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Table of Content

    16 March 2023, Volume 41 Issue 6
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    Efficacy Analysis of Yiqi Huoxue Decoction in the Treatment of Pregnancy-related Uterine Arteriovenous Malformation and the Value of Ultrasonography
    LIU De-quan, GUO Dan, ZHANG Xiu-rong, YIN Hong, ZHANG Feng, SUN Jian-yi
    2023, 41(6):  1-4. 
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    Objective To analyze the efficacy of Yiqi Huoxue Decoction in the treatment of pregnancy-related uterine arteriovenous malformations (UAVM), and to explore the application value of ultrasonography in conservative treatment of pregnancy-related UAVM. Methods A total of 78 patients diagnosed with pregnancy-related UAVM and conforming to conservative treatment principles from January 2019 to June 2022 were collected by ultrasound examination and clinical manifestations. They were randomly divided into the treatment group (31 cases) and the control group (47 cases) by coin throwing method. The control group was treated with conventional therapy, and the treatment group was treated with Yiqi Huoxue Decoction on the basis of conventional treatment. The longest treatment period of both groups was 8 weeks. The differences in cure rate, improvement of clinical symptoms and changes of ultrasonic indexes between the two groups were observed. Results There was no significant difference in the cure rate between the treatment group and the control group (P> 0.05), but the duration of complete disappearance of clinical symptoms in the treatment group was significantly lower than that in the control group, and the duration of disappearance of malformed blood vessels in the uterus in the treatment group was also significantly lower than that in the control group through ultrasonic examination, both of which had significant statistical significance (P< 0.05). Conclusion Yiqi Huoxue Decoction is effective in the treatment of pregnancy related UAVM, and ultrasound examination is of great value in its diagnosis, treatment options and monitoring of treatment effects.
    Observation on the Therapeutic Effect of Agatroban Combined with Ganglioside in Patients with Acute Stroke
    WANG Tuo-di, LI Yan-jun, MU Xiang-yu, HUANG Jing
    2023, 41(6):  4-5. 
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    Objective To investigate the effect Agatroban combined with Ganglioside in patients with acute stroke. Methods 80 patients with acute cerebral infarction admitted to Xian Huashan Central Hospital from January 2020 to December 2021 were selected and divided into two groups according to the treatment method. The control group of patients with acute cerebral infarction used Agatroban, and the observation group of patients with acute cerebral infarction used Agatroban combined with Ganglioside. The two groups were treated for 7 d. The curative effect, before and after the treatment of serum interleukin-6 (IL-6), interlenkin-8 (IL-8), hypersensitive Creactive protein (hs-CRP) and cerebral hemodynamic indicators (whole blood low shear viscosity, middle cerebral artery blood flow velocity, whole blood high shear viscosity, anterior cerebral artery blood flow velocity, blood cell volume and posterior cerebral artery blood flow velocity) of two groups were compared. Results The observation group was more effective than the control group (P<0.05). After treatment, the serum levels of IL-6, IL-8 and hs-CRP in the two groups were significantly decreased (P<0.05), the serum levels of IL-6, IL-8 and hs-CRP in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the hematocrit, whole blood high-cut viscosity and whole blood low-cut viscosity of the two groups were all decreased, before the cerebral artery blood flow velocity, middle cerebral artery blood flow velocity, posterior cerebral artery blood flow velocity were increased (P<0.05), and the observation group of hematocrit, whole blood high shear viscosity, whole blood low shear viscosity are lower than the control group, before the cerebral artery blood flow velocity, middle cerebral artery blood flow velocity, posterior cerebral artery blood flow velocity were higher than control group (P<0.05). Conclusion Agatroban combined with Ganglioside can effectively reduce the inflammatory response, improve the cerebral hemodynamics in patients, and thus improve the efficacy, which is worth application.
    The Effect of Sacubitril Valsartan on Liver and Kidney Function in Patients with Chronic Heart Failure
    YAN Wei, YANG Xiao-lan, YANG Hao, KANG Li-ping, ZHANG Run-mei, LI Wen-juan, HUI Xing-wei
    2023, 41(6):  8-11. 
