Table of Content

16 April 2023, Volume 41 Issue 8

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Value of NLR and SII in the Diagnosis and Evaluation of Community-Acquired Pneumonia in Primary Hospitals

2023, 41(8):  1-4. 

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Objective To explore the value of Neutrophil-lymphocyte ratio (NLR) and Systemic immune-inflammatory index (SII) in the diagnosis of community-acquired pneumonia (CAP) patients in primary hospitals. Methods From January 2022 to September 2022, 70 CAP patients admitted to the First People's Hospital of Siyang County were selected as the CAP group. 70 healthy participants were recruited to the control group. The blood routine examination was analysed in all cases.Conduct ROC curve analysis on the diagnostic effectiveness of each index on CAP. Results Levels of white blood cells, neutrophils and lymphocytes in the experimental group were higher than those in the contronl group (P<0.05). Levels of red blood cells, hemoglobin and platelets were no statistical differences between the two groups (P>0.05). The levels of NLR and SII were higher in the experimental group than those in the contronl group, and the differences between the two groups were statistically significant (P<0.05). The results of the ROC curve showed that the area under the NLR curve was 0.76 (P<0.05), and the area under the SII curve was 0.73 (P<0.05). Conclusion Our study indicated that the levels of NLR and SII in community- acquired pneumonia patients were significantly higher than that in healty participants, they may be important auxiliary indexes for clinical diagnosis of CAP patients.

The Practice and Guiding Role of Stroke Center Management Mode in the Treatment of Acute Ischemic Stroke under the Mode of Medical Community

2023, 41(8):  4-8. 

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Acute ischemic stroke (AIS) is a clinical syndrome that affects the blood supply in the cerebral artery and leads to neurological impairment due to the stenosis or occlusion of blood vessels after the occurrence of cerebrovascular diseases. At present, the management mode of the stroke center has been relatively mature for the treatment of acute ischemic stroke, but the research on the management of the stroke center based on the medical community model is relatively rare. Therefore, this paper intends to elaborate the practice and guiding role of the management mode of the stroke center under the medical community model of our county in the treatment of acute ischemic stroke, with a view to introducing new ideas and discussing with colleagues.

Meta Analysis of Post-Stroke Fatigue Physical Activity Intervention Study

2023, 41(8):  8-12. 

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Objective To systematically evaluate the impact of physical activity management of stroke patients on the level of post-stroke fatigue, and provide reference for the formulation of relevant intervention plans for patients with post-stroke fatigue. Methods According to the principle of PIS retrieval, 8 databases retrieve randomized controlled trials on post-stroke fatigue physical activity intervention in China CNKI, PubMed, Web of Science, Embase, Cochrane, Wanfang Data and Weipu Chinese journals. The warehouse will be built until April 2022. After retrieval, the literature is screened and evaluated, and the heterogeneity test and effect statistics of the included literature are carried out through RevMan 5.3. Use the software Stata 17.0 for sensitivity analysis and publish bias tests. Results Finally, 12 literature containing a total of 832 documents that met the exclusion criteria were analyzed. The heterogeneity test I²=84.6%, so the stochastic effect model was used for effect merging. The meta analysis results: the combined effect amount [d=-1.08, 95%CI: -1.05 (-1.20, -0.90), P<0.00001], indicating that physical activity has a significant effect on improving post-stroke fatigue. The sensitivity analysis results show that after excluding Zhou Ping (2019), Ma Yan (2016), Wang Xiao-li (2021) and Wang Meng-jia (2021), the heterogeneity has decreased. I²=61%, 95%CI: -0.69 (-0.87, -0.51), P<0.00001; using Egger's test to detect publication bias, and it is no obvious publication bias. Conclusion Planned, slow and relaxed exercise, strength training and resistance training can effectively relieve post-stroke fatigue symptoms. It is recommended to formulate a detailed plan for the evaluation of cardiopulmonary function before activity and the monitoring of pulmonary function in the activity center when formulating a physical activity plan for patients with post-stroke fatigue.

Clinical Study of Phentolamine Partial Occlusion Combined with Huoxuexiaozhong Ointment in the Treatment of Dopamine Extravasation Tissue Damage

2023, 41(8):  13-16. 

