Table of Content

16 December 2022, Volume 40 Issue 24

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Study on the Effect of CWM Management Program Based on CFIR Evidence-based Practice Model on Early Inotropic Rehabilitation in Stroke Patients

ZHANG Lin, CHEN Shu-juan, SUN Xiao, YU Xiao-li, ZHU Xiao-ping, CHEN Ya-mei, TAO Yu, LIU Xiao-qing, ZHANG Yu YAN, Qiong-zhi

2022, 40(24):  1-4. 

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Objective To explore the effect of TCM management program based on CFIR on early muscle strength rehabilitation in stroke patients. Methods A total of 72 patients with ischemic stroke admitted to the Shanghai 10th People's Hospital from August 2020 to May 2021 were selected as the research objects. According to the random number table method, they were divided into the control group and the intervention group, 42 patients were included before the evidence-based practice as the control group, and 30 patients were included after the practice as the intervention group. Patients in the control group were given routine management plan, while patients in the intervention group were given evidence-based practice intervention management plan. The National Institute of Health Stroke Scale (NIHSS) and activities of daily living were compared between the two groups living, ADL) score, muscle strength grading, and the implementation of evidence by medical staff. Results After evidence-based practice, the NIHSS score of intervention group was lower than that of control group, and the difference was statistically significant (P<0.05). The ADL score of the intervention group was higher than that of the control group, and the difference was statistically significant (P<0.05). The proportion of patients with muscle strength grade≥4 in intervention group was higher than that in control group, and the difference was statistically significant (P<0.05). After evidence-based practice, the implementation rate of medical staff to evidence was improved, and the differences were statistically significant (P<0.05). Conclusion The TCM and Western medicine management scheme based on CFIR evidence-based practice model can effectively improve the activities of daily living of patients and promote the early recovery of muscle strength and neurological function of stroke patients, which is worthy of clinical application.

Therapeutic Effect of Lupatadine Fumarate Combined with Yupingfeng Granule on Chronic Urticaria

WANG Fu-dong, LIU Jia, JIANG Shu-ling

2022, 40(24):  5-8. 

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Objective To investigate the effect oflupatadine fumarate combined with Yupingfeng Granule on chronic urticaria. Methods A total of 104 patients with chronic urticaria who were treated in the Second Affiliated Hospital of Guilin Medical College from January 2021 to December 2021 were selected and divided into two groups by random number table method, with 40 patients in each group.The control group received lupatadine fumarate tablets, while the observation group received lupatadine fumarate tablets and Yupingfeng granules.The treatment effective rate and recurrence rate of the two groups were observed, and the serum interleukin (IL)-4, immunoglobulin E (IgE), IL-8, interferon-γ (INF-γ) and IL-17 levels, and assess for changes in symptoms. Results The effective rate of the observation group wassignificantly higher than control group (P<; 0.05), and the recurrence rate was lower than control group (P<; 0.05). After treatment, the levels of serum IL-4, IgE, IL-8 and IL-17 in the two groups were significantly decreased (P<; 0.05), the level of INF-γ was increased (P<; 0.05). And the levels of serum IL-4, IgE, IL-8 and IL-17 in the observation group were significantly lower than thosein the control group (P<; 0.05), the levels of serum INF-γ were significantly higher than those in the control group (P<; 0.05). Before treatment, there were no significant differences in the number of wheals, itching degree, duration of wheals, the largest diameter of wheals and the number of daily wheals attacks between the two groups (P>; 0.05). After treatment, the number of wheals, itching degree, duration of wheals, the largest diameter of wheals and the number of daily wheals attacks were significantly reduced between the two group (P<; 0.05). And the number of wheals, itching degree, duration of wheals, the largest diameter of wheals and the number of daily wheals attacks in the observation group were significantly reduced (P<; 0.05). Conclusion Lupatadine fumarate combined with Yupingfeng granule has significant curative effect on chronic urticaria, which is worth popularizing.

Effect of Neovasin on Endothelium - Dependent Vasodilation and Plasma NO Level in Patients with Coronary Heart Disease undergoing Percutaneous Coronary Intervention

XIE Jun, FU Bei-jing, GAO Feng-min

2022, 40(24):  8-11. 

