Table of Content

01 July 2023, Volume 41 Issue 13

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Influence of Stroke Volume Variation-guided Fluid Therapy on the Early Cognitive Function of Elderly Patients Following the Spinal Surgery

HAO Wei, FAN Wei, WANG Jia-ni, WANG Chao

2023, 41(13):  1-4. 

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Objective To study the influence of stroke volume variation-guided fluid therapy on the early cognitive function of elderly patients following the spinal surgery. Methods A total of 80 elderly patients of undergoing the spinal surgery from February 2020 to February 2021 in Inner Mongolia Autonomous Region People's Hospital were chosen as research samples. According to random sampling method, patients were divided into study group 1 (stroke volume variation-guided fluid therapy) and study group 2 (central venous oxygen saturation-guided fluid therapy), 40 cases in each group. The intervention effects were probed. Results The global end-diastolic volume (GEDV), cardiac index(CI)and intrathoracic blood volume index (ITBVI) in study group 1 were higher than those of study group 2, but extravascular lung water index (EVLWI) and systemic vascular resistance index(SVRI) were lower than those of study group 2 (P<0.05); before treatment, mini-mental state examination(MMSE) scores between groups were not significantly different(P>0.05), after 6 h and 24 h of treatment, MMSE scores in study group 1 were higher than those of study group 2 (P<0.05). Conclusion The stroke volume variation-guided fluid therapy can stabilize the hemorheology, improve the early cognitive function. It is worthy of clinical application.

A Single-center Survival Analysis on Maintenance Hemodialysis Patients

DONG He

2023, 41(13):  4-7. 

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Objective To analyze the long-term survival of patients with single-center maintenance hemodialysis (MHD), and to guide clinical practice to improve survival rat. Methods A retrospective study was carried out in 132 MHD patients in. Of the 132patients,54 dead were designated as the experimental group and the other 78 survivals as the control. Cox regression proportional hazard model were used to investigate the effects of clinical indicators on the prognosis of patients. The data of laboratory examination and dialysis indexes, and to count the 10-year survival rate and the risk factors of the survival rate of MHD patients. Results Over all the 10-year survival rate was 33%. Kaplan-Meier analysis showed patient survival as 90% at one-year, 86% at 3-years,82% at 5-years, and33% at 10-years. Cox regression proportional hazard model showed that Internal fistula (or = 0.025,95% CI: 0.095~0.654, P & Lt; 0.001) , age > 60 years (or = 3.17,95% CI: 1.451~6.925, P = 0.004) , cardiovascular disease (OR = 2.01,95% CI: 0.984~4.097, p = 0.055) , Kt/V > 1.2(or = 0.298,95% CI: 0.113~0.690, P = 0.006)were associated with survival. The internal fistula and KT/V ≥1.2 were protective factors, and the age over 60 years with cardiovascular disease and cerebrovascular disease were risk factors.Cardiovascular and cerebrovascular diseases, infection is the main cause of death. Conclusion Cardio- cerebro- vascular diseases,and infection are the main causes of death in maintenance hemodialysis patients. The survival rate can be improved by changing the access of dialysis to internal fistula in time.

Correlation between Ultrasonic Parameters and Malignant Degree of Thyroid Cancer

TANG Wei-yi, SHI Wei-zhen

2023, 41(13):  8-11. 

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Objective To investigate the correlation between ultrasonic parameters and malignant degree of thyroid cancer. Methods A total of 70 patients diagnosed with thyroid cancer in Second Xiangya Hospital of Central South University from January 2019 to January 2019 to January 2022 were selected as the malignant group, and other patients with benign thyroid nodules treated in the same period were selected as the benign group. The ultrasound image features and ultrasound related parameters were compared to analyze the diagnostic value of ultrasound on the malignancy of thyroid cancer. Results The number, boundary, shape, margin, capsule, posterior echo and calcification of lesions in malignant group and benign group were significantly different (P<0.05); The time difference of the first peak and the slope of ascending branch in malignant group were significantly higher than those in benign group (P<0.05); Spearman correlation analysis showed that the number, border, shape, edge, capsule, posterior echo, calcification, time difference of the first peak and the slope of ascending branch of thyroid cancer in ultrasound parameters were positively correlated with the malignant degree of cancer (P<0.05); There was no significant difference between the accuracy of ultrasound in diagnosing thyroid cancer and the accuracy of postoperative pathological diagnosis (100.00%, P>0.05). The area under the curve was 0.828, specificity 91.25%, sensitivity 72.36%, negative predictive value 66.67%, and positive predictive value 81.94%; the area under the curve was 0.931, specificity was 96.42%, sensitivity 89.53%, negative predictive value 97.22%, and positive predictive value 79.19%. Conclusion Ultrasound has high sensitivity and specificity in the diagnosis of thyroid cancer, and can diagnose different forms of thyroid cancer through ultrasound images. Clinical diagnosis of thyroid cancer can be made by combining thyroid ultrasound diagnosis with relevant indicators.

