Objective To investigate the expression level of bromodomain-containing protein 4(BRD4)in esophageal cancer tissues,analyze its association with glutathione-S-transferase P1(GSTP1),and explore the role of BRD4 in the regulation of cisplatin sensitivity in human esophageal cancer cells.Methods Based on The Cancer Genome Atlas(TCGA)data,R language package was used to analyze the expression of BRD4 in esophageal carcinoma and adjacent normal tissues.Gene Expression Profiling Interactive Analysis(GEPIA2)online evaluated the relationship between BRD4 and the expression of chemotherapeutic detoxifying enzyme GSTP1 in esophageal cancer tissue.Small interfering RNA(siRNA)and targeted inhibitor(+)-JQ1(25,50 and 100 nM)were used to treat esophageal cancer TE-1 cells.Western blot was used to verify the expression changes of BRD4 and GSTP1 in esophageal cancer TE-1 cells.After(+)-JQ1 pretreatment(50 nM,24 h)and binding cisplatin(DDP,5 μg/ml,24 h),the expression of apoptosis-related proteins of Bel-2 associated X(BAX),B-cell lymphoma-2(Bcl-2),cysteinyl aspartate specific proteinase 3(Caspase-3),cleaved-cysteinyl aspartate specific proteinase 3(cleaved-caspase-3)were detected by Western blot assay.CCK-8 assay was used to detect the change of DDP sensitivity of TE-1 cells after(+)-JQ1(50 nM,24 h)inhibition of BRD4.Results The analysis of TCGA data showed that the overall expression level of BRD4 mRNA in esophageal cancer was significantly higher than that in adjacent normal tissues[(5.61±0.57)VS(4.80±0.59)],and the difference was statistically significant(P<0.001).Further,by comparing the samples of paired tumors and adjacent normal tissues,it was found that the expression level of BRD4 in esophageal cancer tissues of patients(5.57±0.31),which was generally significantly higher than that of(4.77±0.44)in adjacent normal tissues,and the difference was statistically significant(P<0.01).The GEPIA2 database found that the key detoxification binding enzyme GSTP1 was positively correlated with the expression of BRD4 in tumor tissues during the formation of chemotherapy drug resistance in esophageal cancer(r=0.26,P=0.00029<0.001).Combined with the targeting siRNA treatment Western blot results showed that the expression levels of BRD4 and GSTP1 in esophageal cancer TE-1 cells after sIRNA-BRD4 treatment were significantly higher than those in NC group.However,the down-regulation of GSTP1 expression in TE-1 cells after siRNA-GSTP1 had no significant effect on BRD4 protein.Further treatment with graded concentrations of BRD4-targeting inhibitors confirmed that the expression level of GSTP1 protein in TE-1 cells showed a significant decrease in comparison with that in the negative control group along with the increase in(+)-JQ1 concentration,since(+)-JQ1 acted mainly by binding to the bromodomain of BRD4,the expression inhibition of BRD4 was only observed in the esophageal cancer cells of the highest concentration treatment(100 nM)group.Low concentration of(+)-JQ1(50 nM)treatment can cause the down-regulation of anti-apoptotic protein Bcl-2 and the increase of apoptosis-related protein Bax expression in TE-1 cells,but has no significant effect on caspase-3,whereas the activated form of caspase-3,cleaved-caspase-3,was significantly expressed in cells of the TE-1 group compared to those of the DDP-alone group.Western blot results indicated that inhibition of BRD4 function by(+)-JQ1 pretreatment could enhance the killing effect of DDP on esophageal cancer cells.The results of CCK-8 showed that the sensitivity of TE-1 cells to chemotherapy drug DDP could be significantly improved after pretreatment with inhibition of BRD4 protein function[(+)-JQ1,50 nM,24 h].The median inhibitory concentration(IC50)of DDP in DMSO control group was(19.43±0.59)μg/ml.After pretreatment with(+)-JQ1,it decreased to(10.46±0.24)μg/ml,and the difference was statistically significant(P<0.05).Conclusion The high expression of BRD4 in esophageal cancer may be involved in the regulation of DDP sensitivity through GSTP1 molecule.
