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Table of Content

    01 April 2025, Volume 43 Issue 7
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    Prognostic Effect of 18F-FDG PET-CT Imaging Features on NSCLC Progression
    WANG Ming-yue, YAO Lan, ZHANG Na, ZHU Kun, GAO Shou-bao, YANG Xiao-feng, BAI tian, JI jia, HUANG Qi-cheng
    2025, 43(7):  1-5. 
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    Objective To investigate the predictive effect of 18F-deoxyglucose positron emission tomography (18F-FDG PET-CT) imaging features on progression of non-small cell lung cancer (NSCLC) with lymph node metastasis as the evaluation criterion. Methods A total of 100 patients with NSCLC admitted to the Third Affiliated Hospital of Qiqihar Medical College from May 2021 to May 2023 were retrospectively analyzed, including 40 patients without lymph node metastasis and 60 patients with lymph node metastasis. All patients received 18F-FDG PET-CT examination. The accuracy of 18F-FDG PET-CT staging and the differences of general data and imaging parameters between the two groups were analyzed. Results The staging accuracy of 18F-FDG PET-CT was 87.00%. The maximum standard uptake value (SUVmax), primary metabolic tumor volume (MTV-P), primary and metastatic metabolic tumor volume (MTV-C), total primary and metastatic glycolysis (TLG-P), and total primary and metastatic glycolysis (TLG-C) in lymph node metastasis group were higher than those in non-metastatic lymph node group. The difference was statistically significant (P<0.05). Tumor size, SUVmax, MTV-P, MTV-C, TLG-P and TLG-C were positively correlated with the progression of NSCLC and were all risk factors for the progression of NSCLC. The area under the curve (AUC) of the combined prediction of NSCLC progression was 0.988. Conclusion 18F-FDG PET-CT plays an important role in the prediction of NSCLC progression, especially the combined prediction of SUV, MTV and TLG parameters is good.
    Application of Step Rehabilitation Training in Postoperative Patients with Lumbar Disc Herniation
    WANG Fang
    2025, 43(7):  5-9. 
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    Objective To investigate the effect of step rehabilitation training in patients with lumbar disc herniation (LDH) after operation. Methods A total of 101 LDH patients who underwent surgical treatment in Jinan Third People's Hospital from April 2023 to July 2024 were selected and divided into intervention group (n=51) and control group (n=50) by random number table method. The control group was given routine rehabilitation training, and the intervention group was given stepped rehabilitation training. Both groups were treated for 1 month. Lumbar function, pain and quality of life were compared between the two groups. Results Before intervention, there was no difference in the Japanese Orthopaedic Association(JOA) between the two groups (P>0.05). After intervention, the JOA scores of both groups were higher than before intervention, and the intervention group was higher than control group, the difference was statistically significant (P<0.05). Before intervention, there was no difference in VAS scores between the two groups (P>0.05). After intervention, the visual analogue scale (VAS) scores of both groups were lower than before intervention, and the intervention group was lower than control group, the difference was statistically significant (P<0.05). Before intervention, there was no difference in the scores of World Health Organization Quality of Life -100(WHOQOL-100) between the two groups (P>0.05). After intervention, the WHOQOL-100 scores of both groups were higher than before intervention, and the intervention group was higher than control group, the difference was statistically significant (P<0.05). Conclusion The application of step rehabilitation training in the intervention of LDH patients can improve the function of lumbar spine, relieve pain and improve the quality of life.
    A Study on the Effect of Multidisciplinary Cooperation in Constructing the Perioperative Nutrition Management Program for Patients with Esophageal Cancer
    WANG Min, ZENG Su-hua, DU Yun-yu, XU Xia, YE Mei-juan
    2025, 43(7):  10-15. 
