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Table of Content

    16 November 2022, Volume 40 Issue 22
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    The Predictive Value of D-dimer, Lactate Dehydrogenase and CRP in Children with Refractory Mycoplasma Pneumoniae Pneumonia
    SHA Mi-cun, QIAO Ji-bing, JIANG Ya-zhou, LU Tian-tian, ZHUO Lie
    2022, 40(22):  1-3. 
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    Objective To explore the predictive value of D-dimer, lactate dehydrogenase and CRP in children with refractory mycoplasma pneumoniae pneumonia. Methods Forty-two cases of Refractory Mycoplasma pneumoniae pneumonia admitted to the Suqian Hospital of Nanjing Drum Tower Hospital Group from January 2020 to May 2022 were selected. Children with RMPP (RMPP group) and 77 children with general Mycoplasma pneumoniae pneumonia (GMPP group) were included in this study. The difference of D-dimer, lactate dehydrogenase and CRP concentration levels between the two groups was compared, and the ROC curve of the evaluation value of the three indicators for RMPP was drawn to find the maximum cut off value of each predictor and determine its sensitivity and specificity. Results The levels of D-dimer, lactate dehydrogenase and CRP in RMPP group were higher than those in GMPP group, and the differences were statistically significant (P<0.05). ROC curve showed that the AUC values of D-dimer, lactate dehydrogenase and CRP were 0.888, 0.770 and 0.798, respectively. The sensitivity was 69.02%, 66.71% and 71.43%, respectively. The specificity was 98.73%, 85.72% and 87.01%, respectively. Conclusion The concentrations of D-dimer, lactate dehydrogenase and CRP in peripheral blood of children have certain value in predicting RMPP. The best sensitivity and specificity were CRP and D-dimer, respectively.
    Application Effects of Two Compound Anesthesia Methods in Arthroscopic Minimally Invasive Treatment of Elderly Patients with Tibial Plateau Fractures
    TANG Chao-hu, FAN Peng-xin
    2022, 40(22):  4-7. 
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    Objective To explore and compare the application effect of two compound anesthesia methods in the minimally invasive treatment of elderly patients with tibial plateau fractures under arthroscopy. Methods A total of 126 elderly patients with tibial plateau fracture admitted to Yanqi Hospitalof the Second Division of Xinjiang Construction Corps from May 2019 to October 2021 were selected as the research objects. According to the random number table method, they were divided into general anesthesia group and nerve block group, 63 cases in each group. All patients were treated with arthroscopic minimally invasive incision and internal fixation. The general anesthesia group was treated with simple general anesthesia, and the nerve block group was treated with ultrasound-guided nerve block anesthesia on the basis of the control group. The nerve block related indexes, operation time, intraoperative blood loss, postoperative hospital stay, fracture healing time, postoperative VAS score and excellent and good rate of knee joint were compared between the two groups. Results The maintenance time of sensory nerve block, motor nerve block and postoperative analgesia in nerve block group were significantly higher than those in general anesthesia group (P<0.05). There was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05). The postoperative hospital stay and fracture healing time of the nerve block group were lower than those of the general anesthesia group, and the differences were statistically significant (P<0.05). The visual analogue scale (VAS) scores of the nerve block group at 1 day, 3 days and 7 days after operation were lower than those of the general anesthesia group, and the differences were statistically significant (P<0.05). The excellent and good rates of knee joint in nerve block group at 3 months and 6 months after operation were higher than those in general anesthesia group, and the differences were statistically significant (P<0.05). Conclusion Ultrasound-guided nerve block in the minimally invasive treatment of elderly patients with tibial plateau fracture under arthroscopy can effectively prolong the maintenance time of anesthesia and analgesia, promote the rehabilitation of patients, and will not increase the operation time and intraoperative blood loss, but also can relieve pain, improve the knee function of patients, which is worthy of clinical application.
    Clinical Value of Different Anatomical Approaches in Preventing Biliary Tract Injury in Laparoscopic Complex Cholecystectomy
    BAO Zhong-ming, ZHANG Hua-guo
    2022, 40(22):  8-11. 
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    Objective To explore the value of different anatomical approaches in the prevention of biliary tract injury and its clinical application in laparoscopic complex cholecystectomy. Methods From January 2019 to March 2022, Huai’an Huaiyin Hospital and Huai’an Fifth People’s Hospital were selected. A total of 125 patients undergoing laparoscopic complex cholecystectomy were divided into control group (n=65) and observation group (n=60) according to random number table method. Patients in the control group underwent conventional surgical approach for laparoscopic cholecystectomy, while patients in the observation group underwent laparoscopic cholecystectomy through V-shaped anatomical approach of the gallbladder triangle. The operation conditions, relevant laboratory examination indexes, incidence of complications and postoperative recovery were compared between the two groups. Results The operation time, intraoperative blood loss and conversion rate of the observation group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). After operation, the levels of body temperature, aspartate aminotransferase (AST), white blood cell (WBC), direct bilirubin (DBIL), alanine aminotransferase (ALT), indirect bilirubin (IBIL) and neutrophil percentage (NEU%) in the two groups were lower than those before operation, and the differences were statistically significant (P<0.05). After operation, there were no significant differences in body temperature, AST, WBC, DBIL, ALT, IBIL and NEU% between the two groups (P>0.05). There was no significant difference in postoperative complications between the two groups (P>0.05). The average postoperative drainage tube indwelling time, postoperative exhaust time, hospitalization time and hospitalization cost of the observation group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). Conclusion The gallbladder triangle V-shaped anatomical approach in the process of laparoscopic complex cholecystectomy can reduce the operation time and conversion rate to open surgery, reduce the incidence of complications such as biliary tract injury and biliary leakage, reduce the cost of hospitalization, the curative effect is significant, worthy of clinical application.
