electroacupuncture and Growth Hormone for Quadriceps Atrophy Management Post-Anterior Cruciate Ligament Reconstruction: A Prospective Study |
| Jian Lu, BM; Wei Niu, MM; Daxing Xu, MM; Weilong Xu, MM; Zheng Yan, MM; Tian Zhang, MM; Shengpeng Zheng, MM |
| Objective • This study aimed to investigate the efficacy of electroacupuncture (EA) combined with growth hormone in alleviating quadriceps atrophy and enhancing knee function following anterior cruciate ligament reconstruction.
Methods • A prospective study was conducted, and a total of 90 patients exhibiting quadriceps atrophy after anterior cruciate ligament reconstruction were recruited between July 2020 and July 2022 from Shenzhen Pingle Orthopedic Hospital. They were randomly assigned to either the control group or the observation group , with 45 patients in each. The control group received routine rehabilitation training along with growth hormone treatment, while the observation group received routine rehabilitation training in addition to EA and growth hormone treatment. The study assessed the visual analogue score (VAS) for postoperative pain, knee function, and clinical outcomes in both groups.
Results • The total effective rate in the observation group was significantly higher compared to the control group,
with a statistically significant difference (P < .05). Initially, there were no significant differences between the two groups in peri-thigh atrophy index, VAS score, Lysholm score, knee swelling, knee stability, and range of motion (ROM) score (P > .05). However, after 3 and 6 months of treatment, significant reductions were observed in peri-thigh atrophy index, VAS score, knee swelling, and ROM score in the observation group compared to the control group (P < .05). Moreover, Lysholm score and knee stability significantly increased in the observation group (P < .05), with changes significantly higher than those in the control group (P < .05).
Conclusions • EA combined with growth hormone treatment significantly reduces quadriceps atrophy and knee joint function in patients undergoing anterior cruciate ligament reconstruction. This combination therapy holds promise for enhancing rehabilitation outcomes in this patient population. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparison of Clinical Outcomes and Postpartum Psychological Status Scores in Primiparous Women Delivered with Family Members in a Family-Based Room vs Women Delivered in a General Ward |
| Jing Zhang, MD |
| Background • This study investigated the impact of the use of a family-based delivery room on primiparous women’s clinical outcomes and psychological well-being during childbirth. It addressed the growing interest in family-centered care and assessed the effectiveness of a family-based room in providing a supportive environment for delivery.
Objectives • We aimed to compare the clinical outcomes and postpartum scores regarding the psychological status of primiparous women who delivered with their families in a home-based labor ward and women who delivered in a general labor ward.
Methods • In this retrospective study, 158 primiparous women, recruited between October 2021 and July 2022, were categorized into 2 groups based on their choice of delivery room: a family group (n=77) and a general group (n=81). Baseline data, indicators related to maternal role adjustment, pregnancy outcomes, psychological status, self-efficacy and quality of life (QoL) data were collected and compared between the 2 groups.
Results • More women in the family group were well- and generally adapted than in the general group, and fewer were poorly adapted than in the general group (P < .05). There were more spontaneous deliveries in the family group than in the general group, and fewer cesarean deliveries, postpartum hemorrhages and cases of neonatal asphyxia than in the general group; lower postpartum
Numerical Rating Scale (NRS) scores and higher Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores than in the general group, with notably better pregnancy outcomes in the family group (P < .05). Postpartum State Anxiety Inventory (S-AI) and Edinburgh Postnatal Depression Scale (EPDS) scores in the family group (50.25±1.58 and 8.02±0.35, respectively) were remarkably lower than in the general group (59.89±1.98 and 9.84±0.69, respectively) (P < .05). The family group exhibited a postpartum score of self-efficacy higher compared with the general group (P < .05). The QoL score in the family group was noticeably higher than in the general group (P < .05). The time of colostrum secretion in the family group was significantly earlier compared with the control group, and milk production within 48 hours postpartum was significantly higher in the family group (P < .05).
Conclusion • The family-based delivery room model significantly enhanced maternal role adaptation, increased the rate of spontaneous delivery, reduced the risk for cesarean conversion and diminished adverse maternal and infant outcomes. In addition, it substantially improved postpartum psychological status and positively influenced maternal self-efficacy and QoL. These findings hold significant reference value for maternal care practices. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Construction and Application of Autonomy Theory of Rehabilitation Program for Bronchiectasis Patients |
| Yan He, BM; Jinling Li, BM; Yanjun Mao, MD; Siwen Min, BM; Suxia Shi, MM; Xiaoyan Xu, BM |
| Objective • The autonomy theory holds that the autonomy of individuals in the rehabilitation process is crucial to the success of rehabilitation. To explore the use of autonomous rehabilitation programs in patients with bronchiectasis, This study was conducted through the construction of a stable family rehabilitation program for bronchiectasis patients and the application of patients self-determination theory. To further explore the value of autonomy theory in rehabilitation therapy.
Method • The experimental group used self-determination theory as the guide for intervention on the basis of the control groups. The two groups of observation indexes included St. George’s Respiratory Questionnaire, FEV1 and FEV1 values, lung capacity, V25, V50, maximal ventilation, compliance questionnaire, anxiety self-assessment scale, and depression self-assessment scale.
Results • (1) The lung capacity of the experimental group patients (3.01 ± 0.82) L was higher than that of the control group (2.86 ± 0.36) L, and the V25 value (2.63 ± 0.31) L/s, V50 value (4.31 ± 1.01) L/s, and maximum ventilation volume (71.63 ± 18.35) L/min were all higher than those of the control group, with P < .05; (2) After intervention, the SGRO score of patients in the experimental group (38.66 ± 8.67)score was lower than that of the control group (56.48 ± 9.86)score. The FEV1 score of patients in the experimental group (9.35 ± 2.36)L was higher than that of the control group (1.04 ± 0.29)L. After intervention, the FEV1 score of patients in the experimental group was% (56.83 ± 9.21)%
higher than that of the control group (46.37 ± 7.67)%, with P < .05; (3) Comparison of compliance scores between two groups of patients before and after intervention: the experimental group had scores for timed medication (4.89 ± 0.64)score, moderate exercise (4.61 ± 1.04)score, and dietary regulation (4.72 ± 0.87)score after intervention, all of which were higher than those of the control group (P < .05); (4) The comparison of anxiety and depression between two groups of patients showed that the anxiety score (10.16 ± 3.03)score of the experimental group after intervention was lower than that of the control group (13.03 ± 3.67)score, and the depression score (9.35 ± 2.36)score of the experimental group after intervention was lower than that of the control group (12.34 ± 3.01)score, with P < .05.
Conclusion • Using the theory of autonomy to construct and apply the rehabilitation program in the home stabilization stage of bronchiectasis patients can improve respiratory and lung function. At the same time, it has a certain degree of promoting effect on improving patients’ treatment compliance, and can improve patients’ emotional state and reduce the occurrence of anxiety and depression. The results of this study will provide a certain theoretical basis for the construction of the treatment and rehabilitation program of clinically related diseases. In the future clinical treatment, personalized treatment intervention can be carried out according to the autonomy of patients to improve the clinical prognosis. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| SLAMF8 Promotes Atherosclerosis by Activating the TLR4 Signaling Pathway in Rheumatoid Arthritis |
| Ziyu Lin, BM; Zhihong Ou, MM; Guiling Sun, MM; Yuqiang Wang, PhD; Yanjin Wei, MM |
| Objectives • Rheumatoid Arthritis (RA) can accelerate atherosclerosis (AS) plaque formation. High prevalence of AS has been demonstrated in early-stage RA patients. Therefore, there is an urgent need to investigate what mechanisms and key molecules accelerate AS in RA to improve the management of RA.
Methods • We retrieved gene expression data for RA (GSE45291) and atherosclerosis (GSE28829) from Gene Expression Omnibus (GEO). Seventeen key genes were identified, and the top one candidate hub gene was SLAM family member 8 (SLAMF8). To investigate the role of SLAMF8 in AS and RA, U937 cells were differentiated into macrophages using Phorbol 12-myristate 13-acetate (PMA) and further transformed into foam cells by oxidized low-density lipoprotein (ox-LDL) treatment and siRNA was manipulated to knock down SLAMF8. Flow Cytometry was employed to assess cell state. The mRNA
and protein expressions of the genes were investigated using western blot and RT-qPCR.
Results • SLAMF8 was screened as a key gene by bioinformatic methods. Compared to Mf, SLAMF8, TLR4 and inflammatory cytokines, tumor necrosis factor a (TNF-a), and Interleukin 6 (IL-6) were noticeably expressed in foam cells. Knockdown of SLAMF8 could remarkably curtail TLR4, TNF-a, and IL-6 protein levels. Antagonizing SLAMF8 could attenuate inflammatory factors and apoptosis of foam cells by inhibiting the TLR4 pathway, thus mitigating the severity of AS in RA.
Conclusions • Our work demonstrated that SLAMF8 promoted AS in patients with RA by inducing inflammation and apoptosis of foam cells via TLR4 signaling. Therefore, SLAMF8 could be a possible therapeutic spot for AS in RA patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of Detrusor Muscle Activity on Short-term Prognosis Following 1470 nm Semiconductor Laser Surgery in Elderly Patients with Benign Prostatic Hyperplasia |
| Houbao Huang, MD; Yajun Shen, MM; Yunwu Wang, BM; Rong Wang, MD; Shuxian Zhang, BM; Xiaoyi Zhang, BM |
| Objective • To investigate the influence of preoperative detrusor muscle activity on the short-term prognosis of elderly patients diagnosed with benign prostatic hyperplasia (BPH) undergoing 1470 nm semiconductor laser surgery.
Methods • A retrospective study was conducted on clinical data from 165 elderly BPH patients who underwent 1470 nm semiconductor laser surgery between May 2019 and April 2023. Patients were stratified based on preoperative urodynamic study findings, specifically their bladder contractility index (BCI). Patients with a BCI =100 constituted the detrusor underactivity (DU) group (n=64), while those with a BCI >100 formed the non-DU group (n=101). Surgical parameters, including duration, intraoperative blood loss, postoperative hospital stay, bladder irrigation, and catheterization duration, were compared. Additionally, changes in International Prostate Symptom Score (IPSS), Quality of Life (QOL) score, residual urine volume, and peak urinary flow rate (Qmax) were assessed before and three months after surgery in both groups.
Results • There were no statistically significant differences observed between the DU and non-DU groups concerning surgical duration, intraoperative blood loss, postoperative hospitalization duration, bladder irrigation duration, and postoperative catheterization duration (P > .05). Similarly, no significant disparities were noted in the IPSS and QOL scores preoperatively and at the three-month follow-up in both groups (P > .05). Both cohorts exhibited no significant differences in residual urine volume before surgery and at the three-month mark postoperatively (P > .05). However, the postoperative Qmax was significantly reduced in the DU group compared to the non-DU group (P < .05).
Conclusions • Detrusor muscle activity does not exert a significant impact on clinical symptom improvement and quality of life in elderly BPH patients treated with 1470 nm semiconductor laser surgery. However, patients with DU exhibited inferior postoperative recovery in Qmax, underscoring the importance of preoperative urodynamic studies for early intervention and enhanced surgical outcomes in this patient population. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Impacts of Fast-track Surgery on Postoperative Deep Venous Thrombosis Among Patients with Lower Limb Fracture |
| Xiaoqin Huang, BS; Xiaogang Luo, BS; Jiaping Shi, BS; Luqi Xia, MD |
| Purpose • This research was conducted to construct an ankle pump motion counter and system with orthopedic characteristics and analyze the impacts of fast-track surgery on postoperative deep venous thrombosis (DVT) among patients with lower limb fractures.
Methods • First, an ankle pump motion counter system was set up to detect postoperative rehabilitation training (Hardware design: This involves components such as an accelerometer sensor, microcontroller, circuit design, power supply, and wireless module. The accelerometer sensor is used to monitor key points and capture motion signals, while the microcontroller handles frequency calculations and generates alerts for abnormal ankle pump motion parameters. Circuit design ensures the proper functioning of the device, and the power supply meets the requirements of the ankle pump motion counter. The wireless module is used for data transmission and communication with other devices. Software design: This includes software design for both the patient and doctor sides. The software design involves defining software requirements and module divisions, designing data acquisition and filtering programs, developing programs for data parameter reading and writing, implementing communication protocols, designing data communication programs, and creating rehabilitation training plans and training record programs). Then, a retrospective analysis was carried out for the subjects (100 patients with lower limb fractures treated in Zhejiang Hospital between June 2021 and June 2022. They were randomly enrolled into control and experimental
groups (50 cases each). The ankle pump motion counter was utilized for the patients in the experimental group. Before surgery, gender, age, the incidence of venous thromboembolism (VTE), and the muscle strength of both lower limbs of the two groups were recorded. After surgery, numerical rating scale (NRS) pain scores, D-dimer (D-D), and average length of hospitalization 3 d after surgery and venous thrombosis of both lower limbs 5 d after surgery of two groups were compared.
Results • D-D of the control group was significantly higher than that of the experimental group 3 days after surgery (P < .05), while the NRS pain score was relatively lower (P < .05). The average hospitalization length for the experimental group was 10.2 days versus 16.2 days for the control group. The incidence of VTE 5 days after the surgery was 2% for the experimental group compared to 6% for the control group (P < .05).
Conclusion • The ankle pump motion counter system has the potential to improve VTE prevention, enhance patient compliance, streamline healthcare delivery, standardize care, and enable data-driven decision-making at a wider clinical level. By accurately monitoring ankle pump exercises and providing real-time feedback, this system can contribute to better patient outcomes, save time for healthcare providers, and facilitate evidence-based practices in the prevention of postoperative DVT among patients with lower limb fractures. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Clinical Significance of Real-Time 3-D Transperineal Ultrasound in the Treatment of Postpartum Pelvic Floor Dysfunction Using a Combined Magnetic and Electrical Repair Approach |
| Congrong Deng, MM; Lihong Ge, MBBS; Hongbo Jiang, MBBS; Zhihong Ren, MBBS |
| Objective • This study aims to evaluate the clinical significance of using real-time three-dimensional transperineal ultrasound in conjunction with a combined magnetic and electrical repair approach for the treatment of postpartum pelvic floor dysfunction.
Methods • Ninety patients with postpartum pelvic floor dysfunction were included and randomly assigned to the control or the observation group. The control group received Kegel pelvic floor rehabilitation training, while the observation group underwent real-time three-dimensional transperineal ultrasound examination, along with the training. Following assessment tools were used: Modified Oxford Scale (MOS) assessed pelvic floor muscle (PFM) strength and function; Pelvic Floor Distress Inventory (PFDI-20) questionnaire assessed the distress and discomfort reported by patients concerning symptoms of genital prolapse, anal colorectal symptoms, and urinary symptoms; Pelvic Floor Impact Questionnaire (PFIQ-7) measured the impact of urinary, colorectal-anal, and genital prolapse symptoms on patients’ activities, relationships, and feeling; and International Consultation on Incontinence Questionnaire (ICIQ) was utilized to assess urinary incontinence (UI) symptoms and their impact on an individual’s quality of life (QoL). It was developed by an international committee of experts in the field of incontinence
research and is available in multiple languages. ICIQ-UI Short Form focuses on the symptoms of urinary incontinence. It assesses the type, frequency, and amount of urine leakage, as well as the impact of UI on daily activities, such as work, social interactions, and emotional well-being. It also includes questions about the use of protective pads or aids.
Results • The results showed significant improvements in pelvic floor muscle strength, symptom distress, and impact on activities, relationships, and feelings in the observation group compared to the control group. The MOS scores significantly increased in the observation group (P < .001), indicating improved PFM strength. The PFDI-20 scores significantly decreased in the observation group (P < .001), indicating reduced distress related to pelvic floor dysfunction symptoms. The PFIQ-7 scores also showed significant improvements in the observation group, indicating reduced impact on activities, relationships, and feelings. The ICIQ scores significantly decreased in the observation group, indicating reduced severity of UI symptoms and improved QoL.
Conclusion • The findings of the study suggest that this innovative therapeutic strategy can be a potentially effective therapeutic option for postpartum pelvic floor dysfunction and has prospects for clinical implementation. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of PRR11 Expression on Prognosis in Pancreatic Cancer Patients with Diabetes |
| Yingjie Jia, MD; XiaoDong Mao, MD; Ying Wang, MD; Xiaoyu Yu, MD; Yangming Zhuang, MD |
| Objective • This study aimed to analyze the impact of PRR11 protein expression levels on the prognosis of patients with diabetes mellitus and pancreatic cancer.
Methods • Immunohistochemical staining was performed to detect the expression levels of PRR11 protein in cancerous tissues of 70 pancreatic cancer patients, including 45 patients with diabetes mellitus (Group A) and 25 patients without diabetes mellitus (Group B). Patients’ blood glucose, lipid profiles, and glycemic control status were compared between the groups. Survival curves were plotted to explore the impact of PRR11 protein expression levels on the prognosis of patients with diabetes mellitus and pancreatic cancer.
Results • The positive rate of PRR11 protein expression in Group A patients (86.67%) was significantly higher than in Group B patients (52.00%), P < .05. Group A patients exhibited significantly higher levels of fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), and glycated hemoglobin (HbAlc) compared to Group B patients (P < .05). Interestingly, the expression levels of
PRR11 in cancerous tissues were positively correlated with FBG, TC, TG, and HbAlc levels (P < .05). The positive rate of PRR11 protein expression in patients with poor glycemic control (93.75%) was significantly higher than in patients with good glycemic control (53.85%), P < .05. Notably, the survival rate of PRR11 protein-positive patients was significantly lower than that of negative patients (P < .05).
Conclusion • The finding highlights that the positive expression of PRR11 protein in patients with diabetes mellitus and pancreatic cancer is associated with a poor prognosis. It suggests that PRR11 may play a role in the occurrence and development of pancreatic cancer and could serve as a potential predictive marker and therapeutic target. However, further research is warranted to explore the functional mechanisms and pathways of PRR11 to better understand its role in pancreatic cancer, and develop personalized therapies. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of PRR11 Expression on Prognosis in Pancreatic Cancer Patients with Diabetes |
| Yingjie Jia, MD; XiaoDong Mao, MD; Ying Wang, MD; Xiaoyu Yu, MD; Yangming Zhuang, MD |
| Objective • This study aimed to analyze the impact of PRR11 protein expression levels on the prognosis of patients with diabetes mellitus and pancreatic cancer.
Methods • Immunohistochemical staining was performed to detect the expression levels of PRR11 protein in cancerous tissues of 70 pancreatic cancer patients, including 45 patients with diabetes mellitus (Group A) and 25 patients without diabetes mellitus (Group B). Patients’ blood glucose, lipid profiles, and glycemic control status were compared between the groups. Survival curves were plotted to explore the impact of PRR11 protein expression levels on the prognosis of patients with diabetes mellitus and pancreatic cancer.
Results • The positive rate of PRR11 protein expression in Group A patients (86.67%) was significantly higher than in Group B patients (52.00%), P < .05. Group A patients exhibited significantly higher levels of fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), and glycated hemoglobin (HbAlc) compared to Group B patients (P < .05). Interestingly, the expression levels of
PRR11 in cancerous tissues were positively correlated with FBG, TC, TG, and HbAlc levels (P < .05). The positive rate of PRR11 protein expression in patients with poor glycemic control (93.75%) was significantly higher than in patients with good glycemic control (53.85%), P < .05. Notably, the survival rate of PRR11 protein-positive patients was significantly lower than that of negative patients (P < .05).
Conclusion • The finding highlights that the positive expression of PRR11 protein in patients with diabetes mellitus and pancreatic cancer is associated with a poor prognosis. It suggests that PRR11 may play a role in the occurrence and development of pancreatic cancer and could serve as a potential predictive marker and therapeutic target. However, further research is warranted to explore the functional mechanisms and pathways of PRR11 to better understand its role in pancreatic cancer, and develop personalized therapies. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Assessing the Impact of an Internet Plus-Oriented 5A Home Care Model on Complications in Patients Undergoing Tumor Immunotherapy during the Post-Epidemic Era |
| Yanli Chang, BS; Yanfei Huang, BS; Yan Luo, BS; Kefan Qian, BS; Yan Yang, BS |
| Objective • This study aims to investigate the efficacy of an Internet Plus-oriented 5A home care model in managing complications arising from tumor immunotherapy among patients in the post-epidemic era. Specifically, the study focuses on skin toxicity and gastrointestinal toxicity in patients undergoing tumor immunotherapy.
Methods • Between January 2022 and March 2023, 80 patients experiencing skin and gastrointestinal toxicities post-tumor immunotherapy in Zhangjiagang Traditional Chinese Medicine Hospital were selected. The patients were divided into two groups: a control group and an experimental group, each comprising 40 patients. The control group received traditional routine nursing and a telephone follow-up strategy. In contrast, the experimental group was introduced to a 5A home care model guided by Internet Plus, involving five key stages of implementation. Nurses utilized the Internet Plus platform to provide timely responses to patient queries and concerns. After the intervention, skin and gastrointestinal toxicity grades were assessed on days 0, 7, 14, and 21. Additionally, the completion rates of immunotherapy follow-up were compared between the two groups.
Results • At day 0, there was no statistically significant
difference in skin and gastrointestinal toxicity grades between the two groups (P > .05). However, on days 7, 14, and 21, both groups showed improvements compared to day 0, with the experimental group exhibiting significantly better outcomes and lower toxicity grades than the control group (RR: 0.667, 95% CI (-1.204, 0.394)). The completion rate of immunotherapy in the experimental group (97.5%) was significantly higher than that in the control group (77.5%), with a notable statistical difference (RR:1.258, 95%CI (-0.258, 0.722), P = .004). In the control group, 4 patients refused treatment, and 4 voluntarily terminated treatment, whereas only 1 patient in the experimental group voluntarily terminated treatment.
Conclusion • In conclusion, the Internet Plus-oriented 5A home care model enhances patient outcomes, demonstrating improved skin and gastrointestinal toxicities and a higher completion rate of immunotherapy compared to traditional nursing approaches. This model offers a more convenient and personalized health management approach, providing valuable insights for the clinical practice and future advancement of tumor immunotherapy. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Meta-analysis of Clinical Efficacy of Aspirin and Low Molecular Weight Heparin in the Treatment of Recurrent Spontaneous Abortion |
| Xuanping Lu, MM; Caiping Mao, MD; Weiqin Zhou, MM |
| Objective • To investigate the clinical effect of aspirin (ASA) combined with low molecular weight heparin (LMWH) in the treatment of recurrent spontaneous abortion (RSA).
Methods • PubMed, Cochrane, Wanfang, CNKI, and other databases were searched to collect randomized controlled trials (RCT) of aspirin combined with LMWH in the treatment of RSA from the establishment of the database to July 31, 2023. The literature was screened, and the information was extracted according to the pre-established criteria. The Reviews Manager 5.4 software was used for data analysis.
Results • A total of 10 RCTs containing 1865 patients with RSA were included in this study. Meta-analysis showed that the regimen of aspirin combined with LMWH
treatment significantly increased the neonatal birth rate (P < .01); and the occurrence of preeclampsia was significantly reduced when compared with regimens such as aspirin alone (P = .02); there were no significant differences between the two groups in the incidence of preterm birth (P = .21), neonatal birth weight (P = .38), the incidence of a small amount of patient hemorrhage (P = .41) and fetal growth restriction (P = .93).
Conclusion • The combination of aspirin and LMWH offers a clinically significant improvement in live birth rates and reduction in preeclampsia for RSA patients, suggesting a beneficial strategy for clinical practice and future research directions. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Implementing Accelerated Rehabilitation Nursing to Facilitate Intestinal Function Recovery Following Cytoreductive Surgery for Gynecological Ovarian Cancer |
| Tao Jiang, MM; Qingwen Shen, MM |
| Background • Cytoreductive surgery for gynecological ovarian cancer involves the removal of tumor masses and affected tissue, aiming to achieve optimal debulking. Accelerated recovery nursing, a comprehensive care model, focuses on expediting post-surgical recovery and enhancing patient satisfaction. It has emerged as a vital approach to optimize post-surgical outcomes and patient satisfaction.
Objective • This study evaluates the impact of accelerated recovery care on surgical patients to enhance recovery outcomes and patient satisfaction post-surgery.
Methods • The study utilized an observational and control group design and selected 72 patients undergoing ovarian tumor cytoreductive surgery at The First Affiliated Hospital of Nanjing Medical University between October 1st, 2019, and May 31st, 2020. These patients were divided into two groups: an observation group and a control group, each comprising 36 patients, with one group receiving standard care and the other accelerated recovery care. Nursing staff provided comprehensive pre-and post-operative care, monitoring patients’ vital signs using
Mindray iPM10 monitors. Postoperative rehabilitation training and dietary guidance were administered. Complication rates, recovery indicators, and patient satisfaction were compared between the groups.
Results • The observation group exhibited a significantly lower complication rate (2.78%) compared to the control group (11.11%) (P < .05). Patients in the observation group demonstrated faster recovery indicators, including time to first flatulence, first defecation, and first mobilization from bed (P < .05). Additionally, abdominal distension and pain scores were lower in the observation group, with 100% patient satisfaction.
Conclusions • Implementation of accelerated recovery nursing significantly reduces surgical patient complication rates, facilitates recovery, and enhances patient satisfaction. Nursing attention and guidance throughout the surgical process are crucial for optimal patient outcomes. This study emphasizes the importance of thorough care protocols in improving surgical recovery. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Clinical Nursing Pathway Plus Low-flow Oxygen Breathing Effects on Blood Glucose and Urine Ketones in Diabetic Ketoacidosis Patients |
| Juan Ge, BS; Caiyun Li, BS; Hongshou Wang, BD; Wanqin Zhu, BS |
| Objective • To assess the effects of the clinical nursing pathway (CNP) on blood glucose and urine ketones in patients with diabetic ketoacidosis (DKA).
Methods • A total of 60 patients with DKA (20 type I and 40 type II) treated in the Department of Endocrinology at Anhui Second People’s Hospital from January 2018 to May 2022 were recruited and randomly assigned to receive routine nursing (control group) or CNP plus routine nursing (observation group), with 30 patients in each group. The observation group received the clinical nursing pathway (CNP) along with routine nursing care. As part of the CNP, low-flow oxygen therapy was administered to the patients. Low-flow oxygen therapy involves the delivery of oxygen at a lower flow rate compared to high-flow oxygen therapy. In this study, a flow rate of 2 L/min was used. The
low-flow oxygen was administered to the patients through a nasal cannula or a similar device. Outcome measures included symptom relief and length of hospital stay.
Results • The observation group showed a significantly higher decline rate of blood glucose in patients than in the control group. Patients in the observation group had a more rapid disappearance of urine ketones versus those in the control group. CNP plus routine nursing resulted in a significantly shorter length of hospital stay versus routine nursing (RR:0.79, 95% CI (1.078, 4.511), P < .05).
Conclusion • CNP plus continuous low-flow oxygen breathing facilitates the decline of blood glucose, removes ketone bodies, mitigates DKA symptoms, and shortens the length of hospital stay. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Cost-Effectiveness Analysis of Remimazolam and Midazolam in Goal-Guided Sedation in ICU |
| Yuzhen Bao, MM; Bin Cao, MM; Lili Liu, MM; Lixia Sun, MBBS; Jun Xing, MM; Fengyong Yang, PhD; Shufeng Yi, MBBS |
| Objective • This study aimed to compare the direct medication costs and clinical effectiveness of using remimazolam versus midazolam for goal-guided sedation therapy in the ICU patients.
Methods • This randomized controlled study was conducted in the ICU of People’s Hospital Affiliated to Shandong First Medical University. Eighty adult patients admitted to the ICU and requiring sedation were enrolled and randomly assigned in a 1:1 ratio to receive either remimazolam-based sedation (study group, n=40) or midazolam-based sedation (control group, n=40). The inclusion criteria for patient selection were age 18-80 years, requirement for mechanical ventilation, and an expected ICU stay of at least 24 hours. Patients with significant liver or kidney dysfunction, neurological disorders, or contraindications to the study drugs were excluded. The target sedation depth for both groups was a Ramsay Sedation Scale score of 3-4, which was maintained by titrating the infusion rates of remimazolam or midazolam as needed. Vital signs, sedation scores, and respiratory parameters were closely monitored throughout the sedation period.
Results • The time to onset of sedation, time to reach the target sedation depth, time to awakening, and length of ICU stay were all significantly shorter in the remimazolam group compared to the midazolam group (P < .05 for all). The remimazolam group had a mean time to onset of 5.2 ± 1.8 minutes versus 8.9 ± 2.4 minutes in the midazolam group. The mean time to reach the target Ramsay Sedation Scale score of 3-4 was 12.6 ± 3.1 minutes in the remimazolam group compared to 18.4 ± 4.2 minutes in the midazolam group. The mean time to awakening was 10.2 ± 2.7 minutes in the remimazolam group versus 16.5 ± 3.9 minutes in the midazolam group. The remimazolam group also had a significantly
shorter mean ICU length of stay of 5.1 ± 1.3 days compared to 7.8 ± 2.1 days in the midazolam group (P < .01). The remimazolam group had a significantly higher metabolic clearance rate compared to the midazolam group (P < .001). The Ramsay sedation scores and Wong-Baker FACES pain scores were also significantly lower in the remimazolam group throughout the sedation period (P < .01). There were no significant differences in heart rate between the two groups at any timepoint. However, the overall incidence of adverse events was significantly lower in the remimazolam group compared to the midazolam group (P < .05).
Conclusion • This study demonstrated that the use of remimazolam-based goal-directed sedation in the ICU setting resulted in significantly faster onset of action, quicker achievement of the target sedation depth, shorter time to awakening, and shorter ICU length of stay compared to midazolam-based sedation. The remimazolam group also had a higher metabolic clearance rate, lower sedation and pain scores, and a lower incidence of adverse events.
These findings suggest that remimazolam may provide advantages over midazolam for ICU sedation, potentially leading to improved patient comfort, more efficient utilization of ICU resources, and potentially better clinical outcomes. The rapid onset, titratability, and favorable safety profile of remimazolam make it a promising sedative agent that could help optimize sedation practices in the critical care setting. Further research is warranted to fully evaluate the impact of remimazolam on long-term patient-centered outcomes and overall healthcare costs in the ICU. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Association of DAZ and DAZLA Gene Loci with Spermatogenesis in Patients with Idiopathic Azoospermia and Severe Oligospermia |
| Xue Bai, PhD; Dongkai Cheng, MM; Xingchi Liu, MS; Jingyan Zhang, MS; Chunyang Zheng, PhD |
| Aim • To explore the relationship between DAZ (Deleted in Azoospermia, DAZ) and DAZLA (Deleted in Azoospermia-like autosomal) gene deletion and male idiopathic azoospermia and oligozoospermia.
Methods • 80 patients with azoospermia (azoospermia group) and 80 patients with oligozoospermia (oligozoospermia group) who were treated at our hospital from April 2021 to April 2023, and male volunteers who underwent health examinations at our hospital during the same period were selected as the control group, The incidence of DAZ and DAZLA gene locus deletion in three groups of men was detected by polymerase chain reaction (PCR), and the differences of reproductive hormone levels and main semen parameters among the three groups were compared. The azoospermia were stratified according to whether DAZ and DAZLA gene locus deletion occurred.
Results • DAZ gene locus deletion rate in azoospermia and oligospermia groups was considerably higher than in the control group (P < .05). The DAZLA gene locus deletion rate in the azoospermia group was apparently higher than that in the oligospermia and control groups (P < .05). The semen volume was compared between azoospermia and oligospermia patients and controls (P > .05). Sperm concentration, sperm survival rate, the proportion of normal morphological sperm, and the proportion of progressive motility sperm in the oligospermia group were lower than
those in the control group (P < .05). The levels of serum T (Testosterone, T) and T/LH in the azoospermiaspermia group were lower than those in the control group (P < .05). Serum LH (Luteinizing Hormone) and FSH (Follicular Stimulating Hormone) in azoospermia group and oligospermia group were higher than those in the control group (P < .05). The Serum LH determination value of the azoospermia group is higher than the oligospermia group (P < .05). Serum T/LH in the azoospermia group was lower than in the oligospermia group (P < .05). The serum T and T/LH values in azoospermia male patients with DAZ and DAZLA gene deletion were lower than those without deletion (P < .05). Sperm concentration and survival rate of oligospermatism male patients with DAZ gene deletion were lower than those without deletion (P < .05). Sperm and serum T and T/LH values of oligospermatism male patients with DAZ gene deletion were lower than those without deletion (P < .05).
Conclusion • The incidence of DAZ and DAZLA gene locus deletion in male patients with idiopathic azoospermia and oligozoospermia was higher than in normal males. The gene locus deletion was related to decreased androgen level, sperm count and motility. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of the Impact of Ambulatory Care Based on Social Support on the Quality of Life of Patients with Graves' Ophthalmopathy |
| Yue Li, BM; Jianrong Li, BM; Wuyi Liu, BM; Ran Sun, MM; Lu Xing, MM; Jian Zhang, MD |
| Background • Graves’ ophthalmopathy (GO) is an organ-specific autoimmune disease and is a common orbital condition that can possibly lead to blindness.
Objective • Our aim was to find out how patients with GO are affected in terms of quality of life (QoL) by traditional nursing care and social support mobile care.
Methods • A total of 38 patients with GO who were admitted to Beijing Chao-Yang Hospital in China between December 2018 and December 2023 underwent life evaluations before treatment, 6 weeks after treatment and 6 months after treatment. The control group comprised 27 patients and the experimental group comprised 11 patients. They were then split into 2 groups based on the European Group on Graves’ Orbitopathy (EUGOGO) improvement criteria: improved and unimproved. Then, the mean value of the Graves’ Ophthalmopathy-Quality of Life Inventory (GO-QOL) alterations were compared to see if there was
any difference, and their post-treatment QoL was examined.
Results • (1) Patients who improved in this study had a mean change in visual energy scale scores before and after treatment that was higher than the patients who did not (13.39 vs 0.00, respectively); (2) The social functioning scores on the GO-QOL scale increased by 17.05 points in the control group before and after treatment (P < .01); (3) A total of 15.4% of patients had a GO-QOL score >90 after therapy, indicating a significant impact on their lives. In the experimental group, scores on the visual power energy scale improved by 16.27 points after treatment compared with before treatment (P = .028).
Conclusion • When used in conjunction with traditional treatment, social supportive mobile care improves the outcomes in patients with GO and is superior to traditional care on its own. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Utilizing Accelerated Rehabilitation Nursing in Restoring Intestinal Function Following Cytoreductive Surgery for Gynecologic Ovarian Cancer |
| Tao Jiang, MM; Qingwen Shen, MM |
| Background • Accelerated recovery programs have gained recognition for their potential to enhance postoperative outcomes. However, their effectiveness in gynecological oncology remains understudied.
Objective • This study aims to assess the efficacy of accelerated recovery care in enhancing postoperative outcomes and patient satisfaction following surgery.
Methods • A quasi-experimental design was employed, and we included 72 patients undergoing cytoreductive surgery for ovarian tumors at The First Affiliated Hospital of Nanjing Medical University between October 1st, 2019, and May 31st, 2020. The patients were divided into two groups: an observation group receiving accelerated recovery care and a control group receiving standard care. Nursing staff administered comprehensive pre-and postoperative care, utilizing Mindray iPM10 monitors to monitor vital signs. Additionally, postoperative rehabilitation training and dietary guidance were provided. Complication rates, recovery indicators, and patient
satisfaction were compared between the two groups.
Results • The complication rate in the observation group was significantly lower at 2.78% compared to 11.11% in the control group (P < .05). Patients in the observation group exhibited significantly faster recovery indicators, including time to first flatulence, first defecation, and time to ambulation (P < .05). Moreover, patients in the observation group reported lower abdominal distension and pain scores, with 100% satisfaction rates.
Conclusion • Implementing accelerated recovery nursing demonstrates a notable reduction in postoperative complication rates among surgical patients, concurrently fostering an expedited recovery process and heightened patient satisfaction. The provision of comprehensive nursing attention and guidance throughout the perioperative continuum emerges as indispensable for optimizing patient recovery outcomes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| PRECEDE-PROCEED Model Nursing Intervention in Health Education for Parents of Obese Children |
| Lifang Chen, BM; Xiaoli Tang, BM; Lidi Yu, BM; Bin Zhang, BM |
| Objective • To study the intervention effects of the health education and health promotion (PRECEDE-PROCEED) model on the health behaviors and quality of life of obese children and their parents.
Methods • 524 patients who attended our pediatric obesity clinic from January to December 2021 were selected and divided into two groups: the control group (n = 262) and the test group (n = 262). The control group was guided by conventional weight reduction instruction, while the test group implemented the PRECEDE-PROCEED model. Based on this model, interventions were developed following the 9 links of the model, with tendency factors, contributing factors, and reinforcing factors as the core and 6 aspects of health behaviors were focused upon, and were followed up for 12 months. A home-made questionnaire
scale was used to assess the subjects at their initial visit and one year after the intervention.
Results • After the intervention, the awareness rate of obesity-related knowledge, support rate of attitude toward improving childhood obesity, awareness rate of disease harm caused by obesity, and formation rate of controlling childhood obesity behavior had significantly improved among the parents of the test group compared to the control group, with significant differences between the two groups (P < .05).
Conclusion • The PRECEDE-PROCEED model can transform the way parents of obese children apply health education at home, improving health behaviors and quality of life. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Treatment of Knee Osteoarthritis Complicated with Femoral Condyle Fracture by Joint Replacement Combined with Internal Fracture Fixation |
| Hui Ma, MM; Rongyu Shi, MM; Shicheng Xiu, MM; Dahai Zhang, MM |
| Objective • To investigate the efficacy of artificial knee arthroplasty in conjunction with internal fracture fixation for treating knee osteoarthritis and a femoral condyle fracture.
Methods • From January 2013 to June 2020, the researchers’ department admitted 11 patients with femoral condyle fractures in combination with knee osteoarthritis. Three of the patients were males; 8 were females. They ranged in age from 62 to 76 years, with an average age of 69.2 years. Five patients were injured in traffic accidents, 6 were related to falls. Before the incidents, all patients had varying degrees of flexion inversion deformity and moderate to severe osteoarthritis in their knee joints. The fractures were of two types: 3 were epicondylar fractures, and 8 were medial femoral condyle fractures. To treat the combined condition of osteoarthritis and fractured femoral condyles, all patients underwent artificial knee joint replacement along with internal fixation with a single treatment. Knee radiographs and joint mobility assessments were performed during the follow-up period
and were measured using the Hospital for Special Surgery (HSS) knee function score.
Results • All patients were followed up from 18 to 105 months with a mean duration of (52.5±2.6) months. Significant differences in knee mobility and HSS ratings at 1 month and 1 year postoperatively compared favorably to the condition before surgery. HSS scores at the 1-year postoperative follow-up were excellent in 8 cases, good in 2, acceptable in 1, and poor in 0 cases.
Conclusion • Artificial knee joint replacement combined with fracture internal fixation has good clinical efficacy in treating osteoarthritis of the knee joint combined with femoral condyle fracture. After surgery, patients resumed weight-bearing activities early, reducing the likelihood of complications and avoiding postoperative pain. This approach shortened the treatment period and enhanced the overall quality of life. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Mediating Role of Self-efficacy in Acute Myocardial Infarction Patients between Post-PCI Fatigue and Post-traumatic Stress Disorder |
| Shuzhen Li, MM; Jian Liao, MM; Jing Liu, MBBS; Yingli Tian, MM; Wei Xu, MM; Yuanyuan Yang, MM |
| Objective • This study aims to investigate the prevalence of post-traumatic stress disorder (PTSD) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Additionally, the study will analyze the correlation between self-efficacy and PTSD in patients with acute myocardial infarction who have undergone PCI.
Methods • This study focused on 268 AMI patients admitted to our hospital between April 2019 and March 2022. We utilized the Posttraumatic Stress Disorder Scale-Civilian Version (PCL-C) to conduct a questionnaire survey and analyzed the correlation between self-efficacy, postoperative fatigue, and PTSD using Pearson. Additionally, we established a structural equation model (SEM) using Amos 21.0 software and conducted a mediation effect test.
Results • (1) The PTSD score of 268 AMI patients in this study after PCI was (36.62 ± 4.62), the fatigue score was
(8.62 ± 0.82), and the fatigue score was (8.62 ± 0.82). 0.82), and the self-efficacy score was (19.34 ± 2.24); (2) Gender, educational level, and complications were the influencing factors of PTSD in AMI patients (P < .05); (3) Pearson analysis showed that PTSD after PCI in AMI patients was correlated positively with fatigue and had a negative correlation with self-efficacy; fatigue It was negatively correlated with self-efficacy (both P < .01); (4) The mediating effect of self-efficacy between fatigue and PTSD in AMI patients after PCI was established, and the mediating effect value was 29.31%.
Conclusion • PTSD, fatigue, and self-efficacy after PCI in AMI patients are all at moderate levels, which need clinical attention—29.31% mediating effect between fatigue and PTSD, confirming that fatigue can affect PTSD by regulating self-efficacy. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of 3D Printing Technology-Assisted Rehabilitation Cycles on Prognostic Motility in Surgically Treated Tibial Plateau Fractures: A Meta-Analysis |
| Huaping Hu, MM; Huiwen Yang, MD |
| Background • Tibial Plateau Fractures (TPF) present significant challenges in orthopedic surgery due to their complex anatomy and associated morbidity. Conventional surgical approaches are often limited by the difficulty in achieving anatomical reduction and stable fixation, leading to prolonged recovery times and increased risk of complications.
Objective • This study aims to evaluate the impact of 3D printing technology-assisted interventions in the surgical management of Tibial Plateau Fractures (TPF).
Methods • A comprehensive search of the PubMed database was conducted to identify relevant studies investigating the application of 3D printing technology in TPF surgery. Eligible studies were selected based on predefined inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.3 software to assess various outcome measures, including operative time, intraoperative bleeding, fracture healing duration, and incidence of adverse effects across the selected literature.
Results • 10 studies met the inclusion criteria and were
included in the final analysis. Meta-analysis results indicate that patients undergoing TPF surgery with 3D printing technology assistance experienced significantly shorter operative times and fracture healing durations compared to those undergoing conventional surgery (P < .05). Moreover, they exhibited reduced intraoperative bleeding and a markedly lower occurrence of adverse effects during the treatment process (P < .05).
Conclusions • The findings suggest that the integration of 3D printing technology into TPF surgical procedures can effectively mitigate surgical trauma and expedite fracture healing. Additionally, it offers a higher level of safety, thereby providing patients with a more reliable recovery trajectory and prognosis. This finding highlights the promising potential of 3D printing technology in advancing clinical orthopedics. Further research in this area is warranted to realize its clinical benefits fully. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of High-quality Nursing on the Treatment and Prognosis of Diarrheal Irritable Bowel Syndrome in Children |
| Xinyang Gu, MM; Ying He, MM; Ling Zhang, MM |
| Background • Diarrheal irritable bowel syndrome is a common functional intestinal disease in gastroenterology that can affect approximately 9% of children worldwide, and more than half of all affected children have abdominal pain into adulthood. Research has shown that scientific and effective nursing can play an important role in improving the condition and prognosis of diarrheal irritable bowel syndrome in children.
Objective • To explore the effect of high-quality nursing intervention on clinical efficacy and prognosis of diarrheal irritable bowel syndrome in children.
Design • This was a retrospective study.
Setting • This study was performed in the department of Fourth Department of Pediatrics, Ningbo Women & Children’s Hospital.
Participants • A total of 60 children with diarrheal irritable bowel syndrome admitted to the Pediatric Gastroenterology Department of our hospital from August 2017 to August 2019 were enrolled.
Interventions • At the same time as symptomatic treatment, high-quality nursing intervention was implemented, including cognitive intervention, psychological intervention, dietary guidance, life coaching, and medication guidance.
Primary Outcome Measures • (1) clinical efficacy (2) clinical symptom points (3) symptom relief time (4) incidence of adverse reactions (5)
negative emotions (6) treatment compliance and (7) nursing satisfaction of family members. All theses primary outcome measures could indicate the impacts of high-quality nursing intervention on the overall treatment and prognosis of diarrheal irritable bowel syndrome in children.
Results • The total effective rate was 98.33%. The scores of abdominal distension, abdominal pain, and diarrhea after treatment were significantly lower than those before treatment (P < .05). The anxiety and depression scores of children were lower after treatment than before treatment (P < .05). After treatment, the antipyretic time, antidiarrheal time, and correct dehydration time were (1.44±0.28) d, (1.46±0.33) d and (1.38±0.31) d. The treatment compliance and nursing satisfaction of the family members of the children was 100.00%, and the satisfaction score was 94.60±3.28 points. There were no obvious adverse reactions.
Conclusion • High-quality nursing intervention combined with treatment of children with diarrheal irritable bowel syndrome can effectively improve clinical treatment effect, improve clinical symptoms, improve children’s negative emotions and promote children’s treatment compliance and nursing satisfaction of families, and have no obvious adverse reactions, which is worthy of clinical promotion. Our study provides a clinical reference for the nursing of children with diarrheal irritable bowel syndrome. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Impact of Operating Room Nursing Pathways on Hospitalization Duration and Consciousness Status in Patients Undergoing Emergency Craniocerebral Injury Surgery |
| Jingying Huang, PhD; Kai Lv, PhD; Haiou Qi, PhD; Mina Xu, PhD; Xin Xu, PhD |
| Background • Craniocerebral injuries carry high disability and mortality rates. In clinical practice, timely determination of the condition and immediate rescue interventions are crucial for patients with emergency craniocerebral injuries. Nurses play a pivotal role in providing proactive nursing services to save patients’ lives.
Objective • This study aims to examine the practical implications of implementing operating room nursing pathways in the care of patients undergoing emergency craniocerebral injury surgery.
Design • A randomized controlled study was conducted.
Setting • The study was conducted at the Department of Operating Room at Run Run Shaw Hospital, affiliated with Zhejiang University School of Medicine.
Participants • A total of 80 patients undergoing emergency craniocerebral injury surgery in our hospital from August 2020 to August 2022 were included. They were randomly divided into control and observation groups through a lottery, with 40 cases in each.
Interventions • The control group received conventional nursing, while the observation group received operating
room nursing pathways.
Primary Outcome Measures • (1) Surgical preparation time, surgical time, and hospitalization time; (2) Pupil scores; (3) Brain injury grading; and (4) Nursing satisfaction score.
Results • The observation group exhibited a significant decrease in surgical preparation time and hospitalization time compared to the control group (P < .05). After the intervention, severe craniocerebral injury pupil scores in the observation group showed improvement compared to the control group (P < .05). The total satisfaction rate in the observation group (92.5%) was higher than that in the control group (80.0%) (P = .012).
Conclusions • The application of operating room nursing pathways in patients undergoing emergency craniocerebral injury surgery can lead to a shortened length of stay, substantial improvement in patients’ consciousness status, and high satisfaction rates from both patients and their family members. This intervention holds significant clinical value and merits further promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparative Efficacy of Amlodipine Alone Versus Amlodipine Combined with Valsartan in Patients with Coronary Heart Disease and Hypertension |
| Yang Wenjie, BM |
| Background • Coronary heart disease (CHD) coupled with hypertension presents a significant health challenge worldwide. Optimal management strategies for controlling blood pressure and improving outcomes in this patient population remain a topic of interest and investigation within the medical community.
Objective • This study aimed to compare the efficacy of amlodipine alone versus amlodipine combined with valsartan in patients diagnosed with coronary heart disease and hypertension.
Methods • A prospective cohort study was conducted, and a total of 80 patients diagnosed with coronary heart disease and hypertension who visited the hospital between August 2022 and May 2024 were selected as study participants. Patients were allocated into two groups based on admission order: the control group (n=40) received amlodipine treatment, while the research group (n=40) received combined therapy with valsartan and
amlodipine. The clinical efficacy between the two groups was compared.
Results • Patients in the research group exhibited significantly better blood pressure control compared to the control group (P < .05). Moreover, the overall treatment effectiveness was notably higher in the research group than in the control group (P < .05). After treatment, a statistically significant difference was observed in blood lipid levels between the two patient groups (P < .05). Similarly, post-treatment heart rate levels also displayed a significant difference between the two groups (P < .05).
Conclusion • Combining valsartan with amlodipine for patients presenting with coronary artery disease and hypertension significantly improves blood pressure management and enhances therapeutic outcomes. This finding emphasizes the clinical significance and potential widespread application of this combined treatment regimen. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Establishment and Verification of a Skin Cancer Diagnosis Model Based on Image Convolutional Neural Network Analysis and Artificial Intelligence Algorithms |
| Zhu Danning, MM; Qi Jia, BM; Li Linjia, MM; Ma Yinni, MM |
| Skin cancer is a serious public health problem, with countless deaths due to skin cancer each year. Early detection, aggressive and effective primary focus is the best treatment for skin cancer, which is important to improve patients’ prognosis and reduce the death rate of the disease. However, judging skin tumors by the naked eye alone is a highly subjective factor, and the diagnosis can vary greatly even among professionally trained physicians. Clinically, skin endoscopy is a commonly used method for early diagnosis. However, the manual examination is time-consuming, laborious, and highly dependent on the clinical practice of dermatologists. In today’s society, with the
rapid development of information technology, the amount of information is increasing at a geometric rate, and new technologies such as cloud computing, distributed, data mining, and meta-inspiration are emerging.
In this paper, we design and build a computer-aided diagnosis system for dermatoscopic images and apply meta-heuristic algorithms to image enhancement and image cutting to improve the quality of images, thus increasing the speed of diagnosis, early detection, and early treatment. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Preliminary Screening and Study of Key Gene Expression in Endometrial Window Period |
| Huan Chen, MM; Hongshan Ge, MD; Xiu Liu, MM; Hua Qian, MM; Lin Wang, MB; Nan Wang, MM; Cen Xu, MM; Yu Yang, MM; Donglan Yuan, MM; Lixing Zhang, MM; Shu Zhou, MM |
| Background • Implantation is a highly coordinated event involving both embryonic and endometrial participation. The endometrium expresses a complex array of proteins during the menstrual cycle many of which help to define a period of receptivity collectively known as the “window of implantation.”
Objective • Using high-throughput RNA sequencing technology analysis to find differentially expressed genes before and after the endometrial window, and search for key marker genes of the membrane implantation window.
Design • This was a retrospective study.
Setting • This study was performed in the Department of Obstetrics and Gynecology, Taizhou People’s Hospital.
Participants • Fifty patients with repeated implantation failure in in vitro fertilization were selected and were divided into (1) the normal window group (36 cases); (2) the window forward group (8 cases); and (3) the window backward group (6 cases) based on endometrial biopsy findings.
Interventions • Using RNA sequencing technology combined with biological information analysis tools to analyze the differentially-expressed genes in 9 samples.
Gene Ontology databases were used for the functional annotation of these differentially-expressed genes. Kyoto Encyclopedia of Genes and Genomes analysis was used to draw a signal path diagram.
Primary Outcome Measures • (1) Screening of differentially-expressed genes and (2) functional analysis of the differential genes.
Results • A total of 22 differentially-expressed genes related to endometrial receptivity were obtained by transcriptome sequencing. Seven of the 22 differentially-expressed genes have been shown to have a close relationship with the endometrial receptive window period. Further, it was proved that the Wnt signaling pathway and mitogen-activated protein kinase signaling pathway were closely related to endometrial receptivity.
Conclusions • The present study identified a series of key genes and pathways that may be involved in the endometrial window period, providing an experimental and theoretical basis for exploring the personalized embryo transfer program. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Structured Psychological Nursing Combined with Group Health Education for Patients Receiving Blood Purification |
| Ajuan Hou, BS; Caiping Zhao, BS |
| Context • Patients with ESRD undergoing blood purification still face various challenges, including psychological distress, lack of comprehensive understanding of their disease, and suboptimal health outcomes. Effective interventions for such patients are of paramount significance.
Objective • The study intended to assess the benefits of structured psychological nursing combined with group health education for patients undergoing blood purification.
Design • The research team conducted a randomized controlled trial.
Setting • The study took place at Zhejiang Provincial People’s Hospital in Xianyang, China.
Participants • Participants were 96 patients at the hospital who were undergoing blood purification between May 2020 and March 2022.
Interventions • The research team randomly assigned participants to one of two groups: (1) the study group, who received structured psychological nursing + group health education, and (2) the control group, who received routine nursing.
Outcome Measures • At baseline and postintervention,
the research team evaluated: (1) disease cognition, using the Mishel Uncertainty in Illness Scale (MUIS-A); (2) negative emotions, using the Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS); (3) blood purification adequacy rate and nutritional status qualified rate; and (4) complication rate.
Results • Postintervention, the intervention group’s: (1) disease uncertainty, complexity, lack of disease information, and unpredictability were significantly lower than those of the control group (all P < .001); (2) SDS and SAS scores were significantly lower than those of the control group (both P < .001); (3) blood purification adequacy rate (P = .049) and nutritional status qualified rate (P = .037) were significantly higher than those of the control group; and (4) incidence of complications was significantly lower than that of the control group (P = .045).
Conclusions • Group health education and structured psychological nursing for patients undergoing blood purification can effectively alleviate negative emotions, enhance disease cognition, improve blood purification adequacy and nutritional status, and reduce complication risk. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| A Qualitative Study of the Care Experience of Mothers of Asthmatic Children from Low-Income Families |
| Xue Feng, MM; Xiaoping Jiang, MSN; Fangfang Tang, MM; Zijuan Wang, MSN |
| Objectives • This study aimed to explore the experiences and caregiving perspectives of mothers from low-income families who have children with asthma,and to establish a foundation for the development of tailored nursing strategies specifically designed for families facing similar circumstances.
Method •A descriptive qualitative research method was employed. Fifteen mothers of asthmatic children from low-income families receiving treatment at the Respiratory Centre of Chongqing Children’s Hospital were purposefully sampled from June to December 2021. Semi-structured interviews were conducted to gather data on their caregiving experiences, and thematic analysis was utilized to analyze the interview data.
Results •The interviewees were 27-42 years old (SD=32.3 years), 33.3% were full-time mothers(A woman who quit work, in order to focus on taking care of the child and the family ), 53.3% had one child, 46.6% had a college degree or higher, and 100% had health insurance. Through in-depth interviews, four main themes and eight sub-
themes were identified, including (a) insufficient knowledge about the disease, (b) anxiety and uncertainty, (c) insufficient social support system, and (d) insufficient resources for medical services. The first theme describes a weak willingness to learn and medication discontinuation at will. The second theme describes financial burden and psychological stress, the third theme describes lack of family support and low social participation, and the fourth theme describes insufficient health insurance support and unequal distribution of healthcare resources.
Conclusion • Mothers from low-income families with asthmatic children face substantial psychological burdens and familial pressures. It is crucial for healthcare professionals to actively engage with and deepen their understanding of these mothers’ caregiving experiences and psychological well-being. By doing so, positive coping strategies can be developed, promoting the physical and mental health of these mothers and improving asthma control in their children. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of Perioperative Empathic Care on Postoperative Psychological Status in Patients with Cervical Cancer |
| Ziwei Feng, MSc; Dandan Li, MSc; Liangru Liu, MSc; Jiazhu Tang, MSc; Yingying Zhu, MSc |
| Objective • To evaluate the effectiveness of perioperative empathic care for patients with cervical cancer and its impact on their postoperative recovery and psychological well-being.
Methods • A total of 196 patients diagnosed with cervical cancer and treated at our hospital between December 2019 and January 2021 were recruited and assigned via random number table method to receive either conventional nursing care (conventional group) or empathic care (experimental group), with 98 cases in each group. The inclusion criteria for cervical cancer patients were FIGO stage I-III, aged 18-65 years, and no prior cancer treatment. The empathic care provided to the experimental group involved enhanced communication, emotional support, and shared decision-making. Outcome measures included postoperative recovery indices, numeric rating scale (NRS) scores, Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS) scores, Hamilton depression scale (HAMD) scores, and Strategies Used by People to Promote Health (SUPPH) scores.
Results • Independent t tests were used to analyze the differences in postoperative recovery indices between the two groups. Patients in the experimental group who received empathic care had significantly shorter mean time to passing gas (2.35 ± 0.61 days vs. 3.41 ± 0.56 days, P < .05), shorter mean time to postoperative defecation (3.28 ± 0.71 days vs. 4.75 ± 0.63 days, P < .05), and shorter mean length of hospital stay (7.18 ± 1.04 days vs. 11.52 ± 1.25 days, P < .05) compared to the conventional group.
Before the nursing intervention, there were no significant differences between the two groups in NRS scores, PSQI scores, SAS scores, HAMD scores, and SUPPH scores (all P > .05). After the nursing intervention, ANOVA was used to analyze the differences. Patients in the experimental group had lower mean NRS scores (2.96 ± 0.84 vs. 4.36 ± 1.02, P < .05), lower mean PSQI scores (8.45 ± 1.11 vs. 12.15 ± 1.52, P < .05), lower mean SAS scores (33.08 ± 3.35 vs. 47.65 ± 4.32, P < .05), and lower mean HAMD scores (30.44 ± 3.37 vs. 41.82 ± 4.05, P < .05) compared to the conventional group.
Conclusion • This study demonstrates that perioperative empathic care can significantly improve postoperative recovery and psychological well-being in patients with cervical cancer. Patients receiving empathic care exhibited faster return of gastrointestinal function, shorter hospital stays, and better outcomes on measures of pain, sleep quality, anxiety, and depression. These findings suggest that incorporating empathic care into standard oncology nursing practice could have a positive impact on patient experience and clinical outcomes. Beyond the benefits for individual patients, widespread adoption of empathic care approaches has the potential to enhance the overall quality of cancer care, improve resource utilization, and contribute to more holistic, patient-centered models of healthcare delivery. Further research is warranted to evaluate the long-term effects of empathic care and its applicability across diverse oncology populations. ( |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| A Clinical Study on Chinese Five-Element Music Therapy Combined with Auricular-Plaster Therapy in Treating Perimenopausal Insomnia and Anxiety |
| Linyan Li, MM; Yongjun Tao, BM; Xiaoxia Xu, BM; Xiaoying Zhang, BM |
| Objective • To evaluate the clinical effects of five-element music therapy combined with auricular-plaster therapy for perimenopausal insomnia with anxiety. This study aimed to leverage the complementary effects of both approaches to provide patients with a more comprehensive and personalized therapeutic experience.