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    Objective To explore the effect of perioperative nutrition management scheme in patients with esophageal cancer under the model of multidisciplinary cooperation. Methods A total of 107 patients with esophageal cancer admitted to the First Affiliated Hospital of Nanchang University from January 2022 to December 2023 were selected as research objects, and were divided into control group (53 cases) and observation group (54 cases) by random number table method. The control group received conventional nutrition care, and the observation group implemented the perioperative nutrition management program of patients with esophageal cancer based on the control group. The indexes of nutrition, muscle strength and postoperative complications were compared between the two groups. Results Before operation, there was no difference in the levels of hemoglobin, total protein, albumin, globulin, prealbumin and transferrin between the two groups (P>0.05). 7 days after surgery, the levels of hemoglobin, total protein, albumin, globulin, prealbumin and transferrin in 2 groups were lower than before surgery, but the observation group was higher than the control group, the difference was statistically significant (P<0.05). Before operation, there was no difference in BMI and grip strength between the two groups (P>0.05). After 7 days of operation, the BMIand grip strength of two groups were higher than those before operation, and the observation group was higher than the control group, the difference was statistically significant (P<0.05). The incidence of abdominal distension, diarrhea, pulmonary infection and anastomotic leakage in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion The perioperative nutrition management scheme established in the mode of multidisciplinary cooperation can improve the nutritional status of patients with esophageal cancer, enhance weight and grip strength, and reduce postoperative complications.
    Analysis of Clinical Characteristics of Nosocomial Infection in a Grade A Tertiary Chinese Medicine Hospital from 2019 to 2023
    KONG Yan-lin, CAO Yi
    2025, 43(7):  15-20. 
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    Objective To analyze the clinical features of nosocomial infection in a top three Chinese medicine hospital from 2019 to 2023. Methods The monitoring data of hospital feeling in Tai 'an Hospital of Traditional Chinese Medicine from 2019-2023 were collected retrospectively. The situation of nosocomial infection, underreporting of nosocomial infection, use of antibiotics, infection rate of Class Ⅰ incision and prophylactic antibiotics, multi-drug-resistant bacteria infection, incidence of three-tube related infections, distribution characteristics of nosocomial infection sites and departments were analyzed. Results From 2019 to 2023, the total number of inpatients in our hospital was 168 413, the number of nosocomial infections was 1 626, the incidence of infection was 0.97%, the number of nosocomial infections was 1757, and the rate of infection was 1.04%. The number of missed reports was 27, with a false report rate of 1.66%, and the number of missed reports was 27, with a false report rate of 1.54%.The number of multidrug-resistant bacteria was 198, the infection rate was 0.12%, the number of infection cases was 226, the infection rate was 0.13%. The number of users of antibiotics was 68 301 (40.56%). There were 8900 patients with Class Ⅰ incision surgery, 9 432 cases of operation, 14 cases of surgical site infection, and the infection rate was 0.16%. There were 4 606 cases of antibiotic prophylactic use, and the prophylactic use rate was 48.83%. The number of catheterization patients was 13 821, the total number of days was 127 026, the number of catheter-related infections was 275, the number of infections was 277, the infection rate was 2.18‰. The number of users of central vessel catheters was 1 168, the total number of days was 12 832, the number of central vessel catheter-related infections was 6, the number of infections was 6, and the infection rate was 0.47‰. There were a total of 1 757 nosocomial infections, among which the top 5 were lower respiratory tract infections (including ventilator-related infections), urinary tract infections (including urinary duct related infections), upper respiratory tract infections, bacteremia (including central vascular catheter-related infections) and gastrointestinal infections, accounting for 38.82%, 26.24%, 21.63%, 3.70% and 2.22%, respectively. The top 5 nosocomial infections were in the department of encephalopathy (including the ICU), the Department of intensive Care Medicine, the department of rehabilitation, the department of encephalopathy surgery and the Department of geriatrics, accounting for 23.33%, 19.52%, 7.63%, 7.40% and 6.49% respectively. A total of 226 cases of multidrug-resistant bacteria were nosocomial infections, and the top 5 departments of multidrug-resistant bacteria infection were intensive care medicine, encephalopathy surgery, rehabilitation, encephalopathy (including encephalopathy ICU), and geriatrics, accounting for 57.08%, 12.39%, 7.96%, 7.08%, 7.08%, respectively. The pathogen with the highest incidence was carbapenem-resistant Acinetobacter baumannii. The highest incidence sites were lower respiratory tract infection (including ventilator related) and urinary tract infection (including catheter related), 76.99% and 10.18%, respectively. Sputum, urine, puncture fluid and secretions and blood samples were the main samples for multidrug-resistant bacterial infection. Conclusion The incidence rate of nosocomial infection, the missing report rate and the infection rate of class Ⅰ incision are all up to standard. However, the situation of antibiotics in inpatients and the monitoring and prevention measures of multi-drug-resistant bacteria are still the key and difficult link in the management of nosocomial infection in the future.
