Table of Content

01 January 2023, Volume 41 Issue 1

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The Efficacy of Repeated Transcranial Magnetic Stimulation in the Treatment of Chronic Insomnia and the Improvement of Cognitive Function and Bad Mood

LU Yi, WANG Wei, MI Guo-lin, JIAN Jia, ZHENG Yun-shao, LIU Jin-tong

2023, 41(1):  1-4. 

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Objective To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of chronic insomnia and the improvement of cognitive function, sleep quality, sleep belief and attitude. Methods A total of 240 patients with chronic insomnia who met the inclusion criteria and were treated in the Shandong Mental Health Center from January to December 2019 were selected as the research objects. They were randomly divided into left dorsolateral prefrontal cortex (DLPFC) treatment group, right DLPFC treatment group, 1 cm behind the central point (Cz) treatment group and control group (sham stimulation group), with 60 cases in each group. Pittsburgh sleep quality index (PSQI) and sleep personal belief and attitude scale (DBAS) were used to evaluate the patients’ sleep quality, sleep belief and attitude before and at the end of treatment. The cognitive function of patients was evaluated in neuropsychological and electrophysiological aspects by Montreal Cognitive Assessment Scale (MoCA), symbol number conversion test (SDMT) and event-related potentials (ERPs). Results The PSQI scores of left DLPFC treatment group, right DLPFC treatment group and 1 cm after Cz treatment group were significantly lower than those before treatment, and the DBAS scores were significantly higher than those before treatment (P<0.05). There was no significant difference between PSQI and DBAS before and after treatment in the control group (P>0.05). The PSQI and DBAS of right DLPFC treatment group were significantly lower than those of left DLPFC treatment group and 1 cm after CZ treatment group; MoCA and SDMT in the left DLPFC treatment group, the right DLPFC treatment group and the treatment group 1 cm after CZ were significantly higher than those before treatment (P<0.05), but there was no significant difference in MoCA and SDMT before and after treatment in the control group (P>0.05); The P3 latency after treatment was significantly shorter in the left DLPFC treatment group, the right DLPFC treatment group and the treatment group 1 cm after CZ, and the P3 amplitude was significantly greater than that before treatment (P<0.05). There was no significant difference in P3 latency and P3 amplitude before and after treatment in the control group (P>0.05). Conclusion rTMS can greatly improve the cognitive function, sleep quality, sleep belief and attitude of patients, and the effect is significant. It is worthy to be applied in clinic.

Correlation Analysis of Quality of Life and Its Influencing Factors in Postmenopausal Osteoporosis Patients in Zhongshan City

ZHANG Hua, CHEN Shi-zhong

2023, 41(1):  5-8. 

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Objective To investigate the quality of life of postmenopausal osteoporosis patients in Zhongshan City, and to analysis the related influencing factors. Methods A total of 200 cases of postmenopausal osteoporosis patients in Zhongshan area who were in the orthopaedic outpatient department and hospitalized in our hospital from January 2022 to June 2022 were selected as the study group (BMD<M-2SD). During the same period, the other 200 cases of healthy postmenopausal patients without osteoporosis who underwent physical examination in our hospital were selectedas the control group (BMD>M-1SD). The Chinese version of the WHOQOL-BREF questionnaire were used to evaluate the quality of life of all the participants, and general data were investigated and multivariate analysis were performed. Results The quality of life scores of the study group were significantly lower than those of the control group (P<0.05). There were no significant differences in marital status, occupation, etc. Compared between the study group and the control group (P>0.05), but there were significant differences in age, menopause years, smoking, and years of education compared between the study group and the control group (P<0.05). In the study group, Spearsman analysis showed that age, years of menopause, smoking, years of education were correlated with the total score of quality of life (P<0.05). Logistic regression showed that age, years of menopause, smoking and years of education were risk factors affected the quality of life of patients (P<0.05). Conclusion The quality of life of postmenopausal osteoporosis patients in Zhongshan is relatively low, and age, menopause years, smoking, and years of education are the risk factors for the low quality of life of postmenopausal osteoporosis patients in ZhongshanCity.

