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RSS2021 Vol. 42, No. 10
2021, 42(10): 1-7.
doi: 10.12259/j.issn.2095-610X.S20211040
Abstract:
Objectives To investigate the effects of scutellarin on lipid phagocytosis and the regulation of PKC, and TNF-α expressions in low density lipoprotein （OX-LDL） injured RAW264.7 cells. Methods Murine RAW264.7 macrophages was cultured in vitro. Then, the OX-LDL-induced injury model was replicated. Combined with oil red O staining, cellular cholesteryl ester content was also detected in OX-LDL-induced injury model. Furthermore, Western blot and RT-PCR methods were used to detect changes in PKC and TNF-α protein as well as mRNA expression in RAW264.7 cells. Results （1） The results of oil red O showed that the degree of cell red staining in model group was significantly higher than that in normal control group; compared with model group, the degree of cell red staining in simvastatin group, scutellarin 50 and 100 μmol/L group were lower than that in the model group; （2） The cholesteryl ester content assay showed that: compared with the normal control group, the CE/TC values of the model group cells were significantly increased at each time point; compared with model group, and cellular CE/TC values were significantly decreased in the dosing group at each time point. （3） WB and RT-PCR results showed that compared with normal control group, protein and mRNA expressions of PKC and TNF-α were increased in the model group; compared with the model group, protein and mRNA expression of PKC and TNF-α were decreased in simvastatin group, and scutellarin group showed a concentration-dependent downregulation of PKC and TNF-α expression. Conclusions （1） Scutellarin can significantly inhibit the levels of cholesterol in OX-LDL injuried RAW264.7 cells. （2） Scutellarin can down-regulated the protein and mRNA expressions of PKC, TNF-α in OX-LDL induced RAW264.7 cells.
2021, 42(10): 8-13.
doi: 10.12259/j.issn.2095-610X.S20211026
Abstract:
Objective To provide a model basis for further study of heart failure complicated with sarcopenia, a rat myoblast （L6） atrophy model induced by Ang Ⅱ was established. Methods 2% horse serum was used to induce differentiation of L6 cells. The time of induced differentiation was determined by microscopic observation and MyHC protein expression. CCK-8 was used to detect the effects of different concentrations of Ang Ⅱ on L6 cells. To determine the conditions of the cell atrophy model, different concentrations of Ang Ⅱ were selected to treat L6 cells, and the expression of MyHC protein was detected by Western Blot and immunofluorescence. Results L6 cells were induced to differentiate successfully after growing in 2% horse serum for 6 days. Microscopic observation revealed the fusion and myotubule of L6 cells, and the expression of MyHC protein was also increased. Ang Ⅱ at 0.1 μm to 10 μm had no effect on the activity of L6 cells. Western Blot and immunofluorescence detection showed that the MyHC protein expression level decreased after treated with 5 and 10 μM Ang Ⅱ for 72 h. Conclusions The model of L6 cell atrophy can be established by the treatment with 10 μM Ang Ⅱ for 72 h. This model will provide the basis for in vitro cell study of heart failure complicated with sarcopenia.
2021, 42(10): 14-21.
doi: 10.12259/j.issn.2095-610X.S20211012
Abstract:
Objective To investigate the protective effect of silencing Rho family GTPase3 （RND3） expression against oxygen glucose deprivation/reoxygenation （OGD/R） injury in hippocampal neurons via inhibiting inflammation and apoptosis and its mechanism. Methods The OGD/R model was established after transfecting cells with lentiviral vectors containing the short hairpin RNA of silencing RND3 gene expression （shRND3） and its negative control （shRND3-NC） sequence. CCK-8 assay was used to detect cell viability. RT-qPCR was used to detect the gene expression of RND3 and inflammation-related and apoptotic molecules. ELISA was used to detect the protein concentration of inflammatory factors in the supernatant of cell culture. Western blot was used to detect the protein expression of RND3, apoptotic proteins and NF-κB of cell nucleus.Cell apoptosis rate was determined by Annexin V-FITC/PI staining and flow cytometry. Results Compared with normal cells, the cell viability was decreased after OGD/R injury, the expression of inflammatory factors and NF-κB was increased, the expression of pro-apoptotic proteins was increased, the expression of anti-apoptotic proteins was decreased, and the apoptosis rate of cells was increased. While compared with the negative RND3 silencing group, the cell viability was increased, the expression of inflammatory factors and NF-κB were decreased, the expression of pro-apoptotic protein was decreased, the expression of anti-apoptotic protein was increased, and the apoptosis rate of cells was decreased. Conclusion Silencing RND3 alleviates OGD/R injury in hippocampal neurons via inhibiting inflammatory response and apoptosis and the mechanism of inhibiting the inflammatory response by silencing RND3 may be related to the inhibition of NF-κB pathway.
2021, 42(10): 22-28.
doi: 10.12259/j.issn.2095-610X.S20211037
Abstract:
Objectives To investigate the relationship between mircoRNA gene polymorphisms and the occurrence and development of non-small cell lung cancer in Yunnan Han population. Methods A total of 415 lung cancer patients of non-small cell lung cancer and 460 healthy individuals were included from Yunnan Han population. The genotypes of 3 polymorphism loci, rs2292832 T>C（pre-miR-149）, rs107822 C>T（pre-miR- 219a-1）, rs629367 C>A（pri-let-7a-1）were detected by TaqmanSNP genotyping assay. The distribution of allele and genotype frequency in lung cancer patients and healthy controls were analyzed. Results There was no significant difference of the allele and genotype frequency of 3 SNPs. And in stratification analysis, there was also no significant difference. Conclusions rs2292832, rs107822, rs629367 may not be significantly associated with non-small cell lung cancer in Yunnan Han population.