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Objective To investigate the effects of lyophilized recombinant human brain natriuretic peptide on endothelium dependent vasodilation and plasma NO in patients with coronary artery disease (CAD) after percutaneous coronary intervention. Methods From March 2020 to March 2022, 100 patients with coronary intervention who were admitted to the Hongqi Hospital affiliated to Mudanjiang Medical College were selected and divided into two groups (named study group and control group respectively) according to the random number table. The patients were treated with routine drugs (according to the clinical manifestations and characteristics of the disease, the patients were given a reasonable treatment plan, including nitrates, antiplatelet drugs, anticoagulants, etc.). The study group of 50 patients was treated with lyophilized recombinant human brain natriuretic peptide on a routine basis. The clinical efficacy, changes in biochemical indicators, flow mediated dilation (FMD) Plasma (nitric oxide, NO) and the incidence of adverse reactions. Results The total effective rate of patients in the study group was significantly higher than that in the control group (P<0.05). There was no significant difference in hs-CRP, BNP and IL-6 between the two groups before treatment (P>0.05), after treatment, the indexes in the study group were significantly lower than those in the control group (P<0.05). There was no significant difference between the two groups in the levels of FMD and plasma NO before treatment (P>0.05), and after treatment, the levels of FMD and plasma NO in the two groups were both increased (P<0.05), and the levels of the above indicators in the study group were higher than those in the control group (P<0.05). The incidence of adverse reaction in the study group was lower than that in the control group (P<0.05). Conclusion Lyophilized recombinant human brain natriuretic peptide can improve endothelium dependent vasodilation function, improve cardiac function, increase plasma NO content in patients with coronary heart disease after intervention. It has significant effect, and the incidence of adverse reactions is low. Furthermore, it is safe and reliable. It provides a new idea and treatment method for the treatment of coronary heart disease.

Effect Analysis of Autologous Blood Mixed Silk Thread Embolization in the Treatment of Arterial Hemoptysis

GUO Yong-bin, GUO Jin

2022, 40(24):  12-15. 

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Objective To investigate the effect of autologous blood mixed with silk thread embolization in the treatment of systemic arterial hemoptysis. Methods A total of 60 patients with systemic arterial hemoptysis from February 2016 to March 2019 in Interventional Department of People's Hospital of Wuwei City, Gansu Province were selected as research subjects and were randomly divided into two groups (named experimental group and control group respectively), with 30 cases in each group. The experimental group was embolized by autologous blood mixed wire segment, and the control group used polyvinyl alcohol granule embolization agent. The success rate and recurrence rate were compared between the two groups. Results The immediate success rate of embolization in the experimental group was 100%, while in the control group, 3 cases were excluded during the operation, and the remaining 27 bronchial arteries were successfully embolized, with a success rate of 100%. There was no statistical significance in the embolization success rate between the two groups (P>0.05). During the follow-up period, the recurrence rate of the experimental group was 23.33%, and the recurrence rate of the control group was 23.08%, and there was no statistical significance between the two groups (P>0.05). There were no serious complications in either group. Conclusion Autologous blood mixed silk thread embolization in the treatment of systemic arterial hemoptysis after immediate successful embolization, less recurrence and less complications in follow-up, the effect is comparable to that of polyvinyl alcohol granule embolization agent, and has application value.

Correlation Analysis of Serum TSH and TPO-Ab Expression Levels with Hypothyroidism in the Elderly

WU Bing-si

2022, 40(24):  15-19. 

