Mycoplasma pneumoniae pneumonia (MPP) is a common respiratory tract infection disease in children. To date, there have been few studies on the relationship between cytological changes in bronchoalveolar lavage fluid (BALF) and clinical features. The objective of this study is to investigate the correlation between changes in the proportion of cell classifications in BALF and the clinical features in children with severe MPP (SMPP). In total, the study included 64 children with SMPP requiring bronchoalveolar lavage who were admitted to our hospital between March and September 2022 (study group) and 11 children with bronchial foreign bodies without co-infection (control group), who were admitted during the same period. The proportion of cell classifications in BALF was determined by microscopic examination after performing Wright-Giemsa staining. Patients were grouped according to different clinical characteristics, and between-group comparisons were made regarding the variations in the proportion of cell classifications in BALF. The levels of blood routine neutrophil percentage (GRA
A digital classification system based on AO classification was adopted to study and summarize different types of floating knee injuries. One hundred cases with a floating knee injury from March 2005 to December 2020 were collected, including 74 males and 26 females with an average age of 43.74 years. The distribution of the affected limbs in there were 51 cases (51.0
Objective:This study investigated the effect of letrozole with/without meridian-infusion percutaneous electrical stimulation on the rates of ovulation-induced pregnancy in patients with obese polycystic ovary syndrome (obPCOS). Materials and Methods:Patients with obPCOS, ages 20-40, each with a body mass index (BMI) ≥24 kg/m2, and/or waist circumference ≥80 cm, and at least 1 side tubal patency were enrolled at the Guangdong Women and Children Hospital, Guangzhou, China. They were divided into 2 groups: ZLT [Ziwu Liuzhu + transcutaneous electrical acupoint stimulation] and control. Baseline conditions and pregnancy status were collected for all patients. Multivariate Cox regression analysis and sensitivity analysis of propensity score matching (PSM) were performed for the groups after multiple interpolations. Results:From July 2021 to September 2022, 345 patients with obPCOS were recruited: 53 cases/69 cycles in the ZLT group and 292 cases/396 cycles in the control group. The 2 sets of baselines were flush. The anovulatory cycle rates were: ZLT, 2.89% (2/69); and control, 1.77% (7/396); P > 0.05. Multifollicle growth-cycle rates were: ZLT, 0% (0/69); and control, 0.76% (3/396); P > 0.05. Multivariate COX regression analysis showed adjusted hazard ratio (aHR) 95% confidence interval (CI): 2.11 (1.19, 3.73); P = 0.011. Multivariate Cox regression analysis with multiple imputation showed aHR 95% CI: 2.11 (1.19, 3.73); P = 0.013. In the overweight group (24-28 kg/m2), the pregnancy rate of the control and ZLT groups were 20.2% and 32.3%, respectively, aHR 95% CI: 1.76 (0.87,3.55); P = 0.113. In the obese cohort (≥ 28 kg/m2), the control and ZLT groups, pregnancy rates were 10.7% and 27.3%, respectively, aHR 95% CI: 3.46 (1.21, 9.92); P = 0.021; (Pfor interaction = 0.369). The caliper value was set as 0.2 for BMI and antral-follicle count, and PSM was performed at 1:1, aHR 95%CI: 2.45 (1.01, 5.96); P = 0.048. Conclusions:Letrazole + ZLT had a positive effect on ovulation-induced pregnancy rates in patients with obPCOS.