2021, 42(10): 29-37.
doi: 10.12259/j.issn.2095-610X.S20211030
Abstract:
Objective To explore the effect of miR-373 on depression-like behavior, microglia activation and pyrolysis in depression mice. Methods We Used chronic unpredictable stress to establish depression mice model. Sucrose preference, forced swimming, tail suspension, and Social interaction test were evaluate depression-like behaviors. Immunofluorescence double-stained microglia marker Iba-1 and microglia activation marker OX-42 were used to evaluate the proliferation and activation of microglia in the hippocampus of mice. TUNEL kit was used to detect microglia apoptosis. RT-qPCR was used to detect miR-373 expression. Western blotting was used to detect the expression of P2X7R and pyrolysis-related proteins. The targeting relationship between miR-373 and P2X7R was verified by dual-luciferase reporter gene assay. Results In mice treated with chronic unpredictable stress, sucrose preference and social time were significantly reduced, and immobility time of forced swimming and tail suspension was significantly increased （P < 0.05）. miR-373 washighly expressed, and alleviated depression-like behavior in depression model mice （P < 0.05）. miR-373 targeted and negatively regulated P2X7R expression in microglia ofmice hippocampus （P < 0.01）. miR-373 inhibited the proliferation and activation of microglia （P < 0.01）. miR-373 inhibited caspase-1, c-caspase-1, NLRP3, IL-1β and IL-18 expression, and the apoptosis of microglia （P < 0.05）. Conclusion ImiR-373 inhibits P2X7R expression to alleviate depression-like behavior, and inhibit the activation and pyroptosis of microglia in the hippocampus of depression mice.
2021, 42(10): 38-44.
doi: 10.12259/j.issn.2095-610X.S20211008
Abstract:
Objective To analyze the trend of hypertension prevalence and its relationship with different obesity indices among rural adults in Fumin county of Yunnan province. Methods A repeated cross-sectional surveys was employed. A total of 2544 individuals aged ≥35 years in 2009 and 2502 in 2019 were selected by multistage stratified random sampling method. Each participant received face to face questionnaire interview and physical examination. Results From 2009 to 2019, the overall age-standardized prevalence of hypertension increased from 32.8% to 44.1%, while prevalence of hypertension increased from 31.2% to 43.5% among males, and increased from 33.9% to 44.6% among females, respectively （χ2 = 68.122, χ2 = 39.626, χ2 = 31.456, P < 0.001）. Both in 2009 and 2019, the age-standardized prevalence of hypertension increased with age, whereas decreased with level of education and annual per capita household income （P < 0.05）. The mean of body mass index （BMI） increased from 22.90 kg/m2 to 23.62 kg/m2 （t = -7.326, P < 0.001）, while there were no significant difference of waist circumference （WC）, waist-to-hip ratio （WHR）, body roundness index （BRI） and body adiposity index （BAI） between two survey years （P > 0.05）. The result of multiple logistic regression indicated that both males and females with higher values of WC, WHR, BMI, BRI and BAI had higher risk of suffering from hypertension （P < 0.001）. WHR showed strongest association with hypertension （males: OR = 7.446, females: OR = 2.223, P < 0.001）. The correlation between obesity indices and hypertension prevalence was stronger in males than in females. The result of ROC curve analysis showed that WC, WHR, BMI, BRI and BAI were significant predictors of risk of hypertension in both males and females （P < 0.001）. Conclusion Prevalence of hypertension increased substantially in Fumin county of Yunnan province. WC, WHR, BMI, BRI and BAI were positively correlated with prevalence of hypertension, keep people’ s values of obesity indices within normal interval is beneficial to control of hypertension.
2021, 42(10): 45-50.
doi: 10.12259/j.issn.2095-610X.S20211003
Abstract:
Objective To explore the multi-level knowledge and behavior related antibiotics from the perspective of One Heath among senior undergraduates who have received pharmacology professional knowledge or training in Kunming. Methods From February, 2020 to March, 2021, a stratified cluster sampling survey was conducted among 1658 senior undergraduates majoring in medical, animal medical, pharmaceutical and non-medical sciences from two universities in Kunming. The association between knowledge and behavior of antibiotics in different levels and its influencing factors were analyzed. Results The average accuracy probabilities for basic, professional knowledge of antibiotics, and superbug knowledge among undergraduates were 88.4%, 88.7%, 89.7%, 81.1%; 40.4%, 38.3%, 45.8%, 36.4% and 62.1%, 63.2%, 65.7%, 55.0%, respectively. The basic knowledge and professional knowledge of antibiotics of medical, pharmaceutical and animal medical students were higher than those of non-medical students （P < 0.05）. The professional knowledge level of antibiotics of medical and pharmaceutical students was higher than that of animal medical students （P < 0.05）. The score of antibiotic behavior of medical and pharmaceutical students was higher than that of animal medical and non-medical students （P < 0.05）. The Logistic regression analysis showed that senior undergraduates had the higher score of basic knowledge of antibiotics, and their behavior of antibiotic tended to be more reasonable; the probability of lower score of antibiotic behavior of animal medical and non-medical students was about 1.7 times higher than that of medical students （P < 0.01）. Conclusion Senior undergraduates of medical and pharmaceutical have a great command of basic knowledge of antibiotics, but the knowledge of antibiotics based on One Health perspective is not comprehensive enough, the students of animal medical and non-medical have less knowledge of antibiotics, and the students’ antibiotic cognition level affects the correct use of antibiotics.
