Table of Content

01 June 2024, Volume 42 Issue 11

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Clinical Efficacy Observation of Sodium Diclofenac Capsules Combined with Exercise Rehabilitation in the Treatment of Primary Frozen Shoulder During the Acute Phase

MU Xin, LU Sheng-bo, CHANG Jia-hao, LI Wei

2024, 42(11):  1-4. 

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Objective To explore and analyze the clinical effects of oral administration of Diclofenac Sodium Capsules combined with exercise rehabilitation in the acute phase of primary frozen shoulder. Methods A total of 52 patients with acute frozen shoulder who visited the Department of Sports Medicine at Peking University Shenzhen Hospital from June 2022 to December 2023 were selected as the study subjects. All patients received treatment with Diclofe nac Sodium Dual Release Enteric-coated Capsules combined with exercise rehabilitation. The American Shoulder and Elbow Surgeons Scale（ASES）scores and The Vsual Analog Scale (VAS) scores for pain and shoulder joint range of motion were compared between patients before and one month after treatment, and the treatment effectiveness and patient satisfaction were evaluated. Results There was a significant improvement in the range of motion, ASES scores and VAS scores of all patients after one month of treatment compared to before treatment (P<0.05). The treatment effectiveness rate was 94.23%, and the patient satisfaction score was (7.88±1.43)points. Conclusion The combination of oral administration of Diclofenac Sodium Dual Release Enteric-coated Capsules and exercise rehabilitation in the acute phase of primary frozen shoulder significantly alleviates pain and improves range of motion in patients. The treatment has a high effectiveness rate and patient satisfaction, suggesting that it is worthy of further promotion.

Mendelian Randomization Study on the Correlation between Genetic Prediction Frailty Index and Stroke

LIU Jia, LIU Hong-min, GUI Yuan-yuan, YIN Lei, JIA Jing-jing

2024, 42(11):  4-9. 

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Objective To analyze the correlation between genetic prediction of frailty index (FI) and stroke using Mendelian randomization method (MR). Methods Instrumental variables (IVs) associated with flimsy index (FI) were obtained from a large genome-wide association study (GWAS). Inverse variance weighting was used to estimate the causal effect, and multi-factor MR Analysis was used to eliminate the effects of body mass index (BMI), inflammatory bowel disease, and C-reactive protein on outcomes to evaluate the independent causal effect of FI and stroke. Results MR Results showed an association between genetically predicted FI and a higher risk of any stroke(OR = 1.360, 95%CI: 1.006-1.838, P = 0.046). For stroke subtypes, gene-predicted FI was associated with a higher risk of large atherosclerotic stroke(LAS, OR = 2.482, 95%CI: 1.279-4.816, P = 0.007). There was no causal relationship between genetically predicted FI and ischemic stroke, intracranial hemorrhage, cardiac embolic stroke, and small artery stroke. Multivariate MR Analysis showed that after adjusting for IBD, the association between genetically predicted FI and large atherosclerotic stroke(LAS) was weakened(P = 0.114). Conclusion MR Studies show that gene predicted FI is closely related to stroke. Subgroup analysis showed that gene predicted FI was correlated with LAS, but not with IS, CES, SAS, and ICH.

A Real World Study on the Integrated Management Scheme of Rehabilitation Graded Medical Treatment in Urban Medical Group

LI Shuo, QIAN Qing-wen, LU Yun, LI Jing-yu, PENG Si-jing

2024, 42(11):  9-12. 

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Objective To explore the role of integrated medical management scheme in promoting graded diagnosis and treatment of rehabilitation in the real world, taking urban medical group as the research object. Methods A cohort study was conducted with the rehabilitation center of Tongmei Medical Group as the research object. 120 patients who implemented the medical integration program from March 1, 2023 to August 31, 2023 were selected as the experimental group, and 120 patients who did not implement the program from March 1, 2022 to August 31, 2022 were selected as the control group, and relevant indicator data (referral rate, referral rate, referral rate) were collected. Hospitalization cost, average length of stay, 30-day rehabilitation score, cost consumption index, time consumption index, case-mix index (CMI), SPSS 22.0 statistical software was used for data analysis to evaluate the effect of the scheme. Results The scheme could improve the referral rate, CMI value, reduce the average length of stay, cost consumption index and time consumption index to some extent, hospitalization cost (P<0.05). Conclusion The integrated medical management scheme can assist the graded diagnosis and treatment in the rehabilitation center of urban medical group, and play a role in improving quality and efficiency. To a certain extent, it helps the development of graded diagnosis and treatment of rehabilitation.