    AIC for Innovative Combination Videolaryngoscope and Fiberoptic Endoscopy Guided Airway Exchange Applications
    LIU Xiao-mei
    2022, 40(22):  12-14. 
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    Objective To explore the application of Aintree Intubation Catheter (AIC) innovative combination video laryngoscope and light endoscope in guiding airway exchange. Methods From January 2020 to January 2022, 80 patients with difficult airway intubation admitted to the Xiangcheng Hospital of Traditional Chinese Medicine, Suzhou were selected as the research objects. According to the random number table method, they were divided into the control group and the study group, with 40 cases in each group. Patients with the control group patients receiving optical fiber endoscope intubation, the team accept AIC innovation video laryngoscope intubation, under the comparison of two groups of patients with total success rate, a success rate of intubation, the intubation time, as well as the induced (T0) before and after induction (T1), endotracheal intubation (T2), immediately after 2 min (T3) intubation hemodynamic index, the complication rate of intubation. Results There was no significant difference in the total success rate of intubation and the success rate of one intubation between the two groups (P>0.05). The intubation time of the study group was lower than that of the control group, and the difference was statistically significant (P<0.05). At T0 and T1, there was no significant difference in systolic blood pressure, diastolic blood pressure and heart rate between the two groups (P>0.05). At T2 and T3, heart rate of the study group was lower than that of the control group, and the difference was statistically significant (P<0.05). The incidence of complications in the study group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Using AIC innovative combination video laryngoscope in difficult airway can significantly improve the success rate of one intubation, shorten the intubation operation time, and reduce the stimulation of intubation to patients, which has positive significance for stabilizing the hemodynamic indexes of patients. Moreover, the safety of AIC innovative combination video laryngoscope is worthy of recognition, and the incidence of adverse reaction of intubation is low, so it is recommended to be popularized and applied clinically,worthy of clinical application.
    The Diagnostic Value of Fluorescence Bronchoscopy in Patients with Non-Small Cell Lung Cancer with Supraclavicular Lymph Node Metastasis
    HUANG Chang-ming
    2022, 40(22):  15-17. 
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    Objective To explore the diagnostic value of fluorescence bronchoscopy in patients with non-small cell lung cancer with supraclavicular lymph node metastasis. Methods From May 2019 to January 2022, A total of 80 cases of patients with non-small cell lung cancer who were diagnosed and treated in our hospital were selected as the research subjects. All patients were given white light and fluorescence bronchoscopy, as well as surgical and pathological examinations, with pathological examination as gold standard to judge the diagnostic value. Results In the 80 patients, there were 16 cases (metastasis group) diagnosed as supraclavicular metastatic lymph nodes by surgery and pathology, accounted for 20.00%. There was no significant difference in gender, age, body mass index and pathological type compared between the metastatic group and the non-metastatic group (P>0.05). The sensitivity of white light bronchoscopy and fluorescence bronchoscopy in the diagnosis of supraclavicular lymph nodes in patients with non-small cell lung cancer was 93.75% (15/16) and 100.00% (16/16), respectively, and the specificity were 85.94% (55/64) and 98.44% (63/64), and the accuracy were 87.50% (70/80) and 98.75% (79/80). The specificity of fluorescence bronchoscopy in diagnosing supraclavicular lymph nodes in patients with non-small cell lung cancer was significantly higher than that of white light bronchoscopy (P<0.05). There was no significant difference in sensitivity between different methods (P>0.05). Conclusion Fluorescence bronchoscopy in the diagnosis of non-small cell lung cancer patients with supraclavicular lymph node metastasis can improve the specificity, accuracy of diagnosis on the basis of maintaining high sensitivity, and has a good diagnostic effect.
    Clinical Effect of Reconstruction of Coracoclavicular Ligament with Suture Anchor and Absorbable Suture Combined with Clavicular Hook Plate in the Treatment of Old Acromioclavicular Joint Dislocation
    LIU Jin-hai
    2022, 40(22):  18-21. 