2021, 42(10): 51-60.
doi: 10.12259/j.issn.2095-610X.S20211039
Abstract:
Objective To analyze the clinical characteristics of acute ischemic stroke combined with multiple imaging assessment. Methods Multiple images were combined to evaluate the incidence, arterial pathological changes, the responsible vessels for infarction, and infarct mechanism of 8441 acute ischemic strokes admitted to Xuanwu Hospital of Capital Medical University from 2014 to 2018. Results （1） The incidence of males was higher than that of females （74.7% vs 25.3%; P < 0.001） and the age of onset was smaller than females （58.83±12.56 years vs 63.37±13.27 years; P < 0.0001）, 50-69 years old was the peak period of acute ischemic stroke （57.87%）; （2） Hypertension, diabetes and hyperlipidemia are the main risk factors for acute ischemic stroke, and hypertension is the most common risk factor （28.65%）; （3） Atherosclerosis （62.9%） is the most important pathological change and the most common cause of the arterial wall in acute ischemic stroke; 39.2% of patients have middle cerebral artery stenosis and occlusion; （4） 67.49% of acute ischemia strokeoccurs in the intracranial artery. The incidence of the anterior circulation （58.33%） is higher than that in the posterior circulation （33.47%）, and the difference is statistically significant （ P < 0.0001）; （5） Arterial-to-arterial embolism , local penetrating arterial occlusion and hypoperfusion impaired emboli clearance are common mechanism of acute ischemic stroke, of which arterial-to-arterial embolism is the main mechanism. Conclusion The age of onset of acute ischemic stroke, the proportion of different sexes, the pathological changes of arteries, the incidence of responsible blood vessels, and the mechanism of acute ischemic stroke of a large sample of acute ischemic stroke evaluated by multiple images can guide clinical acute ischemic stroke First aid, secondary prevention, early screening and prevention of stroke have a certain guiding role.
2021, 42(10): 61-67.
doi: 10.12259/j.issn.2095-610X.S20211019
Abstract:
Objective To verify that miRNA can be used as biomarkers to predict the occurrence and development of diabetes mellitus （DM）, and to explore the expression of miR-1181 in patients with type 2 diabetes mellitus （Type 2 Diabetes Mellitus）. Methods Agilent miRNA chip was used to screen plasma samples from patients with T2DM （n = 5） and normal control group （n = 5）. The differentially expressed miRNA were verified by fluorescence quantitative PCR （qRT-PCR）. The target genes were predicted by bioinformatics methods, and the relationship network diagram of miRNA - target gene - metabolic pathway was drawn. The differentially expressed miRNA: miR-1181, MAP2K2 and MAPK12 in plasma were detected by expanding samples. Results miRNA chip screening and qRT-PCR verified the differentially expressed miRNA associated with T2DM: miR-1181.Bioinformatics analysis showed that the target genes of miR-1181 were CCND1, PI3KR2, MAP2K2 and MAPK12. The expression of miR-1181 in the plasma of T2DM was significantly decreased （P < 0.001）. While expression of MAPK12 mRNA was increased （P < 0.01）. Conclusion The decrease of plasma miR-1181 in T2DM patients may be related to inhibiting effect of target gene MAPK12 on MAPK pathway.
2021, 42(10): 68-75.
doi: 10.12259/j.issn.2095-610X.S20211005
Abstract:
Objective To investigate the effect of adding dexmedetomidine （DEX） or dexamethasone （DXM） on the effect of interscalene brachial plexus block. Methods Fifty patients who underwent ultrasound-guided interscalene brachial plexus block were randomly selected, and randomly divided into 5 groups according to different local anesthetic formulations: R group （control group, 0.5% ropivacaine 20 ml, n = 10）; R + LDEX group （0.5% ropivacaine + 1 μg/kg DEX total 20 mL, n = 10）; R + HDEX group （0.5% ropivacaine + 2 μg/kg DEX total 20 mL, n = 10）; R + LDXM group （0.5% ropivacaine + 4 mg DXM total 20 mL, n = 10）; R + HDXM group （0.5% ropivacaine + 8 mg DXM total 20 ml, n = 10）. Results Compared with other groups, the block onset time ofR + LDEX groupand R + HDEX group was significantly shorter （P < 0.05）. Compared with R group, the block time of other experimental groups significantly prolonged （P < 0.01）. The 12 and 24 h VAS scores and the number of postoperative patient-controlled analgesia in the 4 experimental groups were significantly lower than those in the R group （P < 0.001）. The HR of the patients in the R + HDEX group was reduced after 5 minutes of blockade, and lasted for 30 minutes （P < 0.05）. The SBP, DBP and MAP ofR + LDEX and R + HDEX groups increased by 5, 10, and 15 minutes later after blocked （P < 0.05）. After 5 minutes injection of local anesthetics, patients in the R + LDEX and R + HDEX groups showed a decrease in BIS and continued for 30 minutes （P < 0.05）, the decrease in BIS of R + HDEX group was more obvious than that of R + LDEX group. Conclusions Adding DEX and DXM to local anesthetics can significantly prolong the action time of brachial plexus block. DEX can shorten the onset time ofinterscalene brachial plexus block and cause a transient increase in blood pressure. DEX can produce central sedation in a dose-dependent manner effect.
2021, 42(10): 76-83.