    The Value of Failure Mode and Effects Analysis in Unplanned Secondary Surgery Management
    HE Cheng-rong, ZHAI Xiu-li, ZHANG Rong-ping
    2025, 43(7):  50-54. 
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    Objective To explore the effectiveness of failure mode and effect analysis in unplanned secondary surgery management. Method The management of unplanned secondary surgeries at the 926th Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China from January 2021 to December 2022 was selected as the research object. Routine management was performed from January to December 2021 (as the control group), and failure mode and effect analysis was used to analyze the management of unplanned secondary surgeries in the control group. Preventive measures were implemented from January to December 2022 (as the observation group). Compare management results. Result In terms of the management effect of unplanned secondary surgery, the observation group had a significantly lower incidence of unplanned secondary surgery, postoperative bleeding rate, postoperative anastomotic fistula, and hospital stay days compared to the control group, and both groups had statistical significance (P<0.05). In terms of the quality of unplanned secondary surgery management, the observation group scored in the implementation of preventive measures, in postoperative management, and in surgical team communication situation, which were significantly better than the control group (P<0.05). The comparison between the two groups was statistically significant (P<0.05). Conclusion Failure mode and effect analysis was conducted in the management of unplanned secondary surgery, and it was found that the incidence of unplanned secondary surgery is influenced by various factors such as preoperative, intraoperative, and postoperative factors. In response to the influencing factors, measures such as strengthening staff management, emphasizing preoperative evaluation and preparation, and strengthening perioperative management can be taken to reduce the incidence of unplanned secondary surgery, postoperative bleeding, and anastomotic fistula, reduce surgical time and intraoperative blood transfusion, improve surgical safety and effectiveness, and enable patients to be discharged as soon as possible.
    The Value of Ultrasound Diaphragm Function Assessment in Predicting the Effectiveness of Non-Invasive Mechanical Ventilation in ARDS Patients
    YAO Guo-Hua, LIU Quan
    2025, 43(7):  60-64. 
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    Objective To investigate the role of ultrasound diaphragm function assessment in predicting patient withdrawal during non-invasive mechanical ventilation treatment in patients with acute respiratory distress syndrome (ARDS). Method A retrospective analysis was conducted on 120 patients with ARDS who underwent non-invasive mechanical ventilation treatment in our hospital from March 2023 to March 2024. The patients underwent continuous treatment for 48 hours and were divided into a successful non-invasive mechanical ventilation group (80 cases) and a failed non-invasive mechanical ventilation group (40 cases) based on their weaning status. During the treatment of two groups of patients, diaphragm activity and diaphragm thickening score were measured and compared at 6 h, 12 h, 24 h, 30 h, 36 h, 42 h, and 48 h respectively. And evaluate the predictive value of ultrasound diaphragm function assessment. And compare the respiratory rate, PaO2/FiO2, ICU hospitalization time, and total hospitalization time between the two groups. Result The difference in diaphragm activity and diaphragm thickening score between the two groups of patients during treatment was statistically significant (P<0.05). There was a significant difference in respiratory rate and PaO2/FiO2 between the two groups (P<0.05). The difference in ICU hospitalization time and total hospitalization time (P<0.05) is statistically significant. Based on the receiver operating characteristic (ROC) curve analysis, the area under the ROC curve for predicting non-invasive mechanical ventilation effectiveness using diaphragmatic activity is 0.872, with a sensitivity rate of 80.5% for diaphragmatic activity>13.0 mm. The area under the ROC curve for predicting non-invasive mechanical ventilation effectiveness using diaphragmatic thickening score is 0.845, and the sensitivity rate for diaphragmatic thickening score>36.00% is 81.85%. Conclusion Conducting ultrasound diaphragmatic function assessment during non-invasive mechanical ventilation treatment for ARDS patients can predict the treatment effect to a certain extent, and provide guidance for the development and improvement of clinical ventilation treatment plans.