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    Objective To investigate the clinical effect of reconstruction of coracoclavicular ligament with suture anchor and absorbable suture combined with clavicular hook plate in the treatment of old acromioclavicular joint dislocation. Methods A retrospective study was adopted, a total of 60 patients with old acromioclavicular joint dislocation who were admitted to Wuwei People’s Hospital from October 2020 to February 2022 were selected and divided into observation group (coracoclavicular ligament reconstruction combined with clavicle hook plate) and control group ( Simple acromioclavicular joint debridement and fixation) 30 cases in each group. The operative efficacy, operative time, postoperative recovery, Constant-Murley score of shoulder joint function, visual analogue scale (VAS) score, coracoclavicular distance (CCD) and acromioclavicular space (ACD) were compared between the two groups. Results The excellent and good rate of the observation group was 96.67% (29/30), which was significantly higher than that of the control group, 73.33% (22/30), the difference was statistically significant (P<0.05). The operation time of the observation group was longer than that of the control group, the difference was statistically significant (P<0.05). The Constant-Murley score of the observation group was significantly higher than that of the control group, the difference was statistically significant (P<0.05). The VAS score was significantly lower than that of the control group, the difference was statistically significant (P<0.05). There was no difference in CCD and ACD between the two groups (P>0.05). Conclusion The reconstruction of coracoclavicular ligament with suture anchor and absorbable suture combined with clavicular hook plate is effective in the treatment of old acromioclavicular joint dislocation. It can effectively promote fracture healing, restore shoulder function as soon as possible, reduce pain, and have fewer complications, which is worthy of clinical application.
    Meta-analysis of Clinical Efficacy of Duzhong Yaotong Pill on Lumbar Disc Herniation
    ZHAO Ji-rong, CHEN Qian-wen, YAN Chun-juan, SHAO hong, MA Jun-fei, YANG Zheng-han
    2022, 40(22):  22-26. 
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    Objective The efficacy of Duzhong Yaotong Pill in the treatment of lumbar disc herniation was systematically evaluated. Methods According to the requirements of Meta-analysis, CNKI, CBM, WanFang, VIP, PubMed, Web of Science, Cochrane Library and Embase were searched for literatures on randomized controlled trials of Duzhong Yaotong Pill in the treatment of lumbar disc herniation published from the establishment of databases to May 2022. The Cochrane Collaboration bias risk tool was used for risk assessment, and the modified Jadad scale score was used for literature quality assessment. Review Manager 5.3 statistical software was used for Meta-analysis of literatures with modified Jadad scale score ≥ 3, and publication bias was analyzed by Begg’s test. Results Finally, eight eligible literatures were retrieved, of which five were Jadad ≥ 3, with a total of 652 patients ; meta-analysis results showed that compared with other conservative treatment control groups, Duzhong Yaotong pill combined with traditional Chinese and western medicine could significantly improve the effective rate of main clinical symptoms in patients with LDH [RR=1.11,95% CI(0.97,1.26), P>0.05 ] ; in addition, VAS score (MD=-0.65,95% CI(-0.93, -0.37), P<0.05 ) and JOA score (RR=0.87,95% CI(0.60,1.13), P<0.05 ) were significantly better than the control group. Begg’s test showed that there was no significant publication bias between studies [clinical effective rate (Z=1.042, P=0.296) ;VAS score (Z=0.000, P=1.000); JOA score (Z=0.000, P=1.000)]. Conclusion The existing evidence shows that Duzhong Yaotong Pill has certain advantages in the treatment of lumbar disc herniation, which can alleviate the pain of patients, significantly reduce the VAS score of patients and improve the JOA score and worthy of clinical application.
    Effect of Virtual Reality Training Combined with Traditional Chinese Medicine Health Therapy on Neurological Function in Patients with Cerebral Infarction
    XU Ling, SUN Shan-dong, WANG Feng, YIN Liang
    2022, 40(22):  27-29. 
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    Objective To explore the effects of virtual reality training combined with traditional Chinese medicine health therapy on the neurological function of patients with cerebral infarction. Methods From November 2019 to November 2021, 60 cases of patients with cerebral infarction diagnosed and treated in Suzhou Hospital of Traditional Chinese Medicine were selected as the research objects, and the patients were divided into 30 cases in the study group and 30 cases in the control group accorded to the principle of 1:1 parallel control. The control group were given virtual reality training, and the study group were given traditional Chinese medicine health therapy on the basis of the treatment of the control group. The observation time of two groups were 12 weeks, and the neurological function changes, cognitive function scores, upper limb motor function and safety before and after treatment were compared. Results After treatment, the total effective rate of magic function in the study group was higher than the control group, the difference was not statistically significant（P>0.05）. After treatment, the Mini-Mental State Examination (MMSE) scores of the study group and the control group were significantly higher than those before treatment, and the study group was also significantly higher than the control group, the difference was statistically significant (P<0.05). After treatment, the Fugl-Meyer Assessment (FMA) scores of upper limb function in the study group and the control group were significantly higher than those before treatment, and the study group was also significantly higher than the control group, the difference was statistically significant (P<0.05). The incidence of complications such as non-symptomatic cerebral hemorrhage and symptomatic cerebral hemorrhage during treatment in the study group wassignificantly lower than the control group, the difference was statistically significant (P<0.05). Conclusion The application of virtual reality training combined with traditional Chinese medicine health therapy in patients with cerebral infarction can improve cognitive function, promote the recovery of patients’ neurological function, improve cognitive function and reduce complications.
    Effects of Yishen Mingmu Recipe Combined with Xueshuantong for Injection on the Quality of Life and Serum Endothelin-1 Level in Patients with Glaucoma
    PENG Zhi-jia
    2022, 40(22):  30-33. 