doi: 10.12259/j.issn.2095-610X.S20211046
Abstract:
Objective To study MR cerebral perfusion and the retinal oxygenation response in patients with different stages of diabetic retinopathy without hypertension and normal control group, and to analyze the correlation between different cerebral perfusion parameters and retinal oxygenation response. Methods From June 2017 to December 2019, 34 patients with diagnosed type 2 diabetes mellitus （T2DM） and 21 healthy controls were enrolled in the Department of Endocrinology and ophthalmology department, the Affiliated Hospital of Yunnan University. T2DM patients were divided into proliferative stage of diabetic retinopathy （PDR） group and non-diabetic retinopathy （NDR） group according to ophthalmofundoscopy. All subjects with hypertension were excluded. Plain MR, magnetic resonance angiography （MRA）, dynamic susceptibility contrast-perfusion weighted imaging （DSC-PWI）, orbital 3D-spoiled GRASS （3D-SPGR） before and after oxygen uptake scans were performed. Continuous variables were analyzed by unpaired t-test. Pearson product moment correlation was performed between relative cerebral blood flow （rCBF） and variables of retinal delta PO（2） （△P02） in bilateral temporal, nasal and optic disc of eyeballs of PDR and NDR group. Results rCBF of left inferior temporal gyrus and bilateral cingulate gyrus in PDR group was lower than that in NDR group and NC group （P < 0.05）. Relative cerebral blood volume （rCBV） of right inferior temporal gyrus, left occipital lobe and left cingulate gyrus in PDR group was lower than that in NDR group and NC group （ P < 0.05）, and the rCBV of right parahippocampal gyrus in PDR group was higher than that in NDR group and NC group （ P < 0.05）. The mean transit time （MTT） of left inferior temporal gyrus, left cerebellar hemisphere and bilateral middle frontal gyrus in PDR group was higher than that in NDR group and NC group （ P < 0.05）. The mean transit time of left parahippocampal gyrus and right pons in PDR group was lower than that in NDR group and NC group （ P < 0.05）. Time to peak （TTP） of left cerebellar hemisphere, bilateral middle frontal gyrus, left inferior temporal gyrus and right cingulate gyrus in PDR group was higher than that in NDR group and NC group （ P < 0.05）, and TTP of right pontine and right parahippocampal gyrus in PDR group was lower than that in NDR and NC group （ P < 0.05）. The difference of △ P0 2 in bilateral temporal, nasal and optic disc of eyeballs between PDR group, NDR group and NC group was statistically significant （P < 0.05）. rCBF of left inferior temporal gyrus and bilateral cingulate gyrus in PDR group and NDR group were correlated with △P0 2 of bilateral temporal, nasal and optic disc （P < 0.05）. Conclusions There was significant association between cerebral blood flow perfusion and the diabetic retinopathy （DR） severity in type 2 diabetes mellitus. MRI retinal oxygenation response can be used as an imaging marker of diabetic cerebral capillary disease.
2021, 42(10): 84-91.
doi: 10.12259/j.issn.2095-610X.S20211045
Abstract:
Objective To explore the changing rule of morphology and function single parathyroid gland in situ, so as to provide a theoretical basis for the survival, function and prognosis of parathyroid glands with different blood supply types. Methods Forty-two patients who underwent unilateral thyroidectomy, single parathyroid gland transplantation and retained the other parathyroid gland in situ due to the type of blood supply, were selected as objects. Target parathyroid glands were dynamically observded by nasal endoscope with inner diameter of 0.5 cm connected to previously retained drainage tube at different intervals of postoperation. The drainage liquid was collected to detect the level of dPTH in following 1st, 2nd, 3rd day between 7 and 8 am. Above patients were divided into three groups for pairwise comparison. The first group: glands shown ≤50% and＞50% in naked area, the second group: vascular pedicle could be observed in parathyroid glands in situ by naked eye, the third group: the superior parathyroid gland and the inferior parathyroid gland. SPSS17.0 was used for statistical analysis. Results Twenty-six target parathyroid glands were observed by endoscope at different intervals of postoperation, 19 of which were superior parathyroid glands and the rest were inferior parathyroid glands. 18 parathyroid glands were found and recorded while 3 superior parathyroid glands were found by endoscope at 24 h of postoperation. 19 parathyroid glands were found , recorded while 4 superior parathyroid glands were not found at 48 h of postoperation. During operation, 14 of 15 superior parathyroid glands almost completely retained blood supply and contected with visible vascular pedicle, the rest 1 had no obvious vascular pedicle and exhibited black at both 24 h and 48 h of postoperation, being considered as necrosis while other superior parathyroid glands had no symptom of necrosis. The naked area of 7 inferior parathyroid glands in situ ranged from 50.0% to 95.0%, 2 of which exhibited visiable vascular pedicle while the rest 5 did not and fibrous membranes contected to periphery were observed in 4 of 5 inferior parathyroid glands. Extravasated blood was obvious in 2 inferior parathyroid glands in situ and the rest 5 was normal in clolor during operation. As for the rest 5 normal inferior parathyroid glands, 2 exhibited ecru for slight extravasated blood, 1 displayed yellowish-white for ischemia, and the rest 2 were normal at 24 h postoperation. 2 inferior parathyroid glands with slight bleeding shown reddish brown, 5 were normal in color and 1 with ischemia exhibited yellowish-white. Experimental data results of statistical analysis: （1） The difference of dPTH of different intervals on the basis of different naked area pairwise comparison was statistically significant （P < 0.05）. The larger naked area of parathyroid glands remained in situ during operation induced more serious destruction on blood supply, yielding to more profound influence on function of glands. （2） The difference of dPTH of different intervals on the basis of pairwise comparison between the presence and absence of vascular pedicles was not statistically significant （P > 0.05）. However, significance existed between two groups only in term of experimental data of dPTH at different intervals of postoperation. The count of dPTH from the presence of vascular pedicles was more high that of dPTH without vascular pedicles but no statistical difference was found, perhaps sample size could account for divergence. （3） The difference of dPTH of different intervals on the basis of pairwise comparison between superior and inferior parathyroid gland was statistically significant （P < 0.05）. It is further confirmed that compared with inferior parathyroid gland, superior parathyroid gland was more trend in situ because of less in naked area, blood supply and more integrity of peripheral vessels and connective tissue. Conclusions The recent morphology and function of single parathyroid gland preserved in situ can be studied through endoscopic observation and monitoring of the level and changing rule of dPTH after thyroid surgery . The maintenance of dPTH at a high level after operation is a direct evidence of the survival of parathyroid glands preserved in situ.The high postoperative dPTH shows that in most cases, the operation only affects the way of PTH secretion into the blood and the parathyroid gland retained in situ can still secrete a large amount of PTH. The decrease of dPTH to a low level 24 hours after operation shows that the parathyroid gland retained in situ has serious damage, obvious blood supply destroy and depressed secretion.