Correlation Between Prognosis and Vitamin D Level of Two Different Aerosol Inhalation Glucocorticoids in the Treatment of Bronchial Asthma

Saimire·Aisila, Nuerbiye·Aili, Gulanbaier·Abudurexiti

2023, 41(1):  8-11. 

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Objective To investigate the correlation between the prognosis of bronchial asthma and the changes of vitamin D levels by two different nebulized glucocorticoid methods. Methods A total of 80 patients with bronchial asthma treated in the first people’s Hospital of Kashgar region from December 2017 to December 2020 were selected. The patients were divided into two groups according to the random number table method, with 40 patients in each group. The patients in the control group were given oral inhaled glucocorticoids, and the patients in the observation group were given inhaled glucocorticoids through a mask. The treatment effects of the two groups were compared, and the disappearance time of wheezing, wheezing and cough in the two groups were compared and analyzed, The expression levels of vitamin D, IL-4 (interleukin-4), IL-5 and IL-17 were compared among significantly effective patients, effective patients and ineffective patients before treatment, and the correlation between vitamin D level and the prognosis of bronchial asthma was analyzed. Results The total effective rate of the observation group was 95.00%, and that of the control group was 77.50%, which was significantly higher in the observation group than in the control group (P<0.05); The disappearance time of wheezing, wheezing and cough in the observation group were significantly shorter than those in the control group (P<0.05); There was no significant difference in sex, age and BMI among the significantly effective, effective and ineffective patients (P>0.05). There was significant difference in serum vitamin D₃, IL-4 , IL-5 and IL-17 among the significantly effective, effective and ineffective patients before treatment (P<0.05); Pearson correlation analysis showed that serum vitamin D₃ was negatively correlated with the degree of treatment control (P<0.05), and IL-4, IL-5, IL-17 were positively correlated with the degree of treatment control (P<0.05). Conclusion Inhaled glucocorticoids through a mask for patients with bronchial asthma can more effectively control the disease and shorten the duration of clinical symptoms. In addition, the serum vitamin D₃ level, IL-4, IL-5 and IL-17 of patients before treatment are significantly correlated with the degree of disease control. Therefore, it can be considered to increase the vitamin D level on the basis of routine inflammatory factors of IL-4, IL-5 and IL-17 to judge the prognosis of patients.

Effect of Carotid Stents on Cerebral Hemodynamics and Neural Function in Patients with Acute Cerebral Infarction

LI Yan-ke, WANG Ting-rui, CHEN Yan-rong, LI Xiao, ZHANG Yu-qian

2023, 41(1):  12-15. 

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Objective To investigate the application effect of carotid artery stenting in patients with acute internal carotid artery system cerebral infarction and moderate to severe stenosis of ipsilateral internal carotid artery. Methods The clinical data of 40 patients with acute internal carotid system cerebral infarction and ipsilateral internal carotid artery moderate to severe stenosis admitted to Binzhou Central Hospital from June 2019 to June 2021 were retrospectively analyzed into two groups. Twenty-five patients who received conventional dual-antibody+basic medical treatment were the control group, and 15 patients who received conventional dual-antibody+basic medical treatment+carotid stent implantation were the observation group. Both groups were followed up for 6 months. The cerebral hemodynamics, neurological function, cognitive function, quality of life and recurrence of cerebral infarction were compared between the two groups. Results Before treatment, resistance index (RI), maximum systolic blood flow velocity (Vs), mean blood flow velocity (Vm), National Institutes of Health Stroke Scale (NIHSS), Mini-Smart Scale (MMSE), There was no significant difference in the scores of each dimension in Montreal Cognitive Assessment Scale (MoCA) and Quality of Life Comprehensive Assessment Questionnaire (GQOLI-74) (P>0.05). After treatment, the RI and NIHSS scores in the two groups were lower than Before treatment, the scores of each dimension in Vs, Vm, MMSE, MoCA and GQOLI-74 were higher than those before treatment, and the RI and NIHSS scores in the observation group were lower than those in the control group. The score was higher than that in the control group, and the difference was statistically significant (P<0.05). The recurrence rate of cerebral infarction in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Carotid artery stenting can effectively improve cerebral hemodynamics in patients with acute internal carotid artery system cerebral infarction and ipsilateral internal carotid artery moderate-severe stenosis, which is beneficial to the recovery of neurological function, improving cognitive function and life. Quality improvement, effective prevention of recurrence of cerebral infarction.