Study and Application of Drug Balloon in Severe Coronary Stenosis

ZHANG Kai-ping, HUANG Ping, LIANG Hong-tao, CHAI Fang-yun, LI Pan

2023, 41(13):  12-15. 

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Objective To investigate and analyze the research and application values of drug balloon in severe coronary stenosis. Methods From January 2019 to April 2022, 153 cases of patients with severe coronary stenosis diagnosed and treated in our hospital were selected as the study subjects. Accorded to the 1∶1 random number table, the patients were divided into drug balloon group (77 cases) and drug stent group (76 cases). The drug stent group were treated with drug eluting stent therapy, and the drug balloon group were treated with drug balloon. The prognosis of the patients in the two groups were recorded and followed up. Results 1 month after treatment, the treatment success rate of drug balloon groupwas 98.70%, compared with 90.79% in the drug stent group, there was no statistical significance (P>0.05). 1 month after treatment, LVEF was significantly higher than before treatment (P<0.05), LV end-diastolic internal diameter was significantly lower than before in both groups (P<0.05), 1 month after treatment, LVEF in the drug balloon group was higher than that in the drug stent group (P<0.05), and LV end-diastolic internal diameter was lower than the stent group (P<0.05).The 6-min walk test results at 1 month after treatment were higher than before treatment (P<0.05), and the drug balloon group was significantly higher than the drug stents (P<0.05).The incidence rates of adverse cardiovascular events such as myocardial infarction, coronary stent restenosis, revascularization, and cardiac death at 6 months after treatment in the drug balloon group, which compared to the drug stent group were not significantly difference (P>0.05). Conclusion The application of drug balloon in severe coronary stenosis can improve the cardiac function of patients, increase the 6-minute walking test distance of patients, it also has good safety, especially in patients with bifurcation disease, small vessel disease, in stent restenosis and high bleeding score.

Analysis of Self-concept and Delivery Related Factors in Pregnancy with Chronic Hepatitis B

ZHANG Guo-qiang

2023, 41(13):  15-18. 

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Objective To explore the self-knowledge and delivery related factors of pregnant women with chronic hepatitis B. Methods A total of 281 patients with pregnancy complicated with chronic hepatitis B were randomly selected from the First People's Hospital of Lianyungang City from February 2020 to August 2022. A questionnaire survey was conducted on all patients to understand their cognitive status of pregnancy complicated with chronic hepatitis B. Univariate and multivariate analysis was conducted at the same time to identify patients' concerns. According to the birth history, the patients with chronic hepatitis B were divided into the first pregnancy patients and the patients with birth history. Results The results of the questionnaire showed that the cognitive score of mother-to-child transmission of chronic hepatitis B during the first pregnancy, the cognitive score of hepatitis B virus related, and the score of prevention knowledge were shorter than those of the patients with childbirth history, and the difference was statistically significant (P<0.05). Univariate analysis showed significant differences in age, birth history, education level, chronic hepatitis B screening history and other factors, with statistical significance (P<0.05). Multiple logistic regression analysis showed that age, education level, chronic hepatitis B screening history and delivery history were factors influencing the knowledge of mother-to-child transmission in pregnant patients with chronic hepatitis B (P<0.05). Patients were significantly more concerned about breast-feeding, drug safety, blocking methods and success rates, and available treatments. Conclusion In pregnancy with chronic hepatitis B questionnaire survey showed that patients with labor history multiple cognitive score significantly higher, there are many factors can affect the patient's cognitive ability, patients focus on safety, breastfeeding, treatment, blocking the success rate of several problems, in the clinical need for prevention and the corresponding intervention.