    Longitudinal Changes in Body Composition of Patients Undergoing Maintenance Hemodialysis Assessed by BIA
    XU Ming, GAO Yuan-hua, JIAO Chun-xiao, QU Shao-qin, SUN Xiao-yan, LI Hai-qiang
    2025, 43(7):  76-79. 
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    Objective To investigate the longitudinal changes in body composition of patients undergoing maintenance hemodialysis by BIA. Methods Data was collected from patients underwent regular hemodialysis in the hemodialysis center of Yantai Yeda Hospital from January 1, 2020 to February 28, 2023. Data collected from a total number of 120 patients, 61 males and 59 females, aged 29-84 (56.23±13.52), and 50 patients aged over 60. Participants were selected from patients who completed two body composition analysis, and each analysis was completed at least one year apart. Body composition analysis and biochemical indicators such as albumin, prealbumin, creatinine, urea were collected in the month of completing the body composition analysis. Compared the results of laboratory biomarkers and body composition from two tests. Results Compared with one year before, significant differences were discovered that the level of prealbumin (P<0.05) decreased, while ferritin, hemoglobin and creatinine (P<0.05) increased. Body composition analysis showed that indicators like Body Cell Mass, protein, Skeletal Muscle Mass, Fat Free Mass, mineral and Phase Angle were significantly decreased (P<0.05), while Visceral Vat Area increased (P<0.05). After stratified analysis by sex, significant differences of human body composition between different genders were found;Albumin was significantly positively correlated with Body Cell Mass, protein, Skeletal Muscle Mass and Phase Angle in two groups (P<0.05). Conclusion Compared to biochemical indicators, changes in body composition parameters such as body cell mass, protein, skeletal muscle mass, and phase angle are more significant in the longitudinal observation of patients undergoing maintenance hemodialysis. The importance of these parameters in the long-term nutritional management of hemodialysis patients should be emphasized.
    Application of Rehabilitation Training Guided by Green's Model in Patients with Cerebral Infarction and Hemiplegia
    ZHANG Qian-qian, CHEN Lu-lu, YU Xiao-ping
    2025, 43(7):  80-83. 
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    Objective To explore the application effect of rehabilitation training guided by Green's model in patients with cerebral infarction hemiplegia. Methods A total of 86 patients with cerebral infarction and hemiplegia from February 2022 to January 2024 who were admitted in the Third People's Hospital of Liaocheng City were selected, and randomly divided into the intervention group (n=43, rehabilitation training guided by the Green's model) and the control group (n=43, routine rehabilitation training). The compliance, limb function, and daily living ability in both groups were compared. Results The rehabilitation compliance of the intervention group (97.67%) was higher than control group (81.40%), and the difference was statistically significant (P<0.05). Before intervention, there was no significant difference in the scores of Fugl-Meyer assessment (FMA) (upper limb function, lower limb function) between the two groups (P>0.05). After intervention, the FMA (upper limb function and lower limb function) scores of both groups were higher than before intervention, and the intervention group was higher than control group, the difference was statistically significant (P<0.05). Before intervention, there was no statistically significant difference in Modified Barthel Index (MBI) scores between the two groups (P>0.05). After intervention, MBI scores of the two groups were higher than before intervention, and the intervention group was higher than control group, the difference was statistically significant (P<0.05). Conclusion The application of rehabilitation training guided by the Green's model in patients with cerebral infarction hemiplegia can improve rehabilitation training compliance, enhance limb function, and improve daily living abilities.