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    Objective To investigate the effect of Yishen Mingmu Recipe combined with Xueshuantong for injection on the quality of life and serum Endothelin-1 level in patients with glaucoma. Methods FA total of 60 glaucoma patients who were diagnosed and treated in the Department of Ophthalmology, Changshu Hospital Affiliated to Nanjing University of Traditional Chinese Medicine from August 2018 to December 2021 were retrospectively selected as the research subjects. According to the treatment methods, the patients were divided into the control group and the treatment group with 30 cases each group. The patients in the control group was treated with Xueshuantong for injection, and the treatment group was treated with Yishen Mingmu Recipe on the basis of the control group. Both groups were treated and observed for 3 months, total effective rate of best corrected vision, intraocular pressure, changes in anterior chamber depth, complications,the quality of life and serum Endothelin-1 status were observed and recorded. Results The total effective rate of the best corrected visual acuity in the treatment group after treatment was 96.67%, which was higher than that in the control group, which was 83.33%, but there was no significant difference between the groups (P>0.05). The intraocular pressure of the treatment group and the control group after treatment was significantly lower than that before treatment (P<0.05), and the depth of the central anterior chamber was significantly higher than that before treatment (P<0.05). After treatment, the intraocular pressure of the treatment group was lower than that of the control group (P<0.05), and the depth of the central anterior chamber was higher than that of the control group (P<0.05). The incidence rates of corneal epithelial edema, anterior chamber exudation, hyphema during treatment in the treatment group was 3.33%, which was significantly lower than that in the control group (26.67%),(P<0.05). The serum ET-1 content in the treatment group and the control group after treatment was significantly lower than that before treatment (P<0.05), and the treatment group was also significantly lower than that in the control group (P<0.05). The scores of life satisfaction, mental health, emotional health and other quality of life in the treatment group after treatment were significantly higher than those in the control group (P<0.05). Conclusion The application of Yishen Mingmu Recipe combined with Xueshuantong for injection in patients with glaucoma has good safety, can reduce the occurrence of complications, promote the reduction of intraocular pressure, and improve the best corrected visual acuity and central anterior chamber depth of patients. It can also promote the reduction of serum Endothelin-1 content and improve the quality of life of patients.
    Curative Effect Analysis of Cupping Plus Neo-auxiliary Moxibustion in the Treatment of Amenorrhea
    HU Hong-xia, WANG Juan, MEI Dong-yan
    2022, 40(22):  37-40. 
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    Objective To explore the therapeutic effect of cupping and neo-auxiliary moxibustion on amenorrhea. Methods A total of 80 patients with amenorrhea admitted to the Yangzhou Hospital of Traditional Chinese Medicine from January 2019 to January 2022 were selected as the research objects and divided into the control group and the observation group according to the random number table method, with 40 cases in each group. The control group was treated with Chinese patent medicine, while the observation group was treated with cupping combined with new-auxiliary moxibustion. The course of treatment in both groups was 21 days. The clinical efficacy, changes of TCM syndrome scores before and after treatment, blood hormone levels before and after treatment and average time of menstruation were compared between the two groups. Results After treatment, the total effective rate of observation group was higher than that of control group, and the difference was statistically significant (P<0.05). Before treatment, there were no significant differences in the indexes of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T) and LH/FSH between the two groups (P>0.05). After treatment, the levels of LH, T, E2 and LH/FSH in the two groups were decreased, and the levels of FSH were higher than those before treatment. The levels of LH, T, E2 and LH/FSH in the observation group were lower than those in the control group, and the levels of FSH were higher than those in the control group, and the differences were statistically significant (P<0.05). Before treatment, there was no significant difference in the scores of TCM syndrome between the two groups (P>0.05). After treatment, the scores of each TCM syndrome in the two groups were lower than those before treatment, and the scores of each TCM syndrome in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). After treatment, the average menstrual cycle of the observation group was longer than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Cupping combined with Xinpu moxibustion in the treatment of amenorrhea can effectively regulate the blood hormone level and relieve the clinical symptoms. The clinical effect is remarkable and worthy of clinical application.
    Influence of Combined Use of Oxytocin and Xinmupei on Postpartum Hemorrhage During Cesarean Section of Scarred Uterus
    CHEN Lin
    2022, 40(22):  47-49. 
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    Objective To investigate the effect of combined use of oxytocin and Xinmupei on postpartum hemorrhage during cesarean section of scarred uterus. Methods From January 2020 to January 2022, 81 patients with scarred uterus undergoing cesarean section in Xinyu People's Hospital were selected as the research objects. According to the random number table method, they were divided into group A, group B and group C, 27 cases in each group. Group A was given oxytocin, group B was given intramuscular injection of Xinmupei on the basis of group A, and group C was given intramuscular injection of Xinmupei on the basis of group A. The differences in postpartum hemorrhage (postpartum hemorrhage volume in 2 hours, postpartum hemorrhage volume in 24 hours, postpartum hemorrhage rate, blood transfusion rate) among the three groups were analyzed; the changes of blood routine related indicators [red blood cell (RBC) and hemoglobin (HGB)] before and 2 hours after delivery were compared among the three groups; the differences in the incidence of adverse drug reactions within 48 hours after surgery were compared among the three groups. Results The postpartum hemorrhage volume, 24 h postpartum hemorrhage volume, postpartum hemorrhage rate and blood transfusion rate in groups B and C were lower than those in group A (P<0.05), there was no significant difference in the amount of postpartum hemorrhage at 2 h, the amount of postpartum hemorrhage at 24 h, the rate of postpartum hemorrhage, and the rate of blood transfusion between the two groups (P>0.05). Significantly increased (P<0.05), and groups B and C were significantly higher than group A at the same period (P<0.05), and there was no significant difference in RBC levels between groups B and C at 2 h postpartum (P>0.05). At 2 h postpartum compared with prepartum, HGB in the three groups was significantly decreased (P<0.05), but there was significant difference in the degree of HGB decline in groups B and C compared with group A (P<0.05), and there was no difference in HGB levels between groups B and C. Statistical significance (P>0.05); within 48 hours after operation, there was no significant difference in the incidence of adverse drug reactions among the three groups (P>0.05). Conclusion The application of oxytocin combined with Xinmupei in cesarean section of scarred uterus can effectively reduce the postoperative bleeding volume and improve the levels of RBC and HGB in patients. It is beneficial to its prognosis recovery.
