ZHONGHUA YANGSHENG BAOJIAN

Application and Effect Evaluation of CBL Combined with PBL in Probation Teaching of Cardiology Department Under the Background of Professional Certification of Clinical Medicine

LIU Gang-qiong, ZHANG Wen-jing, WU Zhuo-wei, SHANGGUAN Jia-hong, ZHU Xiao-dan, BAI Xue-yang, ZHANG Hui, LIU Hui-fan

2023, 41(9): 1-4.

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Objective To compare the effect of CBL combined with PBL teaching mode and traditional teaching mode in probation teaching of cardiology department. Methods A total of 128 clinical medicine undergraduates who were on probation in the Department of Cardiology from September 2020 to December 2020 were selected as the research subjects, and they were randomly divided into the observation group (n=65) and the control group (n=63). The observation group was treated with CBL combined with PBL teaching mode, while the control group was treated with traditional teaching mode. A comprehensive assessment was conducted at basic theoretical knowledge, medical history taking, specialized physical examination, case analysis, as well as a questionnaire survey on teaching satisfaction to evaluate teaching effectiveness. Results Compared the observation group with the control group, theoretical scores, consultation scores, specialist examinations, case analysis and other comprehensive assessment scores. The observation group was better than the control group, the difference was statistically significant (P<0.05). Compared satisfaction score of teaching of the observation group with the control group, classroom atmosphere, learning interest, retrieval ability, logical thinking ability, clinical communication ability, the observation group was better than the control group, the difference was statistically significant (P<0.05). Conclusion Compared with the traditional teaching model, CBL combined with PBL can effectively activate the learning atmosphere, stimulate students' learning interest, improve retrieval ability, cultivate clinical thinking and enhance clinical communication ability, so as to significantly improve the teaching effect of probation teaching.

Investigation on Health and Lifestyle of Workers in a Petrochemical Enterprise

ZHAO Ya-min, WU Jian-jun, HE Jiang-ning, CUI Chang-jiao, LIU Yong-bin, QI Sheng-shun, WEI Xing-min

2023, 41(9): 4-8.

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Objective To understand the status of life behavior of employees of a petrochemical company in Xigu District, Lanzhou. Methods A total of 8 443 active and retired employees aged 20-65 in a petrochemical company in Xigu District of Lanzhou city in 2019 were selected as the research objects. The health status was investigated by questionnaire survey, and the ratio or composition of qualitative data was expressed. Results The prevalence rate of chronic diseases (hypertension, stroke, hyperlipidemia and obesity) was 22.3%; the diet structure and lifestyle were not reasonable, the diet was spicy, high-salt and high-fat diet was 44.6%, smoked and preserved food was 49.7%, and the intake of milk, dairy products and eggs was low. Only 7.0% and 10.1% of employees reached the daily intake standard; 79.3% of workers spend more than 2 hours a day sitting quietly (watching TV, surfing the Internet, playing mahjong, playing cards, etc.), 25.9% exercise regularly. The overall smoking rate was 41.7%, higher among males than females, and 52.4% among drinkers. Univariate analysis showed that gender, age, occupational status, smoking, drinking, intake of vegetables and fruits, milk and dairy products and other dietary structure had statistical significance difference in chronic diseases related to life behaviors (P<0.05). The results of multi-factor analysis showed that gender, age, occupation, diet structure and so on had important influence on chronic diseases related to lifestyle behavior of workers. Conclusion The lifestyle of the employees of an oil company in Xigu district of Lanzhou city is not reasonable and has not yet formed a healthy lifestyle. Measures should be taken to address the related behavioral factors, while health education and publicity should be done, the health consciousness of residents should be strengthened, and the healthy lifestyle should be promoted.

Thinking on the Teaching Method of TCM Internal Medicine Based on Training Excellent Tcm Doctors

WANG Si-hai, FANG Zhao-hui, ZHAO Jin-dong, NI Ying-qun, BAO Tao-tao, NIU Yun-fei, LIU Jian, SHI Guo-bin, WU Ji-ping

2023, 41(9): 8-11.