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    Objective To observe the effect and influence of liver and kidney function of Sacubitril Valsartan in patients of chronic heart failure. Methods 200 patients with chronic heart failure who were treated or hospitalized in Tongchuan People's Hospital from January 2021 to December 2021 were collected as the subjects of this study. According to the method of random number table, they were divided into observation group and control group, 100 patients in each group, both groups were given diuretics, vasodilators, β-Receptor antagonists and other treatments. The observation group was treated with Sacubitril Valsartan on the basis of the above. The total effective rate, the liver and kidney functions and cardiac functions before and after treatment, and the incidence of adverse reactions after treatment of the two groups were compared. Results The total effective rate of the observation group was higher than that of the control group (P<0.05); there was no significant difference in Alt, AST, SCR and BUN levels between the two groups before treatment (P>0.05), after treatment, the Alt, AST, SCR and BUN levels of the two groups were decreased, and after treatment, the above indexes of the observation group were decreased, the range was greater than that of the control group (P<0.05); there was no significant difference in NT-proBNP levels between the two groups before treatment (P>0.05), after treatment, NT-proBNP levels in the two groups decreased on average, and after treatment, the decrease in the observation group was greater than that in the control group (P<0.05); there was no significant difference in the levels of LVEDD, LVESD, LVEF and 6MWT between the two groups before treatment (P>0.05), after treatment, the levels of LVEDD and LVESD in the two groups decreased, and the levels of LVEF and 6MWT increased on average, the improvement of the above indexes in the observation group was better than that in the control group (P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The treatment of chronic heart failure patients with Sacubitril Valsartan can improve the treatment effect, promote the improvement of liver, kidney function and heart function, delay the progress of the disease, and it will not increase the adverse reactions.
    Effects of Modified Chaizao Decoction Combined with Estazolam Tablets in the Treatment of Insomnia Patients with Internal Disturbance of Phlegm-heat on Their ISI and PSQI Scores
    ZHU Wen-ling, LIU Li
    2023, 41(6):  12-14. 
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    Objective To explore the effect of modified Chaizao decoction combined with Estazolam tablets on the insomnia severity index (ISI) and Pittsburgh sleep quality index (PSQI) in patients with phlegm-heat internal disturbance type insomnia. Methods By random number table method, 100 patients with phlegm-heat internal disturbance type insomnia treated in Tai'an Traditional Chinese Medicine Hospital were divided into a treatment group and a control group, with 50 patients in each group, the admission time was from January 2019 to December 2020. The control group was given Estazolam tablets, and the treatment group was given modified Chaizao decoction on the basis of the control group. The treatment effects, the scores of ISI and PSQI were compared between the two groups. Results The total effective rate of clinical treatment in the treatment group was higher than that in the control group, with a specific statistical difference (P<0.05); the ISI score in the treatment group after treatment was lower than that in the control group, with a specific statistical difference (P<0.05); after treatment, the PSQI score was lower than that of the control group, with a specific statistical difference (P<0.05). Conclusion The application of Chaizao decoction plus Estazolam tablets in the treatment of phlegm heat internal disturbance insomnia has a definite effect, which can improve the clinical symptoms, improve the therapeutic effect and improve the quality of sleep.
    Efficacy Observation of Meropenem combined with Levofloxacin in Patients with Severe Septic Shock
    PENG Zheng-hong, YAN Zhong-ping
    2023, 41(6):  15-18. 
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    Objective To investigate the clinical efficacy of Meropenem combined with Levofloxacin in patients with severe septic shock. Methods 100 patients with severe septic shock from January 2021 to June 2022 in Enshi City Central Hospital were selected as research objects, according to the treatment of all severe septic shock patients were divided into observation group (n=47) and control group (n=53). All patients were given nutritional support, water-electrolyte balance, and anti-infection. The control group received intravenous drip of Meropenem on the basis of conventional treatment, and the observation group received intravenous drip of Meropenem combined with Levofloxacin on the basis of conventional treatment. The clinical efficacy, levels of inflammatory factors, levels of blood urea nitrogen (BUN), serum creatinine (Scr), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate, creatine kinase (CK) and adverse reactions of the two groups were compared. Results The total effective rate of observation group was significantly higher than that of control group (P<0.05). After treatment, the levels of C-reactive protein (CRP), procalcitonin (PCT) and WBC count-related inflammatory factors in the control group were decreased, and the observation group was significantly lower than the control group (P<0.05). After treatment, BUN, Scr, ALT, AST, lactic acid and CK levels were decreased, and observation group was significantly lower than control group (P<0.05). After treatment, the values of CD4+, CD3+ and CD4+/ CD8+ in both groups were increased, and the observation group was higher than the control group (P<0.05). ConclusionMeropenem combined with Levofloxacin in the treatment of severe septic shock patients can reduce the clinical symptoms of patients, improve the therapeutic effect, reduce the level of inflammatory factors, reduce the damage caused by shock to the kidney function, heart function and liver function of patients, reduce the severity of shock, and improve the immune function of patients.
