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Table of Content

    01 August 2023, Volume 41 Issue 15
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    Research on Medical Students' Clinical Thinking Ability Scale Based on PTA Scale Method
    DING Cheng-ming, XIE Yi, CHEN Guo-dong, QI Shuo, QIU Jun, TAO Guang-wei, HOU Jia-feng, FENG Can, JIANG Xin-miao, DENG Xin, LIAO Wen-yan
    2023, 41(15):  1-4. 
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    By means of literature search and expert consultation, this paper defines the content of clinical thinking ability, establishes the evaluation target and chooses the evaluation index, and constructs a set of scientific, systematic, easy-to-operate and suitable clinical thinking ability evaluation rules for Chinese medical students on the basis of the conceptual framework of clinical thinking. The study of students' clinical thinking ability provides a reliable evaluation tool. It can provide a reference for the cultivation of medical students' clinical thinking ability and the reform of teaching mode.
    Analysis of Risk Factors Related to Insulin Antibody Production in Type 2 Diabetes Patients in Hotan Area
    DENG Wei-bing, SU Yun-fu, JING Ya-han, KEREMUJIANG·A-bu-du-re-he-man, MEIHERINISA·Yi-li-ha-er, ADALEITI·Xia-Wu-dong, DENG Li-na, TANG Jian-jiang, LI Hui-ping, LUO Meng-lin, LI Wen-jing
    2023, 41(15):  5-8. 
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    Objective To explore and analysis the risk factors of insulin antibody production in type 2 diabetes patients in Hotan area. Methods A total of 213 patients with type 2 diabetes hospitalized in the Endocrinology Department of Hotan District People's Hospital from April 1, 2021 to September 30, 2022 were selected to detect serum insulin antibody expression levels, and were divided into positive and negative groups according to the test. Results The general information, blood biochemical indexes and dynamic blood glucose indexes of all patients were investigated. Pearson was used to analyze the correlation between positive insulin antibody and 24 h blood glucose standard deviation, 24 h maximum blood glucose fluctuation range, 24 h mean blood glucose fluctuation range, low density lipoprotein and total cholesterol in type 2 diabetes patients. Logistic regression was used to analyze the risk factors of positive insulin antibody in type 2 diabetes patients. Results In 213 cases Among the patients, 4 patients were positive for serum insulin antibody, the resistance rate was 1.88%. There were no significant difference compared between the positive group and the negative group in triglycerides, fasting blood glucose, high-density lipoprotein (P>0.05), while the positive group had significantly higher levels of low-density lipoprotein, total cholesterol (P<0.05). There were no significant difference compared between the two groups in the comparison of 24 h mean blood glucose (P>0.05). The standard deviation of 24 h blood glucose, the maximum fluctuation range of 24 h blood glucose, and the fluctuation range of 24 h mean blood glucose in the positive group were significantly higher than those in the negative group (P<0.05). Pearson analysis showed that the positive correlation serum insulin antibody of type 2 diabetes patients in Hotan area were correlated with the standard deviation of 24 h blood glucose, the maximum amplitude of 24 h blood glucose fluctuation, the average amplitude of 24 h blood glucose fluctuation, low-density lipoprotein, total cholesterol (r=0.862、0.707、0.597、0.655、0.601, P<0.05). Logistic regression analysis showed that 24 h standard deviation of blood glucose, 24 h maximum fluctuation range of blood glucose, 24 h average fluctuation range of blood glucose, low-density lipoprotein and total cholesterol were all risk factors for insulin antibody production in type 2 diabetes patients in Hotan area (P<0.05). Conclusion The proportion of insulin antibody production in type 2 diabetes patients in Hotan area is relatively low, but it still exists. The fluctuation of blood lipid and blood sugar is an important risk factor for insulin antibody production in type 2 diabetes patients in Hotan area.
    Study on Therapeutic Effect of Zixian Zhuyun Decoction Combined with Clomiphene Citrate on Infertility with Polycystic Ovary Syndrome
    FU Zhou, ZHANG Xiao-yang, ZHANG Feng-li
    2023, 41(15):  8-12. 