Objective To analyze the influence of different degrees of liver function injury on postoperative effect and metabolic marker levels in middle-aged and elderly patients with femoral neck fracture.Methods 74 middle-aged and elderly patients with femoral neck fracture were divided into normal liver function group(31 cases),mild liver function injury group(26 cases)and moderate liver function injury group(17 cases)according to different liver function conditions.Comparison was made on surgical conditions(operative time,amount of surgical blood loss,occurrence of complications),clinical therapeutic effects(walking time,first weight-bearing time,fracture healing time,Harris score,quality of life score),metabolic markers[parathyroid hormone(PTH),serum osteocalcin(OC),alkaline phosphatase(ALP),albumin(ALB)]levels.Results In the normal liver function group,the operative time was(83.42±15.63)min,the amount of surgical blood loss was(82.56±25.01)ml,and the incidence of complications was 12.90%;in the mild liver function injury group,the results were(91.28±13.69)min,(93.64±21.33)ml and 23.08%;in the moderate liver function injury group,the results were(87.02±11.94)min,(122.80±31.58)ml and 29.41%.There was statistically significant difference in the amount of surgical blood loss among the three groups(P<0.01).The amount of surgical blood loss in the moderate liver function injury group was higher than that in the normal liver function group and the mild liver function injury group,and the difference was statistically significant(P<0.01).In the normal liver function group,the walking time was(47.57±5.23)d,the first weight-bearing time was(67.95±10.77)d,the fracture healing time was(71.73±9.81)d,the Harris score was(88.62±4.68)points,and the quality of life score was(78.65±3.12)points;in the mild liver function injury group,the results were(50.12±7.06)d,(75.54±12.81)d,(77.68±8.94)d,(84.57±5.66)points,and(71.34±2.89)points;in the moderate liver function injury,the results were(55.78±9.65)d,(86.37±14.10)d,(94.47±17.02)d,(67.61±3.54)points,and(62.23±3.64)points.There were statistically significant differences in terms of walking time,first weight-bearing time,fracture healing time,Harris score and quality of life score among the three groups(P<0.01).The walking time,first weight-bearing time and fracture healing time of moderate liver function injury group were longer than those of normal liver function injury group and mild liver function injury group;the Harris score and quality of life score of moderate liver function injury group were lower than those of normal liver function injury group and mild liver function injury group;the differences were statistically significant(P<0.01).The first weight-bearing time and fracture healing time of normal liver function injury group were shorter than those of mild liver function injury group;the Harris score and quality of life score of normal liver function injury group were higher than those of mild liver function injury group;the differences were statistically significant(P<0.05).In the normal liver function injury group,PTH was(34.91±8.86)ng/L,OC was(27.06±6.68)ng/ml,ALP was(84.87±28.35)U/L,and ALB was(47.38±3.11)g/L;in the mild liver function injury group,the results were(39.57±9.71)ng/L,(23.85±5.42)ng/ml,(103.84±42.86)U/L,and(43.86±4.07)g/L;in the moderate liver function injury group,the results were(49.83±11.04)ng/L,(16.18±5.93)ng/ml,(177.52±37.19)U/L,and(31.24±4.88)g/L.There were statistically significant differences in PTH,OC,ALP and ALB among the three groups(P<0.01).PTH and ALP of the moderate liver function injury group were higher than those of the normal liver function injury group and the mild liver function injury group;OC and ALB in moderate live function injury group were lower than those in normal live function injury group and mild live function injury group;the differences were statistically significant(P<0.01).ALB of normal liver function injury group was higher than that of mild liver function injury group,and the difference was statistically significant(P<0.01).Conclusion There is a certain difference in the recovery of middle-aged and elderly patients with femoral neck fracture with different degrees of liver function injury.In the case of moderate liver function injury,there is a significant impact on walking time and fracture healing time of patients,and its metabolic indexes are also changed correspondingly,which has a certain suggestive effect on the fracture healing effect.
Objective To investigate the efficacy of thalidomide combined with afatinib in the treatment of advanced lung cancer.Methods A total of 65 patients with advanced lung cancer were studied and divided into group A(33 cases,including 1 case of intolerance)and group B(32 cases,including 2 cases of intolerance,accidental death)by random numerical table.Group A was treated with afatinib,group B was treated with thalidomide and afatinib.Both groups were compared in terms of median survival time,incidence of complications,efficacy[objective response rate(ORR),disease control rate(DCR)],and the levels of tumor markers[carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF),cytokeratin fragment 19(CYFRA21-1)]before and after treatment.Results 3 cases were lost to follow-up until April 2023,with a follow-up rate of 95.38%(62/65).The median survival time of group B(12.3 months)was longer than that of group A(11.9 months).The incidence of complications of 3.33%in group B was lower than that of 25.00%in group A,and the difference was statistically significant(P<0.05).ORR of 76.67%and DCR of 90.00%in group B were higher than those of 50.00%and 68.75%in group A,and the differences were statistically significant(P<0.05).In group A,the levels of CEA,VEGF and CYFRA21-1 after treatment were(80.39±15.38)μg/L,(70.58±15.49)pg/ml and(3.55±1.48)μg/L.In group B,the levels of CEA,VEGF and CYFRA21-1 after treatment were(78.49±15.30)μg/L,(68.49±15.35)pg/ml and(3.49±1.53)μg/L.After treatment,the levels of CEA,VEGF and CYFRA21-1 in both groups were lower than those before treatment in this group,and the differences were statistically significant(P<0.05).However,there was no statistically significant difference between groups after treatment(P>0.05).Conclusion Thalidomide combined with afatinib is an effective method for the treatment of patients with advanced lung cancer,which can reduce the incidence of complications,prolong the median survival time,and is well tolerated by patients.
Objective To investigate the application value of ultrasonography in early diagnosis of breast cancer.Methods A total of 100 patients with small breast masses were divided into an observation group(breast cancer)and a control group(benign tumor)according to benign and malignant status,with 50 cases in each group.The diagnostic efficiency of ultrasound was analyzed,and the blood flow and imaging mass characteristics were compared between the two groups.Results Ultrasonography showed 6 missed cases and 3 misdiagnosed cases,and 53 cases of benign breast tumor and 47 cases of breast cancer were detected.The specificity was 94.00%(47/50),the sensitivity was 88.00%(44/50),and the diagnostic accuracy was 91.00%(91/100),the negative predictive value was 88.68%(47/53)and the positive predictive value was 93.62%(44/47).The proportion of grade Ⅱ and Ⅲ blood flow in the observation group was 76.00%,which was higher than that of 20.00%in the control group,and the difference was statistically significant(P<0.05).The proportions of irregular shape,unclear boundary,weakened rear echo and sand-like calcification in the observation group were 20.00%,50.00%,44.00%and 80.00%,which were higher than those of 6.00%,20.00%,10.00%and 40.00%in the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with benign tumors,ultrasonographic images of breast cancer have obvious imaging characteristics,which in combination with blood flow grading can improve the accuracy of early diagnosis of breast cancer,and is worthy of clinical promotion and application.