    Meta-Analysis on Efficacy and Safety of Soothing Liver and Strengthening Spleen Combined with Western Medicine in the Treatment of Peptic Ulcer
    WANG Shao-min, SUN Xu-ran, TAN Bao
    2025, 43(7):  86-90. 
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    Objective Evaluating the therapeutic effect and safety of the soothing liver and strengthening spleen method combined with western medicine on the treatment of peptic ulcer. Methods Searching CNKI, VIP, Wanfang, CBM, PubMed and other databases by computer and including literatures that meet the criteria. Meta-analysis was performed using Review Manager 5.4 software. Outcome indicators included clinical effective rate, quality of ulcer healing, Hp eradication rate, serum inflammatory factor, adverse reactions and recurrence rate. Results A total of 17 literatures were included, with a total of 1837 patients. The results of meta-analysis showed that compared with western medicine alone, the combination of soothing the liver and strengthening the spleen can improve the clinical efficiency of peptic ulcer(OR=4.67,95%CI: 3.24-6.72,Z=8.27,P<0.00001), promote ulcer healing(OR=2.36, 95%CI: 1.13-4.92, P=0.02), improve Hp cure rate(OR=2.82, 95%CI: 1.37-5.83, P=0.005), reduce serum inflammatory factor levels and the adverse reaction is small, recurrence rate is low. Conclusion Compared with western medicine alone, the combination of soothing the liver and strengthening the spleen has better curative effect, less adverse reactions and lower recurrence rate. Due to the general quality of the literature included in the study, the effectiveness and safety need to be verified by well-designed high-quality clinical randomized controlled trial.
    Discussion on TCM Syndrome Differentiation and Nursing Methods of Rheumatism
    MA Qian-qian, TIAN Guang-fang, KE Yi-hong, ZHANG Zhi-hong, NI Jiao-jiao
    2025, 43(7):  98-101. 
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    Rheumatism is a kind of joint, endocrine glands, blood vessels, skin and multiple system damage and accompanied by immune dysfunction disease general term, its clinical manifestations are complex, with pain, swelling, numbness, joint flexion and extension is more common, belongs to the category of Bi syndrome of traditional Chinese medicine. At present, Western medicine treatment of this disease mainly pain relief, has not been able to cure, and the toxic and side effects are large, and Chinese medicine can play the unique advantages of specimen treatment, clinical effect is remarkable. In this paper, through searching the literature at home and abroad in recent years, the rheumatism was summarized from the aspects of syndrome differentiation and traditional Chinese medicine nursing methods, in order to provide some theoretical guidance for the treatment of the disease by traditional Chinese medicine.
    Analysis of Influencing Factors on PICC Deep Vein Thrombosis in Patients with Hemorrhagic Stroke
    TANG Yan-li, CHEN Jian-qin
    2025, 43(7):  119-122. 
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    Objective Understand the influencing factors of deep vein thrombosis in patients with hemorrhagic stroke after PICC catheterization. Methods This study used a retrospective analysis method to analyze the clinical data of 235 PICC patients with hemorrhagic stroke admitted to the First People's Hospital of Changde City from January 2021 to December 2023. According to the formation of deep vein thrombosis, patients were divided into two groups: occurrence group (34 cases) and non occurrence group (201 cases). The age, gender, Wells score at catheterization, Caprini score at catheterization, Glasgow Coma Scale (GCS) score at catheterization, muscle strength at catheterization site, D-dimer before catheterization, plasma fibrinogen before catheterization, and thrombin time before catheterization were analyzed for both groups. Four limb deep vein ultrasound was dynamically re examined after catheterization. Results Among 235 patients with hemorrhagic stroke, 34 developed deep vein thrombosis after PICC catheterization, with an incidence rate of 14.5%; There was no statistically significant difference between the two groups in terms of patient gender, Caprini score at catheterization, GCS score at catheterization, muscle strength at catheterization site, plasma fibrinogen before catheterization, and thrombin time before catheterization (P>0.05); There were statistically significant differences between the two groups in patient age, Wells score at catheterization, and D-dimer before catheterization (P<0.05). Conclusion Being too old, having a low Wells score during catheterization, and having high levels of D-dimer before catheterization can increase the incidence of related venous thrombosis in patients with hemorrhagic stroke after PICC catheterization. For such patients, active prevention of deep vein thrombosis should be taken after catheterization, and dynamic ultrasound examinations of the deep veins in the limbs should be conducted in a timely manner. If necessary, deep vein catheterization should be used instead of PICC.