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Objective To explore and analysis the correlation between the expression levels of serum Thyroid-stimulating hormone (TSH), Thyroid peroxidase antibody (TPO-Ab) and senile hypothyroidism. Methods A total of 90 elderly patients with hypothyroidism who were diagnosed and treated in Nanjing Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Nanjing University of Traditional Chinese Medicine from January 2018 to December 2021 were retrospectively selected as the research subjects, and 40 cases of primary hypothyroidism and 50 cases of subclinical hypothyroidism were included. The serum TSH and TPO-Ab expression levels of the patients were detected. At the same time, the blood lipid and hemoglobin levels of the patients were detected, and the correlation between the expression levels of serum TSH and TPO-Ab and the elderly hypothyroidism was analyzed. Results There were no difference in serum TSH content compared between the two groups, and the difference was statistically significant (P<0.05). The serum TPO-Ab content in the hypothyroidism group were higher than that in the hypothyroidism group, and the difference was statistically significant (P<0.05). There were no difference in hemoglobin and blood lipid indexes [(triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol(HDL-C)]compared between the two groups (P>0.05). The proportion of symptoms such as lethargy and fatigue in the hypothyroidism group were higher than that in the hypothyroidism group, the difference is statistically significant (P<0.05). In the 90 patients, Pearson analysis showed that serum TSH levels were not correlated with subclinical hypothyroidism (P>0.05), but serum TPO-Ab were correlated with subclinical hypothyroidism (P<0.05). Conclusion Subclinical hypothyroidism in the elderly is the main type of hypothyroidism. The expression level of serum TPO-Ab is lower than that in patients with primary hypothyroidism. There is correlation between the expression level of serum TPO-Ab and subclinical hypothyroidism in the elderly.Detection of serum TSH and TPO-Ab expression levels is helpful to predict the occurrence of subclinical hypothyroidism in the elderly.

Clinical Effect of Normal Temperature Liquid and Isothermal Liquid in Rescuing Patients with Hemorrhagic Shock and its Influence on Hemodynamics

WANG Zhen

2022, 40(24):  19-22. 

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Objective To explore the clinical effects of normothermic and isothermal fluids in the treatment of patients with hemorrhagic shock, and to explore the influence of normothermic and isothermal fluids on the hemodynamics of patients. Methods 80 patients with hemorrhagic shock were selected from Xuzhou First People's Hospital from February 2021 to July 2022. They were divided into control group and test group using random number table method, with 40 patients in each group. The patients in the control group were treated with normal temperature liquid, and the patients in the test group were treated with the same body temperature liquid as the patient's temperature. The clinical effects and hemodynamic indexes of the two groups were compared. Results The changes of clinical indicators of the two groups were compared. After treatment, the fluid input, blood loss and blood transfusion of the patients in the test group were lower than those in the control group, and their body temperature and urine volume were higher than those in the control group, there was statistically significant difference between the two groups (P<0.05). The curative rate and adverse reaction rate in the control group were lower than those in the test group, and the adverse reaction rate was higher than that in the test group, there was no significant difference between the two groups (P>0.05). The clinical hematocrit (HCT) , mean arterial pressure (MAP) and central venous pressure pressure (CVP) in the test group were higher than those in the control group, the heart rate (HR) in the test group were lower than that in the control gruop, there was significant difference between the two groups (P<0.05). Conclusion In the rescue of patients with hemorrhagic shock, the application of isothermal fluid resuscitation can improve the clinical curative effect, improve the hemodynamics index, reduce the occurrence of adverse reactions and increase the clinical effective rate.

Application of Bone-setting and Tendon-setting Manipulation Combined with External Application of Diclofenac Diethylamine in Postoperative Rehabilitation of Patients with Ankle Joint Injury

JIN Bing, WANG Jun-peng, HAO Bao-dong

2022, 40(24):  25-28. 

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Objective To explore the application effects of bone-setting and tendon-setting manipulation combined with external application of diclofenac diethylamine in postoperative rehabilitation of patients with ankle joint injury. Methods A total of 100 postoperative patients with foot and ankle joint injuries who were diagnosed and treated in Changping District Hospital of Integrated Traditional Chinese and Western Medicine in Beijing from September 2018 to January 2022 were retrospectively selected as the research objects, and the patients were divided into the manipulation group and the control group with 50 cases in each group accorded to depend on the treatment method. The control group were given diclofenac diethylamine topical treatment, and the manipulation group were given bone-setting and tendon-setting manipulation based on the treatment of the control group. Both groups were treated for 14 days, and the prognosis of the patients were recorded and observed. Results The total effective rates of the manipulation group were significantly higher than the control group (P<0.05). The blood apparent viscosity and erythrocyte sedimentation rate in the two groups after treatment were lower than those before treatment (P<0.05), and the manipulation group were also significantly lower than those in the control group (P<0.05). The pain score and swelling volume in the two groups after treatment were significantly lower than those before treatment (P<0.05), and the manipulation group were also significantly lower than that in the control group (P<0.05). At three months after treatment, the excellent and good rates of ankle joint function in the manipulation group were significantly higher than the control group (P<0.05). Conclusion The application of bone-setting and tendon-setting manipulation combined with external application of diclofenac diethylamine in postoperative rehabilitation of patients with ankle joint injury can promote pain relief and reduce swelling volume, and can also improve the hemorheology of patients, and improve the overall therapeutic effect and ankle joint injury.Excellent rate of joint function.