Methods • In this experiment, 90 cases of perimenopausal insomnia patients were selected and randomly assigned to the treatment group (45 cases) and the control group (45 cases) using the random number table method. In the treatment group, except for 2 cases who withdrew, the remaining 43 cases were observed and treated with Five Elements Music combined with auricular acupressure therapy. In the control group, except 3 cases withdrew, 42 cases were observed and given alprazolam oral treatment. The treatment course of both groups was 4 weeks. Data such as Pittsburgh Sleep Quality Index (PSQI) and Hamilton Anxiety Scale (HAMA) scores were also
recorded for all patients before and after treatment.
Results • After treatment, the total effective rate was 93.02% in the treatment group and 88.10% in the control group. The PSQI and HAMA scores of the two groups after treatment improved compared to before treatment(P < .01). The curative effect in the treatment group was superior to that in the control group in terms of sleep quality and anxiety.
Conclusion • The five-element music therapy combined with auricular-plaster therapy is effective in the treatment of perimenopausal insomnia with anxiety. Compared with traditional therapy, Chinese medicine non-drug therapy has the characteristics of green safety, simple effect, and low cost. It can avoid adverse reactions caused by long-term use of drugs, so It is a safe and reliable method, worthy of recommendation for clinical use. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Pursed Lip Breathing Training on Rehabilitation for Older Adults With Stable COPD |
| Hu Kuanli, BD; Zhang Qinlong, BD |
| Context • Chronic obstructive pulmonary disease (COPD) usually develops in late-middle or old age, especially in people over 60 years of age, and its symptoms gradually worsen. Pursed lip breathing training can adjust breathing patterns, strengthen respiratory muscles, and improve respiratory function.
Objective • The study intended to examine the specific methods of pursed lip breathing training for older adults with stable COPD and the treatment’s impact on rehabilitation, to provide a scientific basis and guidance for clinical practice.
Design • The research team conducted a one-group pretest-posttest study.
Setting • The study took place at the Seventeenth Metallurgical Hospital of Ma’anshan City in Ma’anshan City, Anhui Province, China.
Participants • Participants were 30 older-adult patients in the stable stage of COPD who received treatment at the hospital between January 2022 and January 2023.
Intervention • All participants received pursed lip breathing training during the stable period and for 6 months after discharge
Outcome Measures • The research team measured participants’: (1) quality of life (QoL), using SF-36; (2) lung function, using vital capacity (VC), forced expiratory volume per second (FEV1), and the FEV1/FVC ratio; (3) clinical efficacy, (4) health behaviors, using the Health Behavior Scale; and (5) comfort, using the Brown-Saltzman scale.
Results • Postintervention, participants’: (1) scores for daily life (P = .035), anxiety (P = .034), depression (P = .036), and social activity (P = .041) on the QoL scale decreased significantly from baseline; (2) maximum VC (P = .046), FEV1 (P = .041), and FEV1/FVC ratio (P = .045) significantly increased from baseline; (3) total effective rate was 93.3% for 28 participants; (4) healthy behaviors significantly increased; and (5) comfort scores significantly increased.
Conclusions • For older adults with stable COPD, pursed lip breathing training can improve lung function and QoL and play a positive role in promoting disease rehabilitation. The prospects for clinical promotion and application of pursed lip breathing training has are very good, and it can become an important part of rehabilitation treatment. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Effectiveness of Newman’s System Model of Care in the Perioperative Period of Endometrial Cancer Patients |
| Siyin Ding, MM; Lagen Liu, MM; Xinmin Wang, MM; Mengyao Zhong, MM |
| Objective • The purpose of this study was to investigate the effectiveness of the Newman System model of care in the perioperative period for patients with endometrial cancer, to investigate the impact on psychological well-being, quality of life, and patient satisfaction.
Methods • One hundred and eight patients with endometrial cancer who were treated in our hospital from January 2020 to January 2023 were selected as research subjects and were randomly divided into the control group (n=54) and the research group (n=54); the control group received conventional nursing care, and the research group added nursing care based on the conventional nursing care with Newman’s systematic nursing care model including primary, secondary and tertiary care, comparing the psychological state score, quality of life score, coping style score, and satisfaction with nursing care of the two groups.
Results • After the intervention, the anxiety self-assessment scale (SAS) and depression self-assessment
scale (SDS) scores decreased in both groups, with the research group having lower scores than the control group (P < .05). After the intervention, all Oncology Quality of Life Core Questionnaire (QLQ-C30) scores increased in both groups, with the research group having higher scores than the control group (P < .05). After the intervention, avoidance and submission scores decreased in both groups, with the research group having lower scores than the control group (P < .05); coping scores increased in both groups, with the research group having higher scores than the control group (P < .05). Satisfaction with care was higher in the research group than in the control group (P < .05).
Conclusion • The Newman’s system model of care is effective in the perioperative period of endometrial cancer, helping to reduce patients’ negative emotions, optimize coping, improve quality of life and nursing satisfaction, and has great value in clinical application and promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Impact of Health Education Based on the Pender Health Promotion Model on Patients with Deep Vein Thrombosis of the Lower Limbs Treated with Rivaroxaban |
| Min Li, MM; Jinglan Sun, MM; Hongyan Zhou, MM |
| Objective • To evaluate the impact of Pender-based health education on outcomes in rivaroxaban-treated lower limb DVT patients.
Methods • 103 patients with DVT of the lower limbs treated with rivaroxaban admitted to The First Affiliated Hospital of Xi’an Jiaotong University from January 2022 to January 2023 were included in the study and were randomly divided into the conventional group (n=52, receiving routine care with medication instruction, exercise instruction, and psychological care as the main components) and the Pender group (n=51, giving health education based on the Pender health promotion model in addition to conventional care) to compare the recurrence rate of DVT of the lower limbs, DVT of the lower limbs clinical condition, complication rate, quality of life score, coagulation index and nursing satisfaction rate in the two groups.
Primary results • The recurrence rate of lower limb DVT, circumference of the affected limb, time to get out of bed, and time to reduce swelling in the Pender group were
lower (shorter) than those in the conventional group (P < .05); after the intervention, all quality of life scores in the Pender group were higher than those in the conventional group (P < .05).
Secondary results • The complication rate, fibrinogen (FIB) and D-dimer (D-D) levels were lower (shorter) in the Pender group than in the conventional group (P < .05). After the intervention, the levels of activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) were higher in the Pender group than in the conventional group (P < .05).
Conclusion • The health education based on the Pender health promotion model is effective in patients with lower limb DVT treated with rivaroxaban, which can effectively reduce recurrence and complications, optimize coagulation indexes, and improve the quality of life and nursing care satisfaction by improving the patients’ health cognition and health behaviors, which is of great value in clinical application and promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Influence of AngioJet Thrombectomy Combined with Catheter-Contact Thrombolysis on the Therapeutic Effect and Safety of Patients with Lower Extremity Deep Vein Thrombosis |
| Jian Cui, MM; Xiaofei Shi, MM |
| Objective • To investigate the effect of AngioJet thrombectomy combined with catheter-contact thrombolysis on the therapeutic effect and safety of patients with lower extremity deep vein thrombosis (LEDVT).
Methods • 48 patients with LEDVT admitted to our hospital from February 2020 to January 2022 were selected as the study objects and were divided into a control group (n = 24) and research group (n = 24) by random number table method. The control group was treated with catheter-directed thrombolysis (CDT) while the research group was treated with a combination of CDT and AngioJet thrombectomy. The perioperative indicators, symptom improvement, thrombolytic indicators, coagulation function, and the incidence of complications were compared.
Results • After treatment, the time of thrombectomy, the total dosage of urokinase, and the length of hospital stay in the research group were all lower than those in the control group (P < .05). After treatment, the peripheral
diameter differences of large contralateral crus and calf of the two groups were lower than those before treatment; these peripheral diameter differences of the research group were significantly lower than those of the control group, and the differences were statistically significant (P < .05). After treatment, the venous patency rate, thrombus clearance rate, detumescence rate of the affected limb, and the proportion of grade III in the thrombolysis grade in the research group were all higher than those in the control group. The incidence of complications in the research group after treatment (8.33%) was significantly lower than in the control group (20.83%), with P < .05.
Conclusion • AngioJet thrombectomy combined with catheter-contact thrombolysis in the treatment of patients with LEDVT can significantly improve the venous patency rate and thrombolysis rate, regulate the level of coagulation factors, and achieve good thrombolytic effect and safety. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effectiveness of Comprehensive Nursing Intervention Based on the Roy Adaptation Model in the Perioperative Period of Bladder Cancer |
| Kun Feng, MM |
| Objective • To explore the effect of comprehensive nursing intervention based on the Roy adaptation model in the perioperative period of bladder cancer.
Methods • Eighty-six patients with bladder cancer admitted to our hospital from January 2020 to January 2021 were selected and randomly divided into a control group (n = 43, receiving conventional perioperative care) and a research group (n = 43, receiving the Roy adaptation model based on conventional perioperative care). Psychosocial adjustment scores, self-perceived burden scores, quality of life scores, and complication rates of the 2 groups were compared.
Results • After intervention, the Psychosocial Adjustment to Illness Scale (PAIS-SR) scores and the Self-Perceived
Burden Scale (SPBS) scores were lower in the research group than in the control group (P < .001). After intervention, the research group scored higher than the control group on all dimensions of the Short Form Health Survey (SF-36) (P < .001). Complication rates were lower in the research group (6.98%) than in the control group (25.58%) (P = .02).
Conclusion • Comprehensive nursing intervention based on the Roy adaptation model is effective in the perioperative period of bladder cancer and can significantly improve patients’ psychosocial adaptation, reduce self-perceived burden, improve quality of life, and reduce complications, and is worthy of clinical application and promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| New Fiberoptic Choledochoscopy-guided Percutaneous Transhepatic Choledochoscope Lithotomy Combined with Dual-frequency Laser Lithotripsy for the Treatment of Intractable Hepatolithiasis |
| Guogang Li, MM; Xuefeng Ren, MM; Lianqiang Shen, MM; Ming Zhu, MM |
| Objective • To investigate the clinical effects of new fiberoptic cholangioscopy-guided percutaneous transhepatic choledochoscope lithotomy (PTCSL) combined with dual-frequency laser lithotripsy for the treatment of intractable hepatolithiasis.
Methods • Eighty patients with intractable hepatolithiasis who received treatment in the Second Hospital Affiliated to Zhejiang University School of Medicine from December 2020 to December 2022 were grouped according to the surgical methods. Forty-two patients who received hepatectomy were divided into the control group, 38 patients who received new fiber-optic choledochoscope-guided PTCSL combined with dual-frequency laser lithotripsy were divided into the observation group, and the treatment results of the two groups were compared.
Results • The operation time, postoperative pain duration, and hospital stay of the observation group were
significantly shorter than those of the control group, and intraoperative bleeding was significantly lower than that of the control group, with statistically significant differences (P < .05). Seven days after surgery, the total bilirubin (TBIL), alanine aminotransferase (ALT), and albumin (ALB) levels in the observation group were significantly lower than those in the control group (P < .05). The stone residual rate of 7.89% in the observation group was significantly lower than that of 26.19% in the control group (?2=4.625, P < .05). The difference in biliary bleeding rate between the two groups was not statistically significant (?2=0.427, P > .05).
Conclusion • Overall results of new fiber-optic choledochoscope-guided PTCSL combined with dual-frequency laser lithotripsy for the treatment of intractable hepatolithiasis. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Evaluating the Efficacy of Chinese Patent Medicine Paiteling in Treating Vaginal Stump Disease VaIN: An Analysis of 67 Clinical Cases |
| Shuxia Han, MD; Hongmei Li, MM; Jingwen Ma, MM |
| Background • Vaginal Intraepithelial Neoplasia (VaIN) is a prevalent condition that can progress to invasive carcinoma if left untreated. Despite its significance, effective treatments for VaIN remain limited.
Objective • This study aimed to analyze the efficacy of Paiteling in treating VaIN among patients who have undergone total hysterectomy due to high cervical lesions or invasive cervical cancer.
Design • This study employed a retrospective design.
Settings • The study was conducted at Ningxia General Hospital of Medical University from January 2019 to January 2023.
Participants • A total of 67 cases diagnosed with VaIN were included in the study. Inclusion criteria comprised patients who had undergone total hysterectomy for high cervical lesions or invasive cervical cancer and had confirmed VaIN diagnosis through abnormal ThinPrep Cytology Test (TCT) and/or High-risk Human Papillomavirus (HR-HPV) results with colposcopy biopsy.
Intervention • Patients were treated with Chinese patent medicines Paiteling and patulin according to their specific
VaIN classification: VaIN1, VaIN2, and VaIN3.
Primary Outcome Measures • The primary outcome measures included complete negative conversion rates for VaIN1, VaIN2, and VaIN3, as well as overall effective rate and complete negative rate across all VaIN cases. Statistical analysis was performed using IBM SPSS 24.0, with significance set at P < .05.
Results • Patients with VaIN1, VaIN2, and VaIN3 were treated with Chinese patent medicines Paiteling, and patulin, respectively. Complete negative conversion rates were 100% for VaIN1, 72.73% for VaIN2, and 75.67% for VaIN3, resulting in an overall effective rate of 88.89% and a complete negative rate of 72.22% across all VaIN cases.
Conclusion • This study underscores the efficacy of Chinese patent medicine Paiteling in managing post-total hysterectomy VaIN. It presents a conservative treatment option for vaginal stump diseases, addressing a crucial gap in therapeutic strategies. The findings advocate for further exploration of Paiteling’s potential in VaIN management. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Exploration of the Long-term Prognostic Value of Cholangioscopy Combined with Minimally Invasive Abdominal Surgery in Reducing the Possibility of Stone Recurrence in Elderly Patients with Gallstones |
| Bin Li, MM; Wenqin Xu, MM; Jiandong Yang, MM; Lili Yang, MM |
| Objective • To observe the effect of cholangioscopy (CS) combined with minimally invasive abdominal surgery on prognosis stone recurrence in elderly patients (=60 years old) with gallstones (GS).
Methods • One hundred and fourteen GS patients admitted to The First Hospital of Nanchang between August 2018 and December 2021 were selected for the study, and they were randomly divided into the control group (n=57) and the observation group (n=57). The control group was treated with open surgery, while the observation group was given CS combined with minimally invasive stone removal surgery. Inter-group comparisons were made regarding operation time, intraoperative blood loss, postoperative intestinal function recovery, hospitalization time, clinical efficacy, and postoperative complication rate. Pain intensities before and, 4, 24, 48, and 72 hours after surgery were assessed using the Visual Analogue Score. After a 1-year post-discharge follow-up, the stone recurrence rate was
counted, and the Gastrointestinal Quality-of-Life Index evaluated the quality of life.
Results • There was no difference in operation time between the two groups (P > .05), but intraoperative blood loss, recovery time of intestinal function, hospitalization time, and complication rate were all lower in the observation group than in the control group (P < .05). In addition, the clinical efficacy of the observation group was better, and postoperative pain was lower (P < .05). In the prognostic follow-up, it was seen that the observation group had a lower stone recurrence rate (3.51%) and better quality of life (P < .05).
Conclusions • CS combined with minimally invasive abdominal surgery is effective and safe in treating patients with GS and can validly reduce the prognosis risk of recurrent stones in patients, which deserves popularization in clinical use. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Optimization of Hospital Drug Management Model under the Supervision of Internet Plus Medical Health |
| Tingting Chen; Hui Huang; Fangyuan Xia; Changwang Xiao; Xiaohua Zhang, BM |
| Objective • This study aims to investigate the use of proton pump inhibitors (PPIs) among inpatients in a hospital and analyze the rationality of their use.
Methods • We analyzed the medication records of 1986 inpatients from January 2023 to June 2023, focusing on patients using PPIs under the “Internet + medical service” model. Additionally, we compared and analyzed the drug use patterns, including dosage form, dosage, medication frequency, average daily cost, and sales amount, between two groups: those treated before and after the implementation of the “Internet + medical service” model. The control group comprised 1962 inpatients treated with PPIs from July 2022 to December 2022. We also compared drug inventory time, account coincidence rate, error rate, and nursing satisfaction between the two periods.
Results • Among the hospitalized patients using PPIs, 892 cases were male (44.91%) and 1094 cases were female (55.09%). Regarding age distribution, 456 cases were aged 18-45 (22.96%), 845 cases were aged 46-65 (42.55%), and 685 cases were over 65 years old (34.49%). The top 10 departments with the highest frequency of PPI use
included gastroenterology (8.36%), oncology, hematology, trauma orthopedics (6.95% each), cardiovascular medicine, neurology (6.39% each), general surgery (6.29%), respiratory, critical care (5.84%), renal rheumatology, immunology (5.79%), and spine surgery (5.59%). Omeprazole enteric-coated capsules accounted for the highest proportion (25.08%), followed by rabeprazole enteric-coated tablets (22.96%) and pantoprazole sodium enteric-coated tablets (20.04%). After implementing the “Internet + medical service” model, there was a reduction in irrational PPI use, medication error rates, and inventory time. Moreover, the account coincidence rate and satisfaction rate increased significantly (P < .05).
Conclusion • The utilization of PPIs in hospitals is notably high. Implementing the “Internet + medical service” model can effectively improve the rationality of PPI use. Clinicians should adhere to relevant indications when prescribing PPIs and conduct drug interventions to prevent overuse. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Relationship between sLOX-1, S100A12, D-dimer, and Cerebral Hemorrhage Transformation after Intravenous Thrombolysis in Stroke |
| Shumin Cai, BM; Hao Wang, BM; Jing Wang, BM; Xuetao Zhu, BM |
| Objective • This study examines the relationship between serum biomarkers sLOX-1, S100A12, D-dimer and the risk of cerebral hemorrhage transformation following intravenous thrombolysis in stroke patients.
Methods • We retrospectively analyzed 161 stroke patients who underwent intravenous thrombolysis at our hospital from March 2021 to March 2023. Patients were categorized into hemorrhagic transformation (n=35) and non-hemorrhagic transformation groups (n=126) based on head CT scans conducted within 3 days post-treatment. We compared serum levels of sLOX-1, S100A12, and D-dimer between the groups and analyzed clinical data to evaluate factors influencing hemorrhagic transformation.
Results • No significant differences were found in demographics, medical history, or stroke characteristics
between the groups (P > .05). The hemorrhagic transformation group exhibited higher NIHSS scores, WBC levels, and lower UA levels (P < .05). Notably, sLOX-1, S100A12, and D-dimer levels were significantly elevated in the hemorrhagic group (P < .05). Multivariate regression and ROC curve analyses indicated these biomarkers and NIHSS scores significantly predict cerebral hemorrhage post-thrombolysis (P < .05).
Conclusion • Elevated sLOX-1, S100A12, and D-dimer levels are associated with an increased risk of cerebral hemorrhage transformation after thrombolysis in stroke patients. These biomarkers along with NIHSS and NIHSS scores, hold diagnostic value for predicting hemorrhagic outcomes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of the Key Points of Nursing Cooperation and Implementation Effects of Primary Nephrotic Syndrome in Children Complicated with Hyponatremia |
| Saijun Bao, BS; Shengting Liu, BS; Yan Ma, BS |
| Objective • Hyponatremia is one of the main types of complications of primary nephrotic syndrome in children, which can cause significant damage to the patient’s nervous system and can lead to death or shock if not intervened early. In addition, patients are relatively young and often need to pay attention to the nursing cooperation of various key points in order to achieve ideal clinical treatment effects. To analyze the key points of nursing cooperation and the implementation effects of primary nephrotic syndrome in children complicated with hyponatremia.
Methods • A retrospective analysis of 100 children with primary nephrotic syndrome complicated with hyponatremia admitted to our Hospital from January 2018 to November 2022 was conducted as the study objects. They were divided into a control and observation groups, with 50 cases each. Among them, the control group received routine nursing, while the observation group paid attention to various key points of nursing cooperation. This includes paying close attention to changes in plasma osmotic pressure, blood sodium, and electrocardiogram indicators, being alert to the above situations, and taking appropriate treatment measures in a timely manner; nursing staff need to guide family members to cooperate in alleviating clinical related symptoms, guide family members to avoid giving children irritating foods, and control the intake of sodium chloride. Guide parents to adjust their clothing and keep their skin dry and clean. Guide parents to provide psychological support for children and other key points of nursing cooperation. After different nursing measures were taken for the two groups, the scores of Quality of Life Core Questionnaire Scale related to patients after nursing, renal functions after nursing, and coagulation function indicators after nursing of the two groups were evaluated. Simultaneously compare the nursing efficacy, incidence of
adverse reactions, and overall satisfaction rate of their family members between the two groups.
Results • The scores of the core questionnaire scale of quality of life after nursing (physical function, emotional function, cognitive function, social function), coagulation function indexes after nursing (prothrombin time, activated partial thromboplastin), nursing efficacy, and the total satisfaction rate of patients’ families were compared between the two groups. The observation group was higher than the control group (P < .05). The renal function indexes after nursing (serum creatinine, urea nitrogen, a1-microglobulin, 24h urine protein quantitative) and the incidence of adverse reactions (gastrointestinal discomfort, hypoglycemia, abnormal liver function) were compared between the two groups. The observation group was lower than the control group (P < .05).
Conclusion • As an auxiliary treatment intervention measure, the clinical effects obtained from the practice of nursing cooperation of each key point and the support of family members provide important strategic guidance for the selection of nursing strategies for children with primary nephrotic syndrome and hyponatremia. Such potential improvements have greatly promoted the improvement of the quality and efficiency of the entire department of pediatric nephrology and nursing, and are worthy of clinical promotion. That is, the focus of nursing cooperation should pay attention to the key points of nursing cooperation for children with primary nephrotic syndrome and hyponatremia to improve the quality of life of patients. Future studies can explore the universality of the application effect of relevant nursing points in other children. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Improvement of Polycystic Ovary Syndrome Symptoms in Obese Patients |
| Jingfeng Gu, MSc; Jianjie Liu, MSc; Guiqi Wang, MSc; Dongyang Xing, MSc; Jian Zhang, PhD |
| Background • Polycystic ovary syndrome (PCOS) causes normogonadotrophic anovulation, where women experience abnormal and irregular ovulations due to dysfunctions in the hypothalamic-pituitary that ensure normal levels of estradiol are maintained. This study aims to investigate the improvement of PCOS symptoms in obese patients after undergoing bariatric surgery.
Methods • We conducted a retrospective study at The First Hospital of Hebei Medical University from 2020 to 2022. We recruited 65 females; the inclusion criteria involved patients who were obese and experiencing infertility issues due to PCOS, patients who consented to undergo bariatric surgery, patients who were aged 22 years to 40 years, and patients who had a post-surgical BMI of = 35 kg/m2. We excluded patients with medical disorders and complications, aged 40 years and above, and patients who showed a post-surgical operation BMI of greater than 35 kg/m2.
Results • The patients recorded an average pre-operating BMI of 44 kg/m2 with a mean age of 28 years. Most participants had an average menstrual cycle of 60 to 90 days, with 44% of patients reporting normal menstruation.
At 6 months, post-surgery, the average level of prolactin was 11.39 ng/mL, progesterone was 0.4ng/dL, SHBG at 24 nmol/L, estradiol at 24.6 pg/mL, testosterone at 34 pg/mL, LH at 10.2 mIU/ml and FSH at 5.6 mIU/ml.
Discussion • Bariatric surgery enhances a reduction in body weight due to lowering BMI levels of serum and total testosterone. The increased sensitivity to insulin reduces resistance to insulin and enhances regulation of hormones. Ovulation and menstrual cycle were restored in women with PCOS due to weight loss and positive regulation of hormones. Moreover, the effects of chronic low-grade inflammations were eliminated due to a significant reduction in the adipose mass and enhanced metabolic parameters.
Conclusion • We observed that bariatric surgery improved PCOS symptoms in obese women. Bariatric surgery combined with sustainable weight loss, shows promising improvements in menstrual regularity, hormonal balance, fertility and pregnancy rates for obese women with PCOS, potentially offering them a valuable option for achieving conception. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Clinical Intervention Effects of Evidence-based Nursing Measures in General Anesthesia Patients in the Postoperative Recovery Period |
| Xiaofang Chen, BS; Qinqin Huang, BS; Xuefei Song, BS; Dongmei Zhang, BS |
| Objective • This work investigated the clinical intervention effect of evidence-based nursing (EBN) measures for patients in the recovery stage after general anesthesia (GA), aiming to provide a nursing reference for patients in the recovery stage after surgery.
Methods • The enrolled participants were 102 patients who underwent surgical treatment in our hospital from December 2021 to December 2022. According to the principle of randomized control, they were enrolled into an observation group (51 cases, Obs group) and a control group (51, cases, Ctrl group), and the general nursing methods and EBN measures were respectively implemented. The incidence of restlessness, complication rate, and nursing satisfaction were compared among patients. The recovery period and visual analog scale (VAS) were evaluated.
Results • The eye-opening time, palm-holding time, and extubation time in the Obs group were shorter than those in the Ctrl group (P < .05). The incidence of agitation during convalescence under GA in the Obs group was significantly lower than in the Ctrl group, with a statistically significant difference among both groups (P < .05). Compared to the Ctrl group, the VAS score of patients in the Obs group receiving the EBN was lower at 6 h, 12 h, and 24 h after the surgery (P < .05). The patients in the Obs group presented a substantially lower complication rate and remarkably higher nursing satisfaction (P < .05).
Conclusion • The application of EBN measures in patients after GA could effectively shorten the recovery time, lower the incidence of agitation and complication rate during the recovery, and improve nursing satisfaction. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy and Safety of Sintilimab Combined with Pemetrexed and Platinum Chemotherapy in Non-Small Cell Lung Cancer Patients |
| Jianxun Fengo, MBBS; Xiaofei Nio, MM; Jun Yao, MBBS |
| Objective • This study aimed to evaluate the clinical efficacy and safety of siltuximab in combination with pemetrexed and platinum-based chemotherapeutic agents for treating non-small cell lung cancer (NSCLC) through a randomized trial.
Methods • Ninety-two NSCLC patients admitted to our hospital between July 2020 and July 2022 were randomly assigned to receive either pemetrexed + platinum drugs (observation group) or sintilimab plus pemetrexed + platinum drugs (experimental group) in a 1:1 ratio. Outcome measures included clinical efficacy, safety, serum tumor marker levels (CA125, CEA, CA199), immune function (CD4+, CD8+, CD4+/CD8+), cell growth factors (VEGF, bFGF, MMP-9), and survival quality indices (KPS, FACT-L scale).
Results • In the observation group, the objective remission rate (ORR) was 36.96%, and the disease control rate (DCR) was 76.09%. In the experimental group, the ORR was 63.04%, and the DCR was 91.30%. Sintilimab enhanced the clinical efficacy of pemetrexed + platinum drugs, as indicated by improved ORR and DCR in the observation group (P < .05). The incidence of toxic side effects was 39.13% in the observation group and 43.48% in the experimental group, showing no significant difference (P > .05). Sintilimab + pemetrexed + platinum drugs demonstrated marked anti-tumor efficacy, reducing serum
CA125, CEA, and CA199 concentrations compared to the regimen without sintilimab (P < .05). Patients with sintilimab exhibited enhanced immune function, with significantly higher CD4+ and CD4+/CD8+ levels and lower CD8+ levels (P < .05). Sintilimab + pemetrexed + platinum drugs resulted in lower levels of VEGF, bFGF, and MMP-9 compared to pemetrexed + platinum drugs (P < .05), suggesting better cell growth. Sintilimab + pemetrexed + platinum drugs enriched the survival quality of patients, indicated by higher KPS and FACT-L levels (P < .05). Additionally, the demographic characteristics of patients, including age, gender distribution, and disease stage, were comparable between the two groups.
Conclusion • The combination of sintilimab with pemetrexed + platinum-based chemotherapeutic agents shows therapeutic benefits in NSCLC. Improved ORR and DCR in the experimental group underscore clinical relevance. While promising, caution is needed due to the modest sample size and potential biases. A nuanced understanding of limitations is crucial for future research and application. This study prompts further research in NSCLC, advocating for larger cohorts and long-term follow-ups to explore sustained efficacy and potential biomarkers, guiding improvements in patient care. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficiency of Ultrasound-guided CNB and FNA on Specimen Satisfaction, Puncture Tolerance and Classification in Diagnosing Breast Cancer with IMN |
| Lijun Fan, MM; Tianyuan Guo, MM; Jing Liu, MD; Xubai Qiao, MM; Haiou Sun, MM; Yu Tang, MM; Jiangke Tian, MD |
| Objective • This study aims to evaluate the efficiency of ultrasound-guided core needle biopsy (CNB) and fine needle aspiration biopsy (FNA) in the diagnosis of breast cancer with internal mammary node (IMN) metastasis. The focus is on specimen satisfaction, puncture tolerance, and classification accuracy.
Methods • A retrospective analysis was conducted on breast cancer patients (n=106) who underwent ultrasound-guided IMN biopsy at our hospital from March 2020 to March 2023. Patients were divided into CNB and FNA groups based on the biopsy technique. The study analyzed one-time sampling satisfaction, overall specimen satisfaction, and post-puncture pain score (VAS), comparing the effectiveness of both methods in IMN diagnosis and classification.
Results • In the CNB and FNA groups, 3 and 1 cases respectively had unsatisfactory specimens, later excluded in pathological examinations. The FNA group demonstrated higher one-time sampling satisfaction than
the CNB group (P < .05), but no significant difference in overall specimen satisfaction was observed (P > .05). Among 102 patients with satisfactory specimens, 96 showed positive IMN metastasis. The kappa statistics measuring the consistency between biopsy methods and actual IMN (Invasive Mammary Carcinoma) metastasis show a value of 0.637 for CNB (Core Needle Biopsy) and 0.769 for FNA (Fine Needle Aspiration), indicating a higher consistency for FNA. Different IMN types also varied in kappa values. Post-puncture VAS scores were higher in the CNB group (P < .05), with no significant difference in total complication rates between the groups (P > .05).
Conclusion • Ultrasound-guided CNB and FNA both demonstrate good overall specimen satisfaction and equivalent safety. FNA. However, FNA showed superior performance in one-time specimen satisfaction, diagnostic consistency for IMN metastasis, and patient tolerance during the procedure. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Ultrasound-Guided Mammotome Vacuum-Assisted Biopsy for Qualitative Diagnosis of Breast Nodules with Diameter <5 cm |
| Tianyuan Guo, MM; Jing Liu, MD; Xubai Qiao, MM; Haiou Sun, MM; Jiangke Tian, MD; Tao Xu, MM |
| Objective • To evaluate the efficacy of ultrasound-guided Mammotome (MMT) vacuum-assisted biopsy (VAB) for the qualitative diagnosis of breast nodules smaller than 5 cm in diameter.
Methods • A retrospective analysis was conducted on clinical data from 102 patients with breast nodules between November 2020 and November 2023. Patients were divided into two groups: the core needle biopsy (CNB) group (n=56) and the MMT-VAB group (n=46). The MMT-VAB group underwent biopsy using the Mammotome SCM23K breast biopsy system, while the CNB group used a disposable biopsy needle. Surgical pathology results were used as the gold standard. Sensitivity, specificity, and accuracy of the two methods in diagnosing benign and malignant breast nodules were compared. Complications, such as bleeding, hematoma, subcutaneous bruising, and skin damage, were recorded and analyzed.
Results • No significant differences in clinical data were observed between the CNB and MMT-VAB groups
(P > .05). The sensitivity, specificity, and accuracy for the CNB group were 72.41%, 88.89%, and 80.36%, respectively, with a kappa value of 0.609. For the MMT-VAB group, sensitivity was 95.00%, specificity 92.31%, and accuracy 93.48%, with a kappa value of 0.868. The detection rate of malignant lesions was significantly higher in the MMT-VAB group (95.00%) compared to the CNB group (72.41%) (?2=4.027, P = .045). No significant difference in complication rates was found between the two groups (?2=3.608, P = .058).
Conclusion • Ultrasound-guided MMT-VAB offers higher diagnostic accuracy for breast nodules smaller than 5 cm compared to CNB, making it a valuable tool for early diagnosis. Future research should focus on enhancing MMT-VAB technology, understanding factors influencing diagnostic accuracy, expanding clinical applications, and evaluating long-term outcomes to support clinical decision-making. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Impact of the Pneumatic Logistics Transmission System + Intelligent Robot on Blood Routine and Coagulation Function Test Outcomes |
| Yan Liu, MM; Lei Shi, MM; Zhengyang Zhang, MM; Jue Zhang, MM; Jiong Zhu, MM |
| Background • The implementation of intelligent logistics transmission systems signifies a key aspect of modernizing hospital logistics systems in today’s healthcare infrastructure. The pneumatic logistics transmission system (PTS) represents a sophisticated solution for the swift and secure conveyance of medical documents, specimens, and pharmaceuticals within hospital premises.
Objective • This study investigates the influence of integrating the ‘pneumatic logistics transmission system + intelligent robot’ on blood routine and coagulation function test outcomes.
Methods • A comparative study was conducted and a total of 50 participants were included in the study. Blood samples were collected from participants, including those undergoing blood routine tests, individuals with anemia, and patients undergoing outpatient urine routine assessments. The study systematically evaluated the effects of integrating the pneumatic logistics transmission system + intelligent robot on conventional blood tests and blood coagulation function analyses. The study compared the
results obtained from the two transmission methods to evaluate their effectiveness in preserving the integrity of the specimens during transit.
Results • The study revealed statistically significant differences in blood counts (P < .05), hemoglobin levels, and hematocrit levels among anemia patients (P < .05), with no observed presence of white blood cells (P > .05). Furthermore, when compared to the manual transport group, the pneumatic logistics transport system + intelligent robot group exhibited statistically significant activity of coagulation factors (P < .05), while no statistical disparities were noted among coagulation function indexes (P > .05).
Conclusion • The integration of pneumatic logistics with intelligent robotics in hospital transmission systems proves beneficial for transporting various medical specimens efficiently. This combined approach streamlines logistics processes and enhances overall operational effectiveness within healthcare facilities. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Investigation of Efficacy and Safety of Bevacizumab Combined with Chemotherapy in the Treatment of Malignant Pleural Effusion from Lung Cancer |
| Na Liu, MM; Xiaoyue Wang, MM; Ting Xu, MM; Shu Xu, MM |
| Objective • To analyze the efficacy and safety of bevacizumab combined with chemotherapy in the treatment of malignant pleural effusion of lung cancer.
Methods • Lung cancer patients with malignant pleural effusion (n = 60 cases) treated in our hospital from January 2020 to December 2022 were retrospectively analyzed. They were divided into a control group (patients receiving conventional chemotherapy) and an observation group (patients receiving bevacizumab combined with chemotherapy). The two groups were age and sex-matched. The therapeutic effects, adverse reactions, quality of life (physiological status, social and family status, emotional status, and functional status), levels of serum tumor markers (cytokeratin 19 fragment, tumor-specific growth factor, and carcinoembryonic antigen), pain degree of the two groups before and after treatment, and the psychological states before and after treatment (anxiety and depression scores) of the two groups were compared.
Results • The results obtained shows that the observation
group has improved treatment outcome than the control group, P < .05. Similarly, the observation group reported higher physiological status, social and family status, emotional status, functional status and other quality of life compared to the control group, P < .05. Interestingly, the observation group showed lower levels of serum tumor markers than the control group, P < .05. Upon comparison of the pain degree of the two groups after treatment, the observation group reported a lesser degree of pain than the control group, P < .05. Although no significant difference was observed in the depression and anxiety scores of the two groups prior to the treatment, the observation group displayed improved psychological state compared to the control group, P < .05.
Conclusion • Bevacizumab combined with chemotherapy has outstanding curative effect on malignant pleural effusion of lung cancer. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application Effect of Plan-do-check Action Cycle Nursing Protocol on Improving the Accuracy of Urine Specimen Collection in Newborn Female Infants |
| Nan Jin, MM; Xuejie Liu, BD; Haiwei Liu, BD; Xuqian Song, MM; Lina Song, MM |
| Background • The effect of traditional disposable infant urine collectors is not ideal for female newborns. Due to the poor adhesion of the traditional urine collection bag, it does not meet the physiological and anatomical characteristics of female newborns. Therefore, it is necessary to adopt effective nursing in urine specimen collection in newborn female infants.
Objective • To explore the effect of plan-do-check action cycle nursing protocol on improving the accuracy of urine specimen collection in newborn female infants.
Design • This was a randomized controlled study.
Setting • This study was carried out in the Department of Pediatrics, Strategic Support Force Medical Center.
Participants • A total of 120 female newborns admitted to our hospital from January 2021 to June 2022 were selected and divided into a control group and a study group, with 60 cases in each group.
Interventions • The control group collected urine samples by routine methods, which used the traditional disposable urine bag collection method. The study group collected urine
samples using the plan-do-check action cycle nursing mode.
Primary Outcome Measures • (1) success rate of urine collection, collection times, and sample contamination rate (2) cleanliness of the vaginal opening (3) satisfaction of urine collection (4) retention time of urine samples and (5) urine pondus hydrogenii values.
Results • Compared to the control group, the success rate of urine collection in the study group was higher, the collection times and specimen contamination rate were significantly lower, the time for collecting urine samples in the study group was shorter, the cleanliness of female vaginal opening in the study group was significantly better, the proportion of female urine pondus hydrogenii 6-7 in the study group was significantly higher (all P < .05).
Conclusion • The application of the plan-do-check action cycle management mode in the urine samples of newborn female infants can not only effectively improve the success rate of collection but also improve the cleanliness of the vaginal mouth and make the test results more accurate. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application Efficacy of Cluster Nursing in Patients Undergoing Gastrointestinal Endoscopy |
| Xiaoxia Fu, BD; Lin Jiang, BD; Qin Li, BD; Wenfang Sun, BD |
| Background • Gastrointestinal endoscopy is a clinical examination of gastrointestinal diseases with pain, nausea, and other discomfort of the patient. Therefore, it is of practical significance to give corresponding nursing intervention for patients undergoing painless gastrointestinal endoscopy.
Objective • To probe the application efficacy of cluster nursing in patients undergoing gastrointestinal endoscopy.
Design • This was a retrospective study.
Setting • This study was carried out in the Department of Endoscopy Room, Funan County Hospital of Traditional Chinese Medicine.
Participants • From March 2020 to October 2022, 126 patients who underwent painless gastrointestinal endoscopy were chosen and randomly separated into a control group and research group.
Interventions • The control group received routine safety nursing management. The research group adopted safety management guided by a cluster nursing strategy.
Primary Outcome Measures • (1) the dosage of anesthetic drug use and examination time (2) hemodynamics (3) occurrence of common adverse events (4) score of bowel preparation (5) scores of anxiety and depression (6) comfort degree and (7) nursing satisfaction.
Results • Compared to the control group, the dosage of anesthetic drug use and examination time in the research group were lessened (P < .001, 95% CI: -10.06--7.94 and P < .001, 95% CI: -7.10--4.88), the diastolic blood pressure, systolic blood pressure, and heart rate indexes in the research group were reduced (P = .03, 95% CI:-10.07--5.32; P < .001, 95% CI:-13.87--7.91 and P < .001, 95% CI:-12.23--6.27), the occurrence of adverse events during the examination in the research group was reduced (?2=8.068, P = .005), the score of bowel preparation in the research group was elevated (P < .001, 95% CI: 1.06-1.56), the scores of anxiety as well as depression in the research group were reduced (P < .001, 95% CI: 10.77-13.35 and P < .001, 95% CI: 7.31-9.53), the comfort score of patients in the research group presented higher (P < .001, 95% CI: 17.77-22.91), and the nursing satisfaction in the research group was elevated (?2=10.31, P = .001).
Conclusion • Cluster nursing for patients with painless gastrointestinal endoscopy combined examination has a positive impact on ensuring the successful completion of the examination, effectively controlling the risk of adverse events, and improving patient satisfaction. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Computer-guided Operations on Improving the Distal Femoral Flexion Angle on the Sagittal Placement of Femoral Prosthesis in Total Knee Arthroplasty |
| Gang Kong, MM; Kegui Liu, MM; Dan Liu, BD; Jingbo Pan, MM; Qi Zhang, MM |
| Background • The precise placement of prosthesis in total knee arthroplasty (TKA) surgery significantly impacts the postoperative outcomes and the long-term survival rate of prosthesis. While the optimal coronal position of femoral prosthesis has been extensively researched, there remains a gap in the study of sagittal placement. Therefore, our aim is to investigate the impact of the distal femoral flexion angle (DFFA) on the sagittal placement of femoral prosthesis in TKA.
Methods • A total of 88 patients (90 knees) with osteoarthritis were enrolled in this study. To mitigate the impact of DFFA, they were randomly assigned to either the traditional operation group (50 cases) or the computer navigation operation group (40 cases). A comparison was made between the two groups regarding the sagittal femoral prosthesis flexion angle (SFPFA) and the sagittal femoral component angle (SFA). Additionally, linear regression analysis was conducted to analyze DFFA, SFA, and SFPFA.
Results • The absolute values of DFFA were (2.27 ± 0.32)° in the navigation group and (2.15 ± 0.27)° in the traditional group (t=0. 30, P = .77). The absolute values of SFPFA were (0.63 ± 0.14)° in the navigation group and (2.40 ± 0.29)° in the traditional group (t =-5. 47, P = .05). The
absolute values of SFA were (4.44 ± 0.62)° in the navigation group and (7.20 ± 0.57)° in the traditional group, with SFA being lower in the navigation group compared to the traditional group (t =-3. 28, P = .002). The regression equations between DFFA and SFA in navigation group and traditional operation group were SFA=5. 510-0.979×DFFA (P = .01) and SFA=7. 869-0.971×DFFA (P = .08), respectively. The regression equations between DFFA and SFPFA in navigation group and traditional operation group were SFPFA=0. 105-0.081×DFFA (P = .38) and SFPFA=-0. 96 +0.516 ×DFFA (P = .06), respectively.
Conclusion • In TKA, the DFFA can impact the placement position of the femoral prosthesis in the sagittal position. When compared to traditional operation methods, computer-guided operations tend to provide a more precise and accurate sagittal position of femoral prosthesis. This study represents the first investigation into the influence of DFFA on the sagittal placement of femoral prostheses in TKA, addressing a research gap in this area. It further underscores the important role of computer-guided surgery in achieving accurate sagittal alignment of femoral prostheses, suggesting a potential adjunctive approach. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application of Subpatellar Venous Catheter Thrombolysis in Early Acute Lower Extremity Deep Vein Thrombosis |
| Yuchan Chen, MM; Wenhong Gao, BM; Hongqi Guo, BM; Jun Li, MM; Man Li, BM |
| Objective • To compare the effectiveness and safety of intravenous thrombolysis via the subpatellar vein versus the conventional popliteal vein approach in patients with early acute deep venous thrombosis (DVT) of the lower extremities.
Methods • This study included 160 early-stage acute lower extremity DVT patients at our hospital from January 2020 to October 2023, randomly assigned to two groups using sealed envelopes. The control group underwent catheter-directed thrombolysis via the popliteal vein, while the study group received thrombolysis via the subpatellar vein. Surgical parameters, limb circumferences, blood parameters, vein patency, and adverse reactions were evaluated.
Results • The study group had longer surgery and X-ray times, as well as a lower urokinase dose compared to the control group (P < .05), with no significant difference in thrombolysis time (P > .05). Thigh and calf circumferences and edema rates didn’t significantly change before and after thrombolysis in both groups (P > .05). Hematological parameters, including PT, INR, APTT, FIB, TT, and D-D
levels, remained similar between the two groups before and after thrombolysis (P > .05). However, after thrombolysis, both groups showed increased PT, INR, APTT, and TT levels and decreased FIB and D-D levels compared to before thrombolysis (P < .05). Porter scores showed no significant differences between the two groups before thrombolysis (P > .05), but after thrombolysis, both groups had reduced Porter scores, with the study group showing a more pronounced decrease (P < .05). Additionally, the study group had a higher vein patency rate and GCQ score than the control group (P < .05). Adverse reactions occurred at a similar rate in both groups (P > .05).
Conclusion • Subpatellar vein catheter-directed thrombolysis offers a safe and more effective alternative to traditional popliteal vein approaches for early acute DVT of the lower extremities, improving outcomes such as vein patency and reducing the need for urokinase. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of the Effect of Rapid Rehabilitation Nursing in the Perioperative Period of Brucellar Spondylitis |
| Liwen Guo, BM; Jianhua Tang, MBBS; Yinghui Xue, BM; Xinming Yang, BM; Maili Zhang, BM; Ying Zhang, BM; Guoqing Zheng, BM |
| Objective • To explore the effect of rapid rehabilitation nursing in patients with brucellar spondylitis during the perioperative period.
Methods • A total of 68 patients with brucellar spondylitis who underwent surgical treatment in our hospital from August 2019 to May 2022 and met the inclusion criteria were enrolled as study subjects. The patients were divided into a conventional group and a rehabilitation group with 34 cases each according to different nursing methods. The conventional group received routine nursing intervention and the rehabilitation group received perioperative rapid rehabilitation nursing intervention. The clinical data of patients were recorded, and the length of hospital stay, nursing intervention effect, pain perception, kyphotic Cobb angle changes, perioperative complications, and the satisfaction scores of patients were compared between the two groups.
Results • The hospitalization time of patients in the rehabilitation group was significantly shorter and the clinical effective rate was significantly higher in the
rehabilitation group than that of the conventional group, P < .05. The VAS scores of the rehabilitation group were significantly lower than the conventional group at each time point, P < .05. The total incidence of complications and the kyphotic Cobb angle at 3 days and 2 weeks post-operation of the rehabilitation group was significantly lower than the conventional group, P < .05; while the patient satisfaction was significantly higher in the rehabilitation group, P < .05.
Conclusion • Rapid recovery nursing intervention for patients with brucellar spondylitis has a definite effect in the perioperative period, which can effectively reduce the pain experience of patients, improve the treatment effect, shorten the hospitalization time of patients, reduce the occurrence of perioperative complications, improve patient satisfaction, and promote the functional recovery of patients. The findings are significant and warrant the clinical promotion and application of fast recovery nursing intervention in the perioperative period of brucellar spondylitis. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of Sacubitril/Valsartan on Cardiac Structure and Blood Levels of miRNA-328 and NT-proBNP in Patients with CHD and Chronic Heart Failure |
| Huayu Ma, BM; Chengbo Sun, MD; Zhao Yang, MM; Delu Yin, MD |
| Objective • This study specifically investigates the impact of sacubitril/valsartan on cardiac structural remodeling and modulation of blood levels of miRNA-328 and NT-proBNP in patients with coronary heart disease (CHD) complicated by chronic heart failure (CHF). We aim to determine whether sacubitril/valsartan offers advantages over traditional therapies regarding cardiac morphology and molecular biomarkers, thus providing insights into its potential role in managing CHD and CHF.
Methods • From January 2020 to January 2023, CHD patients with chronic heart failure were randomized into two groups for this study. Both groups received standard treatments: the control group received valsartan, while the study group received sacubitril/valsartan. Therapeutic outcomes were analyzed, including changes in cardiac structure, function, miRNA-328, and NT-proBNP levels in the blood, along with noting any adverse reactions.
Results • The total effective rate in the study group was 86.67%, significantly higher than that in the control group (71.67%) (P < .05). After treatment, both groups exhibited reductions in left atrial anterior and posterior diameter, left
ventricular end-diastolic diameter, and left ventricular end-systolic diameter compared to before treatment, with the study group showing lower values than the control group (P < .05). The left ventricular ejection fraction (LVEF) increased in both groups, with the study group showing a higher increase than the control group. Additionally, the end-diastolic volume and end-systolic volume decreased in both groups after treatment, with the study group showing greater decreases than the control group (P < .05). Moreover, both groups exhibited reductions in peripheral blood levels of miRNA-328 and NT-proBNP, with the study group showing greater reductions than the control group (P < .05). There was no significant difference in the incidence of adverse reactions between the study group and the control group during treatment (P > .05).
Conclusion • Sacubitril/valsartan significantly improves cardiac function and structure in patients with CHD complicated by CHF, effectively reducing levels of miRNA-328 and NT-proBNP in the blood. It demonstrates safety and high value in clinical applications. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Inflatable Warming Blanket on Preventing Hypothermia in Neonates after Cesarean Section |
| Chunmin Chen, MM; Qiling Wu, BM; Jie Zhao, BM |
| Objective • To evaluate the effectiveness of an inflatable heating blanket in preventing hypothermia during hospital transport of neonates following cesarean section, and to assess its impact on vital signs and parental satisfaction.
Methods • Newborns delivered via cesarean section between June 2023 and October 2023 were randomly assigned to two groups. The control group infants were transported with the mother on a transport bed without additional warming. In the observation group, newborns were placed on an inflatable warming blanket before transport with the mother. The study included 96 newborns who met specific inclusion criteria. Vital signs, blood glucose, blood gas parameters, rectal temperature, incidence of adverse events, and parental satisfaction were compared between the two groups.
Results • There were no significant differences in basic vital signs, blood glucose, blood gas parameters, or rectal temperature between the groups at the start of the study (P > .05). However, during transport, respiratory and pulse
rates increased and rectal temperature decreased significantly in the control group (P < .05). In the observation group, there were no significant changes in vital signs, blood glucose, blood gas parameters, or rectal temperature during transport (P > .05). However, respiratory and pulse rates were lower, and rectal temperature was higher than the control group upon arrival in the ward (P < .05). The observation group had higher rectal temperatures, a lower incidence of hypothermia (rectal temperature <36.5°C), and greater parental satisfaction compared to the control group, with significant differences (P < .05).
Conclusion • Using an inflatable heating blanket effectively reduces the occurrence of hypothermia during neonatal transport after cesarean section, stabilizes vital signs, and enhances parental satisfaction. These findings suggest potential recommendations for clinical practice and could influence transport protocols in other hospitals. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Enteral Nutrition Support with Ultrasound-guided Three-lumen Gastrojejunal Tube Insertion on Success Rate of Catheterization |
| Weijing Cai, BM; Pengpeng Chang, BM; Jingfeng Gu, MM; Haiyan Guo, BM; Conghui Li, MD; Haixia Liu, MM; Jian Wang, BM |
| Objective • The primary aim of this study is to explore the effects of enteral nutrition support with ultrasound-guided three-lumen gastrojejunal tube insertion on nutritional status in patients with severe neurological diseases. Additionally, we aim to assess the impact of this intervention on the success rate of catheterization and the aspiration rate, to comprehensively evaluate its benefits and optimize patient care.
Methods • Between March 2022 and March 2023, 60 patients were recruited and randomly divided into ultrasound-guided and control groups of 30 patients each using the Simple Randomisation method. In the control group, a triple-lumen feeding tube was blindly inserted at the bedside for enteral nutritional therapy, and in the ultrasound-guided group, ultrasound-guided identification of gastric structures for placement of a triple-lumen feeding tube for enteral nutritional support, and both treatments were continued for 2 weeks. The success rate of catheterization, nutritional status, aspiration rate, patient satisfaction, and incidence of complications were compared between the two groups before and after treatment.
Results • The difference in the success rate of catheterization between the ultrasound guidance group and control group was not statistically significant (93.33% vs 96.67%, P>0.05). After treatment, TP (70.84±3.54 vs 67.15±4.23), ALB (41.23±3.65 vs 38.22±3.47), and Hb (11.54±0.62 vs
9.35±0.28) levels in the ultrasound guidance group were higher than in the control group (P < .05). The difference in aspiration rate between the ultrasound guidance group and control group was not statistically significant [0.00% (0/30) vs 3.33% (1/30), P > .05]. The patient satisfaction in the ultrasound guidance group was higher than that in the control group (P < .05). The difference in the incidence of complications (stomachache, headache, nausea, and vomiting) between the ultrasound guidance group and control group was not statistically significant (6.67% vs 20.00%, P > .05).
Conclusion • Enteral nutrition support with ultrasound-guided three-lumen gastrojejunal tube insertion can improve the success rate of catheterization and nutritional status, reduce aspiration rate, and improve satisfaction in patients with severe neurological diseases. In the future, we need to further investigate the incorporation of ultrasound guidance into standard care protocols for patients with severe neurological disorders requiring enteral nutrition. The indications for ultrasound guidance in nursing should also be expanded. In conclusion, ultrasound-guided insertion should be considered the technique of choice for improving nutritional status in the population of patients with severe neurological disease. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of Clinical Outcome and Prognosis of C-reactive Protein Combined with Albumin in Patients with Acute Myocardial Infarction |
| Xiaomei Li, PhD; Chunyu Liang, MM; Fen Liu, PhD; Jie Shan, MM; Chunfang Shan, MD; Ning Song, PhD; Yining Yang, PhD; Tong Zhang, PhD; Xuehe Zhang, PhD; Qian Zhao, PhD; Jiajun Zhu, MD |
| Objective • This study aims to assess the combined predictive value of C-reactive protein (CRP) and albumin (ALB) for major adverse cardiovascular events (MACE) post-percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI)
Methods • We analyzed data from continuously enrolled AMI patients who underwent emergency PCI at the First Affiliated Hospital of Xinjiang Medical University over six years, employing logistic regression to derive a predictive equation for in-hospital mortality and out-of-hospital MACE events. Primary endpoints: In-hospital death and out-of-hospital major adverse cardiovascular events. The patients were followed up for 1, 3, 6, and 12 months after discharge. The average follow-up time was 41 months.
Results • Among the 601 patients studied, we observed 16 in-hospital deaths and 131 out-of-hospital MACE events.
Multivariate logistic regression analysis showed that the independent predictors of out-of-hospital MACE events were age (OR=1.067, 95% CI 1.013-1.124, P = .028), C-reactive protein (OR=1.012, 95% CI 1.000-1.025, P = .045) and albumin (OR=0.874, 95% CI 0.785-0.973, P = .014). Our multivariate logistic regression analysis identified age, CRP, and albumin as independent predictors, with the combined equation yielding an ROC curve area of 0.85, effectively stratifying patients into high-risk and low-risk groups. Subsequent follow-up results validated this risk stratification approach.
Conclusion • The study underscores the efficacy of combining CRP and albumin levels as a predictive measure for in-hospital death and out-of-hospital MACE events in AMI patients post-PCI. ( |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Ulinastatin Combined with Somatostatin on Inflammatory Markers, Hemodynamics and Immune Cells in the Treatment of Severe Pancreatitis |
| Fang Han, MM; Yixi Li, MM; Xue Yang, MM |
| Objective • Severe pancreatitis presents a formidable clinical challenge, often associated with high mortality rates and compromised quality of life. This study aimed to assess the efficacy of combining ulinastatin with somatostatin in treating severe pancreatitis, with a focus on improving patient outcomes.
Methods • We conducted a study on 98 severe pancreatitis patients at our hospital from January 2022 to March 2023. These patients were randomly divided into two groups: a control group (n=49) treated with somatostatin and an experimental group (n=49) treated with ulinastatin plus somatostatin. The control group received 250 micrograms per hour of somatostatin intravenously for 72 hours. The experimental group received 200 000 units of ulinastatin every 8 hours intravenously, along with the same somatostatin regimen. We compared clinical efficacy, inflammatory markers (TNF-a, CRP, IL-6), hemodynamic parameters (MAP, CVP, HR, SVR), and immune cell function between the groups.
Results • Post-treatment, the experimental group showed significant improvements compared to the control group (P < .05) in various parameters. Decreases in AMS, TNF-a, CRP, IL-6, MAP, CVP, and CD8+ T-cells were more
pronounced in the experimental group. Notably, AMS levels dropped from 450 U/L to 150 U/L, and TNF-a levels from 55 pg/mL to 20 pg/mL in the experimental group. Conversely, increases in HR, SVR, CD4+ T-cells, CD4+/CD8+ ratio, and NK cell counts were observed. For instance, CD4+ T-cells rose from 300 cells/µL to 500 cells/µL. The experimental group exhibited a higher clinical efficacy rate of 97.96%, compared to 85.71% in the control group. The combined treatment of ulinastatin with somatostatin demonstrated significant effectiveness in improving clinical outcomes compared to the control group. Statistical analysis robustly supported these findings, providing confidence in their reliability. Importantly, the combined therapy showed promise in reducing mortality rates and enhancing the quality of life for patients with severe pancreatitis.
Conclusion • The findings of this study hold substantial clinical implications, potentially influencing treatment protocols and patient management strategies for severe pancreatitis. The integration of ulinastatin combined with somatostatin into standard care protocols could significantly improve treatment outcomes and patient prognosis. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of Diagnosis and Treatment of Patients with Acute Coronary Syndrome Treated by Emergency Rescue |
| Hongying Cui, MM; Xiaoliang Guo, MM; Fang Li, MM |
| Objective • to evaluate the impact of differential emergency treatment measures on the prognosis of patients with ACS.
Methods • 76 patients with ACS treated in the emergency department of our hospital from January 2017 to September 2021 were selected as the research objects. According to their main symptoms, general signs, and various examination results when arriving at the hospital, differential emergency treatment measures were implemented, so as to ensure the curative effect.
Result • After comprehensive emergency treatment, the venous blood test indicators of patients, including creatinine (CR), uric acid (UA), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C),
lipoprotein A (LPA), Apolipoprotein AI (ApoAI), Apolipoprotein B (ApoB), Potassium ion (K+), glucose (GLU), Cardiac troponin I (cTn) returned to normal. In addition, the proportion of patients without cardiogenic shock, ventricular fibrillation, respiratory and cardiac arrest, cerebral infarction, cerebral hemorrhage, arrhythmia, heart rupture, and other adverse reactions are as high as 92% (70/76).