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Internal Medicine of Traditional Chinese Medicine is a bridge between theoretical knowledge of Traditional Chinese medicine and clinical practice of traditional Chinese medicine, as well as an important course to cultivate clinical thinking of traditional Chinese medicine. The traditional teaching methods are boring, boring, abstract and obscure, which is not conducive to cultivating students’ clinical thinking of TCM. The author sorts out the teaching methods of the same kind and puts forward the following six teaching methods combined with his own teaching practice: (1) skillfully use diversified teaching mode to teach; (2) Pay attention to the series and mastery of basic knowledge; (3) Strengthen the study of classical theories of TCM; (4) Use modern multimedia technology to teach; (5) Encourage teachers to teach and learn from teachers repeatedly; (6) Attach importance to clinical practice of traditional Chinese medicine and cultivate students’ practical ability. The combination of these teaching methods may contribute to the two-way growth of teachers and students and the cultivation of outstanding clinical TCM doctors who can take charge of themselves in the future.

Effect of Auricular Point Pressing Combined with Progressive Muscle Relaxation Training on Sleep Quality of Maintenance Hemodialysis Patients

ZHANG Hui, CHEN Nan

2023, 41(9): 12-15.

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Objective To investigate the effect of auricular point pressing combined with progressive muscle relaxation training on sleep quality in patients with maintenance hemodialysis (MHD). Methods 96 patients with MHD sleep disorder in our hospital from September 2020 to August 2022 were randomly divided into control group (48 cases) and study group (48 cases). The control group applied progressive muscle relaxation training, and the research group combined auricular point pressing intervention on this basis. The Pittsburgh Sleep Quality Index (PSQI) score, Piper Fatigue Scale (RPFS) score, nephrotic related quality of life (KDTA) score and nursing satisfaction were observed and compared between the two groups before and after the intervention. Results After 4 weeks of intervention, the PSQI scores of both groups were lower than that before intervention, and the score of the study group was lower than that of the control group (P<0.05). After 4 weeks of intervention, RPFS scores in both groups were lower than those before intervention, and the scores in the study group were lower than those in the control group (P<0.05). After 4 weeks of intervention, the KDTA scores in both groups were higher than those before intervention, and the scores in the study group were higher than those in the control group (P<0.05). The nursing satisfaction rate of the study group was higher than that of the control group (P<0.05). Conclusion Auricular point pressing combined with progressive muscle relaxation training can effectively improve the sleep quality and fatigue of MHD patients, ensure the quality of life, and improve nursing satisfaction, which has clinical application value.

Exploration on the New Mode of Cancer Medical Treatment Based on “Internet plus”

ZHU Xiao-teng, GONG Shi-xia, XU Xiao-qing, ZHU Xiao-dan

2023, 41(9): 15-18.

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The incidence of cancer continues to rise in China, and the burden of cancer is increasing day by day.Internet plus medical model is to make use of information, data and internet platform to deeply integrate the internet and the medical industry, digitally empower medical behavior and health management, achieve precision medical treatment, and create a new industry development ecology. The cancer medical model under the background of “Internet plus” has been initially explored and achieved certain results. This paper analyzes the status quo of “Internet plus” cancer medical mode in recent years from the perspectives of policy support, industry dynamics and academic literature. From the two aspects of in-hospital medical behavior and out-of-hospital health management, the current problems and dilemmas of Internet plus cancer medical treatment are considered, and several strategies are proposed. We will strengthen the construction of data ecology, develop artificial intelligence and digital therapy, increase the training of “Internet plus” cancer-related talents, and integrate traditional Chinese medicine elements, in order to bring enlightenment to the exploration of “Internet plus” new cancer medical mode with Chinese characteristics.

The Prescription Medication Rules of Modern Doctors in the Treatment of Benign Prostatic Hyperplasia in Recent 10 Years Based on Data Mining

WU Li-tong, CHE Zu-zhao, CHEN Shu-chao, LI Qi-xin, CHEN Ying-wen, ZHANG Ze-zheng, YOU Xu-jun, FU Wei*

2023, 41(9): 18-22.