    Effect of Compound α-Ketoacids Combined with Atorvastatin on Chronic Renal Failure
    GAO Ju
    2022, 40(22):  50-52. 
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    Objective To study the clinical effect of compound α-ketoacid combined with atorvastatin in the treatment of chronic renal failure. Methods A total of 860 patients with chronic renal failure admitted to Panjin Liaoyou Baoshihua Hospital from January 2019 to December 2021 were retrospectively selected and divided into observation group and control group according to different treatment methods, with 430 cases in each group. Both groups adopted low protein diet to control blood pressure and blood glucose; the observation group was treated with compound alpha-ketoacid combined with atorvastatin. The two groups were treated for 2 months,and the clinical effects of the two groups were compared. Serum urea nitrogen(BUN),,serum creatinine (Scr),,cholesterol (TC),,albumin (ALB),,triglyceride (TG),,serum calcium,parathyroid hormone (PTH) and serum phosphorus in the two groups before and after treatment were detected level. Results The effective rate of the observation group was significantly higher than control group(P<0.05). Before treatment, there was no significant difference in SCR, bun, TG and TC between the two groups (P>0.05). After treatment,,SCR,,BUN, TG and TC decreased significantly(P<0.05), ALB increased significantly (P<0.05), and SCR, bun, TG and TC in the observation group were significantly lower than those in the control group(P<0.05), ALB was significantly higher than those in the control group (P<0.05). Before treatment, there was no significant difference in the levels of blood calcium, PTH and blood phosphorus between the two groups(P>0.05). After treatment, there was no significant change in the levels of blood calcium, PTH and blood phosphorus in the two groups (P>0.05). Conclusion Compound alpha-ketoacid combined with atorvastatin can effectively protect renal function, reduce blood phosphorus, increase blood calcium content, inhibit PTH secretion, and effectively delay the process of renal failure.
    Comparison of Efficacy and Safety of Ibutilide and Amiodarone in the Treatment of New-Onset Atrial Fibrillation after Permanent Pacemaker Implantation
    MA Li-na, MENG Ting, JIANG Qing-jun, LI Fu, XI Shao-jing
    2022, 40(22):  56-59. 
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    Objective To investigate and compare the efficacy and safety of ibutilide and amiodarone in the treatment of new-onset atrial fibrillation after permanent cardiac pacemaker implantation. Methods From January 2019 to March 2022, A total of 88 patients with new-onset atrial fibrillation after permanent cardiac pacemaker implantation who were diagnosed and treated in our hospital from were selected as the research subjects, and the patients were divided into the control group and the combined group accorded to the simple allocation principle with 44 cases in each group. The control group was given amiodarone treatment, and the combined group was given ibutilide treatment on the basis of the treatment of the control group. The two groups were treated for 7 days. The conversion rate and conversion time within 1 hour of treatment, the changes of QT interval and Tpeak-end/QT interval before and after treatment, the total effective rate at 7 days after treatment, the recurrence rate of atrial fibrillation within 7 days after treatment and the occurrence of adverse reactions at 7 days after treatment were compared between the two groups. Results Compared with the control group, the combined group had higher cardioversion rate and shorter cardioversion time, and the differences were statistically significant(P<0.05). There was no significant difference in the QT interval and Tpeak-end/QT interval between the two groups before treatment (P>0.05).After treatment, there was no significant difference in QT interval and Tpeak-end/QT interval at 2 h in the combination group compared with before treatment (P>0.05), but the QT interval and TPEak-END /QT interval of the control group were significantly different before and after treatment (P<0.05), and the above indexes of the combined group were significantly lower than those of the control group after treatment (P<0.05). After 7 days of treatment, the total effective rate of the combined group was 97.73%, which was significantly higher than 84.09% of the control group,but there was no significant difference (P > 0.05). After treatment for 7 d, the recurrence rate of AF in the combined group was 4.54%, and that in the control group was 2.27%, and there was no significant difference between the two groups (P>0.05).The incidence rates of transient sinus block, hypotension, sinus bradycardia, atrioventricular block and other adverse reactions in the combined group 7 days after treatment was 4.54%, which was significantly lower than 22.73% in the control group (P<0.05). Conclusion The application of ibutilide combined with amiodarone in the treatment of new-onset atrial fibrillation after permanent pacemaker implantation can improve the conversion rate and speed up the conversion time, the recurrence rate of postoperative atrial fibrillation is low and the adverse reactions are controllable, which is worthy of clinical application.
