Table of Content

01 September 2023, Volume 41 Issue 17

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Comparison of Short Curative Effects of Arthroscopic Suture and Partial Meniscectomy in the Treatment of Chronic Ⅲ Degree Meniscus Injury

QIU Fu-ping, XU Shi-gang, ZHANG Lei, WANG Bin

2023, 41(17):  1-4. 

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Objective To investigate the short-term efficacy of arthroscopic suture and partial meniscectomy in the treatment of chronic Ⅲ degree meniscus injury. Methods A retrospective analysis was performed on 67 patients with chronic knee meniscus Ⅲ degree injury admitted to the Nanjing Jiangbei Hospital from June 2019 to June 2021, who were divided into suture group (n=30) and partial meniscectomy group (n=37) according to different treatment ways, and the suture group was treated with arthroscopic meniscus suture, and the partial meniscectomy group was treated with arthroscopic partial resection of the knee meniscus. The Lysholm score, IKDC score, and VAS score of the two groups were recorded before operation and at 1 month, 3 months, 6 months after operation and last follow-up, and the excellent and good rate of knee joint function at last follow-up of the two groups was evaluated. Results All patients received at least 6 months, with an average of (13.51±4.32) months. At 1 month, 3 months, 6 months and the last follow-up, the Lysholm scores of the suture group were better than those of the partial resection group, and IKDC scores were better than partial nephrectomy group, all the differences were statistically significant (P<0.05). At 1 month and 3 months after operation, VAS scores in the suture group were lower than those in the partial resection group, all the differences were statistically significant (P<0.05). There were no significant difference in VAS score between the two groups at 6 months after operation or at the last follow-up (P>0.05). At the last follow-up, the Lysholm scores of the two groups were better than those before operation and IKDC scores were better than those of preoperative, and VAS scores were better than those of preoperative, all the differences were statistically significant (P<0.05). At the last follow-up, the excellent and good rate of the suture group was higher than that of the Partial meniscectomy group, but the difference was not statistically significant (P>0.05). Conclusion Both arthroscopic meniscus suture and partial meniscectomy can effectively treat chronic Ⅲ degree meniscus injury of the knee joint, and the short-term clinical effect were better after meniscus suture.

Application of Various Quality Management Tools in Imaging Examination, Diagnosis, Treatment and Nursing Services

CUI Yuan

2023, 41(17):  4-5. 

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Objective To study the application of various quality management tools in improving imaging examination services. Methods From June 2021 to June 2022, 82 professional and technical personnel in the imaging department of our hospital were selected as the study subjects, including 43 in the radiology department, who were administered with various quality management tools as the observation group, and 39 in other departments, who were administered with common personnel management mode as the control group. After half a year of management, the nursing management quality score, nursing satisfaction and nursing complaint rate of the two groups were compared. Results There was no difference in management quality scores between the observation group and the control group before intervention, but after management, the scores in the observation group were significantly higher than those in the control group (P<0.05). The scores of both the observation group and the control group after management were higher than those before management (P<0.05). The nursing complaint rate of the two groups was significantly lower in the observation group than in the control group, and the nursing satisfaction in the observation group was significantly higher than that in the control group (P<0.05). Conclusion The application of various quality management tools in improving the management of imaging examination appointment service has achieved good results and is worthy of promotion.

Application of SOFA Score in Assessing the Incidence of Multiple Organ Failure in Intensive Care Unit

LONG Xun-hui

2023, 41(17):  8-11. 

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Objective To explore the application effect of sequential organ failure (SOFA) score in assessing the incidence of multiple organ failure in intensive care unit. Methods A total of 50 patients with multiple organ failure admitted to the intensive care unit of our hospital from January 2021 to January 2023 were selected as the study subjects, and divided into the observation group, and 50 patients who were treated in the intensive care unit at the same time were selected as the control group. The SOFA scores of the two groups were compared, and the diagnostic efficacy of SOFA scores on multiple organ failure was analyzed. All patients were followed up in the hospital, 21 patients who died 28 days in the hospital were divided into death group, and the remaining 29 patients were divided into survival group. The general clinical conditions of the two groups were compared, and the prognostic value of SOFA score for multiple organ failure in intensive care unit was analyzed. Results The SOFA score of patients in the control group was lower than that in the observation group (P<0.05). By drawing the ROC curve, the results showed that the area under the curve of SOFA score diagnosis of multiple organ failure was 0.832, the specificity was 91.47%, the sensitivity was 73.59%, and the area under the curve of clinical comprehensive diagnosis was 0.891, the specificity was 98.52%, the sensitivity was 90.26%. There was no significant difference between the survival group and the death group in terms of sex, BMI, basic disease, and time of admission to ICU (P>0.05), but there was significant difference between the survival group and the death group in terms of age, APACHE II score, and SOFA score (P<0.05). The results of logistic regression analysis showed that SOFA score was an independent predictor of multiple organ failure (P<0.05). Conclusion SOFA score can effectively evaluate the occurrence of multiple organ failure in intensive care unit with high sensitivity and specificity. Meanwhile, SOFA score can also help predict the prognosis of multiple organ failure in intensive care unit. Clinically, patients with high SOFA scores need to improve the treatment plan in time to prevent the occurrence of poor prognosis.