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    Objective To investigate the effect of Zixian Zhuyun decoction combined with clomiphene citrate on infertility with polycystic ovary syndrome. Methods 84 cases of polycystic ovary syndrome infertility patients admitted to the Department of Reproductive Medicine of Shandong Liaocheng People's Hospital from September 2020 to September 2021 were selected, and the random number table method was divided into two groups. The control group was treated with clomiphene citrate alone, and the observation group was treated with Zixian Zhuyun Decoction. The 1-year pregnancy rate and excellent ovulation rate of the two groups were recorded, the levels of luteinizing hormone (LH), estradiol (E2), testosterone (T) and follicle stimulating hormone (FSH) were detected, the TCM syndromes of the two groups were evaluated, and the ovarian volume and endometrial thickness of the two groups were compared. Results The 1-year pregnancy rate and excellent egg discharge rate in the observation group were significantly higher than that in the control group (P<0.05). Before treatment, there was no significant difference in the levels of LH, E2, T and FSH between the two groups (P>0.05). After treatment, the LH and T levels in two groups decreased, and the levels of E2 and FSH both increased (P<0.05), and the changes in the observation group were more obvious (P<0.05). Before treatment, the scores of irritability, irregular menstruation, dizziness and tinnitus, emotional depression, waist and knee weakness and chest and rib fullness in the two groups had no significant difference (P>0.05). After treatment, the scores of irritability, irregular menstruation, dizziness and tinnitus, emotional depression, waist and knee weakness and chest and rib fullness in the two groups were significantly reduced (P<0.05), and the observation group was more significant (P<0.05). Before treatment, there was no significant difference in ovarian volume and endometrial thickness between the two groups (P>0.05). After treatment, ovarian volume decreased and endometrial thickness increased in two groups (P<0.05), and changes were more pronounced in the observation group (P<0.05). Conclusion Clomiphene citrate combined with purple fairy help pregnancy soup has a significant effect on polycystic ovary syndrome infertility, can significantly improve the pregnancy rate, reduce symptoms, reduce ovarian volume, increase endometrial thickness.
    Analysis of the Efficacy of Ieccitonin and Teriparatide in Osteoporosis in Elderly Women
    HAN Mei
    2023, 41(15):  12-15. 
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    Objective To explore the efficacy of leccitonin combined with teriparatide on osteoporosis in elderly women. Methods 100 patients elderly female with osteoporosis who were hospitalized in China Hospital of Heibo Bay District, Wuhai City, Inner Mongolia from January 2019 to June 2022 were selected for the study. The patients were divided into observation group and control group, with 50 cases in each group. The patients in the control group were treated with triiodol, while the patients in the observation group were treated with calcitonin combined with triiodol. The clinical effects of the two groups were compared, before and after treatment, bone metabolism marker type 1 collagen carboxyterminal cross-linked end peptide (CTx) and bone mineral density (BMD), blood calcium (Ca) and 25 hydroxyvitamin D (25-OH-D) and sex hormone [follicle hormone (FSH), progesterone (P), estradiol (E2)] levels. Results The total response rate of the observation group was significantly higher than that of the control group (P<0.05). There was no significant difference between the first carboxyl crosslinked peptide (CTx) and BMD of type 1 collagen (P>0.05), CTx, and BMD were increased after treatment, And the observation group was higher than the control group (P<0.05). There was no significant difference in 25-OH-D and Ca levels between the two groups (P>0.05), 25-OH-D and Ca levels were increased in two groups, And the observation group was higher than the control group (P<0.05). After treatment, FSH, P, E2 were decreased, And the observation group was significantly lower than the control group (P<0.05). Conclusion Which improved the bone metabolism and bone density of the elderly female patients. The increase of calcium and vitamin D levels in blood and the increase of sex hormone levels are worthy of clinical application.
    Clinical Study of Apatinib Combined with Albumin-bound Paclitaxel in the Treatment of Distant Metastasis after Surgery for Esophageal Cancer
    LI Liang, QI Di, LI Yu, YUAN Lei, WANG E, ZHU Jun-di, GENG Xiao-meng, LI Wen-wen, REN Wei
    2023, 41(15):  16-19. 