    Efficacy and Safety of Olmesartan in Patients with Chronic Heart Failure
    CHEN Jian, LI Wen-jing
    2023, 41(6):  19-22. 
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    Objective To explore the effects of combined Olmesartan on cardiac function, inflammatory factors, and left ventricular diastolic function in patients with chronic stable heart failure. Methods The 80 chronic stable heart failure patients treated in Fufeng County People's Hospital from June 2020 to January 2022 were divided into the study group (n=40, adding Olmesartan based on the control group) and the control group (n=40, receiving conventional treatment alone). The treatment effect, the left ventricular posterior wall thickness (LVPWD), ventricular septal thickness (LVEDD), inflammatory factor interleukin-23 (IL-23), interleukin-6 (IL-6), myocardial injury-related protein (PTX-3), heart fatty acid binding protein (H-FABP) levels of two groups were compared, and counted the incidence of adverse reactions in the two groups of patients. Results The total treatment response rate of the study group was significantly higher than the control group (P<0.05); there was no significant difference between the LVEF and LVEDD groups in the two groups before the treatment (P>0.05), the LVPWD and LVEDD in the study group were lower than those in the control group (P<0.05); there was no significant difference in the IL-6 and IL-23 levels between the two patient groups before the treatment (P>0.05), IL-6 levels in patients were lower than in the control group, the IL-23 level was higher than that in the control group (P<0.05); there was no significant difference between the groups of PTX-3 and H-FABP levels in the two groups before the treatment (P>0.05), both PTX-3 and H-FABP were lower in the posttreated study group than in the control group (P<0.05); there was no significant difference between the total incidence of adverse reactions in the study group and the control patients (P>0.05). ConclusionOmesartan has a better treatment effect on chronic stable heart failure, compared with traditional therapy, it can better relieve the inflammatory state and myocardial injury of patients, and the treatment safety is also higher.
    Exploring the Pathogenesis of Lymphatic Tract Metastasis in Malignant Tumors from the Form and Function of Triple Energizer
    FAN Guo-dong, XI Meng-chan, JIAO An-nan, CHEN Yang
    2023, 41(6):  22-25. 
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    Lymphatic metastasis of malignant tumor is an important factor in the progression of tumor patients. The existing treatment effect is limited and the prognosis is poor, which seriously threatens the life and health of patients. Traditional Chinese medicine has an in-depth understanding of the shape, quality and function of triple energizer, and holds that triple energizer is a “membrane” four-way pipeline in shape and quality, which can reach the body with subtle distribution and discharge of dirt; in function, the general manager of the whole body is gasified, chemically, and defends against external evils. Recently, it has been found that the shape, quality and function of triple energizer are closely related to tumor lymphatic metastasis. The pathological form of triple energizer is the pathway of tumor metastasis, and its abnormal gasification function is the key to tumor metastasis. Combined with the triple energizer theory, it is considered that if the triple energizer qi machine is unobstructed and the triple energizer waterway is clear, the phlegm and blood stasis cannot be accumulated, the qi of Ying and Wei reaches the whole body, but the evil is difficult to remain, so it is put forward that “air regulator” and “Liquan channel” are the key to the prevention and treatment of lymphatic metastasis of malignant tumor. The abnormality of trifocal function is the core of tumor lymphatic metastasis. According to the triple energizer theory and its related treatment principles, it can guide the treatment of tumors, which is expected to be beneficial to the clinical treatment of tumors in traditional Chinese medicine.
    Application of Propofol Combined with Esketamine or Fentanyl in Painless Artificial Abortion
    ZHOU Jie-fang, HUANG Yi-zhou, XIANG Wen-yue, LIANG Xiu-sheng
    2023, 41(6):  36-39. 