2021, 42(10): 92-98.
doi: 10.12259/j.issn.2095-610X.S20211044
Abstract:
Objective To compare the accuracy of six operative methods of ultrasound-guided fine-needle aspiration biopsy of thyroid nodules and to share the experience of the operation. Methods The data of 1903 patients who underwent thyroid surgery, preoperative fine-needle biopsy （FNA） and definite pathological findings after surgery were included. The data of the above patients were divided into 6 groups: A1-A3, B1-B3 according to the angle of FNA needle insertion and sampling technique. category A for end-lateral and category B for side-lateral; category 1 for negative pressure aspiration, category 2 for normal pressure aspiration, and category 3 for closed pressure entry and exit. Based on the traditional evaluation indexes, the Bowker weighted test was used to compare their differences and the Kappa linear weighted test for consistency. The advantages and disadvantages of the six different operation methods were finally evaluated. Results Sensitivity: Category A was higher than category B. Highest in group A3; 96.47% and lowest in group B2; 87.69%; Specificity: all were 100%; Accuracy: category A was higher than category B subgroups, highest in group A3; 97.69%, and lowest in group B2; 91.20%;Positive prediction rate: all were 100%; Negative prediction rate: category A was higher than class B subgroups. The highest A3 was 95.65% in group A3, and the lowest was 78.57% in group B2;Yordon index: higher in category A than in category B. The highest was 96.47% in group A3 and the lowest was 87.69% in group B2. Bowker’ s weighted test results: the P -values were: A3 > A1 > A2 > B3 = B1 = B2.The P of A1, A2, B1, B2, and B3 < 0.01, statistically significantly different from postoperative histopathological results. The P -value of A3 was 0.072, P > 0.05. There was no statistical difference with the postoperative histopathological result in A3; Kappa consistency test （linear weighted） results: A3 > A1 > A2 > B3 > B1 > B2; The highest value was 0.959 for the A3 group, and the lowest was 0.821 for the B2 group. Conclusions Based on the traditional evaluation index, paired chi-square and Kappa test results, the end-lateral approach with closed-pressure entry and exit sampling method （A3 group） have the closest cytologic pathology results to postoperative histologic pathology and is the best FNA approach with high sampling quality.
2021, 42(10): 99-105.
doi: 10.12259/j.issn.2095-610X.S20211029
Abstract:
Objective To investigate the application of xenogenic acellular （bovine） dermal matrix （ADM） combined with autologous bone powder implantation in open mastoidectomy, and investigate the effect on ear drying, epithelization, survival of autogenous bone meal and reduction of postoperative infection rate. Methods From September 2016 to September 2020, patients with otitis media who were treated by surgery in department I of Otolaryngology, First Affiliated Hospital of Kunming Medical University were divided into three groups according to the requirements of this study: （1） Patients with otitis media who underwent open radical mastoidectomy + xenogeneic （bovine） acellular dermal matrix combined with autologous bone meal implantation （experimental group）; （2） Patients with otitis media underwent open radical mastoidectomy and fascia combined with autologous bone meal implantation （experimental control group）; （3） Otitis media were treated with open radical mastoidectomy and fascia implantation （blank control group）; At 2 weeks, 4 weeks, 6 weeks and 8 weeks after operation, the following four aspects were recorded: （1） dry ear; （2） epithelization; （3） survival of bone powder; （4） infection Results. After 2 weeks, 4 weeks, 6 weeks, the incidence of dry ear and the incidence of epithelization between 4 weeks, 6 weeks after operation were compared. The chi square test showed that the results were P < 0.001, which was statistically significant. The test level was adjusted and compared. Results The blank control group, the experimental control group and the experimental group were all P < 0.001. The incidence of dry ear and epithelialization in the experimental group was higher than that in the blank control group and the experimental control group at 6 weeks and 4 and 6 weeks after operation, but there was no difference between the blank control group and the experimental control group; There was no significant difference in the infection rate among the three groups at 2, 4 and 6 weeks after operation （P > 0.05）. The incidence of dry ear, epithelization and infection were compared between the two groups on the 8th week after operation, and the results were all P > 0.05, without statistical significance. Conclusions Xenogenic acellular （bovine） dermal matrix （ADM） combined with autologous bone powder implantation in open radical mastoidectomy can significantly shorten the dry ear time and epithelialize quickly after operation. It can achieve dry ear and epithelialization within 4 to 6 weeks after operation, and ensure the survival of autologous bone powder implantation, thus effectively reducing the incidence of infection after operation, improving long-term efficacy.
2021, 42(10): 106-111.
doi: 10.12259/j.issn.2095-610X.S20211017
Abstract:
Objective To investigate the effect of surgical treatments for delayed ankles fracture combined with distal tibiofibular syndesmosis injuries （AFTSI）. Methods A retrospective study the operative effects of 38 cases of delayed AFTSI treated with open reduction and internal fixation （ORIF） + Tightrope fixation （group A, n = 18） or ORIF + screw fixation （group B, n = 20） for syndesmosis injuries. AOFAS （Ankle-Hindfoot Score system）, hospital stay, operative time, introperative blood loss, full weightbearing time, difference value between preoperative and postoperative tibiofibular clear space （TFCS） and tibiofibular overlap （TFO） were used to evaluate the postoperative curative effect. All patients were received a follow-up with an average of 18 months, and the syndesmosis screws were removed 2-3 months after operations. Results AOFAS score was higher in group A than in group B, postoperative onset time of full weightbearing was earlier in group A than in group B statistically （P < 0. 05）, while no statistics difference were found between 2 groups in the factors of hospital stay, operative time, introperative blood loss, and the difference value between preoperative and postoperative time on TFCS together with TFO. Conclusion Tightrope syndesmosis fixation is a better options to enable early weight bearing for the delayed AFTSI compared with the traditional screws fixation.