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Objective To analyze the medication regularity and treament ideas of modern physicians in China National Knowledge Infrastructure (CNKI) database for the treatment of benign prostatic hyperplasia (BPH) using traditional Chinese medicine (TCM) in the past ten years. Methods We collected and selected the literatures of treating BPH from January 2010 to January 2020 from CNKI database, and imported the all acupoints to TCM inheritance auxiliary system (V2.5). To analyze the frequency of four properties, five tastes, acupoints, therapeutic targets and new scription by Using the data analysis method in the system. Results A total of 70 eligible literatures were screened, including 77 prescriptions. Through analysis, totally 22 frequently uesd herbs were found, and the top five were Astragali Radix, Achyranthis Bidentatae Radix, Poria, Plantaginis Semen and Angelicae Sinensis Radix. Totally 4 core combination were mined by association rules, and two new prescriptions of treating BPH were mined through the cluster analysis from the database. Conclusion The medicine is mainly based on tonic, blood-activating and clearing damp and promoting diuresis medicine during all herbs of treating BPH. It focuses on the regulation of liver, kidney and spleen meridians. Invigorating Qi and warm Yang, blood-activating and stasis-removing and clearing damp and promoting diuresis are used as the main therapeutic methods. Clinical treatment focuses on the distinction between deficiency and excess of both ends, the combination of tongli, eliminate and supplement together to provide a basis for future treatment of BPH.

The Value of Contrast CT and MR in the Diagnosis of Hepatocellular Carcinoma

ZOU Guang-dong, HUANG Zhao-dong

2023, 41(9): 22-26.

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Objective To study and compare the application value of computed tomography (CT) and magnetic resonance (MR) in the diagnosis of hepatocellular carcinoma. Methods 120 patients with suspected hepatocellular carcinoma who visited Linyi Central Hospital from January 2020 to August 2022 were selected. CT plain scan and enhanced scan, MR plain scan, and diffusion weighted imaging (DWI) were performed in the patients to compare the results of CT, MR plain scan and DWI in the diagnosis of hepatocellular carcinoma. Results According to the gold standard of diagnosis (results of pathological diagnosis of puncture biopsy or surgical pathology), in the diagnosis of hepatocellular carcinoma, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MR plain scan and DWI were higher than those of CT, while the diagnostic indexes of DWI were higher than those of MR plain scan （P<0.05）. The diagnostic results of DWI and MR plain scan were highly consistent with the pathological diagnosis (Kappa=0.892, 0.745), while the diagnostic result of CT was moderately consistent with the pathological diagnosis (Kappa=0.561). In the diagnosis of early hepatocellular carcinoma, the diagnostic coincidence rate of DWI and MR plain scan was higher than that of CT, and the diagnostic coincidence rate of DWI was higher than that of MR plain scan (P<0.05). Conclusion For hepatocellular carcinoma, the diagnostic value of MR is superior to that of CT, especially DWI, which can detect hepatocellular carcinoma more sensitively and accurately, and also assist in differential diagnosis of the staging of hepatocellular carcinoma.

Observation of Clinical Effect of Oral Administration of Dexmedetomidine Hydrochloride-a Prospective Randomized Controlled Study

LI Mu, YANG Sen

2023, 41(9): 26-29.

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Objective To observe the sedative effect of dexmedetomidine hydrochloride on patients under spinal anesthesia. Methods A total of 60 patients [The American Society of Anesthesiologists (ASA) is graded II] were selected from Jinzhou Central Hospital. Using random number table method, the patients were divided into 3 groups (n=20): control group (group A), dexmedetomidine atomization inhalation group (group B) and dexmedetomidine oral spray group (C group). The sedation scores and heart rate changes of patients entering the room (T0) and after anesthesia (T1) after dexmedetomidine administration were recorded at 10 minutes (T2), 20 minutes (T3) and 30 minutes (T4), and the time to sleep after administration in patients with scleropractic combined anesthesia is recorded. The incidence of adverse reactions such as bradycardia and hypotension in each group were recorded. Results Compared with group A, there was no significant difference in the changes of heart rate and sedation score in group B at each time point (P>0.05). with T0 and T1 in group C, the heart rate decreased and the sedation score increased, with a statistically significant difference (P<0.05), but there was no significant difference compared with T4 (P>0.05). Among them, patients in group C could enter sleep state after administration, and the time to fall asleep was (60.15±7.66) min after administration. Among the three groups of patients, only 2 cases of short-term choking occurred in group C, and no adverse reactions were observed in other patients. Conclusion Compared with the control group, there was no significant change in the administration mode of dexmedetomidine hydrochloride 1.5 μg/kg through oral atomization. The administration mode of dexmedetomidine hydrochloride through buccal mucosa spray could produce better sedative effect.