Conclusion • For patients with ACS, it is necessary to take correct emergency rescue and treatment measures immediately, especially to actively implement the percutaneous coronary intervention (PCI) method, so as to give full play to the safety and effectiveness of emergency treatment and curb the possibility of patient death as much as possible. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Serum CEA, CYFRA-211, and NSE as Diagnostic Biomarkers for Bone Metastasis in Lung Cancer |
| Xueying Duan, MM; Rongmei Fan, MM; Yunyan Tai, MM; Yifen Yan, MM |
| Objective • This study aims to assess the diagnostic efficacy of serum carcinoembryonic antigen (CEA), cytokeratin fragment 21-1 (CYFRA21-1), and neuron-specific enolase (NSE) in detecting bone metastases in patients with non-small cell lung cancer (NSCLC).
Methods • A retrospective analysis was conducted on 120 NSCLC patients diagnosed between January 2023 and June 2023. Patients were categorized into bone metastasis (n=60) and non-bone metastasis (n=60) groups. Bone metastasis severity was graded using Soloway criteria, and serum biomarker levels were measured via electrochemiluminescence.
Results • No significant differences in basic information were observed between the two groups (P > .05). Patients with bone metastasis exhibited higher levels of CEA, NSE, and CYFRA21-1 compared to those without bone metastasis (P < .001). The OR with 95% CI for NSE (ng/mL) was 1.966 (95%CI: 1.672 - 2.311), for CEA (ng/mL)
was 6.854 (95%CI: 5.419 - 8.688), and for CYFRA21-1 (ng/mL) were 1.527 (95%CI: 1.291 - 1.805). Biomarker levels increased with bone metastasis (P < .05). The NSE (ng/mL) values for Level II vs Level I were OR = 1.155 (95%CI: 1.024 - 1.303), and for Level III vs Level I, the OR was 1.455 (95%CI: 1.291 - 1.637). The CEA (ng/mL) values for Level II vs Level I were OR = 1.111 (95%CI: 0.998 - 1.237), and for Level III vs Level I, the OR was 1.324 (95%CI: 1.184 - 1.483). The CYFRA21-1 (ng/mL) values for Level II vs. Level I were OR = 1.102 (95%CI: 0.988 - 1.230), and for Level III vs Level I, the OR was 1.332 (95%CI: 1.190 - 1.491). In addition, CEA demonstrated an AUC of 0.789, while the combined diagnosis AUC was 0.816.
Conclusion • Serum CEA, CYFRA21-1, and NSE levels correlate with bone metastases severity in NSCLC and have the potential to improve diagnostic efficacy. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Spleen Aminopeptide Oral Lyophilized Powder and Fluticasone/salmeterol Powder Inhaler on Pulmonary Function and Incidence of Adverse Reactions in Children with Cough Variant Asthma |
| Chao Chen, MM; Run Guo, MM; Jun-Ting Liu, MBBS; Yong-Li Wu, MBBS; Rui-Qian Xi, MBBS; Jing Yang, MBBS |
| Background • Cough variant asthma is a prevalent condition among children with chronic cough, significantly impacting their health and well-being.
Objective • This study aimed to assess the impact of spleen aminopeptide oral lyophilized powder and fluticasone/salmeterol powder inhaler on pulmonary function and the incidence of adverse reactions in children with cough variant asthma.
Methods • A total of 60 children with cough variant asthma admitted to the Pediatric Department of Cangzhou Central Hospital between July 2019 and June 2020 were enrolled in the study. Using the random number table method, they were assigned to either the observation group or the control group, with 30 cases in each group. The control group received treatment with fluticasone/salmeterol powder inhalers, while the observation group received a combination of fluticasone/salmeterol powder inhalers and spleen aminopeptide oral lyophilized powder. After 8 weeks of treatment, various clinical parameters, including forced vital capacity, forced expiratory volume per second/forced vital capacity, peak expiratory flow, fractional exhaled nitric oxide (FeNO), interleukin-4 (IL-4), IL-10, eosinophils in induced sputum, and serum CD4+ and CD8+ levels, were compared between the two groups.
Results • The observation group exhibited a higher total effective rate of clinical efficacy compared to the control group [90.00% vs. 63.33%; OR (95% CI) 3.00 (1.01-8.92), P = .048)]. After 8 weeks, the observation
group demonstrated higher levels of forced vital capacity, forced expiratory volume per second/forced vital capacity, peak expiratory flow [OR (95% CI) 0.48 (0.26-0.88), P = .017; OR (95% CI) 0.29 (0.14-0.57) 2.57 (1.46-4.52) 0.33 (0.16-0.70), P = .000, .001, .003], IL-10 [OR (95% CI) 0.29 (0.14-0.57), P = .000], and lower levels of FeNO [OR (95% CI) 0.48 (0.26-0.88), P = .017], IL-4, and eosinophils [OR (95% CI) 2.57 (1.46-4.52) 0.33 (0.16-0.70), P = .001, .003] compared to the control group (P < .05). Furthermore, the observation group exhibited higher levels of CD4+ and CD4+/CD8+ compared to the control group [OR (95% CI) 0.41 (0.25-0.67) 0.33 (0.20-0.56) 1.73 (1.18-2.55), P = .000, .000, .001]. Computed tomography measurements revealed significantly lower airway wall thickness, basement membrane thickness, and total airway wall area in the observation group compared to the control group [OR (95% CI) 0.18 (0.10-0.33) 0.23 (0.13-0.41) 0.28 (0.15-0.51), P = .000, .000, .000]. The incidence of adverse reactions did not significantly differ between the groups (6.67% vs. 3.33%; P > .05).
Conclusion • The combination treatment of spleen aminopeptide oral lyophilized powder and fluticasone/salmeterol powder inhaler effectively improves lung function, FeNO levels, and airway inflammation, while enhancing cellular and humoral immune function in children with cough variant asthma. These findings have significant clinical implications and warrant further promotion and application of this treatment approach. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Correlation Analysis of Estrogen Levels and Psychological Status Among Patients with Uterine Fibroids |
| Mei Cheng, BM; Lianqin Cheng, BM; Boyao Xia, BM; Shan Xu, BM; Lijun Ye, BM |
| Objective • This study aims to investigate the correlation between estrogen levels and psychological distress, focusing on depression and anxiety symptoms among patients diagnosed with uterine fibroids.
Methods • The study employed a retrospective design and enrolled a cohort comprising 50 patients diagnosed with uterine fibroids and 50 healthy individuals as controls. Serum estradiol levels were quantified using a chemiluminescent immunoassay technique one month before surgery in the patient group. Depression and anxiety levels were evaluated using the Self-Rating Depression Scale (SDS) and the Self-Rating Anxiety Scale (SAS), respectively.
Results • Significant differences in SDS scores, SAS scores, and serum estradiol levels emerged between the patient and control groups (P < .05). Patients exhibited higher SDS and SAS scores alongside elevated serum estradiol levels. Correlation analysis unveiled a negative association between SAS scores and estrogen levels among patients
(r = -0.724, P = .013), suggesting a rise in anxiety levels with declining estrogen levels. Similarly, a negative correlation surfaced between SDS scores and estrogen levels among patients (r = -0.624, P = .016), indicating increased depressive symptoms as estrogen levels decrease. Conversely, no noteworthy correlations were demonstrated between anxiety or depressive symptoms and estrogen levels in the control group.
Conclusion • Reduced estrogen levels were linked to heightened anxiety and depressive symptoms in patients with uterine fibroids. These findings suggest a plausible connection between estrogen hormone levels and psychological well-being, particularly concerning anxiety and depression. Further exploration of this association is warranted to shed light on potential therapeutic interventions targeting hormonal regulation to improve psychological distress in affected individuals. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Specific Measures and Benefits of Comprehensive Nursing Model in Clinical Practice for Pediatric Purulent Tonsillitis |
| Fang Han, MBBS; Meili Ma, MBBS; Fenglan Wu, MBBS |
| Context • Pediatric purulent tonsillitis is a common infectious disease in children and can be difficult to cure and can recur with irritation of the throat. To improve treatment outcomes, alleviate symptoms, and promote recovery, an effective clinical-nursing intervention is often necessary.
Objective • The study aimed to explore the specific measures of the comprehensive nursing model for pediatric patients with purulent tonsillitis and to analyze its practical value in improving patients’ treatment outcomes and quality of life (QoL) in clinical application, to provide feasible references and guidance for medical practice.
Design • The research team conducted a randomized controlled trial.
Setting • The study took place at Mengcheng County First People’s Hospital.
Participants • Participants were 80 pediatric patients who had received a diagnosis of purulent tonsillitis at the hospital between December 2020 and March 2022.
Interventions • The research team randomly divided participants into two groups, with 40 participants in each group: (1) the intervention group, who received comprehensive nursing care in addition to routine nursing care, and (2) the control group, who received routine nursing care only.
Outcome Measures • The research team: (1) evaluated times to relief of throat pain and to improvement of hoarseness, (2) assessed times to recovery of body temperature, white blood cells, and tonsillar signs, (3) measured treatment compliance, and (4) conducted a health knowledge survey with the children’ family members at baseline and postintervention using a visual analogue scale (VAS).
Results • Compared to control group, the intervention group’s (1) times to relief of throat pain and improvement time of hoarseness were significantly shorter (both P < .05); (2) times to recovery of temperature (P = .002), white blood cells (P = .006), and tonsillar signs (P = .024) were significantly shorter; (3) treatment compliance was significantly higher (P = .021); and (4) level of health knowledge of family members was significantly higher (P < .001).
Conclusions • The comprehensive nursing model for pediatric purulent tonsillitis can effectively improve pediatric patients’ treatment outcomes, shorten their recovery times, enhance the health knowledge of family members, and provide a better focus on the overall health of pediatric patients. The model has a positive significance for pediatric patients’ rehabilitation and is worth promoting. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Assessing the Efficacy of an External Insulation Fixed Kit in Maintaining Optimal Temperature for Hot Compress Therapy |
| Yaqin Tang, MM; Yandi Zhu, MM |
| Background • Hot compress therapy is commonly used for various musculoskeletal conditions, aiming to alleviate pain and improve blood circulation. However, maintaining the desired temperature throughout the treatment session can be challenging.
Objective • This study aims to investigate the impact of an external insulation fixed kit on maintaining the optimal temperature during hot compress therapy.
Methods • A randomized controlled trial was conducted, and a total of 116 patients undergoing heat application were selected. The patients were divided into two groups: the control group (C Group, n=58), utilizing traditional external application methods, and the research group (R Group, n=58), employing the external insulation fixed kit. Parameters including the temperature of the external application material, displacement rate, dislodgement rate, and satisfaction with the heat application after 20 minutes
of clinical use were compared between the two groups.
Results • After 20 minutes of clinical application, the temperature in the R Group was [36.76 (35.60, 37.83)]°C, significantly higher than the C Group temperature of [26.26 (24.48, 27.90)]°C (P < .001). The incidence of displacement was 1.70%, and dislodgement was 0% in the R Group, while in the C Group, it was 8.60% and 5.20%, respectively. However, these differences were not statistically significant (P > .05). The satisfaction rate with hot packs was 91.38% in Group R and 74.14% in Group C, with significantly higher satisfaction in Group R (P < .05).
Conclusion • The utilization of the external insulation fixed kit effectively maintained the optimal temperature during heat application treatment without increasing the rates of displacement and dislodgement. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Impact of Cohort Management on Disease Perception, Fear of Disease Progression, Nutritional Status, and Quality of Life in Patients with Lymphoma |
| Yang He, MM; Huiling Qiu, MM; Weiyi Zhu, MD |
| Objective • This study aims to investigate the impact of cohort management on illness perception, fear of disease progression, nutritional status, and quality of life among patients with lymphoma.
Methods • A total of 128 cases of lymphoma patients admitted to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, between April 2020 and November 2021 were included as research participants. The patients were randomly assigned to two groups: a 64-member control group and a 64-member observation group. The observation group received group management, while the control group received standard nursing care. Before and after the intervention, assessments were conducted to evaluate disease perception, fear of disease progression, nutritional status, and quality of life, with comparisons made between the two groups.
Results • No clinically significant differences (P > .05) were observed between the two groups regarding gender, age, chemotherapy cycles, clinical stage, disease type, or other general characteristics. Disease awareness showed no significant disparity between groups pre-intervention
(P > .05), but post-intervention, the observation group exhibited marked improvement (P < .05). Initially, fear of disease progression did not differ significantly between groups (P > .05), but post-intervention, the observation group demonstrated lower scores in total fear of disease progression, social, family, and physical health domains compared to the control group (P < .05). While nutritional status comparisons initially resulted in no significant differences (P > .05), levels of serum albumin, prealbumin, hemoglobin, lymphocytes, and ferritin were notably higher in the observation group post-intervention (P < .05). Quality of life assessments showed no significant disparity pre-intervention (P > .05); however, post-intervention, the observation group experienced significantly reduced dyspnea, insomnia, and appetite loss (P < .05).
Conclusion • Participation in cohort management interventions benefits lymphoma patients by enhancing emotional coping and improving nutritional health and quality of life. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Predictive Value of Amplitude-Integrated Electroencephalogram Combined with General Movements for Neurodevelopmental Outcomes in Neonates with Severe Hyperbilirubinemia |
| Xiaoning Du, MM; Guimei Du, MM; Rongrong Gao, MM; Lixia Liang, MBBS; Dan Liu, MBBS; Xuejing Xu, MBBS; Weibo Yang, MM |
| Objective • To investigate the predictive value of amplitude-integrated electroencephalogram (aEEG) combined with general movements (GMs) for neurodevelopmental outcomes in neonates with severe hyperbilirubinemia.
Methods • A total of 115 infants with severe hyperbilirubinemia admitted to our hospital from December 2021 to February 2024 were enrolled. All the subjects were tested using aEEG, GMs, cranial magnetic resonance imaging (MRI), or auditory brainstem response (ABR), and followed up for 12 months to evaluate the neurodevelopmental outcomes.
Results • Among the 100 children who received follow-up, 19 had adverse neurodevelopmental outcomes. They had significantly higher levels of total serum bilirubin (P < .05) than those with positive neurodevelopmental
outcomes. The examination results of abnormalities in aEEG, GMs, ABR, aEEG + GMs, aEEG + ABR, and MRI + ABR are all correlated with adverse neurodevelopmental outcomes (P < .05). Logistic regression analysis indicated that abnormal aEEG, GMs, and ABR were predictors of adverse neurodevelopmental outcomes. The aEEG + GMs method significantly outperformed the individual use of aEEG or GMs in terms of sensitivity, specificity, positive predictive value, and negative predictive value.
Conclusion • The aEEG + GMs technique can predict the neurodevelopmental outcomes of neonates with severe hyperbilirubinemia and outperforms the individual use of aEEG or GMs in terms of sensitivity, specificity, positive predictive value, and negative predictive value. As a result, the combined technique merits broader clinical use. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Effectiveness of the 4P Nursing Model Combined with Amisulpride and Clozapine in the Management of Psychiatric Patients |
| Shuying Li, MS; Ping Rao, MS; Tao Zhong, MS |
| Objective • To study the clinical effectiveness of the 4P nursing model combined with Amisulpride and Clozapine in the management of psychiatric patients.
Method • 100 patients with refractory schizophrenia treated in the Psychiatry department of Ganzhou People’s Hospital from January 3, 2021, to January 4, 2022, were selected as the study subjects. They were randomly divided into observation and control groups, with 50 patients in each group. The clinical efficacy in the two groups was then assessed and compared using such parameters as the PANSS score, body mass index (BMI), blood lipid levels, incidence of side effects, and nursing satisfaction scores.
Results • The difference in total treatment efficacy was statistically significant (?2=11.724, 9.458, P = .001, RR0.24, 95%CI (0.117-0.363)). The post-treatment PANSS score, positive symptom score, negative symptom score, and general pathological score treatment were all lower than the pre-treatment scores in both groups. The difference was statistically significant (RR0.12, 95%CI (0.098-0.203)).
There was a reduction in the BMI of patients in the observation group after treatment, while there was an increase in that of patients in the control group. However, after treatment, there were significant reductions in the concentrations of T-CHO, LDL-C, and HDL-C in both groups (all P < .05, RR0.26, 95%CI (0.156-0.371)), with more significant reductions seen in the observation group than in the control group. The patients in the observation group recorded a much lower incidence of such side effects as drowsiness, nausea and vomiting, constipation, and weight gain and were more satisfied with the nursing they received as compared to their counterparts in the control group (all P < .05, RR0.28, 95%CI (0.171-0.351)).
Conclusion • The 4P nursing model combined with Amisulpride and Clozapine can improve adherence to treatment, as well as the overall effectiveness of treatment. This nursing method has a high safety profile, improves the quality of life, and its use deserves more widespread promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| IMB-Guided Rehabilitation Nursing in Patients with Diabetic Nephropathy Undergoing Maintenance Hemodialysis |
| Peng Qian, MBBS; Hai-Yun Sun, MBBS; Pei-Ran Yin, MBBS |
| Objective • This study aims to analyze the application effect of IMB (Information-Motivation-Behavioral skills) model rehabilitation nursing, which focuses on enhancing patient knowledge, motivation, and skills for disease management in patients with diabetes and end-stage renal disease receiving maintenance hemodialysis and its impact on the patient’s nutritional status.
Methods • Eighty-four patients with diabetes and end-stage renal disease undergoing maintenance hemodialysis were selected as study subjects at our hospital. All patients met the inclusion criteria and were divided into two groups based on the nursing interventions received. The control group (n=42) received routine rehabilitation nursing intervention, while the observation group (n=42) received IMB-guided rehabilitation nursing intervention. The effects of nursing intervention, psychological conditions, nutritional status, and quality of life were evaluated using standardized measurement tools. Psychological conditions were assessed using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). Nutritional status was evaluated through measurements of albumin (ALB), body composition analysis (BBC), hemoglobin (Hb), triceps skinfold thickness (TSF), arm circumference (A.C.), and arm muscle circumference (AMC). Quality of life was assessed using the SF-36 Health Survey. Comparative analysis was conducted to examine the differences between the two groups in terms of the aforementioned outcomes.
Results • The results of the study revealed compelling data showcasing the effectiveness of the nursing intervention. Notably, after the nursing intervention, ALB (albumin) levels in the observation group increased by 12%, indicating a significant improvement in nutritional status. This increase signifies enhanced protein synthesis and improved overall metabolic functioning among the patients. Additionally, the SF-36 scores, reflecting the quality of life, demonstrated a substantial improvement of 15 points in the observation group following the nursing intervention. This improvement indicates a significant enhancement in various aspects of health-related quality of life, such as physical functioning, mental health, social functioning, and overall well-being.
Furthermore, the total nursing effective rate in the observation group was an impressive 97.62%, surpassing the 80.95% rate in the control group. This statistically significant difference (P < .05) emphasizes the superior outcomes achieved through the nursing intervention in the observation group. Moreover, when comparing psychological conditions, the SAS scores in the observation group after the nursing intervention were significantly lower than those in the control group by 8 points (P < .05). Similarly, the SDS scores in the observation group showed a significant decrease of 10 points compared to the control group (P < .05). These findings indicate a substantial reduction in anxiety and depression levels among patients in the observation group.
Conclusion • The findings of this study have significant implications for patient care and highlight potential areas for future research. The results suggest that integrating IMB-guided approaches into hemodialysis care protocols could significantly enhance patient well-being. The notable improvements in nutritional status, as indicated by the increase in ALB levels, and the substantial enhancement in quality of life, as reflected by the improvement in SF-36 scores, underscore the effectiveness of the nursing intervention.
These findings have important implications for clinical practice, emphasizing the need for broader implementation of IMB-guided approaches in diverse clinical settings. By incorporating these interventions into routine hemodialysis care, healthcare providers can potentially improve patient outcomes and enhance their overall quality of life.
Furthermore, these results also highlight potential areas for future research. Additional studies could explore the long-term effects of the nursing intervention on patient health outcomes, sustainability of the improvements observed, and the cost-effectiveness of implementing IMB-guided approaches in hemodialysis settings. Moreover, investigating the feasibility and efficacy of these interventions in different patient populations could further expand our understanding and inform tailored approaches for specific subgroups. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Combined Effects of Cardiac Rehabilitation Exercise Training and Mindfulness Care on Post-PCI Rehabilitation in Coronary Heart Disease Patients |
| Xiaoling Zhao, BD; Xiaoling Zheng, BD |
| Objective • This study aimed to explore the effects of combining cardiac rehabilitation exercise training with mindfulness care on cardiac function, exercise capacity, and mood in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).
Methods • A total of 108 patients admitted to our hospital from January 2020 to January 2022, following PCI for CHD, were selected for this study. The participants were randomly assigned to either the control group or the observation group, with 54 patients in each group. The control group underwent standard rehabilitation exercise training, while the observation group received a combination of rehabilitation exercise training and mindfulness care. Cardiac function, exercise capacity, and psychological status were assessed and compared between the two groups before and after the intervention.
Results • Post-intervention, both groups showed significant improvements in left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), and left ventricular end-diastolic volume (LVEDV) compared to pre-intervention levels, with the observation group demonstrating significantly greater
improvements than the control group (P < .05). Additionally, the left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic dimension (LVEDD) decreased in both groups, with more significant reductions observed in the observation group (P < .05). Exercise capacity, as measured by the 6-minute walk distance, exercise time, and maximum exercise load, improved in both groups post-intervention, with the observation group showing greater improvements (P < .05). Psychological assessments indicated reductions in Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores in both groups after the intervention, with the observation group experiencing more substantial reductions (P < .05).
Conclusion • Integrating mindfulness care with cardiac rehabilitation exercise training significantly improves cardiac function, enhances exercise capacity, and reduces anxiety and depression in CHD patients post-PCI. This combined approach offers a more effective rehabilitation strategy compared to exercise training alone. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Optimizing the Effects of a Comprehensive Emergency Nursing Model on Rescued Patients with Acute Myocardial Infarction in the Cardiology Department |
| Xuefei Hao, MBBS; Huiting Huo, MBBS; Liming Wang, MBBS; Di Zhang, MBBS; Wei Zou, MBBS |
| Background • Acute myocardial infarction (AMI) requires timely and efficient intervention to mitigate adverse events and enhance patient prognosis. However, variations in emergency nursing protocols may impact treatment outcomes. Therefore, assessing the effectiveness of a comprehensive emergency nursing model, encompassing advanced assessment techniques and tailored interventions, is important for refining care strategies.
Objective • This study aimed to assess the optimization effect of a comprehensive emergency nursing model on rescued patients diagnosed with acute myocardial infarction (AMI) within the cardiology department.
Methods • This retrospective study analyzed data from 80 cases of AMI patients admitted to our hospital between January and June 2023. The study was conducted within our hospital’s cardiology department. The participants were divided into two groups: an intervention group (n=40) and a control group (n=40). The intervention group received care under the comprehensive, optimized emergency nursing model, while the control group received standard emergency care. Evaluation parameters comprised rescue time, effectiveness of emergency treatment, and nursing satisfaction.
Results • No significant differences in baseline patient characteristics were observed between the two groups. However, the intervention group demonstrated notable reductions in triage assessment time, completion of electrocardiograms, venous blood sampling, administration of intravenous medication, and overall emergency duration compared to the control group (P < .001). Additionally, the clinical complication rate in the intervention group, particularly incidences of heart failure and myocardial infarction recurrence, was significantly lower than that in the control group (P < .05). Patients in the intervention group reported significantly higher nursing satisfaction scores compared to their counterparts in the control group (P < .001).
Conclusion • The comprehensive emergency nursing model substantially decreased rescue time for AMI patients, minimized complication rates, and enhanced patient satisfaction with nursing care. This model presents an efficacious strategy for optimizing the rescue process of acute myocardial infarction patients within the cardiology department. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Modified Yiwei Shengyang Decoction in Combination with FOLFOX4 Chemotherapy for Advanced Gastric Cancer |
| Jie Hao, MS; Chaohui Li, MS; Yan Liu, MS; Xiaomei Miao, MS; Hongying Wu, MS; Shu Zhang, MS |
| Objective • To explore the clinical efficacy of modified Yiwei Shengyang Decoction combined with FOLFOX4 chemotherapy regimen in patients with advanced gastric cancer.
Methods • Ninety patients with advanced gastric cancer, admitted to Cangzhou Central Hospital from January 2021 to December 2022, were randomized 1:1 into control and study groups. The control group received FOLFOX4 chemotherapy alone, while the study group received additional modified Yiwei Shengyang Decoction. Chinese medicine (TCM) symptom scores (TCM symptoms refer to the signs and manifestations of imbalances or disharmony within the body according to the principles of Traditional Chinese Medicine. These symptoms are assessed and diagnosed based on a holistic understanding of the individual’s physical, mental, and emotional state. TCM symptoms may include various indicators such as pulse characteristics, tongue appearance, body temperature, complexion, energy levels, sleep patterns, appetite, digestion, pain, and specific subjective experiences reported by the patient, such as fatigue, anxiety, or insomnia), gastric cancer biomarkers such as serum CEA and CA199 levels, immune function, clinical efficacy, and side effects were compared.
Results • Before treatment, both groups had similar TCM symptom scores. Post-treatment, the study group showed significantly greater reductions in appetite, epigastric pain, nausea, vomiting, and diarrhea scores compared to the control group (P < .001). After treatment, CEA and CA199 levels decreased significantly in both groups, with the study group exhibiting significantly lower levels than the control group (P = .001, .001). Post-treatment, CD3+ and CD4+ levels were higher in the study group, while CD8+ levels were lower than in the control group (P < .001). Treatment efficiency was significantly higher in the study group (62.33%) than in the control group (37.78%) (P = .02).
Conclusion • Modified Yiwei Shengyang Decoction combined with FOLFOX4 chemotherapy regimen is a promising option for patients with gastric cancer. It significantly improves immune indicators and appetite, reduces adverse symptoms including epigastric pain, nausea, vomiting, and diarrhea, and substantially enhances quality of life. Moreover, traditional Chinese medicine treatment is safe and merits promotion in clinics. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Development and Validation of a Pathological Upgrading Prediction Model for Low-grade Gastric Mucosal Dysplasia |
| Zhijun Bao, PhD; Danian Ji, MBBS; Feng Li, PhD; Zili Xiao, MM |
| Objective • The objective of this study is to develop a prediction model for the pathological upgrading of low-grade dysplasia (LGD) in gastric mucosa. The study aims to compare the performance of a traditional model based on clinical and endoscopic factors with an enhanced model that incorporates AMACR staining of biopsy tissues.
Methods • The study utilized a training dataset of 405 LGD cases to establish and compare the traditional and enhanced prediction models. Factors associated with upgrading were identified, and the traditional model was based on these factors. The enhanced model incorporated AMACR staining. The models’ performances were evaluated using the area under the curve (AUC), bootstrap resampling, and decision curve analysis. External validation was performed using 171 LGD cases. Statistical techniques such as logistic regression and resampling methods were employed to assess the models’ predictive abilities and robustness.
Results • In the training dataset, the traditional model achieved an AUC of 0.824 (95% confidence interval [CI]: 0.783-0.865) for predicting pathological upgrading. However, the enhanced model, which incorporated AMACR staining, exhibited a significantly improved performance with an AUC of 0.878 (95% CI: 0.843-0.913).
This increase in AUC by 0.054 (95% CI: 0.015-0.093) demonstrates a statistically significant enhancement provided by the inclusion of AMACR staining in the prediction model for pathological upgrading of LGD lesions in gastric mucosa.
Conclusion • The findings of this study highlight the practical implications of the enhanced prediction model incorporating AMACR staining for low-grade gastric mucosal dysplasia (LGD). The significantly improved performance of the enhanced model in predicting pathological upgrading emphasizes its potential to revolutionize the management and treatment strategies for patients with LGD. By providing a more accurate prediction of upgrading, the enhanced model enables early intervention and timely decision-making, leading to improved outcomes and prognosis for patients. The incorporation of AMACR staining in the prediction model holds promise for enhancing diagnostic strategies and reducing the incidence of postoperative pathological upgrading. This research underscores the importance of leveraging advanced techniques to improve the early detection rate of gastric cancer and ultimately benefit patient care. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Clinical Impact of Refined Nursing Intervention on Severe Neonatal Pneumonia Accompanied by Respiratory Failure |
| Fangfang Li, BD; Siqi Li, MM |
| Background • Neonatal pneumonia is a common respiratory disease in the neonatal period, often accompanied by respiratory failure. In addition to timely treatment, effective nursing is essential.
Objective • We attempted to determine the clinical effect of refined nursing applied to the nursing of patients with severe neonatal pneumonia accompanied by respiratory failure.
Design • This was a randomized controlled study.
Setting • This study was performed in the Neonatal Department, The First Hospital of China Medical University.
Participants • A total of 60 newborns with severe pneumonia and respiratory failure diagnosed and treated in the neonatal intensive care unit of our hospital between January 2022 and December 2022 were selected and assigned to either the control group (CG) or the experimental group (EG) based on the random number table method, with 30 patients in each group.
Interventions • The CG received conventional nursing intervention and the EG received refined nursing intervention.
Primary Outcome Measures • (1) Symptom improvement
time; (2) blood gas indicators; (3) vital signs; (4) complication occurrence rate and (5) nursing satisfaction.
Results • The improvement time of cough, shortness of breath and wheezing in the EG was decreased compared with the CG (P < .05). After nursing, the EG exhibited higher partial arterial oxygen pressure and blood oxygen saturation levels and lower partial arterial carbon dioxide pressure relative to the control group (P < .05). After nursing, the heart and respiratory rates in both groups were decreased compared with before nursing, and in the EG group were decreased in comparison with the CG (P < .05). The incidence of adverse events in the EG was lower in comparison with the CG (P < .05). Nursing satisfaction in the EG was higher compared with the CG.
Conclusion • The application of refined nursing in the clinical nursing of patients with neonatal pneumonia accompanied by respiratory failure can facilitate improvement in their condition, improve blood gas indicators and vital signs and prevent adverse events. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Impact of Five-Dimensional Music in Conjunction with Water Delivery on the Labor Process |
| Xiao Chen, BD; Lixin Huang, BD; Wenjuan Shen, BD |
| Objective • To investigate the interventional efficacy of five-dimensional music combined with water labor analgesia in clinical childbirth.
Methods • 180 parturient women who gave birth at Cangzhou MCH Hospital between September 2022 and October 2022 were selected for the study. They were divided into three groups: the traditional group, the water delivery group, and the combined group (five-dimensional music labor analgesia with water delivery analgesia), with 60 participants in each group. The observed outcome indicators were the duration of labor, pain intensity during delivery, postpartum hemorrhage within 2 hours of delivery, and
neonatal Apgar scores. Statistical analysis was conducted using one-way ANOVA and the chi-square test.
Results • Compared with the other two groups, the combined group exhibited a shorter duration of labor, reduced labor pain and postpartum hemorrhage, and higher maternal satisfaction with the labor process (P < .05).
Conclusion • The use of five-dimensional music labor analgesia combined with water labor in clinical delivery can yield satisfactory outcomes, including shortening the duration of labor, alleviating pain, and enhancing maternal satisfaction. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Investigating the Efficacy of Anal Dimple Anorectoplasty in Congenital Anal Atresia: A Systematic Review and Meta-Analysis |
| Hao Li, MA; Zhen Li, MA; Hailong Su, BA; Fengliang Wang, MA; Tingdong Yuan, MA |
| Background • Congenital anal atresia poses a significant challenge in pediatric surgery, necessitating precise and effective interventions to ensure optimal outcomes. While traditional anterior sagittal approach anoplasty has been a standard procedure, emerging evidence suggests potential benefits of anal dimple anorectoplasty.
Objective • This study aims to assess the clinical efficacy of anal dimple anorectoplasty in treating congenital anal atresia.
Methods • We conducted a rigorous systematic review and meta-analysis, extensively searching various databases such as Wanfang, CNKI, VIP, PubMed, Web of Science, and the Cochrane Library. Our aim was to identify randomized controlled trials comparing the efficacy of traditional anterior sagittal approach anoplasty with anal dimple anorectoplasty in treating congenital anal atresia. Search terms included “anal dimple anorectoplasty,” “congenital anal atresia,” and “RCT.” Data regarding operation time, postoperative hospitalization duration, and complication rates were collected.
Results • Anal dimple anorectoplasty exhibited significantly greater clinical efficacy (odds ratio [OR]=4.91, 95% confidence interval [CI]: 2.02-11.94, P < .00001), along with markedly reduced postoperative hospitalization duration (95% CI: -1.27 to -0.57, P < .00001), and a substantially lower incidence of complications (OR=0.1, 95% CI: 0.04-0.25, P < .00001) compared to traditional anterior sagittal approach anoplasty. These findings underscore the clear advantage of anal dimple anorectoplasty over conventional methods, indicating its potential as a preferred surgical approach for congenital anal atresia.
Conclusions • Anal dimple anorectoplasty emerges as a highly effective intervention for pediatric patients with congenital anal atresia, demonstrating a notable decrease in postoperative complications. These findings highlight its potential as a preferred surgical approach to enhance patient outcomes and minimize adverse events. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Trimetazidine on Ventricular Remodeling and Serum Levels of Cys C and ET-1 in Patients with CHF |
| Jiaqi Huo, BM; Houze Tian, BM; Shifeng Xing, MM; Xiaojie Zhang, BM |
| Objective • To analyze the effects of trimetazidine on ventricular remodeling and serum cystatin C (Cys C) and endothelin-1 (ET-1) levels in patients with chronic heart failure (CHF).
Methods • A total of 96 patients with CHF admitted to the fifth affiliated hospital of Xinjiang medical university. were enrolled as the research objects between June 2012 and June 2023. They were randomly divided into a control and observation groups, with 48 cases in each group. The control group was given routine treatment, while the observation group was additionally treated with trimetazidine hydrochloride tablets. All were continuously treated for 6 months. The clinical curative effect between the two groups was compared. The left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) were measured by cardiac echocardiography before and after treatment. 6MVT before and after treatment was recorded. A full-automatic biochemical analyzer detected the level of serum Cys C before and after treatment. The levels of serum ET-1, galectin-3 (Gal-3), brain natriuretic peptide (BNP), and atrial natriuretic peptide (ANP) were detected by enzyme-linked
immunosorbent assay before and after treatment. The incidence of adverse events in the two groups of CHF patients was compared.
Results • The total response rate of treatment in the observation group was significantly higher than that in the control group (91.67% vs 79.17%) (P = .037). After treatment, LVEDD and LVESD decreased, while LVEF and 6MVT increased in both groups. LVEDD and LVESD in the observation group were significantly lower than those in the control group, while LVEF and 6MVT were significantly higher than those in the control group (P < .05). After treatment, serum Cys C, ET-1, Gal-3, BNP, and ANP levels in both groups were significantly decreased, significantly lower in the observation group than in the control group (P < .05). The readmission rate of the observation group was lower than that of the control group (P = .045). There was no significant difference in mortality between the two groups (P = .315).
Conclusion • Trimetazidine is effective in treating patients with CHF. It can improve cardiac function and reduce the rate of re-hospitalization. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Ameliorative Effect of Icariin Mediating NO/cGMP/PKGI Signalling Pathway in Alzheimer's Disease |
| Jinlong Chen, MD; Qing Li, MM; Xuanjun Liu, MD; Fuchang Lu, MM; Shuangyan Wang, MM; Xiaoqi Yu, MM |
| Objective • To investigate the effect of icariin (ICA) on cognitive function and NO/cGMP/PKGI signaling pathway in mice with Alzheimer’s disease (AD).
Methods • Wild-type C57BL/6 mice were used as the Control group, and APP/PS1 double transgenic mice were used to establish the AD model. The mice were randomly divided into AD group, AD+L-icariin group (10 mg/kg), and AD+H-icariin group (40 mg/kg), with 10 mice in each group. Water maze and Y-maze tests were used to evaluate the learning and memory abilities of mice. ELISA was used to measure the levels of serum Aß and cGMP. Tunel staining was used to determine the apoptosis of neurons in the hippocampus. Immunohistochemistry was used to measure the expression of Brdu, Dcx, and NeuN in the hippocampus. The protein expressions of iNOS, sGC, PKGI, Caspase3, Bax, and Bcl-2 in brain tissue were determined by Western blot.
Results • Compared with the control group, the learning and memory ability of the AD group was significantly decreased, the serum levels of Aß and cGMP were increased, the neuronal apoptosis was increased, the contents of Brdu, Dcx and NeuN were decreased, the expression of iNOS, sGC, PKGI, Caspase-3 and Bax proteins was increased, and the expression of Bcl-2 protein was decreased (P < .05). Compared with the AD group, the AD mice treated with icariin (40mg/kg) showed improved learning and memory abilities, decreased serum Aß and cGMP contents, decreased neuronal apoptosis, increased Brdu, Dcx, and NeuN contents, and decreased iNOS, sGC, PKGI, Caspase-3, and Bax protein expressions. The expression of Bcl-2 protein was increased (P < .05).
Conclusion • Icariin improves AD in mice by activating the NO/cGMP/PKGI signaling pathway. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Nursing-sensitive Indicators for Quality Improvement for Patients with Traumatic Brain Injury |
| Wenjuan Dong, BM; Huifang Ren, BM; Hongmei Xu, BM; Yanrong Xu, BM; Xueqin Xu, BM; Yongjie Yang, BS |
| Context • Traumatic brain injury (TBI) can result in lifelong cognitive, emotional, and motor impairments. The emergency department is the first stop for diagnosing and treating patients with acute TBI, and the quality of nursing care can greatly influence the prognosis and progression of a patient’s condition. Currently, standardized evaluation tools are lacking in the world for assessment of the quality of nursing care.
Objective • The study intended to construct a nursing-sensitive indicator system for TBI patients, based on the scientific method of evidence-based nursing and the Delphi method, to provide a quantitative tool for emergency-nursing personnel to manage the quality of care for those patients.
Design • Based on the Joanna Briggs Institute’s evidence-based healthcare model, the research team performed a literature search and consulted reference guidelines, conducted two rounds of consultations with experts. sensitive indicators for quality of care, and constructed the sensitive indicator system. The team then conducted a retrospective study.
Setting • The study took place in the department of emergency surgery at Shanxi Norman Bethune Hospital in Taiyuan, Shanxi, China.
Participants • Participants were 56 patients with TBI who had been admitted to the emergency department between January 2022 and December 2022 and 44 patients with TBI who had been admitted to the emergency department between January 2023 and December 2023.
Interventions • The research team assigned: (1) the 56 patients in the first group to the control group, who received routine nursing care and (2) the 44 patients in the second group to the intervention group, who received treatment using the sensitive indicator system for the quality of
emergency care for TBI patients as well as routine care.
Outcome Measures • In the verification study, the research team compared the group’s rescue effects and satisfaction with emergency care.
Results • In the first and second rounds of inquiries to experts, the research team distributed 25 questionnaires each time, with 25 valid questionnaires collected both times. The response rate for both rounds of inquiries was 100%. The expert authority coefficients for the first and second rounds of inquiries are 0.844 and 0.878, respectively. The sensitive indicator system’s final construction included three primary indicators, seven secondary indicators, and 17 tertiary indicators. The AUC for the sensitive indicators was 0.8355882. The indicator system’s use found that the intervention group had a shorter time to diagnosis (P < .001), emergency-department stay (P < .001), and emergency-department-to-surgery time (P < .001) compared to the control group. The intervention group also has a higher success rate for the emergency treatment (P = .014) and a higher nursing satisfaction with nurse-patient communications (P = .003), first-aid operations (P < .001), nursing attitudes (P < .001), and emergency environment (P < .001) compared to the control group.
Conclusions • The process of constructing quality-sensitive indicators for the nursing care of TBI patients was scientific. The constructed quality-sensitive indicator system for the care of patients with TBI covers key factors that influence the quality of care. It’s highly practical and has the ability to transform certain indicators, which can better guide the management of quality of care for TBI. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Mechanism of Xianling Gubao Capsule Regulating Runt-Related Transcription Factor 2 (RUNX2) and Promoting Osteoblast Differentiation by N6-Methyladenosine (m6A) Methyltransferase-Like 3 (METTL3) |
| Lingyun Gou, MBBS; Qi He, MBBS; Mingjun Liao, MBBS; Kaihao Ma, MBBS; Haibin Wang, MBBS; Junzheng Yang, MBBS |
| Background • Osteoporosis (OP) is a chronic skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue, resulting in increased bone fragility and a higher risk of fractures. It is a significant public health concern, particularly among postmenopausal women and older adults. The imbalance between bone formation and resorption is the fundamental cause of OP. Current clinical drugs for OP have limited efficacy and can cause side effects. Therefore, there is a need to explore alternative treatments and investigate their mechanisms to improve OP management. The Xianling Gubao capsule, a traditional Chinese medicine, is commonly used to treat OP by tonifying the kidney. However, the specific mechanism of action of the Xianling Gubao capsule in improving OP remains unclear, necessitating further research in this area.
Methods • The N6-methyladenosine (m6A) content was evaluated by dot blot and m6A ribonucleic acid (RNA) methylation assay kit. The contents of methyltransferase-like 3 (METTL3), runt-related transcription factor 2 (RUNX2), alkaline phosphatase (ALP), and bone gamma-carboxyglutamate protein (BGLAP) were appraised by quantitative Reverse Transcription polymerase chain reaction (qRT-PCR) and western blot. The bilateral ovariectomy (OVX) method was used to establish an animal model of OP. OP bone marrow mesenchymal stem cells (OP-BMSCs) were extracted from mice in the OVX group by the whole bone marrow method. METTL3 overexpression and control vectors were transfected to OP-BMSCs using X-tremeGENE HP DNA Transfection Reagent. The ALP activity in OP-BMSCs was assessed by ALP staining. The calcium nodules in OP-BMSCs were detected by Alizarin Red S (ARS) assay. The Xianling Gubao capsule solution was employed to gavage mice, and the drug-containing serum was used to treat OP-BMSCs. Dot blot allows for the assessment of relative levels of m6A modification. The m6A RNA methylation assay kit is a specialized kit designed to quantitatively measure m6A levels in RNA samples. qRT-PCR allows for the measurement of mRNA levels of target genes. Western blot is used to detect and quantify specific proteins in a sample, and provides information about protein expression levels. OVX mimics
the hormonal changes occurring in postmenopausal women and leads to bone loss and osteoporotic conditions in animals. This model allows for the investigation of the effects of the Xianling Gubao capsule on OP in a controlled experimental setting.
Results • The m6A modification and METTL3, RUNX2, ALP, and BGLAP levels were reduced in bone samples of patients with OP and OVX mice compared with the corresponding control groups. Upregulated METTL3 enhanced the osteogenic ability of OP-BMSCs. METTL3 overexpression obviously increased m6A modification and METTL3, RUNX2, ALP, and BGLAP levels in OP-BMSCs. Xianling Gubao capsule treatment could weaken the impact of OP in mice by regulating the m6A modification and METTL3, RUNX2, ALP, and BGLAP levels. Serum containing Xianling Gubao capsule could enhance the osteogenic capability of OP-BMSCs and boost METTL3, RUNX2, ALP, and BGLAP levels. Treatment with the Xianling Gubao capsule shows promising effects in attenuating the impact of OP. The capsule is found to regulate m6A modification and increase the levels of METTL3, RUNX2, ALP, and BGLAP in OP-BMSCs. This indicates that the Xianling Gubao capsule may rescue the diminished osteogenic capability of OP-BMSCs by modulating METTL3. These findings suggest that the Xianling Gubao capsule has the potential to be an effective drug for the treatment of OP.
Conclusion • Taken together, the m6A modification and contents of osteogenic-related factors were reduced in OP. Upregulated METTL3 improved the osteogenic ability, m6A modification, and osteogenic-related factor abundances in OP-BMSCs. Xianling Gubao capsule rescued the diminished osteogenic capability of OP-BMSCs by modulating METTL3 and might serve as an effective drug for OP. The Xianling Gubao capsule, as a traditional Chinese medicine, could potentially complement existing therapeutic approaches for OP. By targeting the m6A modification pathway and promoting osteogenic differentiation, the capsule may help to expedite bone formation and repair, which are critical for managing OP and reducing the risk of fractures. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Personalized Psychological Nursing on Quality of Lifein Patients with Advanced Lung Cancer |
| Shuangping Lu, MM; Juan Wang, MM |
| Objective • We aimed to explore the effect of personalized psychological nursing on the quality of life (QoL) in patients with advanced lung cancer (ALC).
Methods • A total of 126 patients with ALC who were admitted to The First People’s Hospital of Fuyang District in China from March 2018 to March 2021 were selected as study participants. They were randomly assigned to either the control group or the study group. The degree of anxiety, depression, cancer-related fatigue, sleep quality, QoL and treatment compliance in the 2 groups were observed and compared.
Results • HAM-D (Hamilton Depression Rating Scale), HAM-A (Hamilton Anxiety Rating Scale) and (PFS-R) scores in the 2 groups after nursing were lower, and those in the study group were significantly lower (P < .05). The
Pittsburgh Sleep Quality Index (PSQI) scale scores in the study group after nursing were lower than in the control group (P < .05). After nursing, body, role, cognition, emotion, social function and overall QoL in the study group were significantly higher than in the control group (P < .05). The nursing compliance in the study group was 96.83%, significantly higher than in the control group (88.89%) (P < .05).
Conclusion • The implementation of personalized psychological nursing for patients with ALC can alleviate anxiety, depression and cancer-related fatigue, improve their sleep quality and QoL and improve medication compliance, which is worthy of clinical promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Tea Polyphenols on Nuclear Factor Erythroid 2-related Factor 2 (NRF2) and Kelch-like ECH-associated Protein 1 (KEAP1) Gene Expression in Mice with Acute Cadmium Poisoning |
| Linyu Li, MM; Xiaoshan Li, BD; Tingting Tao, MM |
| Background • Cadmium poisoning is mainly caused by inhalation of cadmium dust or cadmium compound dust, which greatly harms people’s lives. Tea polyphenols extracted from green tea have wide biological properties, including anti-cardiovascular disease, anti-tumor, anti-inflammatory, and immune regulation. The transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) and Kelch-like ECH-associated protein 1 (KEAP1) are involved in the regulation of cadmium-induced oxidative damage. However, whether tea polyphenols relieve acute cadmium poisoning via regulating NRF2 and KEAP1 gene expression remains unclear.
Objective • To explore the influences of tea polyphenols on NRF2 and KEAP1 gene expression in mice with acute cadmium poisoning.
Design • This is an animal experiment that adopts hematoxylin and eosin (HE) staining and immunohistochemistry (IHC) staining.
Setting • This study was carried out in Zunyi Medical and Pharmaceutical College.
Participants • Fifty specific pathogen-free (SPF) male Kunming mice aged 9 weeks, weighing 18-22 g were divided into five groups: normal group, model group, low-dose tea polyphenols group, middle-dose tea polyphenols group, and high-dose tea polyphenols group.
Interventions • Tea polyphenols were administered intraastrically into mice with doses of 50 mg/kg, 100 mg/kg, and 200 mg/kg for 10 consecutive days, respectively.
Observation indicators • (1) liver coefficient, (2)
pathological liver injury, (3) liver function, (4) oxidative damage, and (5) NRF2 and KEAP1 gene expression.
Results • The liver coefficient, pathological liver injury, serum aspartate transaminase and alanine transaminase levels of the model group were higher relative to the normal group (P < .05). Relative to the model group, different doses of tea polyphenols treatment significantly relieved liver coefficient, pathological liver injury, serum aspartate transaminase, and alanine transaminase levels (P < .05). Malondialdehyde content in liver tissues of the model group was significantly higher compared to the normal group, while glutathione together with glutathione peroxidase contents of the model group was lower (P < .05). Compared to the model group, malondialdehyde content in liver tissues declined while glutathione together with glutathione peroxidase contents were elevated after different doses of tea polyphenols treatment (P < .05). Relative to the normal group, NRF2 expression in the liver tissues of the model group was significantly lower, while KEAP1 expression was higher (P < .05). Relative to the model group, NRF2 expression in the liver tissues was elevated after treatment of different doses of tea polyphenols, while KEAP1 expression was declined (P < .05).
Conclusion • Tea polyphenols can relieve liver injury in mice with acute cadmium poisoning by regulating NRF2 and KEAP1 expression. Our study might provide a promising treatment strategy for acute cadmium poisoning. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Efficacy of Early Microsurgical Clipping of Tumor Neck in the Treatment of Cerebral Aneurysm Rupture and Bleeding and Its Impact on Oxidative Stress Response and Prognosis of Patients |
| Zhenglou Chen, MM; Xuqi Hu, MM; Yunjiang Wang, MM; Hongsheng Wang, MM; Min Xu, MM |
| Background • Cerebral aneurysm can rupture a blood vessel and cause bleeding in the brain. Microsurgical clipping of the tumor neck has been reported to be effective in treating cerebral aneurysm rupture and bleeding.
Objective • This research attempted to clarify the clinical efficacy of early microsurgical clipping of tumor neck for treating cerebral aneurysm rupture and bleeding, and its impact on prognosis of patients.
Design • This was a retrospective study.
Setting • This study was carried out in the Department of Neurosurgery, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People’s Hospital.
Participants • One hundred patients with cerebral aneurysm rupture and bleeding patients aged from 23 to 70 years old, and diagnosed with CA rupture and bleeding through imaging examinations such as CT angiography (CTA) and digital subtraction angiography (DSA), and there was spontaneous subarachnoid hemorrhage treated in our hospital from November 2020 to November 2022 were selected and divided into an experimental group (n=25) and a control group (n=25) according to surgical time.
Interventions • All patients underwent microsurgical clipping of the tumor neck for therapy. Under microscope monitoring, the temporal and frontal lobes of the patient were separated, and the tumor body was selected in the internal carotid artery and cerebral artery. After the tumor neck of the patient was exposed, the artery supplying blood was clipped and appropriate tumor clips were selected. The control group chose to undergo surgery 72 h after the onset of cerebral aneurysm rupture and bleeding, while the experimental group chose to undergo complete surgery within 72 h after the onset of cerebral aneurysm rupture and bleeding. After surgery, targeted treatment were given to patients in 2 groups based on their physical condition, such as dehydration to reduce intracranial pressure, anti-vasospasm, anti-infection, monitoring of neurological changes, and monitoring of vital signs. Cerebral angiography
should also be performed for reexamination.
Primary Outcome Measures • (1) incidence of complications (2) cognitive function scores assessed by Montreal Cognitive Assessment (MoCA) (3) prognosis assessed by Glasgow Outcome Scale (GOS) (4) surgical indicators (5) oxidative stress response and (6) quality of life assessed by short form 36 health survey questionnaire (SF-36).
Results • Compared to the control group, the incidence of complications in the experimental group exhibited depletion (24.0% vs 8.0%) (P < .05), the prognosis in the experimental group exhibited elevation [(2.23±0.45) points vs (4.12±0.3) points] (P < .05), the hospitalization time in the experimental group exhibited depletion [(15.69±1.21) d vs (11.31±0.65) d] (P < .05), the nomination, abstraction, language, orientation, attention, delayed recall and visual and executive function scores and total scores in experimental group exhibited elevation [(2.69±0.52 points, 2.07±0.63 points, 3.02±0.44 points, 2.45±0.51 points, 3.12±0.36 points, 2.14±0.75 points, 3.15±0.64 points and 17.24±2.15 points) vs (4.25±0.65 points, 3.88±1.08 points, 5.03±0.73 points, 3.34±0.72 points, 4.05±0.66 points, 3.85±0.33 points, 5.02±1.04 points and 26.89±1.33 points)] (P < .05), serum levels of oxidative stress-related indicators in the experimental group exhibited depletion [(462.14±48.47 ng/mL, 281.14±36.44 ng/mL and 1.62±0.12 nmol/mL) vs (365.58±44.56 ng/mL, 201.51±34.47 ng/mL and 1.15±0.1 nmol/mL)](P < .05) and the quality of life in experimental group exhibited elevation [(73.65±7.43 points, 72.24±7.23 points, 73.25±7.36 points, 70.24±7.05 points and 72.16±7.25 points) vs (81.25±8.14 points, 80.87±8.09 points, 81.43±8.15 points, 80.57±8.07 points and 81.32±8.14 points)] (P < .05).
Conclusion • Early microsurgical clipping of the tumor neck can downregulate risk of complications and cognitive impairment of cerebral aneurysm rupture and bleeding patients, which is worthy for clinical application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Influences of Early Rehabilitation Nursing on Motor Function, Swallowing Function as Well as Quality of Life in Stroke Patients |
| Hui Chen, BD; Juan Jia, BD; Zhiguang Liu, MD; Xinyan Meng, MM; Chunxiu Wan, BD; Dongdi Wang, BD; Yannan Zhang, BD |
| Background • Stroke is a major cause of long-term disability in adults. Routine nursing mainly meets the life needs of patients through the intervention of patients’ general life but only provides the most basic services for patients, which makes it difficult to meet the requirements of patients’ physical exercise and other aspects, affecting the prognosis. Early rehabilitation after a stroke is important for the recovery of bodily functions in stroke patients. However, the impacts of early rehabilitation nursing on motor function, swallowing function as well as quality of life in stroke patients remain to be further explored.
Objective • To investigate the effects of early rehabilitation nursing on motor function, swallowing function as well as quality of life in stroke patients.
Design • This was a randomized, single-blind, controlled experiment.
Setting • This study was carried out in the neurology department at Xuzhou Central Hospital.
Participants • A total of 116 acute stroke patients validated by craniocerebral computed tomography (CT) and magnetic resonance imaging (MRI) from January 2021 to December 2022 were chosen and separated into the control group (n=58) and research group (n=58) following the random number method.
Interventions • The control group was given routine
nursing. The research group implemented early rehabilitation nursing 24 hours after admission on the basis of the control group.
Primary Outcome Measures • (1) recovery of swallowing dysfunction (2) recovery of limb function (3) self-care ability (4) sleep quality (5) quality of life and (6) total satisfaction of patients.
Results • The research group had an elevated total effective rate of swallowing dysfunction recovery in contrast to the control group after nursing (P < .05). The recovery of limb function, self-care ability, sleep quality, and quality of life were promoted in both groups, followed by nursing (P < .05), and those in the research group were higher relative to the control group (P < .05). The total satisfaction of patients in the research group presented higher relative to the control group (P < .05).
Conclusion • The application effect of early rehabilitation nursing in acute stroke patients is outstanding, and the swallowing dysfunction and limb dysfunction of patients can be effectively improved, which has a high nursing value and is worth promoting and applying. Therefore, an early physical rehabilitation program for acute stroke inpatients should be considered for implementation in clinical settings. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Expression and Clinical Significance of Ezrin and MMP-9 in Colorectal Cancer Tissue |
| Fabiao Liao, MM; Zhiqian Ye, BM; Qingfei Zhang, MM; Yuanchan Zhang, MM |
| Objective • Colorectal cancer is a malignant tumor with high mortality, but is hard to detect at its early stage. Recent studies highlighted the crucial roles of Ezrin protein and MMP-9 in the development and malignancy of colorectal cancer, but Ezrin protein and MMP-9 in early diagnosis of colorectal cancer require further investigation. Therefore, we aimed to investigate their roles in the occurrence and metastasis of colorectal cancer, and to analyze their clinical significance in diagnosing and treating colorectal cancer.
Method • The diagnosis of collected colorectal cancer tissue and adjacent tissue samples from colorectal cancer patients confirmed by clinical symptoms was performed using Hematoxylin Eosin staining. The expression levels of Ezrin and MMP-9 in 50 colorectal cancer tissue and 50 cases adjacent colorectal cancer tissue were detected by the immuno-histochemical MaxVision method. The relationship between the positive expression rate of Ezrin and MMP-9 in colorectal cancer tissue and clinical pathological factors was analyzed, and the correlation between Ezrin and MMP-9 was examined.
Results • The positive expression rate of Ezrin in colorectal cancer tissue (78%) was significantly higher compared to adjacent non-cancerous tissues (6.0%) (P < .05). There was
no significant correlation of gender/age and Ezrin/MMP-9 expressions (P > .05). The expression level of Ezrin exhibited statistically significant differences in the pathological factors including tumor diameter, depth of invasion, degree of differentiation, presence or absence of lymph node metastasis, and distant metastasis (P < .05). Additionally, the positive expression rate of MMP-9 in colorectal cancer tissue (76%) was markedly elevated compared to adjacent tissues (8.0%) (P < .05). The expression level of MMP-9 showed statistically significant differences in the pathological factors including tumor diameter, depth of invasion, degree of differentiation, presence or absence of lymph node metastasis, and distant metastasis (P<0.05). In addition, the expression of Ezrin and MMP-9 in colorectal cancer tissue showed a significant positive correlation (r=0.637, P < .01).
Conclusion • Ezrin and MMP-9 may synergistically participate in the occurrence, invasion, and metastasis of colorectal cancer. The combined assessment of Ezrin and MMP-9 expression levels in colorectal cancer patients holds significant potential for clinical diagnosis and personalized therapeutic applications. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Correlative Study on the Association Between Breast Cancer and Autoimmune Thyroid Disease |
| Jian Ding, MM; Wenlian Li, MM; Yanyan Que, MM |
| Objective • This study aims to investigate the correlation between breast cancer and autoimmune thyroid diseases.
Methods • A cross-sectional observational study enrolled 100 breast cancer patients at Zhongshan Hospital of Xiamen University from March 2020 to October 2021. Patients were categorized into benign and malignant groups based on tumor pathology. Additionally, 100 healthy female participants underwent physical examinations at the hospital’s outpatient center during the same period as controls. The incidence of autoimmune thyroid diseases was assessed via B-type ultrasound, thyroxine level examination, and biopsy. Statistical analyses explored the relationship between autoimmune thyroid diseases and breast cancer.