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    Objective To investigate the efficacy and adverse effects of apatinib combined with albumin-bound paclitaxel in the treatment of patients with distant metastases after esophageal cancer. Methods A retrospective analysis was performed on 70 patients with distant metastasis after esophageal cancer admitted to Tai'an Cancer Hospital from March 2019 to January 2022, according to the treatment plan, 35 cases were divided into treatment group (paclitaxel albumin-binding combination with apatinib for injection) and 35 cases in the control group (paclitaxel albumin-binding chemotherapy for single-agent injection), and the short-term efficacy, disease-free progression, and adverse reactions of the two groups were observed. Results The difference was statistically significant compared with the objective response rate (ORR) and the disease control rate (DCR) between the treatment group and the control group (P<0.05). There were statistical differences between the median PFS of the treatment group and the control group (P<0.05). There were no significant differences in white blood cell decrease, platelet decrease, abnormal liver function, and gastrointestinal reactions during treatment (P>0.05), The symptoms of hypertension, proteinuria, and hand-foot syndrome in the treatment group were tolerated during oral apatinib, and alleviated after symptomatic treatment, and there was no significant difference between the two groups (P>0.05). Conclusion Apatinib combined with albumin-bound paclitaxel in patients with distant metastasis after esophageal cancer surgery has good local control rate, prolonged disease-free progression, and less adverse reactions.
    Effect of Air Enema on Acute Intussusception and Different Monitoring Significance of HMGB1
    SU Zhen-lei
    2023, 41(15):  19-22. 
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    Objective To explore the clinical effect of air enema in patients with acute intussusception, and to monitor the expression level of high mobility group protein 1 (HMGB 1) in different periods. Methods The Xinjiang production and construction corps 13 division red star hospital since January 2017 to December 2022 admitted 68 cases of acute intussusception children as the observation of the study, enrolled children are given simple air enema treatment, choose the same period in the Xinjiang production and construction corps 13 division red star hospital health examination 68 cases of healthy children as a control group, observe the clinical effect of air enema treatment of acute intussusception and the clinical significance of HMGB 1 monitoring. Results In 68 children of the observation group, 66 cases were successfully reset, with a success rate of 97.06%. After successful reduction, 53 children (80.30%) had mild diarrhea, all of them improved after treatment, and no other adverse reactions were found. 2 patients were transferred to surgery after failed reduction. HMGB1, IL-6, TNF-α in the observation group before and after treatment. The levels were significantly higher than those of the healthy control group, but decreased significantly after treatment (P<0.05). After treatment, 7 children recurred, and the level of HMGB1 in the recurred children was significantly higher than that in the non-recurred group, with a statistically significant difference between the groups (P<0.05). Conclusion The clinical effect of acute intussusception is significant, the recurrence rate of children is low, and the level of HMGB 1 and TNF- αand IL-6 are significantly reduced, which has certain diagnostic significance for the diagnosis of acute intussusception and deserves attention.
    Effect of Aerosol Inhalation of Azithromycin and Guanosine Propionate on Children with Bronchopneumonia and Influence of Inflammatory Factors
    SUN Bai-di
    2023, 41(15):  41-45. 