    Effect of Nursing Intervention Based on Cross Theoretical Model on Improving Lifestyle of Patients with Acute Myocardial Infarction
    CUI Ying-zi, HU Ya-juan, ZHONG Zhi-yuan, LIU Xiao-bu
    2022, 40(22):  66-68. 
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    Objective To explore the effect of nursing intervention based on cross theoretical model on improving the lifestyle of patients with acute myocardial infarction. Methods 100 patients with acute myocardial infarction treated in our hospital from April 2021 to September 2021 were randomly divided into control group (n = 50) and test group (n = 50) according to the numerical table method. Both groups were given routine treatment. The control group was given routine nursing intervention based on routine treatment, and the test group was given nursing intervention based on cross theoretical model. The scores of disease management ability, Health Promoting Lifestyle Scale (Health Promotion Lifestyle Profile, HPLP) and incidence of adverse cardiac events and readmission rate. Results The scores of emergency management, self-care knowledge and clinical symptoms in the test group were significantly higher than those in the control group (P<0.05); the scores of nutrition management, rehabilitation exercise, health responsibility, interpersonal relationship, self realization and stress management in the test group were significantly higher than those in the control group (P < 0.05); the incidence of adverse cardiac events and readmission rate in the test group were significantly lower than those in the control group (P<0.05). Conclusion Nursing intervention based on cross theoretical model can help to improve the self-efficacy and lifestyle of patients with acute myocardial infarction, improve their disease management ability, so as to reduce adverse cardiac events and reduce the readmission rate, which is worthy of clinical application.
    Clinical Application of Parallel Acquisition Technique in Dynamic Enhancement of Breast MR
    XIAO Ying, XU Hua-wen, XU Jing-jing, LI Yang-kang
    2022, 40(22):  143-145. 
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    Objective To explore the application of parallel acquisition technology in GE breast dynamic enhancement (VIBRANT) technology based on 3.0TMR platform. Methods 70 patients with breast cancer who underwent MR dynamic contrast-enhanced scanning from January 2020 to December 2020 in the Affiliated Cancer Hospital of Shantou University Medical College were selected prospectively, all of whom were female. All patients were examined by dynamic enhanced scanning with parallel acquisition technology and dynamic enhanced scanning without parallel acquisition technology. The scanning time, spatial resolution, signal-to-noise ratio and contrast of the two methods were calculated and compared statistically. The scan time, image quality, diagnostic performance sensitivity, specificity, and accuracy of the two methods of dynamic contrast-enhanced MR with and without the ARC technique were compared. Results In VIBRANT breast dynamic enhancement scan, the scanning time with parallel acquisition technology technology was significantly shorter than that without parallel acquisition technology technology (P<0.05). The spatial resolution of the two inspection methods was the same. There was no significant difference in signal-to-noise ratio and contrast between the two methods (P>0.05). Taking pathological diagnosis as the gold standard, there was no significant difference in the sensitivity, specificity, accuracy and negative predictive value of dynamic contrast-enhanced MRI between the two methods (P>0.05). Two methods were highly consistent with pathological diagnosis of breast cancer. Conclusion VIBRANT dynamic enhanced breast scan sequence based on parallel acquisition technology has good diagnostic sensitivity, specificity and accuracy, and does not affect its diagnostic efficiency on the premise of significantly shortening the scanning time.
    Clinical Study on the Effect of Vascular Morphology on Wave Dynamics by High Resolution Magnetic Resonance Imaging
    ZHANG Xue-feng
    2022, 40(22):  146-149. 
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    Objective To explore and study the clinical effects of high-resolution magnetic resonance imaging in evaluating the effect of vascular morphology on wave dynamics. Methods A total of 82 patients with cerebral ischemia and cerebral hemorrhage who were diagnosed and treated in the Third People’s Hospital of Baiyin City, Gansu Province from January 2018 to January 2022 were selected and divided into ischemia groups according to different types of cerebrovascular diseases (n=36) and the bleeding group (n=46). All patients were examined by high-resolution magnetic resonance imaging (MRI), and were to evaluate the values of vascular morphology on wave dynamics, and were to judge the diagnostic value. Results The cerebral hemorrhage group were more showed low signal on T1WI, high signal on T2WI and high signal on DWI; In cerebral ischemia group, most of them showed equal signal or high signal on T1WI, high signal on T2WI and DWI. The time to peak (TTP) of intracerebral hemorrhage group were higher than that of cerebral ischemia group (P<0.05), and the cerebral blood flow (CBF) were lower than that of cerebral ischemia group (P<0.05). There were no significant difference compared between the two groups in cerebral blood volume (CBV) and mean transit time (MTT) (P>0.05). Used the b values of 500 s/mm2 and 800 s/mm2, the apparent diffusion coefficient (ADC) of intracerebral hemorrhage group were lower than that in cerebral ischemia group (P<0.05). With clinical and MRI routine imaging diagnosis as the gold standard, there were 33 cases were diagnosed as cerebral ischemia and 49 cases as intracerebral hemorrhage by high-resolution MRI in the 82 cases. The sensitivity and specificity of high-resolution MRI in the differential diagnosis of cerebral ischemia and intracerebral hemorrhage were 88.9% (32/36) and 97.8% (45/46). The receiver operating characteristic curve (ROC) curve showed that the area under the curve of high-resolution MRI for differential diagnosis of cerebral ischemia and cerebral hemorrhage was 0.836. Conclusion The evaluation of high-resolution MRI technology is helpful to evaluate the changes of vascular morphology and wave dynamics in patients with cerebral ischemia, which can effectively differentiate between cerebral ischemia and cerebral hemorrhage, and has a good application value.
