Table of Content

16 June 2022, Volume 40 Issue 12

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Clinical Evaluation of Glucocorticoid Combined with Leflunomide in the Treatment forPatientswith IgA Nephropathy

CAO Kun, WANG Zhen

2022, 40(12):  1-4. 

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Objective To study the clinical effect of glucocorticoid combined with leflunomide on patients with IgA nephropathy. Methods A total of 100 patients with IgA nephropathy admitted to Pingyi County People’s Hospital were divided into 50 cases in each group by drawing lots from January 2020 to January 2021. The routine group was treated with prednisone, while the experimental group was treated with glucocorticoid combined with leflunomide. 24-hour urine protein quantity, serum myotoxicity, systolic blood pressure, diastolic blood pressure, glomerular filtration rate (GFR), urinary vascular cell adhesion molecule-1 (VCAM-1), Toll-like receptor-9 protein (TLR-9) were observed and compared; Treatment effect, clinical symptoms and other indicators were also evaluated and compared. Results After treatment, the indexes of the two groups were improved,with significant differences(P<0.05), and the 24-hour urinary protein quantity, systolic blood pressure, diastolic blood pressure, GFR, VCAM-1, TLR-9 group were significantly different in the experimental group(P<0.05). The average hospitalization time, symptom improvement time and symptom disappearance time of the experimental group were significantly shorter than those of the conventional group, and the difference was statistically significant (P<0.05). The effective rate of the experimental group was higher than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Glucocorticoid combined with leflunomide in the treatment of patients with IgA nephropathy has achieved good results, which is helpful to improve the 24-hour urinary protein and plasma albumin, shorten the treatment time and improve the cure rate, which is worthy of clinical application.

the Association of Morning Serum Cortisol with Glucose Metabolism and Islet β-cell Function in Patients with Type 2 Diabetes Mellitus

DI Yan-an, WANG Zhi-yong, DONG Lin, SHANG Wei, WANG Feng

2022, 40(12):  4-8. 

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Objective To observe the morning serum cortisol levels in patients with type 2 diabetes mellitus (T2DM), patients with first-diagnosed and untreated type 2 diabetes mellitus (T2DM) and healthy controls, and to analyze the relationship between serum cortisol and glucose metabolism and islet β-cell function. Methods 59 patients with T2DM were selected and 26 patients were diagnosed as T2DM for the first time and did not treated in Taixing people’s Hospital affiliated to Bengbu Medical College from September 2019 to September 2020, and 34 healthy adults matched in age and sex were selected as the control group. In the morning, fasting venous blood samples were collected to detect glycosylated hemoglobin (HbA1c), blood glucose (FPG), insulin (FINS), C-peptide and cortisol, and insulin resistance index (HOMA-IR) and islet β-cell function (HOMA- β) were calculated by steady-state model formula. All data were processed by statistical software MedCalc 15.2.2. Results ANOVA analysis showed that there was significant difference in morning serum cortisol levels among groups(P<0.05); Student-Newman-Keuls test showed that morning serum cortisol levels in first-diagnosed and untreated T2DM group were significantly higher than those in T2DM group and healthy control group (P<0.05); Mann-Whitney test showed that morning serum cortisol level in HbA1c<7.0% group was significantly lower than that in HbA1c>7.0% group (P< 0.05). In patients with T2DM, Spearman correlation analysis showed that serum cortisol level in the morning was positively correlated with FPG and HbA1c, and negatively correlated with HOMA- β, but no correlation was found between serum cortisol level and age, FINS, C-peptide and HOMA-IR. Conclusion There is a correlation between early morning serum cortisol and many glucose metabolic indexes in patients with T2DM, including fasting blood glucose, HbA1c and islet β-cell function, and there is a higher level of cortisol in patients with poorly controlled T2DM and first-diagnosed and untreated T2DM.

the Diagnostic Value of Retinal Thickness Combined with Central Retinal Blood Flow Velocity in Patients with Non-Proliferative Type 2 Diabetic Retinopathy

LI Xiao-yan

2022, 40(12):  8-12. 