Objective:To understand the polymorphisms of CYP2C19*2/ *3/ *17 alleles 9154G>A, 7948G>A, and 806C>T in Guangzhou population, and to provide reference for the clinical application of voriconazole in the treatment of invasive fungal infections. Methods:A total of 318 patients with suspected invasive fungal infection who were scheduled to be treated with voriconazole and were tested for CYP2C19*2/ *3/ *17 allele in Guangzhou Chest Hospital from January 2022 to February 2023 were selected for analysis, including 249 males and 69 females, aged 19-94 years (with a mean age of 58 years old). The polymorphism of CYP2C19*2 (9154G>A), CYP2C19* 3 (7948G>A), and CYP2C19* 17 (806C>T) in the patients was detected by digital fluorescence molecular hybridization sequencing. The distribution frequencies of genotypes and haplotypes in patients with fast, medium, and slow voriconazole metabolism types were analyzed. Results:GG, AG, and AA genotypes were detected on the CYP2C19* 2 (9154G>A) locus, with the distribution frequencies of 47.80% (152/318), 42.45% (135/318), and 9.75% (31/318), respectively. GG, GA, and AA genotypes were detected on the CYP2C19* 3 (7948G>A) locus, with the distribution frequencies of 90.88% (289/318), 8.81% (28/318), and 0.31% (1/318), respectively. CC and CT genotypes were detected on the CYP2C19* 17 (806C>T) locus, with the distribution frequencies of 99.37% (316/318) and 0.63% (2/318), respectively. In the 318 patients to be treated with voriconazole, there were 135 (42.45%), 140 (44.03%), and 43 (13.52%) patients with fast, medium, and slow voriconazole metabolism types, respectively. The haplotypes of the 3 gene loci were 2 fast metabolism haplotypes of GG-GG-GC and GG-GG-CT, with the distribution frequencies of 99.26% (134/135) and 0.74% (1/135), 3 medium metabolism haplotypes of AG-GG-CC, GG-GA-CC, and AG-GG-CT, with the distribution frequencies of 87.86% (123/140), 11.43% (16/140), and 0.71% (1/140), and 4 medium metabolism haplotypes of AA-GG-CC, AG-GA-CC, AA-GA-CC, and GG-AA-CC, with the distribution frequencies of 69.77% (30/43), 25.58% (11/43), 2.33% (1/43), and 2.33% (1/43). Conclusions:From the genetic background of CYP2C19 gene, although most people in Guangzhou are fast and medium voriconazole metabolism types, slow voriconazole metabolism type account for a certain proportion. Therefore, the attention should be paid to the detection of its gene polymorphism in clinical diagnosis and treatment, so as to guide the reasonable clinical application of voriconazole.
Objective:To study the diagnostic value of myocardial zymogram and echocardiography in acute myocardial infarction.Methods:A total of 100 patients with acute myocardial infarction who came to the Third People's Hospital of Liaocheng City from January 2021 to February 2023 were selected as the observation group, and 83 healthy subjects who came to our hospital for physical examination during the same period were selected as the control group. In the observation group, there were 61 males and 39 females, aged (56.47±8.65) years; in the control group, there were 56 males and 27 females, aged (56.58±9.02) years. The general data such as gender, age, and occupation were compared between the two groups. The left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and myocardial enzyme indexes were compared between the two groups. Independent sample t test, χ2 test, and Pearson correlation analysis were used. Results:There were no statistically significant differences in the body mass index, age, gender, smoking history, drinking history, marital status, occupation, residence address, systolic blood pressure (SBP), and serum triglyceride (TG) and fasting blood glucose (FPG) levels between the two groups (all P>0.05). The LVEF of the observation group was lower than that of the control group [(55.48±3.16)% vs. (65.42±3.37)%], while the LVEDD of the observation group was higher than that of the control group [(53.85±7.22) mm vs. (47.20±2.83) mm], with statistically significant differences (both P<0.05). There were no statistically significant differences in the serum lactate dehydrogenase (LDH) and homocysteine (HCY) levels between the two groups (both P>0.05), while the serum creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) levels in the observation group were higher than those in the control group, with statistically significant differences (both P<0.05). Pearson correlation analysis showed that LVEF was negatively correlated with CK-MB in patients with acute myocardial infarction ( P<0.05), while LVEDD was positively correlated with CK-MB ( P<0.05). The areas under the curves of LVEF, LVEDD, CK-MB, and their combination in the diagnosis of acute myocardial infarction were 0.917, 0.800, 0.929, and 0.953, the sensitivities were 0.861, 0.816, 0.893, and 0.904, respectively, and the specificities were 0.825, 0.889, 0.795, and 0.764, respectively. Conclusions:The levels of LVEF and serum CK and CK-MB in patients with acute myocardial infarction decrease, while the LVEDD increases. The combination of LVEF, LVEDD, and CK-MB in the diagnosis of acute myocardial infarction is more advantageous than that of single diagnosis, and better diagnostic efficacy can be obtained.