Effect of Anlotinib Targeted Therapy on Immune Function and CYFRA21-1 and CEA in Patients With Non-small Cell Lung Cancer

GUO Dainian, FANG Ling, XU Jun, LIN Fei

2023, 41(9): 47-50.

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Objective To investigate and analysis the effects of anlotinib targeted therapy on immune function and CYFRA21-1 and CEA in patients with non-small cell lung cancer. Methods From January 2019 to June 2020, a total of 87 cases of patients with non-small cell lung cancer who were diagnosed and treated in the Cancer Hospital Affiliated to Shantou University School of Medicine were selected as the research subjects. The patients were divided into anlotinib group of 44 cases and control group group of 43 cases according to the treatment methods. The control group were given radiotherapy, and the anlotinib group were given anlotinib based on the treatment of the control group. Both groups were treated for 4 weeks, and the immune function and the changes of CYFRA21-1 and CEA expression were detected. Results After treatment, the total effective rate of the anlotinib group was significantly higher than that of the control group, and the difference were statistically significant (P<0.05). The incidence rates of radiation pneumonitis and radiation esophagitis during radiotherapy in the anlotinib group was slightly lower than the control group, and the comparison was not statistically significant (P>0.05). The proportion of CD3⁺T lymphocytes and CD4⁺T lymphocytes in the anlotinib group after treatment were significantly higher than those before treatment (P<0.05), and the proportions of the two T lymphocytes of the anlotinib group were also significantly higher than those in the control group, and the differences were statistically significant (P<0.05). The serum CYFRA21-1 and CEA levels in the anlotinib group after treatment were significantly lower than those before treatment (P<0.05), and the levels of serum CYFRA21-1 and CEA in anlotinib group were also significantly lower than those in the control group, and the differences were statistically significant (P<0.05). Conclusion The application of anlotinib targeted therapy combined with radiotherapy in patients with non-small cell lung cancer can effectively inhibit the expression of serum CYFRA21-1 and CEA, improve the immune function of patients, effectively improve the treatment effect.

Effect of Lumbar Spine-Pelvic Balance on Adjacent Vertebral Fractures after Balloon Kyphoplasty

LIU Yu-tao

2023, 41(9): 54-57.

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Objective To investigate the influence of lumbar spine-pelvic balance on the secondary adjacent vertebral fractures after balloon kyphoplasty. Methods From January 2018 to May 2021, 86 patients with vertebral fracture combined with lumbar degenerative disease who were diagnosed and treated in the Eighth People's Hospital of Dongguan City, Guangdong Province were selected as the research objects. All patients were treated with balloon kyphoplasty, and the patient’s lumbar spine-pelvic balance were judged before the operation. The Oswestry Dysfunction Index (ODI) score of the patients was evaluated and recorded 1 day before and 7 days after the operation; the loss of the height of the injured vertebra and the anterior edge of the adjacent intervertebral space was determined 3 months after the operation. Including high loss, moderate loss and low loss; the patients were followed up 1 year after surgery to observe the fracture of adjacent vertebrae. Results Among the 86 patients, there were 60 patients were preoperative lumbar-pelvic balance (balance group) and 26 patients wewre unbalanced (imbalance group). All patients were recovered and discharged smoothly. The ODI scores of the two groups at 7 d after surgery were lower than that of the preoperative 1 d (P<0.05), and the balance group were lower than the imbalance group, the difference is statistically significant (P<0.05). The high loss rate, moderate loss rate, and low loss rate of the balance group were lower than those of the unbalance group at 3 months after operation, the difference is statistically significant (P<0.05). After 1 year of followed-up, the incidence of secondary adjacent vertebral fractures in the balance group were lower than the unbalance group, the difference is statistically significant (P<0.05). Conclusion Lumbar-pelvic balance reduces the incidence of secondary adjacent vertebral fractures in patients after balloon-expandable vertebral kyphoplasty, and can also reduce the occurrence of height loss of the injured vertebrae and the anterior edge of the adjacent intervertebral space, and promote the recovery of the patient’s lumbar spine features.