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Objective To explore and analyze the diagnostic value of retinal thickness combined with central retinal blood flow velocity in patients with non-proliferative type 2 diabetic retinopathy. Methods From February 2019 to June 2021, used the simple random sampling method, 122 cases of patients with non-proliferative type 2 diabetic retinopathy who were diagnosed and treated in Foshan Hospital of Traditional Chinese Medicine Sanshui Hospital, were selected as then on-proliferative group. And the other 122 cases with proliferative type 2 diabetic retinopathy in Department of Ophthalmology, Foshan Hospital of Traditional Chinese Medicine Sanshui Hospital, during the same period were selectedas the proliferative group. The retinal thickness was detected by optical coherence tomography (OCT), and the blood flow velocity of the central retinal blood vessels was detected by color Doppler diagnostic instrument,the correlation, influencing factors and diagnostic value was analyzed. Results The retinal MRT and CMT in the non-proliferative group were significantly lower than those in the proliferative group, the difference is statistically significant (P<0.05). The maximum blood flow velocity of central retinal artery (PSV) and the maximum blood flow velocity of central retinal vein (Vmax) in the non-proliferative group were significantly higher than those in the proliferative group, the difference is statistically significant (P<0.05). In two groups of 244 patients, pearson correlation analysis showed that non-proliferative type 2 diabetic retinopathy was significantly correlated with retinal MRT, CMT thickness, central retinal vascular velocity PSV, Vmax (P<0.05). Multiple linear stepwise regression analysis showed that retinal MRT, CMT thickness, maximum central retinal artery blood flow velocity (PSV) and central retinal vein maximum blood flow velocity (Vmax) were all important factors leading to non-proliferative type 2 diabetic retinopathy (P<0.05). Receiver operating characteristic curve (ROC) curve analysis showed that the area under the curve of retinal thickness combined with central retinal blood flow velocity for non-proliferative type 2 diabetic retinopathy patients was 0.820. Conclusion Patients with non-proliferative type 2 diabetic retinopathy may be accompanied by decreased retinal thickness and increased central retinal blood flow velocity. There is a correlation between retinal thickness and central retinal blood flow velocity and non-proliferative type 2 diabetic retinopathy. The combined diagnosis of non-proliferative type 2 diabetic retinopathy has high value.

Effects of Gushang No. 1 on the Levels of Serum TNF-α and IL-1β in patients with Acute Ankle Sprain

WANG Shao-guang, FU Qiang, TIAN Tao, ZHU Jian-kui, QIU Song-ming

2022, 40(12):  12-16. 

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Objective To investigate the effect of Gushang No. 1 on the levels of serum tumor necrosis factor (TNF)-α and interleukin (IL)-1β in patients with acute ankle sprain. Methods From September 2016 to September 2021, 106 patients with acute ankle sprain who were diagnosed and treated in Yangzhou Hospital of Traditional Chinese Medicine, Jiangsu Province were retrospectively selected as the research objects, and they were divided into the observation group and the traditional group with 53 cases in each group according to the treatment methods. The traditional group was given massage therapy, and the observation group was given local hot compress on Gushang No. 1 on the basis of the treatment of the traditional group. The two groups were treated and observed for 20 d. The curative effects, pain scores, serum TNF-α, IL-1β, VEGF, PDGF levels before and after treatment, and the excellent and good rate of ankle joint function were observed in the 5-month follow-up. Results The total effective rate after treatment in the observation group was 98.11%, which was higher than 86.79% in the traditional group, but there was no statistical significance after comparison (P>0.05). The pain VAS scores in the the observation group and traditional group after treatment were significantly lower than those before treatment (P<0.05), and the observation group was also significantly lower than that in the traditional group (P<0.05). The levels of serum TNF-α and IL-1β in the the observation group and traditional group after treatment were significantly lower than those before treatment (P<0.05), and the observation group was also significantly lower than that in the traditional group (P<0.05). The levels of serum vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF) in the the observation group and traditional group after treatment were significantly higher than those before treatment (P<0.05), and the observation group was also significantly higher than the traditional group group (P<0.05). After 5 months of follow-up, the excellent and good rates of ankle function in the observation group and the traditional group were 98.11% and 83.02%, respectively, and the observation group was significantly higher than the traditional group (P<0.05). Conclusion Gushang No. 1 in the treatment of acute ankle sprain can promote the secretion of VEGF and PDGF, and can also inhibit the release of serum TNF-α and IL-1β. It has good short-term and long-term effects, and can also promote sustained pain relief.