Objective:To explore the application of the new clinical teaching mode of "dual guidance system" and highlighting the cultivation of core competence of traditional Chinese medicine nursing in improving the teaching quality of traditional Chinese medicine nursing.Methods:A total of 47 nursing interns from Huangpu Branch, The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine from July 2021 to June 2022 were selected as the control group, including 35 females and 12 males, aged 19-22 (20.34±1.07) years. A total of 50 nursing interns from July 2022 to June 2023 were selected as the research group, including 36 females and 14 males, aged 19-23 (20.92±1.34) years. The control group adopted the conventional teaching mode; on the basis of the traditional clinical teaching mode, the research group added online MOOCs, offline flipped classrooms, and problem-based teaching methods (PBL) based on the "dual guidance system". In addition to the original assessment methods, the assessment of traditional Chinese medicine nursing programs for specialized dominant diseases and Objective Structured Clinical Examination (OSCE) were added. The teaching satisfaction scores, results of theoretical assessment and operation assessment, and traditional Chinese medicine nursing practice quality scores of the two groups were compared. χ2 test, rank sum test, and t test were used. Results:The satisfaction of clinical teachers in the research group was higher than that in the control group, with a statistically significant difference ( Z=-2.884, P=0.004). The results of theoretical assessment and operation assessment of the study group were (88.27±3.70) points and (90.17±3.79) points, respectively, while those of the control group were (83.72±5.51) points and (85.75±5.77) points, with statistically significant differences ( t=4.80 and 4.38, both P<0.001). The scores of 9 dimensions of the Self-rating Scale of Traditional Chinese Medicine Nursing Practice Quality in the study group were better than those in the control group (all P<0.05). Conclusion:The clinical teaching mode based on the "dual guidance system" and highlighting the cultivation of core competence of traditional Chinese medicine nursing can effectively improve the independent learning ability and enthusiasm of nursing students, and improve their professional skills and clinical dialectical thinking ability, which provides a new way to cultivate high-quality traditional Chinese medicine nursing talents.
Objective:To analyze the clinical efficacy and safety of belizumab in the treatment of patients with systemic lupus erythematosus and conduct a meta-analysis.Methods:The PubMed, Web of Science, Cochrane Library, EMBASE, China National Knowledge Internet (CNKI), China Biomedical Literature Database (CBM), VIP database, and Wanfang database were searched for all the randomized controlled trials related to belizumab and systemic lupus erythematosus from their establishment to February 2023. According to the including and excluding criteria, the literatures were screened, and the data were obtained. The RevMan5.4.1 software and Sata16 software were used for the meta-analysis of the obtained data. Relative risk and weighted mean difference were used to represent the effect indicators. The efficacies and safety of the two groups were compared. The sensitivity and publication bias were analyzed.Results:A total of 9 randomized controlled trials were included, with a total of 2 657 patients, including 1 522 cases in the belizumab group and 1 135 cases in the placebo group. Clinical efficacy: compared with the placebo group, the qualified rate of the systemic lupus erythematosus responder index (SRI4) ( RR=1.29, 95% CI 1.17-1.42, P<0.001; I2=0, P=0.91) of belizumab continuous treatment for 52 weeks significantly increased; the patients' clinical symptoms were effectively improved; the severe flare (SF) was reduced ( RR=0.68, 95% CI 0.58-0.79, P<0.001; I2=0, P=0.48); the disease activity was effectively reduced; the patients' quality of life was improved; the decrease of the SELENA-SLEDAI score ≥4 points ( RR=1.28, 95% CI 1.17-1.40, P<0.001; I2=0%, P=0.95); the systemic lupus erythematosus disease activity index (SLEDAI) score ( WMD=-4.77, 95% CI -8.67--0.86, P=0.02; I2=97%, P<0.001). Safety: there were no statistical differences in the total incidence of adverse events ( RR=0.99, 95% CI 0.96-1.02, P=0.54; I2=0, P=0.90) and the incidence of serious adverse events ( RR=0.85, 95% CI 0.64-1.12, P=0.25; I2=57%, P=0.05) between the two groups. Conclusion:Belizumab as an additional treatment for patients with systemic lupus erythematosus has good efficacy and does not increase the incidence of adverse reactions after medication.
In the post-epidemic era, traditional face-to-face teaching is difficult to meet the needs of undergraduate ultrasound teaching due to a variety of constraints. Distance learning has become the solution, but it has not been effective in the past. This paper analyses and proposes the combination of 5G technology and flipped classroom to explore the advantages, disadvantages, and application value of this new teaching model. It is hoped that through the above teaching reform solution, we can adapt to the normal management of COVID-19 epidemic, deepen students' understanding of basic theoretical knowledge and ultrasound images, improve their practical skills, expand their clinical thinking, mobilize their subjective motivation and interest in learning, to ensure the quality of medical distance learning.