Objective To study the effect of labor induction of dinoprostone suppositories,cervical double balloon and oxytocin in patients with prolonged pregnancy.Methods A total of 135 patients with prolonged pregnancy were divided into group A,group B and group C according to different intervention methods,with 45 cases in each group.Group A was induced by oxytocin,group B was induced by cervical double balloon,and group C was induced dinoprostone suppositories.Comparison was made on cervical maturity score,success rate of labor induction,labor time,medication cost,total duration of labor,delivery mode and maternal and infant outcomes among the three groups.Results After treatment,the cervical maturity scores in group B and group C were(8.45±0.37)and(9.39±0.51)points,which were higher than that of(6.70±0.45)points in group A,and the difference was statistically significant(P<0.05).The cervical maturity score of group C was higher than that of group B,and the difference was statistically significant(P<0.05).The success rates of labor induction in group B and group C were 80.00%and 95.56%,which were higher than that of 55.56%in group A,and the difference was statistically significant(P<0.05).The success rate of labor induction in group C was higher than that in group B,and the difference was statistically significant(P<0.05).The labor time and total duration of labor in group B and group C were(8.05±1.23),(8.92±1.48)h and(5.72±1.06),(7.09±1.20)h,which were shorter than those of(11.68±1.49)and(10.84±1.91)h in group A;the medication cost in group B and group C were(525.60±91.30)and(385.90±88.40)yuan,which were higher than that of(125.20±80.07)yuan in group A;the differences were statistically significant(P<0.05).The labor time and total duration of labor in group C were shorter than those in group B,and the medication cost was lower than that in group B.The differences were statistically significant(P<0.05).The vaginal delivery rates in group B and group C were 93.33%and 95.56%,which were higher than that of 73.33%in group A,and the difference was statistically significant(P<0.05).There was no statistically significant difference in vaginal delivery rate between group C and group B(P>0.05).The rates of postpartum hemorrhage and the incidence perinatal adverse outcomes in group B and group C were 4.44%,6.67%and 2.22%,2.22%,which were lower than those of 20.00%and 22.22%in group A,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the rate of postpartum hemorrhage and the incidence of perinatal adverse outcomes between group C and group B(P>0.05).Conclusion For labor induction in patients with prolonged pregnancy,the effect and safety of dinoprostone suppositories and cervical double balloon are higher than that of oxytocin,and inoprostone suppositories has a better effect on promoting cervical maturity,helping to shorten duration of labor,and the price is lower than cervical double balloon.Therefore,it is more suitable for promotion in primary medical institutions.
Objective To investigate the clinical efficacy of Baohe pills combined with amoxicillin and clavulanate potassium in the treatment of children with mesenteric lymphadenitis(ML).Methods A total of 80 children with mesenteric lymphadenitis were randomly divided into a control group and an observation group,with 40 cases in each group.The control group was treated with amoxicillin and clavulanate potassium,while the observation group was treated with Baohe pills.Both groups were compared in terms of efficacy of Western medicine,efficacy of traditional Chinese medicine,remission time of abdominal pain,disappearance time of abdominal pain,the number,transverse diameter and longitudinal diameter of enlarged lymph nodes before and after treatment,and the occurrence of adverse reactions.Results After 7 d of treatment,the total effective rate of Western medicine in the observation group was 90.00％,which was higher than that of 67.50％in the control group,and the difference was statistically significant(P<0.05).After 7 d of treatment,the total effective rate of traditional Chinese medicine was 95.00％in the observation group,which was significantly higher than that of 72.50％in the control group,and the difference was statistically significant(P<0.05).The remission time of abdominal pain and disappearance time of abdominal pain in the observation group were(3.75±0.63)and(6.72±1.22)d,which were shorter than those of(4.94±0.87)and(7.83±2.06)d in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the number,transverse diameter and longitudinal diameter of enlarged lymph nodes between the two groups(P>0.05).After 7 d of treatment,the transverse diameter and longitudinal diameter of enlarged lymph nodes in both groups were significantly shorter than those before treatment in this group,and the number of enlarged lymph nodes was less than that before treatment in this group;the transverse diameter and longitudinal diameter of enlarged lymph nodes in the observation group were significantly shorter than those in the control group;the number of enlarged lymph nodes in the observation group was less than that in the control group;the differences were statistically significant(P<0.05).The incidence of adverse reactions was 10.0％(4/40)in the observation group and 12.5％(5/40)in the control group.There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ2 = 0.125,P = 0.723>0.05).Conclusion Baohe pills combined with amoxicillin and clavulanate potassium in the treatment of children with mesenteric lymphadenitis can improve the clinical efficacy,effectively improve the related clinical symptoms and signs,reduce the recurrence rate,and has high safety.
Objective To discuss the clinical efficacy of biological long handle artificial femoral head replacement(FHR)in the treatment of femoral intertrochanteric fracture.Methods The medical records of 105 patients with femoral intertrochanteric fracture were retrospectively analyzed and divided into a control group(52 cases)and a study group(53 cases)according to different surgical methods.The control group was treated with proximal femoral nail anti-rotation(PFNA),and the study group was treated with biological long handle artificial femoral head replacement.The operative time,intraoperative blood loss and Harris score before and after surgery were compared between the two groups.Results The operative time of(81.2±9.6)min in the study group was longer than that of(66.5±6.8)min in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in intraoperative blood loss between the study group(324.2±25.6)ml and the control group(314.5±24.7)ml(P>0.05).After surgery,the Harris score in both groups was higher than that before surgery in this group,and the Harris score of(91.2±4.2)points in the study group was higher than that of(83.5±4.4)points in the control group.The differences were statistically significant(P<0.05).Conclusion Although the operative time of biological long handle artificial femoral head replacement in the treatment of femoral intertrochanteric fracture is long,the intraoperative blood loss does not increase,and the postoperative hip function recovery is better than PFNA,which is worthy of clinical promotion.