Correlation Analysis of Iron Saturation, Transferrin and Peptic Ulcer Complicated with Malnutrition

ZHAO Li-ying

2024, 42(11):  13-16. 

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Objective To investigate the correlation between iron saturation, transferrin and peptic ulcer complicated with malnutrition. Methods A total of 80 patients with peptic ulcer complicated with malnutrition in our hospital from August 2020 to July 2023 were selected as the research object and divided into the observation group, and 80 patients with peptic ulcer without malnutrition in our hospital in the same period were selected as the control group. The general clinical data, iron saturation and transferrin expression levels of the two groups were compared, Logistic regression analysis was used to analyze the independent influencing factors of peptic ulcer complicated with malnutrition. Subsequently, 80 patients with peptic ulcer complicated with malnutrition were divided into three subgroups according to body mass index (BMI), namely, BMI<16 kg/m² was severe malnutrition group (n=12), BMI 16~16.9 BMI<16 kg/m² was moderate malnutrition group (n=28), BMI 17~18.4 kg/m² was mild malnutrition group (n=40). The iron saturation and transferrin expression levels of the three groups were compared, and Spearman correlation analysis method was used to analyze the iron saturation, transferrin expression level, and the iron saturation, transferrin expression level of the three groups The correlation between transferrin and the severity of peptic ulcer complicated with malnutrition. Results There were no significant differences in gender, duration of peptic ulcer, HP test results and alcohol consumption between the observation group and the control group (P>0.05). There were significant differences in age, maximum ulcer diameter, BMI, ulcer location, iron saturation and transferrin levels between the two groups (P<0.05); Logistic regression analysis showed that age, BMI, increased iron saturation and decreased transferrin were independent risk factors for peptic ulcer complicated with malnutrition (P<0.05); There were significant differences in iron saturation and transferrin expression among the three groups, and iron saturation in severe malnutrition group was higher than that in moderate malnutrition group and mild malnutrition group, while transferrin was lower than that in moderate malnutrition group and mild malnutrition group (P<0.05). Spearman correlation analysis showed that iron saturation was positively correlated with the severity of peptic ulcer complicated with malnutrition (P<0.05). Transferrin was negatively correlated with the severity of peptic ulcer complicated with malnutrition (P<0.05). Conclusion The increase of iron saturation and the decrease of transferrin are the independent influencing factors of peptic ulcer complicated with malnutrition, and have obvious correlation with the severity of malnutrition. Therefore, the clinical patients with peptic ulcer with increased iron saturation and decreased transferrin should be alert to the occurrence of malnutrition and take nutritional supplement measures in time.

Effect of Huayu Qingsan Decoction Combined Internal and External Therapy on Non proliferative Type 2 Diabetic retinopathy

LI Xiao-yan, CHEN Wan-fen, OU Shao-chang

2024, 42(11):  16-19. 

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Objective To explore the effect of Huayu Qingsan Decoction in combination with internal and external therapy on non proliferative type 2 Diabetic retinopathy. Methods A total of 80 patients with nonproliferative type 2 Diabetic retinopathy admitted to our hospital from January 2023 to July 2023 were selected as the study subjects. All patients were divided into an observation group and a control group by lot drawing, with 40 cases in each group. The control group was treated with simple basic Sex therapy, and the observation group was treated with Huayu Qingsan Decoction combined with internal and external treatment on the basis of the control group. The changes of TCM syndrome integral, fundus examination related indicators and central retinal artery blood flow parameters before and after treatment were compared between the two groups. Results There was no significant differencein the scores of traditional Chinese medicine syndromes related to visual acuity, thirst, irritability, sleep, appetite, defecation, urination, tongue condition, and pulse condition between the two groups of patients before treatment (P>0.05) . After treatment, the scores of traditional Chinese medicine syndromes related to visual acuity, thirst, irritability, sleep, appetite, defecation, urination, tongue condition, and pulse condition decreased in both groups of patients, with the observation group being lower than the control group (P<0.05). There was no significant difference in retinal CNP area, retinal MCT, retinal VT area, number of microvascular tumors, and CMT between the two groups before treatment (P>0.05). After treatment, the retinal CNP area, retinal MCT, retinal VT area, number of microvascular tumors, and CMT of the two groups of patients decreased, and the observation group was lower than the control group (P<0.05). There was no significant difference in the blood flow parameters of the central retinal artery between the two groups of patients before treatment (P>0.05). After treatment, the RI of the two groups of patients decreased, and the observation group was lower than the control group, while the EDV and PSV increased. The observation group was higher than the control group (P<0.05). Conclusion Huayu Qingsan Decoction is effective in the treatment of non proliferative type 2 Diabetic retinopathy, which can improve the clinical symptoms, the degree of fundus disease and retinal hemodynamics.