    Anesthetic Effect of Lidocaine Combined with Midazolam and Cis-Atracurium in Laparoscopic Cholecystectomy
    YIN Ying-ying
    2022, 40(22):  153-157. 
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    Objective To investigate the anesthetic effect of lidocaine combined with midazolam and cis-atracurium in laparoscopic cholecystectomy. Methods A total of 90 patients with laparoscopic cholecystectomy who were admitted to the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from July 2019 to January 2022 were selected and divided into expermental group (n=45) and control group (n=45) according to the random table method. The control group was given midazolam, cisatracurium, sufentanil and propofol for anesthesia induction. The experimental group was given lidocaine for anesthesia induction on the basis of the control group. The recovery time of the first bowel sound and the first anal exhaust time, visual analogue scale (VAS) score at different postoperative time, the expression level of angiotensin Ⅱ(Ang Ⅱ) at 2 h after surgery, the levels of adrenaline (E), norepinephrine (NE), cortisol (Cor), T lymphocyte subsets CD8+, CD4+, CD3+, and self were compared between the two groups NK cell level, CD4+/CD8+ ratio and adverse reaction rate. Results The recovery time of the first bowel sound and the first anal exhaust time in the experimental group were shorter than those in the control group (P<0.05). It was lower than the control group (P<0.05), and the VAS scores between the two groups at different times were compared,the difference was statistically significant (P<0.05); the levels of Ang II, E, NE, and Cor were compared between the two groups before operation,the difference was not statistically significant (P>0.05). The levels of the above indexes increased at 2 h, but the experimental group was lower than the control group (P<0.05); the comparison of CD8+, CD4+, CD3+, NK, CD4+/CD8+ indexes 30 minutes before anesthesia induction between the two groups,the difference was not statistically significant (P>0.05), the above indexes in both groups showed a downward trend 24 hours after operation, and the levels of CD4+, CD3+, NK and CD4+/CD8+ indexes in the experimental group were higher than those in the control group (P<0.05), and the CD8+ levels in the two groups were compared,the difference was not statistically significant (P>0.05). There was no statistically differencein the adverse reaction rate of respiratory depression, hypotension, restless hess during awakening between the experimental group and the control group (P>0.05). Conclusion Lidocaine combined with midazolam and cis-atracurium for anesthesia induction in laparoscopic cholecystectomy can shorten the recovery time of the first bowel sound and the time of the first anal exhaust, relieve postoperative pain, relieve the body’s stress response, improve immune function. Meanwhile, it has a certain safety, and is worthy of clinical application.
    Clinical Study of Ultrasound-Guided Puncture and Drainage in the Treatment of Spinal Hematoma
    YU Hu, DUAN Xiao-yi
    2022, 40(22):  158-160. 
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    Objective To investigate the clinical effect of ultrasound-guided puncture and drainage on spinal hematoma. Methods 164 cases of hematoma in the operative area after spinal surgery admitted to Xi ‘an 521 Hospital of Ordnance Industry from January 2020 to July 2022 were selected as the research objects. The clinical treatment methods were retrospectively analyzed. According to the treatment methods, the patients were divided into ultrasound guided drainage group （n=25）, blind perforation drainage group （n=37） and conservative treatment group （n=102）. The effective rate, postoperative hospital stay and symptom duration of the three groups were compared and analyzed after operation. Results On the 1st and 5th day after operation, the effective rate of patients in ultrasound puncture and drainage group and blind puncture and drainage group was significantly higher than that in conservative treatment group （P<0.05）. The postoperative hospital stay and symptom duration of patients in ultrasound puncture drainage group and blind puncture drainage group were significantly lower than those in conservative treatment group, and the differences were statistically significant （P<0.05）. There were no significant differences in the effective rate, postoperative hospital stay and symptom duration between the two groups （P>0.05）. Conclusion Ultrasound guided puncture and drainage is safe, minimally invasive and effective, meanwhile the curative effect is significantly higher than that of conservative treatment. It is the first choice for the treatment of spinal hematoma after spinal surgery.
    Effect of Zhuangguzhitong Capsule on Postmenopausal Osteoporotic Vertebral Compression Fracture Patients after PVP
    HAN Jun-bu
    2022, 40(22):  168-171. 