Study on the Effect of Chaihu Jia Longgu Muli Decoction Combined with Flupentixol and Melitracen in the Treatment of Post-stroke Depression

HU Sheng-gen

2022, 40(24):  29-32. 

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Objective To investigate the effect of Chaihujia Longgu Muli Decoction combined with flupentixol and melitracen in the treatment of post-stroke depression. Methods Selected 120 cases of patients with post-stroke depression who were treated in Qingyang Hospital of Traditional Chinese Medicine, Gansu Province of April 2020 to January 2022, divided into two groups randomly. The control group was treated with flupentixol and melitracen alone, and the observation group was treated with Chaihujia Longgu Muli Decoction. The HAMD scale factors of the patients with post-stroke depression in the two groups were evaluated, and the serum norepinephrine and serotonin levels were detected in the two groups. 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 scores of body weight, anxiety, sleep disturbance, day and night, block, hopelessness and cognitive impairment between the two groups (P>0.05). After treatment, the scores of body weight, anxiety, sleep disturbance, day and night, block, sense of hopelessness and cognitive impairment in both groups were significantly decreased (P<0.05), and the scores of body mass, anxiety, sleep disturbance, day and night, block, sense of hopelessness and cognitive impairment in the observation group were significantly lower than those in the control group (P<0.05). Before treatment, there was no significant difference in the levels of serum norepinephrine and serotonin between the two groups (P>0.05). After treatment, the levels of serum norepinephrine and serotonin in the two groups were significantly increased (P<0.05), and the serum levels of norepinephrine and serotonin in the observation group were significantly higher than those in the control group (P<0.05). Conclusion Chaihujia Longgu Muli Decoction combined with flupentixol and melitracen has a significant effect on post-stroke depression, which is worthy of promotion.

Effectiveness of Dyclonine Hydrochloride Mucilage Combined with Flurbiprofen Axetil for Prevention Catheter-Related Bladder Discomfort Caused by Urinary Tube Stimulation in Male Patients after General Anesthesia Endoscopic Lithotripsy

HU Bin, XU Zhen-hai, LIU Bing, ZHAO Hao-yan, CHEN Xue-ling

2022, 40(24):  45-48. 

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Objective To investigate the clinical efficacy of dyclonine hydrochloride mucilage combined with flurbiprofen axetil in the prevention of catheter-induced bladder irritation symptoms in men after general anesthesia endoscopic lithotripsy. Methods A total of 80 male patients with upper urinary tract stones admitted to our urology department from January 2020 to December 2021 were selected and divided into four groups using the randomized numerical table method. Group A was the dyclonine hydrochloride mucilage group. Group B was the flurbiprofen axetil group. Group C was the dyclonine hydrochloride mucilage combined with flurbiprofen Axetil group, and group D was the control group, with 20 cases in each group. After lithotripsy, before catheterization, groups A and C injected 3 mL of dyclonine hydrochloride mucilage into the urethra and used dyclonine hydrochloride mucilage to lubricate the catheter for catheterization, while groups B and D used aqueous lubricant to lubricate the catheter for catheterization. Following return to the ward, groups B and C were immediately given 0.9% NaCl solution 100 mL + flurbiprofen axetil 50 mg IV, and groups A and D were given 0.9% NaCl solution 100 mL IV. The period between the removal of the laryngeal mask for general anesthesia awakening and the removal of the urinary catheter was divided into three time periods. The time period from mask removal to ward return was T1, the time period from ward return to full wakefulness was T2, and the time period from full wakefulness to urethral catheter removal was T3. The occurrence of catheterization-related agitation at different stages was observed in each group, and the pain level at different time periods was evaluated using the pain numerical rating scale (NRS). Results The agitation rate of group C at T1 time was lower than that of B and D groups (P<0.05), and there was no statistical difference compared with group A (P>0.05); the agitation rate of group C at T2 time was lower than that of groups A and D (P<0.05), there was no statistical difference compared with group B (P>0.05); there was no statistical difference in the incidence of urinary catheter agitation among the four groups at T3 time (P>0.05). At the same time, with the extension of time, the restlessness rate of each group gradually decreased (P<0.05). The NRS score of group C at T1 time was lower than that of B and D groups (P<0.05), and there was no statistical difference compared with group A (P>0.05); the NRS score of group C at T2 time The score was lower than that of group A and D (P<0.05), and had no statistical difference compared with group B (P>0.05); the NRS score of group C at T3 time was lower than that of group A (P<0.05), and there was no statistical difference compared with group B and D (P>0.05); at the same time, with the prolongation of time, the NRS scores of groups B and C gradually decreased (P<0.05). Conclusion sThe combination of dyclonine hydrochloride mucilage with flurbiprofen axetil in men after general anesthesia endoscopic can significantly and consistently reduce the symptoms of bladder irritation caused by catheter and relieve pain, and the effect is better than that of single drug use, which is worthy of clinical promotion.