Effect of Gutongling Tincture on Serum 5-HT and β-EP Level in the Lumbar Disc Herniation Patients

ZHANG Hui-hui, LI Bo

2024, 42(11):  26-29. 

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Objective To explore and analysis the effects of Gutongling tincture on serum 5-hydroxytryptamine (5-HT) and β-Endorphins(β-EP) leveles in the Lumbar disc herniation patients. Methods From April 2019 to January 2023, 120 cases of patients with lumbar disc herniation diagnosed and treated in Xinjiang Production and Construction Corps Hospital, Chengbei Branch were selected as the study subjects, and the 120 patients were divided into the Gutongling tincture group of 60 cases and the control group of 60 cases accorded to the 1:1 random drawing method. The control group were treated with conventional drugs, while the Gutongling tincture group were treated with Gutongling tincture on the basis of the control group's treatment. Continuous treatment observation were conducted for eight weeks in the two groups, and serum 5-HT and β-EP levels were detected in both groups of patients, observed the clinical efficacy, the changes of range of lumbar flexion and pain MPQ score. Results After eight weeks of treatment, the excellent and good efficacy rate of the Gutongling tincture group were significantly higher than the control group (P<0.05). The pain MPQ scores of both groups after eight weeks of treatment were significantly lower than before treatment (P<0.05), while the pain MPQ scores of the Gutongling tincture group after eight weeks of treatment were significantly lower than those of the control group (P<0.05). After eight weeks of treatment, the range of lumbar flexion in both groups were significantly higher than before treatment (P<0.05), and the range of lumbar flexion in the Gutongling tincture group were significantly higher than that in the control group after eight weeks of treatment (P<0.05). The serum 5-HT and β-EP levels after eight weeks of treatment in two groups were lower than that before treatment (P<0.05), and the serum 5-HT and β-EP levels in the Gutongling tincture group were also decreased significantly compared with the control group (P<0.05). Conclusion The application of Gutongling tincture in patients with lumbar disc herniation can inhibit serum expression of 5-HT and β-EP, it can promote pain relief, improve the overall therapeutic effect of patients, and also improve the range of lumbar flexion of patients.

Analysis of the Therapeutic Effect of Tongxinluo Capsule on Elderly Patients with Coronary Heart Disease and Angina Pectoris

LIU Chun-ting

2024, 42(11):  30-33. 

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Objective To explore and analyze the effectiveness of Tongxinluo capsules in treating elderly patients with coronary heart disease and angina pectoris. Methods From May 2021 to May 2023, 100 elderly patients with coronary heart disease and angina pectoris at the People's Hospital of Inner Mongolia Autonomous Region were selected and divided into an observation group (treated with telmisartan combined with Tongxinluo capsules) based on different treatment methods; The control group (treated with telmisartan alone), with 50 cases each. Comparative analysis of cardiac function indicators, quality of life, incidence of angina pectoris, thioredoxin interaction protein (TXNIP), and chemokine CX3C ligand 1(CX3CL1) indicators in patients undergoing 1-month intervention. Results After treatment, the left ventricular ejection fraction in the observation group was higher than that in the control group, while the left ventricular end systolic diameter, left ventricular end diastolic diameter, and left atrial diameter were lower (P<0.05); The social, environmental, physical, and psychological factors in the observation group were higher than those in the control group (P<0.05); The frequency of angina attacks in the observation group was lower than that in the control group, and the duration of angina was shorter, with a statistically significant difference (P<0.05); The levels of CX3CL1 and TXNIP indicators in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). Conclusion The combination of Tongxinluo Capsule intervention for elderly patients with coronary heart disease and angina pectoris can improve the level of cardiac function indicators and the quality of life of patients, shorten the onset time of angina pectoris, and reduce the frequency of episodes.

Effect of Zhengan Xifeng Decoction Combined with Buflomedil on Vertebrobasilar Artery Insufficiency Vertigo

YANG Xi, SUN Wen-yan

2024, 42(11):  33-36. 