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    Objective To compare the effect of esketamine or fentanyl combined with propofol in painless induced abortion。MethodsFrom February 2021 to May 2021, 60 patients who underwent induced abortion under intravenous general anesthesia in the gynecological Operating room of the day Clinic of Qingyuan People's Hospital were randomized into group A (esketamine combined with propofol) or group B (fentanyl combined with propofol), with 30 patients in each group.In group A, patients received intravenous esketamine 0.2 mg/kg, propofol 1.5 mg/kg. In group B, sedation was provided by intravenous fentanyl 1 μg/kg and propofol 1.5 mg/kg. The recovery times, total propofol consumption and number of patients intravenous propofol additional were recorded, and the degree of uterine contractions pain during rest and activity at 5 min, 15 min, 30 min were assessed by numeric rating scale (NRS). The adverse events related to sedation (hypoxemia, bradycardia, nausea and vomiting, et al) were recorded. Results Compared with group B,recovery times in group A was significantly shorter, the total propofol dosage and the number of people need additional propofol were significantly decreased (P<0.05). The degree of uterine contractions pain during activity at 5 min, 15 min, 30 min were significantly lower than that in group B (P<0.05). The incidence of hypoxemia, bradycardia, and the need for open airway intervention were significantly lower than that in group B (P<0.05). ConclusionPropofol combined with esketamine can reduce propofol dosage requirements in painless induced abortion, improve the postoperative analgesic effect, and have few adverse effects, which is worth clinical application.
    Effects of Abdominal Massage on Lumbar Spine Function and Serum Thromboxane B2, Prostaglandin I2 in Patients with Lumbar Disc Herniation after Operation
    LIU Yang-jie, GAO Ying, HE Cheng-bin
    2023, 41(6):  42-46. 
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    Objective To explore and analysis the effect of abdominal massage on lumbar spine function and serum thromboxane B2 (TXB2), prostaglandin I2 (PGI2) in patients with lumbar disc herniation after surgery. Methods From April 2019 to February 2022, 88 patients with postoperative lumbar disc herniation who were diagnosed and treated in the Red Star Hospital of the 13th Division of Xinjiang Production and Construction Corps were selected as the research objects. Accorded to the principle of envelope randomization, the patients were divided into the traditional group and the massage group of 44 cases in each groups. The conventional group was given conventional oral NSAIDs, while the massage group was given abdominal massage therapy on the basis of the traditional group. The massage group and the traditional group were treated and observed for 4 courses, and the lumbar spine function and the expression changes of serum TXB2 and PGI2 were recorded. Results After treatment, the total effective rates of massage group was significantly higher than traditional group (P<0.05). The Visual Analogue Scale (VAS) score and Oswestry Dability Index (ODI) score of the two groups after treatment were significantly lower than those before treatment (P<0.05), and the massage group were also significantly lower than the traditional group (P<0.05). After treatment, the lumbar mobility-posterior extension and anterior flexion in the massage and traditional groups were significantly higher than that before treatment (P<0.05), and the massage group was also significantly higher than that in the traditional group (P<0.05). The serum TXB2 values of the massage group and the traditional group after treatment were lower than those before treatment (P<0.05), and the serum PGI2 values were higher than those before treatment (P<0.05). After treatment, the serum TXB2 value of the massage group was lower than that of the traditional group, and the serum PGI2 value of the massage group was higher than that of the traditional group (P<0.05). ConclusionThe application of abdominal massage in patients with lumbar intervertebral disc herniation can improve the overall therapeutic effect, promote pain relief, improve lumbar spine function and lumbar spine mobility, and also help patients maintain a balance in the secretion of serum TXB2 and PGI2.
    Application of PDCA Cycle Supported by Information Technology in Reducing Underreporting of Adverse Nursing Events
    HE Yun-xia, DAI Yu-mei, DING Yan, Xu Hong, YIN Feng, TAO Hui, WU Han
    2023, 41(6):  193-196. 
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    With the support of information technology, the PDCA project to reduce the underreporting of adverse nursing events was carried out, combined with automatic retrieval of information, increased screening methods and scope, identified the main problems of underreporting, carried out root cause analysis and implemented targeted measures, quarterly statistics, analyze and compare missed-report events (rates), sum up experience and continue to improve, cyclically improve. The quarterly underreporting rate of nursing adverse events decreased, the quarterly reporting rate of Ⅰ and Ⅱ nursing adverse events increased, and the annual active reporting rate of nursing adverse events before and after the improvement increased significantly. Adding information technology to the PDCA cycle can ensure the comprehensiveness and objectivity of under-reporting of nursing adverse events, effectively reduce under-reporting of nursing adverse events, increase the rate of active reporting, and ensure the standardized management of nursing adverse events.