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    Objective To investigate the clinical efficacy of azithromycin and propoxyguanosine aerosol inhalation in children with bronchopneumonia and the effect on the level of inflammatory factors. Methods A total of 84 children with bronchopneumonia admitted to the pediatrics department of Yantai Beihai Hospital from August 2021 to August 2022 were selected as the subjects of this study. The children were randomly divided into control group and study group according to coin toss method. Among them, 42 cases in the control group received atomized inhalation therapy of propioguanosine, and 42 cases in the study group. Azithromycin combined with propoxyguanosine atomized inhalation therapy, the duration of clinical symptom disappearance, length of hospital stay, total response rate, levels of inflammatory factors (TNF-α, interleukin-1β), lung function [(forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) were compared between the two groups )]. Results The duration of cough relief, fever disappearance, shortness of breath disappearance and hospital stay in the study group were shorter than those in the control group (P<0.05). The total effective rate of the study group was higher than that of the control group (P<0.05). The levels of TNF-α and IL-1β in the two groups before treatment were compared (P>0.05), and the levels of TNF-α and IL-1β in the two groups were decreased after treatment, and the levels in the study group were lower than those in the control group (P<0.05). The levels of FVC, FEV1 and FEV1/FVC in both groups before treatment (P>0.05), and the levels of FVC, FEV1 and FEV1/FVC in both groups were improved after treatment, and the study group was higher than the control group (P<0.05). Conclusion The combined treatment of azithromycin and propoxyguanyside aerosol inhalation in children with bronchopneumonia has definite curative effect, can significantly shorten the improvement time of clinical symptoms, reduce the inflammatory reaction of the body, improve lung function, and is worthy of clinical use.
    Study on the Efficacy and Safety of Pneumatic Pump Therapy Machine in Improving Subcutaneous Hydrops after Modified Radical Mastectomy for Breast Cancer
    WEI Fa-qiang
    2023, 41(15):  51-54. 
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    Objective To investigate the efficacy and safety of pneumatic pump in improving subcutaneous effusion after modified radical mastectomy for breast cancer. Methods From February 2018 to February 2022, 64 cases of patients with postoperative subcutaneous effusion after modified radical surgery for breast cancer were selected as the study subjects. Accorded to the principle of random envelope drawing, the patients were divided into the pneumatic pump group of 32 cases and the control group of 32 cases. The control group were treated with conventional methods such as chest band compression bandage, limb function exercise, and the air pump group were treated with air pump therapy machine on the basis of the control group. Both groups were treated and observed for 14 days, and recorded the excellent and good rate of curative effect, subcutaneous fluid accumulation and subcutaneous drainage flow of the two groups, and determine the score of the Disability of Arm Shoulder and Hand (DASH) and quality of life score. Results The excellent efficacy rate of the pneumatic pump group was higher than that in the control group, but there was no difference (P>0.05). The volume of subcutaneous fluid accumulation and subcutaneous drainage volume in the air pump group were significantly lower than those in the control group (P<0.05). The DASH upper limb function score in the air pump group and the control group after treatment were significantly higher than that before treatment (P<0.05), and the DASH upper limb function score in the air pump group after treatment were higher than that in the control group (P<0.05). The life quality scores of physiology, society/family, emotion, function and additional attention in the air pump group after treatment were significantly higher than those in the control group (P<0.05). Conclusion The pneumatic pump therapy can reduce the subcutaneous fluid volume and subcutaneous drainage volume of patients with subcutaneous fluid after modified radical mastectomy for breast cancer, improve the overall treatment effect of patients, and also improve the upper limb function and overall quality of life of patients, with good application effects.
    Analysis of the Effect of Non-invasive Ventilator-assisted Respiration on the Prognosis of Patients with Acute Cerebral Hemorrhage Complicated with Respiratory Failure Type II
    CHEN Guang-mei
    2023, 41(15):  54-58. 
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    Objective To explore the effect of non-invasive ventilator-assisted respiration on the prognosis of patients with acute cerebral hemorrhage and respiratory failure type II. Methods A total of 90 patients with acute intracerebral hemorrhage and respiratory failure type II admitted to Hotan District People's Hospital from February 2020 to January 2023 were selected, and the patients were divided into observation group and control group, with 45 patients in each group. The control group was treated with invasive ventilators on the basis of routine treatment, and the observation group was treated with non-invasive ventilators on the basis of routine treatment. The clinical treatment effect and respiratory function index changes of the two groups were compared, and the ICU hospitalization time, ventilation time, total hospitalization time, tracheotomy rate, hospital mortality rate and hospital infection rate of the two groups were compared. Results There was no significant difference in the total clinical effective rate between the two groups (P>0.05). PaO2 levels and PaCO2 levels increased after 12 h and 24 h after treatment, but there was no significant difference between PaCO2 and PaO2 levels before, 12 h and 24 h after treatment (P>0.05). There was no significant difference in the tracheotomy rate and mortality rate between the two groups (P>0.05). The length of stay, ventilation time, total length of stay and infection rate of patients in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Both non-invasive and invasive ventilator-assisted breathing can improve the treatment effect of respiratory failure and improve the respiratory function index of patients with acute cerebral hemorrhage complicated with respiratory failure type II, but non-invasive ventilator-assisted breathing can improve the prognosis of patients, reduce the time of hospitalization and ventilation, and reduce the incidence of nosocomial infection.