Analysis of the Application Value of MSCT and Image Post-processing Technology in the Diagnosis and Differential Diagnosis of Inguinal Hernia

Chen Guo-zhang

2023, 41(1):  15-19. 

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Objective To investigate the application value of multi-slice spiral CT (MSCT) and image post-processing technology in the diagnosis of inguinal hernia. Methods From June 2018 to December 2021, 60 patients with suspected inguinal hernia admitted to Haixi People’s Hospital were included in the study. The analysis of related data of patients showed that all suspected patients underwent MSCT and image post-processing technology examination before diagnosis, and surgical and pathological examination was taken as the gold standard. The detection rate, diagnostic accuracy, sensitivity and specificity of MSCT and image post-processing techniques were evaluated, and the imaging manifestations were analyzed. Results The detection rate, diagnostic accuracy, sensitivity and specificity of MSCT and image post-processing technology were high, and the results are consistent with the gold standard; under MSCT image post-processing technology, there was no significant difference in the accuracy of transverse and sagittal diagnosis (P>0.05); MSCT and image post-processing techniques were consistent with the pathological results. Conclusion The examination results of MSCT and image post-processing technology in the diagnosis of inguinal hernia are highly consistent with the postoperative diagnosis results, which can provide important diagnostic basis for clinicians and guide clinical determination of personalized surgical plan.

Application of Serum Total IgE and Allergen-Specific IgE Combined with Eosinophil Detection in the Diagnosis of Atopic Dermatitis

WANG Yun-peng, YANG Rui-hai, LI Fang, LI Gui-shuang

2023, 41(1):  19-22. 

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Objective To investigate the clinical value of serum total immunoglobulin E (IgE), allergen-specific IgE (sIgE) combined with eosinophils (EOS) in the diagnosis of atopic dermatitis. Methods The clinical data of 72 patients with atopic dermatitis admitted to Rizhao City Dermatology Prevention and Treatment Center from January 2020 to January 2022 were retrospectively analyzed and included in the observation group. All selected subjects were collected blood to detect serum total IgE, sIgE and EOS levels. Serum levels of total IgE, sIgE, and EOS were compared between the two groups, and the severity of atopic dermatitis patients was graded by SCORAD score, and the levels of total IgE, sIgE, and EOS between different severity levels were compared; Positive detection in patients with atopic dermatitis; receiver operating curve (ROC) was drawn to analyze the clinical value of serum total IgE, sIgE, EOS and combined detection in the diagnosis of atopic dermatitis; Pearson correlation analysis was used Correlation between serum total IgE, sIgE and EOS levels and severity. Results The serum total IgE,sIgE and EOS levels in the observation group were higher than those in the control group,and the difference was statistically significant (P<0.05);the positive rate of combined detection was higher than that of total IgE,sIgE and EOS single detection, and the difference was statistically significant (P<0.05).The areas under the curve (AUC) for the detection and diagnosis of atopic dermatitis were:0.808,0.828,0.746,and 0.963,respectively,and the combined detection had the highest diagnostic value;serum total IgE,sIgE and EOS levels were positively correlated with the SCORAD score (r=0.421,0.513,0.387,P<0.05). Conclusion Serum total IgE,sIgE combined with EOS detection can improve the diagnostic accuracy of atopic dermatitis,and the above indicators are positively correlated with the severity of the disease,which can provide a reference for clarifying the patient’s condition.