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Objective To study the effect of Zhengan Xifeng Decoction combined with buflomedil on vertebrobasilar artery insufficiency vertigo. Methods A total of 84 patients with vertebra basilar insufficiency vertigo from January 2020 to January 2023 in Fugu County Hospital of Traditional Chinese Medicine were selected and divided into two groups by random number table method. Both groups were treated with routine supportive therapy such as sedation, flunarizine and citicoline. On this basis, the intravenous infusion dose of 0.2 g buflomedil was given to the control group once a day. The observation group was combined with Zhengan Xifeng Decoction. Compare the vascular pulsatility index, and average blood flow velocity of the basilar and vertebral arteries between the two groups, evaluate the vertigo disorder questionnaire and vertigo assessment scale scores, and detect blood rheology. Results After treatment, the pulse index of the basilar artery and the vertebral artery in the two groups was significantly decreased (P<0.05), and the mean blood flow velocity was significantly increased (P<0.05). Moreover, the pulse index of the basilar artery and the vertebral artery in the observation group was significantly lower than that in the control group (P<0.05), and the mean blood flow velocity was significantly higher (P<0.05). After treatment, the scores of vertigo disorders questionnaire and vertigo assessment scale in the two groups were significantly lower (P<0.05), and the scores of vertigo disorders questionnaire and vertigo assessment scale in the observation group were significantly lower (P<0.05). After treatment, the reduced whole-blood viscosity, plasma viscosity, hematocrit and whole-blood viscosity of the two groups were significantly reduced (P<0.05), while the reduced whole-blood viscosity, plasma viscosity, hematocrit and whole-blood viscosity of the observation group were significantly lower (P<0.05). Conclusion Zhengan Xifeng Decoction combined with bufldil has satisfactory effect on vertebrobasilar artery insufficiency vertigo, which can significantly increase blood flow velocity, reduce blood viscosity of patients, improve blood circulation disorders and vertigo symptoms of vertebrobasilar artery. It's worth application.

The Effect of Dynamic Hip and Antirotation Intramedullary Nail Fixation on Hip Joint Function in Elderly Patients with Intertrochanteric Fractures of the Femur

XU Hui, ZHANG Yin-gang

2024, 42(11):  43-46. 

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Objective To explore and analysis the effects of dynamic hip and anti rotation intramedullary nail fixation on hip joint function in elderly patients with intertrochanteric fractures of the femur. Methods From August 2019 to December 2022, 97 cases of elderly patients with intertrochanteric fractures of the femur who underwent treatment at Hancheng Jiaoda Hospital were selected as the research subjects. Accorded to the random number table method, the 97 patients were divided into the intramedullary nail group of 49 cases and the control group of 48 cases. The control group were received dynamic hip screw internal fixation surgery, while the intramedullary nail group were received anti rotation intramedullary nail fixation internal fixation surgery.The recovery of hip joint function in both groups was recorded and observed. Results All patients were successfully completed the surgery, and the time of postoperative callus appearance, postoperative fracture healing time, postoperative hospitalization time, surgical time, intraoperative bleeding volume,and first postoperative movement time in the intramedullary nail group were significantly shorter than those in the control group (P<0.05). The incidence of complications such as hip varus, infection, prosthesis loosening, venous thrombosis, and limb shortening 6 months after surgery in the intramedullary nail group was 6.12%, compared to 22.92% in the control group. The incidence of complications in the intramedullary nail group were significantly lower than that in the control group (P<0.05). The Harris score at 6 months after surgery in both groups was significantly higher than that on the 1st day before surgery (P<0.05), and the Harris score at 6 months after surgery in the intramedullary nail group was also significantly higher than that in the control group (P<0.05). The excellent and good rate of hip joint function in the intramedullary nail group at 6 months after surgery was 97.96%, which was significantly improved compared to 83.33% in the control group (P<0.05). Conclusion The treatment of elderly intertrochanteric fractures with proximal femoral interlocking intramedullary nails can promote patient recovery, reduce trauma to patients, reduce the incidence of postoperative complications, and improve the Harris score of hip joint function, thereby improving the overall prognosis and efficacy of patients.

Study on the Correlation between Novel Cytokine Interleukin-38 and Allergic Asthma in Children

ZHANG Rui

2024, 42(11):  46-50. 

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Objective To investigate the relationship and significance of interleukin-38 (IL-38), a new cytokine,with allergic asthma in children. Methods Sixty paediatric allergic asthma patients who attended the paediatric department of Friendship Hospital of Urumqi from January 2018 to December 2022 were selected. At the same time,30 healthy children were selected as the healthy control group. Clinical data such as IL-38 level in induced sputum,exhaled nitric oxide (FeNO),lung function and childhood asthma control test (C-ACT) were collected. Results Compared with the healthy control group and the clinical remission group,the level of IL-38 in induced sputum of the acute attack group was significantly lower(P<0.05). Correlation analysis showed that in the acute exacerbation group, the level of IL-38 in induced sputum was negatively correlated with FeNO (P<0.05), but had no correlation with eosinophils,IgE,lung function, C-ACT score and other indicators(P>0.05). In the clinical remission group and healthy control group,there was no correlation between induced sputum IL-38 level and each index(P>0.05). Multivariate logistic regression analysis showed that the score of Children's Asthma Control Test(C-ACT) was an independent influencing factor for the acute attack of allergic asthma in children(OR= 5.427,95%CI: 4.926~6.112), while IL-38 was not an independent influencing factor for the acute attack of allergic asthma in children(OR= 1.597,95%CI: 0.758~1.761). Conclusion IL-38 may participate in the process of allergic asthma in children,but it is not an independent factor influencing the acute attack of allergic asthma in children.