Objective:To explore the application effect of bovine basic fibroblast growth factor gel combined with anal bag negative pressure drainage and flushing device in nursing care for patients with incontinence-associated dermatitis (IAD) in intensive care unit (ICU).Methods:This study was a randomized controlled trial. A total of 60 IAD patients were selected as research subjects from July 2021 to March 2023 in the ICU of Jieyang People's Hospital. The subjects were divided into a control group (30 cases) and an observation group (30 cases) by the random number table method. In the course of the study, 3 patients withdrew from the study. Finally, 28 cases were included in the control group and 29 cases in the observation group. In the control group, there were 18 males and 10 females, aged (62.43±13.63) years; in the observation group, there were 16 males and 13 females, aged (63.62±14.11) years. The control group was treated with anal bag negative pressure drainage and flushing device on the basis of routine operation, and the observation group was treated with bovine basic fibroblast growth factor gel and anal bag negative pressure drainage and flushing device on the basis of routine operation. The severity of IAD, the reduction rate of the Chinese version of the Incontinence-Associated Dermatitis and Its Severity Instrument (IADS), and the IAD healing time were compared between the two groups. t test, non-parametric test, and χ2 test were used. Results:There was no statistically significant difference in the severity of IAD between the two groups before intervention ( Z=-0.154, P=0.878). On the 3rd and 6th day after intervention, the severity of IAD in the control group decreased to 2.0 (3.0) and 0 (0) points, respectively, while that in the observation group decreased to 3.0 (2.0) and 0 (3.0) points, respectively, with statistically significant differences (both P<0.05); the reduction rates of IADS in the control group were 33.33% (19.92%) and 100.00% (42.71%), respectively, and those in the observation group were 57.14% (63.33%) and 100.00% (0), respectively, with statistically significant differences (both P<0.05). The healing time of IAD was (8.04±4.97) days in the control group and (6.10±3.89) days in the observation group, without statistically significant difference between the two groups ( t=1.638, P=0.107). Conclusion:The application of bovine basic fibroblast growth factor gel combined with anal bag negative pressure drainage and flushing device in ICU IAD patients can effectively alleviate the severity of IAD and promote the healing of IAD, worthy of clinical promotion.
Objective:To explore the effect of parecoxib on Edinburgh depression scores, postpartum depression, and blood levels of brain-derived neurotrophic factor (BDNF) and 5-hydroxytryptamine (5-HT) of puerperants who receive analgesia with single epidural morphine injection combined with dezocine intravenous analgesia after cesarean section.Methods:Eighty full-term pregnant women treated at Department of Obstetrics, Foshan Second People's Hospital from January 2022 to December 2022 were recruited. Their American Society of Anesthesiologists (ASA) grade was Ⅰ-Ⅱ; they were 20-39 years old; their body weight was 50-80 kg; they were 37-41 weeks pregnant. They were divided into a control group and an observation group by the random number table method, with 40 cases in each group. They planned to take selective cesarean section. The single epidural morphine injection combined with intravenous analgesia with dezocine was used in both groups; parecoxib was added in the above analgesic methods in the observation group. The postoperative pain scores [Visual Analogue Scale (VAS)] and analgesic adverse reactions were observed. The maternal Edinburgh Postnatal Depression Scale (EPDS) score was evaluated 1 day before and 3 days and 2 weeks after cesarean section. The incidence of postpartum depression was recorded. The serum levels of BDNF and 5-HT were measured by the enzyme-linked immunization. One-way ANOVA and χ2 test were used for the statistical analysis. Results:The scores of VAS 12, 24, and 48 h after delivery in the observation group were lower than those in the control group [(2.23±0.83) vs. (3.05±0.82), (2.98±0.86) vs. (3.78±1.03), and (3.43±0.87) vs. (3.90±0.96)], with statistical differences (all P<0.05). There was no statistical difference in the overall incidence of adverse reactions during the analgesia between the two groups ( P>0.05). The scores of EPDS 3 days and 2 weeks after delivery in the observation group were lower than those in the control group [(7.23±2.55) vs. (9.55±3.52) and (8.15±3.09) vs. (9.58±2.78)], with statistical differences (both P<0.05). The incidences of postpartum depression in the observation group 3 days and 2 weeks after delivery were lower than those in the control group [7.50% (3/40) vs. 25.00% (10/40) and 5.00% (2/40) vs. 22.50% (9/40)], with statistical differences (both P<0.05). The serum levels of BDNF and 5-HT 3 days and 2 weeks after delivery in the observation group were higher than those in the control group, with statistical differences (all P<0.05). Conclusion:Parecoxib can enhance the analgesia effect of epidural morphine combined with dezocine intravenous analgesia, reduce the EPDS score and the incidence of postpartum depression after cesarean section, and increase the serum levels of BDNF and 5-HT without increasing adverse reactions.