2021, 42(10): 112-116.
doi: 10.12259/j.issn.2095-610X.S20211032
Abstract:
Objective To study the expression and clinical significance of miRNA-145 and OCT4 in endometriosis. Methods From August 2018 to August 2020, 30 EMs patients （experimental group） and 30 patients with infertility caused by fallopian tube factors （control group） were collected. Ectopic endometrial tissues were collected during operation in experimental group and eutopic endometrial tissues in control group. The expressions of miRNA-145 and OCT4 in ectopic and eutopic endometrial tissues were detected by QPCR, and the expression of OCT4 protein in tissues was detected by Western blot. Results Compared with non-EMs patients, the expression of miRNA-145 in endometriotic tissues increased （P < 0.01）, while the expression of OCT4 decreased （P < 0.01）, showing a negative correlation between them. Conclusion miRNA-145 is expected to be a potential marker for diagnosis of endometriosis. miRNA-145 and OCT4 play a certain role in the occurrence and development of endometriosis, and this finding provides a possible research direction and potential target for the pathogenesis and treatment of EMS.
2021, 42(10): 117-120.
doi: 10.12259/j.issn.2095-610X.S20211027
Abstract:
Objective To observe the effect on two kinds of tracheal intubation guiding equipment （video laryngoscope andfiberoptic bronchoscope）for awake orotracheal intubation. Methods Sixty patients with difficult airway requiring conscious intubation were randomly divided into two groups, respectively with UE video laryngoscope（groupⅠ） and fiberopticbronchoscope （FOB） （groupⅡ）. Heart rate （HR）, mean arterial pressure （MAP）, the change of hemodynamic at four time points were recorded: 5 min after enteringthe room （T0）, sprayed local anesthetic on the endotracheal tube or sprayed local anesthetic via FOB （T1）, the endotracheal tube entered the trachea （T2）, the patient’ s reactionto the completion of three minutes of intubation （T3）. Results Compared with T0, the HR and MAP in groupⅠat T2 were both higher （P < 0.05）, Compared with T0, the HR and MAP in groupⅡat T2 were both significantly higher （P < 0.01）, there were no significant differences between the two groups at T0, T1, T2, and T3 （P > 0.05）, There were significant differences between the two groups intubation time （P < 0.05）, Similarly there were no significant differences between the two groups in patient’ s reaction and satisfaction （P > 0.05）. Conclusion UE video laryngoscope can be widely used in the case of awake orotracheal intubation with stable hemodynamics, safe and comfortable, and convenient operation.
2021, 42(10): 121-126.
doi: 10.12259/j.issn.2095-610X.S20211014
Abstract:
Objective To summarize the curative effect of different surgical resection methods for hilar cholangiocarcinoma （HCCA）. Methods The clinical data of 52 patients with HCCA who underwent surgery in Lincang people's Hospital from January 2015 to December 2020 were retrospectively analyzed. Among them, 36 cases were treated with hemihepatectomy/extended hemihepatectomy + total caudate lobectomy （combined hemihepatectomy group）, 16 cases of hilar/perihilar region + total caudate lobectomy （perihilar resection group）, The preoperative data, intraoperative blood loss, operation time, positive rate of tumor margin, postoperative hospital stay, CA19-9 value at 3 months after operation, and 1, 3-year survival rate of the two groups were compared and analyzed. Results The indexes of the combined hemihepatectomy group and perihepatectomy group were as following: the intraoperative blood loss [（705.5±54.3） mL vs （809.9±61.4） mL], the operation time [（240.4 ± 22.5） min vs （358.1 ± 31.1） min], the positive rate of tumor resection margin （8.3% vs 18.8%）, the negative rate of CA19-9 3 months after operation （88.2% vs 73.3%）, and the 1-year survival rate （58.8% vs 40.0%）. The difference was statistically significant between the two groups （P < 0.05）. Conclusion Combined hemihepatectomy and perihilar hepatectomy are effective surgical methods for HCCA, But the former has higher R0 resection rate and short-term survival rate.
2021, 42(10): 127-131.
doi: 10.12259/j.issn.2095-610X.S20211007
Abstract:
objective To investigate the value of MRI diagnosis of nodular breast benign and malignant lesions. Methods Retrospective analysis of 71 patients with nodular breast disease confirmed by pathology in our hospital, Perform MRI multi-parameter imaging before surgery, Select DCE-MRI and DWI for analysis, After processing: TIC time-signal curve, peak time, peak enhancement rate, SImax peak and ADC apparent diffusion coefficient, Combined with morphological characteristics: rough edges, ring strengthening, edge burr sign and leaf leaf sign for analysis. Results 43 malignant lesions, 28 benign lesions.There were 22 TIC time-signal curves of type I, with 17 cases of benign lesions and 5 cases of malignant lesions.There were 35 cases of type Ⅱ, of which 24 were malignant and 11 were benign.14 of type Ⅲ are all malignant lesions.The TIC time-signal curve types of benign and malignant lesions are different, and the difference is statistically significant （P < 0.05）; The peak time, peak enhancement rate, SImax peak and ADC apparent diffusion coefficient of benign and malignant lesions were significantly different, and the difference was statistically significant （P < 0.05）. Conclusion MRI dynamic enhanced scanning hemodynamic parameters, ADC combined with morphological features are of great value in the diagnosis of breast nodular benign and malignant diseases.