The Relationship between Serum Alkaline Phosphatase Expression and Postoperative Healing of Osteoporotic Spinal Fractures in Postmenopausal Women

ZHANG Xi

2024, 42(11):  50-53. 

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Objective To explore and analysis the relationship between serum alkaline phosphatase expression and postoperative healing of osteoporotic spinal fractures in postmenopausal women. Methods The study period were from January 2018 to January 2022, and 76 cases of postmenopausal female patients with osteoporotic spinal fractures who were treated at a certain hospital were selected as the research subjects. The serum alkaline phosphatase expression levels of all patients were detected, and the fracture healing time of the patients were followed up for correlation analysis. Results All patients were completed balloon dilation and kyphoplasty of vertebral body,and there were no serious complications during the perioperative period. Followed up until May 1, 2023,the average fracture healing time of 76 patients were (67.28±1.38) days, with a minimum of 45 days and a maximum of 114 days. There were 16 cases of delayed fracture healing that accounted for 21.05%(delayed healing group). There were no significant difference in gender, body mass index, main site of fracture, and time from fracture to surgery compared between the delayed healing group and the normal healing group (P>0.05), but there were significant difference in bone density, age, diabetes compared between the two groups (P<0.05). There were no significant difference in surgical time and intraoperative bleeding compared between the two groups (P>0.05), while there were significant difference in diabetes and hospitalization time compared between the delayed healing group and the normal healing group (P<0.05). The serum alkaline phosphatase content in the delayed healing group were significantly higher than that in the normal healing group (P<0.05). In the 76 patients, Pearson analysis showed there were correlation between serum alkaline phosphatase content, diabetes, postoperative hospital stay, bone density, age, and fracture healing time (P<0.05). Multiple logistic regression analysis showed that serum alkaline phosphatase content, diabetes, postoperative hospitalization time, bone density,age,and other important factors affected the healing time of postmenopausal women with osteoporotic spinal fractures(P<0.05). Conclusion The incidence of osteoporotic spinal fracture healing in postmenopausal women is relatively high, which is correlated with the patient's serum alkaline phosphatase content,age, bone density,diabetes and postoperative recovery. Serum alkaline phosphatase content is an important factor affecting fracture healing time.

Five Methods for Syndrome Differentiating and Treating Liver Fibrosis Based on the Holism

ZHONG Yun-chang, TAN Hong-tao, ZENG Yuan-gui, LI Guang-zhao, ZHONG Qi-teng

2024, 42(11):  66-70. 

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Professor Zhong Qiteng is a famous TCM doctor in Guangdong Province, who has accumulated rich clinical experience in TCM diagnosis and treatment of various liver diseases. On the basis of summarizing the physiological and pathological understanding of liver disease and the experience in pattern identifying and treating liver disease of doctors from all dynasties, Professor Zhong summed up liver treatment methods based on the holism of TCM, which have been proven effective in clinical practice.Through this project,we plan to explore liver-clearing bile-draining purgative method, liver-clearing dampness-draining spleen-fortifying method, yin-tonifying liver-emolliating blood-activating method, liver-nourishing phlegm-resolving binds-dissipating method, liver-soothing qi-moving menstruation-regulating method, and analyze in detail the application of Professor Zhong Qiteng's liver treatment method based on the holism in liver fibrosis caused by chronic hepatitis B combined with one medical case.

Discussion on the Regularity and Mechanism of Flower Drugs in Treating Acne by Data Mining and Network Pharmacology

ZHAO Yue, LIAO Cheng-cheng, ZHAO Wen-bin, GUO Yuan-yuan, GUO Qing, XIE Bing, CHENG Jie

2024, 42(11):  70-74. 