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Objective To explore the therapeutic effect of phentolamine early local closure combined with Huoxuexiaozhong ointment in the treatment of local tissue damage caused by dopamine extravasation. Methods A total of 80 patients with tissue damage caused by extravasation of dopamine through peripheral intravenous pumping were collected from July 2020 to July 2022 in the intensive care units of 3 hospitals in Qingdao. These patients were randomly divided into an intervention group (Huoxuexiaozhong ointment group, 40) and a control group ( 50% magnesium sulfate group, 40). The two groups of patients were treated with the same partial sealing method. The intervention group was applied with external application of Huoxuexiaozhong ointment. The control group was use to external application 50% magnesium sulfate. Change the dressing every 4 h/time. We observed the therapeutic effect of the two groups every 8 hours. The degree of tissue damage was reassessed until they are discharged or died, and the US Food and Drug Administration (FDA) skin damage scores were compared between the two groups after treatment, and carry out multiple linear regression analysis. Results The FDA score of the intervention group was significantly lower than that of the control group (P<0.05). The results of multiple linear regression analysis showed that the ability of Huoxuexiaozhong ointment can reduce the FDA skin damage score was 2.85 times that of 50% magnesium sulfate, and the clinical effect was significant. Conclusion Early partial closure of phentolamine combined with Huoxuexiaozhong ointment in the treatment of dopamine extravasation tissue damage can significantly reduce the incidence of inflammation and necrosis of extravasated skin.

Application and Clinical Effect Evaluation of Traditional Chinese Medicine Rehabilitation for Sports Injury of Knee Joint

2023, 41(8):  16-19. 

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Objective To explore the implementation value of traditional Chinese medicine rehabilitation in the treatment of knee joint sports injury, and to evaluate its application effect. Methods A total of 100 patients with knee joint sports injury were selected from the Department of Sports Medicine of Zhuzhou Traditional Chinese Medicine Injury Hospital from May 2021 to May 2022.According to the parity value of hospitalization number, the patients were divided into the control group (odd patients) and the study group (even number patients), 50 cases in each group. The control group was treated with sodium hyaluronate injection into the joint cavity. The study group selected TCM rehabilitation. The differences of effective rate after treatment, knee function, pain score, knee range of motion and complications after treatment were compared between the two groups. Results After treatment, the pain score of the study group was lower than that of the control group, and the range of motion of the joint was higher than that of the control group (P<0.05). The analysis of complications showed that the data of the study group was lower than that of the control group(P<0.05). There was no difference in knee joint function between the two groups before treatment (P>0.05), but after treatment, the study group was higher than the control group (P<0.05). After treatment, the treatment effective rate of the study group was higher than that of the control group (P<0.05). Conclusion Acupuncture, massage and traditional Chinese medicine application are of high value. After implementation, the joint function of patients can be effectively improved, and it has positive significance for the inhibition of pain and complications, which is worthy of application.

Comparison of Colloidal Gold Method and Particle Agglutination Test in Detection of Treponema Pallidum Antibody and Toluidine Red Antibody

2023, 41(8):  19-22. 

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Objective To compare and analyze the difference between colloidal gold method and particle agglutination test in the detection of Treponema pallidum antibody and toluidine red antibody. Methods A total of 100 patients who were examined in Guizhou Armed Police Corps Hospital due to suspected syphilis from January 2019 to January 2022 were selected as the study objects. The gold standard positive was that the blood, cerebrospinal fluid VDRL and FTA ABS were all positive. The detection efficiency of colloidal gold method, particle agglutination test and toluidine red test for Treponema pallidum antibody was examined by blind method and compared between groups. Results The positive results of VDRL and FTA ABS in blood and cerebrospinal fluid of patients were regarded as gold standard positive. Among 100 suspected syphilis patients, 83 were positive, 17 were negative; 81 were positive by colloidal gold method; 19 were negative, 83 were positive by particle agglutination test; 17 were negative, 53 were positive by toluidine red, 47 were negative. The diagnostic accuracy of colloidal gold method was 94.00%, sensitivity was 95.18%, specificity was 88.24%, missed diagnosis rate was 4.82%, misdiagnosis rate was 11.76%; diagnostic accuracy of particle agglutination test was 94.00%; sensitivity was 96.39%, specificity was 82.35%, missed diagnosis rate was 3.61%, misdiagnosis rate was 17.65%; diagnostic accuracy of toluidine red was 56.00%, sensitivity was 55.42%, specificity was 58.82%, missed diagnosis rate was 44.58%, misdiagnosis rate was 41.18%. The ROC curves of colloidal gold method, particle agglutination test and toluidine red test for the diagnosis of Treponema pallidum antibody were drawn respectively, and the AUC was 0.907 (P<0.001), 0.894 (P<0.001) and 0.571 (P=0.356). Conclusion The colloidal gold method, particle agglutination test and toluidine red test have certain diagnostic efficacy for Treponema pallidum antibody, but the diagnostic accuracy, sensitivity and specificity of the colloidal gold method and particle agglutination test are higher than those of the toluidine red test, which can be considered for the differential diagnosis of syphilis patients in clinical practice.