Objective:To investigate the inhibitory effects and therapeutic efficacy of 3% hypertonic saline combined with dexmedetomidine on the levels of serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), neuron-specific enolase (NSE), and central nervous system-specific protein (S100B) in patients with severe craniocerebral injury, and to provide new insights and methods for the treatment of patients with severe craniocerebral injury.Methods:The prospective study selected 58 patients with craniocerebral injury admitted to Department of Neurosurgery, Jieyang People's Hospital from September 2022 to August 2023 as the study objects. The patients were randomly divided into a control group and an observation group by the single blind method. The control group took mannitol and other sedative and analgesic drugs; in addition, the observation group took 3% hypertonic saline and dexmedetomidine. The serum levels of IL-6, TNF-α, NSE, and S100B were measured 12 (T 1), 24 (T 2), 48 (T 3), and 72 h (T 4) after injury. The data were compared between the two groups by t and χ2 tests. Results:The serum levels of IL-6, TNF-α, NSE, and S100B at T 2, T 3, and T 4 in the observation group were (276.11±18.64) ng/L, (165.07±15.32) ng/L, and (126.07±16.15) ng/L, (1.27±0.21) ng/L, (1.22±0.25) ng/L, and (0.78±0.15) ng/L, (16.74±3.51) μg/L, (19.07±4.91) μg/L, and (14.97±2.21) μg/L, and (0.47±0.15) μg/L, (0.56±0.23) μg/L, and (0.32±0.16) μg/L, and those in the control group were (315.23±19.54) ng/L, (199.05±16.16) ng/L, and (141.02±17.98) ng/L, (1.47±0.25) ng/L, (1.45±0.22) ng/L, and (0.91±0.19) ng/L, (20.17±3.21) μg/L, (24.17±5.61) μg/L, and (17.06±2.98) μg/L, and (0.67±0.28) μg/L, (0.87±0.32) μg/L, and (0.47±0.13) μg/L, the difference between the two groups was statistically significant (all P<0.05). Conclusion:Three percent hypertonic saline combined with dexmedetomidine can inhibit the expression of neuroinflammatory factors in patients with severe craniocerebral injury and alleviate secondary brain injury.
Objective:To explore the application value of pestle needle combined with acupoint application in traditional Chinese medicine (TCM) nursing for patients with cervical vertigo.Methods:This study was a randomized controlled trial. A prospective study was conducted to select 82 patients with cervical vertigo admitted to Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from July 2020 to July 2022. They were divided into a control group (41 cases) and an observation group (41 cases) according to the random number table method. In the control group, there were 23 males and 18 females, aged (42.59±4.61) years, with a course of disease of (36.91±8.24) months; in the observation group, there were 24 males and 17 females, aged (42.81±4.32) years, with a course of disease of (37.49±8.56) months. The control group received routine nursing care, while the observation group received TCM characteristic nursing techniques (pestle needle combined with acupoint application). Both groups received 21 days of nursing care. The symptoms and function of cervical vertigo, sleep quality, and quality of life were compared and analyzed in the two groups. t test and χ2 test were used. Results:After nursing, the scores of shoulder and neck pain [(2.98±0.35)], vertigo [(12.58±1.43)], psychological and social status [(3.01±0.45)], headache [(1.49±0.18)], and daily life and work [(3.08±0.39)] and the total score [(23.14±3.06)] of the Evaluating Score for the Symptoms and Function Rehabilitation of Cervical Vertigo in the observation group were higher than those in the control group [(2.34±0.31), (10.32±1.76), (2.38±0.30), (1.14±0.26), (2.43±0.34), and (18.61±2.97)], the score of quality of life questionnaire was higher than that in the control group [(105.34±9.02) vs. (90.13±8.17)], and the score of Pittsburgh Sleep Quality Index was lower than that in the control group [(7.21±1.23) vs. (9.61±1.83)], with statistically significant differences ( t=8.765, 6.381, 7.459, 7.087, 8.044, 6.802, 8.003, and 6.970, all P<0.001). Conclusion:TCM characteristic nursing technique of pestle acupuncture combined with acupoint application can alleviate the clinical symptoms in patients with cervical vertigo, improve their cervical function, reduce the impact on sleep, and improve their quality of life, with high clinical application value.