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Objective To explore the rule of treating acne with flowers and the mechanism of high-frequency flowers by Liu Fuxing School in southern Yunnan. Methods Collect outpatient medical records and analyze the tropism of sex and taste, category efficacy and association rules; Screening high-frequency flowers and acne targets, and taking intersection genes; Traditional Chinese medicine-component-target network and PPI network were constructed, and GO and KEGG analysis were carried out to visualize the molecular docking results. Results Heat-clearing drugs were the main drugs, with 11 core drugs. High-frequency flower drugs are honeysuckle, chrysanthemum indicum, safflower and rose, which have 6 core components and 7 core targets, involving cancer, lipid, endocrine and other pathways, and have good molecular docking and binding ability. Conclusion Liu Fuxing School in southern Yunnan pays attention to the middle and upper energizer, harmonizing qi and blood, taking clearing away heat as the main method and five-flavored disinfectant as the basic prescription, and strives for both attack and tonic, balancing cold and heat, and nourishing yin and yang. Flower drugs may act on acne targets through MAPK pathway, immune-inflammatory reaction, lipid and endocrine, among which stigmasterol and β-sitosterol may be the main components.

Survey on the Cognitive Characteristics of Humanistic Care of Grass Roots General Practitioners in Jiangsu Province and the Construction of Related Scales

ZHOU Yang, LING Ting-ting, SHI Wei-hong

2024, 42(11):  78-82. 

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Objective To investigate the cognitive characteristics of humanistic care of primary general practitioners in Jiangsu Province. Methods The general practitioners of primary medical and health service institutions in Jiangsu Province were randomly selected as the research objects. Questionnaire survey and data analysis were conducted. Delphi expert consultation method was used to determine the final evaluation items of the questionnaire. Results Professional title, working years, employment form and monthly income were the key factors influencing the cognition of the importance of humanistic care. 154 people (89.0%) thought that humanistic care was "caring for life and fearing life", 149 people (86.1%) thought that humanistic care was "providing warm and thoughtful service", but only 69 people (39.9%) said that they could always maintain a warm attitude towards patients in the process of daily diagnosis and treatment. 156 (90.2%) thought that "follow-up work after discharge" was an important part of the medical process, and 106 (61.3%) thought that "consultation work for patients after discharge" should be done well. General practitioners' understanding of humanistic care quality mainly focused on "good communication skills", "strong professional ability", "strong humanistic feelings", "noble professional ethics" and "persistent scientific research ability". After two rounds of Delphi expert consultation, a total of 24 items were formed, including five dimensions of "dedication", "sincerity", "Empathy", "trust" and "patience". Conclusion Based on the Delphi method, the questionnaire of humanistic care quality of general practitioners was constructed, which can provide reference for the effective evaluation of humanistic quality of general practitioners.

Surveillance Results of Drinking Water Type Eendemic Fluorosis in Minqin County and Investigation and Analysis of Skeletal Fluorosis

WANG Bing-yi, LIU Wei-guo, REN Jie, BAI Sheng-cun, MA Zhong-rui

2024, 42(11):  88-91. 

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Objective To analyze the monitoring results of drinking water type endemic fluorosis in Minqin County and the investigation results of skeletal fluorosis. Methods From 2019 to 2022, a simple random sampling method was used to select Wanghua Village in Hongshaliang, Zhixiang Village in Xiqu, and Tiaoyuan Village in Donghu as fixed monitoring villages. Collect one deep well water sample from each monitoring village in five directions: east, west, south, north, and central, to determine water fluoride. According to the Hygienic Standard for Drinking Water (GB5749-2006), determine the excessive fluoride in water, and use the Diagnostic Standard for Endemic Skeletal fluorosis (WS192) to check and determine the occurrence of skeletal fluorosis. Analyze the monitoring results of water fluoride in drinking water endemic fluorosis areas in Minqin County from 2019 to 2022, the operation of water improvement projects in improved villages, the prevalence of skeletal fluorosis, and the age and gender distribution of skeletal fluorosis. Results From 2019 to 2022, the water fluoride levels in all three administrative villages were lower than 1.0mg/L, and there was no statistically significant difference in water fluoride levels between different years in the same administrative village (P>0.05). In the three administrative villages sampled and surveyed, all had completed water improvement in 2019, accounting for 100%, and the water improvement projects were all operating normally. A total of 1 663 people were investigated in three villages, of which the detection rate of clinical skeletal fluorosis was 2.47% (41/1663), among them, 14 were mild (34.15%), 19 were moderate (46.34%), and 8 were severe (19.51%). There was no statistical significance in the detection rate of different administrative villages (P>0.05). Among the 1 663 people surveyed, the number of male patients accounted for 1.21%, and the number of female patients accounted for 1.26%. There was no statistical significance between male and female in skeletal fluorosis (P>0.05). In different ages, the incidence rate of skeletal fluorosis was the highest among 50-60 people, which were 60-70 years old and 70-80 years old respectively, but there was no statistical significance between the groups (P>0.05). Conclusion The water improvement project has significantly improved the drinking water fluoride exceeding the standard in the drinking water endemic fluorosis area in Minqin County. The incidence of skeletal fluorosis is 2.47%, and there is no difference in the incidence rate among different gender and age groups.