Results • The pathological type of the malignant group was more severe than that of the healthy group. Although the levels of triiodothyronine (T3), thyroxine (T4), and free thyroxine (FT4) in the malignant group fell within the normal range, the concentrations of T3 and T4 in the malignant group were significantly lower than those in the
benign and healthy groups. Additionally, the levels of FT4 and antibodies (anti-thyroid peroxidase [anti-TPO] and anti-thyroglobulin [anti-TG]) were significantly higher in the malignant group compared to the benign and healthy groups, demonstrating statistical significance (P < .05). Conversely, the concentrations of free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH) in the malignant group showed no statistical significance (P > .05). Furthermore, the levels of T3 and T4 did not correlate with the expression of estrogen receptor (ER) and progesterone receptor (PR) in the study group (P > .05). However, both hormone levels were lower in patients with negative HER-2 expression and those with lymph node metastasis (P > .05).
Conclusion • Autoimmune thyroid disease correlates with breast cancer occurrence. Thyroid hormone and autoantibody levels aid clinical monitoring and prognosis. Positive anti-TG and anti-TPO expressions, along with T3, T4, and FT4 alterations, impact patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Effect of Holistic Nursing on Inflammatory Response, Lung Function and Quality of Life in Elderly Patients with Acute COPD |
| Shuangping Lu, MD; Qundan Zhang, MD |
| Objective • To investigate the effects of holistic nursing on the quality of life overall, inflammation, and lung function in older persons experiencing acute episodes of chronic obstructive pulmonary disease (COPD).
Methods • Considering that good nursing care improves cardiorespiratory fitness, increases treatment adherence and improves prognosis in patients with chronic obstructive pulmonary disease (COPD), From June 2019 through May 2020, 96 patients with newly diagnosed acute COPD will be recruited to take part in the trial. In total, 48 people were split into the study group and the control group at random. When compared to the control group, the research group received more comprehensive care. Procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) blood levels were compared before and after care, as were forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FEV1, and quality of life.
Results • None of the demographic characteristics, including mean age, BMI, illness duration, gender, or comorbidities, differed significantly (P > .05) between the two groups. After care, serum PCT, CRP, and IL-6 levels decreased in both groups compared to pre-nursing values (P < .05); however, after care, serum PCT, CRP, and IL-6
levels were significantly lower in the study group compared to the control group. Both groups’ FEV1, FVC, and FVC improved significantly (P < .05) after care compared to their baseline conditions; Statistics show that after care, the study group had significantly better FEV1, FVC, and FVC than the control group. The overall success rate of the study group was statistically significantly higher than that of the control group (P < .05). After Care, both groups’ scores for illness impact, disease symptoms, and mobility restriction were much lower than they were before to care, and the difference was statistically significant (P < .05); After Care, people in the study group significantly improved on measures of mobility impairment, sickness symptoms, and disease effect compared to those in the control group. There was a statistically significant difference (P < .05) between the two groups. Patients in the study group reported significantly higher levels of satisfaction with their nursing care than patients in the control group (P < .05).
Conclusion • Elderly patients with acute COPD can benefit greatly from holistic nursing care in terms of reduced inflammation, enhanced lung function, and enhanced quality of life. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Impact of Standardized Nursing During the Perioperative Period of Microballoon Compression in Patients with Trigeminal Neuralgia |
| Haibin Lu, BD; Jie Yin, BD |
| Background • Trigeminal neuralgia (TN), characterized by severe facial pain, warrants effective perioperative care. There is a critical need for evidence-based perioperative nursing interventions to enhance outcomes and well-being in patients undergoing microballoon compression for trigeminal neuralgia.
Objective • This study aims to investigate the impact of standardized nursing during the perioperative period of microballoon compression in patients with trigeminal neuralgia (TN).
Methods • A total of 22 TN patients admitted to our hospital from December 2021 to December 2022 underwent microballoon compression treatment. The control group (CG) received standard neurosurgical routine nursing, while the observation group (OG) received standardized nursing during the perioperative period. Comparative analysis included assessments of pain intensity, psychological status, sleep quality, overall quality of life, incidence of complications, and patient satisfaction.
Results • Following nursing interventions, both groups exhibited a decrease in scores on the Neuropathic Pain Scale (NPS), Hamilton Depression Scale (HAM-D), Hamilton Anxiety Scale (HAM-A), and Pittsburgh Sleep Quality Index (PSQI). The OG demonstrated significantly lower scores compared to the CG (P <.05). Post-nursing, SF-36 scores decreased in both groups, with the OG displaying lower scores than the CG (P < .05). Although complications were less frequent in the OG, and patient satisfaction was higher, these differences were not statistically significant (P > .05).
Conclusions • The implementation of standardized nursing during the perioperative period of microballoon compression in TN patients resulted in reduced pain intensity, improved psychological well-being, enhanced sleep quality, and better overall quality of life. These findings suggest the intervention’s potential for valuable clinical application and merit further promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Utilizing Psychological Nursing in Non-invasive Ventilator Treatment for Type II Respiratory Failure in Patients with Chronic Obstructive Pulmonary Disease |
| Shuangping Lu, MD; Qundan Zhang, MD |
| Objective • This study aims to investigate the impact of psychological nursing on patients with type II respiratory failure (II-RF) complicated by chronic obstructive pulmonary disease (COPD) undergoing non-invasive ventilator therapy.
Methods • A total of 100 patients diagnosed with type II respiratory failure complicated by COPD and undergoing non-invasive ventilator therapy at our hospital between July 2019 and July 2021 were included. Using a random number table, patients were divided into a control group (n=50) receiving routine nursing and an observation group (n=50) receiving psychological nursing in addition to routine care. Both groups received nursing care until the completion of non-invasive ventilator treatment. Assessment measures included scores on the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), clinical compliance, SpO2, PaO2, PaCO2 levels, and incidence of complications.
Results • After nursing interventions, significant reductions in SAS and SDS scores were observed in both
groups compared to pre-nursing levels, with the observation group exhibiting significantly lower scores than the control group (P < .05). Additionally, significant improvements in SpO2 and PaO2 levels and a decrease in PaCO2 levels were noted in both groups post-nursing, with the observation group showing superior outcomes compared to the control group (P < .05). Furthermore, the incidence of complications significantly decreased in the observation group (10.00%) compared to the control group (24.00%) (P < .05).
Conclusions • Psychological nursing demonstrates a significant therapeutic effect in patients with type II respiratory failure complicated by COPD undergoing non-invasive ventilator therapy. It effectively enhances patients’ psychological well-being, improves clinical compliance, enhances treatment efficacy, and reduces complication rates. These findings underscore the clinical relevance and importance of integrating psychological nursing into the management of such patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Correlation Between Patent Foramen Ovale and Migraine Based on Meta Analysis |
| Donglan Liu, MM; Aijun Liu, MM; Yonglin Zhang, MM; Guangzhi Zhou, MM |
| Objective • This meta-analysis systematically investigates the association between Patent Foramen Ovale (PFO) and the prevalence of migraine. Our goal is to quantify this relationship and evaluate its implications for clinical practice and future research.
Methods • An extensive literature search was carried out in various databases, such as PubMed, Embase, The Cochrane Library, Web of Science, CNKI, VIP, WanFang Data, and CBM, up to November 2023. The search focused on case-control, cross-sectional, and cohort studies examining the link between PFO and migraine. The literature screening and data extraction, based on predefined inclusion and exclusion criteria, were independently conducted by two reviewers. The studies’ quality was evaluated using the Newcastle-Ottawa Scale (NOS), and RevMan 5.3 software was employed for the meta-analysis.
Results • A total of 27 studies involving 8,875 participants
were included in the meta-analysis. The results indicate a statistically significant association between PFO and migraine prevalence. Key findings include: (1) Overall, individuals with migraine had higher rates of PFO compared to healthy controls (OR = 3.22, 95% CI = 2.21 to 4.67, P < .00001). (2) The association was stronger in the Migraine with Aura group (OR = 3.69, 95% CI = 1.93 to 7.04, P < .0001) than in the Non-Migraine with Aura group (OR = 1.48, 95% CI = 1.09 to 2.00, P = .01). (3) The prevalence of PFO was notably higher in the Migraine with Aura group compared to the Non-Migraine with Aura group (OR = 2.32, 95% CI = 1.96 to 2.76, P < .00001).
Conclusion • The analysis confirms a noteworthy correlation between PFO and migraine, underscoring the relationship and suggesting additional studies need to elucidate the underlying mechanisms and clinical ramifications. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Exploring the Effects of Various Early Hospital Feeding Approaches on Feeding Tolerance and Growth in Premature Infants |
| Wei Jiang, BD; Rongrong Jiang, MM; Cheng Shi, BD; Yuhong Sun, BD; Qiongwei Wu, BD; Menghua Wu, BD |
| Background • Feeding intolerance poses a significant risk of malnutrition in premature infants and may result in postnatal growth restriction, leading to irreversible damage to brain function and structure.
Objective • This study aims to investigate the impact of various early hospital feeding methods on feeding tolerance and the early growth and development of premature infants.
Design • A retrospective study design was adopted in this study.
Setting • This study was conducted at Tongling Maternal and Child Health Hospital between January 2018 and June 2023.
Participants • A total of premature, low birth-weight infants admitted to our hospital between January 2018 and June 2023 were selected for the study. The preterm infants were randomly assigned to either the experimental group (EG) or the control group (CG) using the random number table method.
Interventions • The EG group received deep hydrolyzed protein formula (DHPF) milk for 1-3 weeks after opening,
whereas the CG group received preterm infant formula milk continuously after the milk was opened.
Primary Outcome Measures • (1) Growth and development, (2) Feeding tolerance, and (3) Incidence of complications.
Results • Following 14 days of feeding, both study groups exhibited notable increases in body length, body weight, and head circumference (P < .05). These measurements were significantly higher in the EG compared to the CG (P < .05). Furthermore, the EG demonstrated a marked improvement in feeding tolerance relative to the CG (P < .01). Notably, there was no significant difference in the incidence of complications between the two groups (P > .05).
Conclusions • The administration of deep hydrolyzed protein formula (DHPF) milk presents a promising strategy for enhancing the growth and development of premature infants while concurrently improving feeding tolerance. These findings underscore the potential clinical benefits of incorporating DHPF milk into neonatal care protocols. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Predicting Bloodstream Infection in High-risk Groups of Liver Failure Patients with Artificial Liver Support System |
| Yiqun Chen, MB; Yuzhen Ding, MB; Jinchun Liu, MB; Sufang Lu, MB; Dandan Wang, MB; Jian Wang, MB; Xiaoyan Zhang, MB; Hongli Zhao, MB; Hong Zhou, BM |
| Background • Liver failure is a rare, life-threatening disease that has a high mortality rate and affects many organ systems. Bloodstream bacterial infection has played a key role in liver failure patients with plasma exchange-centered artificial liver support systems, but the predicted risk factors of infection have not been fully understood.
Objective • We aimed to predict bloodstream bacterial infection in high-risk groups of liver failure patients during a plasma exchange-centered artificial liver support system.
Design • This was a prospective cohort study.
Setting • This study was performed in Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School.
Participants • 118 liver failure patients with plasma exchange-centered artificial liver support system therapy from Nanjing Drum Tower Hospital from November 2019 to November 2020 were selected.
Interventions • We used a stepwise binary logistic regression model to select the optimal risk factors of infection with minimum Akaike information criterion, and the Nomogram prognostic model for bloodstream infection was constructed for visualization.
Primary Outcome Measures • Risk factors of bloodstream infection (2) predictive accuracy of the constructed nomogram model.
Results • Among the 118 liver failure patients, 22 (18.64%) were diagnosed with bloodstream bacterial infection. The univariable and multivariate logistic regression analyses suggested that culture level, glucocorticoids use, number of punctures, blood platelet counts, white blood cell counts, and indwelling catheter time were the sex predictors of bloodstream infection for liver failure patients during plasma exchange-centered artificial liver support system (P = .042, P = .013, P = .025, P = .003, P = .024 and P = .026). The nomogram predictive model was established with high prediction accuracy, of which the area under the curve was 0.935 (95% confidence interval: 0.884-0.986), the sensitivity was 0.955, and the specificity was 0.854.
Conclusion • The constructed nomogram prognostic model can recognize the risk factors and accurately predict bloodstream infection for liver failure patients during plasma exchange-centered artificial liver support system. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Enhancing Respiratory Symptoms: The Impact of Acupoint Application Combined with Back Tapping in Patients with Expectoration and Wheezing |
| Yujuan Cao, BD; Yali Gao, BD |
| Background • Expectoration and wheezing are prevalent symptoms of respiratory diseases. Acupoint application and back tapping have shown effectiveness in alleviating cough, wheezing, and associated symptoms.
Objective • This study aimed to investigate the influence of combining acupoint application with back tapping in patients experiencing expectoration and wheezing.
Design • A retrospective study design was employed.
Setting • The study was conducted at Lujiang County Hospital of Traditional Chinese Medicine.
Participants • A total of 96 patients presenting with expectoration and wheezing between January 2019 and June 2021 were randomly allocated into an observation group (n=48) and a control group (n=48).
Interventions • The control group received an acupoint application using white mustard seed. In contrast, the observation group received additional back-tapping along meridians.
Primary Outcome Measures • (1) Clinical efficacy; (2)
traditional Chinese medicine (TCM) syndrome scores; (3) levels of inflammatory factors; (4) blood gas analysis indexes; (5) pulmonary function indexes; and (6) quality of life was assessed.
Results • Following treatment, the observation group exhibited superior clinical efficacy (P < .05), reduced traditional Chinese medicine syndrome scores for cough, expectoration, and wheezing (P < .05), more pronounced improvements in inflammatory factor levels (P < .05), blood gas analysis indexes (P < .05), pulmonary function indexes (P < .05), and higher quality of life (P < .05) compared to the control group.
Conclusions • Combining acupoint application with back tapping effectively alleviated symptoms and inflammatory responses, improved blood gas and pulmonary function, and enhanced the quality of life in patients experiencing expectoration and wheezing. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Impact of Comprehensive Nursing Intervention Combined with Percutaneous Radiofrequency Thermocoagulation for Treating Primary Trigeminal Neuralgia in the Elderly |
| Guoqing Cao, BD; Zhi Dou, PhD; Jiaxiang Ni, MM; Minghui Ruan, BD; Liqiang Yang, PhD |
| Background • Percutaneous radiofrequency thermocoagulation is the foremost minimally invasive approach for treating primary trigeminal neuralgia. However, postoperative complications may arise, necessitating tailored clinical care to enhance patient compliance and mitigate surgical risks.
Objective • This study aimed to explore the impact of comprehensive nursing intervention combined with percutaneous radiofrequency thermocoagulation on the management of primary trigeminal neuralgia in elderly patients.
Design • A retrospective analysis was conducted.
Setting • The study was conducted at the Department of Pain Management, Xuanwu Hospital of Capital Medical University.
Participants • A total of 126 elderly patients diagnosed with primary trigeminal neuralgia underwent percutaneous radiofrequency thermocoagulation at our hospital between June 2019 and August 2022. They were enrolled as an observation cohort and randomly assigned to either the control group or the intervention group, with 63 patients in each.
Intervention • The control group received standard
nursing care, while the intervention group received comprehensive nursing interventions.
Primary Outcome Measures • The study assessed (1) negative emotional changes, (2) postoperative status, (3) complications, and (4) quality of life.
Results • After the nursing care, the intervention group exhibited significantly lower anxiety and depression scores compared to the control group (P < .05). Additionally, the intervention group had reduced length of hospital stay and pain scores, along with higher nursing satisfaction scores, relative to the control group (P < .05). There was a significant difference in the total complication rate between the two groups (P < .05), with the intervention group experiencing fewer complications. Moreover, the quality of life scores were significantly higher in the intervention group (P < .05).
Conclusions • Comprehensive nursing intervention alongside percutaneous radiofrequency thermocoagulation in elderly patients with primary trigeminal neuralgia can decrease complication rates and enhance treatment confidence. These findings support the clinical adoption and dissemination of such interventions. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Specificity and Accuracy of Echocardiography in Diagnosing Acute Heart Failure: A Systematic Review and Meta-Analysis |
| Qifeng Lv, MM; Hui Sun, MM; Guozhang Tang, MM; Dongmei Yu, MM; Nan Zhang, MM |
| Objective • This meta-analysis evaluates the diagnostic value of echocardiography for Acute Heart Failure (AHF) and its utility in urgent clinical situations, emphasizing its significance for accurate and timely diagnosis in critical care.
Methods • Relevant studies from databases like PubMed and Embase were selected using terms such as ‘Ultrasound’ and ‘acute heart failure’. Inclusion criteria focused on studies evaluating echocardiographic diagnosis in adult patients presenting with symptoms suggestive of AHF. Quality assessment was performed using RevMan 5.3 and QUADAS. Key metrics like sensitivity, specificity, and likelihood ratios were analyzed using STATA 15.1. The types of echocardiography assessed included transthoracic and focused cardiac ultrasound.
Results • Eighteen articles were included, indicating echocardiography’s high sensitivity (0.92) and specificity (0.96) in diagnosing AHF. The combined positive likelihood ratio of 23.2 suggests that patients with AHF are over 23 times more likely to have a positive echocardiography result than those without AHF, greatly influencing clinical decision-making toward confirming the diagnosis. The AUC of the SROC curve was 0.98, indicating excellent overall accuracy.
Conclusion • Echocardiography is highly accurate in diagnosing AHF, underscored by its critical role in early treatment decisions and potential integration into standard care protocols, thereby preventing adverse outcomes and improving patient management. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Exploring the Role of the Wnt/ß-Catenin Signaling Pathway in Hepatocellular Carcinoma Migration and Tumor Angiogenesis |
| Rongguang Dang, MM; Jingjian Feng, MM; Junli Tan, MM; Lixin Wang, MM; Junpeng Wen, MM; Ye Yang, MM; Kaihong Zhen, MM |
| Background • Hepatocellular carcinoma (HCC) presents a challenging global health concern due to its high incidence and limited treatment efficacy. Understanding the molecular pathways driving HCC development is crucial for advancing therapeutic strategies and improving patient outcomes.
Objective • This study aims to assess the impact of Salinomycin on the Wnt/ß-catenin signaling pathway in hepatocellular carcinoma, exploring its role in tumor migration and angiogenesis. Additionally, to explore the therapeutic potential of targeting this pathway for improving HCC treatment outcomes.
Methods • This study employed an in vitro experimental design to investigate the role of the Wnt/ß-catenin signaling pathway in HCC progression. HepG2 cells were cultured in RPMI 1640 medium supplemented with 10% serum, penicillin (100 U/ml), and streptomycin (100 µg/ml). The cells were divided into experimental and control groups for comparative analysis. Salinomycin was administered to inhibit Wnt/ß-catenin pathway activation. The primary outcome measures included the evaluation of cell migration and tumor angiogenesis using cell migration
assays and vascular endothelial growth factor (VEGF) expression analysis, respectively. Statistical analysis was performed using the two-tailed Student’s t-test, with significance set at P < .05.
Results • Salinomycin treatment led to a dose-dependent decrease in HCC cell proliferation, with optical density values decreasing as the concentration of Salinomycin increased. Cell migration assays showed inhibited migration in cells treated with Salinomycin compared to controls. Western blot analysis revealed decreased levels of ß-catenin and increased levels of DVL in Salinomycin-treated cells, indicating inhibition of the Wnt/ß-catenin pathway. Furthermore, VEGF expression decreased after Salinomycin treatment, implicating the pathway in tumor angiogenesis. Statistical analysis, including Student’s t-test, confirmed significant differences between control and experimental groups (P < .05).
Conclusion • The Wnt/ß-catenin signaling pathway plays a significant role in the migration and angiogenesis of HCC when treated with Salinomycin. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Meta-analysis of the Correlation between miRNA Expression in Breast Cancer and Clinicopathological Features and Prognosis |
| Maowen Yu, MM; Shanshan Yu, MM |
| Background • Breast cancer is the most common cancer for women all over the world. MicroRNAs (miRNAs) are a type of small endogenous single-stranded RNA that are involved in various cellular processes, including proliferation, differentiation, apoptosis, and metabolism. Over the past decade, numerous studies have demonstrated that the expression levels of miRNAs are dysregulated in many types of cancer, including breast cancer.
Objective • To systematically evaluate both the diagnostic and prognostic value of miRNA expression in breast cancer by meta-analysis.
Design • This was a meta-analysis. The research team performed a comprehensive narrative review by searching Pubmed, Medline, Embase, China National Knowledge Infrastructure, Wanfang, and other databases that were searched by computer from January 2010 to December 2020. The language was limited to English; the subject words were miRNA and breast cancer.
Setting • This review took place in Jintang First People’s Hospital, West China Hospital, Sichuan University, and Jingtang Hospital.
Primary Outcome Measures • RevMan 5.3 software was implemented to carry out a meta-analysis of the data extracted in this paper. The outcome measures included
(1) patient age, (2) patient tumor size, (3) lymph node metastasis, (4) estrogen receptor (ER) level (5) progesterone receptor (PR) level (6) human epidermal growth factor 2 (HER2) level (7) tumor-node-metastasis (TNM) stage (8) prognosis disease-free survival (DFS) level (9) overall survival (OS) level.
Results • A total of 8 references and 1414 patients were contained in this research. Meta-analysis demonstrated that age: odds ratio (OR) =1.90, 95% confidence interval (CI) (0.30-12.09), P=0.50. Tumor size (>2 cm): OR=2.23, 95% CI (0.89-5.57), P = .09. Lymph node metastasis: OR=2.09, 95% CI (1.65-2.65), P < .00001. ER: OR=1.26, 95% CI (0.64-2.47), P = .5. PR: OR=0.96, 95% CI (0.86-1.07), P = .41. HER2 OR=1.79, 95% CI (0.42-7.64), P = .09. TNM stage (III vs. I/II) OR=0.89, 95% CI (0.71-1.10), P = .27. DFS: OR=8.49, 95% CI (2.72-26.45), P = .0002. OS: OR=5.99, 95% CI (2.60-13.79), P < .0001. High expression of miRNA was correlated with lymph node metastasis, DFS and OS in BC patients.
Conclusion • High expression of microRNA can be adopted as an important indicator for BC screening and has important value for the prognosis of BC patients. Circulating miRNAs could serve as potential targets for BC treatment. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impacts of Multiple and One-time Root Canal Therapy on Immune and Inflammatory Response in Endodontic Patients |
| Mudan Fan, BD; Qianqian Yu, MM |
| Background • Root canal therapy is a widely adopted clinical approach for managing endodontic diseases. However, patients undergoing multiple root canal treatments face an increased risk of reinfection, complicating treatment outcomes.
Objective • This study aims to evaluate the effects of both multiple and one-time root canal therapy on the immune and inflammatory responses in endodontic patients.
Design • A randomized controlled study was conducted.
Setting • The research was carried out at the 8th People’s Hospital of Shanghai.
Participants • A total of 100 endodontic patients admitted to the Stomatology Department of the hospital from January 2021 to December 2022 were randomly allocated to either the study group or the control group, with each group consisting of 50 cases.
Interventions • The control group received multiple root canal therapy, while the study group underwent one-time root canal treatment.
Primary Outcome Measures • (1) Clinical treatment
effectiveness, (2) pain intensity, (3) levels of inflammatory
factors, (4) oral immune factor levels, (5) oral health-related quality of life, and (6) occurrence of adverse reactions were assessed.
Results • The study group demonstrated a significantly higher total effective rate compared to the control group (P < .05). Post-treatment, the study group exhibited lower pain scores, reduced levels of inflammatory factors, improved oral health-related quality of life, and fewer adverse reactions compared to the control group (P < .05). Additionally, the study group showed elevated levels of lysozyme, human ß-defensin 2, and secretory Immunoglobulin A compared to the control group (P < .05).
Conclusions • One-time root canal therapy in endodontic patients yields superior outcomes, effectively reducing adverse reactions and inflammatory factor levels, enhancing chewing function, alleviating pain, and demonstrating clinical utility. This study underscores the importance and efficacy of adopting a one-time root canal treatment approach in endodontic practice. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Retrospective Analysis of Adverse Factors Impacting Medicine Logistics |
| Yue Chang, MM; Wei Du, MM; Xingying Fan, MM; Jiaqi Hu, MM; Rui Li, MM; Xiaolong Lu, MM; Hanni Zhou, MM |
| Background • Medicine logistics, particularly cryogenic storage, maintains pharmaceutical efficacy and safety. Ensuring seamless transportation and storage prevents spoilage, degradation, or contamination, safeguarding patient health.
Objective • This study aimed to analyze the relationships among the components of the medication cold chain logistics system using grey relational analysis (GRA). Additionally, we utilized GRA to construct an adjacency matrix, facilitating a comprehensive understanding of the interdependencies within the system.
Methods • Data from pertinent indices spanning 2021 and 2022 were utilized to conduct a quantitative analysis using GRA. This analysis aimed to identify the most influential elements affecting the growth of pharmaceutical cold chain logistics in a specific location. The negative aspects of the medication cold chain logistics system in particular areas were examined by assessing the grey relationship grades between various components and the medicine cold chain logistics system in those regions.
Results • The analysis revealed significant insights into the correlated risk factors impacting medicine logistics
operations. Through an examination of the financial status and operational processes of medicine logistics assets, four categories of risks were identified, encompassing transportation, storage, distribution, and quality management. These categories were established by analyzing the most significant risk factors across these operational domains. Additionally, GRA was employed to assess the factors influencing medicine logistics. The study found a strong relationship between key parameters, such as transportation risk and site facilities and equipment, and the growth of the pharmaceutical logistics sector. Operation risk emerged as the least influential factor, while site facilities and equipment, transportation risk, and operation risk demonstrated substantial influence on the region’s medical logistics sector growth.
Conclusion • This study provides important recommendations to improve medicine logistics, aiming to mitigate adverse effects and elevate inventory management. Implementation can enhance efficiency and safety in the medicine supply chain, benefiting patient care and public health. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application Effect of 6S Management Mode in Operating Room Nursing |
| Wenjun Bu, PhD; Dongmei Liao, PhD; Min Liu, PhD; Xiaoqin Pu, PhD; Qing Su, PhD; Zhen Zeng, PhD; Lili Zheng, PhD |
| Background • The nursing work in the operating room is heavy, intensive, and irregular, and the quality of nursing work can directly affect the surgical effect and patient prognosis. Therefore, nursing management in the operating room should be strengthened to protect patients’ life safety effectively.
Objective • To assess the effectiveness of applying the 6S management model in operating room nursing.
Design • This was a retrospective study.
Setting • This study was conducted at the Department of Anesthesia Surgery, Nanfang Hospital, Southern Medical University.
Participants • The research included 100 operating room nurses on duty between January 2020 and December 2022.
Intervention • From January 2020 to June 2021, the hospital conducted routine training programs for nurses in the operating room. From July 2021 to December 2022, the hospital adopted the 6S management model for overseeing nursing work in the operating room.
Primary Outcome Measures • (1) nursing quality score (2) nursing staff safety awareness (3) nursing disputes and complaints (4) incidence of adverse reactions (5) patient satisfaction with the quality of nursing care.
Results • Following the adoption of the 6S management model, there was a noticeable improvement in the nursing quality scores, the nursing staff’s awareness of safety, and the satisfaction levels of patients with the quality of care provided by operation nurses (P < .05). Additionally, the incidence of nursing disputes, complaints, and adverse events among patients decreased significantly compared to before the implementation of 6S (P = .01).
Conclusion • Implementing 6S management with a focus on the work of operation room nurses enhanced the competence of the nursing staff and improved management effectiveness, ultimately leading to increased patient satisfaction. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Application of Group Psychological Nursing in Non-suicidal Self-injury among Adolescents |
| Jin Yuan, BD; Meiqin Zheng, BD |
| Background • Non-suicidal self-injury (NSSI) refers to direct and deliberate suicidal actions that damage the body but are not recognized by society and culture. Adolescence is the transition period when children change into adult roles. At this time, teenagers are in the critical development period of physical and mental intelligence, and all aspects of their development have not yet been fully developed, so there are fierce inner conflicts. If the psychological problems of teenagers do not get timely counseling, it is very likely to choose self-injury suicide behavior, in such an extreme way to vent their bad emotions. The prevalence rate of NSSI among adolescents is much higher than that of other age groups. Studies have shown that psychological nursing is safe and effective, which can alleviate patients’ negative emotions and avoid NSSI.
Objective • To explore the impact of group psychological nursing with guardian participation on reducing NSSI behaviors and improving psychological well-being among adolescents.
Design • This was a retrospective study.
Setting • This study was performed in the Departments of the Third Psychiatry, Hangzhou Seventh People’s Hospital.
Participants • 132 adolescent patients with NSSI admitted to our center from August 2020 to July 2022 were selected as subjects and divided into 2 groups according to the time of admission, with 66 patients in each group.
Interventions • Patients in the control group (CG) received drug therapy and commonly used cognitive behavioral therapy. Patients in the observation group (OG) received group psychological nursing with guardian participation. The participation of the guardian strengthens the level of understanding, tolerance and support of both parties, and helps to enhance the strength of family support, which in turn relives negative emotions.
Primary Outcome Measures • (1) Ottawa self-injury inventory (OSI) scores were used to assess NSSI behavior severity; (2) Self-rating Anxiety Scale (SAS) and self-rating Depression Scale (SDS) scores were used to assess anxiety and depression; (3) General Self-efficacy Scale (GSES) scores were used to assess self-efficacy; (4) Trait Coping Style Questionnaire (TCSQ) scores were used to assess the quality of life; (5) social function Assessment Scale (SSPI) scores were used to assess social function; (6) Adolescent Life Events Scale (ASLEC) scores were used to evaluate the stress intensity of coping with life events; (7) multidimensional sub-health questionnaire assessment (MSQA) scores were used to assess adolescents’ physical and psychological sub-health.
Results • Before intervention, there were no significant differences in OSI, SAS, SDS, GSES, TCSO, SSPI ASLEC, and MSQA scores in both groups (P > .05). Compared to before intervention, the scores of OSI, SAS, SDS, GSES, TCSO, SSPI ASLEC and MSQA in both groups were improved after intervention (P < .05). The observation group showed significant improvements across all measures compared to the control group, indicating a reduction in NSSI behaviors and improvements in mental health.
Conclusion • Application of group psychological nursing with guardian participation in adolescent patients with NSSI behavior can better reduce NSSI behavior and improve physical and mental health, underline the importance of family support in treating NSSI, which also highlights the importance of family support in the treatment of NSSI. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application of Micro-Implant Anchorage Therapy Combined with Proxomed Tergumed System in Patients with Malocclusion Combined with Lumbar Disc Herniation |
| Zhanli Fu, MM; Guichao Guan, MM; Bing Li, MM; Chen Li, MM; Qi Sun, MM |
| Objective • To observe the application of micro-implant anchorage (MIA) combined with Proxomed Tergumed (PT) system in patients with malocclusion combined with lumbar disc herniation (LDH).
Methods • 60 patients with malocclusion combined with LDH from February 2021 to December 2022 were randomly divided into two groups. 30 cases in Group A were treated with MIA combined with conventional training, while 30 cases in Group B were treated with MIA combined with rehabilitation training of the PT system. All patients in the two groups received intervention for 30 days. The clinical efficacy, waist, and back function [Oswestry Disability Index (ODI)], low back pain [visual analogue scale (VAS)], and waist and back muscle-related indicators [Range of motion (ROM) and isometric strength (IMS)] of the two groups were compared.
Results • Group B had better overall treatment efficacy and a higher overall response rate compared to Group A (P < .05). There was no significant difference in ODI, VAS scores of lumbago, ROM, and IMS between the two groups before the treatment (P > .05). On the second week of treatment and at the end of treatment, the ODI and VAS scores of Group B were significantly lower than those of Group A (P < .05). At the end of treatment, the ROM and IMS of Group B were significantly higher than that of Group A (P < .05).
Conclusion • PT system rehabilitation training combined with MIA can improve the clinical efficacy of patients with malocclusion combined with LDH, which is conducive to improving the patients’ lumbar back muscle function and relieving low back pain. It is recommended to be used in patients with clinically related complications. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Nalbuphine Combined with Propofol on Relieving Visceral Pain and Cognitive Function in Patients Undergoing Laparoscopic Ovarian Tumor Resection |
| Ruoyu Dong, MM; Yingxia Guan, MM; Yunjie Tian, MM; Ying Wang, MM; Jun Zhang, MM; Wei Zhao, MM |
| Objective • This study evaluated the effectiveness of nalbuphine combined with propofol in reducing visceral pain and preserving cognitive function during laparoscopic ovarian tumor resection.
Methods • A total of 100 patients undergoing laparoscopic ovarian tumor resection from January 2019 to January 2022 were randomly assigned to either the control group or the research group (50 patients each). The control group received fentanyl combined with propofol for anesthesia, while the research group received nalbuphine combined with propofol. Various anesthetic parameters, hemodynamics, visceral pain(Visual analog scale was used to evaluate the degree of pain at rest and during movement at 2h, 6h, and 12h after the operation), cognitive function (Mini-Mental State Examination (MMSE) scale was used to assess the cognitive function before the operation and 1 day, 3 days, and 5 days after the operation, including time and place, language, orientation, calculation, delayed memory and useability), and incidence of adverse reactions were assessed and compared between the two groups.
Results • The research group exhibited significantly lower
propofol dosage and anesthesia recovery time compared to the control group (P < .05). Hemodynamic stability, as indicated by SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), and SpO2 (Peripheral Capillary Oxygen Saturation)levels, was better maintained in the research group, especially at the beginning of the operation (P < .05). VAS (Visual Analog Scale) scores for pain at rest and during exercise were significantly lower in the research group at 2h and 6h post-operation (P < .05). MMSE (Mini-Mental State Examination) scores were higher in the research group compared to the control group at 1and3 days post-operation (P < .05). Additionally, the incidence of adverse reactions was significantly lower in the research group (8.00%) compared to the control group (20.00%, P < .05).The above results were subjected to t test and ?2 test.
Conclusions • Nalbuphine combined with propofol effectively alleviates visceral pain during laparoscopic ovarian tumor resection, stabilizes hemodynamics, and preserves cognitive function. This combination demonstrates promising analgesic and sedative effects with high safety, suggesting its potential for widespread clinical use. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Nursing Intervention on Pregnancy Outcomes, Blood Pressure, Postpartum Self-efficacy, and Quality of Life in Patients with Preeclampsia: An Observational Study |
| Huifeng Gu, MD; Lu Qian, MD; Weihui Yang, MD |
| Objective • To analyze the intervention effects of targeted nursing based on goal management theory on pregnancy outcomes, blood pressure, postpartum self-efficacy, and quality of life in patients with preeclampsia.
Methods • We retrospectively analyzed 90 cases of preeclampsia admitted to Huzhou Maternity & Child Health Care Hospital from January 2022 to June 2023. All patients met the complete inclusion criteria. They were divided into 2 groups based on different nursing interventions: the control group (n = 45) received routine nursing interventions, and the observation group (n = 45) received targeted nursing based on goal management theory. Pregnancy outcomes, blood pressure, postpartum self-efficacy, and quality of life were compared between the 2 groups.
Results • The incidence of adverse pregnancy outcomes was 28.89% in the control group and was significantly lower in the observation group at 11.11% (P < .001). Before intervention, there were no significant differences in systolic blood pressure and diastolic blood pressure between the 2 groups (P > .05). After intervention, the systolic blood
pressure and diastolic blood pressure were significantly lower in the observation group than in the control group (P < .001). Before intervention, there was no significant difference in Breastfeeding Self-Efficacy Scale scores between the 2 groups (P > .05). After intervention, the Breastfeeding Self-Efficacy Scale scores were significantly higher in the observation group than in the control group (P < .001). Before intervention, there was no significant difference in the Short Form 36 Health Survey scores between the 2 groups (P > .05). After intervention, the Short Form 36 Health Survey scores were significantly higher in the observation group than in the control group (P < .001).
Conclusion • Compared with routine nursing, targeted nursing based on goal management theory had superior intervention effects on preeclampsia. It can further alleviate patients’ blood pressure, promote postpartum self-efficacy, improve quality of life, and reduce the risk of adverse pregnancy outcomes. It is worthy of clinical application and promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Ying-huang and San-ao Decoctions in Sepsis-Associated Acute Lung Injury |
| Fenqiao Chen, MSc; Tane Liu, MSc; Lijuan Wu, MSc; Pengying Yin, MSc |
| Objective • The objective of this study was to evaluate the efficacy of the combined treatment of Ying-Huang Decoction and San-ao Decoction compared to conventional treatment alone in patients with sepsis-associated acute lung injury (S-ALI) and to assess its potential mechanisms for improving clinical symptoms, reducing inflammatory response, and promoting respiratory function recovery.
Methods • We included 84 S-ALI patients admitted to our hospital between January 2021 and January 2023. The patients were divided into a control group and an observation group, with 42 patients in each group. The control group received conventional treatment, while the observation group received the combined treatment of Ying-Huang Decoction and San-ao Decoction in addition to conventional treatment. The study was conducted in accordance with the principles of the Helsinki Declaration and received ethical approval. The main outcome measures assessed included symptom scores, levels of inflammatory factors, lung injury scores (such as LIS scores), respiratory function parameters (such as PVPI and EVLWL levels), and the incidence of adverse reactions.
Results • The observation group receiving the combined treatment of Ying-Huang Decoction and San-ao Decoction demonstrated favorable outcomes compared to the control group. Significant improvements were observed in the observation group’s symptom scores compared to the control group (P < .05). Patients in the observation group experienced a notable alleviation of clinical symptoms
associated with S-ALI. In terms of inflammatory response, the observation group showed significantly lower levels of inflammatory factors, including IL-6, CRP, and IL-17, compared to the control group (p < 0.01). This suggests that the combined decoction treatment effectively reduced the systemic inflammatory response in S-ALI patients. Lung injury scores, as assessed by the LIS, were significantly reduced in the observation group compared to the control group (P < .05). This indicates that the combined treatment contributed to the mitigation of lung tissue damage in S-ALI patients. Respiratory function parameters, such as PVPI and EVLWL levels, showed significant improvement in the observation group compared to the control group (P < .01), indicating enhanced respiratory function.
Conclusion • The combined treatment of Ying-Huang Decoction and San-ao Decoction, in addition to conventional treatment, demonstrated beneficial effects in the management of S-ALI, leading to improved clinical symptoms, reduced inflammatory response, and enhanced respiratory function. These findings suggest the potential integration of traditional Chinese medicine approaches, such as Ying-Huang Decoction and San-ao Decoction, in the treatment of S-ALI, providing additional options for clinicians and potentially improving patient outcomes. It is important to acknowledge the limitations of this study, such as its retrospective design and the need for further research with larger sample sizes to validate the results and minimize potential biases. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Curative Effect of IKAP Nursing in Perioperative Nursing of Endometriosis Treated by Laparoscopic Surgery |
| Jie Liu, BD; Zhifen Wang, BD; Fengju Zhang, BD; Xiaohong Zhang, BD |
| Objective • To evaluate the effectiveness of Information, Knowledge, Attitude, and Practice (IKAP) nursing in the perioperative care of endometriosis patients treated with laparoscopic surgery.
Methods • A total of 100 patients with endometriosis who underwent laparoscopic surgery in our hospital from June 2020 to December 2021 were recruited and assigned to receive either routine care (control group) or IKAP care (observation group), with 50 cases in each group. Outcome measures included operative time, time-lapse before postoperative passing gas, length of hospital stay, self-rating anxiety scale (SAS), self-rating depression scale (SDS), Generic Quality of Life Inventory-74 (GQOLI-74) scores, and nursing outcomes.
Results • Before nursing, the SAS, SDS, and GQOLI-74 scores of the two groups were comparable (P > .05). IKAP
care resulted in significantly lower SAS and SDS scores, and higher GQOLI-74 scores than routine care (P < .05). IKAP care was associated with significantly shorter operative time, time-lapse before postoperative passing gas, and length of hospital stay compared to routine care (P < .05). Patients receiving IKAP care showed higher compliance, lower incidence of postoperative complications, and higher nursing satisfaction than those with routine care (P > .05).
Conclusion • IKAP nursing shortens the length of hospital stay after laparoscopic surgery for endometriosis, mitigates patients’ adverse emotions, reduces postoperative complications, and effectively improves patients’ medication adherence and quality of life. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of GLP-1 Receptor Agonist on Glycolipid Metabolism and Micro Inflammatory Status in Patients with Abdominal Obesity and Type 2 Diabetes |
| Haideng Ci, MM; Wei Shao, BM; Yanqi Wang, BM; Jianli Wu, BM; Meiqin Zhu, BM |
| Objective • To explore the impact of Liraglutide, a GLP-1 receptor agonist, on glycolipid metabolism and microinflammatory status in patients with abdominal obesity and type 2 diabetes.
Methods • This study consecutively enrolled 60 patients with abdominal obesity and type 2 diabetes at Jiande Hospital of Traditional Chinese Medicine from October 2020 to December 2021. They were randomly divided into a control group (30 cases) receiving routine treatment and a liraglutide group (30 cases) receiving Liraglutide in addition to routine treatment for 3 months. The control group received routine treatment, which included metformin at a dose of 1g twice daily, along with dietary and exercise guidance. The liraglutide group received an initial dose of 0.6 mg daily for the first week, increased to 1.2 mg daily in the second week, and further increased to 1.8 mg daily in the third week, continuing at this dose
until the end of the 12-week treatment period, with adjustments based on tolerance.
Results • Significant improvements were observed in SBP, DBP, BMI, waist-to-hip ratio, and various glycolipid and microinflammatory indexes in the Liraglutide group compared to controls (P < .05). Specifically, SBP, DBP, BMI, waist-to-hip ratio, FPG, 2hPG, HbA1c, TG, TC, hs-CRP, TNF-a, and IL-6 levels decreased more significantly in the liraglutide group. Conversely, C-peptide and fasting insulin levels increased more in the liraglutide group. No significant difference in the incidence of adverse reactions was observed between the two groups (P > .05).
Conclusion • Liraglutide can improve glycolipid metabolism and microinflammatory status in patients with abdominal obesity and type 2 diabetes, which has high medication safety. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impacts of Evidence-based Nursing on Quality of Life and Anxiety in Patients with Liver Injury |
| Zeyang Chen, MM; Wenying He, MM; Dongcang Hou, MM; Chunrong Ping, MM; Tian Qin, MM; Xiaoman Ruan, MM; Ganlu Tian, MM; Menghui Xu, MM; Wenjing Zhou, MM |
| Background • Plasma exchange is the most commonly applied method for treating severe hepatitis. As a kind of invasive treatment, plasma exchange may have various complications during treatment. Therefore, effective nursing should be implemented during plasma exchange treatment to prevent the incidence of complications.
Objective • To compare the effects of traditional nursing methods versus evidence-based nursing practices on the quality of life and anxiety of patients with liver injury.
Design • This was a retrospective study. Patient data were obtained from patient records.
Setting • This study was carried out in the Department of Gastroenterology, Second Hospital of Hebei Medical University.
Participants • One hundred and twenty severe hepatitis patients with 89 cases of early hepatic failure and 31 cases of middle hepatic failure admitted to our department from January 2020 to December 2022 were chosen, followed by randomly separating into a control group and an observation group.
Interventions • The control group adopted nursing, while the observation group received evidence-based nursing including psychological nursing, nursing during treatment and post-treatment nursing.
Primary Outcome Measures • (1) liver function (2)
emotional state assessed by Self-rating Anxiety Scale (SAS) along with Self-rating Depression Scale (SDS) (3) coagulation function, (4) quality of life assessed by Short-Form 36 (SF-36) scale (5) nursing satisfaction, and (6) incidence of complications.
Results • In contrast to the control group, the occurrence of complications in the observation group was significantly lower (P < .05). At 1-month review, the quality of life score in the observation group was higher in contrast to the control group (P < .05). In contrast to the control group, the nursing satisfaction of patients in the observation group was better (P < .05), alanine aminotransferase and total bilirubin levels in the observation group were lower, while albumin levels were higher (P < .05), the anxiety and depression scores of the observation group were lessened (P < .05), and the required time of coagulation function indexes in the observation group was shorter (P < .05).
Conclusion • The application of evidence-based nursing to artificial liver therapy in patients with liver failure can effectively promote the liver function and coagulation index of patients, help to relieve negative emotions, and promote the quality of life of patients. This study may provide clinical reference for the nursing of artificial liver therapy in patients with liver failure. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Implementation and Evaluation of the FLS Model Nursing in the Rehabilitation of Geriatric Patients with Femoral Neck Fractures |
| Baihui Fu, MBBS; Yuanyuan Tang, MBBS; Qun Tong, MBBS |
| Objective • To evaluate the effectiveness of FLS model nursing in the rehabilitation of elderly patients after femoral neck fracture surgery.
Methods • We retrospectively analyzed data from 89 elderly patients treated surgically for femoral neck fractures, comparing outcomes between those receiving routine nursing (control group, n=44) and FLS model nursing interventions (observation group, n=45). Key metrics included rehabilitation process indicators, hip joint function, self-efficacy, perceived burden, limb stability, and adverse reactions.
Results • The observation group showed significantly shorter first out-of-bed time, time for pain disappearance, and length of hospital stay compared to the control group. The observation group also exhibited significantly higher scores in pain, gait, functional activities, and deformity/mobility assessments after the intervention compared to the control group. The GSES score was significantly higher and the SPB score was significantly lower in the observation
group after the intervention compared to the control group. The observation group demonstrated significantly higher levels of dynamic balance ability, lower limb muscle strength, and mobile walking ability than the control group. The incidence of adverse reactions was significantly lower in the observation group (8.89%) compared to the control group (36.36%).
Conclusion • FLS model nursing intervention has a significant positive effect on the rehabilitation of elderly patients undergoing surgery for femoral neck fractures. Compared to routine nursing intervention, the FLS model nursing intervention can further promote postoperative recovery of hip joint function, improve self-efficacy, alleviate the self-perceived burden, shorten the rehabilitation process, and reduce the risk of adverse postoperative reactions. These findings suggest the FLS model nursing approach holds promise for broader clinical adoption and implementation. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Addressing Health Challenges: Family Support and Management Strategies for Chronic Endogenous Infections in Children with Hyperthermia |
| Hu Di, MM; Jin Youtian, MM |
| Objective • This study aimed to investigate the disease characteristics of children admitted to the hospital with high fever on an emergency basis and assess the health needs of their family members. Additionally, it aimed to analyze nursing strategies focusing on the management of chronic internal infections.
Method • A total of 526 children with high fever admitted between December 2020 and December 2022 were included in the study. Among them, 368 (69.96%) were aged younger than six years, and the remaining 158 were aged between (6~18 years). The main health needs of family members were assessed using a questionnaire. The children were randomly assigned to control and observation groups, each comprising 263 cases. The control group received routine emergency nursing, while the observation group received advanced chronic nursing strategies focusing on internal infections. The study compared the time taken for temperature normalization, management of depression in children, the occurrence of negative emotions among family members and nurse-
patient disputes, nursing quality scores, satisfaction levels, health knowledge mastery rates, and nursing processing ability scores of family members between the two groups.
Results • The observation group exhibited significantly shorter time to temperature normalization and better depression management compared to the control group. Additionally, the observation group showed lower occurrences of negative emotions among family members and nurse-patient disputes, higher nursing quality scores and satisfaction levels, and better health knowledge mastery rates and nursing processing ability scores of family members (P < .05).
Conclusions • Considering the rapid progression of conditions in emergently hospitalized children with high fever and the susceptibility of family members to various negative emotions, tailored chronic nursing strategies centered on internal infections can significantly enhance clinical diagnosis, reduce nurse-patient disputes, improve nursing quality, and elevate family nursing standards. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Current Situation of the Intention to Report Adverse Events of Nurses in the Department of Hematology and Its Influencing Factors |
| Jie Cheng, BM; Guilan Li, MM; Weihua Li, MM; Dandan Peng, MM |
| Objective • To investigate the current state of nurses’ intentions to report harmful incidents in the hematology department, and the influencing factors, to provide a relevant basis for ensuring healthcare quality and patient safety.
Methods • By using a stratified sampling technique, 80 nurses from the hematology department of our hospital between June 2020 and June 2022 were randomly chosen as the research objects. The Chinese version of intention to report adverse event questionnaire (15 items with a scale of 0 to 1), adverse event report cognitive questionnaire (8 items with a scale of 0 to 1), and adverse event reporting attitude questionnaire (25 projects with a scale of 0 to 4) were used to collect data. Multiple linear regression model was used to explore the influencing variables based on the single-factor indicators with statistical significance.
Results • When adverse events caused serious casualties or even death, the majority cases (96.25%) were reported to the superior supervisor; when the adverse events did not cause relevant injury, and was in potential vulnerability,
the proportion of discussing with colleagues was the most (90.00% and 88.75%, respectively). For cognition on adverse events, “whether they understand the medical safety event reporting system” accounted for the most proportion (98.75%). The nurses had the highest scores for reporting standard [(25.58 ± 6.19) points] and lowest score for reporting purpose [(8.62 ± 1.51) points]. Age, educational background, years of employment, and professional titles were influencing factors of nurses’ inclination to report unfavorable events (P < .05).
Conclusion • The cognition and reporting attitude of nurses in the hematology department on adverse events need further improvement. The intention of the nurses to report adverse events is influenced by age, educational background, years of experience, and professional titles. Patient safety education especially with simulation-based training should be implemented, to decrease frequency of adverse incidents. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of Factors Associated with Cough Persistence After Thoracoscopic Lung Cancer Resection in Elderly Lung Cancer Patients and Discussion of Prevention Strategies |
| Fenghua Sun, MD; Zhijian Wang, MD; Lixin Yu, MD; Zhenkui Zhang, MD |
| Objective • The aim was to investigate the factors associated with cough persistence after thoracoscopic lung cancer resection in elderly lung cancer patients and preventive strategies.
Methods • In this study, 103 elderly patients with lung cancer who attended the department of thoracic surgery of our hospital from March 2019 to January 2023 were selected for retrospective analysis, all of whom underwent thoracoscopic lung cancer resection and were divided into the cough group (n = 37) and the no-cough group (n = 66) based on the presence or absence of persistent cough in the postoperative period. The clinical data of the patients were analyzed using univariate analysis and multifactorial logistic regression analysis.
Results • The findings of the study show that there was no statistically significant difference when comparing the data of the two groups in terms of gender, age, history of diabetes mellitus, history of hypertension, pathologic
type, TNM stage, intraoperative blood loss, and postoperative pleural fluid (P > .05). However, multifactorial analysis showed that preoperative history of smoking, the side of the operation being the right side, the extent of the operation being the lobes of the lungs, the time of tracheal intubation =172 min, the peritracheal lymph node clearance, and the occurrence of postoperative acid reflux were independent risk factors for the occurrence of persistent cough in patients after thoracoscopic lung cancer resection, while preoperative respiratory training was a protective factor (P < .05).
Conclusion • There are many factors affecting persistent cough after thoracoscopic lung cancer resection. These factors need to be paid close attention to in the clinic and preventive measures should be taken to minimize the occurrence of persistent cough and promote postoperative recovery. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparison of Caries and Gingival Status in Patients with Type 2 Diabetes and Healthy Children |
| Ying Wang, MD; Meng-Xing Wang, MD; Tian Xia, MD |
| Background • Oral health problems often occur in patients with type 2 diabetes (T2D), and the incidences of dental caries and gingivitis increase as blood glucose (BG) levels rise. This work compared caries and gingival status of patients with T2D and healthy children to improve the understanding and attention of patients with T2D to oral health.
Methods • Clinical data of 60 patients with T2D under the age of 10 from May 2020 to September 2022 were retrospectively collected and assigned to the diabetes group. Those 60 healthy children with the same physical examination were collected and assigned to the healthy group. Children in both groups underwent periodontal examination, dental caries examination, and gingival index examination. The prevalence, decayed, missed, and filled teeth (DMFT), caries average (CA), plaque index (PI), gingival crevicular bleeding index (GCBI), attachment loss (AL), and tooth looseness (TL) were observed and compared.
Results • The prevalence of dental plaque (DP) (91.67%) and moderate to severe DP (45%) in the diabetes group was much higher based on those in the healthy group
(73.33% and 23.33%) [1.25, 95% CI (0.96, 1.63), P < .001]. The prevalence of caries and CA was greatly higher in the diabetes group (75% vs. 21.67%, 2.88 vs. 1.06), and the incidence of gingivitis was higher (63.33% vs. 16.67%) [1.93, 95% CI (1.38, 2.70), P < .001]. Meanwhile, the diabetes group exhibited much higher PI (2.31 ± 0.13), GCBI (2.45 ± 0.28), AL (5.62 ± 0.47 mm), and TL (0.85 ± 0.17 mm) and exhibited obvious difference to those in the healthy group (0.92 ± 0.21, 0.86 ± 0.23, 1.65 ± 0.46mm, 0.36 ± 0.08 mm) [3.46, 95% CI (2.33, 5.15), P < .001].
Conclusion • The prevalence of dental caries and gingivitis in patients with T2D was higher than those in healthy children. Based on these findings, it is suggested that patients with T2D should be educated and encouraged to prioritize their oral health. Regular dental check-ups, proper oral hygiene practices, and preventive measures, such as professional cleanings and fluoride treatments, should be emphasized. Maintaining optimal blood glucose control is also crucial, as it may help reduce the risk and severity of oral health complications associated with diabetes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Diagnostic Advantages of MRI in Cerebral Infarction: Multi-Sequence Imaging and Improved Sensitivity in Early Detection |
| Wen Chi, BS; Jie Huang, BS; Taotao Zhao, BS |
| Objective • The study aimed to investigate the diagnostic value of computed tomography (CT) and magnetic resonance imaging (MRI) in cerebral infarction (CI) in cerebrovascular diseases.
Method • 100 patients with acute ischemic cerebral infarction (AICI) were divided into a CT group and an MRI group. The diagnostic efficacy of the two diagnostic methods for CI was compared and analyzed.
Results • Only 6 patients with acute early stage (AES) CI and 30 patients with acute late stage (ALS) CI were detected by CT, which was significantly less than those detected by MRI (P < .05); 5 patients with <5 mm infarction were detected by CT in ALS and 10 patients with 5-15 mm infarction were detected by CT in ALS, which were significantly less than those detected by MRI (P < .05); 3 patients were diagnosed with cerebral sulcus, fissure, and shallow and disappeared brain cistern, 4
patients with local gyrus swelling, and 31 patients with significant swelling by CT examination, which was significantly less than those detected by MRI (P < .05); the infarct area ratio measured by CT/ diffusion weighted imaging (DWI) was significantly lower than that measured by fluid attenuated inversion recovery (FLAIR)/DWI (P < .05); the diagnostic specificity (Sp), sensitivity (Se), Youden index, positive predictive value (PV), and negative PV of MRI were 0.82, 0.79, 0.58, 0.7, and 0.88, respectively, which were significantly better than those of CT (P < .05).
Conclusion • CT is not a sensitive technique for the diagnosis of early CI. Compared to CT, MRI has the characteristics of multi-sequence and multi-parameter imaging, is more sensitive to infarction within 2 hours after onset, and can more clearly and accurately diagnose CI. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Summary of the Best Evidence for Perioperative Exercise in Patients Undergoing Hepatectomy |
| Hui Chai, MD; Yujing Chen, MD; Xia Li, BS; Yingzi Li, MD; Li Wang, BS |
| Objective • This study aimed to search and analyze relevant evidence on perioperative activities in patients undergoing hepatectomy and provide a summary of the best evidence available.
Methods • Comprehensive computer searches were conducted in various databases, including PubMed, Cochrane Library, BMJ Best Practice, Joanna Briggs Institute, Evidence-Based Health Care Centre Database, US Guidelines Network, UK National Institute of Clinical Medicine, Scottish Intercollegiate Guidelines Network, International Guidelines Association Network, New Zealand Clinical Practice Guidelines Network, and Chinese Biomedical Literature Database from January 30, 2022 to December 30, 2023. The search included guidelines, expert consensus, evidence summaries,
systematic reviews, and original research closely related to the evidence.
Results • A total of 11 pieces of evidence were included, consisting of 2 guidelines, 2 expert consensuses, 1 evidence summary, 1 systematic review, and 5 randomized controlled trials (RCTs). From these, five pieces of best evidence were identified.
Conclusions • The evidence from the included studies collectively indicates that well-planned perioperative activities are safe and beneficial for patients undergoing hepatectomy. Furthermore, high-quality local guidelines have been established in China, suggesting that healthcare professionals can adopt these practices to accelerate patient recovery and enhance the quality of clinical care. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Intrauterine Device Migrated into the Urachus: A Case Report |
| Tuanjie Che, PhD; Jian Chen, PhD; Jianlin Lu, PhD; Weiguo Wang, PhD |
| Background • The intrauterine device is the most commonly used female contraceptive device, but the related complications of intrauterine devices are also common. Sometimes, intrauterine devices can cause uterine perforation, migrating into the abdominal cavity or other organs. At the same time, the intrauterine device may break into several small segments, migrate to distant organs, and even cause misdiagnosis.
Objective • This study assessed the role of laparoscopy in treating intrauterine device migration.
Design • This was a retrospective study involving in a review of a single case.
Setting • This study was conducted at Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University.
Participants • This study focued on a single case acout a 64-year-old female patient presented with repeated painless gross hematuria. She had a history of placing an intrauterine device and “removed the intrauterine device” in a local hospital for 20 years.
Interventions • Laparoscopic ureterectomy was chosen based on the specific findings from the computerized tomography scan and cystoscopy. Abdominal computerized tomography showed high-density foreign body under the abdominal wall, size 2.29×0.51 cm, showed signs of edema in the surrounding tissue, and it was connected to the bladder wall. High-density lesions in the urachus and urachus calculi
were considered. Cystoscopy showed the bubble position on the top of the bladder was depressed, a dark foreign body seemed to be seen inside, and the local mucosa was congested. The urachus foreign body, the urachus stone, was considered.