Analysis of the Clinical Efficacy and Related Mechanism of Holographic Scraping Therapy in the Treatment of Lumbar Disc Herniation

WEI Jin-rong, XU Shu-ying, XU Hong-mei, MA Bo, SHANJuan

2022, 40(12):  16-19. 

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Objective To explore and analysis the clinical efficacy and related mechanism of holographic scraping therapy in the treatment of patients with lumbar disc herniation. Methods From June 2020 to January 2022, 100 cases of patients with lumbar intervertebral disc herniation treated in the Department of Orthopedics and Traumatology of Yangzhou Hospital of Traditional Chinese Medicine were selected as the research objects, and divided into the holographic group and the traditional group accorded to the random number table method with 50 patients in each groups. The traditional group was given traditional scraping therapy, the holographic group was given holographic scraping therapy, and both groups were treated for 24 days. The total effective rate, visual analogue scale (VAS) score of pain and the contents of inflammatory factors IL-1β, IL-6 and TNF-α before and after treatment in the two groups were observed. Results The total effective rates of the holography group after treatment was 98.00%, which were significantly higher than 80.00% of the traditional group (P<0.05). After treatment, the VAS score in the two groups was significantly lower than that before treatment (P<0.05), and the holographic group was significantly lower than that in the traditional group (P<0.05). The serum superoxide dismutase (SOD) levels in the two groups after treatment were significantly higher than those before treatment (P<0.05), and the holography group was higher than the traditional group (P<0.05).The levels of serum interleukin (IL)-1β, IL-6, tumour necrosis factor-α(TNF-α) in the two groups after treatment were lower than those before treatment (P<0.05), and the holographic group was significantly lower than that in the traditional group (P<0.05). Conclusion The application of holographic scraping therapy in the treatment of patients with lumbar intervertebral disc herniation can improve the balance of oxidative stress in the body, inhibit the expression of inflammatory factors, promote pain relief, and improve the therapeutic effect of patients.

the Significance of ARDS Severity in the Prognosis Assessment of Multiple Organ Failure

HUANG Sen

2022, 40(12):  20-23. 

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Objective To explore and study the significance of acute respiratory distress syndrome (ARDS) severity in the prognosis assessment of multiple organ failure. Methods From May 2019 to May 2021, 110 patients with multiple organ failure were selected in the department of critical care medicine of Xuzhou hospital of traditional Chinese medicine, Emergency Intensive Care Unit(EICU)were selected as the research object, the severity of ARDS in all patients were determined, and the prognosis of the patients were investigated and given correlation analysis. Results All patients were followed up until February 2022, with no loss of cases and 20 deaths, and the mortality rate was 18.18 %. The age and mechanical ventilation time of the death group were significantly higher than those of the survival group, and the difference was statistically significant (P<0.05). The incidence of ARDS in the death group were higher than that in the survival group, and the acute physiology and chronic health evaluation (APACHE II) and clinical pulmonary infection score (CPIS) scores were higher than those in the survival group that compared were statistical significance (P<0.05). Spearman and Pearson correlation analysis showed that the prognosis of deathwere correlated to the ARDS, APACHE II score, CPIS score, age, mechanical ventilation time(P<0.05). Multivariate logistic regression showed that ARDS, APACHE II score, CPIS score, age, and mechanical ventilation time were the main factors leaded to death (P<0.05). Receiver operator characteristic curve (ROC) analysis showed that ARDS evaluated the area under curve (AUC) value of multi-organ failure prognosis and death were 0.918. Conclusion Multiple organ failures are often accompanied by ARDS, which can lead to poor prognosis. ARDS, APACHE II score, CPIS score, age, and mechanical ventilation time are the main factors leading to the death of patients.