    The Effect of Problem Oriented Early Warning Intervention on the Prevention of Pressure Ulcers in Bedridden Patients after Cerebral Infarction
    QI Li
    2025, 43(7):  157-161. 
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    Objective To explore the effect of problem oriented early warning intervention on the prevention of pressure ulcers in bedridden patients after cerebral infarction. Methods A prospective study was conducted on 80 bedridden patients with cerebral infarction admitted to Chifeng Municipal Hospital from March 2021 to March 2024. According to the random number table method, patients were divided into an observation group and a control group, with 40 cases in each group. The control group received early warning intervention, while the observation group received problem oriented early warning intervention. The intervention effect was evaluated after 7 days of continuous intervention. The risk of pressure ulcer was compared between the two groups before intervention and after 7 days of intervention [assessed by pressure ulcer score scale (Braden)]. After 7 days of intervention, the bed comfort of patients was evaluated [according to Kolcaba's comfort scale (GCQ) and combined with the situation of bedridden patients after cerebral infarction to develop bed comfort evaluation table]. The occurrence of pressure sores during in-hospital bed rest treatment was counted in the two groups. Results After 7 days of intervention, the scores of each dimension of the Braden scale decreased in both groups of patients, and the observation group was lower than the control group, with a statistical significant difference (P<0.05). After 7 days of intervention, the proportion of total comfort in the observation group was higher than that in the control group (P<0.05). The incidence of pressure ulcers in the observation group was lower than that in the control group, with a statistical significant difference (P<0.05). Conclusion Implementing problem oriented early warning interventions for bedridden patients after cerebral infarction can reduce the risk of pressure ulcers, reduce the occurrence of pressure ulcers, and improve patient bed comfort.
    Clinical Observation of Laparoscopic Radical Resection of Colon Cancer in Patients with Colon Cancer
    LI Yu
    2025, 43(7):  173-177. 
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    Objective To observe the clinical effect of laparoscopic radical resection of colon cancer in patients with colon cancer. Methods 74 patients with colorectal cancer treated in Zhangye Second People's Hospital from April 2021 to November 2023 were selected and divided into control group and observation group with 37 cases in each group by random number table method. The control group received conventional open surgery, and the observation group received laparoscopic radical resection of colon cancer. Serological indexes, perioperative related indexes, stress response and complications were compared between the two groups. Results Before operation, there was no difference in the levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) between two groups (P>0.05). After operation, serum CEA and CA125 levels in 2 groups were lower than before operation, and observation group was lower than control group, the difference was statistically significant (P<0.05). The intraoperative blood loss and postoperative drainage volume in the observation group were lower than those in the control group, and the operation time, postoperative exhaust time, bowel sound recovery time, diet recovery time and hospital stay in the observation group were shorter than those in the control group, with statistical significance (P<0.05). Before operation, there was no difference in serum epinephrine, norepinephrine and cortisol levels between the two groups (P>0.05). After operation, the serum levels of epinephrine, norepinephrine and cortisol in 2 groups were higher than before operation, but the observation group was lower than control group, the difference was statistically significant (P<0.05). The incidence of complications in the observation group was lower than control group, and the difference was statistically significant (P<0.05). Conclusion Laparoscopic radical resection of colon cancer is effective in the treatment of colon cancer patients, which can promote the recovery of patients, reduce the level of tumor markers, reduce the stress reaction of surgery, and reduce the risk of complications.