The Diagnostic Values of Ultrasound Combined with Normal Saline Enema in Children with Intestinal Wall Thickening Lesions

CHAI Pei, MI Cheng-rong

2022, 40(24):  52-55. 

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Objective To explore and analysis the diagnostic values of ultrasound combined with normal saline enema in children with intestinal wall thickening lesions. Methods From February 2019 to February 2022, 70 cases of children with intestinal wall thickening lesions who were diagnosed and treated in our hospital were selected as the research subjects. All children were given ultrasound combined with normal saline enema examination, and the imaging characteristics were recorded. With endoscopic pathology as the gold standard, intussusception and intestinal necrosis were mainly recorded. The children were divided into intussusception group (38 cases) and intestinal necrosis group (32 cases). The ultrasonic characteristics (intestinal wall gas accumulation, “rolling sign”, “grape cluster sign”, “crab foot sign”), pressure of normal saline enema reduction, and ultrasonic blood flow classification (grade I, grade II, grade III)were compared between intussusception and intestinal necrosis groups. Results In the 70 children, there were 38 cases of intussusception (intussusception group) and 32 cases of intestinal necrosis (intestinal necrosis group) were determined by endoscopy. All the children were showed thickening of the intestinal wall, and the intestinal wall gas, “rolling sign”, “grape bunch sign” and “crab foot sign” in the intussusception group accounted for 73.68%, 81.58%, 84.21%, 81.58%, which were significantly higher than 50.00%, 56.25%, 62.50%, 59.38% of the intestinal necrosis group, the difference is statistically significant (P<0.05). The normal saline enema reduction water pressure in the intestinal necrosis group was significantly lower than that in the intussusception group, the difference is statistically significant (P<0.05). In the intussusception group, there were 30 cases were grade I, 5 cases were grade II, and 3 cases were grade III; in the intestinal necrosis group, there were 12 cases, 10 cases, and 10 cases, respectively, and there were significant differences compared between the two groups, the difference is statistically significant (P<0.05). In the 70 children, there were 39 cases of intussusception and 31 cases of intestinal necrosis were judged by ultrasound combined with normal saline enema. Therefore, the sensitivity and specificity of ultrasound combined with normal saline enema in the diagnosis of intestinal wall thickening lesions in children were respectively were 100% and 96.88%, the Kappa value of consistency test with endoscopic pathological examination was 0.971 (P<0.001). Conclusion Intussusception and intestinal necrosis are the main lesions of intestinal wall thickening in children. The ultrasound characteristics and blood flow characteristics of the two are different. At the same time, there are also differences in the water pressure of normal saline enema. The diagnosis of intestinal wall thickening lesions has high sensitivity and specificity, and the results are highly consistent with endoscopic pathological examination.

Comparison of Application Effects of Different Inflation and Collapse Methods in Cone-Type Deep Lung Nodule Surgery

ZHANG Xiao-kang, YU Zhong-lin, ZHU Ya-nan

2022, 40(24):  55-58. 