Objective To discuss the application effect of pelvic floor rehabilitation training on patients with pelvic floor dysfunction after total hysterectomy.Methods A total of 80 patients with pelvic floor dysfunction after total hysterectomy were divided into an observation group and a control group according to random double-blind method,with 40 cases in each group.The control group was given conventional nursing,and the observation group was given conventional nursing combined with pelvic floor rehabilitation training.Both groups were compared in terms of Hamilton anxiety scale score,Hamilton depression scale score,quality of life score,contractile pressure of pelvic floor muscle fibers,prolapse-urinary incontinence score and recovery effect of pelvic floor dysfunction.Results After intervention,the Hamilton anxiety scale score and Hamilton depression scale score in both groups were significantly lower than those before intervention in this group;the Hamilton anxiety scale score of(10.12±1.94)points and Hamilton depression scale score of(10.21±1.56)points in the observation group were significantly lower than those of(13.56±2.23)and(13.57±2.13)points in the control group;the differences were statistically significant(P<0.05).After intervention,the scores of material life,physical function,mental function and social function in both groups were significantly higher than those before intervention in this group;in the observation group,the material life score was(92.12±6.94)points,the physical function score was(93.21±5.23)points,the mental function score was(93.12±4.94)points and the social function score was(93.21±5.56)points,which were significantly higher than those of(82.45±6.12),(83.21±4.12),(83.45±4.34)and(82.55±5.12)points in the control group;the differences were statistically significant(P<0.05).After intervention,the contractile pressure of pelvic floor muscle fibers in both groups was higher than that before intervention in this group,and the prolapse-urinary incontinence score was lower than that before intervention in this group;the contractile pressure of pelvic floor muscle fibers of(3.62±0.81)kPa in the observation group was higher than that of(3.13±0.71)kPa in the control group;the prolapse-urinary incontinence score of(14.34±1.52)points in the observation group was lower than that of(23.41±2.51)points in the control group;the differences were statistically significant(P<0.05).The total effective rate of pelvic floor dysfunction recovery in the observation group was 100.00%,which was higher than that of 80.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion The effect of pelvic floor rehabilitation training on patients with pelvic floor dysfunction after total hysterectomy is definite,which can effectively improve the pelvic floor function and quality of life of patients,reduce the anxiety and depression of patients,and is worth promoting.
Objective To evaluate the value of vascular color Doppler ultrasound,serum D-dimer detection and Wells score in the diagnosis of deep vein thrombosis(DVT)of lower extremities.Methods 20 patients with DVT of lower extremities after traumatic orthopedic fracture surgery were selected as an observation group,and 20 traumatic fracture patients without DVT of lower extremities were selected as a control group.Vascular color Doppler ultrasound,serum D-dimer detection and Wells score were performed in both groups.Venography was used as the gold standard,and the results of vascular color Doppler ultrasound,serum D-dimer detection and Wells score were compared between the two groups.Results Vascular color Doppler ultrasound showed that 19 cases of DVT of lower extremities were detected in the observation group,the detection rate was 95.00%;no DVT of lower extremities was detected in the control group.Serum D-dimer level of(0.60±0.20)mg/L and Wells score of(0.70±0.20)points in the observation group were higher than those of(0.20±0.10)mg/L and(0.20±0.10)points in the control group,and the differences were statistically significant(P<0.05).Conclusion Vascular color Doppler ultrasound,serum D-dimer and Wells score have diagnostic value for DVT lower extremities after tramatic fracture.
Objective To study the effect of dietary nutrition intervention on blood rheology indexes of women with hypertension during pregnancy and the prevention effect of preeclampsia(PE).Methods A total of 120 women with hypertension during pregnancy were divided into a control group and an observation group according to random numerical table,with 60 cases in each group.The control group was given low-dose aspirin combined with labetalol intervention,and the observation group was combined with dietary nutrition intervention on the basis of the control group.Both groups were compared in terms of blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],24-h urinary protein excretion and blood rheology indexes before and after intervention,gestational week of PE,gestational week of delivery,pregnancy outcome and neonatal outcome after intervention.Results After intervention,SBP,DBP and 24-h urinary protein excretion in both groups were significantly lower than those before intervention in this group;the observation group had SBP of(112.55±2.09)mm Hg(1 mm Hg= 0.133 kPa),DBP of(79.16±1.08)mm Hg,and 24-h urinary protein excretion of(1.01±0.25)g/24 h,which were significantly lower than those of(128.23±2.21)mm Hg,(87.86±1.32)mm Hg,and(2.23±0.43)g/24 h in the control group;the differences were statistically significant(P<0.05).After intervention,the whole-blood high-shear reduction viscosity,whole blood low-shear reduction viscosity,plasma viscosity,whole-blood high-viscosity and whole-blood low-shear reduction viscosity in both groups were significantly lower than those before intervention in this group;in the observation group,the whole-blood high-shear reduction viscosity was(7.16±0.96)mPa·s,the whole-blood low-shear reduction viscosity was(19.78±2.96)mPa·s,the plasma viscosity was(1.41±0.15)mPa·s,the whole-blood high-shear viscosity was(4.51±0.33)mPa·s,and the whole-blood low-shear viscosity was(8.97±1.22)mPa·s,which were lower than those of(7.72±1.02),(22.78±3.02),(1.63±0.23),(5.01±0.39),and(10.64±1.59)mPa·s in the control group;the differences were statistically significant(P<0.05).After intervention,the observation group had incidence of PE,preterm delivery,cesarean section,placental abruption,premature rupture of membranes,and postpartum hemorrhage were 28.3%,8.3%,25.0%,1.7%,3.3%and 3.3%,which were significantly lower than those of 55.0%,21.7%,61.7%,11.7%,13.3%and 20.0%in the control group;the gestational week of PE of(33.86±1.56)weeks and gestational week of delivery of(37.45±2.35)weeks in the observation group were significantly longer than those of(30.16±1.67)and(34.23±2.16)weeks in the control group;the differences were statistically significant(P<0.05).After intervention,the incidence of fetal distress and neonatal asphyxia were 3.3%and 1.7%in the observation group,which were significantly lower than those of 18.3%and 11.7%in the control group;the neonatal Apgar score of(8.53±1.24)points and neonatal weight of(2578.33±265.46)g in the observation group were significantly higher than those of(6.43±1.06)points and(2267.24±231.18)g in the control group;the differences were statistically significant(P<0.05).Conclusion Based on low-dose aspirin combined with labetalol intervention,dietary nutrition intervention can effectively control and stabilize blood pressure levels in women with hypertension during pregnancy,improve blood rheology indexes,prevent PE occurrence,and improve maternal and fetal outcomes.