The Effect of Continuous Care Based on IMB Model on the Quality of Life and Self-Efficacy in Patients with Pancreatitis During Convalescence

SUN Mei-hui, REN Li

2024, 42(11):  99-102. 

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Objective To investigate the effect of continuous care based on IMB model( also called information- motivation- behavior model) during convalescence on the quality of life and self-efficacy in patients with pancreatitis. Methods 98 patients with acute pancreatitis received by the 2nd Department of Gastroenterology from June 2021 to June 2023 were enrolled as the objects. According to the single and double numbers at admission, they were arranged in control group (49 cases) and observation group (49 cases) respectively. Patients in the control group were offered routine care for acute pancreatitis, and the observation group received continuation care based on the IMB model. Quality of life, self-efficacy, and satisfaction were evaluated separately. Results Before intervention, the scores of quality of life and self-efficacy from the both groups were not significantly different, but significantly different with the scores from both groups improved after intervention( P<0.05). The differences of satisfaction scores between the two groups were significant after intervention( P<0.05). Conclusion Continuation care based on IMB model can improve patient quality of life and improve patient self-efficacy, and then significantly improve patient satisfaction.

Effects of Team Resource Management Combined with Health Education on Vaccination Coverage Rate and Vaccination Awareness Rate of School-age Children

ZHAO Li

2024, 42(11):  149-152. 

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Objective To explore the effect of team resource management combined with health education on vaccination coverage rate and vaccination awareness rate of school-age children. Methods A total of 96 children of appropriate age who were vaccinated from January 2020 to December 2022 were selected as the study subjects. The study method was retrospective study. The subjects were divided into 48 groups according to different intervention schemes. The control group received routine health guidance, while the research group jointly carried out team resource management and health education. The intervention effect of the two groups was evaluated after the intervention. Results After intervention, the scores of all dimensions of PACV scale of parents in the two groups were significantly higher than before intervention, and the scores in the study group were more significantly higher than those in the control group,statistically significant difference (P<0.05); After intervention, the awareness rate of parents of children in the two groups was significantly higher than before intervention, and the increase was more obvious in the study group compared with the control group, statistically significant difference (P<0.05);In terms of vaccination compliance, the study group was higher than the control group, respectively, and the difference between groups was significant (P<0.05); The incidence of adverse reactions in the study group was lower than that in the control group, statistically significant difference (P<0.05); The rate of timely vaccination in the study group was higher than that in the control group, and the rate of delayed and missed vaccination was lower,statistically significant difference (P<0.05). Conclusion The combination of team resource management and health education can effectively change parents' attitude towards vaccination, improve the vaccination awareness rate, improve children's vaccination compliance and vaccination prevention rate, and reduce the incidence of adverse reactions, which is worthy of vigorous promotion in the vaccination of school-age children.

Professor Liu Wanli's Experience in Treating Upper Gastrointestinal Reflux Diseases From the Perspective of "Homotherapy for Heteropathy"

SU Kun-han, LIU Wan-li

2024, 42(11):  165-168. 

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The theory of“homotherapy for heteropathy”is the essence of traditional Chinese medicine theory.Professor Liu Wanli treated the upper digestive tract reflux disease from the theory of“homotherapy for heteropathy”.He believed that liver and gallbladder dysfunction, spleen and stomach disharmony is the basic pathogenesis of the disease,and the obstruction of qi and blood runs through the beginning and end of the disease.Professor Liu took the principle of treating reflux diseases by lowering adverse reactions and stomachand relieving depression. He formulated "Jiangni soup" and "Tongjiang mixture", which have the effects of soothing the liver and clearing heat, eliminating dampness and phlegm, suppressing acid and protecting the stomach, regulating qi and calming the adverse-rising energy, and have goodclinical effect.

Professor Xu Jinkang's Experience in Discriminating and Treating Precancerous Lesions of Gastric Cancer by Combining “Disease, Syndrome, Symptoms and Constitution”

XU Qian-fei, XU Jin-kang

2024, 42(11):  169-172. 