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Objective To explore and compare the application effects of different inflation and collapse methods in the operation of cone deep nodules. Methods From May 2019 to May 2022, 84 cases of patients with deep conical lung nodules who were treated in Ankang Central Hospital of Shaanxi Province were selected as the research subjects, and the patients were divided into the study group and the control group with 42 cases in each group according to the principle of random 1:1 drawing. The control group was treated with traditional inflation-collapse anatomical segmentectomy, while the study group was treated with modified inflation-collapse anatomical segmentectomy. The prognosis of the patients was recorded and observed. Results There was no statistical significant difference in the number of lymph nodes dissected and operation time compared between the two groups (P>0.05). The postoperative hospital stay and intraoperative blood loss in the study group were significantly less than those in the control group (P<0.05). The incidence rates of complications such as pulmonary leakage, pulmonary infection, atelectasis, and incision infection in the study group at 7 days after operation was significantly lower than that in the control group (P<0.05). The percentage of forced vital capacity (FVC%) and forced expiratory volume in 1 second as a percentage of predicted (FEV1%) in the two groups at 3 months after operation were significantly higher than 1 day before surgery (P<0.05), and the study group was also significantly higher than the control group (P<0.05). The life quality scores of vitality, physiological function, emotional function, physical pain, social function, general health, emotional function and mental health in the study group were significantly higher than those in the control group 3 months after operation (P<0.05). Conclusion The application of modified inflation-collapse anatomical segmentectomy in cone-type deep lung nodule surgery can promote the recovery of patients, reduce the occurrence of complications, improve the lung function of patients, and improve the quality of life of patients.

Clinical Application of Double-Tunnel Approach Through Intramembranous Approach in Laparoscopic Low Rectal Cancer Surgery

ZHAO Shao-hui, MA Shuo, SU Jin-da, HE Ya-qin, XIE Xiao-liang

2022, 40(24):  59-62. 

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Objective To explore the value of double tunnel approach through membranous space in laparoscopic surgery for low rectal cancer. Methods A retrospective study of 60 patients with low rectal cancer who underwent laparoscopic surgery in Ningxia Medical University General Hospital from January 2020 to April 2021 were selected as the research subjects. According to the differences of operation methods, they were divided into the study group (n=30, double tunnel method through membranous space approach) and the control group (n=30, conventional laparoscopic radical surgery). The general operation data of the two groups (operation time, intraoperative bleeding, hospital stay, postoperative ventilation time) were compared Postoperative indexes (anastomotic leakage, anastomotic stenosis,celiac hemorrhage, incidence of incision infection), pelvic neuroprotective effect (sexual function, micturition function score and anal sphincter defecation control ability at 1, 3 and 6 months after operation) and long-term follow-up (anastomotic bleeding, abdominal bleeding, prophylactic fistula, deep venous thrombosis and pulmonary embolism). Results The operation time and intraoperative blood output of the study group were higher than those of the control group, but the hospital stay and postoperative ventilation time were lower than those of the control group. The difference between the groups was statistically significant (P<0.05); there were 1 case of anastomotic leakage, 1 case of anastomotic stenosis and 1 case of incision infection in the study group, 2 cases of anastomotic leakage, 1 case of abdominal bleeding and 2 cases of incision infection in the control group. There was no significant difference in postoperative indexes between the two groups (P>0.05); at 1 month, 3 months and 6 months after operation, the urinary function scores of the patients in the study group were significantly lower than those in the control group, and the sexual function scores were significantly higher than those in the control group. The stool control ability scores were significantly higher than those in the control group, and the difference between the two groups was statistically significant (P<0.05). At 3 months and 6 months after operation, the scores of urination function and sexual function in the two groups were lower than that of one month before operation, and the defecation control ability was significantly higher than that of one month after operation, and the difference between groups was statistically significant (P<0.05); there were no deep venous thrombosis and pulmonary embolism in both groups after operation. The follow-up for 1 year showed no local recurrence, distant metastasis and death. Conclusion Intermembrane approach double tunnel method has good application value in laparoscopic low rectal cancer surgery, can significantly improve postoperative urinary function, sexual function and defecation control ability, and the operation is safe.

Efficacy of Ipratropium Bromide Combined with Terbutaline in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

ZUO Guo-zhang

2022, 40(24):  62-66. 