Effects of Zirconia all Ceramic Restorations on Masticatory Function and Periodontal Health in Patients with Dental Defects

DING Chang-xue

2023, 41(13):  18-21. 

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Objective To analyze the application value of zirconia all ceramic restoration in patients with tooth defects. Methods The medical records of 78 patients with tooth defects admitted to Lanshan District People's Hospital in Rizhao from April 2021 to April 2022 were analyzed retrospectively, and they were divided into two groups according to the different repair methods. Among them,40 patients with metal ceramic restorations were included in the control group, and 38 patients with zirconia all ceramic restorations were included in the observation group. Both groups were observed until 6 months after operation. The restorative effect, masticatory function, periodontal health related indicators, levels of inflammatory factors in gingival crevicular fluid and satisfaction were compared between the two groups. Results The proportion of color matching, marginal sealing, normal gingival and complete and stable prosthesis in the observation group were higher than those in the control group, with statistically significant difference (P<0.05);After operation, the masticatory efficiency and bite force of the observation group were higher than those of the control group, and the plaque index (PLI) score, gingival index (GI) score, depth of detection (PD), C-reactive protein (CRP),tumor necrosis factor (TNF-α(TNF-α)、 Interleukin-6 was significantly lower than that of the control group (P<0.05); The satisfaction of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05). Conclusion Zirconia all ceramic restoration has a significant effect in the treatment of patients with tooth defects. It can effectively improve their masticatory function, reduce the level of inflammatory factors, improve periodontal health, and improve patient satisfaction. It has a high clinical application value.

Evaluation of the Clinical Effect of Traditional Chinese Medicine Treatment of Mycoplasma Pneumonia in Children Based on "the Theory of the Lung and the Large Intestine"

LI Hong-le

2023, 41(13):  22-24. 

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Objective To explore and analyze the clinical effect evaluation of the treatment of mycoplasma pneumonia in children with traditional Chinese medicine based on "the theory of the lung and the large intestine". Methods 120 children with mycoplasma pneumonia treated from January 2020 to May 2022 were divided into control group and observation group, 60 cases in each group. The control group was treated with conventional azithromycin, and the observation group was treated with Yujin injection + compound Danshen injection + raw rhubarb on the basis of the control group. Both groups were treated for one month. The efficacy, main symptom scores, lung function and immune function indexes of the two groups were compared, and the incidence of adverse reactions was observed. Results The total clinical effective rate of observation group was significantly higher than that of control group (P<0.05). The scores of fever, cough, phlegm obstructing and wheezing were lower in the observation group than in the control group. The levels of maximum mid-expiratory flow (MMEF), 50% maximum expiratory flow (MEF50) and 25% maximum expiratory flow (MEF25) were higher in the observation group after treatment, and immunoglobulin A(IgA) were increased. Immunoglobulin G (IgG), immunoglobulin M (IgM) and immunoglobulin E (IgE) were decreased, and the differences were statistically significant(P<0.05). No obvious adverse reactions were found in both groups during treatment. Conclusion The treatment of mycoplasma pneumonia in children based on the "theory of the surface and the inside of the lung and the large intestine" can significantly promote the relief of clinical symptoms and signs of mycoplasma pneumonia in children, improve lung function, improve the body's immune function, and no obvious adverse reactions during the treatment, with high safety.

Effect and Economic Analysis of Fluorinated Foam and Fluorinated Protective Paint on the First Permanent Molar Caries in Preschool Children

HAN Ya-ting

2023, 41(13):  43-46. 

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Objective To explore the efficacy and economic analysis of fluorinated foam and fluorine protected paint on dental caries of the first permanent molars in preschool children. Methods A total of 280 preschoolers with caries in the first permanent molars admitted to Yumen Hospital of Traditional Chinese Medicine, Gansu Province from May 2020 to September 2022 were randomly divided into control group and experimental group with 140 cases in each group. The control group received fluorinated foam treatment and the experimental group received fluorinated protective lacquer treatment. Both groups were treated 4 times. The clinical indexes, average number of new caries, average caries surface, total effective rate and satisfaction level were compared between the two groups. Results There was no significant difference between the two groups before treatment (P>0.05). After treatment, the average caries and the average caries surface of the two groups increased, and after treatment, the increase in the experimental group was less than that in the control group, with significant differences (P<0.05); After treatment, the average of newly added caries and the average of caries surface in the experimental group were lower than those in the control group, and the difference was statistically significant (P<0.05); The total effective rate of patients in the experimental group was higher than that in the control group, with a statistically significant difference (P<0.05); The treatment satisfaction of patients in the experimental group was higher than that of the control group, but the difference was not statistically significant (P>0.05). Conclusion Fluoride protector is of great significance in clinical treatment. It can not only improve the caries related indicators of the first permanent molars of preschool children, but also improve the total effective rate of children, the satisfaction level of family members, and has significant promotion value.