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Precancerous lesions of gastric cancer are gastric mucosal changes with the possibility of malignant transformation. The weakness of the spleen and stomach, the disharmony of the rise and fall of the spleen and stomach are the pathogenesis of the disease, the mixture of deficiency and deficiency is the transformation law, the stasis of the stomach is the pathological key of the disease, and the dampness invading the stomach is an important link of the disease. The treatment of the disease is also the hot spot and difficult point in the current clinical treatment. Traditional Chinese medicine has certain characteristics in the treatment of the disease. According to the diagnosis and treatment theories of spleen and stomach diseases of the Wumen School of Medicine and the Meng He School of Medicine, Professor Xu Jinkang advocates the use of philosophy and dialectics to establish the thinking of differentiation and treatment, and proposes the four-part clinical thinking mode of"differentiation of disease, differentiation of syndrome, differentiation of main symptom and differentiation of constitution", which can more accurately grasp the evil, positive, weak and solid, disease course evolution and prognosis development of precancerous lesions of gastric cancer. Therefore, it can better delay and delay the process of gastric cancer prelesions. It is the inheritance and development of traditional syndrome differentiation and treatment, embodies the spirit of advancing with The Times, and has certain clinical practicability. Case 1 is attached for proof.

Comparison of Therapeutic Effects Between Bidirectional Isobaric Drainage and Low Incision and High Thread Hanging in the Treatment of Complex Anal Fistula

ZHANG Qiang, XIE Yan-chun

2024, 42(11):  175-178. 

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Objective To compare the efficacy of bidirectional isobaric drainage and low incision and high thread-drawing in the treatment of complex anal fistula. Methods From January 2019 to December 2022, 70 patients with complex anal fistula treated in Yuyang District Hospital of Yulin City were selected as the research object,according to the different treatment methods of patients, they were divided into experimental group and conventional group, with 35 patients in each group. The experimental group adopted bidirectional isobaric drainage treatment, the conventional group adopted low incision and high hanging line treatment.The treatment effect, wound healing time, anal pain, 1 d, 3 d, 7 d, and anal function, 5 d, 1 and 3 month were compared between the two groups. Results There was no significant difference between the experimental group and the routine group (P>0.05). The length of postoperative hospital stay and wound healing in the experimental group were shorter than those in the routine group, and the difference was statistically significant (P<0.05). On the 1st, 3rd and 7th day after operation, the VAS scores of patients in the two groups decreased gradually, and the scores in the experimental group were lower than those in the routine group, with statistical significance (P<0.05). On 5th postoperative day, the scores of Wexner in both groups increased, and gradually decreased in January and March after operation. Compared between groups, the scores in the experimental group were lower than those in the routine group on 5th postoperative day, January and March, and the difference was statistically significant(P<0.05). Conclusion Bi-directional isobaric drainage is as effective as low incision and high thread-drawing in the treatment of complex anal fistula, but it causes lower pain and faster healing time, and can effectively protect the function of anal sphincter and prevent anal incontinence.

Analysis of Efficacy and Adverse Reactions of Intensity Modulated Radiotherapy and Three-dimensional Conformal Radiotherapy for Nasopharyngeal Carcinoma

WANG Bao-Ming

2024, 42(11):  194-197. 

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Objective To explore the effects of intensity modulated conformal radiotherapy(IMRT) and three-dimensional conformal radiotherapy(3DCRT) on the efficacy and safety of nasopharyngeal carcinoma(NPC). Methods A total of 80 patients with locally advanced nasopharyngeal carcinoma who were diagnosed and treated in the Traditional Chinese Medicine Hospital of Zouping City from March 2018 to March 2022 were retrospectively selected, including 37 patients receiving intensity modulated conformal radiotherapy(IMCR)(treatment group) and 43 patients receiving three-dimensional conformal radiotherapy(3D-CRT)(control group). The short-term efficacy, maximum/average organ threatening dose,and adverse reactions of the two groups were observed. Results There was no difference in the total short-term treatment response rate between the treatment group (97.30%) and the control group (93.02%) (P>0.05); There was no difference in the maximum/average doses of the optic nerve and the chiasmatic nerve in the organs at risk between the two groups (P>0.05); The maximum/average dose of organs in the middle ear (left and right), brain stem, and spinal cord in the treatment group was lower than that in the control group (P<0.05); The incidence of acute adverse reactions such as radiation mucositis (45.95%) and radiation dermatitis (35.14%) in the treatment group was significantly lower than that in the control group (P<0.05); The incidence of radiation induced salivary gland injury in the treatment group (29.73%) was lower than that in the control group (76.74%) six months after radiotherapy (P<0.05). There was no difference in the incidence of radiation brain injury between the two groups (P>0.05). Conclusion IMRT and 3D-CRT have similar efficacy in the treatment of locally advanced NPC, but IMRT has higher advantages in both radiation dose and reducing adverse reactions caused by radiation damage.