Effect of thyroid hormone on insulin resistance in type 2 diabetes patients with subclinical hypothyroidism

YU Shan

2023, 41(1):  22-25. 

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Objective To study the effect of thyroid hormone on insulin resistance in type 2 diabetes patients with subclinical hypothyroidism. Methods A total of 120 patients with type 2 diabetes who were treated in Liaocheng Second People’s Hospital from January 2018 to December 2020 were divided into mild subclinical hypothyroidism group, severe subclinical hypothyroidism group and normal group. All patients were tested for glucose and lipid metabolism and insulin function. The results were compared. The left ventricular function of patients with different TSH levels was compared, and the correlation between TSH and clinical indicators was analyzed. Results Total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), fasting insulin (FINS), glycosylated hemoglobin (HbA1C), insulin resistance index (HOMA-IR), 2h postprandial blood glucose (2hPG) and thyroid stimulating hormone (TSH) in the severe subclinical hypothyroidism group were higher than those in the subclinical hypothyroidism group and the normal group. Fasting C peptide and islet β cell function index (HOMA-β) were lower than those in the subclinical hypothyroidism group and the normal group. The above indexes in the subclinical hypothyroidism group were different from those in the normal group, and the difference was statistically significant (P<0.05). After treatment, the fasting blood glucose (FPG), TC, TG, LDL-C, FINS, HbA1C, HOMA-IR, 2hPG and TSH in the subclinical hypothyroidism group were lower than those in the severe subclinical hypothyroidism group, and the fasting C peptide and HOMA-β were higher than those in the severe subclinical hypothyroidism group, the differences were statistically significant (P<0.05). The left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular early diastolic mitral valve blood flow velocity / left ventricular end diastolic flow velocity ratio (E/A) in patients with TSH level>10 mIU/L were lower than those in patients with TSH≤10 IU/L, and the differences were statistically significant (P<0.05). TSH level was negatively correlated with fasting C-peptide and HOMA-β, and positively correlated with other indicators above in patients with subclinical hypothyroidism and subclinical hypothyroidism, P<0.05. Conclusion Patients with type 2 diabetes mellitus complicated with subclinical hypothyroidism will have increased insulin resistance and left ventricular dysfunction. Thyroid hormone replacement therapy is helpful to improve the glucose and lipid metabolism disorder and insulin resistance of patients, which can provide reference for the formulation of clinical treatment plan.

Efficacy Evaluation of Saccharomyces Boulardii Powder Combined with Mesalazine in the Treatment of Moderate and Mild Ulcerative Colitis

HUO Yan

2023, 41(1):  50-53. 

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Objective To investigate the therapeutic effect of Saccharomyces boulardii powder + Mesalazine on moderate to mild ulcerative colitis (UC). Methods A total of 88 patients with moderate and mild ulcerative colitis admitted to Hospital of Dunhua City from January 2021 to December 2021 were selected. They were divided into groups according to the random number table method. 44 cases in the control group were treated with Mesalazine, and 44 cases in the observation group were treated with Saccharomyces boulardii powder + Mesalazine, the curative effect of two groups were compared. Results Compared with the total effective rate, the observation group was higher than the control group (P<0.05). After treatment, the serum tumor necrosis factor-α (TNF-α), interleukin-6 (interleukin-6, IL-6) and interleukin-10 (interleukin-10, IL-10) levels were lower than those in the control group (P<0.05); The endoscopic score and related symptom scores in the observation group after treatment were lower than those in the control group (P<0.05). There was no significant difference in adverse reaction rate between two groups (P>0.05). Conclusion Compared with Mesalazine alone in patients with moderate to mild UC, the combined treatment of Saccharomyces boulardii powder + Mesalazine is more effective, significantly reduces serum inflammatory factors, relieves symptoms, and reduces endoscopic scores, and fewer adverse reactions and better safety.