2021, 42(10): 132-138.
doi: 10.12259/j.issn.2095-610X.S20211006
Abstract:
Objective To investigate the changes and clinical significance of plasma levels of soluble myeloid cell trigger receptor-1 （sTREM-1）, soluble Fms-like tyrosine kinase receptor-1 （sFLT-1） and superoxide dismutase （SOD） in patients with severe pneumonia （SP）. Methods A total of 150 patients with pneumonia admitted to our hospital （January 2018 to January 2019） were selected and divided into normal pneumonia group （n = 63） and SP group （n = 87） according to their condition, follow-up for 28 days after treatment, SP was divided into death group （n = 32） and survival group （n = 55） according to whether or not they died, and 60 healthy people who had physical examination during the same period were selected as control group.The plasma levels of sTREM-1, sFLT-1, and SOD in each group were compared, multivariate Logistics regression was used to analyze the factors affecting the adverse prognosis of SP patients, the ROC curve analyzed the predictive value of plasma sTREM-1, sFLT-1, and SOD levels on the adverse prognosis of SP patients. Results The plasma levels of sTREM-1 and sFLT-1 in the control group, common pneumonia group and SP group gradually increased, while the SOD level gradually decreased （P < 0.05）.Multivariate logistic regression analysis showed that intensive care unit （ICU） time （OR = 1.784, 95%CI: 1.077～2.955）, Acute Physiology and Chronic Health Assessment Ⅱ （APACHE Ⅱ） score （OR = 1.834, 95%CI: 1.130～2.976）, sTREM-1 （OR = 1.236, 95%CI: 1.034～1.477）, sFLT-1 （OR = 1.095, 95%CI: 1.026～1.169） was an independent risk factor for poor prognosis in SP patients, arterial blood oxygen pressure （PaO2） （OR = 0.894, 95%CI: 0.809～0.988）, SOD （OR = 0.933, 95%CI: 0.879～0.990） was a protective factor （P < 0.05）.The ROC curve showed that the sensitivity and specificity of sTREm-1+sFLT-1+SOD （AUC = 0.913, 95%CI: 0.833～0.963） in predicting the poor prognosis of SP patients were higher than those of sTREm-1 （AUC = 0.799, 95%CI: 0.699～0.877）, sFLT-1 （AUC = 0.780, 95%CI: 0.678～0.861）, and SOD （AUC = 0.801, 95%CI: 0.701～0.879）. Conclusions Plasma sTREM-1 and sFLT-1 levels in SP patients are significantly increased, and SOD levels are significantly reduced. These are independent factors affecting poor prognosis. Combined detection can increase the predictive value of poor prognosis.
2021, 42(10): 139-144.
doi: 10.12259/j.issn.2095-610X.S20211036
Abstract:
Objective To investigate the vitamin D （VD） and calcium supplement’effect on the occurrence of cardiovascular and cerebrovascular diseases in Primary osteoporosis （POP） patients accompanied with hypertension or coronary heart disease. Methods From October 2018 to September 2019, the 317 cases diagnosed as hypertension or coronary heart disease accompanied with primary osteoporosis diagnosis and complying with inclusion criteria in Cardiovascular department of Liyang Municipal People’s Hospital were recruited, divided into hypertension and coronary heart disease groups, with 224 and 93 participants in each group. Then participants in each group were again divided into VD deficiency （25（OH）D≤20 ng/mL） and severe deficiency （25（OH）D≤10 ng/mL） groups, treated with one Calcium carbonate D3 pill and two pills per day, respectively. Treatment lasts for 18 months, during which the participants should recorded the occurrence times of angina pectoris （including myocardial infarction）, atherosclerosis （newly occurrence except for coronary）, lower limbs’ venous thrombosis and cerebral infarction, which forced the participant to turn to hospital, as well as the VD and Ca concentrations examined during the periods. The occurrence and non-occurrence proportion and VD and Ca concentrations between the two groups among the corresponding group were compared. Results POP hypertension groups: The incidents proportion of heart, cerebral and vessels diseases in VD severe deficiency group （19.0%） was higher than that （7.5%） of VD deficiency group, P = 0.018. There was an obviously positive correlation between VD and Ca, P < 0.001. Compared with VD deficiency group, the VD and Ca levels of VD severe deficiency group at the occurrence of angina pectoris were higher, P < 0.05. POP coronary heart disease groups: The incidents proportion of heart, cerebral and vessels diseases in VD severe deficiency group （86.2%） was higher than that （62.7%） of VD deficiency group, P = 0.030. There was an obviously positive correlation between VD and Ca, P < 0.001. Compared with VD deficiency group, the VD and Ca levels of VD severe deficiency group at the occurrence of angina pectoris were higher, P < 0.05 and P < 0.01, respectively. When suffering from atherosclerosis, the Ca level of participants in VD severe deficiency group was higher than that in VD deficiency group, P < 0.05, with a increasing trend of VD level. Conclusion Properly added VD and decreased Ca supplement might be suitable for hypertension accompanied with POP patients with VD severe deficiency. For coronary heart disease accompanied with POP patients with VD severe deficiency, decreased VD and Ca supplement may be more fit.
2021, 42(10): 145-150.
doi: 10.12259/j.issn.2095-610X.S20211021
Abstract:
Objective To assesse the changes and abnormal patterns of coagulation indicators in distinguishing malignant pleural effusion of lung adenocarcinoma （AD-MPE） and tuberculous pleural effusion （TPE） and acquire the optimal diagnostic model. Methods Patients with 200 AD-MPEs or 209 TPEs participated in this retrospective study. Coagulation function indicators, including activated partial thromboplastin time （APPT）, prothrombin time （PT）, fibrinogen （FIB）, thrombin time （TT）, fibrinogen degradation products （FDP）, and D-dimer（D-D）, were measured; their levels and abnormal patterns were analyzed separately and in combination, to determine the diagnostic performance of individual and combined values and the optimal diagnostic model. Results PT, FIB, FDP, and D-Dlevels in patients with TPE were significantly higher than those in patients with AD-MPE （all P < 0.01）. PT, FIB, FDP, and D-D values, particularly FDP and D-D, could distinguish between AD-MPE and TPE. The diagnostic performance was better for the combination of the four indicators and their abnormal patterns than for any single indicator （area under the curve: 0.732）. The proportion of patients with abnormal patterns of all four indicators was significantly higher in those with TPE than in those with AD-MPE （all P < 0.001）. Conclusions In the two groups of patients, the levels and abnormal patterns of PT, FIB, FDP and D-D are not the same. The combination of the four indicators and their abnormal patterns is helpful for the differential diagnosis of TPE and AD-MPE.