Objective To observe the clinical effect of holographic image laparoscopic fusion technique in renal tumor resection.Methods 40 patients who underwent renal tumor resection using holographic image laparoscopic fusion technique were selected as the study group,and another 40 patients who underwent renal tumor resection using conventional laparoscopic technology were selected as the control group.The perioperative related indexes,intraoperative and postoperative complications,and negative rate of postoperative surgical margins of the two groups were compared.Results The study group had operative time of(95.43±13.35)min,vascular occlusion time of(21.95±2.52)min,postoperative eating time of(2.04±0.27)d and hospital stay of(5.23±0.42)d,which were significantly shorter than those of(104.48±16.46)min,(26.43±4.37)min,(2.56±0.25)d and(6.99±0.65)d in the control group;the intraoperative blood loss of(142.31±20.41)ml in the study group was less than that of(182.95±25.56)ml in the control group;the differences were statistically significant(P<0.05).The complication rate of 5.00%in the study group was slightly lower than that of 15.00%in the control group;the negative rate of postoperative surgical margins of 100.00%in the study group was slightly higher than that of 97.50%in the control group;but the differences were not statistically significant(P>0.05).Conclusion For patients undergoing renal tumor resection,the holographic image laparoscopic fusion technology is carried out with clear intraoperative vision,which can significantly shorten the operative time,vascular occlusion time and postoperative recovery time,reduce the amount of intraoperative blood loss with high surgical safety.It is worthy of clinical promotion.
Objective To investigate the efficacy of thoraco-laparoscopic esophagectomy combined with intrathoracic anastomosis in the treatment of patients with esophageal cancer and its influence on surgical indexes and complications,and analyze its clinical application value.Methods A total of 78 patients with esophageal cancer were divided into a control group and an experimental group according to different surgical methods,with 39 cases in each group.The control group underwent open esophagectomy combined with intrathoracic anastomosis,while the experimental group underwent thoraco-laparoscopic esophagectomy combined with intrathoracic anastomosis.Both groups were compared in terms of surgical indicators,complications and pulmonary function indicators[forced expiratory volume in one second(FEV1),FEV1 as a percentage of the expected value(FEV1%)and the ratio of FEV1 to forced vital capacity(FEV1/FVC)].Results The operative time of(213.48±23.15)min in the experimental group was shorter than that of(265.95±15.63)min in the control group;the number of lymph nodes dissection of(16.29±2.12)nodes in the experimental group was higher than that of(11.21±3.21)nodes in the control group;the amount of blood loss of(175.63±17.26)ml in the experimental group was less than that of(216.28±20.26)ml in the control group;the differences were statistically significant(P<0.05).The complication rate of 5.13%in the experimental group was significantly lower than that of 20.51%in the control group,and the difference was statistically significant(P<0.05).Before surgery,there was no statistically significant difference in FEV1,FEV1%and FEV1/FVC between the two groups(P>0.05).After surgery,FEV1,FEV1%and FEV1/FVC in both groups were higher than those before surgery in this group;the experimental group had FEV1 of(2.76±0.31)L,FEV1 of(86.28±4.26)%and FEV1/FVC of(66.68±4.59)%,which were higher than those of(1.94±0.35)L,(79.65±4.23)%and(59.69±4.26)%in the control group;the differences were statistically significant(P<0.05).Conclusion The combination of thoraco-laparoscopy and intrathoracic anastomosis in the clinical treatment of patients with esophageal cancer has a definite effect,which can effectively improve the basic surgical indicators of patients in the process of application,and can also reduce the incidence of complications of patients,with good clinical application value.
Objective To discuss the effect of mometasone furoate combined with adenoidectomy on clinical symptoms of children with chronic rhinosinusitis.Methods A total of 100 children with chronic rhinosinusitis were randomly divided into drug combined surgical treatment group and drug treatment group,with 50 cases in each group.The drug treatment group was treated with mometasone furoate,and the drug combined surgical treatment group was treated with adenoidectomy based on the drug treatment group.Both groups were compared in terms of therapeutic effect,incidence of adverse events,scores of sinusitis symptoms and health survey summary before and after treatment,time of disappearance of runny nose,time of relief of nasal congestion,time of improvement of tonsils.Results The total effective rate of the drug combined surgical treatment group was 98.00%,which was higher than that of 78.00%of the drug treatment group,and the difference was statistically significant(P<0.05).After treatment,the score of sinusitis symptom in both groups were lower than that before treatment in this group,and the score of health survey summary was higher than that before treatment in this group;the score of sinusitis symptom of(0.13±0.02)points in the drug combined surgical treatment group was lower than that of(1.21±0.13)in the drug treatment group;the score of health survey summary of(92.19±3.67)points in the drug combined surgical treatment group was higher than that of(80.29±3.11)points in the drug treatment group;the differences were statistically significant(P<0.05).The time of disappearance of runny nose,time of relief of nasal congestion,time of improvement of tonsils in the drug combined surgical treatment group were(5.35±1.02),(5.56±1.21)and(4.13±0.56)d,which were all shorter than those of(7.42±2.05),(8.78±2.85)and(7.21±1.88)d in the drug treatment group,and the differences were statistically significant(P<0.05).The incidence of adverse events was 8.00%in the drug combined surgical treatment group and 10.00%in the drug treatment group,and the difference was not statistically significant(P>0.05).Conclusion Mometasone furoate combined with adenoidectomy has ideal effect in the treatment of chronic rhinosinusitis,and can obviously improve the clinical symptoms of patients.