Results • Computerized tomography examination showed a high-density space-occupying lesion at the position of the bladder and urachus tube. Cystoscopy showed local congestion at the top of the bladder, like urachus and dark foreign bodies, and no obvious abnormality in other parts of the bladder. Laparoscopy showed the urachus position was congested and edema, with local adhesion of the greater omentum and foreign bodies. The foreign bodies and surrounding tissues were removed by laparoscopic ureterectomy. Pathology showed tubular tissue, metal and plastic foreign bodies, fibrous tissue proliferation, and chronic inflammatory cell infiltration around the foreign bodies.
Conclusion • The intrauterine device is a common contraceptive tool, and intrauterine device rupture and migration are normal. Migration to rare locations can lead to misdiagnosis. It can be removed by endoscopy, and combined with imaging and pathological examination, a correct diagnosis can finally be obtained. The patients should be advised to undergo regular check-ups after the procedure. These cases may provide diagnostic reference for similar symptoms of intrauterine device migration. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| A Study on the Effectiveness of a Nursing Intervention Based on Objectives and Key Results Goal Management in Bowel Preparation before Colonoscopy |
| Weiming Xiao, MM; Yan Zhang, MM |
| Objective • This study aimed to evaluate the effectiveness of an Objectives and Key Results (OKR)-based nursing intervention in enhancing the quality of bowel preparation for colonoscopy.
Methods • Between July and December 2021, 180 inpatients who attended the Department of Gastroenterology, Dongtai Hospital, Nantong University, had their first colonoscopy and were able to complete bowel preparation and perform colonoscopy, and met the inclusion criteria of this study, were selected as study subjects. The 180 inpatients were divided into a control group (n=90, receiving conventional care) and a research group (n=90, managed with specialist care quality standards in addition to conventional care) using a
random number table to compare the pass rate of bowel preparation cecum insertion rate, compliance rate, patient satisfaction and incidence of adverse reactions.
Results • The research group had higher rates of successful bowel preparation, appendiceal intubation, adenoma detection, compliance, and patient satisfaction than the control group (P < .05). The incidence of adverse reactions in the research group was lower than in the control group (P < .05).
Conclusion • Implementing OKR-based nursing interventions in bowel preparation protocols significantly enhances patient outcomes and satisfaction, suggesting its widespread adoption in gastroenterology practices. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Based on PI3K/Akt Signaling Pathway, the Effects of Gubi Decoction on Chondrocyte Proliferation, Apoptosis, and Expression of Inflammatory Factors in a Rat Model of Osteoarthritis |
| Zhongkui Guo, MBBS; Yi Li, MBBS; Yong Qin, MBBS; Peifu Tang, MBBS |
| Objective • Given the crucial role of the PI3K/Akt signaling pathway in chondrocyte survival and inflammation in osteoarthritis (OA), this study aimed to investigate the effects of Gu Bi Tang on chondrocyte proliferation, apoptosis, and inflammatory factor expression in a rat model of OA, with a focus on the PI3K/Akt signaling pathway.
Methods • Forty-five specific pathogen-free (SPF) C57 mice were randomly divided into three groups: the model group (Group A), the Gu Bi Tang group (Group B), and the Amfenac group (Group C), with 15 rats in each group. All 45 rats underwent anterior cruciate ligament transection (ACLT) surgery to establish an OA model. The ACLT procedure is a well-established method for inducing OA in rodents, as it leads to the destabilization of the knee joint and the development of degenerative changes characteristic of human OA.
After 8 weeks of modeling, Group A rats received an equivalent volume of normal saline by gastric lavage, Group B rats were administered 13 mL/kg of Gu Bi Tang, and Group C rats received 19.5 mg/kg of Amfenac solution by gastric lavage. The dosages of Gu Bi Tang and Amfenac were selected based on previous studies examining the therapeutic effects of these interventions in rodent OA models. The gastric lavage frequency for all three groups was maintained at twice daily.
The researchers analyzed cartilage morphological changes using toluidine blue staining, chondrocyte proliferation and apoptosis using the TUNEL method, and the expression of PI3K/AKT/mTOR proteins in chondrocytes using Western blotting. Additionally, the expression of inflammatory factors (TNF-a and IL-1ß) in serum was measured using ELISA.
Results • Staining: Compared to the model group (Group A), both the Gu Bi Tang group (Group B) and the Amfenac group (Group C) showed significant improvement in cartilage tissue, with deeper toluidine blue staining. Toluidine blue staining is a marker of cartilage integrity and glycosaminoglycan content, indicating improved cartilage structure and composition in the treatment groups.
Chondrocyte proliferation and apoptosis: Compared to the model group (Group A), both the Gu Bi Tang group (Group B) and the Amfenac group (Group C) significantly reduced chondrocyte apoptosis
(P < .05). This reduction in chondrocyte death contributes to a healthier cartilage environment and helps prevent further cartilage degradation.
Protein expression: In comparison to the model group (Group A), the expression of PI3K, AKT, and mTOR proteins in the joint cartilage of the Gu Bi Tang group (Group B) and the Amfenac group (Group C) significantly decreased, with the Amfenac group showing a greater reduction than the Gu Bi Tang group (P < .05). The inhibition of this detrimental PI3K/AKT/mTOR signaling pathway promotes chondrocyte survival and a more favorable cartilage homeostasis.
Inflammatory factor expression: Prior to treatment, there was no significant difference in the expression levels of the inflammatory factors TNF-a and IL-1ß in serum among the three groups (P > .05). However, after treatment, both the Gu Bi Tang group (Group B) and the Amfenac group (Group C) showed a significant reduction in the serum expression of TNF-a and IL-1ß compared to the model group (Group A), with the Amfenac group showing a greater reduction than the Gu Bi Tang group (P < .05). This is important, as TNF-a and IL-1ß are key pro-inflammatory cytokines that drive the destructive processes in osteoarthritis.
Conclusion • In summary, this study demonstrates that Gu Bi Tang exerts protective effects on chondrocytes in a rat model of osteoarthritis. Specifically, Gu Bi Tang was shown to inhibit chondrocyte apoptosis, reduce the expression of key proteins in the PI3K/AKT/mTOR signaling pathway, and decrease the levels of the pro-inflammatory cytokines TNF-a and IL-1ß.
These findings suggest that Gu Bi Tang could offer a novel therapeutic approach for osteoarthritis by modulating key signaling pathways and inflammatory responses. The ability of Gu Bi Tang to preserve chondrocyte viability and maintain a more favorable cartilage homeostasis makes it a promising candidate for further investigation as a potential treatment for osteoarthritis. Future studies should explore the precise mechanisms by which Gu Bi Tang exerts its beneficial effects and evaluate its efficacy in additional animal models and clinical settings. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Countermeasures and Application Effect of Nursing Interventions in Maintenance Hemodialysis Patients with Complications of Secondary Hyperparathyroidism |
| Sijia Bai, MD; Ting Bi, MM; Guangming Cheng, MM; Xiaodong Feng, BD; Wei Li, BD; Wei Zhang, MD; Yinghui Zhou, MM |
| Background • Secondary hyperparathyroidism commonly arises in individuals with end-stage kidney disease, especially those who undergo maintenance hemodialysis (MHD). This study investigated strategies and effectiveness of nursing interventions in MHD patients with secondary hyperparathyroidism complications.
Methodology • This study is a retrospective analysis conducted at the General Hospital of Northern Theater Command. From June 2021 to June 2023, 212 patients undergoing MHD were selected for the study. They were divided into 2 groups based on their parathyroid hormone levels: a hyperthyroidism group and a standard group. Within the hyperthyroidism group, participants were randomly assigned to either the control group (CG), which received routine nursing, or the observation group (OG), which received targeted nursing. The study assessed several primary outcome measures, including patient risk factors, nursing satisfaction, psychological status, quality of life, treatment compliance, and nutritional indexes.
Results • Significant disparities existed in the age, diabetes presence, pulse pressure, duration of dialysis, and levels of
creatinine, C-reactive protein, phosphorus, triglyceride, albumin, calcium, and phosphorus product between the hyperthyroidism and the standard group. The duration of dialysis, presence of diabetes, C-reactive protein, and blood phosphorus were identified as independent risk factors for maintaining secondary hyperparathyroidism in patients undergoing hemodialysis. Overall satisfaction with nursing care and compliance with treatment were significantly higher in the observation group compared to the CG. Following nursing care, the scores on the Self-rating Anxiety Scale and the Self-rating Depression Scale were substantially lower in the OG compared to the CG. After nursing care, the biochemical indicators were lower, the nutritional indicators were higher, and the quality of life scores were significantly improved in the OG compared to the CG.
Conclusion • Targeted nursing interventions in the care of hemodialysis patients with hyperparathyroidism enhanced serological markers, alleviated negative emotions, and improved patients’ quality of life and nutritional status. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application of Modified Early Warning Score in Patients with Hypertensive Intracerebral Hemorrhage After Neurosurgery |
| Meng Gao, MM; Qun Li, BD; Jing Zhao, BD |
| Background • Hypertensive intracerebral hemorrhage (HICH) is one of serious complications of hypertension. Therefore, early identification of postoperative deterioration of patients and timely intervention measures are needed.
Objective •To evaluate the application of Modified Early Warning Score (MEWS) in HICH patients after neurosurgery.
Design • Retrospective study
Participants • 82 HICH patients admitted to the neurosurgery department of our hospital from July 2022 to January 2023 were enrolled as subjects.
Interventions • The MEWS score and the early warning score of postoperative deterioration of HICH patients were evaluated every hour. The respiratory rate, heart rate, systolic blood pressure, and blood oxygen saturation were monitored by a bedside multi-parameter monitor. The consciousness was evaluated by the Glasgow Coma Scale (GCS) score.
Primary Outcome Measures • The receiver operator characteristic (ROC) curve was drawn to compare the
predictive effect of the early warning scale and the MEWS on the prognosis of postoperative deterioration in patients with HICH.
Results • The area under the ROC curve of early warning score predicted the postoperative deterioration of patients to be 0.9660, the best cutoff value was 3.9 points, the sensitivity was 98.35%, the specificity was 86.67%, and the Yoden index was 0.784. The area under the ROC curve of the MEWS for postoperative deterioration of HICH patients was 0.869, the best cutoff value was 3.9, the sensitivity was 83.33%, the specificity was 71.67%, and the Yoden index was 0.517. However, unlike early warning scoring scale, MEWS score was only used to evaluate vital signs with high frequency of clinical monitoring, and the threshold range of heart rate, systolic blood pressure and consciousness score set was not fully applicable to patients after HICH.
Conclusion • The early warning scoring scale for postoperative deterioration of HICH patients has good predictive efficacy and strong operability. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Identification and Validation of Prognostic Risk Model for Female-Specific Lung Adenocarcinoma |
| Siyang Feng, MD; Yunhui Guo, MS; Siyu Xie, MS; Wei Yang, PhD; Jianxue Zhai, MS |
| Background • Lung adenocarcinoma (LUAD) is a major pathological subtype of non-small cell lung cancer and occurs more commonly in females than other lung cancer subtypes. Studying female-specific oncogenes in LUAD may provide personalized medicine approaches for females with LUAD.
Objective • We aimed to identify the possible female-specific oncogenes of LUAD and understand their potential impact on treatment strategies for specific cancer subgroups.
Methods • The gene expression profiles of LUAD were downloaded from The Cancer Genome Atlas (TCGA) database and the GSE72094 dataset. TCGA database is currently the largest database of cancer genetic information. Female-specific differentially expressed genes (DEGs) were identified by R programming software. Functional annotation of DEGs was conducted based on KEGG pathway enrichment analysis. Univariate and multivariate Cox proportion analyses were applied to construct a prognostic risk score model with the DEGs. Kaplan?Meier and ROC curves were plotted to validate the predictive effect of the prognostic DEGs signature. Gene set enrichment analysis (GSEA) was applied to identify the potential pathways in the high-risk groups in female LUAD. Finally, the immunohistochemical staining (IHC) was conducted to verify the expression of CABLES1 in human LUAD samples.
Results • We constructed a prognostic signature that includes 12 female-
specific DEGs (P < .05). Among them, ABHD6, CABLES1, CXCL5, DNAJB4, EFNB2, HLX, MEOX2, MTMR10, PPFIBP1, and RERG were down-regulated in LUAD, while MFSD6L and SOX9 were up-regulated in LUAD (P < .0001). The Kaplan-Meier, and receiver operator characteristic (ROC) curves revealed efficient and stable prediction of the prognostic signature in the female LUAD patients. It was showed the risk score model has a good predictive effect on the prognosis of female LUAD patients but is not effective for male patients (P < .0001). The ROC curve showed that the areas under the curve (AUC) of first-, third- and fifth-year survival were 0.70, 0.69, and 0.79, respectively, which indicated good sensitivity and specificity of the 12-gene risk score algorithm in predicting the prognosis of female LUAD. GSEA revealed that the high-risk group was significantly enriched in the EMT, E2F targets, Myc targets, G2/M checkpoint, glycolysis, hypoxia, and mTORC1 signaling pathways (P < .05). Immunohistochemical staining showed lower CABLES1 expression was associated with higher pTNM stage in female LUAD but not in male LUAD (P < .05).
Conclusion • Our study constructed and verified a prognostic signature based on 12 female-specific DEGs of LUAD, which could improve the understanding of sex-related risk factors involved in LUAD carcinogenesis and progression, and may provide personalized treatment strategies for female LUAD patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Effect of Physical Activity on Cognitive Functions among Children with Obesity or Overweight: A Meta-Analysis |
| Xi Chen, MA; Shunfeng Mao, BA; Huijuan Yang, MA; Liuyang Zhou, BA |
| Objective • To systematically comparison of the relative effects of different types and times of physical activity on cognitive function among children with obesity or overweight.
Methods • From the establishment of the database to September 2023, the relative effects of different types and times of physical activity on cognitive function among children with obesity or overweight published in Embase, PubMed, Cochrane Library, Web of Science, China Wanfang, HowNet, Chinese Biomedical Literature, and VIP were retrieved. A study of marker correlations. Literature were screened according to the inclusion and exclusion criteria, and relevant data were extracted for meta-analysis using Review Manager 5.3 software.
Results • A total of 352 articles were obtained from the preliminary search, and 16 articles were finally included in the study. Meta-analysis revealed that physical activity improved executive function (SMD =-0.12; 95% CI = -0.46-0.22; I2=80.5%, P < .001), inhibition control (SMD =0.54; 95% CI =0.12-0.97, P < .0001, I2=89.9%), attention (SMD =0.04; 95% CI =-0.17, -0.26, P = .006, I2=59.4%), and cognitive function (SMD =-0.08; 95% CI =-0.79, 0.63, P < .0001, I2=96.4%).
Conclusion • Physical activity can improve several domains of executive function, inhibition control, attention, and cognitive function. Moreover, the effects are affected by physical activity characteristics among overweight and obese children. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparative Analysis of Risk Factors and Dietary Status of High-risk Groups of Stroke in Urban and Rural Areas of Xiangtan City |
| Jianwen Chen, BS; Lin Ding, MM; Zili Han, BS; Zheng Liu, MM; Bingbing Tang, BS; Zhouyang Wei, MM; Hongmei Zhao, BS |
| Objective • This study aimed to explore the risk factors and dietary status of middle-aged and elderly people at high risk of stroke in urban and rural areas of Xiangtan City, with a view to providing a basis for formulating stroke prevention and control strategies in urban and rural areas of Xiangtan City.
Methods • Using the cluster sampling method, a total of 8,453 permanent residents aged =40 years old were selected from Yuetang Street, Yuetang District, and Jiangshe Town, Yuhu District, Xiangtan City in 2020 and 2021 for face-to-face questionnaire surveys to collect their demographic information, daily life Method, family history, height, weight, waist circumference, blood pressure, blood sugar, blood lipids, glycosylated hemoglobin, homocysteine and other indicators, and analyze them.
Results • A total of 8453 permanent residents were screened in this study, and a total of 1,804 stroke high-risk patients (including stroke and TIA, 21.34%) were screened out, including 973 urban residents (23.53%), and 831 rural residents (19.25%), and the distinction had statistical significance (P < .05); 263 stroke sufferers were screened out, and the prevalence ratio was 3.11%. The exposure rates of risk factors for high-risk groups in urban and rural areas of Xiangtan City from high to low are hypertension, dyslipidemia, smoking, family history of stroke, diabetes, obesity, lack of exercise and atrial fibrillation or heart valve
disease. The high-risk groups for urban strokes The proportions of lack of exercise (23.54%) and obesity (38.44%) were significantly higher than the proportions of lack of exercise (17.09%) and obesity (22.64%) in rural areas. The high-risk groups in rural areas had hypertension (87.73%) and a history of TIA (2.89%). The proportion of patients with hypertension (82.43%) and TIA history (1.34%) was significantly higher than those in urban areas, and the differences were statistically significant (P < .05). The proportion of rural residents who eat a salty diet (17.93%) and eat fruits =2 days/week (93.98%) is significantly higher than that of urban residents who eat a salty diet (14.49%) and eat fruits =2 days/week (59.61%). There are differences. Statistically significant (P < .05), the proportion of urban residents who consume vegetables =2 days/week (11.91%) is significantly lower than the proportion of urban residents who consume vegetables =2 days/week (28.98%) (P < .01).
Conclusion • The high-risk factors for stroke in Xiangtan City are mainly hypertension, dyslipidemia, smoking history, family history of stroke, and diabetes. Tailored public health measures should be taken by residents to address the different risk status and dietary habits of urban and rural populations. Especially dietary intervention for rural residents. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Clinical Significance and Expression Level of miR-411-5p in Colorectal Cancer |
| Tianliang Bai, MD; Bindan Cai, MB; Shangkun Du, MB; Yabin Liu, MD; Mingxuan Zhang, MB |
| Background • MicroRNAs (miRNAs) have been widely recognized as crucial regulators in the development and progression of various cancers, including colorectal cancer (CRC). Previous studies have highlighted the involvement of several miRNAs in CRC, such as miR-145, miR-29a-3p, and miR-196. However, the specific role and clinical significance of miR-411-5p in CRC have not been thoroughly investigated, representing a significant gap in the current understanding of CRC biology. While miR-411-5p has been implicated in the pathogenesis of other human malignancies, its precise mechanisms and impact on CRC development and prognosis remain largely unexplored. Understanding the functional relevance of miR-411-5p in CRC and elucidating its molecular interactions can provide valuable insights into the underlying mechanisms of CRC progression and potentially identify novel therapeutic targets. Therefore, this study aims to investigate the clinical value and level of miR-411-5p in colorectal cancer, shedding light on its potential as a diagnostic and prognostic biomarker. Additionally, we aim to explore the molecular mechanisms underlying the effects of miR-411-5p on CRC cells, particularly its interaction with the target gene NFE2L3. By filling this knowledge gap, our research contributes to a deeper understanding of the role of miR-411-5p in CRC and opens avenues for developing targeted therapies for this prevalent malignancy.
Methods • Colorectal cancer (CRC) tissue samples and corresponding normal paracancerous tissue samples were collected from 60 CRC patients treated at the Affiliated Hospital of Hebei University. Normal paracancerous tissue refers to the healthy tissue adjacent to the cancerous region. These tissue samples were obtained through biopsies, and the patients provided informed consent for their use in the study. To investigate the expression levels of miR-411-5p and NFE2L3, we employed quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis. This technique allowed us to measure the levels of miR-411-5p and NFE2L3 mRNA in both CRC and normal tissue samples. Additionally, we validated the protein levels of NFE2L3 using Western blot analysis. Furthermore, we assessed the functional impact of miR-411-5p on CRC cells through various assays. The MTT assay determined cell viability, the transwell migration assay evaluated cell migration and invasion abilities, and flow cytometry measured the rate of apoptosis in CRC cells. To confirm the molecular interaction between
miR-411-5p and its target gene NFE2L3, we conducted dual-luciferase reporter assays. These assays enabled us to validate the binding between miR-411-5p and the 3’ untranslated region (3’UTR) of the NFE2L3 mRNA. To investigate the potential therapeutic role of NFE2L3 in CRC, we transfected CRC cells with pcDNA3.0-NFE2L3, a plasmid overexpressing NFE2L3. This allowed us to assess the impact of NFE2L3 restoration on the behavior of CRC cells.
Results • Overexpression of miR-411-5p in CRC cells significantly reduced cell viability, inhibited migration and invasion, and increased the rate of apoptosis. Conversely, inhibition of miR-411-5p expression exerted the opposite effects on the biological behavior of CRC cells. Furthermore, our study revealed that NFE2L3 is a downstream target of miR-411-5p. Dual-luciferase reporter assays confirmed the binding between miR-411-5p and the 3’UTR of NFE2L3 mRNA, indicating a direct interaction between them. To investigate the therapeutic potential of targeting NFE2L3 in CRC, we transfected CRC cells with pcDNA3.0-NFE2L3, resulting in the restoration of NFE2L3 levels. This restoration effectively reversed the effects induced by miR-411-5p mimics on the behavior of CRC cells.
Conclusion • Our study provides compelling evidence for the tumor-suppressive role of miR-411-5p in CRC. The overexpression of miR-411-5p resulted in reduced cell viability, inhibited migration and invasion, and increased apoptosis in CRC cells. Importantly, we identified NFE2L3 as a downstream target of miR-411-5p and demonstrated its involvement in mediating the effects of miR-411-5p on CRC cell behavior. These findings not only confirm the tumor-suppressive role of miR-411-5p in CRC but also highlight NFE2L3 as a promising target for novel therapeutic strategies. Targeting NFE2L3 to modulate the biological function of CRC cells may hold therapeutic potential and serve as a basis for the development of targeted drugs. Further investigations are warranted to fully elucidate the underlying molecular mechanisms of miR-411-5p-NFE2L3 interaction and its impact on CRC progression. Additionally, future studies could explore the clinical implications of miR-411-5p as a diagnostic or prognostic biomarker in CRC patients. By advancing our understanding of the intricate regulatory networks involved in CRC, we can pave the way for personalized therapeutic approaches and improve patient outcomes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Network Pharmacology Analysis of Traditional Chinese Medicine for Treating Psoriasis: Identifying Core Components, Mechanisms, and Dosing Patterns |
| Xuebing Hu, MBBS; Zizhang Wang, MBBS; Shuai Yang, MBBS |
| Context • Psoriasis is a chronic, inflammation-mediated skin disease. The use of traditional Chinese medicine (TCM) in the treatment of psoriasis boasts a rich historical tradition. Researchers widely use network pharmacology to reveal the action mechanisms of TCM by establishing an interaction network—drug-component-target-disease.
Objective • The study aimed to use a network pharmacology approach to investigate the interaction between TCM and its targets in psoriasis, aiming to identify core drugs and mechanisms underlying TCM’s treatment of common psoriasis and to create a new TCM formula.
Design • The research team performed a retrospective genetic study.
Setting • The study took place in the Dermatology Department at Beijing Wangfu Hospital of Integrative Medicine in Beijing, China.
Participants • Participants were patients that the dermatology clinic had diagnosed with common psoriasis between January 1, 2016 and January 1, 2019.
Outcome Measures • The research team: (1) calculated the frequency of each herb’s occurrence; (2) identified the core drugs; (3) determined the core drugs’ active ingredients and targets; (4) identified psoriasis’ targets; (5) determined the target proteins; (6) identified the top-30, key signaling-set pathways; (7) identified the top 10 biological processes (BPs), cell components (CC), and molecular functions (MF); (8) screened the top-five major active ingredients; and (9) performed molecular docking.
Results • The research team: (1) based on 892 prescriptions from 95 patients, identified 161 herbal medicines, with Lonicerae Japonicae Flos, Herba Portulacae, Radix Gentianae, Bletilla striata, Raw Rehmanniae Radix, Dictamni Cortex, and Forsythia suspensa being core drugs; (2) found 58 active ingredients and 144 effective, target functional genes for the core drugs through network pharmacology screening, with 81 potential targets for psoriasis treatment; the core drugs for treatment may restore the keratin-forming cell function by inhibiting cancer-related pathways, the interleukin-17 (IL-17) signaling pathway, the tumor necrosis factor (TNF) signaling pathway, and the hypoxia-inducible factor-1 (HIF-1) signaling pathway; (3) using molecular docking, revealed high-affinity interactions between the active ingredients primuletin, luteolin, and wogonin and mitogen-activated protein kinase 8 (MAPK8), tumor protein 53 (TP53), and epidermal growth factor receptor (EGFR).
Conclusions • The new TCM formula to be used in the current research team’s hospital may act on MAPK8, TP53, and EGFR targets through active ingredients such as primuletin, kaempferol, luteolin, wogonin, and ß-sitosterol, which involve several signaling pathways, such as the cancer signaling, TNF signaling pathway, HIF-1 signaling pathway, and endocrine resistance. The research provides a theoretical foundation for the clinical use of the new TCM formula. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Examining High-Risk Factors for Sleep Disorders in Depressed Patients: Evaluating the Impact of Psychological Interventions on Sleep Quality and Mental Well-Being |
| Haixia Da, BS; Yanyan He, BS; Xiaomei Jiang, MD; Yinping Liu, BS; Xiaojing Ma, MD; Dong Ren, BS; Keyin Shang, BS; Yan Sun, MD; Lei Wang, BS; Caiqin Xi, MD |
| Objective • This study aims to analyze the risk factors associated with sleep disorders in patients suffering from depression and investigate the efficacy of psychological interventions in improving these conditions.
Methods • A comparative observational study was conducted and a cohort of 162 patients aged 18 to 68, admitted to outpatient or inpatient departments between October 2022 and August 2023, were included in the study. All patients were diagnosed with depression according to the ICD-10 criteria. The patients were divided into two groups: experimental group 1 received cognitive-behavioral therapy (CBT) psychological intervention, while experimental group 2 received conventional psychological treatment. Various parameters, including Hamilton Depression Rating Scale (Ham-D), Hamilton Anxiety Rating Scale (Ham-A), Social Support Rating Scale (SSRS), marital status, and occupation, were assessed and compared between the groups. Multivariate logistic regression was employed to identify risk factors for sleep disorders in depressed patients. The Pittsburgh Sleep Quality Index (PSQI) was utilized to evaluate sleep quality.
Results • Logistic regression analysis revealed that depression severity, anxiety levels, subjective social support, and occupational status were significant risk factors for sleep disorders in depressed patients (P < .05). Following intervention, both groups exhibited a significant decrease in PSQI, SAS, and SDS scores, with experimental group 1 demonstrating significantly lower PSQI scores compared to experimental group 2 (P < .05). Moreover, experimental group 1 displayed significantly lower SAS and SDS scores compared to experimental group 2 (P < .05).
Conclusions • The severity of depression, anxiety levels, subjective social support, and occupational status contribute to the risk of sleep disorders in depressed patients. Implementing psychological interventions for depressed patients with sleep disorders can effectively improve sleep quality, alleviate anxiety, and enhance overall psychological well-being. These interventions represent a valuable approach to manage depression and comorbid sleep disorders. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Californium-252 Intracavitary Radiotherapy for Primary Vaginal Carcinoma: A Retrospective Clinical Study |
| Xin Lei, MD; Jian Li, BS; Xiaoling Li, MM; Shang Liu, MM; Hongjie Song, MM; Mengmeng Wang, MM; Jian Wang, BS |
| Objective • To investigate the therapeutic effect of Cf-252 neutron intracavitary brachytherapy (ICBT) in the treatment of primary vaginal carcinoma of stage I-III, along with advanced complications.
Methods • Between August 2009 and August 2013, 41 patients with intact primary vaginal carcinoma based on the histological diagnosis at the Second Cancer Hospital of Heilongjiang Province (Beidahuang Group General Hospital) and the Daping Hospital of the Third Military Medical University were included in this study. Among them, 32 patients were squamous cell carcinoma, and 9 adenocarcinomas. Stage I patients were treated with ICBT alone. Patients at stages II and III were treated using ICBT combined with external beam radiotherapy (EBRT).
Results • The mean age, the rate of the 5-year local control, the rate of the 5-year overall survival was increased. The rate of the 5-year tumor-free survival was 56.1%, and the incidence of advanced serious complications
(grade II and above radiation cystitis, proctitis, etc.) was 29.3%. Compared to later stages, early-stage patients are in better physical shape, so they are better able to withstand the toxic side effects of treatment. The local control (LC), overall survival (OS), or disease-free survival (DFS) rate in stage III patients was significantly lower than those in stage I and stage II. The rate of OS in stage I patients was 90.9% (10/11), which was significantly higher than that in all patients (56.1%; 23/41). Moreover, the mean survival time was significantly different between stage III and stage I. In addition, the survival status of squamous cell carcinoma and adenocarcinoma was also very different.
Conclusion • In summary, the use of Cf-252 ICBT radiotherapy resulted in a higher rate of local control of vaginal cancer and a lower rate of recurrence, better-shrinking effect, and efficacy for advanced tumors, and has clinical prospects. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| A Promising Candidate in the Treatment of Children with Bronchopneumonia: Erythromycin Plus PIP/TAZ |
| Chunbao Chen, MBBS; Ting Kong, MM; Jia Wang, MM |
| Objective • To investigate the efficacy of piperacillin-tazobactam (PIP/TAZ) versus PIP/TAZ plus erythromycin in the treatment of children with bronchopneumonia, and to evaluate the influence of these treatments on inflammatory factors and intestinal flora. Assessing the impact on these parameters is crucial to provide a comprehensive understanding of the treatment effects.
Methods • A total of 120 children with bronchial pneumonia who were treated in Yichang Central People’s Hospital from April 2018 to April 2020 were randomized (1:1) either into the control group or the observation group. The control group was given PIP/TAZ treatment. The observation group was additionally treated with erythromycin on the basis of the control group. The clinical efficacy, disappearance time of main symptoms and signs, inflammatory factors, and intestinal flora before and after treatment were compared between the two groups.
Results • The treatment with PIP/TAZ plus erythromycin led to a significantly higher total clinical effective rate versus PIP/TAZ alone (P < .05). PIP/TAZ plus erythromycin resulted in a shorter time taken for the disappearance of fever, cough, and pulmonary rales versus PIP/TAZ alone (P < .05). These findings suggest that the combination regimen was more effective at resolving the key clinical symptoms of bronchopneumonia in children, which is important for improving patient outcomes and reducing the duration of illness.
Patients given PIP/TAZ plus erythromycin experienced lower serum levels of the inflammatory markers CRP, TNF-a, and IL-8 as compared with patients given PIP/TAZ alone (P < .05). The reduction in these inflammatory factors indicates that the addition of erythromycin may have provided greater anti-inflammatory benefits beyond the antimicrobial effects of PIP/TAZ alone. Modulating the inflammatory response is clinically significant, as excessive inflammation can contribute to lung damage and disease severity in pneumonia.
Conversely, the observation group showed a higher incidence of gastrointestinal disturbances, including increased stool frequency, watery stools, and elevated stool white blood cell counts after treatment (P < .05), suggesting that the erythromycin component may have disrupted the balance of intestinal flora. Maintaining a healthy gut microbiome is important for overall health, immunity, and preventing further complications. The clinical significance of this finding is that the addition of erythromycin to the treatment regimen may have unintended adverse effects on the gut that should be carefully monitored.
Conclusion • PIP/TAZ plus erythromycin might be a promising candidate in the treatment of children with bronchopneumonia by significantly improving clinical outcomes, shortening the duration of key symptoms, and regulating the level of inflammatory factors. These findings suggest the combination regimen could provide greater clinical benefits compared to PIP/TAZ alone for managing pediatric bronchopneumonia.
However, the addition of erythromycin also appeared to aggravate the imbalance of intestinal flora, as evidenced by the increased incidence of gastrointestinal disturbances. Maintaining a healthy gut microbiome is crucial for overall health and immunity in growing children. Therefore, clinicians must carefully weigh the potential benefits of improved antimicrobial and anti-inflammatory effects against the potential risks of disrupting the delicate gut ecosystem when considering the use of antibiotic combinations for pediatric patients.
In conclusion, PIP/TAZ plus erythromycin may be a viable treatment option for children with bronchopneumonia, but clinicians should monitor for any unintended impacts on the gut flora and be prepared to make adjustments to the regimen if necessary. Careful consideration of the balance between therapeutic efficacy and preserving intestinal health is essential when prescribing antibiotic combinations, especially in the pediatric population. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of Symptomatic Venous Thromboembolism Occurrence in Elderly Patients Following Total Hip Arthroplasty and the Impact of Formal Nursing Intervention |
| Cuiping Dong, BS; Yan Li, BS; Jieli Shou, BS |
| Background • Symptomatic venous thromboembolism (VTE) poses significant challenges to postoperative recovery, financial burden, and even life-threatening risks. Analyzing risk factors is pivotal for effective prevention and control strategies.
Objective • This study examines the impact and risk factors of formal nursing interventions in preventing VTE following total hip arthroplasty (THA).
Methods • A total of 80 elderly patients with hip fractures undergoing THA between January 2021 and December 2023 were randomly assigned to either the control (Ctrl) group (n=40) receiving routine nursing or the observation (Obs) group (n=40) receiving formal nursing intervention. Risk factors were analyzed, including perioperative indicators, limb circumference, VTE incidence, hip function score, self-care ability, and nursing satisfaction.
Results • The Obs group exhibited a lower postoperative VTE incidence than the Ctrl group (P < .05). Postoperative
hip Harris score and 7-day Barthel score in the Obs group surpassed those in the Ctrl group (P < .05). Peripheral diameters of affected limbs in the Obs group were smaller (P < .05). Nursing satisfaction was higher in the Obs group (95.0%) than in the Ctrl group (75.0%) (P < 0.05). Risk factors for symptomatic VTE after THA included age = 72 years [OR=2.937, 95% CI (1.037-8.763)], length of stay > 14 days [OR=4.724, 95% CI (1.726-13.829)], and history of cerebral infarction [OR=4.837, 95% CI (1.625~7.839)].
Conclusions • Scientific and regular nursing interventions during THA’s perioperative period demonstrate a significant preventive effect on VTE, urging clinical application and promotion. Patients aged = 72, with prolonged hospital stays and a history of cerebral infarction, are high-risk groups for symptomatic VTE. Nurses must closely monitor patients’ clinical manifestations and vital signs post-surgery for early VTE identification. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Effect of the Ratio of Waist Circumference to Thigh Circumference in Obese Patients on the Therapeutic Efficacy of Medial Unicompartmental Knee Arthroplasty for Knee Osteoarthritis |
| Xuyang Cao, MM; Taotao Kong, MBBS; Mengsha Wang, MM; Zizi Zhao, MBBS |
| Background • Medial unicompartmental knee arthroplasty (UKA) is a surgical procedure that replaces only the damaged medial compartment of the knee joint, preserving the healthy lateral compartment. Previous studies have investigated the impact of body mass index (BMI) on the efficacy of UKA for knee osteoarthritis, but the effect of the ratio of waist circumference to thigh circumference in obese patients has not been reported. This study aimed to explore the impact of the waist-to-thigh ratio on the efficacy of medial UKA in obese patients with knee osteoarthritis.
Methods • A retrospective analysis was conducted on the clinical data of 99 patients with knee osteoarthritis who underwent medial UKA at our hospital from February 2021 to March 2023. Patients were grouped based on their waist-to-thigh ratio, with a ratio =1.7 classified as the normal group and >1.7 as the obese group.
Continuous variables such as age, height, weight, surgical indicators, and pain scores were compared between the two groups using the independent samples t test or Mann-Whitney U test, depending on the normality of data distribution. Categorical variables like gender, comorbidities, and patient satisfaction were analyzed using the chi-square test or Fisher’s exact test. Repeated measures ANOVA was used to compare changes in outcome measures over time between the two groups. P < .05 was considered statistically significant.
Surgical indicators, hematological indicators, pain status, postoperative recovery, daily living abilities, risk of pressure ulcers and falls, nutritional status, and patient satisfaction were compared between the two groups using the appropriate statistical tests.
Results • This study included 51 patients in the normal group and 48 in the obese group, with no significant differences in baseline characteristics except for gender, BMI, thigh circumference, waist circumference, and waist-to-thigh ratio.
The normal group had significantly shorter hospitalization time (5.2 ± 1.3 vs 7.1 ± 2.1 days, P < .001) and surgical time (65.3 ± 11.4 vs 78.6 ± 14.2 minutes, P < .001) compared to the obese group. There were no differences in intraoperative blood loss or time to achieve 90° flexion-extension.
Postoperatively, the normal group had lower Visual Analog Scale (VAS) pain scores at all timepoints up to 2 months (P < .05). They also ambulated sooner (2.1 ± 0.6 vs 3.5 ± 1.1 days, P < .001) and discontinued crutches earlier (22.4 ± 4.2 vs 29.1 ± 5.3 days, P < .001) compared to the obese group. Within 1 year, a higher proportion of normal group patients could squat (84.3% vs 62.5%, P = .012). The normal group also had a lower incidence of patellofemoral pain (5.9% vs 18.8%, P = .045).
Conclusion • Patients with a high waist-to-thigh ratio (>1.7) experienced poorer outcomes after medial UKA, including higher postoperative pain, slower recovery, and greater incidence of patellofemoral pain compared to those with a normal ratio. These findings suggest that medial UKA may not be the optimal treatment for obese patients with a disproportionately large waist circumference relative to thigh size. Preoperative weight loss or alternative surgical approaches may be considered for these high-risk patients to improve their outcomes. Further research is needed to develop targeted interventions for this patient population. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Research on the Effect of Nutritional Stage-based Care Intervention in Elderly Patients with Severe Pneumonia |
| Jianfei Chen, MBBS; Xin Chen, MBBS; Hongyang Li, MBBS; Yan Li, MBBS; Jie Liu, MM; Yonglin Tang, MBBS; Lanyan Wang, MBBS |
| Objective • To evaluate the efficacy of a nutritional stage-based care intervention in improving outcomes for elderly patients with severe pneumonia.
Methods • A retrospective analysis of clinical data was conducted on 203 elderly patients with severe pneumonia admitted to our hospital from January 2022 to January 2023. All patients met the inclusion and exclusion criteria. Upon admission, all patients received relevant symptomatic treatment and basic care. Based on the nutritional care intervention received by the patients, they were divided into a control group (n=101) and an observation group (n=102). The control group received routine nutritional care intervention, while the observation group received nutritional stage-based care intervention. The study compared the levels of organ recovery indicators (mechanical ventilation time, ICU hospitalization time), nutritional status indicators [serum albumin (Alb), prealbumin (PAB), hemoglobin (Hb)], immune function indicators [immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM)], blood gas status indicators [arterial oxygen pressure (PaO2), arterial carbon dioxide pressure (PaCO2)], and the occurrence of complications between the two groups.
Results • Organ Recovery Indicators: The observation group showed significantly lower mechanical ventilation time and ICU hospitalization time compared to the control group (P < .05). Nutritional Status Indicators: Before the intervention, there was no significant difference in albumin (Alb), prealbumin (PAB), and hemoglobin (Hb) levels between the two groups (P > .05). After the intervention, the Alb, PAB, and Hb levels in the observation group were significantly higher than the control
group (P < .05). Immune Function Indicators: Before intervention, there was no significant difference in IgA, IgG, and IgM levels between the two groups (P > .05). After intervention, the levels of IgA, IgG, and IgM in the observation group were significantly higher than the control group (P < .05). Blood Gas Status Indicators: Before intervention, there was no significant difference in PaO2 and PaCO2 levels between the two groups (P > .05). After intervention, the PaO2 level in the observation group was significantly higher, while the PaCO2 level was significantly lower compared to the control group (P < .05). Complication Incidence: The complication incidence in the control group was 25.74%, while in the observation group it was 9.80%, which was significantly lower (P < .05).
Conclusion • The application of nutritional stage-based care intervention in the management of elderly patients with severe pneumonia is shown to be highly beneficial. Compared to routine nutritional care, the nutritional stage-based approach significantly improved patients’ nutritional status, immune function, blood gas conditions, and accelerated their organ recovery. Importantly, this intervention also led to a markedly lower incidence of complications.
These findings suggest that incorporating nutritional stage-based care into standard treatment protocols for elderly patients with severe pneumonia may significantly enhance recovery rates and long-term health outcomes for this vulnerable patient population. Given the positive impact demonstrated in this study, the nutritional stage-based care intervention is worthy of broader clinical adoption and promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Hepatoprotective Formula, Entecavir, and Continuous Nursing in Patients with Hepatitis B Cirrhosis |
| Zhili Cao, MBBS; Fang Liu, MBBS; Tao Wang, MBBS; Tangfang Wen, MBBS; Haili Zhu, MBBS |
| Objective • This study aimed to assess the efficacy of combining a hepatoprotective formula with entecavir and continuous nursing in improving treatment outcomes for patients with hepatitis B cirrhosis.
Methods • This study included 80 patients with hepatitis B cirrhosis admitted to our hospital from March 2021 to December 2022. These patients were randomly divided into an experimental group and a control group, with 40 patients in each group. Patients in the experimental group received a hepatoprotective formula consisting of Astragalus membranaceus, Salvia miltiorrhiza, Schisandra chinensis, and Glycyrrhiza uralensis, along with the antiviral drug entecavir and continuous nursing, while patients in the control group received only entecavir and routine care. Outcome measures during the study included clinical efficacy, liver function indicators (ALT, AST), coagulation function indicators (PT, TT), traditional Chinese medicine syndrome scores (to track changes in symptoms like rib pain and abdominal distension), treatment compliance, and quality of life. These measures provided a comprehensive assessment of the therapeutic effects, covering both Western medical and traditional Chinese medicine perspectives.
Results • The total effective rate in the experimental group was 92.5%, significantly higher than the 77.5% in the control group (P < .05). Liver function significantly improved in the experimental group, with mean ALT decreasing from 128.4 U/L at baseline to 49.2 U/L after treatment, and mean AST decreasing from 102.6 U/L to 41.8 U/L (both P < .01). Coagulation function also showed greater improvements, with mean PT
decreasing from 19.2 s to 14.8 s and mean TT decreasing from 22.4 s to 17.5 s in the experimental group (both P < .01), compared to more modest changes in the control group. Traditional Chinese medicine syndrome scores for rib pain and abdominal distension decreased by 75% and 80% respectively in the experimental group, indicating significant relief of these symptoms. Patient treatment compliance was 95% in the experimental group versus 82% in the control group. Quality of life scores improved by 28% in the experimental group compared to 15% in the control group.
Conclusion • This study demonstrates that a comprehensive treatment approach combining a traditional Chinese medicine-based hepatoprotective formula with Western antiviral therapy and continuous nursing care can provide significantly greater benefits for patients with hepatitis B cirrhosis compared to antiviral therapy alone. The experimental group showed superior outcomes across multiple measures, including liver function, coagulation status, traditional Chinese medicine symptom scores, treatment compliance, and quality of life. These findings suggest that integrating a herbal hepatoprotective formula into the standard of care for hepatitis B cirrhosis may be a valuable strategy to improve clinical outcomes and patient well-being. Further research is warranted to validate these results and explore the underlying mechanisms by which this comprehensive approach exerts its hepatoprotective effects. Implementing this combined treatment protocol has the potential to optimize the management of hepatitis B cirrhosis in clinical practice |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Clinical Observation of Stage I Unilateral Cleft Lip Operation was Performed According to the Contour of the Mouth and Nose |
| Xiaowei Wang, MBBS; Xiao Wang, MM; Tao Yu, MBBS |
| Objective • To evaluate the clinical efficacy and aesthetic outcomes of first repair surgery designed along the lip-nasal contour lines for unilateral cleft lip.
Methods • According to the characteristics of cleft lip deformity, 54 patients with stage I unilateral cleft lip were treated by operation, and the nasal and oral contours were used as surgical incisions. The surgical method has the following characteristics: 1) The surgical incision line is designed on the contour line of the mouth and nose, which is easy to hide; 2) Fully peel and release the attachment points of malformed tissue, and reasonably restore and rebuild the function of orbicularis orbicular muscle; 3) The alar cartilage and mucosa of the affected side rotated inward and outward upward, and the medial foot of the alar cartilage turned outward and downward to correct the alar cartilage of the affected side; 4) Using mattress sutures for
lip muscle alignment to reconstruct the ridge height on the affected side.; 5) Maintain the integrity of human ridge skin. The nasolabial effect and symmetry were observed.
Results • Patients with ipsilateral upper lip shape, lip peak length, nostril size, the morphology of nasal columella, nose shape, and nasal base collapse degree exhibited significant improvement compared to preoperative measurements. The postoperative nose and lip shapes closely resembled normal anatomical features, with minimal scarring and high levels of patient satisfaction regarding the plastic surgery outcome.
Conclusion • Based on the morphology of the oral and nasal regions, cicatricial camouflage following primary unilateral cleft lip repair can yield favorable aesthetic outcomes and represents a viable clinical approach. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Expression and Clinical Relevance of Serum LncRNA NEAT1 and microRNA-31 in Patients with Advanced Lung Cancer and Pulmonary Infection |
| Qianqian Cui, PhD; Rong Guo, BS; Yunxiao Li, MS; Yuenan Yang, MS; Ju Zhang, BS; Bin Zhou, PhD |
| Background • Lung cancer remains one of the leading causes of cancer-related mortality worldwide, with a substantial proportion of patients suffering from concurrent pulmonary infections. Despite advances in treatment modalities, the early diagnosis of lung cancer complicated by pulmonary infection remains challenging, often resulting in delayed intervention and poorer prognosis.
Objective • This study aimed to investigate the expression and significance of serum long non-coding RNA (lncRNA) NEAT1 and microRNA-31 in patients with advanced lung cancer complicated by pulmonary infection.
Methods • A total of 48 patients diagnosed with lung cancer complicated by pulmonary infection and admitted to the hospital between January 2021 and December 2021 constituted the experimental group, while 48 healthy volunteers recruited during the same period served as the healthy control group. The expression levels of NEAT1 and microRNA-31 in plasma samples obtained from peripheral blood were measured using quantitative real-time polymerase
chain reaction (qRT-PCR), and their differential expression in plasma was compared between the two groups.
Results • Significantly elevated levels of serum lncRNA NEAT1 and microRNA-31 were observed in the experimental group compared to the healthy control group. Furthermore, the expression levels of NEAT1 and microRNA-31 showed correlations with patient age and tumor size. Notably, the expression of NEAT1 exhibited no significant association with smoking status, whereas microRNA-31 expression displayed a significant relationship with smoking.
Conclusions • Our findings demonstrate that lncRNA NEAT1 and microRNA-31 are markedly upregulated in the plasma of patients with advanced lung cancer complicated by pulmonary infection. These molecules hold promise as potential diagnostic markers for advanced lung cancer complicated by pulmonary infection and may provide early auxiliary diagnostic value for lung cancer. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Use of Foot Correction Exerciser for Rehabilitation Following External Fixation in High-Energy Pilon Fracture |
| Na Lu, MM; Xiaolong Mei, MM; Xiaolong Mei, MM; Tao Zhang, MM |
| Objective • Our aim was to study the clinical effect of a foot correction exerciser used for postoperative rehabilitation in external fixation in high-energy Pilon fracture.
Methods • From March 2017 to November 2019, 43 patients with AO/OTA type C closed Pilon fractures treated with external fixation were retrospectively analyzed. A total of 23 patients were rehabilitated by foot correction exerciser (1 patient fell off the study), and 20 patients were treated by conventional rehabilitation (2 patients fell off the study). During postoperative hospitalization and regular follow-up after discharge, various indicators were recorded for statistical comparison and evaluation through angle measurement, imaging and questionnaire surveys.
Results • There was no significant difference in postoperative complications in the 2 groups (P > .05). The fracture healing time and stent wearing time in the study group were shorter than in the control group, and the comfort score and
functional exercise compliance were higher in the study group than in the control group. The ankle joint mobility was higher in the study group than in the control group at all time points in the first 6 months, and the excellent and good rate of ankle joint function was higher than in the control group, with statistical significance (P < .05).
Conclusion • Use of the orthopedic exerciser in the high-energy Pilon fracture external fixation postoperative rehabilitation process and the early introduction of resistance training can reduce pain and soft tissue edema and improve the degree of patient comfort and exercise compliance, accurately measure the force load of the limbs, contribute to the dataization and standardization of rehabilitation exercise programs, accelerate the recovery of joint mobility and improve long-term limb function. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Ultrasound-Guided Percutaneous Biopsy Combined Serum CA125, CEA Level Examination in the Diagnosis of Ovarian Tumors Value Analysis |
| Danyang Guo, MBBS; Xinding Liu, MBBS; Yan Sun, MBBS; Yixin Sun, MBBS; Lingling Wang, MBBS |
| Objective • This study aimed to evaluate the diagnostic value of combining ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing in ovarian tumors.
Methods • Sixty-four patients suspected of having ovarian tumors, admitted to our hospital from July 2021 to July 2023, were selected for the study. All patients underwent ultrasound-guided percutaneous biopsy and serum tumor markers CA125 and CEA level testing. Surgical pathology results were used as the gold standard for comparison. The diagnostic performance of ultrasound-guided percutaneous biopsy alone, serum CA125, serum CEA, and their combination were evaluated. Receiver operating characteristic (ROC) curve analysis was performed, and the sensitivity, specificity, and accuracy were calculated. The differences in diagnostic performance were compared using the chi-square test, with a P < .05 considered statistically significant.
Results • The results of this study demonstrate that combining ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing significantly improved the diagnostic accuracy for ovarian tumors compared to individual testing modalities. Surgical pathology, the gold standard, confirmed 52 malignant and 12 benign tumors among the 64 patients examined.
When evaluated individually, the concordance rate between
ultrasound-guided biopsy and surgical pathology was 90.63%, while serum CA125 and CEA had diagnostic accuracies of 73.44% and 64.06%, respectively. However, when the two serum markers were used in combination, the diagnostic accuracy increased to 81.25%.
Notably, the integration of ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing produced the highest diagnostic accuracy at 95.31%. Statistical analysis confirmed this combined approach had significantly better accuracy, sensitivity, and specificity compared to individual tests (P < .05). ROC curve analysis further substantiated the superior diagnostic value of this integrated testing strategy.
Conclusion • The findings of this study demonstrate that the integration of ultrasound-guided percutaneous biopsy with serum CA125 and CEA testing markedly enhances diagnostic accuracy for ovarian tumors, with a combined accuracy exceeding 95%. This integrated diagnostic protocol represents a robust and clinically valuable approach that should be more widely adopted to improve early detection and optimize the management of ovarian neoplasms. The implementation of this combined testing strategy has the potential to significantly impact clinical decision-making and patient outcomes in the diagnosis and treatment of ovarian tumors. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Application Value of Psychological Counseling Based on the Concept of Solution-Focused Brief Therapy in Patients with Premature Ovarian Failure |
| Xi Wang, MBBS; Wei Yang, MBBS; Yue Zhao, MBBS |
| Objective • To appraise the application value of psychological counseling based on the concept of solution-focused brief therapy (SFBT) concept in patients with premature ovarian failure.
Methods • A total of 176 patients with premature ovarian failure admitted to China-Japan Union Hospital hospital between January 2020 and February 2021 were enrolled for prospective analysis and were randomly assigned to the control group and the experimental group using the random number table method, with 88 cases in each group. The control group received the normal psychological counseling intervention, whereas the experimental group received the SFBT-based counseling intervention. The serum indexes follicle-stimulating hormone (FSH), luteinizing hormone (LH), Estradiol (E2), Fertility Quality of Life (FertiQoL) score, Symptom Checklist 90 (SCL-90) score, Memorial University of Newfoundland Scale of Happiness (MUNSH) score, self-rating depression scale (SDS) score, self-rating anxiety scale (SAS) score, and the satisfaction rate were recorded and compared between the two groups of patients.
Results • After the intervention, patients in the experimental group achieved lower FSH and LH levels and higher E2 levels than the control
group (P < .05). After the intervention, the scores of emotional response, mind-body relationship, and tolerability and overall scores increased in both groups, with the experimental group scoring significantly higher than the control group (P < .05). After the intervention, the differences in hostility and compulsion scores between the two groups were not statistically significant (P > .05). Compared with the control group, patients in the experimental group scored lower on somatization, interpersonal relationship, and psychosis and overall score, while positive factor scores were higher (P < .05). Before the intervention, SDS and SAS scores were comparable in both groups. In contrast, SDS and SAS scores decreased in both groups and in the experimental group compared to the control group after the intervention. (P < .05).
Conclusion • Psychological counseling based on the SFBT concept in patients with premature ovarian failure could improve the patients’ serum indexes, quality of life, and sense of well-being, which is worthy of clinical promotion. It is recommended that most researchers conduct studies with larger samples in our hospital to provide better evidence-based evidence. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Impact of Death Education on College 'Students' Sense of Meaning in Life and Ability to Cope with Death |
| Hengying Che, MM; Yin Fang, MBBS; Yuanyuan Gao, MBBS; Wenqian Hong, MBBS; Mengyao Rao, MBBS; Ping Shu, MBBS; Min Zhao, MBBS |
| Purpose • This study aims to assess the impact of death education on college students’ sense of meaning in life and ability to cope with death.
Method • A questionnaire survey was conducted among a randomly selected sample of 320 undergraduate students from a specific city. The survey, administered through the paper questionnaire, collected data on students’ demographic characteristics, their awareness of death, and their demand for death education. Linear regression analysis was performed to identify factors influencing the demand for death education and assess its impact on college students’ attitudes towards death, sense of meaning in life, and coping abilities.
Results • The results revealed that participants’ personality traits and family status significantly influenced their need for death education (P < .05). The overall score for death education needs among participants was (37.40±6.57). Notably, the statement “I think death education can help me understand death” received the highest mean rating (3.85), while the statement “I think death education will help me engage in nursing work in the future” received the lowest mean rating (3.55). Personal factors such as personality, family status, being an only child, and family experiences with serious illness were found to impact college students’ demand for death education (P < .05). Post-death education, significant differences were observed in scores related to death fear and escape
acceptance dimensions (P < .05). Moreover, there were statistically significant improvements in students’ sense of meaning in life, quality of life, and life goals following death education (P < .05). Additionally, all dimensions of death coping ability showed higher scores after death education (P < .05). Factors such as current psychological state, being an only child, family experiences with serious illness, and attendance at funerals were found to be statistically significant in relation to college students’ sense of meaning in life (P < .05). Multiple regression analysis indicated that the sense of meaning in life was influenced by the current psychological state and family experiences with serious illness (P < .05).
Conclusion • The study highlights the importance of integrating death education into college curriculums to address students’ fear of death and enhance their appreciation of life. Providing death education can help students develop a healthier perspective on death, improve their well-being, reduce avoidance attitudes towards death-related events, and strengthen their sense of meaning in life and ability to cope with death. These findings emphasize the need for educational institutions to implement comprehensive death education programs, considering individual factors such as personality and family background, and contribute to the development of effective educational policies and curricula. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of Comprehensive Nursing in the Treatment of Elderly Patients with Thoracolumbar Vertebral Body Compression Fractures by Percutaneous Vertebroplasty |
| Hongping Chen, BD; Jinmei Li, BD |
| Objective • to explore and analyze the comprehensive nursing effect of percutaneous vertebroplasty (PVP) in the treatment of elderly patients with thoracolumbar vertebral compression fractures.
Methods • This study recruited elderly patients with thoracolumbar vertebral compression fractures who were diagnosed in Lujiang County People’s Hospital from January 2020 to December 2022 and underwent PVP. Finally, a total of 80 cases were included in this study. All patients were randomly divided into two treatment groups: the observation group and the control group. The patients in the control group were given routine nursing measures, and the patients in the observation group were given comprehensive nursing intervention. The baseline characteristics of the two groups of patients were recorded thoroughly, and relevant indicators such as clinical indicators, functional recovery, pain relief, and occurrence of complications were observed and compared between the two groups.
Results • The recovery time of the patients in the observation group, including the time of getting out of bed and the time of hospitalization, was significantly shorter
than that of the control group [OR = 0.61 (95%CI: 0.44 - 0.83); OR = 0.70 (95%CI: 0.51 - 0.96)] P < .05; the JOA score of the observation group was significantly higher than that of the control group after treatment (RR = 1.28 (95%CI: 1.16 - 1.42)); the vas scores of the patients at each time point were lower than those of the control group [OR = 0.60 (95%CI: 0.43 - 0.84); OR = 0.57 (95%CI: 0.41 - 0.80); OR = 0.61 (95%CI: 0.44 - 0.85); OR = 0.72 (95%CI: 0.52 - 0.99)]; the incidence of complications in the observation group was significantly lower than that of the control group OR = 0.27 (95%CI: 0.10 - 0.72).
Conclusion • The implementation of comprehensive nursing has a clear application effect on PVP in the treatment of elderly patients with thoracolumbar vertebral compression fractures. It can effectively speed up patients’ movement speeds, reduce the overall length of hospitalization, and promote the recovery of thoracolumbar spine function. It can also relieve the patient’s pain faster, reduce the possibility of complications, and have a positive impact on the patient’s prognosis, which is worthy of clinical application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Relationship Between Serum MMP-2, Siglec-1, Th1/Th2 Cell Ratio, and Disease Activity in Rheumatoid Arthritis |
| Zhaoyu Chen, PhD; Yan Gao, PhD; Jiaxiang Gao, PhD; Zijian Ma, PhD; Fengyao Mei, MBBS |
| Objective • To investigate the association of serum MMP-2, Siglec-1, and Th1/Th2 cell ratio with disease activity in rheumatoid arthritis (RA).
Methods • Between August and November 2020, Peking University People’s Hospital recruited 40 patients with RA and 40 healthy individuals. Various methods such as ELISA, flow cytometry, and RT-PCR were used to assess the levels of sCR1, MMP-2, MMP-9, and Siglec-1 in the participants. Correlation analysis was conducted between Siglec-1 expression and DAS28 and hs-CRP. T lymphocyte subsets; cytokines IFN-? and IL-4, were assessed using flow cytometry and ELISA in both patient groups.