Effect of Shexiang Baoxin Pill Combined with Trimetazidine Hydrochloride Tablets in the Treatment of Elderly Patients with Unstable Angina Pectoris and Its Influence on Heart Function and Blood Lipid Level

2023, 41(8):  29-32. 

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Objective To investigate and analysis the effects of Shexiang Baoxin Pill combined with trimetazidine hydrochloride tablets in the treatment of elderly patients with unstable angina pectoris and its influence on heart function and blood lipid level. Methods From March 2020 to March 2021, 180 cases of elderly patients with unstable angina pectoris diagnosed and treated in our hospital were selected as the study objects. Accorded to the random number table method, the patients were divided into the combined group and the traditional group with 90 cases in each groups. The traditional group was treated with trimetazidine hydrochloride, and the combined group was treated with Shexiang Baoxin Pill on the basis of the traditional group. All the cases were to determine the treatment effects and cardiovascular adverse events, and to detect the changes of cardiac function and blood lipid levels. Results After treatment, the total effective rates of the combined group were significantly higher than that of the traditional group ( P<0.05). The levels of TC, TG and LDL-C in the combined group and the traditional group after treatment were significantly lower than those before treatment (P<0.05), and HDL-C were also significantly higher than those before treatment (P<0.05). There were also significant difference compared between the combined group and the traditional group after treatment (P<0.05). The ventricular end diastolic diameter and ventricular end systolic diameter in the combined group and the traditional group after treatment were significantly lower than those before treatment, left ventricular ejection fraction were all higher than before treatment (P<0.05), and there were also significant difference compared between the combined group and the traditional group after treatment (P<0.05). At 1-year of follow-up after treatment, the incidence rates of major cardiovascular adverse events such as recurrent angina pectoris, myocardial infarction, cardiac death and heart failure was lower than in the traditional group, and the statistical analysis did not differ (P>0.05). Conclusion The combination of Shexiang Baoxin Pill and Trimetazidine Hydrochloride Tablets in the treatment of elderly patients with unstable angina pectoris can improve the cardiac function, improve the therapeutic effect, improve the blood lipid level of patients, and will not increase the incidence of cardiovascular adverse events.

Effects of Aripiprazole Combined with Transcranial Magnetic Stimulation on Oxidative Stress and Metabolic Syndrome in Patients with Schizophrenia

2023, 41(8):  36-39. 

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Objective To investigate the clinical efficacy of aripiprazole in combination with transcranial magnetic stimulation (TMS) in the treatment of schizophrenia and the influence on the level of oxidative stress in patients and the incidence of metabolic syndrome. Methods 90 schizophrenic patients admitted to Xi'an Kangning Psychiatric Hospital from October 2020 to October 2022 were selected as research subjects. The patients were divided into three groups, A, B and C, each with 30 patients using a random number table. Group A was treated with conventional olpin, group B with aripiprazole and group C with aripiprazole combined with transcranial magnetic stimulation. PANSS score, oxidative stress response, glucose and lipid metabolism and the incidence of metabolic syndrome were compared between the three groups. Results There was no significant difference in PANSS scores of positive and negative symptoms between groups A, B and C prior to treatment (P>0.05). After treatment, PANSS levels of positive and negative symptoms were lower in group C than in group A and group B (P<0.05), but there was no significant difference between group A and group B after treatment (P>0.05). There was no significant difference in the concentrations of catalase (CAT), superoxide dismutase (T-SOD) and glutathione peroxidase (GSH- Px) related to oxidative stress in patients in groups B and C prior to treatment (P>0.05). After treatment, CAT levels decreased in the patients in the three groups. The values of T-SOD and GSH Px in Group C were lower than those in Group A and Group B, and the values of T-SOD and GSH-Px in Group C were higher than those in Group A and Group B (P<0.05). However, there was no significant difference in GSH-Px levels after treatment (P>0.05). There was no significant difference between blood sugar, fasting blood sugar, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) in the three pre- and post-treatment groups (P>0.05). After treatment, blood sugar, fasting blood sugar and LDL decreased in both groups and were significantly lower than in group A (P<0.05). The incidence of metabolic syndrome in group B and C was significantly lower than in group A, but there was no significant difference between group B and group C (P>0.05). Conclusion Treatment of aripiprazole combined with transcranial magnetic stimulation for patients with schizophrenia may improve the therapeutic effect of schizophrenia, reduce patients' oxidative stress response and promote glucose and lipid metabolism and reduce the incidence of metabolic syndrome compared to conventional treatment of olpin.