Objective To discuss the clinical effect of irbesartan combined with nifedipine controlled-release tablets in the treatment of hypertension in the community.Methods A total of 126 patients with hypertension in the community were divided into a control group and an observation group according to the random numerical table,with 63 cases in each group.The control group was treated with nifedipine controlled-release tablets alone,and the observation group was treated with irbesartan and nifedipine controlled-release tablets.Both groups were compared in terms of therapeutic effect,blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],urea nitrogen and urinary microalbumin levels before and after treatment,and the occurrence of adverse reactions.Results The total effective rate of the observation group was 93.65%(59/63),which was higher than that of 77.78%(49/63)of the control group,and the difference was statistically significant(χ2=6.481,P=6.481<0.05).After treatment,SBP and DBP levels in both groups were lower than those before treatment in this group;SBP of(123.21±9.89)mm Hg(1 mm Hg= 0.133 kPa)and DBP of(80.21±4.87)mm Hg in the observation group were lower than those of(142.89±10.11)and(94.89±5.89)mm Hg in the control group;the differences were statistically significant(P<0.05).After treatment,the levels of urea nitrogen and urinary microalbumin in both groups were lower than those before treatment in this group;the urea nitrogen of(8.33±0.70)mmol/L and urinary microalbumin of(48.68±3.03)mg/L in the observation group were lower than those of(9.48±0.39)mmol/L and(53.27±2.99)mg/L in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ2=0.151,P=0.697>0.05).Conclusion Irbesartan combined with nifedipine controlled-release tablets has a good effect in the treatment of hypertension in the community,which can improve the blood pressure level of patients,and correct the level of biochemical indicators,and is worthy of popularization and application.
Objective To analyze the clinical efficacy of Tongmai Jiangtang capsule combined with metformin tablets in the treatment of type 2 diabetes mellitus.Methods A total of 60 patients with type 2 diabetes mellitus were divided into a conventional group and a study group according to the random numerical table,with 30 cases in each group.The conventional group was treated with glibenclamide tablets,and the study group was treated with Tongmai Jiangtang capsule and metformin tablets.The therapeutic effect,blood glucose indicators[glycated hemoglobin(HbA1c),2 h postprandial glucose(2 h PG)and fasting plasma glucose(FPG)]levels,traditional Chinese medicine symptom score and quality of life of the two groups were compared.Results The total effective rate of 93.33%in the study group was significantly higher than that of 73.33%in the conventional group,and the difference was statistically significant(P<0.05).After treatment,the study group had FPG of(5.49±1.75)mmol/L,2 h PBG of(6.74±1.48)mmol/L and HbA1c of(6.35±1.53)%,which were lower than those of(6.88±1.44)mmol/L,(7.53±1.25)mmol/L and(7.34±1.78)%in the conventional group,and the differences were statistically significant(P<0.05).After treatment,the scores of dizziness,heavy cumbersome head and body,chest pain and tightness,general lassitude and shortness of breath and unwillingnessto apeak were(0.43±0.14),(0.34±0.12),(0.22±0.15),(0.34±0.12)and(0.34±0.21)points in the study group,which were lower than those of(1.21±0.31),(1.34±0.11),(1.49±0.23),(1.34±0.25)and(1.31±0.22)points in the conventional group,and the differences were statistically significant(P<0.05).After treatment,the scores of clinical symptoms,physical function,interpersonal communication and social function were(96.43±1.34),(85.34±1.42),(95.34±2.45)and(88.34±1.21)points in the study group,which were higher than those of(91.21±1.31),(75.34±1.11),(86.34±2.55)and(75.31±1.22)points in the conventional group,and the differences were statistically significant(P<0.05).Conclusion For patients with type 2 diabetes mellitus,Tongmai Jiangtang capsule combined with metformin tablet can significantly improve the clinical effect,improve the quality of life and blood glucose level of patients,and reduce the score of traditional Chinese medicine symptoms,which is worthy of clinical promotion.
Objective To discuss the value of transvaginal ultrasound and transabdominal ultrasound in the diagnosis of hysteromyoma.Methods 60 patients with hysteromyoma diagnosed by surgical pathology underwent transvaginal ultrasound and transabdominal ultrasound.The diagnostic accuracy of the two examination methods was compared.Results Transvaginal ultrasound detected 30 cases of intramural myoma,3 cases of broad ligament myoma,7 cases of subserous myoma,9 cases of submucous myoma,and 7 cases of cervical myoma,with a diagnostic accuracy of 93.33%(56/60).Abdominal ultrasound detected 25 cases of intramural myoma,2 cases of broad ligament myoma,7 cases of subserous myoma,6 cases of submucosal myoma,and 5 cases of cervical myoma,with a diagnostic accuracy of 75.00%(45/60).The diagnostic accuracy of transvaginal ultrasound was significantly higher than that of transabdominal ultrasound,and the difference was statistically significant(P<0.05).Conclusion Transvaginal ultrasound has a high diagnostic accuracy in patients with hysteromyoma,which can provide an important reference basis for clinical treatment.