Research on the Demand of Home-based Rehabilitation Products for Some Elderly in Jining

LIU Jing, LI Zhi-jian, WU Meng-yue, LIU Xia, GE Shu-hui, WANG You-quan

2023, 41(9): 61-64.

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Objective To understand the demand of some elderly in Jining for home-based rehabilitation products. Methods A total of 238 elderly people over 60 years old in Rencheng District of Jining were randomly selected by convenient sampling method,then investigate their basic situation and demand for home rehabilitation products. Results The demand for home-based rehabilitation products among the elderly in Jining is widespread, but awareness is low. In terms of product and service content, 22.96% of the elderly wanted to rehabilitate hypertension, 17.91% of the elderly wanted to rehabilitate cerebrovascular disease and 17.49% of the elderly wanted to rehabilitate low back and leg pain;in terms of product features,the top two were the evaluation and training of motor function (54.20%) and physical health of TCM (15.55%) . Conclusion We should strengthen the propaganda of home-based rehabilitation, strengthen the training of innovative rehabilitation talents, make full use of modern science and technology, and actively research and develop those which meet the needs of the elderly group, based on the integration of traditional Chinese medicine theory and modern rehabilitation technology, intelligent home-based rehabilitation products can improve the health status of the elderly, ease the pressure of elderly care, and promote the standardized management of elderly rehabilitation medical services.

Clinical Investigation on TCM Constitution, TCM Syndrome, Pathological Type and Risk Factors of Colonic Polyps in Tai'an

LIU Hong-bo

2023, 41(9): 65-68.

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Objective To summarize the incidence of colonic polyps in Tai'an, and to clarify the correlation among the pathogenic features, pathogenic factors, TCM syndrome types, TCM constitution and pathological types of colonic polyps. Methods Through a retrospective survey, we collected the information about TCM constitution, TCM syndrome types, pathological types and risk factors of hospitalized patients with colon polyps diagnosed in the Department of Spleen and Stomach Diseases, Tai’an Hospital of Traditional Chinese Medicine, Shandong Province from March to October 2022. The statistical software SPSS 24.0 was used to analyze the distribution of TCM constitution, TCM syndrome types, pathological types and risk factors of colon polyps in Tai’an area. Results The patients with colonic polyps in Tai’an area are mostly male, smoking, drinking, high cholesterol, high triglycerides, and people with high body mass index. The age range of the patients is 50~59 years old. The TCM syndrome types are mainly liver qi stagnation, large intestine damp heat, spleen stomach qi deficiency, and the TCM constitution is mainly phlegm dampness, qi stagnation, and qi deficiency. The multiple Logistic regression analysis of myocardial infarction showed that triglyceride was correlated with liver qi stagnation syndrome (OR=0.478, 95%CI: 0.238~0.959), and triglyceride was correlated with liver qi stagnation syndrome (OR=0.139, 95%CI: 0.050~0.388). Conclusion The occurrence and development of colonic polyps in Tai'an area is closely related to gender, age, smoking, drinking, high cholesterol, high triglyceride, body mass index, TCM syndrome type, and TCM constitution. To do the colonoscopy timely is helpful to reduce the incidence and mortality of colonic polyps and colon cancer for those people who combined with the above risk factors.

Analysis of Psychological Status of Syphilis Serofix Patients and Evaluation of Nursing Effect of Targeted Psychological Intervention

WEI Shao-feng

2023, 41(9): 75-78.

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Objective To explore the psychological status of syphilis serofix patients and evaluate the nursing effect of targeted psychological intervention. Methods 104 patients with syphilis serum fixation admitted to our hospital from June 2020 to June 2021 were selected as the research objects, and randomly divided into the control group and the research group, with 52 cases in each group, according to the number table method.The control group was given routine nursing, and the study group was given targeted psychological nursing. The SCL-90 scale scores and quality of life scores between the control group and the study group were compared. Results The SCL-90 scores of the study group were significantly lower than those of the control group; The scores of quality of life in the study group were significantly higher than those in the control group (P<0.05). Conclusion Patients with syphilis serum fixation have serious negative emotions and bad psychology, and their confidence in prognosis is obviously insufficient. However, targeted psychological intervention can significantly improve their negative emotions and help to improve the quality of life, which is worthy of application.

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