Objective:To study the effects of glimepiride combined with metformin and rhythmic exercise on islet function and cardiovascular risk in patients with type 2 diabetes mellitus.Methods:A total of 99 patients with type 2 diabetes mellitus treated in Jinan Second People's Hospital from January 2020 to February 2023 were selected and were divided into a control group and an observation group according to the coin toss method. In the control group, 50 patients were treated with metformin combined with rhythmic exercise, including 31 males and 19 females, aged (61.25±2.64) years. In the observation group, 49 patients were treated with glimepiride combined with metformin and rhythmic exercise, including 30 males and 19 females, aged (61.31±2.60) years. The therapeutic effect, islet function, inflammatory factors, blood lipid indexes, and occurrence of adverse reactions were compared between the two groups. t test and χ2 test were used. Results:After treatment, the levels of fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS), and postprandial 2 h blood glucose (2hPG) were decreased in the two groups and the four indexes of the observation group [FPG (6.68±1.21) mmol/L, HbA1c (7.10±0.95) %, FINS (7.68±2.57) μU/ml, and 2hPG (7.34±1.14) mmol/L] were lower than those of the control group [FPG (7.25±1.26) mmol/L, HbA1c (7.71±1.03) %, FINS (8.94±2.96) μU/ml, and 2hPG (8.04±1.23) mmol/L] (all P<0.05). After treatment, the insulin resistance index (HOMA-IR) was decreased in the two groups, and that in the observation group was lower than that in the control group [(2.15±0.39) vs. (2.39±0.40)] (all P<0.05). The insulin sensitivity indexes (ISI) and islet β cell function indexes (HOMA-β) of the two groups after treatment were higher than those before treatment, and those in the observation group [HOMA-β (47.63±2.75) and ISI (2.95±0.43)] were higher than those in the control group [HOMA-β (45.91±2.61) and ISI (2.64±0.47)] (all P<0.05). After treatment, the levels of interleukin-1β (IL-1β), C-reactive protein (CRP), and tumor necrosis factor (TNF) -α were decreased in the two groups, and the levels of IL-1β [(4.86±1.02) ng/L], CRP [(1.34±0.03) mg/L], TNF-α [(8.62±1.36) ng/L] in the observation group were lower than those in the control group [IL-1β (5.48±1.23) ng/L, CRP (1.39±0.04) mg/L, and TNF-α (9.54±1.59) ng/L] (all P<0.05). After treatment, the levels of triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) were decreased in the two groups, and the levels of TG [(4.17±1.18) mmol/L], TC [(2.28±0.95) mmol/L], LDL-C [(2.50±0.29) mmol/L] in the observation group were lower than those in the control group [TG (4.73±1.02) mmol/L, TC (2.89±1.13) mmol/L, and LDL-C (2.69±0.32) mmol/L] (all P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the observation group [14.29% (7/49)] and the control group [10.00% (5/50)] ( χ2=0.427, P=0.514). Conclusion:The combination of glimepiride, metformin, and arrhythmic exercise for type 2 diabetes mellitus has better hypoglycemic effect, which can significantly improve the islet function and blood lipid level, with lower inflammatory response and fewer adverse cardiovascular reactions.
The nursing experience of a patient with immunotherapy-associated myocarditis and myositis caused by tirelizumab was summarized. The nursing key points were as below: the multidisciplinary specialist nursing team was established; a phased and individualized early rehabilitation exercise program was developed; the formulation of endurance exercise prescription, early cardiopulmonary rehabilitation exercise, and limb rehabilitation exercise combined with Borg classification; monitoring the conditions closely; cooperation with the treatment; psychological nursing; posture management; pressure ulcers prevention; early nutritional support. After multidisciplinary treatment and careful nursing, the patient was improved and discharged from the hospital. The follow-up after discharge showed that the patient basically resumed self-care.
The study on the safety and efficacy of high intensity interval training (HIIT) in chronic heart failure (CHF) has been the hot spot of clinical research. Low and moderate intensity aerobic exercise is chosen for clinical intervention in CHF. It is concerned that more and more sports rehabilitation programs choose HIIT as a means of cardiac rehabilitation. This review summarizes the clinical effect of HIIT intervention on CHF in terms of maximum oxygen consumption (VO 2 max), vascular endothelial function, and cardiac function, and compares HIIT with other exercise training such as moderate intensity continuous training, moderate intensity interval training, and resistance training, in order to provide a reference for the safe and effective treatment of CHF patients with HIIT.
Objective:To investigate the relationship between the expression of tumor-infiltrating lymphocytes (TILs) and clinicopathological characteristics, and the effect of TILs on prognosis in patients with human epidermal growth factor receptor 2 (HER2) positive breast cancer.Methods:A total of 94 female patients with HER2 positive breast cancer treated at Tengzhou Central People's Hospital from October 2016 to October 2018 were collected, with a median age of 51 years (32-73 years). Among them, 49 patients took trastuzumab and chemotherapy, and 45 chemotherapy. The degree of TILs in the tumor area of each patient's HE section was evaluated. χ2 test was used to analyze the category data. The Kaplan Meier survival curve and Cox proportional hazard regression model were used to analyze the prognostic factors. The relationship between the degree of TILs and the clinicopathological characteristics and the effect of TILs on the patients' recurrence free survival (RFS) were analyzed. Results:Among the 94 patients, 61 had low infiltration, and 33 high infiltration. There were no significant correlations between the degree of TILs and clinical pathological parameters (all P>0.05). In the targeted therapy group, 32 cases had low infiltration, and 17 cases high infiltration. The RFS of the patients with high TILs was longer than that of the patients with with low TILs ( P=0.036); TNM stage and the degree of TILs were independent factors for the patients' prognosis ( P=0.003 and 0.029). In the general chemotherapy group, 29 cases had low infiltration, and 16 cases high infiltration. The RFS of the patients with high TILs was longer than that of the patients with with low TILs ( P=0.049); TNM stage and TILs were independent factors related to the patients' prognosis ( P=0.001 and 0.028). Conclusions:TILs can be used as tumor markers in predicting the prognosis and therapeutic effect of patients with HER2 positive breast cancer, and may become new therapeutic targets for tumors.