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Objective To explore and analysis the efficacy of ipratropium bromide combined with terbutaline in patients with acute exacerbation of chronic obstructive pulmonary disease. Methods From January 2020 to January 2022, 88 cases of patients with acute exacerbation of chronic obstructive pulmonary disease who were diagnosed and treated in our hospital were selected as the research subjects. Accorded to therandom number table of 1:1, the patients were divided into the combined group and the control group with 44 cases in each group. The control group were given ipratropium bromide treatment, and the combined group were given terbutaline treatment on the basis of the treatment of the control group. Both groups were treated for 3 months, and the therapeutic effect of the patients were observed. Results The total effective rates of the combined group was higher than the control group, and the difference was not statistically significant (P>0.05). The incidence rates of adverse reactions such as tremor, stomach discomfort, and palpitations during treatment in the combined group were not significantly different from those in the control group (P>0.05). After treatment, the percentage of exhaled volume in 1 second (FEV1) to the predicted value and FEV1/forced vital capacity (FVC) in the two groups were significantly higher than those before treatment (P<0.05), and the combined group were also significantly higher than the control group (P<0.05). The arterial partial pressure of carbon dioxide (PaCO2) in the two group after treatment were significantly lower than that before treatment (P<0.05), and blood oxygen saturation (SpO2) was significantly higher than that before treatment (P<0.05). And after treatment, the PaCO2 in the combined group was significantly lower than the control group (P<0.05), the SpO2 was significantly higher than the control group (P<0.05). The quality of life scores of role, body, emotion, cognition and society in the two groups after treatment were significantly increased (P<0.05), and the scores of quality of life such as role, body, cognition and society after treatment in the combined group were significantly higher than the control group (P<0.05). Conclusion The application of ipratropium bromide combined with terbutaline in patients with acute exacerbation of chronic obstructive pulmonary disease can improve the quality of life of patients, improve the pulmonary function of patients, and promote the improvement of treatment effect without increasing the occurrence of adverse reactions. It also promotes recovery of the patient's blood gas status.

Efficacy of Antiangiogenic Targeted Therapy Combined with Chemotherapy in the Treatment of Advanced Lung Cancer and Its Effect on Carcinoembryonic Antigen,Liver and Kidney Function, Blood Pressure

WANG Xiao-li, CAO Yong-feng, ZHOU Yan

2022, 40(24):  70-73. 

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Objective To investigate the efficacy of anti-angiogenic targeted therapy combined with chemotherapy in the treatment of advanced lung cancer and its effect on carcinoembryonic antigen, liver and kidney function and blood pressure. Methods A total of 78 patients with advanced lung cancer who were treated in Nantong Cancer Hospital were selected as the research objects, and they were divided into control group (n=39) and observation group (n=39) by random number table method from November 2020 to November 2021. The control group received paclitaxel (albumin binding) combined with cisplatin chemotherapy, and the observation group was treated with bevacizumab on the basis of the treatment of the control group. The clinical treatment effect, blood pressure, cyto-keratin 19 fragment antigen 21-1 (CYFRA21-1) level, carbohydrate antigen 125 (CA125) level, serum cancer levels were compared between the two groups Carcinoembryonic antigen (CEA) level, serum alanine aminotransferase (ALT) level, serum creatinine (Scr) level, serum glutamyl transpeptidase (GGT) level and the occurrence of adverse reactions. Results The clinical treatment effect of the two groups of patients was compared, and the observation group was significantly higher than the control group (P<0.05); the systolic blood pressure and diastolic blood pressure index levels were compared between the two groups before treatment, and there was no statistical difference (P>0.05). After systolic blood pressure and diastolic blood pressure index levels, both groups increased, and the observation group was higher than the control group (P<0.05). compared the levels of CYFRA21-1, CA125, and CEA between the two groups after treatment, the two groups were decreased, and the observation group was lower than the control group (P<0.05). There was no statistical difference (P>0.05). Comparing the levels of ALT, Scr, and GGT between the two groups after treatment, the two groups were all higher than before treatment (P<0.05), but the levels of ALT, Scr, and GGT in the two groups after treatment There was no statistical difference between the two groups (P>0.05). There was no statistical difference in the incidence of adverse reactions such as hematological toxicity, myelosuppression, gastrointestinal reactions, and skin reactions between the two groups (P>0.05). Conclusion Anti-angiogenic targeted therapy combined with chemotherapy in the treatment of advanced lung cancer patients can improve the clinical effect, promote the improvement of tumor marker levels, and will not affect liver and kidney function and increase adverse reactions, but it is easy to increase the blood pressure level of patients, and clinical research needs to continue to deepen Research.