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    Objective To explore and analysis the effects of Zhuangguzhitong capsule on postmenopausal osteoporotic vertebral compression fractures after percutaneous vertebroplasty （PVP）. Methods A total of 96 postmenopausal patients with osteoporotic vertebral compression fractures who completed PVP surgery in Qingyang Traditional Chinese Medicine Hospital from May 2019 to January 2022 were selected as the research subjects, and the patients were equally divided into the traditional Chinese medicine group and the control group accorded to the simple random number table method. The control group were given routine physical therapy, and the traditional Chinese medicine group were given Zhuanggu Zhitong Capsule on the basis of the treatment of the control group. The two groups were treated for 3 months. The VAS thoracolumbar back pain score, ODI spine score, lumbar vertebral bone mineral density changes, and complications during treatment were compared between the two groups before and after treatment. Results The VAS thoracolumbar back pain scores in two groups after treatment were lower than those before treatment （P<0.05）, and the traditional Chinese medicine group were also significantly lower than that in the control group （P<0.05）. The ODI spine scores in two groups after treatment were significantly lower than those before treatment （P<0.05）, and the traditional Chinese medicine group were also significantly lower than that in the control group （P<0.05）. After treatment, the bone mineral density of lumbar vertebrae in two groups were significantly higher than that before treatment （P<0.05）, and the traditional Chinese medicine group were also significantly higher than that in the control group after treatment （P<0.05）. The incidence of complications such as vertebral body refracture, lower extremity deep venous thrombosis, bedsore, and pneumonia in the traditional Chinese medicine group were significantly lower than that in the control group （P<0.05）. Conclusion The application of Zhuanggu Zhitong Capsules in postmenopausal osteoporotic vertebral compression fracture patients after PVP can reduce the incidence of complications, improve the bone mineral density of the patients, and also promote the relief of thoracolumbar back pain and improve the lumbar spine function of the patients.
    The Effect of LDP on Children with UPJO Hydronephrosis and Its Influence on Renal Function
    DING Wei, FENG Yue-long
    2022, 40(22):  189-191. 
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    Objective To investigate the effect of laparoscopic ureteropelvic plasty (LDP) on hydronephrosis in children with ureteropelvic junction obstruction (UPJO) and its influence on renal function. Methods A retrospective selection of 85 children with UPJO hydronephrosis who were treated in the People's Hospital of Ningxia Hui Autonomous Region from January 2019 to January 2022 were selected and divided into observation group (n=43, LDP) and control group (n=42, open pyeloplasty) according to the surgical methods. Operation indexes(operation time, hospitalization expenses, intraoperative blood loss, total amount of perirenal drainage, postoperative analgesic dosage and hospitalization time), renal function, renal morphology and complications were compared between the two groups. Results Compared with the control group, the operation time and hospitalization expenses in the observation group increased significantly (P<0.05). Compared with the control group, blood loss during operation, the total amount of perirenal drainage, postoperative analgesic dosage and postoperative hospitalization time were significantly reduced (P<0.05). After operation, the glomerular filtration rate (GFR) of both groups was significantly higher than that before operation, and the Serum creatinine (Scr) level was significantly lower than that before operation (P<0.05). However, there was no significant difference in GFR and Scr levels between the two groups (P>0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (P<0.05). After operation, the renal volume of both groups decreased significantly (P<0.05) and the renal parenchyma thickness increased significantly (P<0.05). However, there was no significant difference in renal volume and renal parenchyma thickness between the two groups (P>0.05). Conclusion LDP is effective in the treatment of children with UPJO hydronephrosis, which can promote the recovery of renal function and renal morphology and reduce postoperative complications.
    Observation on the Effect of Low Frequency Repetitive Transcranial Magnetic Stimulation Combined with Agomestatin in the Treatment of Post-Stroke Depression Patients
    GAO Xue-qin
    2022, 40(22):  192-196. 
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    Objective To investigate the effect of low frequency repetitive transcranial magnetic stimulation combined with agomestatin in the treatment of post-stroke depression patients. Methods A total of 70 patients with post-stroke depression who were admitted to Shuyang Minghe Hospital from January 2020 to December 2021 were prospectively selected and divided into two groups according to the random number table method. The control group was treated with agomestatin alone, while the observation group was treated with low-frequency repetitive transcranial magnetic stimulation on the basis of agomestatin. The effectiveness of treatment,levels of 5-hydroxytryptamine (5-HT), brain-derived neurotrophic factor (BDNF), norepinephrine (NE) and nerve growth factor (NGF) in the two groups were detected, and the quality of life of the two groups was evaluated. Results The effective rate of the observation group was significantly higher than control group (P<0.05). Before treatment, there was no significant difference in the levels of NE, 5-HT, BDNF and NGF between the two groups (P>0.05). After treatment, the levels of NE, 5-HT, BDNF and NGF in the two groups were significantly increased (P<0.05), and the levels of NE, 5-HT, BDNF and NGF in the observation group were significantly higher than those in the control group (P<0.05). Before treatment, there were no significant differences in the scores of activity, language, personality, energy, emotion, thinking, social function, family role, self-care ability, upper limb function, vision and work ability between the two groups (P>0.05). The scores of activity, language, personality, energy, emotion, thinking, social function, family role, self-care ability, upper limb function, vision and work ability of stroke patients were significantly increased (P<0.05). Personality, energy, emotion, thinking, social function, family role, self-care ability, upper limb function, vision and work ability scores were significantly higher than those in the control group (P<0.05). Conclusion Low-frequency repetitive transcranial magnetic stimulation combined with agomestatin has better effect on patients with post-stroke depression, can significantly increase the levels of NE, 5-HT, BDNF and NGF, and improve the quality of life.