Objective:To investigate the efficacy of continuous renal replacement therapy (CRRT) combined with prone position ventilation in patients with severe acute respiratory distress syndrome (ARDS).Methods:Twenty two patients with severe ARDS who were admitted to Huaihe Hospital of Henan University from August 2020 to March 2023 and needed to be treated with bedside CRRT combined with prone position ventilation were selected, including 8 males and 14 females, aged (61.2±10.2) years. The patients' oxygenation index, hemodynamics, and inflammation indexes before and after treatment were compared. Paired t test was used for the measurement data. Results:After treatment, the arterial partial oxygen pressure (PaO 2) [(92.23±10.08) mmHg] (1 mmHg=0.133 kPa), blood oxygen saturation (SpO 2) [(94.62±1.16)%], and oxygenation index (PaO 2/FiO 2) [(280.02±25.64) mmHg] were all higher than those before treatment [(56.25±7.14) mmHg, (85.07±2.69)%, and (176.62±15.42) mmHg], while the arterial partial carbon dioxide pressure (PaCO 2) [(35.65±5.20) mmHg] was lower than that before treatment [(47.72±8.69) mmHg], with statistically significant differences ( t=8.944, 2.134, 11.012, and 4.113; all P<0.05). The heart rate [(90.55±2.26) beats/min] after treatment was lower than that before treatment [(102.50±5.52) beats/min], and the mean arterial pressure (MAP) [(80.05±5.35) mmHg] was higher than that before treatment [(62.26±4.50) mmHg], with statistically significant differences ( t=2.375 and 5.125, both P<0.05). There was no statistically significant difference in the central venous pressure (CVP) before and after treatment ( t=0.608, P>0.05). After treatment, the levels of C-reactive protein (CRP) [(37.87±10.68) mg/L], interleukin (IL)-1 [(25.75±7.18) ng/L], IL-6 [(20.87±8.47) ng/L], and IL-10 [(31.03±7.24) ng/L] in serum were all lower than those before treatment [(120.56±40.78) mg/L, (42.25±6.26) ng/L, (58.32±9.06) ng/L, and (65.75±7.62) ng/L], with statistically significant differences ( t=10.177, 3.241, 6.262, and 6.014; all P<0.05). The overall fatality rate at 28 days was 22.7% (5/22). Conclusion:The combination of bedside CRRT and prone position ventilation significantly improves the oxygenation, hemodynamics, and inflammatory indicators in severe ARDS patients, buying time for the treatment of primary diseases in ARDS patients and promoting their recovery.
With the change of people's working environment, the number of patients with vertigo caused by cervical spine diseases is increasing gradually, and the age of onset is becoming younger. The etiology and pathogenesis of the disease are not clear, so the related clinical researches change with each passing day, and the treatment methods emerge in an endless stream. In many therapies after baptism, massage therapy is a classic inheritance of the treatment of this disease and is considered effective by doctors and patients. The authors searched numerous literatures related to vertigo. Therefore, the authors summarized the treatment of cervical vertigo based on massage published in the relevant core journals and papers in the past 5 years (2017.06-2022.06), to understand the treatment progress and existing problems of cervical vertigo based on massage, in order to provide clinical basis.