Objective To investigate the effect of ozone autohemotherapy treatment combined with statin lipid-lowering drugs in the treatment of acute ischemic cerebrovascular disease and its influence on low-density lipoprotein cholesterol.Methods A total of 90 patients with acute ischemic cerebrovascular disease were divided into a control group and an observation group according to the random numerical table,with 45 cases in each group.The control group was treated with conventional treatment and statin lipid-lowering drugs,and the observation group was treated with ozone autohemotherapy treatment on the basis of the control group.Both groups were compared in terms of clinical efficacy,occurrence of adverse reactions during treatment,the degree of neurological deficit[National Institutes of Health Stroke Scale(NIHSS)score],activities of daily living score(Barthel index)and the serum level of low-density lipoprotein cholesterol before and after treatment.Results The total clinical effective rate of the observation group was 93.33%,which was higher than that of 73.33%of the control group,and the difference was statistically significant(P<0.05).After treatment,NIHSS score and serum level of low-density lipoprotein cholesterol in both groups were lower than those before treatment in this group,and the Barthel index was higher than that before treatment in this group;NIHSS score of(5.44±1.76)points and serum levels of low-density lipoprotein cholesterol of(3.25±0.09)mmol/L in the observation group were lower than those of(8.99±3.21)points and(4.35±0.12)mmol/L in the control group;Barthel index of(88.65±7.50)points in the observation group was higher than that of(76.31±6.54)points in the control group;the differences were statistically significant(P<0.05).No obvious adverse reactions occurred in the two groups during treatment.Conclusion Ozone autohemotherapy treatment combined with statin lipid-lowering drugs has outstanding clinical effects in the treatment of acute ischemic cerebrovascular disease,which can significantly improve the degree of neurological defect,improve the activities of daily living,adjust the level of low-density lipoprotein cholesterol without increasing adverse reactions.It is worthy of clinical promotion.
Objective To observe the effect of rehabilitation training guidance for parturients after cesarean section.Methods A total of 80 cases of parturients after cesarean section were divided into a control group and a study group according to the random numerical table,with 40 cases in each group.The control group was given routine guidance,and the study group was given rehabilitation training.The indexes related to uterine involution,quality of life score before and after guidance,the incidence of postoperative complications and satisfaction were compared between the two groups.Results In the study group,the postpartum urination time was(4.56±1.08)h,the duration of lochia was(16.24±2.56)d,the time to obvious relief of uterine pain was(4.02±0.55)d,the time between the umbilical and pubic fundus descending into the pelvis was(9.16±0.77)d and the time to uterus descending into the pelvis was(7.74±0.81)d,which were significantly shorter than those of(5.33±1.72)h,(17.99±3.62)d,(4.58±0.62)d,(10.25±1.18)d and(8.95±1.76)d in the control group;the fundus uterus height of(12.25±2.56)cm in the study group was lower than that of(14.59±3.84)cm in the control group;the differences were statistically significant(P<0.05).Before guidance,there was no statistically significant difference in the scores of overall health,mental health,role-emotional,role-physical,physical functioning and social functioning between the two groups(P>0.05).After guidance,the scores of overall health,mental health,role-emotional,role-physical,physical functioning and social functioning in both groups were higher than those before guidance;the scores of overall health,mental health,role-emotional,role-physical,physical functioning and social functioning were(92.01±2.92),(94.53±3.86),(93.41±2.06),(94.47±3.36),(94.87±2.18)and(93.72±3.51)points,which were significantly higher than those of(87.02±6.35),(85.47±5.97),(86.49±4.03),(89.99±4.58),(89.10±3.20)and(87.45±4.96)points in the control group;the differences were statistically significant(P<0.05).The incidence of postoperative complications of 2.50%in the study group was lower than that of 20.00%in the control group,and the total satisfaction rate of 100.00%was higher than that of 85.00%in the control group.The differences were statistically significant(P<0.05).Conclusion Rehabilitation training guidance for parturients after cesarean section can significantly improve the indexes related to uterine involution,enhance the quality of life of parturients,reduce the occurrence of postoperative complications,and improve the satisfaction of parturients with guidance,and the effect is ideal.