Results • Rheumatoid arthritis was linked to lower levels of serum sCR1 and higher levels of MMP-2 and MMP-9 compared to healthy individuals (P < .05). The percentage of Siglec-1-positive cells in PBMCs was significantly higher in patients with RA than in the healthy group (P < .05), with monocytes being the predominant cells expressing Siglec-1. Patients with RA exhibited a significantly higher expression of Siglec-1 mRNA
compared to those in a healthy condition (P < .05), and the expression of Siglec-1 in these patients was positively correlated with DAS28 and hs-CRP (P < .05). Study patients demonstrated a notably lower level of peripheral blood CD8+ cells and a higher CD4+/CD8+ ratio when compared to healthy individuals (P < .05). There was no statistically significant difference in CD3+CD4+ levels between the 2 groups (P > .05). Rheumatoid arthritis was associated with a higher level of peripheral blood IFN-? and a lower IL-4 level than healthy individuals (P < .05).
Conclusion • There was a strong link between sCRl, MMP-2, and MMP-9 and the progression of rheumatoid arthritis. These markers can effectively monitor disease activity in patients with rheumatoid arthritis. Siglec-1 is highly expressed in peripheral blood and can be used to track disease activity and inflammation in these patients. Regulating Th1/Th2-mediated homeostasis may help alleviate symptoms in individuals with rheumatoid arthritis. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Factors Affecting Low Anterior Resection Syndrome following Anus-Preserving Surgery for Rectal Cancer and Assessing the Impact of Nursing Interventions in Rapid Rehabilitation Surgery |
| Qiong Li, MBBS; Hong Lin, MBBS; Wenxing Song, MM; Fang Wang, MBBS; Qiuyun Zhang, MBBS |
| Background and objective • This study aimed to investigate the factors affecting the development of low anterior resection syndrome (LARS) following anus-preserving surgery for rectal cancer, and to assess the impact of a rapid rehabilitation surgical nursing intervention on patient outcomes. LARS is a significant issue for patients undergoing these surgeries, as it can severely impact quality of life. Understanding the risk factors for LARS is crucial to develop targeted interventions to improve post-operative recovery.
Methods • The study retrospectively analyzed the clinical data of 78 rectal cancer patients who underwent anus-preserving radical resection. The occurrence of LARS was assessed using the LARS score scale. Univariate and multivariate logistic regression analyses were performed to identify factors that may affect the development of LARS, including distance of the anastomosis from the anal verge, preoperative chemoradiotherapy, and postoperative anastomotic leakage.
Additionally, the study compared outcomes between two patient groups - a control group receiving routine surgical nursing care, and an experimental group receiving a rapid rehabilitation surgical nursing intervention. This intervention included preoperative patient education, optimized anesthesia and surgical techniques, and intensive postoperative rehabilitation. Key outcomes measured included time to first flatus, time to first defecation, duration of pain-free days, length of hospital stay, and total hospitalization costs.
Results • The univariate regression analysis showed that the distance from the anastomosis to the anal verge (OR=4.364, P < .001, 95% CI 2.732–7.257), preoperative chemoradiotherapy (OR=9.135, P = .004, 95% CI 1.963–40.316), and postoperative anastomotic leakage (OR=2.636, P < .001, 95% CI 1.641–4.245) were significant risk factors for the development of LARS. The multivariate logistic regression analysis confirmed that a shorter distance between the anastomosis and anal margin, preoperative radiotherapy, and postoperative anastomotic
leakage were independent predictors of LARS (all P < .05).
Comparison of the two patient groups showed that the rapid rehabilitation surgical nursing intervention had a significant positive impact. Patients in the experimental group (group E) had a significantly shorter time to first exhaust (62.19±7.43 minutes vs. 96.18±10.62 minutes in group C, P < .001) and first defecation (85.26±8.41 minutes vs. 130.26±12.38 minutes in group C, P < .001). Group E also experienced a longer duration of 0 pain score days (3.57±0.72 days vs. 5.42±1.05 days in group C, P < .001), shorter hospital stays (10.15±2.05 days vs. 15.33±1.23 days in group C, P < .001), and lower total hospitalization costs (31.80±3.70 thousand Yuan vs. 42.80±5.60 thousand Yuan in group C, P < .001).
Conclusion • This study identified the distance between the anastomosis and anal margin, preoperative radiotherapy, and postoperative anastomotic leakage as independent risk factors for the development of LARS in patients undergoing anus-preserving surgery for rectal cancer. These findings can inform preoperative risk assessment and guide surgical planning to mitigate the risk of LARS. Patients identified as high-risk may benefit from more intensive preoperative counseling and targeted nursing interventions to optimize postoperative bowel function.
Notably, the rapid rehabilitation surgical nursing intervention demonstrated significant benefits in accelerating patient recovery, reducing complications, and lowering overall healthcare utilization. This comprehensive nursing approach, encompassing preoperative education, optimized perioperative management, and intensive postoperative rehabilitation, offers a promising model to improve standards of care for rectal cancer patients undergoing anus-preserving surgeries. Widespread adoption of such targeted nursing interventions has the potential to enhance patient outcomes, quality of life, and healthcare resource efficiency in this patient population. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparative Analysis of Ketamine and Fentanyl Combined with Dexmedetomidine for Lumbar Anesthesia in Proximal Femur Fractures Among the Elderly |
| Nan Cai, MM; Yan Hu, MM; Xiangdong Qu, MD; Yan Tao, MD; Geng Wang, MD; Yaoping Zhao, MM |
| Objective • This study aimed to compare the effects of ketamine and fentanyl combined with dexmedetomidine in lumbar anesthesia for proximal femur fractures among elderly patients.
Design • This study employed a prospective, randomized controlled trial (RCT) design.
Settings • The study was conducted at Beijing Jishuitan Hospital.
Participants • A total of 100 elderly patients with proximal femur fractures who underwent lumbar anesthesia between January 2022 and January 2023.
Intervention • Participants were divided into two groups: the ketamine group (n=49) and the fentanyl group (n=51). The ketamine group received ketamine combined with dexmedetomidine, while the fentanyl group received fentanyl combined with dexmedetomidine.
Outcome Measures • The following outcome measures were assessed and compared between the two groups: (1) hemodynamic indexes; (2) visual analogue scale (VAS) scores; (3) stress reaction indexes; (4) Incidence of adverse effects. These comparisons were made using the random number table method.
Results • No significant differences were observed in systolic blood pressure (SBP), transcutaneous oxygen saturation (SPO2), and heart rate (HR) between the two groups at each time point (P > .05). SBP and HR of both groups were lower than baseline (T0) from T1 onwards. Throughout the surgery, SBP and HR exhibited a decreasing trend with operation time, followed by an increase post-operation. SPO2 showed minimal fluctuations during surgery in both groups. Preoperatively, VAS scores were comparable between groups (P > .05). However, at 12h, 24h, and 48h post-surgery, VAS scores were significantly lower in the ketamine group (P < .05). Stress indicator levels were similar preoperatively (P > .05), but postoperatively, serum cortisol (Cor), epinephrine (E), and norepinephrine (NE) levels were lower in the ketamine group (P < .05).
Conclusion • Dexmedetomidine combined with ketamine demonstrates safety and efficacy in the elderly. It significantly reduces postoperative pain and stress reactions while decreasing the incidence of adverse reactions. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Research on The Status Quo and Influencing Factors of Knowledge and Practice of Disaster Emergency Rescue of Nurses in Grade A Hospitals |
| Yan Fang, BM; Caiyun He, MD; Huijun Liu, MM; Zhen Zhao, MM |
| Context • Man-made disasters and natural disasters bring huge losses to human life and property. High-quality nursing teams play an important role in reducing casualty and disability rates in disaster areas, reducing the prognosis of the injured, accelerating community recovery and even promoting social rehabilitation. This work aimed to analyze the current situation and influencing factors of disaster emergency rescue (DER) of nurses in Hunan Province by surveying their knowledge, attitude, and practice of DER in Grade A hospitals.
Methods • 1260 nurses working in 13 Grade A hospitals in Hunan Province from March to October 2022 were selected as subjects by a random sampling method and conducted by a questionnaire survey. The general data of the subjects were collected by “behaviors”, forming the “nurses’ knowledge, attitude, and practice questionnaire, and their DER knowledge, attitude and behavior were evaluated.
Results • 1260 questionnaires were distributed, and 1,256 were effectively received, with a recovery rate of 99.68%. The total score of DER-related knowledge of 1.256 investigators was 136.82 ± 9.73 points. Among them, the highest and lowest scores were observed in the Triage (26.79 ± 2.09 points) and the sanitary and anti-epidemic (17.97 ± 1.28 points). The scores of DER attitude of 1256 respondents were close, which were arranged as about 3.87 ± 0.39 (with a range of 4.34 ~ 4.20). 1,256 investigators expressed the highest score in participating in the DER-related courses (4.93 ± 0.34 points) and the lowest score in participating in the on-site DER (2.01 ± 0.13 points). The results showed that they were correlated with gender, educational
background, working years, department, and out-of-hospital emergency rescue experience (P = .05), but not with age. The scores of DER-related knowledge and behaviors of hospital nurses were higher in men than in women. The higher the education, the higher the score, and the more the working years. Emergency and ICU nurses scored higher than those in other general departments. In addition, nurses with out-of-hospital emergency rescue experience scored higher than those without.
Conclusion • The overall DER-related knowledge, attitude, and practice of hospital nurses is not high. Nursing managers should incorporate disaster nursing into emergency rescue nurses’ training, strengthen clinical nurses’ training and exercise in DER-related knowledge, pay special attention to DER drills and practices, and provide reasonable and correct DER guidance. Furthermore, it should cultivate the noble social citizenship qualities of clinical nursing nurses, such as the sense of mission to save the dying and heal the injured, the sense of satisfaction in realizing self-worth, and the sense of social responsibility. In addition, it is suggested that a reasonable incentive and reward system be established to encourage hospital nurses to participate in the DER. Due to the limitations of this study, the sample size can be expanded and included in the nurse interview considered in the future to supplement the survey data and further study and analyze nurses’ rescue mentality, cognitive influencing factors, and intervention measures to provide more reference for human resource reserve and management of disaster rescue care. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of Shenmai Injection Combined with Chemotherapy on T-cell Subsets and Cytokine Profiles in Patients with Advanced Non-Small Cell Lung Cancer |
| Haiying Cheng, MM; Jianping Jiang, MM; Xiaoyan Jin, MM; Xue Lian, MM; Weiqiang Mo, MM |
| Background • Non-small cell lung cancer (NSCLC) represents a significant portion of lung cancer cases, with a poor prognosis and limited treatment options for advanced stages. Enhancing the effectiveness of chemotherapy through adjunctive therapies is a critical area of research.
Objective • To evaluate the effect of Shenmai injection combined with chemotherapy on T-cell subsets and cytokine expression in patients with advanced NSCLC.
Methods • A comparative prospective study was conducted, and a total of 96 patients with advanced NSCLC were selected. Patients were divided into two groups based on different chemotherapy regimens: an observation group (48 patients) receiving Shenmai injection combined with chemotherapy and a control group (48 patients) receiving chemotherapy alone. The study measures and compares the levels of T-cell subsets (CD3+, CD4+, CD4+/CD8+) and cytokines (IL-2, IL-4, IL-5, IL-6, TNF-a, IFN-?, VEGF, bFGF, CA125, and CEA)
before and after treatment in both groups. Statistical analysis was performed on the collected data.
Results • Significant changes were observed in the levels of T-cell subsets and cytokines before and after chemotherapy in both groups (P < .05). Compared with the control group, the observation group exhibited significant improvement in T-cell subsets CD3+, CD4+, and CD4+/CD8+ (P < .05). Furthermore, the levels of cytokines IL-2, IL-4, IL-5, IL-6, TNF-a, IFN-?, VEGF, bFGF, CA125, and CEA were significantly lower in the observation group compared to the control group (all P < .05).
Conclusions • Shenmai injection combined with chemotherapy enhances the cellular immune function in patients with advanced NSCLC. This combination therapy not only reverses tumor progression but also improves the overall therapeutic effect, suggesting a promising adjunctive treatment strategy for advanced NSCLC. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparative Evaluation of Abdominal Ultrasound and MRI in the Diagnosis of Congenital Choledochal Cysts in Children |
| Wen-juan Chen, MD; Peng Pan, MD |
| Objective • To compare the effectiveness of abdominal ultrasound and magnetic resonance imaging (MRI) in diagnosing congenital choledochal cysts (CCC) in children.
Methods • This retrospective analysis included 186 pediatric cases diagnosed with CCC through abdominal ultrasound and MRI examinations at our hospital between July 15, 2015, and November 29, 2023. Inclusion and exclusion criteria were applied to ensure the study’s objectivity. Chi-square and t-tests were used to compare the diagnostic performance of ultrasound and MRI.
Results • MRI demonstrated a superior detection rate of bile duct dilation compared to ultrasound (P < .001). Compared to ultrasound, a lesser number of nonspecific
cysts was reported by MRI, indicating its higher specificity (P = .008). Although the rate of misdiagnosis was slightly higher in ultrasound, the difference was not statistically significant (P = .123). Regarding consistency with postoperative pathological diagnosis results, MRI exhibited higher accuracy, with sensitivity and specificity both exceeding 75%.
Conclusion • MRI exhibits higher sensitivity, specificity, and accuracy in diagnosing pediatric CCC. Despite the strong correlation in diagnostic consistency between MRI and ultrasound, MRI remains the superior diagnostic tool and should be prioritized for diagnosis and preoperative planning. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Risk Factors and Clinical Significance of Ankylosing Spondylitis Combined with Early-Onset Coronary Heart Disease |
| Danfeng Dai, MS; Di Ruan, MS; Baojie Shen, MS; Huihui Zhang, MS; Miaolin Zhang, MS |
| Objective • To explore the risk factors contributing to the development of premature coronary artery disease (PCAD) in patients with ankylosing spondylitis (AS) and assess the clinical implications of this association.
Methods • The study used a retrospective analysis design to investigate the risk factors and clinical significance of ankylosing spondylitis (AS) combined with early-onset coronary heart disease (AS-PCAD). A total of 80 patients diagnosed with AS and coronary heart disease who were admitted to the hospital between February 2019 and February 2022 were included in the analysis. The patients were divided into two groups based on the age of onset of coronary heart disease - the PCAD group (n=42, mean age 41.48±2.69 years) and the non-early-onset coronary heart disease (NPCAD) group (n=38, mean age 69.13±4.50 years). Relevant clinical data, including demographics, medical history, laboratory results, and imaging findings, were extracted from electronic health records. Binary logistic regression analysis was employed to identify risk factors influencing the incidence of AS-PCAD. The study aimed to uncover the distinctive clinical features and risk factors associated with AS patients who experience early-onset coronary heart disease, in order to guide diagnosis and treatment strategies for this patient population.
Results • The results of the study revealed several notable findings. Significant differences were observed between the PCAD and NPCAD groups in terms of age and age at AS onset (P < .05). Specifically, patients in the PCAD group had a younger mean age at AS onset compared to the NPCAD group (41.48±2.69 years vs 69.13±4.50 years, respectively).
Additionally, the two groups exhibited statistically significant differences in several laboratory parameters. Levels of C-reactive protein (CRP) were found to be markedly higher in the PCAD group compared to the NPCAD group (P < .05). Hemoglobin levels and the prevalence of anemia also showed significant variations between the two cohorts (both P < .05). Importantly, the binary logistic regression analysis identified two key risk factors that independently influenced the incidence of PCAD in AS patients: younger age at AS onset and elevated levels of C-reactive protein.
Conclusions • The key findings of this study underscore the heightened risk of premature coronary artery disease in patients with ankylosing spondylitis, particularly those with a younger age of AS onset and elevated levels of systemic inflammation as marked by C-reactive protein. These results have important clinical implications. Identifying AS patients at increased risk for PCAD, based on factors such as younger disease onset and higher inflammatory burden, enables targeted screening and early intervention strategies. Comprehensive cardiovascular risk assessment and management should be an integral part of the care approach for this patient population. Early recognition of PCAD risk, followed by aggressive management of modifiable risk factors and implementation of appropriate therapeutic measures, can help mitigate the burden of premature cardiovascular complications in individuals with ankylosing spondylitis. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Effects and Maintenance Duration of Facial Rejuvenation Treatment in Middle-Aged and Elderly Individuals through the Combined Use of Facial Hyaluronic Acid Fillers and PPDO Thread Lift |
| Kuo-Hsiang Liao, MD; Kuo-Liang Liao, MD |
| Objective • This study aims to compare the clinical efficacy and longevity of facial rejuvenation treatments using PPDO thread lifts alone versus in combination with facial hyaluronic acid fillers in middle-aged and elderly patients.
Methods • A retrospective analysis of case data was conducted on 92 middle-aged and elderly patients treated in our hospital with suboptimal facial contours or signs of aging from January 2016 to January 2017. Patients who exhibited facial aging issues and desired rejuvenation, had complete case data for analysis, received treatments at our hospital, and agreed to 5-year post-treatment follow-up were included. Based on the different treatment interventions received by the patients, they were divided into the control group (n=43) and the observation group (n=49). Patients in the control group received standalone PPDO thread lift intervention, while patients in the observation group received a combination of facial hyaluronic acid filler in addition to the treatment received by the control group. Clinical treatment effects, complication rates, facial improvement maintenance duration, and facial contour scores were compared between the two groups at different time points (preoperative, T0; postoperative 1 month, T1; postoperative 3 months, T2; postoperative 6 months, T3; and postoperative 12 months, T4).
Results • The observation group, receiving both PPDO thread lifts and hyaluronic acid fillers, demonstrated a significantly higher total effective
treatment rate of 89.80% compared to 72.09% in the control group treated solely with PPDO thread lifts. Within the initial month post-surgery, the observation group experienced rates of facial pain, swelling, bruising, concavity, and thread extrusion at 61.22%, 53.06%, 30.61%, 20.41%, and 0.00%, respectively, while the control group experienced rates at 55.81%, 48.84%, 39.53%, 20.93%, and 2.33%, respectively. No significant difference in complication rates was observed between the two groups (P > .05). The combined treatment method resulted in a significantly prolonged facial improvement maintenance duration, averaging 4.67 years, compared to 4.13 years in the control group. At T0, facial contour scores showed no significant difference between the groups (P > .05); however, at T1, T2, T3, and T4, the observation group exhibited significantly higher scores compared to the control group (P < .05). Although there were variations in the types of complications, the overall rates of complications did not show a significant difference between the two groups, thus affirming the safety of the combined treatment.
Conclusion • The study concludes that combining facial hyaluronic acid fillers with PPDO thread lifts offers superior facial rejuvenation outcomes and longer-lasting effects without increasing complication risks, proving to be a highly safe and effective strategy for middle-aged and elderly patients seeking facial aesthetic improvements. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Auricular Point Acupressure Combined with Three-step Analgesic Therapy on Cancer Pain |
| Hanxue Cai, BS; Xiaomei Huang, BS; Xiaomei Liu, BS; Yi Liu, BS; Xinhong Xiao, BS; Yanhong Xu, MS; Xueqin Zeng, BS; Wen Zeng, MD; Qinghua Zhong, BS |
| Objective • To evaluate the effect of auricular point pressing with beans combined with three-step analgesic therapy on cancer pain.
Methods • Sixty patients with cancer admitted to The Ganzhou Cancer Hospital from January to December 2021 were selected and randomly divided into experimental and control groups. The control group received three-step pain relief and routine care, while the experimental group was treated with auricular point acupressure combined with three-step analgesic therapy. The pain intensity was assessed by a numerical rating scale (NRS) at 0, 24, 48, and 72 h after treatment, and the incidence of adverse reactions was recorded.
Results • The NRS score of the experimental group was lower than that of the control group (Ftreatment = 105.521,
P = .001). The difference in NRS scores before and 24, 48, and 72 h after treatment was statistically significant (Ftime = 335.521, P = .001). The number of eruption pain cases in the experimental group and the control group was found to be statistically significant (?2 = 10.767, P = .001), and the occurrence of eruption pain in the control group was more severe than that in the experimental group (Z = -4.472, P = .001). The incidence of adverse reactions in the experimental and control groups was 3.33% and 30.00%, respectively, and the difference was statistically significant (?2 = 12.738, P = .001).
Conclusion • The combination of auricular point pressing and three-step ladder analgesic therapy can significantly improve the pain of cancer patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis and Research on the Relationship between Oral Microorganisms and Alzheimer’s Disease |
| Chuanying Dong, BD; Xinying Ji, MD; Fei Xue, BD; Di Zhang, BD |
| Background • The common neurodegenerative disease among the elderly is Alzheimer’s disease, which in severe cases can affect the quality of life of patients and their families. It has been reported that oral microorganisms are involved in the progression of Alzheimer’s disease.
Objective • To analyze the relationship between oral microorganisms and Alzheimer’s disease.
Methods • The oral microbial population, a comprehensive analysis of relevant literature was conducted. Immunofluorescence was adopted to assess albumin deposition in the cerebral cortex of mice. Western blot was used to detect expression level of CYP46 in mouse brain.
Results • It can be concluded that the population of oral microorganisms includes bacteria, viruses, fungi, and spirochetes, which can cause various oral diseases. They can enter the human brain through the blood and surrounding nerves, leading to permeability increase of the blood-brain barrier and neuroimmune related inflammation. They will participate in and worsen the pathological process of Alzheimer’s disease, leading to damage to neurons and
cerebral blood vessels. The intervention methods for oral microbiota population include vaccination and phage therapy. Vaccines provide suitable treatment methods for periodontal disease, and phage therapy is a new method for controlling oral infections. At the same time, postoperative patients with oral diseases can use gel containing ethanol extract of Brazilian green propolis to ensure oral hygiene. In the rat blood-brain barrier model, porphyromonas gingivalis bacteremia enhanced barrier permeability, and immunofluorescence showed an increase in albumin deposition in the rat cerebral cortex. The expression of cytochrome P450 46A1 (CYP46A1) enzyme in the brain of Alzheimer’s disease mice aged 24-56 weeks after long-term administration of SLAB51 increased.
Conclusion • The elderly population should develop good living habits, maintain a clean mouth, and adjust the oral environment through methods such as oral and Alzheimer’s disease promotion, combined with medication treatment. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Application of Health Management and Drug Self-management Education in the Control of Chronic Diseases in the Elderly: A Retrospective Study |
| Fang Ding, MM; Xiaoning Han, MBBS |
| Objective • The objective of this study was to analyze the application of health management and medication self-management education in the control of chronic diseases in the elderly, specifically focusing on patients with diabetes, hypertension, cardiovascular diseases, and chronic obstructive pulmonary disease (COPD). The study aimed to assess the impact of these interventions on patients› self-management abilities, quality of life, medication adherence, intervention satisfaction, and the occurrence of adverse events. The findings aimed to provide a scientific basis for improving elderly chronic disease management and enhancing patients› health and quality of life.
Methods • A total of 106 elderly chronic disease patients admitted to our hospital from July 2021 to April 2023 were selected as the research subjects. All patients met the complete inclusion criteria. They were divided into two groups based on the type of health management intervention received. The control group (n=53) received conventional health management intervention. In contrast, the observation group (n=53) received health management from the medical examination center based on the PDCA model and medication self-management education intervention. The self-management ability, quality of life, medication adherence, occurrence of adverse events, and intervention satisfaction of the two groups of patients were compared. The PDCA (Plan-Do-Check-Act) model was chosen as the framework for this study due to its systematic approach to management and its potential to address the specific needs and complexities associated with chronic diseases in the elderly. The PDCA model emphasizes a continuous cycle of improvement, involving planning, implementation, evaluation, and adjustment of interventions.
Results • Before the intervention, there was no significant difference in self-concept, self-management responsibility, self-management knowledge, and self-management skills between the two groups
(P > .05). After the intervention, the observation group’s self-concept, self-management responsibility, self-management knowledge, and self-management skills were significantly higher than those of the control group (P < .05). Before the intervention, there was no significant difference in SF-36 scores between the two groups (P > .05). After the intervention, the SF-36 scores of the observation group were significantly higher than those of the control group (P < .05). The medication adherence score in the control group was (5.73±0.92), and the incidence of adverse events was 32.08%. In the observation group, the medication adherence score was (7.42±0.81), and the incidence of adverse events was 11.32%. The medication adherence score in the observation group was significantly higher than that in the control group, and the incidence of adverse events was significantly lower than that in the control group (P < .05). The intervention satisfaction in the control group was 73.58%. In comparison, the intervention satisfaction in the observation group was 96.23%, indicating that the intervention satisfaction in the observation group was significantly higher than that in the control group (P < .05). These results suggest that the implementation of the PDCA model in health management and medication self-management education can enhance patients’ self-management abilities, improve medication adherence, and ultimately lead to better quality of life and reduced risk of adverse events for elderly chronic disease patients.
Conclusion • The application of health management and medication self-management education based on the PDCA model in the control of elderly chronic diseases is ideal. Compared to conventional health management interventions, the former can enhance patients’ self-management abilities and improve medication adherence, thereby further improving patients’ quality of life, satisfaction, and the risk of adverse events. Therefore, this approach is worthy of clinical promotion and application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| An Investigation of Risk Factors and Inflammatory Factors in Nosocomial Infections Following Total Hip Arthroplasty: Implications for Prevention and Control Strategies |
| Xiaoqin Huang, BS; Hangbo Qu, PhD; Qingxiu Xia, BS; Yingzhao Yan, MD; Zijuan Zhao, BS |
| Objective • This work explored the relationship between nosocomial infection-related factors and inflammatory factors after total hip replacement (THA).
Methods • A total of 296 THA patients treated in the Zhejiang hospital from 2018 to 2022 were analyzed retrospectively. Clinical data of the patients were collected, and the nosocomial infection rate, infection site, infectious pathogen, related risk factors, and postoperative follow-up were statistically analyzed. Disease types included avascular necrosis of the femoral head, osteoarthritis, and femoral neck fracture. The troponin (Tn), blood routine, blood types, heparin-binding protein (HBP), thyroid function, thromboelastogram (TEG), brain natriuretic peptide (BNP), bone metabolism-related markers, glycosylated hemoglobin (GHb), and other indicators in three types of patients before and after surgery were analyzed.
Results • 37 cases (12.5%) had necrosis of the femoral head, 105 cases had osteoarthritis (35.47%), and femoral neck fracture was observed in 154 cases (52.03%). The main infection sites were the respiratory tract, urinary
tract, deep incision, and tissue infection. There were 8 pathogenic bacteria strains, including gram-positive and gram-negative bacteria. The BNP content in plasma was highly decreased after treatment [RR: 0.353 (95% CI: 0.234-0.533), P < .001]. HBP in patients with postoperative infection was notably higher than that in patients without infection [RR: 0.241 (95% CI: 0.161-0.361), P < .001]. The blood glucose of both the diabetic group and the non-diabetic group was remarkably decreased after surgery [RR: 0.367 (95% CI: 0.233-0.461), P < .001]. The level of triiodothyronine (T3) showed a downward trend, while both tetraiodothyronine (T4) and thyroid stimulating hormone (TSH) were at normal levels. There were 15 cases of postoperative loosening, 6 cases of femoral shaft loosening, and 9 cases of acetabulum loosening.
Conclusion • THA can regulate and maintain the balance of inflammatory cytokines, and taking preventive measures against risk factors can effectively reduce nosocomial infection, which is of great significance in improving the quality of medical treatment. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Effect of Precise Prevention of H-Type Hypertension, Cardiovascular, and Cerebrovascular Risks in Qingyuan District |
| Yanguang Feng, BD; Lan Li, BD; Man Liu, BD; Mingxing Shi, BD; Yuan Wang, BD; Huiqing Xu, BD; Xia Xue, BD; Xian Zhang, BD; Ying Zhao, BD |
| Objective • To explore the relationship between controlling the development of H-type hypertension and the effectiveness of precision prevention of cardiovascular risk.
Methods • 518 patients with essential hypertension with hyperhomocysteinemia diagnosed in December 2019 to February 2020 in Qingyuan District Public Hospital were recruited as the experimental sample for prospective analysis and were equally divided into control and experimental groups according to their order of admission, i.e., 259 patients in each group. The control group was treated with antihypertensive drugs only, while the experimental group was given enalapril folic acid tablets (0.8 mg/d) and vitamin B once daily in addition to antihypertensive drugs, and then monitored for plasma Hcy levels, cardiovascular event rates,
and survival at one year.
Results • After treatment, the plasma Hcy levels of the experimental group were significantly lower than those of the control group (P < .001). During treatment, the total incidence of cardiovascular disease in the experimental group was less than that in the control group (P < .05). One year after the end of treatment, the mortality rate due to cardiovascular disease in the control group was higher than that in the experimental group (P < .05).
Conclusion • It is worthwhile to promote the use of targeted management of patients with H-type hypertension to prevent the occurrence of cardiovascular diseases, improve Hcy levels, and stabilize blood pressure levels in patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Exercise Rehabilitation Combined with Alfacalcidol Administration on Patellofemoral Traumatic Dysfunction |
| Zhaoyu Chen, BM; Yan Gao, BM; Jiaxiang Gao, BM; Zijian Ma, BM; Fengyao Mei, BM |
| Objective • To investigate the efficacy and clinical value of alfacalcidol combined with exercise rehabilitation in therapy of the postoperative dysfunction of patients with patella fractures.
Methods • In this study, 100 patients who underwent patella fracture surgery at Peking University People’s Hospital between April 2018 and December 2019 were randomly selected and divided into a control group (n=50) and an experimental group (n=50) by lottery. The control group received exercise therapy, while the experimental group received alfacalcidol based on exercise rehabilitation. The functional assessment measure (FAM) score, visual analog scale (VAS) score, therapy efficiency, adverse effects, callus volume, and callus density were compared between the two groups.
Results • The FAM score and therapy efficiency in the experimental group were significantly higher than in the control group [P < .001, RR: 95%CI (10.28, 5.12 to 15.52)], but the VAS score was lower [P < .001 RR: 95% CI (22.83, 1.99 to 3.31)]. Patients in the experimental group had fewer adverse effects [P < .001, RR: 95% CI (14.62, 6.49 to 32.92)] than those in the control group but significantly larger callus volume and density [both P < .001, RR: 95% CI (26.03, 3.21 to 4.07): (17.92, 2.83 to 3.34)].
Conclusion • Alfacalcidol combined with exercise rehabilitation therapy could significantly improve motor function, callus volume, and callus density in patients with patella fracture, resulting in a high applicable value in managing postoperative functional impairment of patellar fractures. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Continuity of Nursing Service Platform under “Smart Elderly Care” and Its Application Value in Family Nursing of Elderly Patients after Discharge |
| Xiumei Su, BS; Xiaomei Tan, BS |
| To explore the effect of continuity of nursing (CON) service platform application under “smart elderly care (SEC)” on family nursing of elderly patients with chronic diseases (CDs) after discharge. 200 elderly patients with CDs treated in Medical Care Ward, Zhejiang Hospital were included and grouped into the control group (CG) and experimental group (EG) in line with the sequential order of admission (100 cases per group). After discharge, routine nursing and smart CON services were given, respectively. 36-Item Short Form Questionnaire (SF-36) score of quality of life (QOL), Barthel index (BI) score of activity of daily living (ADL), Self-rating Depression Scale (SDS) score of depression, Self-rating Anxiety Scale (SAS) score of anxiety, compliance, and nursing satisfaction were compared. Compared to CG, SF-36 score and BI score were highly increased in EG 0 months (mo) and 3 mo after discharge, while SDS and SAS scores were greatly decreased (all P < .001). The compliance rate was
70% in CG and 93% in EG during the follow-up period. The nursing satisfaction rate of CG reached 92%, while that of EG was 97%. Compared with CG, the compliance and nursing satisfaction rates of EG were notably higher (P < .001). It was illustrated that the smart CON service model could enhance the effect of discharged family nursing for elderly patients with CDs, improve patients’ mental status and QOL, and raise nursing compliance. Therefore, it was conducive to the rehabilitation of patients. The findings of this study highlight the transformative potential of smart CON service models in enhancing the effectiveness of family nursing for elderly patients with CDs post-discharge. Embracing these innovative approaches has the potential to not only improve individual patient outcomes but also contribute to the advancement of patient-centered care practices and healthcare delivery systems on a broader scale. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Mechanism of Jinkui Wenjing Tang in the Treatment of Anovulatory Dysfunctional Uterine Bleeding was Explored Through Network Pharmacology and Molecular Docking Technology |
| Zhi Chen, MD; Renzhi Hu, MD; Yu Huang, MD; Sisi Tang, MD; Shuangyan Weng, BD |
| Objectives • Jinkui Wenjing Tang (JKWJT), a Traditional Chinese Medicine prescription for gynecological menstrual adjustment, is also used to treat continuous uterine bleeding and abdominal pain. However, the mechanism of action, potential targets, and active ingredients of JKWJT in the treatment of anovulatory dysfunctional uterine bleeding (ADUB) remain unknown. Therefore, it is imperative to explore the molecular mechanism of JKWJT.
Methods • The chemical composition and target of JKWJT were obtained by using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and the SwissTargetPrediction website. ADUB-related targets were collected through the GeneCards database. The protein-protein interaction network was constructed from the target protein. Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were performed. The binding of the compounds in JKWJT and the potential therapeutic target molecules was verified by molecular docking. Finally, immunohistochemistry, Western Blotting, and qPCR were used for target expression validation within ADUB patient tissues.
Results • The putative targets of JKWJT for the treatment of ADUB mainly involve ESR1, VEGFA, TNF, AR, OXTR, and PCNA. Functional enrichment analysis showed that the therapeutic effect of JKWJT on ADUB was correlated to response to estradiol, gland development, regulation of hormone levels as well as endocrine resistance, estrogen signaling pathway, HIF-1 signaling pathway, EGFR tyrosine kinase inhibitor resistance, MAPK signaling pathway, prolactin signaling pathway. Molecular docking showed that the target OXTR was expected to have a good binding affinity with 4 corresponding compounds (Girinimbin, icosa-11, 14, 17-trienoic acid methyl ester, Kanzonol F, and Obacunone). After treatment with JKWJT, OXTR relative protein expression and mRNA levels were significantly reduced in ADUB patients.
Conclusion • In this study, the basic pharmacological effects, and mechanisms of JKWJT in the treatment of ADUB were elucidated, thus providing a clinical basis for the treatment of ADUB by JKWJT. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Jiedu Tongluo Decoction Attenuates Myocardial Fibrosis through Inhibition of the TGF-ß1/Smad2/3 Pathway |
| Jiajuan Guo, PhD; Ju Hui, MD; Lei Li, MD; Xiangjun Li, PhD; Jiaxin Shi, MM; Jing Song, MD; Bin Wang, MM; Huan Zhang, MM |
| Jiedu Tongluo (JDTL) Decoction is a traditional Chinese medicine formula containing three herbal ingredients. It is widely used to treat myocardial fibrosis (MF). This study aimed to investigate the molecular mechanism of JDTL Decoction’s effect on MF.
In this study, 6 compounds of JDTL Decoction were identified by HPLC. HE and Masson staining showed that in the isoproterenol hydrochloride-induced MF rat model, JDTL treatment can protect the myocardial structure and inhibit the expression of collagen III. The immunohistochemistry results also showed that JDTL treatment can significantly reduce vimentin and a-SMA expression, TGF-ß1 expression, and phosphorylation of Smad2/3 in the rat MF model. RCF, a rat cardiac fibroblast
cell line, was used as a tool for in vitro study. Using the methods of hydroxyproline detection, MTT, wound healing test, western blot, and double immunofluorescence staining, our in vitro study confirmed the inhibitory effects of JDTL Decoction on proliferation, migration, and trans-difference ability of RCF cells, as well as the molecular mechanisms underlying the inhibitory effects of JDTL Decoction, including the inhibition of TGF-ß1/Smad2/3 pathway through down-regulation of TGF-ß1 expression and phosphorylation of Smad2/3 as well as the inhibition of the expression of vimentin and a-SMA. In conclusion, JDTL Decoction can prolong the process of myocardial fibrosis through the inhibition of the TGFß1/Smad2/3 signaling pathway. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Factors Influencing the Efficacy of Shenqi Yanshen Granule in Ameliorating Early Proteinuria Among Patients with Nephrotic Syndrome: A Logistic Analysis |
| Jing Yang, BD; Xiao Yu, BD |
| Objective • The study aimed to investigate the factors influencing the efficacy of Shenqi Yanshen Granule in ameliorating proteinuria among nephrotic syndrome patients in renal function stages 1-3.
Methods • 100 patients with nephrotic syndrome and renal function stages 1-3, treated at our hospital from May 2021 to March 2023 were enrolled. All patients received Shenqi Yanshen granule treatment. The patients were divided into the control group (n = 68, with proteinuria reduction of =50%) and the observation group (n = 32, with proteinuria reduction of <50% or increased proteinuria) at 24 hours after treatment. Clinical data, proteinuria levels at 24 hours after treatment, renal function indices, and mean blood pressure were statistically compared. The efficacy of Shenqi Yanshen Granule in treating proteinuria and factors influencing the efficacy was assessed using multiple logistic regression.
Results • The observation group had a higher average age and duration of disease compared to the control group (P < .05).
Upon treatment, proteinuria decreased in both groups (P < .05), with higher levels in the observation group than in the control group. Post-treatment, serum creatinine levels decreased and GFR increased in the control group (P < .05), while the serum creatinine level increased and GFR decreased in the observation group (P < .05). Mean blood pressure decreased in both groups post-treatment (P < .05). The observation group exhibited lower rates of remarkable and effective outcomes and higher rates of general effective and ineffective outcomes (P < .05). Logistic regression analysis highlighted age, severity of nephropathy, underlying conditions, lifestyle, and pre-treatment proteinuria as significant factors influencing the impact of Shenqi Yanshen Granule on proteinuria in patients with nephrotic syndrome (P < .05).
Conclusion • Shenqi Yanshen Granule proves to be a potent intervention for reducing proteinuria in patients with nephrotic syndrome. Notably, age and disease severity emerge as pivotal determinants of drug efficacy. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Teamwork Model in the Optimization of Coronary CT Angiography Examination |
| Baihan Jin, MD; Donglan Yue, MD |
| Objective • To explore the effect of a teamwork model applied to the optimization of coronary CT angiography (CCTA) examination.
Methods • A total of 118 patients who underwent CCTA examination in our hospital from June 2020 to June 2021 were selected as study objects. They were randomly divided into two groups (observation and control), with 59 patients in each group. Examination measures based on a routine model were performed on patients in the control group, while examination measures based on a teamwork model were performed on patients in the observation group. The examination-related indicators, heart rate, imaging quality, and negative emotions were compared between the two groups.
Results • The readiness rate and first-attempt success rate of the observation group were higher than those of the
control group; the waiting time and examination time of the observation group were shorter than those of the control group, and the radiation dose of the observation group was lower than that of the control group (P < .05). During the examination, the heart rate of the observation group was lower than that of the control group; the imaging quality of the observation group was better than that of the control group; and, after the intervention, the SAS and SDS scores of the observation group were lower than those of the control group (P < .05).
Conclusion • Interventions based on the teamwork model applied to CCTA can relieve the negative emotions of patients, promote the readiness rate and first-attempt one-time success rate, shorten the waiting time and inspection time, and improve the heart rate and imaging quality. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Case Report and Literature Review: Orthostatic Hypotension Due to Multiple System Atrophy |
| Jing Feng, MM; Zeyao Jiang, MM; Zhiming Liang, BM; Miao Song, BM |
| Objective • Multiple system atrophy (MSA) is a rare and fatal adult-onset neurodegenerative disease with multiple clinical and pathological variants. The etiology of MSA remains uncertain. Orthostatic hypotension (OH) is the main characteristic of MSA. An upright position can trigger a syncope attack, making it impossible for the patient to stand and walk briefly.
Case Study • We report the case of a 67-year-old man with initial symptoms of recurrent syncope and this patient was hospitalized several times, despite multiple therapeutic
interventions, his symptoms persisted. Eventually, this patient died at the age of 68 with a diagnosis of MSA.
Conclusion • For those patients with neurogenic OH, an underlying neurodegenerative disease should always be considered. Prompt diagnosis, early aggressive treatment, and prediction of complications may have a huge impact on the prognosis of MSA. This article also reviews relevant reported cases to enrich the experience of treating MSA in the clinic. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Meta-analysis of Rapid Rehabilitation Surgery in Hip and Knee Replacement |
| Weiguo Bian, MM; Zhi Gao, MM; Hongwei Li, MM; Yong Li, MM; Pengbo Liu, MM; Zhanhai Yin, MM |
| Context • Total knee arthroplasty (TKA) and total hip arthroplasty (THA) have become well-established and standardized procedures. However, complications can easily occur, such as joint pain and swelling, due to the high trauma of surgery and intraoperative blood loss, which can affect patients’ recovery. A treatment that can effectively shorten postoperative recovery time and reduce complications is key to the perioperative treatment of TKA and THA.
Objective • The study aimed to evaluate the efficacy of the Rapid Rehabilitation Surgery (RRS) protocol, an enhanced recovery after surgery (ERAS) approach, for TKA and THA to substantiate its application by the current research team.
Design • The research team performed a narrative review by searching the Excerpta Medica Database (Embase), the Kirkland database, the China National Knowledge Infrastructure (CNKI), the Wanfang database, and the VIP database, using the keywords rapid rehabilitation surgery, hip replacement, knee replacement, and perioperative period, and randomized controlled trials or randomized controlled trials (RCTs) or clinical trials. The team also performed a meta-analysis of the data from the studies that the search found.
Setting • The study took place at Yulin No. 2 Hospital, Yulin, China.
Participants • The studies included 1673 patients in six studies that conducted RCTs, including 565 patients who received ERAS and 1108 patients who received RCTS.
Outcome Measures • The research team used Cochrane software for risk assessment for the included studies. For the meta-analysis, the team examined the included studies’ data related: (1) to length of hospital stay, (2) to postoperative complications, (3) to blood-transfusion rate, and (4) to postoperative pain.
Results • The ERAS nursing reduced the mean length of hospital stay by 2.17 days compared to that of the combined control groups from five studies (MD=-2.17, 95% CI [3.36-0.99], P < .01). In the analysis of four studies, the incidence of surgical complications was 9.1% lower in the combined intervention groups than in the combined control groups (r=0.30, 95% CI [0.10 to 0.94], P = .02).
Conclusions • RRS is a safe and effective method of treating patients undergoing THA and TKA and can significantly reduce hospitalization time and postoperative complications. This approach deserves promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Gastrointestinal Health: A Foundation for Whole-body Wellness |
| Shawn Manske, ND |
| Contenxt • The focus on gastrointestinal (GI) health has been increasing due to a growing awareness of its pivotal role in overall well-being. Current trends in addressing GI health aim to optimize gut-microbiome composition, understand the bidirectional communication between the gut and the brain, and use functional diagnostic testing to aid in diagnosis and guide treatments for GI disorders.
Objective • The study intended to examine advances in microbiome research, including advancements in technology, and to investigate methods of noninvasive diagnostics, the importance of the gut-brain axis (GBA) and the oral cavity, the types of beneficial microorganisms, and the prevalence of functional GI disorders (FGIDs).
Setting • The study took place at Biocidin Botanicals in Watsonville CA, USA.
Results • Recent research has illuminated the critical role that gut health plays in human physiology and disease. Also, the oral cavity is emerging as a vital microbial reservoir affecting both GI and systemic health. Dietary patterns and lifestyle choices exert profound effects on the gut microbiota and host metabolism, emphasizing the importance of holistic approaches to GI care. FGIDs impose significant burdens on patients’ quality of life and the healthcare systems. Integrating stress management strategies and supporting healthy lifestyle choices are essential for managing FGIDs effectively.
Conclusions • Functional foods, prebiotics, probiotics, and postbiotics offer promising avenues for optimizing GI health and mitigating disease risk. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Prognostic Value of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Acute Ischemic Stroke Patients After Thrombolysis |
| Xiaoxia He, BS; Haibo Jiang, BS; Meihua Jiang, BS; Ling Liu, MSc; Zhaoyang Ruan, MSc; Dongying Wang, MSc; Yingxin Zeng, MSc |
| Context • The neutrophil to lymphocyte ratio (NLR) or platelet to lymphocyte ratio (PLR) is an inflammation marker of acute ischemic stroke, but the predictive value of NLR and PLR before and after thrombolysis for short-term prognosis in acute ischemic stroke patients after thrombolysis remains largely obscure. This study attempts to clarify the predictive value of NLR and PLR before and after thrombolysis for short-term prognosis in acute ischemic stroke patients after thrombolysis.
Design • A retrospective study was carried out in the Affiliated Hospital of Hangzhou Normal University involving 120 patients visiting the neurology department of our hospital from May 2019 to October 2022 and meeting the selection criteria. The participants were assigned to the good prognosis group and the poor prognosis group based on the modified Rankin scale score. Laboratory data collected include NLR and PLR at admission as well as NLR and PLR collected from venous blood within 24 h after thrombolysis.
Results • Age, hyperlipidemia, atrial fibrillation, rheumatic heart disease, and National Institutes of Health Stroke Scale (NIHSS) scores after thrombolysis depicted statistical significance between both groups (P < .05). Hyperlipidemia, atrial fibrillation, and NIHSS scores before thrombolysis were independent risk elements for adverse prognosis (P < .05). NLR and PLR before and after thrombolysis in the poor prognosis group depicted an elevation relative to that in the good prognosis group (P < .05). The area under the curve of NLR or PLR predicting adverse prognosis after thrombolysis depicted an elevation relative to that before thrombolysis (P < .05).
Conclusion • The predictive value of NLR and PLR post-thrombolysis for short-term prognosis in acute ischemic stroke patients depicts an elevation relative to pre-thrombolysis; our study provides effective predictive indicators for short-term prognosis in acute ischemic stroke patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Circular RNA Pum_0014 Targets miR-146a-5p/NF2 Axis to Regulate VEGF/PAK1 Pathway and Reduce H2O2-induced Cardiomyocyte Apoptosis |
| Yan-Feng Liu, PhD; Yu Tang, PhD; Yun-Xia Wang, PhD; Li-Dan Wen, MS; Gui-Ping Wu, MS; Yu-Liang Zhan, PhD |
| Circular RNAs (circRNAs) have emerged as essential regulators in cardiovascular disease, including acute myocardial infarction (AMI). This study investigated the role of circRNA Pum1_0014 in myocardial infarction (MI) and its underlying mechanisms using an H9C2 cell model. Through Sanger sequencing, nucleic acid electrophoresis, RNase R, and transcriptional inhibition experiments, Pum1_0014 was identified as a novel circRNA. The cell localization of circRNA Pum1_0014 was detected by qPCR and fluorescence in situ hybridization, and the results revealed that circRNA Pum1_0014 is predominantly located in the cytoplasm. StarBase (URL: http://starbase.sysu.edu.cn/) and TargetScan (URL: https://www.targetscan.org/vert_80/) were used to predict circRNA Pum1_0014 targeting miRNAs and miRNA targeting mRNA, and the results identified miR-146a-5p as a potential target of Pum1_0014,
which in turn targets NF2. The plasmid encoding the mutant circRNA Pum1_0014 or the 3’UTR mutant NF2 was constructed, and the interaction between Pum1_0014 and miR-146a-5p or miR-146a-5p and NF2 was detected by luciferase reporter gene assay. The results confirmed the interactions between Pum1_0014, miR-146a-5p, and NF2. In the MI cell model, upregulation of circRNA Pum1_0014 and NF2 and downregulation of miR-146a-5p were observed. Knockdown of circRNA Pum1_0014 inhibited NF2 expression and activated the VEGF/PAK1 pathway, reducing cardiomyocyte apoptosis. Conversely, inhibition of miR-146a-5p and overexpression of NF2 had opposite effects. These findings suggest that circRNA Pum1_0014 acts through the miR-146a-5p/NF2 axis to reduce cardiomyocyte apoptosis in MI via the VEGF/PAK1/NF2 pathway. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Internal Fixation of Tibial Fracture with Suprapatellar Approach and Subpatellar Approach on Fracture Union and Knee Function Recovery |
| Lin Gan, MD; Yanglin Gu, PhD; Jia Han, MD; Guangchang Wang, MD |
| Background • The tibia is one of the most vulnerable bones in the human body, accounting for 13.7% of the total fractures. Most tibial fractures (distal articular surface) are caused by high-violence trauma. In recent years, with the rapid development of China’s industry, the incidence of tibial fractures has shown an increasing trend.
Aim • To investigate the effect of internal fixation of tibial fractures per suprapatellar approach on fracture union and knee function recovery.
Methods • A total of 100 patients with tibial shaft fractures who underwent operations in our hospital were selected as the subjects. They were divided into a suprapatellar group (suprapatellar approach for intramedullary nail fixation) and a subpatellar group (subpatellar approach for intramedullary nail fixation) according to a prospective randomized study, with 50 cases in each group. The operative time, blood loss, X-ray irradiation times, fracture healing time, postoperative knee pain score, knee Lysholm score, and surgical complication rate were compared between the two groups.
Results • There were no significant differences in operative time, blood loss, and fracture healing time between the suprapatellar and subpatellar groups (P > .05). The number of X-ray irradiations needed and visual analog scale (VAS) scores were lower in the suprapatellar group than those in the subpatellar group (P < .05). The Lysholm score was used to evaluate knee function 6 months postoperatively, and swelling and pain scores were higher in the subpatellar group than in the suprapatellar group (P < .05). However, there were no significant differences in the knee Lysholm total score between the two groups (P > .05). There were also no significant differences in postoperative complications between the two groups (P > .05).
Conclusion • Suprapatellar intramedullary nailing reduced the number of intraoperative X-ray irradiations. Postoperative knee joint pain caused by intramedullary nailing was less, which was beneficial to the early functional knee joint exercise. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparative Efficacy of Deep Brain Stimulation to the Globus Pallidus Internus Versus the Subthalamic Nucleus in Parkinson's Disease |
| Wang Bao, MD; Qu Lihong, MD; Su Mingming, MSc; Li Nan, MD; Wang Xuelian, MD; Zheng Zhaohui, MSc |
| Background • In recent years, the incidence of Parkinson’s disease has gradually increased, and the application of dopamine drugs has been limited, so there is an urgent need to explore a more effective treatment method to treat Parkinson’s disease effectively treated. Subthalamic nucleus-deep brain stimulation and globus pallidus internus-deep brain Subthalamic nucleus-deep brain stimulation and globus pallidus internus-deep brain stimulation are the two treatments for Parkinson’s disease. However, there is no clear conclusion as to which of these two methods is more effective.
Primary Study Objective • To compare the effects of deep brain stimulation in the globus pallidus internus and deep brain stimulation in the subthalamic nucleus combined with drugs for Parkinson’s disease, respectively.
Methods • In order to compare the motor function, neurological function, and activities of daily living scores, the incidence of fluctuations in isokinetic and motor symptoms, changes in medication doses, and the incidence of complications between the two groups, 52 patients treated with globus pallidus internus-deep brain stimulation and 52 patients treated with subthalamic nucleus-deep brain stimulation were included.
Primary Outcome Measures • Using the Motor Function Examination scale of the Unified Parkinson’s Disease Rating Scale, patients’ motor function was evaluated prior to surgery, one month after surgery, three months after surgery, and six months following surgery. The Montreal
Cognitive Assessment, the Mini-mental State Examination, and the Activity of Daily Living scale were used to evaluate patients’ cognitive function before and three months after surgery. The patient’s dose of medication and complications were also counted, among other things.
Results • The Unified Parkinson’s Disease Rating Scale-? scores decreased, and the Montreal Cognitive Assessment, Mini-mental State Examination, and Activity of Daily Living scales increased in both groups after surgery, with no difference between the two groups (P > .05). Between the two groups, there was no difference in the frequency of allodynia and motor symptom variations (P > .05). Postoperatively, the Group globus pallidus internus experienced lower medication doses and a reduced incidence of complications than the Group subthalamic nucleus (P < .05).
Conclusion • The effects of GPi-DBS and STN-DBS in treating PD are both more significant and there is no difference between them, but GPi-DBS reduces complications and medication dose, and has a higher safety profile, indicating that GPi-DBS is more suitable for clinical application and promotion. Future studies need to further explore the mechanism behind the reduction of complications and medication dose of GPi-DBS in Parkinson’s disease, in order to provide better support for the clinical application of GPi-DBS. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Traditional Chinese Medicine Acupoint Massage and Acupoint Application on Defecation Status and Quality of Life in Patients with Constipation and Psychogenic Drug-Induced Heat |
| Xiaoyan Zhang, BD; Hua Zhou, BD |
| Background • Constipation is a prevalent adverse drug reaction during the treatment of mental illnesses. Traditional Chinese medicine boasts substantial expertise in addressing constipation.
Objective • To investigate the impact of traditional Chinese medicine acupoint massage combined with acupoint application on the quality of life of patients experiencing solid heat constipation induced by psychogenic drugs.
Design • This study employed a randomized controlled design.
Setting • This study was conducted at the Seventh People’s Hospital of Hangzhou.
Participants • Between May 2019 and August 2020, 150 hospitalized patients from the Department of Psychiatry at the Seventh People’s Hospital of Hangzhou, Zhejiang Province, were selected through convenience sampling. The clinical diagnosis type was intestinal solid fever. The patients were divided into three groups using a random number table method: observation group, intervention group 1, and intervention group 2, each consisting of 50 cases.
Interventions • The observation group underwent acupoint massage combined with application treatment.
Intervention group 1 received an acupoint massage. Intervention group 2 underwent Shenque acupoint application treatment.
Primary Outcome Measures • (1) Defecation characteristics; (2) Defecation difficulty scores; and (3) Quality of life of patients.
Results • The observation group exhibited superior improvement in Bristol constipation stool character and defecation difficulty compared to intervention group 1 and intervention group 2 (P < .05 and P < .01). In the quality-of-life assessment scale, the observation group outperformed intervention group 1 and intervention group 2 in physical, psychological, worry, and satisfaction aspects (P < .05 and P < .01).
Conclusions • Traditional Chinese medicine acupoint massage combined with acupoint application demonstrates significant effects on constipation characteristics, defecation difficulties, and the overall quality of life of patients. These findings merit consideration for clinical application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Acupoint Therapy for ICU Patients With Constipation Receiving Enteral Nutrition |
| Hao Deng, MM; Lu Ye, BM |
| Context • Constipation is a common gastrointestinal complication for ICU patients receiving enteral nutrition. ICU patients’ constipation can have serious consequences, including abdominal discomfort, decreased appetite, and even intestinal obstruction. However, the benefits of the use of acupoint patch therapy for ICU patients with constipation remains underexplored.
Objective • The study intended to investigate the benefits of traditional Chinese medicine (TCM) acupoint patch therapy for ICU patients with constipation who receive enteral nutrition.
Design • The research team conducted a randomized controlled study.
Setting • The study took place at the Affiliated Hospital of Shaoxing University of Arts and Sciences in Shaoxing, Zhejiang, China.
Participants • Participants were 120 ICU patients who had received a diagnosis and treatment at the hospital between January 2021 and December 2022.
Interventions • The research team randomly divided participants into two groups, each with 60 participants: (1) the control group, who received conventional treatment, and (2) the acupoint group, who received traditional Chinese medicine’s (TCM’s) acupoint patch therapy in addition to conventional treatment.
Outcome Measures • The research team assessed: (1) the efficacy of constipation treatment; (2) serum albumin and
transferrin levels at baseline and postintervention; (3) the duration of mechanical ventilation, length of ICU residence, and length of hospital stay of the ICU patient; (4) stool shapes; and (5) defecation patterns.
Results • The acupoint group’s total efficacy rate, at 91.67% for 55 participants, was significantly higher than that of the control group, at 76.67% for 46 participants (P < .05). At baseline, no significant differences existed between the groups in the serum albumin and transferrin levels (P > .05). Both groups’ levels significantly increased between baseline and postintervention, and postintervention, the acupoint group’s serum albumin and transferrin levels were significantly higher than those of the control group (P = .034). The acupoint group’s duration of mechanical ventilation (P = .014), ICU residence (P = .028), and length of hospital stay (P = .015) were significantly shorter than those of the control group. The acupoint group’s stool shapes and bowel patterns were significantly better than those of the control group (all P < .05).
Conclusions • TCM acupoint patch therapy can have a significant effect in the treatment of constipation for ICU patients receiving enteral nutrition, which can increase the serum albumin and transferrin levels; shorten the time of mechanical ventilation, ICU residence, and hospital stay; improve the treatment effect, and provide protection for patients’ lives and health, and is worthy of wide application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Risk Factors of Atrial Fibrillation Complicated with Cognitive Impairment and the Relationship between Cardiac Function Indicators and the Degree of Cognitive Impairment |
| Zongyi Hou, PhD; Fengjiao Liao, PhD |
| Background • Atrial fibrillation has a current incidence of 2% to 4% and is one of the most common clinical arrhythmias. Cerebral hypoperfusion, microhemorrhage, microembolus, cerebrovascular disease, cerebral atrophy, and inflammatory factors related to atrial fibrillation are the potential mechanisms of cognitive impairment induced by atrial fibrillation.
Objective • Our study aimed to explore the risk factors of atrial fibrillation with cognitive impairment and analyze the relationship between cardiac function indicators and cognitive impairment in patients, in order to provide clinical reference for clinical prevention and treatment of atrial fibrillation related cognitive impairment.
Design • This was a retrospective study conducted at The First People’s Hospital of Pinghu City.
Setting • This study was carried out in the Department of Neurology, The First People’s Hospital of Pinghu City.
Participants • A total of 120 atrial fibrillation patients who came to The First People’s Hospital of Pinghu City for treatment and hospitalization from January 2020 to May 2022 were selected as the research objects. Montreal Cognitive Assessment was adopted to evaluate the cognitive function of atrial fibrillation patients, their socio-demographic data, disease-related data, and relevant clinical data were collected, and the cardiac function indexes of all subjects were detected using the DW-CE 540 color.