Objective:To explore the correlation between different degrees of placental abruption and coagulation function indicators.Methods:Seventy-two pregnant women with placental abruption admitted to Pingshan District People's Hospital from January 2019 to September 2021 were collected as an observation group, with an age of (28.67±3.05) years and a gestation period of (33.69±1.35) weeks. According to the severity of placental abruption, they were divided into a mild group (42 cases) and a severe group (30 cases). During the same period, 72 healthy pregnant women were collected as a reference group, with an age of (28.56±3.11) years and a gestation period of (33.42±1.23) weeks. The prothrombin times (PT), activated partial thromboplastin times (APTT), and thrombin times (TT) and levels of fibrinogen (FIB) and D-Dimer (D-D) were compared between the control group and the observation group. The coagulation function indicators and adverse pregnant outcomes were compared between the mild group and the severe group. The efficiencies of the coagulation indicators in predicting different degrees of placental abruption were analyzed. The t test, ANOVA, and χ2 test were used. The areas (AUC) under the receiver operating characteristic curves (ROC) were used to evaluate the prediction efficiencies. Results:The PT and D-D levels in the observation group were higher than those in the reference group [(14.22±1.54) s vs. (9.11±0.45) s and (4.46±1.37) μg/L vs. (0.34±0.10) μg/L], with statistical differences ( t=27.026 and 25.450, both P<0.001). The FIB level of the observation group was lower than that of the reference group [(3.46±0.42) g/L vs. (4.52±0.97) g/L], with a statistical difference ( t=8.509, P<0.001). There were no statistical differences in APTT and TT between the observation group and the reference group (both P>0.05). The D-D level in the severe group was higher than that in the mild group [(5.88±1.73) μg/L vs. (3.05±1.01) μg/L], with a statistical difference ( t=8.734, P<0.001); the FIB level in the severe group was lower than that in the mild group [(3.00±0.26) g/L vs. (3.93±0.59) g/L], with a statistical difference ( t=8.079, P<0.001). There were no statistical differences in PT, APTT, and TT between the mild group and the severe group (all P>0.05). The AUC's of FIB and D-D in the prediction of mild and severe placental abruption were 0.630 and 0.609, respectively; the sensitivity and specificity of FIB combined with D-D in predicting mild and severe placental abruption were 87.99% and 86.59%, and the AUC was 0.897, which were better than FIB or D-D alone. By DeLong test, the AUC of the combined prediction was better than those of FIB and D-D, with statistical differences ( Z=2.983 and 2.784, both P<0.001). The incidence of adverse pregnancy outcomes in the severe group was higher than that in the mild group [70.00% (21/30) vs. 30.95% (13/42)], with a statistical difference ( χ2=30.501, P<0.001). Conclusions:The maternal and fetal outcomes of placental abruption are closely related to the severity of placental abruption, and the decrease of FIB level and increase of D-D level in pregnant women with placental abruption are closely related to the severity of placental abruption. The combination of FIB and D-D is effective in predicting the severity of placental abruption.
Objective:To investigate the effect of traditional Chinese medicine prescription for clearing heat, promoting blood circulation, and softening combined with occluder in reducing ureteral stricture caused by holmium laser lithotripsy.Methods:Clinical data of 200 patients with middle and upper ureteral calculi from Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2015 to March 2023 were retrospectively analyzed, including 144 males and 56 females, aged (52±13.8) years. According to whether the occluder was used during operation and whether traditional Chinese medicine was used after operation, they were divided into group A (66 cases, holmium laser combined with occluder and traditional Chinese medicine), group B (70 cases, holmium laser alone), and group C (64 cases, holmium laser combined with occluder). Self-designed Chinese medicine prescription was as follow: spreading hedyotis herb, sophora, cordate houttuynia, glabrous greenbrier rhizome, epimedium, dogwood, grifola, alisma, motherwort, and radix cyathulae. The incidence of perirenal hematoma, ureteral stenosis, stone clearance rate, and improvement of hydronephrosis were observed 3 months after operation. F test, rank sum test, and χ2 test were used. Results:There was no statistically significant difference in the incidence of perirenal hematoma among the three groups ( χ2=2.474, P>0.05). There was a statistically significant difference in the incidence of postoperative ureteral stricture among the three groups ( χ2=6.412, P<0.05); there was a statistically significant difference between group A and group B ( χ2=5.402, P<0.05); there was no statistically significant difference between group A and group C ( χ2=0.374, P>0.05); there was no statistically significant difference between group C and group B ( χ2=3.331, P>0.05). There was a statistically significant difference in the stone clearance among the three groups ( χ2=12.842, P<0.05); there was a statistically significant difference between group A and group B ( χ2=9.597, P<0.05); there was no statistically significant difference between group A and group C ( χ2=0.374, P>0.05); there was a statistically significant difference between group C and group B ( χ2=7.022, P<0.05). There was no statistically significant difference in the improvement degree of hydronephrosis among the three groups ( H=2.894, P>0.05). Conclusion:The treatment of middle and upper ureteral calculi with heat-clearing, blood-activating, and helping softening prescription combined with occluder can reduce the incidence of ureteral stricture or atresia caused by ureteral holmium laser lithotripsy, reflecting the effect of traditional Chinese medicine prescription on ureteral wall regeneration and repair, promoting blood circulation, clearing heat, reducing dampness, and promoting softening.