Analysis of the Differential Value of MSCT Combined with Helical CT Enhanced Scanning in Liver Tumor Types

RAN Hua, ZENG Xian-guang, RONG Hong-guang, FAN Wen-xiu

2022, 40(12):  23-27. 

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Objective To explore and analysis the values of multislice computer tomography (MSCT) combined with enhanced helical CT scan in differentiating liver tumor types in physical examination patients. Methods From September 2016 to December 2018, a total of 80 cases of liver tumors diagnosed and treated in 32261 Army Radiology Department were selected as the research subjects. All patients were given MSCT combined with helical CT enhanced scanning, and the imaging features were recorded and the diagnostic value were judged. Results In the 80 patients, 43 cases were pathologically diagnosed as benign liver tumors (benign tumor group), and 37 cases were malignant liver tumors (malignant tumor group). The proportion of CT tumor hemorrhage, necrosis and cystic degeneration and calcification in the malignant tumor group(56.76%,59.46%,64.86%)were significantly higher than that in the benign tumor group(13.95%,9.30%,11.62%) (P<0.05). The CT value of the CT enhanced scan in the malignant tumor groupof arterial phase, portal phase, equilibrium phase were significantly higher than that in the benign tumor group (P<0.05). The CT enhancement mode of malignant tumor group were mostly heterogeneous enhancement(n=32), while benign tumor groupwere mostly homogeneous enhancement(n=40), and there were significant difference in contrast (P<0.05). MSCT combined with helical CT enhanced scanning were judged to be 42 cases of benign liver tumors and 38 cases of liver malignant tumors. The sensitivity and specificity of MSCT combined with helical CT enhanced scanning for differential diagnosis of benign and malignant liver tumors were 97.67% and 100.00%. The receiver operating characteristic (ROC) curve showed that the maximum area under the curve of MSCT combined with helical CT enhancement for predicting benign and malignant liver tumors was 0.719. Conclusion Morphological features, enhancement features, and CT values of benign and malignant liver tumors can be used as differential parameters. MSCT combined with helical CT enhanced scanning has important significance in the differential diagnosis of benign and malignant liver tumors, and has clinical application value.

Effect of Comprehensive Nursing Based on “Internet + Exercise Management” on Prognosis and Perinatal Outcome of Primipara

WEN Xue-heng, LIU Ping, CHEN Xiao-lin, HUANG Ai-mei, PAN Ru-dan

2022, 40(12):  27-30. 

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Objective To study the effect of comprehensive nursing based on “Internet+Exercise Management” on the prognosis and perinatal outcome of primipara. Methods A total of 225 primiparas who gave birth in Futian District Maternal and Child Health Hospital, Shenzhen City, Guangdong Province from October 2020 to February 2021 were included in the study. They were divided into Internet group (112 cases) and routine group (113 cases) by computer random number table. The routine group carried out routine nursing intervention, while the Internet group added comprehensive nursing intervention based on “Internet+Exercise management” on the basis of routine group. The differences in labor time, postpartum hemorrhage, weight change, delivery outcome and newborn birth between the two groups were analyzed. Results The time of the first and second stages of labor in the Internet group was shorter than that in the conventional group, and the amount of postpartum hemorrhage was less than that in the conventional group (all P<0.05). After intervention, the changes of body weight in Internet group were lower than those in routine group (P<0.05). The proportion of vaginal spontaneous delivery in Internet group was higher than that in conventional group, while the proportion of cesarean section was lower than that in conventional group (all P<0.05). The incidence of low birth weight and macrosomia in Internet group was lower than that in conventional group (all P<0.05). There was no significant difference in the incidence of neonatal asphyxia between the two groups (P>0.05). Conclusion Comprehensive nursing based on “Internet+Exercise Management” can obviously improve the vaginal spontaneous delivery rate, shorten the labor process, reduce the amount of postpartum hemorrhage, effectively control the weight during pregnancy, and reduce the risk of low birth weight infants and macrosomia.