Objective To discuss the significance of serum procalcitonin(PCT)level in optimizing anti-infection therapy in acute exacerbation of chronic obstructive pulmonary disease.Methods A total of 100 patients with acute exacerbation of chronic obstructive pulmonary disease were divided into serum PCT guidance group and conventional clinical experience group according to different anti-infection treatment methods,with 50 cases in each group.The conventional clinical experience group applied antibiotics according to the guidelines for antibiotic treatment,white blood cell count(WBC)and clinical manifestations,and the serum PCT guidance group applied antibiotic according to the serum PCT level.Both groups were compared in terms of pulmonary function classification,acute exacerbation symptom grading,antibiotic application,serum inflammatory index[C-reactive protein(CRP),PCT,erythrocyte sedimentation rate(ESR),WBC,neutrophils]levels,blood gas analysis[blood oxygen saturation(SaO2),arterial partial pressure of oxygen(PO2),arterial partial pressure of carbon dioxide(PCO2)],clinical efficacy,time to first recurrence,length of hospital stay,total hospitalization cost,dual infection,intensive care unit(ICU)transfer and recurrence within 6 months.Results After treatment,the pulmonary function classification in both groups was better than that before treatment in this group,and the pulmonary function classification in serum PCT guidance group was better than that in conventional clinical experience group.The differences were statistically significant(P<0.05).After treatment,the acute aggravation symptom grading in both groups was better than that before treatment in this group,and the acute aggravation symptom grading in serum PCT guidance group was better than that in conventional clinical experience group.The difference were statistically significant(P<0.05).The antibiotic application rate of 60.00%(30/50)in serum PCT guidance group was lower than that of 94.00%(47/50)in conventional clinical experience group,and the difference was statistically significant(χ2=16.318,P<0.05).The average course of antibiotics of(6.30±1.14)d in serum PCT guidance group was shorter than that of(9.50±1.30)d in conventional clinical experience group,and the difference was statistically significant(t=13.087,P<0.05).The per capita cost of antibiotics of(2034.13±340.33)yuan in serum PCT guidance group was lower than that of(3142.25±534.24)yuan in conventional clinical experience group,and the difference was statistically significant(t=12.370,P<0.05).In serum PCT guidance group,the serum CRP,PCT,ESR,WBC,neutrophil,SaO2,PO2 and PCO2 were(30.00±5.81)mg/L,(2.03±0.32)ng/ml,(23.35±3.46)mm/h,(10.00±1.30)×109/L,(0.81±0.06),(91.87±4.85)%,(65.00±11.45)mm Hg(1 mm Hg= 0.133 kPa)and(57.35±8.67)mm Hg before treatment,and those were(12.88±2.11)mg/L,(1.75±0.32)ng/ml,(18.25±3.36)mm/h,(7.04±1.60)×109/L,(0.67±0.03),(95.10±3.60)%,(85.92±8.33)mm Hg and(46.85±5.03)mm Hg after treatment.In conventional clinical experience group,the serum CRP,PCT,ESR,WBC,neutrophils,SaO2,PO2 and PCO2 were(29.20±4.04)mg/L,(2.05±0.30)ng/ml,(23.52±3.16)mm/h,(9.97±1.80)×109/L,(0.80±0.04),(91.23±4.11)%,(63.46±13.40)mm Hg and(58.23±9.80)mm Hg before treatment,and those were(14.15±2.00)mg/L,(1.86±0.15)ng/ml,(20.10±3.12)mm/h,(8.31±1.23)×109/L,(0.77±0.05),(93.77±2.77)%,(76.50±8.21)mm Hg and(52.71±7.41)mm Hg after treatment.Before treatment,there were no statistically significant differences in serum CRP,PCT,ESR,WBC,neutrophil,SaO2,PO2 and PCO2 levels between the two groups(P>0.05).After treatment,the serum levels of CRP,PCT,ESR,WBC,neutrophils and PCO2 in both groups were lower than those before treatment in this group,while the levels of SaO2 and PO2 were higher than those before treatment in this group;the serum levels of CRP,PCT,ESR,WBC,neutrophils and PCO2 in serum PCT guidance group were lower than those in conventional clinical experience group,while the levels of SaO2 and PO2 were higher than those in conventional clinical experience group;the differences were statistically significant(P<0.05).The total effective rate of 90.00%(45/50)in serum PCT guidance group was higher than that of 66.00%(33/50)in conventional clinical experience group,and the difference was statistically significant(χ2=8.392,P<0.05).The time to first recurrence of(5.16±0.86)months in serum PCT guidance group was longer than that of(4.38±0.64)months in conventional clinical experience group,and the difference was statistically significant(t=5.145,P<0.05).The length of hospital stay of(10.44±1.24)d in serum PCT guidance group was shorter than that of(12.41±2.53)d in conventional clinical experience group,and the difference was statistically significant(t=4.944,P<0.05).The total hospitalization cost of(8736.14±1245.13)yuan in serum PCT guidance group was lower than that of(11242.12±435.23)yuan in conventional clinical experience group,and the difference was statistically significant(t=13.434,P<0.05).The dual infection rate and ICU transfer rate in serum PCT guidance group were 2.00%(1/50)and 8.00%(4/50),which were lower than those of 16.00%(8/50)and 26.00%(13/50)in conventional clinical experience group,and the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the recurrence rate within 6 months between the two groups(P>0.05).Conclusion The level of serum PCT in patients with acute exacerbation of chronic obstructive pulmonary disease is of great significance in the guidance of anti-infection therapy.
Objective To investigate the safety and economic efficacy of entacarbon levodopa and carbidopa tablets in the treatment of Parkinson's disease.Methods The clinical data of 157 patients with Parkinson's disease were retrospectively analyzed,and the patients were divided into a control group(78 cases)and an observation group(79 cases)based on different treatment methods.The control group was treated with pramipexole,and the observation group was treated with entacarbon levodopa and carbidopa tablets.After 3 months of treatment,cost-effectiveness analysis was performed on both group,and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate of 69.62%in the observation group was significantly higher than that of 53.85%in the control group,and the difference was statistically significant(P<0.05).The total cost of entacarbon and levodopa and carbidopa tablets for 3 months in the observation group was 2070.09 yuan,which was higher than that of 508.14 yuan of pramipexole dihydrochloride tablets for 3 months in the control group.The cost-effectiveness ratio(C/E)of 29.73 in the observation group was obviously higher than that of 9.44 in the control group.In the incremental cost-effectiveness comparison between the observation group and the control group,the incremental cost(ΔC)was 1561.95 yuan,the incremental effectiveness(ΔE)was 15.77%,and the incremental cost-effectiveness ratio(ICER)was 99.05.The incidence of adverse reactions of 5.07%in the observation group was significantly lower than that of 15.38%in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of entacarbon levodopa and carbidopa tablets in the treatment of patients with Parkinson's disease has high drug safety and more significant cost-effectiveness,which can effectively reduce the economic burden of patients.