    Research on the Origin of TCM and Modern Mechanism Research on the Basis of Prescription of Fetal Chrysanthemum Wolfberry Tea
    YU Qing-qian, WU Feng-zhi, LI Ru-ting, WU Fang-zhu, ZHENG Yu-jun, LI Feng
    2023, 41(15):  70-75. 
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    Physical fatigue is a feeling of bodily lassitude, lack of strength, or general exhaustion, which may be accompanied by a decline in physical activity. There are many relevant expositions on physical fatigue in ancient books of traditional Chinese medicine, most of which believe that it is closely related to the liver, kidney, lung, and spleen.There are mainly four theories about the mechanism of physical fatigue in modern medicine, namely the theory of energy failure, the theory of blockage, the theory of protection and inhibition, and the theory of free radicals. Based on ancient TCM literature and modern theoretical understanding of pathophysiology, relevant research was conducted to explore the efficacy of the monarch, minister, adjuvant, and shi drugs in fetal chrysanthemum and wolfberry tea and the basis for their prescriptions. Fetal chrysanthemum wolfberry tea can not only embody the basic theory of traditional Chinese medicine and the experience of doctors of past dynasties, but also embody the research results of modern pharmacology. Fetal chrysanthemum wolfberry tea is in line with the essence of syndrome differentiation in traditional Chinese medicine, and the prescriptions are based on sufficient basis, which is worthy of further study.
    Effect of Transcutaneous Nerve Stimulation Combined with Thoracic Paravertebral Nerve Block on Pain and Sleep Quality after Thoracoscopic Radical Resection of Lung Cancer
    CUI Yu-pei, FENG Xiu-mei, LIU Jing
    2023, 41(15):  174-177. 
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    Objective To investigate the effect of transcutaneous nerve stimulation combined with thoracic paravertebral nerve block on pain and sleep quality after thoracoscopic radical resection of lung cancer. Methods From January 2020 to June 2022, 120 patients with thoracoscopic radical resection of lung cancer were randomly divided into two groups, 60 patients in each group. The control group was treated with thoracic paravertebral nerve block, and the experimental group was treated with transcutaneous nerve stimulation combined with thoracic paravertebral nerve block. NRS was used to evaluate the rest and active pain after operation in the two groups, and the occurrence of postoperative relief analgesia was recorded. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality on the 1st, 2nd and 3rd day after operation. Results The NRS score of resting pain at 24 h and 48 h after operation in the experimental group was significantly lower than that in the control group (P<0.05), while the NRS score of resting pain at 4 h, 8 h, 12 h and 72 h after operation in the two groups was not statistically significant (P>0.05). The NRS score of active pain in the two groups at 4 h, 8 h, 12 h, 24 h and 48 h after operation was not statistically significant (P>0.05). The NRS score of active pain in the experimental group at 72 h after operation was significantly lower than that in the control group (P<0.05). The rescue analgesia rate in the experimental group was significantly lower than that in the control group (P<0.05), and there was no significant difference in the rescue analgesia rate between the two groups on the first and third day after operation (P>0.05). The PSQI scores of the experimental group on the 1st and 2nd day after operation were significantly lower than those of the control group (P<0.05), and there was no statistically significant difference between the two groups on the 3rd day after operation (P>0.05). Conclusion Compared with simple thoracic paravertebral nerve block, combined with percutaneous nerve electrical stimulation has limited improvement on active pain, but it can effectively relieve resting pain, reduce relief pain, and reduce PSQI score.