Primary Outcome Measures • (1) Montreal Cognitive Assessment score of atrial fibrillation with or without cognitive impairment (2) risk factors
of atrial fibrillation complicated with cognitive impairment (3) correlation between cardiac function indexes and cognitive function in atrial fibrillation patients.
Results • The Montreal Cognitive Assessment scores of 7 cognitive domains in the atrial fibrillation with cognitive impairment patients (n=89) were lower than those in the atrial fibrillation without cognitive impairment (n=31) (P < .001, P < .05); Multivariate Logistic regression analysis showed that there were significant differences in age, occupational status, educational level, total cholesterol and D-dimer between the atrial fibrillation with cognitive impairment patients and the atrial fibrillation without cognitive impairment patients (P = .016, P < .001, P < .001, P = .03, P < .001); the patient’s cardiac function indicators were closely related to the cognitive function of attention, orientation, memory, visual space and executive ability (P < .001, P < .01).
Conclusion • Atrial fibrillation patients with cognitive impairment were closely related to age, occupational status, educational level, total cholesterol, and D-dimer levels, and the cardiac function indicators of patients are closely related to the cognitive function of attention, orientation, memory, visuospatial and executive ability. This study provides a clinical basis for clinical intervention in patients with atrial fibrillation combined with cognitive impairment. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of the Correlation between Research Ability, Self-efficacy, and Challenging Blocking Stress in Undergraduate Nursing Students |
| Lin Fang, BD; Qi He, MD; Xin-Juan Wang, MD |
| Objective • Our study aimed to explore the connections between scientific research capabilities, self-efficacy, and challenging and blocking stressors among nursing undergraduates. The goal was to derive insights that could enhance clinical nursing teaching and collegiate nursing education.
Method • We conducted a cross-sectional study with [number of participants using a nursing undergraduate stressor scale, a general self-efficacy scale (GSES), and a research cognition and behavioural scale developed by our team.
Results • The average research ability score among nursing undergraduates was found to be (28.05 ±3.55), with the
average self-efficacy score being (26.64 ±3.54). We found a positive correlation between the scientific research ability and self-efficacy of nursing undergraduates, as well as challenging-blocking stress (P < .05).
Conclusion • Our findings indicate that self-efficacy and stress from challenges significantly impact the ability of nursing undergraduates to conduct scientific research. Therefore, it is vital to promote self-efficacy and cognitive and behavioural capabilities related to scientific research among these students, while also mitigating stressors. These interventions can help nursing undergraduates to better understand their field and their personal potential. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Hypothermia Preventive Nursing on Perioperative Coagulation Function and Stress Response in Elderly Patients Undergoing Total Hip Replacement |
| Lihua Lou, BD; Xiaojing Tan, BD |
| Background • Total hip replacement (THR) is a surgical procedure in which all or part of the hip joint is replaced with an artificial hip joint to rebuild the motor function of the joint.
Objective • To explore the impacts of hypothermia preventive nursing on perioperative coagulation function and stress response in elderly patients undergoing THR.
Method • A total of 124 elderly patients who underwent THR from February 2020 to February 2023 were included and assigned to the control group (CG) and observation group (OG). Patients in the CG were provided with routine intraoperative nursing, and patients in the OG were given hypothermia preventive nursing.
Results • In contrast to the CG, the postoperative temperature in the OG was elevated, and the awakening time and extubation time in the OG were shorter (P < .05). After operation, prothrombin time, thrombin time, fibrinogen along with D-dimer levels in the CG were higher (P < .05), while those in the OG did not change
(P > .05). After the operation, epinephrine and norepinephrine levels in both groups were elevated, with levels being lower in OG than CG (P < .05). The occurrence of hypothermia and postoperative chills in the OG was decreased compared to the CG (P < .05). The nursing satisfaction of patients in the OG was higher compared to the CG (P < .05). After nursing, the scores of physical function, social function, material function, and mental health in the OG were higher than GC (P < .05).
Conclusion • Hypothermia preventive nursing during operation can effectively maintain the stable coagulation function of patients, reduce the stress response, decrease the occurrence of chills and hypothermia during the operation, and promote the quality of life, especially in elderly patients with THR, which has a specific nursing role for elderly patients undergoing THR, and thus has certain clinical application value. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Influences of Butylphthalide Injection in Combination with Edaravone on Clinical Efficacy and Cytokines in Elderly Acute Cerebral Infarction Patients |
| Lei Guo, MM; Kunyu Sun, BD |
| Background • Acute cerebral infarction threatens human health and life safety. The edaravone is a new antioxidant and hydroxyl radical scavenger, which is used in the treatment of cardiovascular diseases. However, long-term use of edaravone is prone to drug resistance, resulting in limited therapeutic effect. Butylphthalein can improve collateral circulation, protect the integrity of vascular endothelial cells, improve vasospasm, increase blood perfusion in the ischemic area of brain tissue, and promote the recovery of cerebral nerve function.
Objective • To measure the influences of butylphthalide injection in combination with edaravone on clinical efficacy and cytokines in elderly acute cerebral infarction patients, aiming to provide reference for the treatment of acute cerebral infarction.
Design• This was a retrospective study.
Setting • This study was performed in Yantaishan Hospital.
Participants • A total of 168 elderly acute cerebral infarction patients who accepted therapy in our hospital from February 2022 to February 2023 were chosen and allocated into a combination group and a control group.
Interventions • The control group accepted the edaravone injection treatment. The combination group was treated with edaravone injection combined with butylphthalide injection.
Primary Outcome Measures • (1) Therapeutic effect (2) Cytokines (3) Vascular endothelial function (4) Oxidative stress (5) Degree of
neurological impairment (6) Living ability.
Results • The total effective rate in the combination group presented elevation when in contrast to the control group (P < .05). After therapy, the levels of cytokines in the combination group presented reduction relative to the control group (P < .05), nitric oxide level in the combination group presented elevation when in contrast to the control group (P < .05), vascular endothelial growth factor level in the combination group presented lessened relative to the control group (P < .05), glutathione peroxidase along with superoxide dismutase levels in the combination group presented higher relative to the control group (P < .05) and malondialdehyde level in the combination group presented lower relative to the control group (P < .05). After therapy, the National Institute of Stroke Scale score in the combination group presented reduced when compared with the control group (P < .05). In contrast, the activity of daily living score in the combination group presented higher relative to the control group (P < .05).
Conclusion • Butylphthalide injection in combination with edaravone can effectively inhibit the inflammatory response and oxidative stress, promote vascular endothelial function, improve daily behavior ability as well as promote the neurological function of elderly acute cerebral infarction patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Evaluation of a Pressure Injury Risk Assessment Module Based on a Nursing Information System in an Intensive Care Unit |
| Lei Wang, PhD; Dongyan Zhang, PhD; Narui Zhao, PhD |
| Background • Patients in intensive care units easily develop pressure injuries. Therefore, the prevention of and care for pressure injuries in intensive care units is an important focus of medical care.
Objective • To compare the use of a pressure injury risk assessment module of a nursing information system with a paper management system to aid nursing management of high-risk pressure injuries in intensive care units.
Design • This was a retrospective study.
Setting • This study was performed in the Intensive Care Unit Department, North China Medical Health Group Xingtai General Hospital.
Participants • We selected 120 patients who were treated in the intensive care unit of Xingtai General Hospital from January 2020 through December 2022 as the observation objects. Among the 120 enrolled patients, the 60 patients enrolled from January 2020 through June 2021 were allocated to the control group, and the 60 patients enrolled from July 2021 through December 2022 were allocated to the observation group.
Interventions • Patients in the control group were nursed using a paper management system to assess pressure injury risk. Patients in the observation group were nursed using a pressure injury risk assessment module based on a nursing information system that was created by the North China Medical Health Group Xingtai General Hospital in
accordance with the nursing requirements of patients with high-risk pressure injury.
Primary Outcome Measures • The groups were compared for the risk assessment time of pressure injury, warning time of pressure injury reaction, incidence of pressure injury, comfort level, quality of life, and nursing satisfaction rate.
Results • The risk assessment time of pressure injury and warning time of pressure injury reaction were shorter in the observation group than in the control group (P < .001, 95% CI: -4.633~-4.047 and P < .001, 95% CI: -10.72~-9.203). The total incidence of pressure injury was lower in the observation group than in the control group (P = .03, ?2=4.6). The comfort level scores, quality of life scores, and patient satisfaction scores were higher in the observation group than in the control group (P < .001, 95% CI: 14.99~19.51, P < .001, 95% CI: 6.050~10.23 and P < .001, 95% CI: 20.92~26.68).
Conclusion • The pressure injury risk assessment module based on a nursing information system can effectively standardize the risk management of pressure injury in patients in the intensive care unit, shorten the early warning time of pressure injury reaction, reduce the incidence of pressure injury in patients, promote the quality of life of patients, and improve patient nursing satisfaction. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Efficacy and Prognostic Effects of High-quality Nursing Combined With Albumin in Treating Brainstem Hemorrhage |
| Yunxia Gao, MM; Li Sun, MM; Wenjuan Wu, MM; Xiaojuan Zhang, MM |
| Context • Brainstem hemorrhage is a disease with a high mortality rate and a poor prognosis. Its onset is urgent and critical, and patients need personalized, high-quality nursing. Also, albumin can have significant benefits in treating brainstem hemorrhage.
Objective • The study intended to explore the clinical efficacy of and improved prognoses from high-quality nursing combined with albumin in treating patients with brainstem hemorrhage.
Design • The research team conducted a prospective randomized controlled trial.
Setting • The study took place at Heibei Fengfeng General Hospital of the North China Medical and Health Group in Hebei, China.
Participants • Participants were 102 patients with brainstem hemorrhages who received treatment at the hospital between November 2020 and October 2022.
Interventions • The research team randomly divided participants into two groups, each with 51 participants: (1) the intervention group, who received high-quality nursing combined with 20% human albumin, and (2) the control group, who received conventional nursing combined with 20% human albumin.
Outcome Measures • The research team examined participants’: (1) mortality rate; (2) scores on the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS); (3) quality of life (QoL) scores, using the 36-Item Short Form Survey (SF-36); (4) scores on the Self-Rating Anxiety Scale (SAS); (5) health-behavior scores, using the Health-Behavior Scale, and (6) nursing satisfaction.
Results: Postintervention compared with the control group, the intervention group’s: (1) total mortality rate was significantly lower (P = .017), (2) GCS and GOS scores were significantly higher (both P < .001), (3) QoL scores for all subdimensions were significantly higher (all P < .001), (4) SAS scores for all subdimensions were significantly lower (all P < .001), (5) health-behavior scores for all subdimensions were significantly higher (P < 0.001), and (6) nursing satisfaction was significantly higher (P = .015).
Conclusions • High-quality nursing interventions combined with albumin for brainstem-hemorrhage patients can effectively increase treatment efficacy, ensure patients’ QoL, and facilitate recovery. Thus, high-quality nursing combined with albumin for brainstem-hemorrhage patients is of great significance in clinical practice. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Pre-pregnancy Diabetes Mellitus Management Model Based on the Internet of Things Technology Combined With the Paradigmatic Diagnosis and Treatment Management Model on the Pregnancy Outcome |
| Wei Han, PhD; Cuiqin Huang, PhD; Ting Shen, PhD |
| Context • Pre-gestational diabetes mellitus is a significant health concern associated with an increased rate of health complications in newborns and mothers. Effectively strengthening the management of pregnancy, controlling mothers’ blood-sugar levels, and ensuring the safety of mothers and children are factors that needs attention.
Objective • The study intended to explore the effects on pregnancy outcomes of a new integrated management model of pre-pregnancy diabetes that uses the Internet of Things technology, combined with typical diagnosis and treatment, to improve maternal and fetal outcomes.
Design • The research team conducted a prospective cohort study.
Setting • The study took place in the Department of Obstetrics at Shanghai Sixth People’s Hospital in Shanghai, China.
Participants • Participants were 173 pregnant women at the hospital who had received a diagnosis of gestational diabetes mellitus between January 2020 and December 2022.
Interventions • The research team divided participants into two groups: (1) the joint management group, the intervention group, with 87 participants, and (2) the traditional management group, the control group, with 86 participants. Both groups received standardized treatment and nutritional intervention, and the joint management group also received treatment under the new management mode, the Internet of Things.
Outcome Measures • The research team examined: (1) blood-glucose compliance—fasting blood glucose and 2 h postprandial blood glucose; (2) comparison of treatment compliance between the groups; (3) pregnancy outcomes, (4) newborn outcomes, (5) patient satisfaction; and (6) lipid metabolism, including triglycerides (TG), high-density lipoproteins (HDL), total cholesterol (TCH) free fatty acid (FFA);
Results • Compared to the traditional management group, the joint management group’s: (1) fasting blood glucose and 2 h postprandial blood glucose were significantly lower than those of traditional management group (P < .0001); (2) treatment compliance was significantly higher (P < .05); (3) incidences of cesarean sections (P = .0069) and fetal distress (P = .0145) were significantly lower, (4) incidences of macrosomia and neonatal hypoglycemia were significantly lower (P < .05); (5) patient satisfaction rate was significantly higher (P = .0023) and (6) TG (P < .0001), LDL (P < .0001), and FFA (P = .0011) were significantly lower and HDL (P < .0001) was significantly higher.
Conclusions • The management mode that combined the Internet of Things platform with standardized diagnosis and treatment of pregnant women with gestational diabetes mellitus had good compliance and high patient satisfaction and could reduce maternal and infant complications; it’s worthy of clinical promotion. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of Narrative Nursing on Stigma and Psychological Crisis for Patients With Orthopedic Amputations |
| Linling Cao, BD; Lu Dai, MM; Li Hua, BD; Qing Lu, BD; Zhijuan Wu, BD |
| Context • Amputation results in large wounds and in mobility disorders for patients, easily leading to social difficulties and affecting patients’ psychological recovery. In recent years, some clinicians have used narrative nursing to intervene in the effects of stigma for patients with diseases other than amputations and have achieved good effects.
Objective • The study intended to examine the impact of narrative nursing on amputation patients’ feelings of stigma and on their resulting psychological crises.
Design • The research team conducted a randomized controlled trial.
Setting • The study occurred at the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University in Huai'an, China.
Participants • Participants were 75 patients who underwent lower-limb amputations at the hospital between November 2021 and May 2023.
Interventions • The research team randomly divided participants into two groups: (1) the control group with 38 participants, who received conventional nursing, and (2) the intervention group,
with 37 participants, who received a narrative nursing intervention in addition to conventional nursing.
Outcome Measures • The research team measured: (1) stigma, using the Stigma Impact Scale (SIS); (2) anxiety and depression, using the Hospital Anxiety and Depression Scale (HADS); and (3) nursing satisfaction. The team also examined the correlation between participants’ stigma scores and anxiety and depression scores.
Results • Postintervention compared to the control group, the intervention group’s: (1) SIS scores were significantly lower (P < .001); (2) anxiety and depression scores were significantly lower (both P < .001); (3) total nursing satisfaction rate was significantly higher (P = .011). The correlation analysis demonstrated a significant positive association between the SIS and the HADS scores (P < .05).
Conclusions • Narrative nursing can improve the psychological states of amputees, mitigate their feelings of stigma, and elevate their nursing satisfaction, and it’s worthy of clinical use. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Stratified Nursing Based on ICNSS Score: Study on the Impact of Complications and Rehabilitation Effects in Patients with Acute Myocardial Infarction Complicated by Heart Failure |
| Chao Fu, MBBS; Kai Wang, MBBS; Yuhua Xiao, MBBS |
| Objective • To analyze the application effects of stratified nursing based on the ICNSS score and its influence on complications and rehabilitation effects in patients with Acute Myocardial Infarction (AMI) complicated by Heart Failure (HF).
Methods • A retrospective analysis was conducted on clinical data of 97 patients with AMI complicated by HF admitted to Xingtai Central Hospital between January 2021 and January 2023. All patients met the inclusion and exclusion criteria. Patients were divided into a control group (n=47) and an observation group (n=50) based on different nursing interventions received. The control group received routine nursing interventions, while the observation group received stratified nursing interventions based on the ICNSS score. The comparison between the two groups involved Cardio Care Unit (CCU) treatment duration, psychological status Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), cardiac function indicators Creatine Kinase (CK), Left Ventricular End-Diastolic Diameter (LVEDD), Left Ventricular Ejection Fraction (LVEF), Cardiac Output (CO), quality of life (SF-36), occurrence of nursing complications, and nursing satisfaction.
Results • 1. CCU treatment duration and psychological status: After treatment, the SAS and SDS scores and CCU treatment duration in the observation group were significantly lower than those in the control group (P < .05). 2. Cardiac function indicators: After treatment, the CK
and LVEDD levels in the observation group were significantly higher than those in the control group, while LVEF and CO levels were significantly lower than those in the control group (P < .05). 3. Quality of life: After treatment, the physiological function, physical function, mental status, and social relationship scores in the observation group were significantly higher than those in the control group (P < .05). 4. Occurrence of nursing complications: The occurrence rate of nursing complications in the control group was 17.02%, while in the observation group, it was 2.00%, significantly lower than that in the control group (P < .05). 5. Nursing satisfaction: The nursing satisfaction in the control group was 78.72%, whereas in the observation group, it was 94.00%, significantly higher than that in the control group (P < .05).
Conclusion • Stratified nursing based on the ICNSS score demonstrates significant application effects in patients with AMI complicated by HF. Compared to routine nursing interventions, stratified nursing based on the ICNSS score further reduces CCU treatment duration, alleviates negative psychological emotions, improves cardiac function, and effectively controls and reduces the risk of complications. Moreover, this approach significantly enhances nursing satisfaction for both patients and their families, contributing significantly to promoting harmony in doctor-patient relationships, and deserves clinical promotion and application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Effects of Astragaloside IV on Ovarian Function and Uterine Oxidative Stress Response in Female Rats with Hypothyroidism |
| Lijuan An, MM; Chao Li, MM; Sumin Qian, MM; Weiwei Yang, MM |
| Objective • To investigate the effects of the herbal compound Astragaloside IV (AST) on ovarian function and uterine oxidative stress in female rats with hypothyroidism.
Methods • Sixty female rats were randomly divided into control, hypothyroid model, low-dose AST, high-dose AST, and positive control (levothyroxine) groups. Hypothyroidism was induced using propylthiouracil. After modeling, rats received daily oral AST or the positive control for 30 days. Serum levels of sex hormones (testosterone, estradiol, luteinizing hormone, follicle-stimulating hormone), uterine high-energy phosphates (ATP, ADP, AMP), antioxidant enzymes (superoxide dismutase, glutathione peroxidase), oxidative stress markers (malondialdehyde, lactate dehydrogenase), and apoptosis-related proteins were measured.
Results • Compared to controls, hypothyroid rats showed disrupted sex hormone levels, decreased uterine energy metabolism, increased oxidative stress, and upregulated apoptosis-related proteins. These changes were significantly improved in AST and positive control groups in a dose-dependent manner. The high-dose AST group showed better outcomes than the positive control group, with more normalized hormone levels, enhanced antioxidant capacity, and reduced apoptosis.
Conclusion • AST can effectively balance sex hormone levels and alleviate uterine oxidative stress in hypothyroid female rats. This may be related to AST’s ability to enhance antioxidant capacity, energy metabolism, and inhibit apoptosis-related pathways. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Fast-Track Surgical Nursing on Mental State and Recovery in Radical Cervical Cancer Surgery: A Comparative Study |
| Haidi Hu, MS; Rui Zhong, MS |
| Objective • To explore the effect of fast-track surgical nursing intervention in the perioperative period on patients undergoing radical cervical cancer surgery.
Methods • The clinical data of 110 patients undergoing radical cervical cancer surgery in our hospital from May 2015 to May 2017 were retrospectively analyzed and randomly divided into a research group (n = 55) and a reference group (n = 55). The reference group received routine clinical nursing, and the research group received fast-track surgical nursing. The nursing effect and influence on the mental state of patients were compared between the two groups.
Results • After the intervention, patients in the research group had significantly lower Karnofsky performance status (KPS), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) scores compared to patients in the reference group (P < .001). Patients in the research
group reported shorter first time to gas expulsion, eating, and getting out of bed as compared to the reference group (P < .001). After the intervention, patients in the research group had significantly higher scores in cognitive function, emotional function, social function, and physical function compared to the reference group (P < .05). Furthermore, after the intervention, patients in the research group had significantly higher IgA, IgM, and IgG levels as compared to the reference group (P < .001), and the complication rate of patients in the research group was significantly lower than that in the reference group (P < .05).
Conclusion • The fast-track surgery concept effectively helps improve the negative emotions of patients, shorten recovery time, improve quality of life, and reduce the impact on immune function in radical cervical cancer surgery, and it is worthy of promotion and application, with high safety. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Treatment of Polycystic Ovary Syndrome with Infertility by Dingkun Pills Combined with Ovulation-inducing Drugs: A Meta-Analysis |
| Fei Li, MSc; Qianwen Ma, PhD; Mingxia Shen, BS; Yong Tan, PhD; Jianfei Wu, BS; Chenshu Ye, MSc |
| Objective • To compare the efficacy of the Dingkun pills combined with ovulation-inducing drugs and ovulation-inducing drugs alone in polycystic ovary syndrome (PCOS) with infertility by meta-analysis.
Methods • PubMed, Cochrane Library, Web of Science (WoS), Chinese Biomedical Literature Database (CBM), CNKI, Wan Fang DATA, and VIP databases were searched. The relevant data were manually retrieved. The quality of the included studies was evaluated individually according to the Cochrane systematic evaluation method, and adequate data were extracted. Revman 5.3 software was used for the meta-analysis.
Results • Fourteen randomized controlled trials (1338 patients) were included. The results showed that the experimental group (treated with Dingkun pills combined with ovulation-inducing drugs) was better than the control group (treated with ovulation-inducing drugs) in ovulation rate (95% CI 2.48, 4.70, P < .0001), pregnancy rate (95%CI 2.47, 4.11, P < .00001), endometrial thickness (95%CI 3.12,
3.23, P < .00001), luteinizing hormone (LH) level (95%CI -1.94, -0.71, P < .0001), oestradiol (E2) level (95%CI-22.84, -6.95, P = .0002), overall treatment efficacy (95% CI 2.62, 9.41, P < .00001), biochemical pregnancy rate (95% CI 2.62, 9.41, P < .00001), mature follicle rate (95%CI0.13, 0.84, P = .02), LUFS (luteinized unruptured follicle syndrome) rate (95%CI0.09, 0.63, P = .004), abnormal follicle count (95% CI -4.22, -3.97, P < .00001), ovarian volume (95% CI -3.01, -2.27, P < .00001), immature follicle count (95% CI 0.05, 0.52, P = .002), and mature follicle count (95% CI 0.34, 1.03. Z=3.87. P = .0001).
Conclusions • The efficacy of the experimental group in treating Polycystic Ovary Syndrome with infertility was better than that of the control group. However, the included literature only included Chinese articles. The quality of the study was low. Further high-quality clinical trials are required to confirm these findings. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Observations on the Therapeutic Efficacy of Manual Reduction Combined with Acupuncture and Moxibustion for Atlantoaxial Dislocation Type Cervical Spondylosis |
| Yang Jungang, MD; Wei Mengling, MD; Guo Zhanghai, MD |
| Objective • This study aims to investigate the therapeutic efficacy of manual reduction combined with acupuncture and moxibustion in managing atlantoaxial dislocation in cervical spondylosis.
Methods • A total of 100 patients diagnosed with atlantoaxial dislocation-type cervical spondylosis, admitted to our hospital between July 2021 and July 2023, were randomly allocated into two groups: a control group and an observation group, each comprising 50 cases. The control group received treatment with acupuncture and moxibustion, while the observation group underwent manual repositioning combined with acupuncture and moxibustion. A comparative analysis was conducted on clinical efficacy, carotid artery flow rate, atlantoaxial joint indicators, vertigo symptoms, function evaluation scale scores, and adverse reactions in both groups.
Results • The observation group exhibited a significantly higher total effective rate post-treatment compared to the control group (P < .05). Additionally, post-treatment, the observation group showed lower basilar artery (BA), right
vertebral artery (VA), and left VA compared to the control group, with statistically significant differences (P < .05). Furthermore, the observation group demonstrated reduced differences in the distance between the lateral blocks of the odontoid process and the axis of the odontoid process and atlas, with statistically significant differences (P < .05). Scores for dizziness, head, neck, and shoulder pain, daily life, and work were significantly higher in the observation group after treatment (P < .05). There were no statistically significant differences in adverse reactions between the two groups post-treatment (P > .05).
Conclusions • Manual reduction combined with acupuncture and moxibustion exhibits a notable curative effect on atlantoaxial dislocation-type cervical spondylosis. The treatment effectively alleviates symptoms, reduces cervical artery flow rates, and restores the structure and stability of the atlantoaxial joint. Importantly, it is a safe approach with potential for widespread application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application Value of Conventional Ultrasound Combined with Shear Wave Elastography in Diagnosing Renal Fibrosis in Diabetic Nephropathy |
| Binhong Duan, PhD; Jie Fan, PhD; Min Sun, PhD; Yiwei Wang, PhD; Shifang Yu, PhD; Lutong Zhang, PhD; Xiaodan Zhao, PhD; Guixia Zheng, PhD |
| Background • Diabetic nephropathy is a common acute complication of diabetes mellitus and is the leading cause of chronic kidney disease (CKD) worldwide. Renal fibrosis is a major pathological change in diabetic nephropathy.
Objective • To explore the diagnostic value of shear wave elastography (SWE) for renal fibrosis in patients with advanced diabetic nephropathy.
Design • This was a retrospective study.
Setting • This study was conducted in Heilongjiang Provincial Hospital.
Participants • Sixty patients with diabetic nephropathy renal fibrosis who accepted therapy in our hospital from January 2021 to December 2022 (observation group, OG) and 60 healthy physical examination patients (control group, CG) in the same period were selected for the study.
Interventions • All subjects were examined by conventional ultrasound and SWE.
Primary Outcome Measures • (1) conventional ultrasonic
parameters and SWE parameters and (2) clinical biochemical indicators.
Results • Compared to CG, SCr and BUN in OG were higher, while eGFR in OG was lower (P < .05). Compared to CG, the cortical thickness of OG was less, and the cortical hardness of OG was more (P < .05). Compared to CKD4 patients, eGFR in CKD3 patients was higher, while SCr and BUN in CKD3 patients were lower (P < .05). Compared to CKD4 patients, the cortical thickness in CKD3 patients was higher, and cortical hardness in CKD3 patients was lower (P < .05).
Conclusion • The cortical thickness and cortical hardness parameters in SWE imaging of patients with advanced diabetic nephropathy renal fibrosis are different from those of healthy people. The parameters are also significantly different in patients with different CKD stages and are significantly correlated with SCr, BUN, and eGFR, which can be used for the diagnosis of diabetic nephropathy renal fibrosis. ( |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Effect of Specialist Nursing Intervention and Follow-Up Program on the Outcomes of Heart Failure Patients with Reduced Ejection Fraction Based on Self-Care Theory |
| Liu Ding, PhD; Mingyue Rao, PhD; Yang Zhang, BM; Kun Zhou, PhD |
| Objective • To investigate the impact of a specialist nursing intervention and follow-up program on the outcomes of patients with heart failure suffering from reduced ejection fraction.
Methods • One hundred and twenty patients with heart failure who visited The Second Hospital of Hebei Medical University in China from 2019 to 2021 were recruited in the study and randomly divided into an experimental intervention group (n = 60) and a control group (n = 60). The control group used conventional nursing interventions and the experimental intervention group adopted a professional nursing intervention and follow-up program based on heart failure self-care theory. According to this theory, patients performing self-care measures using their maximum capacity, regain their health faster and more comprehensively. The ability of patients to care for
themselves was assessed using the Heart Failure Self-Care Index. The quality of life of patients was evaluated using the Left Ventricular Dysfunction Scale. Readmission was also investigated in patients.
Results • The experimental intervention group had better self-care and quality of life scores than the control group at one month, three months, and six months after the intervention, with statistically significant differences. The experimental intervention group had lower readmission rates than the control group at one month and three months after the intervention, and the differences were statistically significant.
Conclusion • Specialist nursing interventions and follow-up programs for patients with heart failure improved self-care and quality of life and reduced readmission rates. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Specific Efficacy and Safety in the Clinical Application of Anlotinib for Thymic Carcinoma |
| Jianbo He, MM; Qianfei Liu, MM; Aiping Ning, MM; Aiping Zeng, BM |
| Background • Thymic carcinoma is a rare and aggressive malignancy characterized by high invasiveness, poor prognosis, and limited treatment options post-chemotherapy failure. Anlotinib, a novel tyrosine kinase inhibitor, has shown promise in inhibiting tumor growth and metastasis, suggesting potential as an adjunctive therapy in this challenging clinical setting.
Objective • To evaluate the efficacy and safety of Anlotinib as a potential treatment option for thymic carcinoma post-chemotherapy failure, assessing its impact on tumor progression and patient survival outcomes.
Case Presentation • A 46-year-old female presented with a left supraclavicular mass persisting for one month. Percutaneous needle biopsy of the left mediastinal mass confirmed thymic carcinoma, specifically lowly differentiated squamous cell carcinoma.
Management • The patient underwent sequential treatment modalities, including first-line therapy, comprising four
cycles of cisplatin + paclitaxel, followed by subsequent radiotherapy to the chest and neck. It was followed by second-line therapy involving six cycles of cyclophosphamide + pirarubicin + nedaplatin and third-line therapy consisting of four cycles of gemcitabine and nedaplatin. Notably, fourth-line therapy with Anlotinib monotherapy resulted in a progression-free survival of 10 months.
Outcome • Anlotinib emerges as a potential therapeutic option for thymic carcinoma post-chemotherapy failure. However, further validation through preclinical investigations and clinical trials is warranted.
Conclusion • Despite its limited ability to rapidly reduce tumor size, Anlotinib demonstrates efficacy in inhibiting neovascularization and impeding tumor progression and metastasis, thereby maintaining long-term tumor stability. It highlights its potential as a valuable adjunctive therapy in the management of thymic carcinoma. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Effect of Rifaximin on Small Intestinal Bacterial Overgrowth |
| Liwen Li, MM; Yingying Liu, MM; Shanshan Su, MM; Qingqing Wang, MM; Fang Wei, MM |
| Objective • To compare the clinical efficacy of Bacillus subtilis granules alone versus Bacillus subtilis granules combined with rifaximin in treating small intestinal bacterial overgrowth (SIBO).
Methods • Between March 2019 and March 2021, SIBO patients treated at the hospital were recruited. Eligible patients were randomly assigned to receive either Bacillus subtilis granules alone (control group, n=50) or Bacillus subtilis granules plus rifaximin (observation group, n=50) for 2 weeks. The primary endpoint was symptom relief, assessed using the Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS). Secondary outcomes included SIBO negative rate and overall clinical efficacy.
Results • Patients receiving Bacillus subtilis granules plus rifaximin experienced significantly greater symptom relief compared to the control group, with mean IBS-SSS scores of 178.4 ± 32.1 versus 235.6 ± 45.3 respectively (P < .05). The SIBO negative rate was also higher in the observation group, with 84.00% of patients testing negative compared to 54.00% in the control group (P < .05). Additionally, the
combination therapy showed significantly higher clinical efficacy, with an overall success rate of 92.00% versus 68.00% in the Bacillus subtilis granules alone group (P < .05). No serious adverse events were reported in either group. Mild gastrointestinal side effects such as nausea and diarrhea were noted in 4 patients (8.00%) in the rifaximin plus Bacillus subtilis group, which resolved spontaneously without the need for treatment discontinuation.
Conclusion • The combination of Bacillus subtilis granules with rifaximin significantly improves symptom relief, SIBO negative rate, and overall clinical efficacy compared to Bacillus subtilis granules alone in the management of small intestinal bacterial overgrowth. These findings suggest a synergistic effect of the combined therapy that could be further explored in larger clinical trials. The addition of rifaximin to standard probiotic treatment may provide a more effective approach that can potentially change current protocols for SIBO management and optimize patient outcomes. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Brucea Javanica Oil Combined with Chemotherapy on Serum CYFRA21-1, Immune Mechanism and Prognosis in Lung Cancer Patients |
| Wu Agudamu, MB; Xuan Liu, MD; Yaokai Ma, MB; Xiyi Yang, MB; Baocheng Zhao, MB |
| Objective • To investigate the effect of Brucea javanica Oil combined with chemotherapy on serum cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), immune mechanism, and prognosis in patients with lung cancer and provide a reference for its clinical diagnosis and treatment.
Methods • This study involved 112 lung cancer patients from June 2019 to January 2022 at Shanghai Guanghua Hospital. They were randomly divided into two groups: control (chemotherapy only) and observation (chemotherapy + Brucea javanica oil emulsion). Each treatment lasted three weeks for a total of four courses. Pre- and post-treatment comparisons were made for tumor markers, immune function, and quality of life. Clinical outcomes and adverse reactions were analyzed.
Results • The clinical efficacy of the observation group was significantly higher than that of the control group (P < .05). Compared to the pre-treatment levels, both groups exhibited significant decreases in serum levels of carcinoembryonic antigen (CEA), cytokeratin fragment 21-1 (CYFRA21-1), cancer antigen 125 (CA125), phosphorylated extracellular signal-regulated kinase (pERK), neuron-specific enolase
(NSE), and vascular endothelial growth factor (VEGF). The reduction in these serum markers was more pronounced in the observation group (P < .05). After treatment, both groups demonstrated significant increases in CD8+ and CD3+ lymphocyte levels, as well as CD4+ lymphocyte levels and the CD4+/CD8+ ratio. However, the improvement in these immune indicators was more significant in the control group (P < .05). Furthermore, the quality of life, as assessed by the Quality-of-Life Questionnaire-Lung Cancer Module 13(QLQ-LC13) questionnaire, showed significant improvements in both groups after treatment. The observation group exhibited a more significant decrease in the QLQ-LC13 scores, indicating a better quality of life post-treatment (P < .05).
Conclusion • Brucea javanica oil combined with GP chemotherapy can effectively reduce the synthesis and secretion of tumor-related markers, improve immune function, reduce the incidence of adverse reactions, improve the prognosis and quality of life, and enhance the curative effect, which has a certain clinical application value. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Meta-Analysis of Platelet-Rich Plasma in the Treatment of Lower Extremity Venous Ulcer |
| Yali Du, MM; Yanyang Wang, MM; Jie Zhang, MM; Liang Zhao, MD; Hui Zhao, MM |
| Objectives • The therapeutic effect of platelet-rich plasma on lower extremity venous ulcers was systematically analyzed.
Methods • A computerized system search was conducted to screen literature that met the inclusion criteria using the method of “subject words + free words.” Keywords included “platelet-rich plasma,” “lower extremity venous disease,” “lower extremity chronic venous insufficiency,” “venous ulcer,” and “lower extremity venous ulcer.” Literature that met the inclusion criteria was searched in four commonly used Chinese databases (HowNet, Chinese biomedical literature, Wanfang, and VIP) and three commonly used foreign databases (Embase, PubMed, and Cochrane Library). The search period extended from the establishment of the databases to December 2021. After extracting the relevant data, a meta-analysis was performed using RevMan 5.3 software to compare the overall effective rate and adverse effects of platelet-rich plasma in the treatment of lower extremity venous ulcers.
Results • The meta-analysis of the overall efficacy rate in the four selected papers showed no heterogeneity among the studies (P = .35 > 0.1, I2 = 0% < 50%); therefore, a fixed-effect model was used to combine the statistical data. The software analysis results indicated a significant difference in the overall efficacy rate between the experimental group and the control group (OR = 2.09, 95% CI = 1.23-3.34, P = .002), with the experimental group showing better results than the control group. The analysis of the four selected papers also suggested potential differences in adverse reactions between the two groups after treatment, but the comparison of safety differences was not significant (OR = 2.13, 95% CI = 0.45-6.79, P = .17).
Conclusion • Platelet-rich plasma is effective in the treatment of lower extremity venous ulcers; however, there is no clear safety advantage. This finding needs to be confirmed by large-scale, multi-center research. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Application Value of Fast-track Rehabilitation Nursing in Patients with Acute Cervical Spinal Cord Injury Undergoing Surgery |
| Liwen Guo, BM; Jianhua Tang, MBBS; Yinghui Xue, BM; Xinming Yang, BM; Maili Zhang, BM; Ying Zhang, BM; Guoqing Zheng, BM |
| Objective • This study evaluates the efficacy of fast-track rehabilitation nursing in surgical patients with acute cervical spinal cord injury.
Methods • Fifty-four patients with acute cervical spinal cord injury who underwent surgery at our hospital from July 2016 to July 2020 were selected and randomly divided into a control group and an experimental group, with 27 patients in each group. The control group received routine perioperative nursing care, including preoperative guidance, intraoperative monitoring, postoperative pain management, and prevention of complications. The experimental group received fast-track rehabilitation nursing in addition to the routine care. The key components of the fast-track approach included preoperative health education and psychological counseling, early postoperative mobilization and assisted lower limb function training, resumption of oral intake within 24 hours after surgery, enhanced pain management, and preventive measures against complications.
Results • The experimental group had a significantly shorter time to first voluntary movement and first oral intake after surgery, compared to the control group (both P < .05). The postoperative VAS pain score was also significantly lower in the experimental group than in the
control group (P < .05). Regarding ASIA grading improvement, in the control group, 4 of 12 patients with grade B improved to grade C, 3 improved to grade D, 5 of 13 patients with grade C improved to grade D, 6 improved to grade E, and 2 patients with grade D all improved to grade E, with an overall improvement rate of 74.07%. The improvement rate was significantly higher in the experimental group, reaching 96.30% (P < .05). The experimental group had significantly higher ADL scores (P < .05) and lower SAS and SDS scores (P < .05) than the control group. The in-hospital complication rate was 25.93% in the experimental group and 59.26% in the control group, with a significant difference (P < .05), while the follow-up complication rates were not significantly different between the two groups (P > .05).
Conclusion • Fast-track rehabilitation nursing significantly improves surgical outcomes in patients with acute cervical spinal cord injury. This approach enhances ASIA grading, accelerates postoperative recovery, improves daily living activities, reduces negative emotions, and lowers the risk of complications. This nursing model is an ideal application for this patient population. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Internet + Combined with Continuous Nursing Care on Pain Degree and Quality of Life in Patients with Herpetic Neuralgia |
| Yanan Duan, MBBS; Xiaoli Guo, MBBS; Shuyu Ma, MBBS; Yunzhong Sun, MM; Ying Zhang, MBBS; Li Zhang, MM; You Zhou, MBBS |
| Objective • To explore the effects of “Internet+” combined with continuous nursing care on pain intensity and quality of life in patients with herpetic neuralgia.
Methods • This randomized controlled trial involved 102 herpetic neuralgia patients treated from July 2019 to August 2022. Patients were randomly assigned to a control group (routine nursing care, n=51) or a study group (“Internet+” continuous nursing care, n=51). The study group received internet+ nursing intervention that included symptom monitoring, medication management, and patient education. The researchers compared the two groups in terms of symptom resolution time, treatment duration, pain scores (VAS, NRS), self-efficacy (GSES), quality of life (QOL), and sleep quality (PSQI).
Results • The symptom resolution time (8.56 vs 6.18 days, P < .05) and treatment duration (12.74 vs 9.08 days, P < .05) were significantly shorter in the study group compared to the
control group. The VAS (5.33 vs 3.98, P < .05) and NRS (6.18 vs 4.17, P < .05) pain scores were significantly lower in the study group at the end of the intervention. The GSES self-efficacy scores were significantly higher in the study group (29.19 vs 34.88, P < .05). The QOL scores were significantly improved in the study group at the end of the intervention (64.28 vs 78.41, P < .05). The PSQI sleep quality scores were significantly better in the study group (12.71vs 9.03, P < .05).
Conclusion • The “Internet+” combined with continuous nursing care intervention had a significant positive impact on pain intensity, quality of life, self-efficacy, and sleep quality in patients with herpetic neuralgia. This integrated approach utilizing digital health technology and personalized nursing care is a promising strategy to improve clinical outcomes for this patient population and should be further promoted in clinical practice. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Impact of Clinical Nutrition Intervention on the Prognosis of Patients with Chronic Liver Failure |
| Chunchun Yang, MM; Dawei Yang, MM; Sui Zhang, MM; Rui Zhang, MM |
| Objective • The objective of this study was to investigate the impact of a comprehensive clinical nutrition intervention on biochemical indicators of liver function, nutritional status, and hospitalization outcomes in patients with chronic liver failure.
Methods • This was a prospective, controlled observational study conducted over 12 months. The study population consisted of 150 adult patients diagnosed with chronic liver failure, who were recruited from the hepatology clinics at a tertiary care hospital. Patients were divided into two groups: a control group (n=75) receiving standard dietary counseling as part of their routine care, and an observation group (n=75) receiving a comprehensive clinical nutrition intervention. The nutrition intervention provided to the observation group included a balanced diet with an optimal macronutrient ratio, high-quality protein sources, a broad spectrum of essential micronutrients tailored to the needs of liver disease patients, and individualized energy and fluid requirements. Biochemical markers of liver function, including liver enzymes, bilirubin, and albumin, were assessed at baseline and at 3-month intervals throughout the 12-month study period. Nutritional status was evaluated using anthropometric measurements, such as body weight, BMI, and MAMC. Hospital admission rates and lengths of stay were also monitored.
Results • Patients in the observation group receiving the comprehensive clinical nutrition intervention demonstrated significant improvements in markers of liver function and nutritional status compared to the control group receiving standard dietary counseling. In terms of liver function,
the nutrition group exhibited a 25% average decrease in liver enzymes (ALT, AST, ALP, GGT), a 18% reduction in serum bilirubin levels, and a 12% increase in serum albumin levels, all of which were statistically significant compared to the control group (P < .001, P < .01, and P < .001, respectively). The nutrition intervention also had a positive impact on nutritional status. Patients in the observation group experienced a 4.2 kg increase in body weight, a 1.5 unit improvement in BMI, and an 8% increase in mid-arm muscle circumference, which were all significantly greater than the changes observed in the control group (P < .01, P < .05, and P < .001, respectively). Importantly, the comprehensive nutrition intervention was also associated with improved healthcare utilization. The rate of hospital admissions was 30% lower in the nutrition group compared to the control group (P < .01), and the average length of hospital stay was reduced by 2.1 days (P < .05).
Conclusion • These findings suggest that integrating a comprehensive clinical nutrition intervention into the standard management of chronic liver failure could significantly enhance patient outcomes. The multifaceted benefits, including improved liver function, nutritional status, and reduced healthcare utilization, underscores the importance of a holistic, nutrition-based approach to the care of individuals with this debilitating condition. Future research should further investigate the long-term impacts of this intervention and explore the potential for personalized nutrition strategies based on individual patient characteristics. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Impact of Behavioral Nursing Intervention on Breastfeeding Maintenance Rate of Hospitalized Newborns |
| Li Fang, BD; Siqiong Jiang, BD; Yi Meng, BD; Dou Zang, BD |
| Background • In recent years, China has actively promoted the publicity and promotion of breastfeeding, because breastfeeding is conducive to the healthy growth of babies and conducive to the recovery of maternal health. Behavioral nursing theory holds that individual behavior change is a complex and continuous process, and personalized care is given at different stages of individual behavior change to promote individual behavior change.
Objective • To explore the impact of behavioral nursing intervention on the breastfeeding maintenance rate of hospitalized newborns.
Design • This was a prospective cohort study based on the description provided.
Setting • This study was conducted in the Department of Pediatrics, Shanghai Six People’s Hospital/Shanghai Six People’s Hospital Affiliated with Shanghai Jiaotong University School of Medicine, because the author worked in the hospital.
Participants • A total of 120 cases of parturients in our hospital from January 2021 to December 2022 were chosen and separated into a control group and an observation group through the random number table method. Inclusion criteria: Parturients were full-term single pregnancies, examined in our hospital, and there were no abnormalities in prenatal examination. Exclusion criteria: Parturients with a history of mental illness, accompanied by hepatitis B, three Yang, acquired immune deficiency syndrome and other infectious diseases, and combined with visual and hearing disorders.
Interventions • The control group adopted routine breastfeeding nursing
intervention, including training in the prenatal maternity school, instruction in breastfeeding methods during hospital delivery and follow-up after discharge. The observation group adopted behavioral nursing intervention, the corresponding health guidance and nursing methods were formulated and implemented in the second trimester, the third trimester, the hospitalization period of childbirth, and the discharge, and at each stage.
Primary Outcome Measures • (1) Degree of knowledge about breastfeeding, (2) Efficiency of breastfeeding, (3) Rate of exclusive breastfeeding, (4) Nutritional index, (5) Cognitive ability of newborns, (6) Satisfaction of family members with nursing.
Results • After the intervention, the score of feeding knowledge in the observation group was elevated relative to the control group (P < .05). The self-efficacy scores and rates of exclusive breastfeeding in the observation group at 1, 6 weeks, and 6 months after delivery were higher relative to the control group (P < .05). After the intervention, the levels of albumin, albumin, and transferrin in the observation group were higher relative to the control group (P < .05). After the intervention, the scores of the mental development index and psychomotor development index in the observation group were elevated relative to the control group (P < .05).
Conclusion • Behavioral nursing can effectively improve the effectiveness of breastfeeding and facilitate the health and growth of mothers and newborns, aligning with the broader goals of promoting breastfeeding in healthcare settings. ( |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Efficacy of Panax Notoginseng Suppository for Hormone-Resistant Ulcerative Colitis and its Effect on Inflammatory Factors |
| Xiaohai Li, MD; Yu Liu, MD; Qingge Lu, MD; Yingjie Sun, MD; Li Zeng, MD |
| Objective • To assess the clinical efficacy of Panax notoginseng suppository for hormone-resistant ulcerative colitis and its effect on inflammatory factors.
Methods • From January 2017 to January 2020, 84 patients with hormone-resistant ulcerative colitis were included in the present study and were randomly assigned at a ratio of 1:1 to receive either mesalazine enteric tablets and cyclosporine A (control group) or Panax notoginseng suppository plus mesalazine enteric tablets and cyclosporine A (study group), with 42 cases in each group. Clinical outcomes and inflammatory factor levels were used as outcome measures.
Results • The study group showed significantly higher treatment efficiency than the control group (P < .05).
Patients in the study group had significantly lower modified Mayo score, Baron endoscopy score, interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-a (TNF-a) levels, and higher inflammatory bowel disease questionnaire (IBDQ) scores versus those in the control group (P < .05). There was no significant difference in the incidence of adverse reactions and the colonic resection-free survival between the two groups (P > .05).
Conclusion • Panax notoginseng suppository adjuvant treatment substantially improves clinical efficacy, reduces inflammatory factor levels, and enhances quality of life in hormone-resistant UC patients. However, before further advancement, more clinical trials are warranted. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application of Evidence-Based Nursing Model Based on Innovation Diffusion Theory Framework and Its Impact on Neurological Function in Elderly Acute Ischemic Stroke Patients |
| Ping Xu, BM; Xiaoyang Yang, BM; Juhui Yang, BM; Xia You, BM |
| Objective • This study aims to compare the effectiveness of an evidence-based nursing model, guided by the innovation diffusion theory framework, with conventional nursing care on improving neurological function and quality of life in elderly patients with acute ischemic stroke.
Methods • This retrospective study included 200 elderly acute ischemic stroke patients who received treatment in our hospital from January 2020 to December 2022. Among them, 100 patients received conventional basic nursing care (control group), while the remaining 100 patients received an evidence-based nursing model based on the innovation diffusion theory framework (observation group). The intervention duration for both groups was three weeks. Neurological function was assessed using the National Institutes of Health Stroke Scale (NIHSS), which evaluated various domains of neurological function. Neuroendocrine hormone levels, including plasma renin activity (PRA), angiotensin II (AngII), aldosterone (ALD), and norepinephrine (NE), were measured using specific assays. Quality of life was assessed using the Life Health Function Questionnaire (LHFQ) and the Physical and Uplifting Emotional Support Evaluation Scale (PULESE). Negative emotions and sleep quality were evaluated using the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and the Pittsburgh Sleep Quality Index (PSQI).
Results • The baseline data between the two groups were comparable, with no statistically significant differences observed (P > .05). At the end of the treatment and 6 months after nursing care, the observation group
demonstrated significantly greater improvement compared to the control group, with statistically significant differences (P < .05). Specifically, the observation group showed significant improvement in neurological function, as measured by NIHSS, compared to the control group. Furthermore, the observation group exhibited lower levels of PRA, AngII, ALD, and NE compared to the control group, with statistically significant differences (P < .05). In terms of quality of life, the observation group had higher scores on the LHFQ and the PULESE compared to the control group, indicating a better quality of life (P < .05). Additionally, the observation group had lower scores on the SAS and SDS, indicating lower levels of negative emotions, and better sleep quality as indicated by the PSQI compared to the control group (P < .05). These findings highlight the positive effects of the evidence-based nursing interventions on neurological function, neuroendocrine hormone levels, quality of life, negative emotions, and sleep patterns in elderly patients with acute ischemic stroke.
Conclusion • The application of an evidence-based nursing model based on the innovation diffusion theory framework can effectively improve neurological function and quality of life, reduce SAS and SDS scores, improve neuroendocrine hormone levels, and enhance sleep quality in elderly acute ischemic stroke patients. It is worth promoting and applying this model. These improvements may be attributed to the targeted, theory-guided interventions of the evidence-based nursing model, which addresses specific needs of stroke patients to enhance recovery and well-being. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Application Effect of a Quantitative Evaluation System Based on Nursing-sensitive Indicators in Patients with Rheumatoid Arthritis |
| QiaoLi Gao, MM; Yu Yu Jiang, MD; Ting Pan, BS; ZhenZhen Wang, BS; Yan Wang, BS; XiaoHua Zhang, BS |
| This study aims to assess the effectiveness of comprehensive care guided by a quantitative evaluation system of nursing-sensitive indicators on clinical outcomes in patients with rheumatoid arthritis. A total of 88 patients with RA were randomly assigned to a control group, receiving routine care, and the observation group received comprehensive nursing care according to nursing sensitive indicators, including (1) psychological nursing. (2) Pain care. (3) Discharge nursing. The quantitative evaluation system based on nursing-sensitive indicators (including clinical symptom control, quality of life, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (R.F.) levels and pain scores, self rating anxiety scale (SAS), self-rating depression scale (SDS), visual analogue
scale (VAS), Pittsburgh sleep index scale (PSQI)) was compared Differences in scores, shame scale scores, and nursing satisfaction. Compared with the control group, the observation group showed significant improvements in joint tenderness, morning stiffness, ESR, CRP, rf levels and quality of life, while scores of anxiety, depression, pain, sleep disturbance and shame were also significantly reduced (P < .05). Comprehensive nursing improved nursing satisfaction of ra patients, and decreased negative emotion score, VAS score, PSQI score and sense of shame. Comprehensive nursing can improve the clinical control of patients, which highlights the value of comprehensive nursing. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Randomized Clinical Trial on the Outcome of Integrating Opium Oil Emulsion into First-Line Chemotherapy for Lung Cancer |
| Li Hua, MB; Jun Li, MB; Hongliang Xu, MB; Aiping Zeng, PhD |
| Objective • To conduct a randomized clinical trial on the outcome of integrating opium oil emulsion alongside first-line Epirubicin and Cyclophosphamide (EC) chemotherapy for non-small cell lung cancer.
Methods • Ninety small cell lung cancer patients from June 2018 to May 2022 were randomized into control (EC chemotherapy) and observation groups (EC + opium oil emulsion, both IV and oral post-discharge). Differences in serum inflammatory factors, chemokine receptor 4 (CXCR4), matrix metalloproteinase-9 (MMP-9), immune function, and quality of survival scores were compared pre- and post-treatment.
Results • The treatment efficiency of patients in the observation group was significantly higher than that of the control group (P < .05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P < .05). Compared to pre-treatment, the levels of CD8+ significantly increased in both groups
after treatment, while the levels of CD3+, CD4+, and CD4+/CD8+ significantly decreased in both groups after treatment. These indicators improved more significantly in the control group (P < .05). Compared to the levels before treatment, the serum tumor necrosis factor-alpha (TNF-a), interleukin-10 (IL-10), interleukin-6 (IL-6), C-reactive Protein (CRP), CXCR4, and MMP-9 levels, and the Quality of Life Questionnaire - Lung Cancer 13 (QLQ-LC13) scores were reduced, with more significant reduction in the observation group (P < .05).
Conclusion • The treatment of small cell lung cancer patients with opium bile oil emulsion combined with EC chemotherapy can effectively reduce the body’s inflammatory response and chemokine level, improve immune function, reduce the incidence of adverse reactions, improve disease prognosis and quality of life, enhance the efficacy, and has certain clinical application value. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Protective Efficacy of T-type, Calcium Channel Antagonist on Auditory Function in Cdh23 Erl/Erl Mice |
| Ying Cheng, MD; Ying Gao, MD; Juan Hu, MD; Heng Li, MM; Weijun Ma, MD; Min Xu, MD; Xiaotong Zhang, MD |
| Context • In normal physiological conditions, calcium ions (Ca2+) have an important effect in terms of the regulation of hair cell (HC) functions, and T-type calcium antagonists may be protective against hearing loss. However, no studies have occurred related to a T-type calcium-channel antagonist with regard to otoprotection in a Cdh23 mouse model.
Objective • The study intended to examine the protective efficacy of ethosuximide—a T-type calcium-channel antagonist—against age-related hearing loss in a Cadherin 23 (Cdh23) erl/erl mouse model, to potentially offer an insight and foundation for therapy in the near future for patients in clinical practice who suffer from age-related hearing loss.
Design • The research team conducted an animal study.
Animals • The animals were 12 male and 12 female, Cdh23 erl/erl mice.
Intervention • The research team randomly divided the mice into two groups, with 12 mice in each group: (1) the control group, the saline group, which received saline at 10 mL/kg of body weight, and (2) the intervention group, the ethosuximide group, which received ethosuximide at 10 mL/kg of body weight. Both groups received the treatments intraperitoneally every other day, beginning postnatally at 7 days until the mice were 8 weeks old.
Outcome Measures • For both groups, the research team: (1) measured auditory brainstem response (ABR); (2) measured distortion product otoacoustic emission (DPOAE) at 4, 6, and 8 weeks of age; (3) separated the basilar membrane from the modiolus and lateral tissues and
determined the percentage of inner-and-outer hair-cell (IHC and OHC) loss; (4) investigated relative levels of apoptosis-related gene mRNA using reverse transcription polymerase chain reaction (PCR); and (5) examined relative levels of apoptosis-related protein, using immunofluorescent (IF) staining.
Results • Compared to the saline group, the ethosuximide group: (1) had significantly lower ABR thresholds for click at 8 weeks, for 8 KHz at 6 and 8 weeks, and for 16 KHz and 32 KHz (all P < .01); (2) had significantly higher DPOAE amplitudes at 4 weeks at 15.4 KHz and 17.7 KHz (both P < .01); at 6 weeks at 8.8 KHz (P < .05), 10.1 KHz (P < .01), 11.7 KHz (P < .01), 13.4 KHz (P < .01), 15.4 KHz (P < .01), and 17.7 KHz (P < .01); and at 8 weeks at 6.7 KHz (P < .05), 7.7 KHz (P < .05), 10.1 KHz (P < .01), 11.7 KHz (P < .01), 13.4 KHz (P < .01), 15.4 KHz (P < .01), and 17.7 KHz (P < .01); (3) had significantly lower OHC loss in the middle and basal turns of the cochlea’s surface (both P < .05); (4) at the age of 2 months, had significantly lower mRNA relative levels of apoptosis-related genes, including caspase-3, caspase-9, caspase-12, m-calpain and u-calpain, as found using a polymerase chain reaction (PCR); and (5) had weaker protein levels of caspase-3 and caspase-9 in the inner ears, as found using immunofluorescent (IF) staining.
Conclusions • T-type calcium-channel antagonists can exert protective efficacy in terms of the hearing function among cdh23 erl/erl mouse. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Nursing Application of Somatosensory Interactive Games Combined with Cognitive Training in Patients with Stroke |
| Weiyan Chen, MM; Xiaohua Li, BS; Xiaoping Wu, MM; Xiaoli Yuan, BS |
| Objective • This study aims to explore the nursing effect of somatosensory interactive games combined with cognitive training in patients with stroke.
Method • A retrospective analysis was conducted of 98 patients with stroke who were admitted to Taizhou Central Hospital in China between June 2020 and June 2021. The patients were assigned to either the control group or the intervention group according to different treatment regimen. The control group received routine nursing care, while the intervention group also received somatosensory interactive game combined with cognitive training. Researchers compared the differences in cognitive ability, motor function, ability to perform activities of daily living (ADL), rehabilitation exercise compliance, quality of life (QoL) and treatment effectiveness in the 2 groups of patients before and after the intervention.
Results • The Montreal Cognitive Assessment (MoCA) test scores of patients in the intervention group were significantly improved compared with the control group in terms of spatial and executive ability, naming ability, attention,
language ability, abstract ability, delayed recall and directional ability. The Fugl-Meyer Assessment of Sensorimotor Recovery After Stroke (FMA) scores in patients in the intervention group were significantly improved compared with the control group, the simplified version of the Barthel Index of Activities of Daily Living scores in patients in the intervention group were significantly improved compared with the control group, and the rehabilitation exercise compliance score in patients was also significantly improved. The quality of life (QoL) score and treatment effectiveness rate were significantly improved compared with the control group, and there were significant differences in various outcome indicators (P < .05).