Observation of CRRT Related Indexes of Patients with Sepsis Interfered by Enteral Nutrition

ZHOU Wen-lei, LI Xing-xiang

2023, 41(13):  55-59. 

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Objective To observe the therapeutic effect and related indexes of continuous renal replacement therapy (CRRT) in the treatment of enteral nutrition in patients with sepsis. Methods Sixty patients with sepsis (from February 2020 to February 2022) in Yunnan Central Hospital of Honghe Prefecture (Gejiu City People's Hospital) were selected and randomly divided into control group (30 cases) with CRRT and observation group (30 cases) with CRRT and enteral nutrition intervention. PA, HB, ALB, CRP, IL-6, IL-8, TNF-α, APACHE Ⅱscore, SOFA, gastric residual, abdominal pressure of the two groups were detected and compared. Results After intervention, the levels of PA, HB and ALB in 2 groups were increased, and the above indexes in observation group were higher than control group after intervention(P<0.05). After intervention, the levels of CRP, IL-6, IL-8 and TNF-α were decreased in both groups, and the above indexes in observation group were decreased more than control group after intervention(P<0.05). The incidence of complications was 3.33% in observation group and 20.00% in control group, which was lower in observation group than in control group(P<0.05). After intervention, APACHE Ⅱ and SOFA scores of both groups were decreased, and the above indexes of observation group were reduced more than control group after intervention(P<0.05). After intervention, gastric residual and abdominal pressure were decreased in both groups, and the above indexes in the observation group were reduced more than that in the control group after intervention (P<0.05). Conclusion CRRT and enteral nutrition intervention in sepsis patients can improve the nutritional status of patients, reduce inflammatory response, effectively improve the condition, reduce gastric residual and abdominal pressure, which is worth learning.

The Effect of Endoscopic Submucosal Dissection in the Treatment of Early Gastric Cancer and the Risk Factors Related to Postoperative Recurrence

XI Ting

2023, 41(13):  175-178. 

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Objective To analyze the efficacy of endoscopic submucosal dissection in the treatment of early gastric cancer and the risk factors related to postoperative recurrence, so as to provide evidence for ESD treatment of early gastric cancer. Methods 200 cases of early gastric cancer treated with ESD in Liaocheng People's Hospital from January 2017 to January 2019 were selected, and the gender, age, family history, presence of Helicobacter pylori infection, tumor size, differentiation, pathological type, metastasis, treatment and clinical manifestation of all patients were recorded. To analyze the efficacy of ESD in the treatment of early gastric cancer. After 3 years of follow-up, the patients were divided into two groups according to the follow-up. Results postoperative recurrence group and postoperative non-recurrence group. The basic situation and clinical data of patients in the two groups were compared, and the risk factors related to postoperative recurrence were analyzed by logistic regression. Results Survival of patients: The follow-up time of this study was 10~36 months. As of January 30,2022,the average follow-up time was (30.35 ± 5.01) months. There were no deaths. Recurrence of patients: 26 of 200 patients with early gastric cancer treated with ESD recurred, with a recurrence rate of 13.0%. All relapsed patients were treated with ESD again and achieved long-term survival. Through univariate and multivariate analysis of postoperative recurrence of early gastric cancer patients treated with ESD, it was found that tumor size (OR: 3.981, 95% CI: 1.077 ~ 2.991), depth of invasion (OR: 2.945, 95% CI: 1.946 ~ 4.997), histological classification (OR: 2.909, 95% CI: 1.964 ~ 6.964) were independent risk factors for postoperative recurrence. Conclusion ESD has a good clinical effect in the treatment of early gastric cancer.Tumor size, depth of invasion and histological classification are independent risk factors for postoperative recurrence.