Clinical Observation on the Treatment of Stroke Related Pneumonia (Phlegm Dampness Accumulated in the Lung Type) Based on Acupuncture Combined with Fuling Decoction

WU Chang-zheng, LIU Jing, WANG Li, ZHU Xuan-xuan, MA Li-jing

2023, 41(17):  11-14. 

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Objective To explore the effect of acupuncture combined with Fuling Decoction on the severity of the disease, serum inflammatory factors and complications of stroke associated pneumonia (phlegm dampness accumulated in the lung type), and summarize a superior scheme of integrating traditional Chinese and Western medicine. Methods A total of 60 patients with post-stroke pneumonia of phlegm dampness accumulation type were divided into observation group and control group according to the order of admission time, with 30 cases in each group. The control group was treated with general routine treatment and Fuling Decoction, while the observation group was treated with acupuncture on the basis of general routine treatment. The severity of pneumonia, serum inflammatory factors, clinical efficacy and complications were compared between the two groups. Results Before treatment, there was no significant difference in the severity of pneumonia and serum inflammatory factors between the two groups (P>0.05). After treatment, the severity of pneumonia and serum inflammatory factors in the observation group were lower than those in the control group (P<0.05); the total effective rate of the observation group was higher than that of the control group (P<0.05); the incidence of antibiotic related diarrhea in the observation group was lower than that in the control group, but there was no significant difference between the two groups (P>0.05). Conclusion Acupuncture combined with Fuling Decoction can reduce the severity of stroke associated pneumonia (phlegm dampness accumulation in the lung type), reduce the serum inflammatory factor index and improve the clinical efficacy, and also reduce the incidence of antibiotic related diarrhea.

Effect of Apatinib Combined with Tizio on Clinical Efficacy and Serum VEGF and ESM-1 in Patients with Advanced Gastric Cancer

DING Mingcui, MU Ling

2023, 41(17):  15-18. 

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Objective To explore the clinical efficacy of Apatinib combined with Tizio in patients with advanced gastric cancer and the effects of serum vascular endothelial growth factor (VEGF) and endothelial cell specific molecule-1 (ESM-1). Methods The clinical data of 50 patients with advanced gastric cancer admitted to our hospital from January 2017 to June 2022 were retrospectively analyzed, and they were divided into control group (25 cases) and study group (25 cases) according to different chemotherapy regimen. The control group was treated with Tiggio, and the study group was treated with Apatinib combined with Tiggio for two courses. The clinical efficacy of the two groups was observed, and the levels of serum tumor markers [regenerative gene protein Ⅳ (REGⅣ), response factor (SRF) and matrix metalloproteinase-2 (MMP-2)], VEGF and ESM-1 in the two groups were compared before and after treatment, and safety assessment was carried out. Results The Objective remission rate of the study group was higher than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the serum REG, SRF and MMP-2 levels in two groups were decreased compared with before treatment, and the research group was lower than the control group, the difference was statistically significant (P<0.05). After treatment, the serum VEGF and ESM-1 levels in two groups were decreased compared with before treatment, and the levels in the study group were lower than those in the control group, the difference was statistically significant (P<0.05). There was no significant difference in the incidence of bone marrow transplantation, nausea and vomiting, alopecia, diarrhea and abnormal liver and kidney function between two groups (P>0.05). Conclusion Combined treatment with Apatinib and Tizio has a definite effect in patients with advanced gastric cancer, which can better down-regulate the expression of serum tumor markers, regulate the levels of serum VEGF and ESM-1, and does not increase the incidence of adverse reactions. It is safe and worthy of promotion.

Effect of Modified Yihuang Decoction Combined with Acupoint Application on HPV Negative Transformation and Inflammatory Reaction in Patients with HPV Positive Chronic Cervicitis

GUO Wei, YANG Yan, WANG Ying

2023, 41(17):  32-35. 

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Objective To explore the application value of modified Yihuang Decoction combined with acupoint application in patients with HPV positive chronic cervicitis (CCS). Methods The clinical data of 74 patients with HPV-positive CCS admitted to Donggang District Maternal and Child Health Hospital of Rizhao City from September 2021 to September 2022 were analyzed retrospectively. They were divided into groups according to different treatment methods, among which 37 patients who received routine treatment were the control group, and 37 patients who received modified Yihuang Decoction combined acupoint application treatment were the observation group. Both groups were treated for 4 weeks. Compare and analyze the negative conversion of HPV, inflammatory reaction, immune function, TCM syndrome score and adverse reactions between the two groups. Results The negative rate of HPV in the observation group was higher than that in the control group, and the difference was statistically significant (P<0.05), After treatment, in the observation group, hypersensitive C-reactive protein (hs-CRP), interleukin (IL)-10, IL-6, IL-2, tumor necrosis factor-α(TNF-α) and the scores of excessive underband volume, abnormal underband color, low back pain and bloating, bitter mouth and dry throat, and frequent urination pain were lower than those of the control group, and the scores of CD4⁺, CD8⁺, CD4⁺/CD8⁺were higher than those of the control group, with statistically significant differences (P<0.05); There were no adverse reactions in both groups. Conclusion Modified Yihuang Decoction combined with acupoint application can promote HPV negative in HPV-positive CCS patients, reduce inflammatory reaction, improve immunity, and accelerate symptom recovery, with high safety.