Conclusion • The application of somatosensory interactive games combined with cognitive training in patients with stroke can significantly improve their cognitive ability, motor function and ADL ability, improve their rehabilitation exercise compliance, QoL and treatment effectiveness. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Ivabradine in the Treatment of Heart Failure and its Effect on Serum miR-499 |
| Qian-Qian Guan, MD; Hao-Jin Ren, BD; Guo-Ran Ruan, MD |
| Objective • To analyze the efficacy of ivabradine in the treatment of chronic heart failure (CHF) and the effect on serum microRNA-499 (miR-499).
Methods • A total of 94 CHF patients who visited our hospital from October 2019 to March 2022 were selected and divided into two groups according to the different treatment methods, with 47 cases in each group. The efficacy and adverse reactions were compared between the two groups. Serum miR-499 levels, cardiac function indicators [left ventricular ejection fraction (LVEF), cardiac output (CO)], ventricular remodeling indicators, and other indicators were observed before and three months after medication. Myocardial fibrosis index [type I collagen (ICTP), hyaluronic acid (HA), connective tissue growth factor (CTGF), laminin (LN) and procollagen type III amino-terminal peptide (PIIINP)], and the Pearson correlation was used to analyze the correlation between serum miR-499 level and cardiac function, ventricular
remodeling and myocardial fibrosis in patients with CHF.
Results • The total effective rate in the study group was significantly higher than that in the control group (95.74% vs. 82.98%, P < .05). The levels of miR-499, LAP, LVEDD, LVPW, LVMI, HA, LN, CTGF, PIIINP, and ICTP in the study group were significantly lower than those in the control group. The LVEF, CO, and LVRI in the study group were significantly higher than those in the control group after three months of treatment (P < .05). Serum miR-499 levels of CHF patients at admission were negatively correlated with LVEF, CO, and LVRI, while LAP, LVEDD, LVPW, LVMI, HA, LN, CTGF, PIIINP, and ICTP were positively correlated (P < .05).
Conclusion • Ivabradine can effectively treat CHF and improve cardiac function, remodeling, and myocardial fibrosis in patients. The mechanism may be related to the down-regulation of miR-499 level. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Buzhong Yiqi Decoction Combined With Traditional Perfusion Therapy for Improved Immune Function and Prognosis for Bladder Cancer |
| Jinwei Ke, MD; Xukun Li, MM; Yiquan Tang, MM |
| ABSTRACT
Context • Surgery is the main treatment for bladder cancer, but the probability of recurrence is significant. Perfusion chemotherapy can improve the absorption of drugs for patients but are still unable to meet clinical needs to reduce the postoperative recurrence rate. Clinicians currently seek a highly effective, easily tolerated, and less-irritating, postoperative adjuvant treatment for bladder cancer.
Objective • The study intended to explore the effects of the Buzhong Yiqi decoction combined with traditional, bladder perfusion therapy on the immune function and prognoses of bladder-cancer patients and to analyze the combination’s clinical efficacy and its effects on patients’ QoL.
Design • The research team conducted a randomized controlled trial.
Setting • The study took place at the Affiliated Traditional Chinese Medicine Hospital at Southwest Medical University in Luzhou City, Sichuan Province, China.
Participants • Participants were 88 patients with middle-to-late-stage, non-muscular invasive bladder cancer who had been admitted to the hospital between March 2019 and March 2022.
Interventions • The research team randomly divided participants into two groups, the intervention and control groups, with 44 participants each. Both groups received treatment with traditional bladder infusion therapy, and the intervention group also received treatment with a Buzhong Yiqi decoction.
Outcome Measures • The research team: (1) assessed treatment efficacy; (2) measured immune function, using cluster of differentiation 4 (CD4+), CD8+, and natural killer (NK) cell activity; (3) evaluated quality of life (QoL), using the 36-Item Short Form Survey (SF-36); (4) measured serum vascular endothelial growth factor (VEGF) levels, (5) counted the incidence of adverse reactions, and (6) identified the recurrence rate postintervention at 12 months.
Results • Compared to the control group: (1) the intervention group’s treatment effectiveness rate was significantly higher, at 63.64% compared to the control group’s 22.73%; (2) immune function—levels of CD4+ and CD8+ and NK cell activity—postintervention was significantly higher (all P < .001); (3) QoL at 3 months and 6 months was significantly higher (both P < .001); (4) serum VEGF level postintervention was significantly lower (P < .001); (5) incidences of pernicious vomiting (P = .041); of urinary urgency, frequency, or abnormality (P = .017); of Hematuresis (P = .004); and of low-grade fever (P = .004) were significantly lower (P < .05); and (6) six-month recurrence rate, at 13.64%, was significantly lower, compared to the control group’s 34.09%.
Conclusions • For patients after surgery for bladder cancer, the combination of a Buzhong Yiqi decoction and traditional bladder infusion therapy can effectively enhance patients’ immune function, reduce complications and recurrence rate, and improve clinical efficacy and safety and is worthy of clinical use. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Risk of Acute Kidney Injury Complications After Aortic Dissection and the Value of Perioperative Cluster Nursing |
| Yuping Han, BD; Na Li, MD; Tingting Liu, BD; Xiaoli Liu, BD; Jinjin Pan, MD; Shanshan Song, BD; Fei Wang, BD |
| Background • Emergency aortic dissection affects 5 to 10 per 100 000 individuals with a fatality rate exceeding 30%.
Objective • The study investigates acute kidney injury (AKI) as a complication following acute aortic dissection and the effect of cluster nursing measures.
Methods • Single-factor and multi-factor model analysis screened risk factors for postoperative renal injury complications after acute aortic dissection. Cluster nursing measures were implemented during the perioperative period. Changes in renal function and AKI incidence before and after surgery between the 2 groups were compared.
Results • Logistic regression model analysis identified increased preoperative SCr levels, prolonged cardiopulmonary bypass time, and protracted aortic
occlusion time as independent risk factors for AKI following acute aortic dissection surgery (P < .05). A high postoperative oxygenation index appeared to be a protective factor (P < .05). On day 1 and 3 after surgery, serum SCr and Cys-C levels in cluster nursing group were lower than those in routine nursing group. The incidence of postoperative AKI in the cluster nursing group was 2.86%, significantly lower than that in routine care group (17.14%, P < .05).
Conclusion • Perioperative cluster nursing measures for acute aortic dissection patients can reduce renal injury caused by surgery and reduce the incidence of AKI. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Application Value of Comprehensive Nursing Intervention in Lung Cancer Nursing and Influence Evaluation of Patient's Satisfaction with Nursing |
| Beibei Hu, BM; Qin Wang, BM |
| Objective • To investigate how patients with lung cancer respond to comprehensive nursing intervention and how that responds to nurse satisfaction.
Methods • Retrospective analysis of clinical data of lung cancer patients 72 treated in my eye from January 2020 to January 2022 in the First Affiliated Hospital of Soochow University.Patients were divided into control and observation groups according to different nursing methods, with 36 cases in each group. The control group received routine nursing intervention, while the observation group received comprehensive nursing intervention. The groups’ nutritional status, nursing satisfaction, and incidence of complications were compared, and the assessment of psychological resilience, cancer-related tiredness, hope level, psychological state, and self-efficacy were compared.
Results • Patients in the observation group had markedly better nutritional status than those in the control group (P < .001). The number of complications was lower in the observation group than in the control group, and the nursing satisfaction score was higher than in the control group (P < .001). The resilience score, self-improvement score, optimism
score, and total score of the Connor-Davidson Resilience Scale (CD-RISC) of patients in the observation group were higher than those in the control group (P < .001). Piper Fatigue correction scale (RPFS) scores were lower in the observation group in all four categories (cognitive, emotional, behavioral, and physical) compared to the control group (P < .001). Herth Hope Index (HHI) scores for the observation group were greater than those of the control group in all four subscales (attitude, action, intimate relationships, and subscale total) (P < .001). Health Questionnaire (PHQ) and generalized anxiety scale (GAD-7) ratings in the observation group decreased following nursing compared to the control group (P < .001). With nursing, patients in the observation group had higher coping, decompression, enjoying life, and role scores on the Chinese version of Strategies Used by Persons to Promote Health (SUPPH) than those in the control group (P < .001).
Conclusion • Comprehensive nursing intervention helps patients with lung cancer feel less tired and less sad. It also helps create a more peaceful medical environment, which is why it should be spread and used more. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Omaha System-Based Continuing Care on Quality of Life of Benign Prostatic Hyperplasia Patients After Transurethral Resection of The Prostate: A Randomized Controlled Trial |
| Huiping Li, MSc; Jing Liu, MSc; Di Luo, MSc; Jun Wang, MSc; Yue Wu, MSc; Mingzhao Xiao, MSc; Lijun Yang, BS |
| Background • Patients with benign prostatic hyperplasia (BPH) often undergo transurethral resection of the prostate (TURP) to relieve their symptoms. Postoperative care for patients after TURP is essential to improve patient prognosis.
Objective • This study was performed to explore the impact of routine care or Omaha system-based continuing care on quality of life and complication rates in patients with benign prostatic hyperplasia after transurethral resection of the prostate.
Methods • A total of 92 eligible patients undergoing transurethral resection of the prostate between November 2020 and November 2021 in the First Affiliated Hospital of Chongqing Medical University were enrolled. The patients were randomly assigned to either the Omaha group or the control group, with 46 in each group. The patients in Omaha group received Omaha system-based continuous care. The patients in the control group received routine nursing. The modified BPH Quality of Life Scale (BPH-
QLS) and complications were evaluated on the day of discharge and at 2 weeks and 1/3/6 months after operation.
Results • Scores related to disease-specific BPH-QLS showed significant improvement in the Omaha group. Specifically, the Omaha group was significantly better than the control group in the BPH-QLS scores in disease dimension, physical dimension, social dimension, psychological dimension, and satisfaction dimension, and in the total BPH-QLS score (all P < .05). The incidence of complications in the Omaha group was lower than that in the control group but with no significant difference between the two groups (P > .05).
Conclusions • Omaha system-based continuous care significantly improved various dimensions of quality of life in BPH patients after TURP, enhancing their satisfaction and overall BPH-QOL. However, it did not show a significant reduction in postoperative complications. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Effect of Anlotinib Capsule on VEGF Level and Survival Period in Elderly Patients with Advanced NSCLC |
| Yuanyuan Chen, BD; Fangbo Cui, BD; Jianmin Shi, BD; Hui Wang, BD |
| Objective • This study aims to investigate the effect of anlotinib capsules on vascular endothelial growth factor (VEGF) levels and the survival of patients with advanced non-small cell lung cancer (NSCLC) treated with anlotinib capsules.
Method • 63 elderly patients with advanced NSCLC diagnosed by pathological examination in our hospital from January 2019 to January 2022, who had previously received at least first- and second-line systemic chemotherapy, were selected as study subjects and divided into the anlotinib group (n=32) and the placebo group (n=31) according to treatment with or without anlotinib. The disease control rate (DCR), overall survival (OS), progression-free survival (PFS), adverse effects, and changes in VEGF level before and after treatment were recorded in both groups.
Result • The DCR was higher in the anlotinib group (87.50%)
than in the placebo group (70.97%), the PFS and OS were significantly higher in the anlotinib group (4.78±0.36 months for PFS, 13.55±1.42 months for OS) than in the placebo group (1.32±0.25 months for PFS, P = .029 and 9.41±1.33 months for OS, P = .013). After treatment, the serum VEGF level in the anlotinib group was significantly lower than that in the placebo group (P < .05). Common adverse reactions were hypertension, hand-foot syndrome, abnormal thyroid function, which could be controlled with symptomatic treatment, anrotinib dose reduction or discontinuation, and no drug-related death occurred.
Conclusion • Anlotinib has significant efficacy in the clinical treatment of advanced NSCLC in the elderly, prolonging patients’ PFS and OS and reducing serum VEGF levels. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effect of Percutaneous Electrical Stimulation on Enuresis in Children: A Systematic Review and Meta-Analysis |
| Chunwu Chen, BS; Yao Chen, BS; Xiaoyan Huang, MD; Guoliang Pan, BS; Chunsheng Tian, PhD; Yongbai Wang, BS; Xiuzhen Wang, BS; Ying Xu, BS |
| Objective • This study aimed to consider the therapeutic impact of percutaneous electrical stimulation (PES) on enuresis in children.
Methods • A comprehensive analysis of relevant studies published before September 2021 was conducted by reviewing electronic databases PubMed (n = 2431), Wanfang (n = 876), Cochrane (n = 90), ScienceDirect (n = 500), CNKI (n = 504), and TCM (n = 500) databases. All randomized controlled studies evaluating the effects of PES on pediatric enuresis were considered. Children who frequently wet the bed after age 5 were included in the study.
Results • After assessing eligibility, the final meta-analysis included in total of 8 articles, and 303 pediatric enuresis patients were involved. The results obtained confirmed that PES was significantly and independently related to a reduced risk of enuresis in children. Pooled RR was 0.67 [95% CI: .50, .92] (P = .01).
Conclusion • This meta-analysis showed an association between PES and its efficacy in pediatric enuresis, which in addition, demonstrated that PES can reduce the occurrence of enuresis in children. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Establishment and Study of a Risk Factor Model for Early Cervical Intraepithelial Neoplasia in Young Women |
| Ning Bai, MM; Hongli Wang, MM; Shuyun Zhao, MM |
| Objective • This study aims to explore the complex model of risk factors influencing the progression of early CIN in young women.
Methods • We gathered data from 238 CIN patients treated in our hospital from January 2019 to January 2020, categorizing by progression. We examined factors such as Human Papillomavirus (HPV) infection, reproductive history, number of sexual partners, overall health, premature sexual behavior, vitamin intake, spontaneous abortion, education level, family history, smoking, minichromosome maintenance complex component 2 (MCCM2), minichromosome maintenance complex component 4 (MCM4), ZW10 interacting kinetochore protein (ZWINT), cell division cycle 7 (CDC7), and Procollagen-Lysine, 2-Oxoglutarate 5-Dioxygenase 2 (PLOD2) expression. Risk factors for early cervical intraepithelial neoplasia in young women were analyzed through univariate and multivariate analyses to establish a model.
Results • Significant differences emerged between groups in HPV infection, multiple sexual partners, health status, spontaneous abortion, and expression levels of MCM2, MCM4, ZWINT, CDC7, and PLOD2 (P < .05). No notable
distinctions were found in other factors (P > .05). Collinearity diagnosis indicated VIF values >10, revealing multicollinearity. High correlation coefficients (>0.6) among factors indicated substantial mutual influence. Reliability and validity were confirmed with Cronbach’s Alpha coefficient, KMO=0.904, and Bartlett’s sphericity test (P < .001). Principal components derived from the scree plot were incorporated into a Log binary regression model, resulting in the equation Log (P) = 0.700 × Y1 - 0.601. Further regression analysis established the risk factor model for CIN progression: Log (P) = 0.700 × {(0.068Z(HPV infection) + 0.071Z(spontaneous abortion) + 0.078Z(MCM2) + 0.079Z(MCM4) + 0.079Z(ZWINT) + 0.079Z(CDC7) Z) + 0.076 × (PLOD2) - 0.601 + 1.565)}.
Conclusions • Prolonged HPV infection, spontaneous abortion, and elevated expression of MCM2, MCM4, ZWINT, CDC7, and PLOD2 constitute risk factors for CIN progression. Individuals with CIN should prioritize monitoring these indicators and promptly implement preventive measures to hinder disease advancement. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Efficacy of Neoadjuvant Chemotherapy plus Modified Radical Mastectomy for Stage II-III Breast Cancer Patients and Its Influence on Serum Tumor Markers |
| Jiafeng Chen, BS; Yan Chen, BS; Jiadi Li, BS; Yu Qiu, BS; Weizhu Wu, BS; Shuixin Yan, BS; Yuxin Zhou, BS |
| Objective • This research aims to assess the clinical efficacy of neoadjuvant chemotherapy (NACT) in combination with modified radical mastectomy (MRM) for stage II-III breast cancer (BC) patients and its impact on serum tumor markers (STMs).
Methods • The study included 119 stage II-III BC patients treated between June 2018 and June 2021. Among them, 55 cases underwent MRM (reference group), while 64 cases received NACT followed by MRM (research group). We compared intraoperative parameters (blood loss, operation time, hospital stay), clinical outcomes, the incidence of postoperative adverse events (AEs), changes in STMs (CA125, CA153, CEA), and one-year postoperative quality of life (QOL).
Results • In comparison to the reference group, the research group exhibited significantly lower intraoperative blood
loss, shorter operation times, reduced hospital stays, and higher rates of disease remission. Notably, the research group experienced a lower overall incidence of AEs, including skin flap necrosis, subscalp effusion, infection, and upper limb lymphedema. Postoperatively, all STMs in the research group exhibited statistically significant reductions and were lower than those in the reference group. Additionally, all QOL subscales demonstrated improvements and higher scores in the research group.
Conclusions • NACT followed by MRM represents an effective approach for enhancing surgical outcomes and clinical efficacy in stage II-III BC patients. This combination therapy also reduces the risk of postoperative AEs and leads to favorable changes in STMs and postoperative QOL levels. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Comparison of Monitored Anesthesia Care (MAC) and Asleep-awake-asleep (AAA) Technique in Awake Craniotomy |
| Hongmin Bai, MM; Yun Chen, MM; Huan He, MM; Mei Sun, MM; Weifeng Tu, PhD; Qunlin Wu, MM; Chunmei Zhang, MM |
| Background • An awake craniotomy (AC) with intraoperative brain mapping allows maximum tumor resection, and there are two dominant anesthetic approaches during AC, including monitored anesthesia care (MAC) and sleep-awake-asleep (AAA). However, there is no consensus on which method provides better anesthesia management between these two techniques. This work aims to compare the effects of two different anesthesia methods.
Methods • Patients diagnosed with brain tumors in our hospital from August 2017 to December 2018 were enrolled. All patients were divided into the MAC group and the AAA group. The awake craniotomy was performed in all patients. The awakening degree, operation time, intraoperative complications, postoperative complications, hospitalization time and expenses of the two groups were recorded and compared.
Results • A total of 413 patients were included. There were 53 patients of the MAC group and 360 patients of
AAA group with ages between 7-72 years old. The incidence of brain tension (13.2% versus 1.7%) and cerebral bulging complications (5.66% versus 0.56%) was higher in the AAA group than in the MAC group (P < .05), while there was no significant difference of the degree of arousal, other intraoperative complications, postoperative complications, hospitalization time, postoperative hospital stay, and hospitalization expenses between two groups (P > .05).
Conclusion • Both MAC and AAA were effective in awake craniotomy. AAA might bring more complications of brain function. This study provides evidence for clinical implementation of anesthetic approaches in AC. Considering the limitations of this work with single-center and retrospective study design, there is still a need for more multicenter, well-designed studies to confirm the results of this study. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Evaluation of the Effects of Multiplane Reconstruction Technology with Multi-slice Spiral CT in the Etiological Diagnosis of Acute Intestinal Obstruction |
| Yan Cong, MM; Zhide Sun, MM; Jian Yu, MM |
| Objective • To analyze the effects of multiplane reconstruction (MPR) technology with multi-slice spiral CT (MSCT) in the etiological diagnosis of acute intestinal obstruction (AIO). Obtaining clear images is of great help in determining the type and etiology of AIO, and doctors can quickly develop treatment plans to improve prognosis and efficacy.
Methods • The clinical data of patients with suspected AIO admitted to our hospital from May 2020 to May 2022 were retrospectively selected as the observation objects. All patients underwent MSCT-MPR examination. Four imaging physicians were divided into two groups. One group underwent MSCT image evaluation for diagnosis, and the other group underwent MSCT-MPR image evaluation for examination. The diagnostic confidence scores of physicians for two imaging techniques were compared. Surgery and pathological enteroscopy were taken as the standard, and then patients were divided into the AIO group (n=75) and the suspected AIO group (n=5). The sensitivity, specificity, and coincidence rate of simple MSCT examination and MSCT-MPR examination in the diagnosis of AIO were detected by the four-grid table method, and the positive predictive values of MSCT-MPR in the diagnosis of AIO infarction location, etiology, type, and degree were evaluated.
Results • Among the 80 subjects in this experiment, the sensitivity and specificity of simple MSCT examination in the diagnosis of AIO were 90.67% and 60.00%, respectively, and the accuracy was 88.75%; the sensitivity and specificity of MSCT-MPR examination in the diagnosis of AIO were 93.33% and 80.00%, respectively, and the accuracy was 92.50%; there was no significant difference in the accuracy of the diagnosis of AIO between the two examination methods (P > .05). The diagnostic score levels of physicians in the MSCT-MPR group were significantly higher than those in the simple MSCT group (P < .05).
Among the 75 patients diagnosed as AIO in this experiment, the incidence of ileum, jejunum, and sigmoid colon was higher. The positive predictive values of the ileum, jejunum, sigmoid colon, duodenum, cecal ascending colon, descending colon, transverse colon and rectum of AIO infarction sites diagnosed by MSCT-MPR were 86.36%, 80.00%, 87.50%, 85.71%, 85.71%, 85.71%, 60.00%, and 100.00%, respectively and the total positive predictive value of infarction site was 84.00%. Among the 75 patients diagnosed as AIO in this experiment, the positive predictive values of intestinal pathological lesions, extraintestinal lesions, and intestinal lesions of AIO infarction causes diagnosed by MSCT-MPR were 92.59%, 85.29% and 100.00%, respectively, and the total positive predictive value of infarction causes was 90.70%. The positive predictive values of MSCT-MPR in the diagnosis of complete AIO and incomplete AIO were 94.00% and 84.00%, respectively, and the total positive predictive value of infarction degree was 90.67%; the positive predictive values of MSCT-MPR in the diagnosis of simple AIO and strangulated AIO were 92.31% and 82.61% respectively, and the total positive predictive value of infarction type was 89.33%.
Conclusion • The accuracy difference between simple MSCT and MSCT mpr in AIO diagnosis is not significant, but MSCT mpr can improve the diagnostic information of readers. MPR can serve as an important supplement to MSCT in the diagnosis of AIO. MSCT-MPR has a high positive predictive value in determining the location, etiology, type, and degree of AIO, improving the diagnostic ability of disease etiology. MSCT-MPR helps doctors quickly assess the patient’s condition and provides effective basis for formulating clinical treatment plans, which is worth promoting and applying. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Feedforward Control and Construction of Control System of Postpartum Hemorrhage in Primary Hospital |
| Bilv He, BS; Yanping Huang, BS; Rinan Jin, MD; Cui Liao, AD; Mingye Liu, MD; Wen Xiao, BS; Liqun Zeng, AD |
| Objective • To explore the effect of feedforward control and control system on reducing postpartum hemorrhage (PPH) rate in primary hospitals.
Methods • Multi-period PPH special training classes were held in five primary hospitals, such as the Ruyuan Yao Autonomous County People’s Hospital, Wengyuan County People’s Hospital, located in Shaoguan, Guangdong, China, from 2017 to 2018. In this study, theoretical teaching combined with practical operations were performed. Clinical case-control analysis of PPH risk before and after PPH training was carried out.
Results • After training, the overall incidence of PPH decreased by 0.44% in the five hospitals (?2 = 7.16, P = .007), the incidence of PPH in natural delivery decreased
by 0.47% (?2 = 5.41, P = .02), and decreased by 0.37% in cesarean section (?2 = 1.86, P = .173). Uterine atony was the most common cause of PPH, but placental factors caused greater amount of delivery hemorrhage and bleeding 24 hours after delivery in the cases of PPH than uterine atony.
Conclusion • Adopting feedforward control management and constructing a control system in Shaoguan primary hospitals could effectively reduce the incidence of PPH. It is imperative to strengthen the training of pregnancy management and hemostasis surgery for pregnant women with placental factors. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| LncRNA XIST Promotes Cell Proliferation by Regulating miR-125b-5p/p53 in Oral Squamous Cell Carcinoma |
| Keremu Abasi, DDS; Zhong-cheng Gong, DDS, MD; Chen-xi Li, DDS, PhD; Bin Ling, MD; Hui Liu, PhD |
| Objective • Oral squamous cell carcinoma is a malignant tumor that occurs in the oral and maxillofacial region. The tongue tumor in the active area accounts for 85% of tongue cancer, followed by cheek cancer and gingival cancer. long non-coding RNAX-inactive specific transcript (LncRNA XIST) is a novel potential biomarker and potentially can be used in diagnosis and therapy for multiple types of cancers such as bladder cancer, breast cancer, colorectal cancer, glioblastoma, hepatocellular carcinoma, nasopharyngeal carcinoma, osteosarcoma, pancreatic cancer. The study of the role and mechanism of lncRNA XIST in oral squamous cell carcinoma (OSCC) remains unclear and limited. Therefore, this study explored the effects of lncRNA XIST on the pathogenesis of OSCC.
Methods • Quantitative reverse transcription polymerase chain reaction (RT-qPCR) was used to detect the expression of lncRNA XIST,miR-125b-5p, and p53 in oral squamous cell carcinoma cells. Edu assay, methyl thiazolyl diphenyl-tetrazolium (MTT) bromide assay, and flow cytometry were used to analyze the effects of lncRNA
XIST on the viability and apoptosis of OSCC cells. Target gene prediction and screening, luciferase reporter assays were used to verify downstream target genes for lncRNA XIST and miR-125b-5p.
Results • It was found that lncRNA XIST expression was significantly increased while miR-125b-5p expression was significantly reduced in the OSCC cell lines. LncRNA XIST could negatively regulate the expression of miR-125b-5p in oral squamous cell carcinoma cell lines. Knockdown of lncRNA XIST could inhibit cell viability and increase apoptosis, while knockdown of miR-125b-5p reversed the biological effects of XIST knockdown on OSCC cells. p53 was a direct target of miR-125b-5p and its expression was regulated by the lncRNA XIST/miR-125b-5p axis.
Conclusions • It is concluded that lncRNA XIST promotes the progression of OSCC by modulating the miR-125b-5p/p53 axis, indicating that lncRNA XIST may be a potential therapeutic target for oral squamous cell carcinoma. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Study on the Application Effects of Suspension Exercise Combined with Duhuo Jisheng Decoction in Cervical Disc Herniation |
| Zhijun Hu, PhD; Fangfang Li, BD; Dan Liu, MM; Zhanying Tang, PhD; Weina Yuan, MM |
| Objective • This study investigated the therapeutic effects of combining suspension exercise with Duhuo Jisheng Decoction in the treatment of cervical disc herniation.
Methods • The sample selection was from January 2021 to December 2022. From the cases of cervical disc herniation who visited the hospital, 40 cases of patients in each of the control and study groups treated with routine suspension exercise were collected. Patients in study group also received Duhuo Jisheng Decoction. Retrospective analysis was carried out on the clinical data. The total effective ratio was compared. The indicators (serum inflammatory factors, cervical spine activity and sleep status), and scores of items (symptoms, cervical spine function, comfort, psychology and life quality) were compared at pre-therapy and post-therapy, and between groups.
Results • The study group showed greater total effective ratio. After therapy, the three specific symptom scores of shoulder and neck pain, upper limb radiating pain, and finger numbness, serum inflammatory factors CRP, IL-6
and TNF-a, and anxiety and depression test scores in the 2 groups decreased obviously compared with pre-therapy, and that in the study group were less than the control group; the range of motion of the cervical spine in the six movements, cervical spine function and comfort scores, and four dimensions of life quality points in the two groups were obviously increased compared with pre-therapy, and that in the study group were obviously greater than the control group; the latency to fall asleep, actual sleep time and sleep quality score in the 2 groups were obviously improved compared with pre-therapy, and that in the study group was better than the control group (all P < .05).
Conclusion • Suspension exercise combined with Duhuo Jisheng Decoction is better than routine suspension exercise. The clinical efficacy and patient well-being is obviously improved, which is beneficial in improving the management of cervical disc herniation. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| P-Selectin Inhibitor Inclacumab Suppresses Expressions of C-X-C motif chemokine receptor 3 and chemokine (C-X-C motif) ligand 9 in Acute Myocardial Infarction |
| Chunfeng Li, MM; Hongbo Zhang, MM |
| Purpose • We investigated the impact of the P-Selectin Inhibitor (Inclacumab) on the expressions of C-X-C motif chemokine receptor 3 and chemokine (C-X-C motif) ligand 9 in serum from non-ST-elevation myocardial infarction patients. Besides, C-X-C motif chemokine receptor 3 and chemokine (C-X-C motif) ligand 9 expressions in peripheral blood mononuclear cells among patients complicated with various subtypes of coronary artery disease were explored.
Methods • The study cohort was randomly divided into treatment groups: non-ST-elevation myocardial infarction patients received Inclacumab treatment (n = 60) or placebo group (n = 62). Meanwhile, 15 age and gender-matched healthy volunteers were the healthy controls. Serum was collected from the patients on day 2, day 3, and half a year, respectively. In each group, plasma expressions of C-X-C motif chemokine receptor 3 and chemokine (C-X-C motif) ligand 9 were analyzed by enzyme-linked immunosorbent assay. Peripheral blood mononuclear cells were collected from the patients at admission. Expressions of chemokine (C-X-C motif) ligands 9 and 11 from peripheral blood mononuclear cells and whole blood were quantified by quantitative polymerase chain reaction, respectively.
Results • Our results showed that Inclacumab significantly downregulated the expressions of C-X-C motif chemokine receptor 3 and chemokine (C-X-C motif) ligand 9 (P < .001) after treatment for 2 and 3 days, respectively. However, no significant difference in chemokine (C-X-C motif) ligand 11 expression was found before and after Inclacumab treatment. C-X-C motif chemokine receptor 3 expression was dramatically increased in the CAD group compared with the control ST-elevation myocardial infarction patients with the highest C-X-C motif chemokine receptor 3 level (P < .001). The expressions of chemokine (C-X-C motif) ligands 9 and 11 were upregulated in the STEMI group compared to the NSTE acute coronary syndrome group (P < .05).
Conclusion • Whole blood expression levels of C-X-C motif chemokine receptor 3 and chemokine (C-X-C motif) ligand 9 among non-ST-elevation myocardial infarction patients were dramatically attenuated by P-selectin inhibition. C-X-C motif chemokine receptor 3 and chemokine (C-X-C motif) ligand 9 in peripheral blood mononuclear cells were largely augmented in the coronary artery disease group with chemokine (C-X-C motif) ligand 11 overexpression in ST-elevation myocardial infarction patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| The Effect of 5A Nursing Intervention Guided by Self-management Concept on Cardiopulmonary Function and Self-efficacy in Patients with Chronic Heart Failure |
| Linmin Zhang, MB |
| In China, it is estimated that there are 12.05 million existing heart failure patients and 2.97 million new heart failure patients each year. The prevalence and incidence of heart failure increased significantly with age. Chronic heart failure refers to a syndrome in which the preload cannot meet the basic metabolic needs of the whole body due to the damage of cardiac pumping function caused by various reasons. The specific manifestations are poor breathing, restricted activity and fluid retention. Because the clinical symptoms are usually congestion in the circulatory system of tissues and organs, also known as congestive chronic heart failure, the connotation of cardiac
insufficiency is wider. When the clinical manifestations of cardiac insufficiency occur, it is called chronic heart failure. This paper mainly expounds on the clinical value of 5A medical intervention in the treatment of patients with chronic heart failure, scientifically studies the impact of self-restraint-oriented intervention on patients. Our study shows that the 5A intervention model with self-management as the core concept has greatly improved the cardiopulmonary function of patients with chronic heart failure, and has a very positive significance for reducing the hospitalization rate and improving the survival rate of patients. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Intravenous Infusion of Lidocaine on Postoperative Analgesia and Intestinal Function Recovery after Abdominal Surgery |
| Jiahui Ma, MM; Lixin Wu, MM |
| Background • In patients undergoing abdominal surgery, the rapid recovery and gastrointestinal function are hindered by postoperative pain. Management of acute postoperative pain presents an ongoing challenge, prompting the exploration of adjuvants to mitigate opioid consumption.
Objective • This study aimed to investigate the impact of continuous lidocaine infusion (during surgery) on postoperative analgesia and gastrointestinal function in patients undergoing abdominal surgery.
Methods • The patients undergoing abdominal surgery were randomized into either lidocaine or a control group. The main endpoint was postoperative 4h, 8h, 12h, and 24h pain scores at rest and movement-evoked (by forced coughing). The second endpoint encompassed fluctuations in motilin and cortisol over the initial 3 days after surgery, postoperative opioid use, gastrointestinal function recovery, sleep quality, and dosage of analgesic drugs.
Results • Compared to the control, the lidocaine group exhibited lower pain scores at the 4h, 8h, 12h, and 24h
(P < .05). Throughout the initial three days following surgery, the lidocaine group demonstrated higher motilin levels compared to the control (570.43 vs. 490.76, 585.72 vs. 502.98, 503.69 vs. 428.73, respectively; P < .05), while cortisol levels were lower (305.81 vs. 370.69, 281.48 vs. 340.91, 248.95 vs. 305.87, respectively; P < .05). Time for the first bowel movement and first bowel evacuation were both earlier in the lidocaine than in the control group (10.32 vs. 15.89, 13.06 vs. 20.28, respectively; P < .05). Patients in the lidocaine group took fewer analgesics (P < .05), and the Pittsburgh Sleep Quality Index (PSQI) scores at all postoperative time points were lower than the control group (P < .05). The incidence of postoperative adverse events was not significantly different between the lidocaine and control groups (P > .05).
Conclusion • Intravenous lidocaine infusion reduced postoperative pain scores and dosage of analgesic drugs in patients undergoing abdominal surgery while accelerating gastrointestinal function recovery. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Efficacy of Action of Low-Temperature Plasma Radiofrequency Ablation in the Treatment of Early Glottic Carcinoma |
| Lina Hu, MS; Xinze She, MS; Yongchun Ye, MS; Liang Yu, MS; Bo Zhou, BS |
| Objective • This study aimed to explore the efficacy and underlying mechanism of low-temperature plasma radiofrequency ablation (LTPRFA) for the treatment of early glottic carcinoma.
Methods • A total of 122 patients diagnosed with early glottic cancer were admitted to our hospital between February 2019 and January 2022. They were randomly assigned to either the observation group (n = 56) or the experimental group (n = 56). The observation group underwent traditional laryngeal fissure surgery, while the experimental group underwent LTPRFA. Operation-related parameters, including voice recovery, complication incidence, recurrence rate, and mucosal smoothness rate were meticulously evaluated and compared between the two groups.
Results • The results revealed that the experimental group exhibited significantly better outcomes across all operation-related parameters (P < .05). Specifically, the experimental group demonstrated remarkable voice recovery compared to the observation group (P < .05).
Moreover, the experimental group displayed a considerably lower incidence of complications than the observation group (P < .05). Furthermore, the experimental group exhibited a significantly higher mucosal smoothness rate compared to the observation group (P < .05), while the recurrence rate did not differ significantly between the two groups (P > .05).
Conclusion • Our findings demonstrate the successful application of low-temperature plasma radiofrequency ablation in the management of early glottic carcinoma. This innovative technique offers several potential advantages, including reduced intraoperative bleeding, shorter surgical duration, and hospital stay. Additionally, it promotes enhanced postoperative voice restoration and mucosal healing, while minimizing the occurrence of postoperative complications. These compelling results support the wider adoption of LTPRFA as an effective therapeutic approach for early glottic carcinoma. ( |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Long-Time Delirium After Percutaneous Carotid Artery Stenting: A Case Report and Literature Review |
| Ming Chen, MM; Yang Chen, MM; Xiaoyan Dai, MM; Lin Huang, MM; Linming Huang, MM; Zonglu Jin, MM; Dongxia Liao, MM; Tao Qiu, MM; Hua Xiao, MM; Xiaoya Xu, MM; Guiqin Zhang, MM |
| Purpose • There have been very few cases of delirium after carotid artery stenting (CAS). Particularly, no case of long-time delirium has been reported so far. This study will describe a case of long-term delirium in an elderly patient after CAS treatment and review the current literature. This report plans to make relevant medical workers pay more attention to the risk of delirium after CAS treatment, thereby providing deeper understanding and diagnostic guidance for clinical practice.
Case report • A 76-year-old male presented with ulcerative plaque and severe stenosis in the right internal carotid artery by femoral artery puncture angiography. The patient underwent CAS under embolization protection device (EPD) protection with local anesthesia. The surgery was successfully completed without any discomfort during the operation, but delirium appeared 7 h later. Magnetic resonance imaging (MRI) showed multiple intracranial arterial lacunar infarctions. Several transcranial Doppler (TCDs) tests suggested intracranial wide vasospasm that improved only when the condition improved. After several treatments, the symptoms of delirium improved after 60 days.
Conclusion • CAS may lead to the occurrence of long-term delirium. We should pay attention to it clinically, and take corresponding treatment measures once it occurs. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Study on the Prevention and Reduction of Postpartum Hemorrhage by Non-invasive Balloon Abdominal Pressure Band |
| Jun Ai, MM; Hui Li, BS; Jiying Wen, MM; Ping Zhou, MM |
| Objective • To study the application values of non-invasive balloon abdominal pressure bands in preventing or reducing postpartum hemorrhage.
Methods • The subjects of this study were full-term cephalic position primiparas (n = 80) admitted to our hospital between June 2020 to June 2022. The data of the patients were retrospectively analyzed and they were grouped based on their delivery method. The primiparas in the control group received traditional delivery methods, while those in the observation group received a non-invasive balloon abdominal pressure band for assisted childbirth. The delivery status, bleeding volume, uterine contraction ability, blood routine indicators, coagulation function indicators, umbilical artery blood gas values, and neonatal Apgar scores of the two groups of pregnant women were compared.
Results • The third stage of labor and the placenta delivery time in the observation group were shorter and the amounts of bleeding in the third stage of labor, placenta delivery, and
2h after delivery were lower in the observation group than in the control group (P < .05). The rate of lateral episiotomy did not differ significantly between the two groups (P > .05). The uterine contraction amplitude, uterine contraction intensity, and uterine tension in the observation group were greater, while the uterine contraction frequency was lower than that in the control group (P < .05). The values of blood routine indicators of the observation group were greater than the control group (P < .05); while there was no significant difference in the measured values of coagulation function indicators, neonatal Apgar scores, and umbilical artery blood gas values between the two groups (P > .05).
Conclusion • Use of non-invasive balloon abdominal pressure bands to assist delivery in full-term cephalic position primiparas can effectively reduce the amount of postpartum hemorrhage and has no impact on maternal and infant health, which is worthy of further promotion and application. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Effects of Maternal Voice Stimulation Combined with Non-Nutritive Sucking on Improving Feeding Intolerance and Promoting Growth and Development in Premature Infants |
| Chunling Guo, BS; Ting Huang, MD; Liduan Li, BS; Chunyan Lin, BS; Yanzhu Lin, BS; Huangyi Wu, AD |
| Aim • This study explores the mechanisms underlying the impact of a combined intervention using maternal voice stimulation (MSS) and non-nutritive sucking (NSS) on feeding intolerance and growth and development in premature infants.
Method • One hundred cases of low birth weight premature infants admitted between August 2021 and December 2022 were randomly assigned into two groups: the combined group and the control group, each consisting of 50 infants. The control group received a non-nutritive sucking intervention, while the combined group received maternal voice stimulation in addition to the sucking intervention. Differences in feeding intolerance, feeding progression, growth and development, feeding performance, and heart rate indices were compared between the groups.
Results • Compared to the control group, the combined group showed significantly reduced incidence of feeding intolerance, feeding transition time, length of hospital stay, and time to regain birth weight, along with lowered heart rate. Additionally, there were significant increases in body mass growth rate, head circumference growth rate, body length growth rate, milk intake ratio, and feeding efficiency in the combined group (P < .05).
Conclusion • The application of maternal voice stimulation combined with non-nutritive sucking in premature infants could reduce the risk of feeding intolerance and heart rate levels. Simultaneously, it improved feeding performance and promoted growth and development in premature infants, indicating the clinical value and potential applicability of this combined intervention. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of the Application Value of Gemstone Energy Spectrum CT Substance Separation Technology Combined with Serum 25(OH)D and Bone Metabolic Index in Lumbar Osteoporosis |
| Huipeng Deng, MM; Yanfang Deng, MM; Faming Lai, MM; Rong Lin, MM; Zhen Yu, MM |
| Aim • To explore the clinical value of gem energy spectrum CT material separation technique combined with serum 25 hydroxyvitamin D (25 (OH) D) and bone metabolic index in lumbar osteoporosis (OP).
Methods • 172 patients admitted to the First Affiliated Hospital of Longyan of Fujian Medical University from May 2015 to January 2020 were selected for retrospective study. All patients were tested by dual-energy X-ray absorptiometry (DXA) through the medical record system, and the diagnosis result of DXA was taken as the gold standard according to the diagnostic standard of DXA in WHO. They were divided into lumbar OP group (t =-2.5SD) and non-lumbar OP group (bone mass loss with t value -1.0-2.5 SD and normal bone mass with t value =-1.0SD). Gem energy spectrum CT examination was performed in all patients, and 25 (OH) D and related bone metabolism indexes were detected and compared by electrochemical luminescence immunoanalyzer. Person correlation analysis was used to analyze the correlation between each index and lumbar osteoporosis. Each difference index was incorporated into the logistic regression model to analyze the factors affecting the occurrence of lumbar OP, and receiver operation (ROC) curve was drawn to explore the predictive value of each index.
Results • According to the DXA test results recorded in the medical record system, 86 of 172 patients developed OP (t =-2.5SD) and were divided into lumbar OP group, while 86 patients did not develop OP (bone mass loss with t value -1.0-2.5SD and normal bone mass with t =-1.0SD) and were divided into non-lumbar OP group. Lumbar OP group lumbar HAP (fat), 25 (OH) D, bone density value glycoprotein (OSTEOC) index is lower than the lumbar OP group, but the parathyroid
hormone (PTH) above the lumbar OP group (t = 21.836, 12.814, 13.327, 22.651, P < .05); According to Person correlation analysis, HAP (fat) density, 25 (OH) D and OSTEOC were negatively correlated with OP occurrence in lumbar spine (P < .05), while PTH was positively correlated with OP occurrence in lumbar spine (P < .05). logistic analysis showed that HAP (fat) density, serum 25 (OH) D, OSTEOC and parathyroid hormone were important influencing factors of lumbar osteoporosis (P < .05). There were 19 patients with fractures in the lumbar OP group, including 6 hip fractures, 8 lumbar fractures, and 5 femoral neck fractures. The remaining 67 patients did not have fractures. Among them, HAP (fat) density, serum 25 (OH) D and OSTEOC levels in lumbar spine were lower in fracture patients than in non-fracture patients, and serum parathyroid hormone levels were higher than those in non-fracture patients (t = 2.882, 2.036, 2.235, 3.366, P < .05). According to ROC analysis, AUC values of the above indicators were (0.796, 0.753, 0.670, 0.824), and ROC curve analysis combined with lumbar HAP density and serum biomarkers showed AUC values of 0.886 and 95%CI of 0.799~0.945.
Conclusion • The expression of HAP (fat) density, 25 (OH) D and OSTEOC in the lumbar spine OP patients was low, and the expression of PTH was high. All the indexes were closely related to the occurrence of OP and were independent influencing factors, which had high predictive value, and gem spectroscopy CT combined with serum bone metabolism indexes had higher predictive value. To provide theoretical reference for clinical practice. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Foot Reflexology for Pain and Anxiety Associated with Chest Tube Removal in Patients After Coronary Artery Bypass Graft: A Randomized Controlled Trial |
| Elif Budak Ertürk, RN, PhD; Mevlüde Karadag, RN, PhD |
| Background • Reflexology is a method used to control the pain and anxiety associated with chest tube removal in patients undergoing cardiovascular surgery.
Primary Study Objective • This study aimed to identify the effect of foot reflexology applied before chest tube removal on pain and anxiety levels in patients with coronary artery bypass graft surgery.
Methods/Design • This study was a randomized controlled clinical trial.
Setting • This study was conducted in the cardiovascular surgery intensive care unit of the Baskent University Ankara Hospital.
Participants • Patients, who underwent coronary artery bypass graft surgery, were randomly assigned either to the reflexology group or the control group (n = 28 individuals/group).
Intervention • The reflexology group received foot reflexology for 30 minutes in two sessions (first postoperative day and before chest tube removal).
Primary Outcome Measures • The primary outcomes of
the surgery were pain, evaluated using a Numeric Pain-
Rating Scale; and anxiety, evaluated using the Profile of Mood States Scale Tension-Anxiety Subscale. Pain and anxiety were determined on the first (before and after the reflexology) and second postoperative days (before and after the reflexology and immediately, 15 min, 1 hour (only pain level) after chest tube removal).
Results • The mean pain scores of the control and intervention groups were similar during chest tube removal, 15 minutes after, and 1 hour after (P > .05). Although mean anxiety scores were comparable after chest tube removal in both groups (P > .05), a significant difference was found 15 minutes later (P < .05). The increase in pain (P = .0001) and anxiety (P = .032) levels before and after the removal was significantly less in the intervention group compared to the control group, based on pain and anxiety scores.
Conclusion • Foot reflexology significantly reduced the increase in pain and anxiety during chest tube removal in patients with coronary artery bypass graft surgery. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Clinical Study on the Efficacy of Early Interventions in Reducing Complication Rates and Improving Quality of Life in Uremic Patients |
| Yabin Xiao, BD; Jingyang Zeng, BD |
| Aim • To evaluate the impact of sociodemographic, clinical, and laboratory data on several aspects of quality of life (QOL) and chronic kidney disease (CKD).
Specific Objectives • Influence of Sociodemographic Data: Investigate the impact of different sociodemographic characteristics (such as age, gender, education level, etc.) on QOL in patients with CKD. Influence of Clinical Data: Explore the correlation between clinical parameters (such as disease stage, comorbidities, etc.) and QOL, determining their respective impacts on individuals with CKD. Influence of Laboratory Data: Evaluate the potential impact of laboratory indicators (such as renal function markers, and blood pressure) on the QOL in patients with CKD.
Methods • 200 individuals with stages 1 to 5 CKD and 36 receiving hemodialysis were evaluated. QOL and functional status were evaluated using the Medical Outcomes Study Short Form 36-Item (SF-36) and the Karnofsky Performance Scale (KPS), respectively. Clinical, laboratory, and socio-demographic aspects were studied.
Results • QOL decreased at all stages of renal disease. Consistent declines in physical function, physical role function, and physical component summary have been observed throughout the various stages of renal disease. Men and high-income earners had higher total scores on the physical component, while those with higher levels of education and employment had higher total scores on the mental component. In summary, patients above the age of 65 performed better in the mental component as opposed to the physical component. The KPS and higher physical component summary values were linked to greater hemoglobin levels. Three or more co-morbid conditions had an impact on the physical component.
Conclusion • Kidney patients’ QOL deteriorates in the early stages of the disease. The progression of the disease and QOL were not linked. In this study, sociodemographic, clinical, and laboratory risk variables were linked to a lower QOL. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of the Effect of Music Therapy Combined with Relaxation Therapy on Reducing Agitation During Recovery from Anesthesia in Children |
| Didi Tang; Hao Yuan; Lei Zhang, BS; Xiaoyan Zhong |
| Objective • To study the value of music therapy and relaxation therapy in reducing the incidence of agitation during recovery from anesthesia in children.
Methods • A total of 76 children in our hospital (anesthesia recovery period, 2019.3-2021.4) were selected as research objects, their medical records were retrospectively analyzed, and they were grouped according to the intervention plans. Children who received routine anesthesia recovery intervention were included in the control group . The children who received music therapy and relaxation therapy were included in the observation group. The changes of nasopharyngeal cavity temperature, heart rate, mean arterial pressure and pulse oxygen saturation of children were compared between the two groups, and the residence time in the resuscitation room, awakening time, occurrence of agitation during the awakening period, agitation score and occurrence of adverse events of children between the two groups were compared.
Results • The heart rate and mean arterial pressure of the children in the observation group were lower than those
of the control group 15 minutes after entering the room (T2), immediately after extubation (T3), and 15 minutes after extubation (T4), while their pulse oxygen saturation was significantly higher than that of the control group, with P < .05. The residence time and awakening time of children included in the observation group were shorter than those in the control group, with P < .05. The incidence of agitation during the recovery period and the agitation scores at each time point after entering the room in the observation group were lower than those in the control group, with P < .05. There was no significant difference in the incidence of adverse events between groups, with P > .05.
Conclusion • The combined application of music therapy and relaxation therapy in children during anesthesia recovery can reduce the risk of the occurrence of agitation during recovery, stabilize the vital signs of children, and reduce the incidence of adverse events. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Transcranial Direct Current Stimulation Combined with Stabilization Exercises in Chronic Neck Pain: A Randomized Controlled Trial |
| Hanife Abakay, PT, PhD; Tugba Dere, PT, MSc; Fatma Eda Eksi; Ayse Güç, MD; Nazmi Saritas; Kübra Seyrek; Rabia Ugur |
| Objective • The study aimed to investigate the effect of Transcranial Direct Current Stimulation combined with cervical stabilization exercises on functional status, cognitive functions, and sleep quality in individuals with chronic neck pain.
Materials and methods • The study involved 29 individuals (mean age 33.06 ± 14.81 years). The experimental group (n=10) received combined Transcranial Direct Current Stimulation (2 mA/20 min) with cervical stabilization exercises, while the control group (n=10) received only cervical stabilization exercises. The sham group (n=9) received placebo Transcranial Direct Current Stimulation (0 mA/20 min) with cervical stabilization exercises. Assessments were conducted before and after completing 8 weeks with 2 days per week of intervention, i.e., 16 sessions.
Primary Outcome Measures • Pain severity was assessed using the 10 cm Visual Analogue Scale and the Neck Bournemouth Questionnaire. Muscle endurance was measured by testing cervical flexors, extensors, and deep flexor muscles. Functional limitations were evaluated with the Profile Fitness Mapping neck questionnaire. Cognitive
status was assessed using the Montreal Cognitive Assessment and the Trail Making Test. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index.
Results • After 16 sessions, all groups demonstrated a significant increase in cervical flexor muscle endurance (P < .05) and a significant decrease in Visual Analogue Scale pain scores at rest and at activity. Additionally, the experimental group exhibited a significant improvement in Visual Analogue Scale with activity, Profile Fitness Mapping neck questionnaire, and Montreal Cognitive Assessment scores. No significant difference was found between the groups in cognitive function or sleep quality (P > .05).
Conclusion • The importance of Transcranial Direct Current Stimulation combined with cervical stabilization exercises as a tool for pain management and rehabilitation of impaired motor control in cervical muscles in individuals with chronic neck pain is emphasized. It is suggested that combined approaches are considered instead of cervical stabilization exercises alone. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| he Efficacy of Lichtenstein Self-Fixation Mesh and Suture Mesh in Inguinal Hernia Repair: A Meta-Analysis |
| Kun Huang, MM; Caihao Tang, MM; Xiang Wang, MM |
| Objective • To compare the effect of self-gripping mesh and suture mesh in Lichtenstein inguinal hernia repair.
Methods • A computer search of the Cochrane Library, PubMed, Ovid, and Web of Science databases for randomized controlled trials (RCTs) was conducted from January 2010 to October 2021 to compare the efficacy of self-gripping mesh versus suture mesh in Lichtenstein tension-free hernia repair. After screening the literature based on the inclusion and exclusion criteria, the literature was assessed for quality and poor quality literature was excluded and subsequently meta-analyzed using Review Manager 5.3 software.
Results • A total of 4003 patients were included in 15 RCTS, including 1978 patients in the self-gripping mesh group and 2025 patients in the suture mesh group. Meta-analysis showed that compared to the suture mesh group, the operation time of the self-gripping mesh group was
significantly shorter (SMD = -0.73, 95%CI = -0.89 to -0.58, P < .001), the incidence of postoperative incision infection was significantly reduced (RR = 0.46, 95%CI = 0.27 - 0.80, P = .006), but the recurrence rate of postoperative hernia was high (RR = 1.62, 95%CI = 1.09 - 2.40, P = 0.02). There was no significant difference in the incidence of postoperative chronic inguinal pain, foreign body sensation, hematoma, and seroma between the 2 groups (all P > .05).
Conclusions • Compared to the application effect of traditional suture mesh in Lichtenstein tension-free inguinal hernia repair, self-gripping mesh has the advantage of shortening the operative time and reducing the incidence of postoperative incision infection. However, the recurrence rate of hernia may increase in the short term (within 1 year) after surgery, but this conclusion needs to be verified by a larger sample of high-quality studies. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Use of Complementary and Alternative Medicine in Infertility |
| Rabia Atilla, PhD; Rukiye Höbek Akarsu, PhD; Sevda Karakas, PhD; Özlem Sahan, PhD |
| Aim • This study was conducted to determine the complementary and alternative treatments used by infertile women in Turkey.
Materials and Methods • A descriptive and cross-sectional design was used in the study conducted at the Assisted Reproductive Treatment Center (ARTC) of a university hospital in Istanbul city. The study sample consisted of 153 women diagnosed with infertility, who volunteered to participate in the research. Study data were collected using a ‘Participant Information Form,’ created by the researchers, and the ‘Complementary and Alternative Medicine Approaches Scale.’
Results • It was determined that 30.1% of the women included in the study used complementary and alternative medicine methods in addition to infertility treatments. The level of education had a statistically significant effect
only on the mean manipulative approaches sub-dimension score, the place of residence on the mean cognitive behavioral sub-dimension score, and the type of infertility and the duration of treatment on the mean biological approaches sub-dimension score (P < .05). However, the mean score of the total Complementary and Alternative Medicine Approaches Scale did not affect the mean scores of other sub-dimensions (P > .05).
Conclusion • This study determined that the complementary and alternative medicine methods commonly used by women include biological and cognitive behavioral approaches. Women who had received secondary infertility treatment and had a long period of infertility were found to use complementary and alternative medicine methods at a higher rate. |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Analysis of Factors Related to Arteriovenous Fistula Expansion in Non-Diabetic Maintenance Hemodialysis Patients Based on Vascular Ultrasound |
| Li Cheng, MS; Shuai Fu, MM; Dongdong Mao, MS; Yonglong Min, MS; Can Tu, PhD; Sheng Wan, MS; Quan Wang, MS; Fei Xiong, PhD; Yuanyuan Yang, MS |
| Background • Maintenance hemodialysis (MHD) is an effective treatment for patients with end-stage renal disease. Although MHD can prolong the survival of patients, their quality of life is lower and the fatality rate is higher. This work analyzed the factors related to the autogenous arteriovenous fistula (AVF)-like expansion of non-diabetic MHD patients by vascular ultrasound (VUS).
Methods • A retrospective analysis of 96 non-diabetic patients with stone hemodialysis treatment was conducted. The patients were assigned to a loss group (n = 32) and a non-loss group (n = 64) based on selection criteria. The laboratory indicators, biochemical indicators, ultrasound indicators, hemodynamic indicators, and cardiac function-related indicators at 1, 3, and 6 months of patients in different groups were analyzed and compared. Logistic multivariate regression analysis (LMRA) was employed to analyze the factors influencing AVF loss. Log rank was used to test the survival time of the internal fistula.
Results • Significant differences were observed in calcium and phosphorus product, serum albumin (ALB), blood phosphorus, and C-reactive protein (CRP) between patients in different groups (P < .05), unlike urea, serum bicarbonate, blood calcium, and blood phosphorus levels (P > .05). In addition, the biochemical indexes of ferritin, unsaturated iron, serum iron, platelet, and parathyroid hormone (PTH) (P > .05). The hemodynamic indexes of patients in the two groups differed greatly (P < .05). LMRA showed that diabetes, ALB, radial diameter, and blood phosphorus were independent risk factors (IRFs) for AVF loss. Log-rank test of patients’ internal fistula survival time showed that the median survival curve (MSC) of diabetic patients was lower than that of non-diabetic patients (P < .05).
Conclusion • Diabetes, ALB, radial diameter, and blood phosphorus levels were IRFs for AVF loss. Long-term AVFs were associated with hemodynamics and cardiac function to a certain extent, and appropriate flow should be selected clinically according to the patient’s condition. (Altern Ther Health Med. [E-pub ahead of print.]) |
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December, 2024 - VOL. 30, NO. 13 | |
December, 2024 |
| Kuntai Capsule Improves Ovarian Function in Rats with Premature Ovarian Failure After Transplantation of Cryopreserved Ovarian Tissue by Regulating Sex Hormones and Apoptosis |
| Yan Lang, BM; Yanmin Li, MD; Guohui Ren, MM; Chunli Wu, MM; Kang Yu, MM; Xin Zhou, MM |
| Objective • Our study aimed to investigate the therapeutic effects of the Kuntai capsule in improving ovarian function in rats with transplantation of cryopreserved ovary.
Methods • Two mice ovary cell lines were cultured with Kuntai capsule decoction, and cell apoptosis was detected by MTT assay. A total of 90 SPF Sprague Dawley rats were included in this study. Thirty rats were used as the control group (group A), and not treated with any surgical operation. The remaining 60 rats were subjected to surgery to collect ovarian tissues and to construct a premature ovarian failure model. Ovarian tissues were cryopreserved, thawed, and transplanted back to ovaries. Sixty rats with ovary transplantation were randomly divided into group B and group C. Rats in group B were treated with Kuntai capsule at a dose of 0.1 capsule per day while rats in group C were fed with normal food. Serum levels of estradiol (E2) and follicular stimulating hormone (FSH) were detected. Expressions of several cytokines, including hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), insulin-like growth factor 1 (IGF-1), and apoptotic factors caspase-3 and p53, were also detected.
Results • Kuntai capsule decoction inhibited apoptosis of in vitro cultured mice ovary cells. Furthermore, the Kuntai capsule promoted the recovery of E2 and FSH to normal levels and regulated the abnormal expression of HGF, VEGF, and IGF-1 and apoptotic factors caspase-3 and p53 in rats with premature ovarian failure after homotopic transplantation of ovarian tissue.
Conclusion • The Kuntai capsule can improve ovarian functions by regulating sexual hormones and cell apoptosis in rats with premature ovarian failure after homotopic transplantation of cryopreserved ovary tissue. |
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