Progress of Research on the Mechanism of Fire Needles in the Treatment of Postherpetic Neuralgia

WANG Lan, CHEN Ying-ying, DENG Ai-mei, LI Shi-hua, WANG Wei, ZHANG Ying

2023, 41(17):  51-54. 

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Postherpetic neuralgia is a common and difficult-to-treat neuropathic pain, and its treatment is often hampered by various factors. Through a systematic literature review, the mechanism of action of fire needles in the treatment of postherpetic neuralgia is summarized and analyzed, to provide some guidance for clinical treatment plans. The analysis revealed that fire acupuncture can play a positive role in postherpetic neuralgia by interfering with pain information transmission, improving pain threshold, regulating immune and inflammatory responses, etc. At the same time, fire acupuncture therapy has obvious advantages in relieving pain, improving the quality of survival, improving patients' sleep, and regulating emotions.

Meta-Analysis of Associations between Polymorphisms of SLC6A11 Genes and Drug-Resistant Epilepsy

ZHAO Ming-yang, HU Xue-mei, WANG Dong-sen, WU Qing-jian

2023, 41(17):  55-60. 

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Objective To investigate the association between rs2272394, rs2272395 and rs2272400 polymorphisms of SLC6A11 gene and drug-resistant epilepsy. Methods Formulate a literature search plan, and search the Chinese and foreign literature related toSLC6A11 gene polymorphisms. PubMed, Embase, Cochrane Library, Web of Science, China []National Knowledge Infrastructure, Wan-fang Data Knowledge Service Platform, and China Science and Technology Journal Database were searched for relevant studies. The two people jointly screened the literature, extracted the data and cross-checked, and after evaluating the quality of the included literature, the literature that met the criteria was included. Meta-analysis of the literature using R4.2.1 software was performed and a genetic model was used for analysis. ResultNine studies from four studies were included, with a total of 1 172 cases in the drug-resistant group and 1 340 cases in the drug-responsive group. For alleles C and T, OR=0.89, 95%CI= 0.79~1.01 were obtained by fixed effect model. After excluding one marginal study, the results showed that OR=0.93, 95%CI= 0.82~1.06; the OR=0.79, 95%CI=0.67~0.92 of the recessive gene model CC/TC+TT; the OR of dominant gene model TT/TC+CC was 0.99, and 95%CI=0.80~1.23; the OR=0.86, 95%CI=0.63~1.16 of the additive gene model CC/TT; the OR=0.83 of the over-dominant gene model TT+CC/TC, and 95%CI=0.72~0.97. Conclusion There is currently no clear evidence that rs2272394, rs2272395 and rs2272400 polymorphisms of SLC6A11 gene are associated with drug-resistant epilepsy.

Analysis of Barriers to the Use of Evidence for Prevention and Intervention of Refeeding Syndrome in Critically Ill Patients Based on the I-PARIHS Framework

FENG Ya-ting, ZHU Jun, QIU Chang-cui, CHEN Shu-juan

2023, 41(17):  70-73. 

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Objective To understand the problems existing in the prevention of refeeding syndrome in critically ill patients and the application of intervention evidence, and to provide the basis for the formulation of corresponding action strategies. Methods Objective sampling method was adopted to conduct semi-structured interviews with doctors and nurses in intensive care units of a Grade-III Class A public hospital in Shanghai from October to December 2022. The interview data were sorted out, analyzed and extracted according to the Action Facilitation Framework for the application of research results in the field of health services (i-PARIHS framework). Results The interview content was summarized into three themes, included evidence of change: evidence application and environment did not match well; evidence application implementation is a dynamic process; change recipients: the knowledge reserve of practitioners needs to be improved, and the compliance of severe patients is poor; organizational environment: the workload increases in the early stage of reform, and it is urgent to improve the information system; lack of prescriptive documentation requiring changes in routine care practices. Conclusion Project implementation when carrying out the evidence application project, the evidence should be adjusted according to the suggestions of stakeholders, pay attention to the dynamic adjustment of treatment and nursing measures in the implementation process, timely update the evidence and actively carry out relevant training, do a good job of publicity and education to improve the compliance of critically ill patients, improve the information system for patient management, so as to ensure the continuity of evidence application.