2021, 42(10): 151-156.
doi: 10.12259/j.issn.2095-610X.S20211031
Abstract:
Objective To analyze the control effect and prognosis of Levetiracetam injection on convulsive epileptic status （CSE）, in order to promote its clinical application. Methods A total of 80 CSE patients were enrolled in the Department of Neurology intensive Care Unit （NICU） of Qujing No.1 Hospital from September 2018 to April 2021. 40 patients in the Levetiracetam group （experimental group） and 40 patients in the Valproate group （control group） were randomly assigned to compare the efficacy, adverse reactions, EEG changes, Synek grading and prognosis. Results The effective control rate was 77.5% in the Levetiracetam group and 67.5% in the Valproate group, with no statistical difference between the two groups （P = 0.317）. The onset time of Levetiracetam group was shorter than that of Valproate group, and the difference between the two groups was statistically significant （P < 0.05）. Prognostic analysis: Univariate analysis showed that symptoms were not effectively controlled, successful control time ≥60 min, abnormal discharge in EEG, Synek grading and poor prognosis were significantly correlated （P < 0.05）. Multivariate Logitstic regression analysis showed that, Synek grade was negatively correlated with prognosis （β= -3.867, OR < 1）, and higher Synek grade was an independent risk factor and predictor of poor prognosis （P < 0.05）. Conclusion Levetiracetam injection can control CSE more quickly and effectively, which can be used in clinic. EEG analysis （EEG abnormal discharge and Synek grading） can provide a reliable basis for judging the prognosis of CSE.
2021, 42(10): 157-161.
doi: 10.12259/j.issn.2095-610X.S20211015
Abstract:
Objective To investigate the diagnostic effect and imaging characteristics of high-frequency ultrasound in skeletal muscle injury of limbs. Methods Seventy-two patients with limb musculoskeletal injury after major exercise admitted to Yunnan St.John's Hospital from January 2019 to June 2020 were selected. CT diagnosis and high-frequency ultrasound diagnosis were performed on all patients.The clinical effect, diagnostic efficacy, specificity, sensitivity, accuracy of CT, high-frequency ultrasound and the combination of the two diagnostic methods were compared, as well as the recognition of the two diagnostic methods by clinicians, the sonographic characteristics of muscle injury and the sonographic characteristics of bone injury. Results There was no statistical significance between high frequency ultrasound and CT in the detection rate of vascular injury （P > 0.05）.The detection rates of muscle injury, bone injury and nerve injury were higher than those of CT diagnosis （P < 0.05）. The diagnostic sensitivity and specificity of high-frequency ultrasound combined with CT were better than that of single high-frequency ultrasound and CT （P < 0.05）. The diagnostic sensitivity and specificity of high-frequency ultrasound were better than that of CT （P < 0.05）. The practicability, economy, safety and accuracy of high-frequency ultrasound were higher than that of CT （P < 0.05）. Under high-frequency ultrasound, the main manifestations were broken cartilage echo continuity, neat section edge, visible dislocation at fracture, and swelling or hematoma in surrounding soft tissue. It is characterized by linear strong echo continuity interruption of nerve, and the interrupted area is hypoechoic or non-echoic.The broken end can be swollen and thickened or retracted with spindle hypoechoic shape. Conclusion High frequency ultrasound has good diagnostic effect in skeletal muscle injury, and can obtain high diagnostic sensitivity.It can provide scientific basis and guiding value for clinical treatment, and is worthy of popularization and application.
2021, 42(10): 162-166.
doi: 10.12259/j.issn.2095-610X.S20211025
Abstract:
Objective To compare the clinical efficacy and prognosis of patients with severe stroke complicated with atelectasis or respiratory distress syndrome after different pulmonary reopening treatments. Methods We made a prospective analysis of 96 patients with severe stroke complicated with respiratory distress syndrome or atelectasis admitted to the Third People’ s Hospital in Kunming from October 2017 to October 2019. The stratified randomized method was used to divide the patients into 2 groups: control group and experimental group with 48 cases in each group. Both groups underwent active symptomatic treatment. On the basis of this, the control group was subjected to progressive end-expiratory pulmonary recruitment, and the experimental group was performed with compliant lung recruitment. The clinical efficacy and prognosis of the two groups of patients after different lung recruitment were compared and analyzed. Results PaO2, PaO2/FiO2 indicators in the two groups of patients after lung recruitment were changed to some extent before treatment. The PaO2 index of 0.5 h after treatment in the experimental group and the PaO2 and PaO2/FiO2 indexes at 1 h after treatment were higher than the control group. The difference was significant （P < 0.05）. The intracranial pressure and cerebral perfusion pressure index of the control group after lung recruitment were significantly different from those before treatment, while the indexes in the experimental group were more stable before and after treatment, and there was significant difference compared with the control group （P < 0.05）. The NSE level of the group was lower than that of the control group （P < 0.05）. The total effective rate of clinical treatment in the experimental group was （79.17%） higher than that in the control group （60.42%）, and the difference between the groups was significant （χ2 = 4.002, P = 0.045）. There was no significant difference in the mortality rate and adverse reaction rate between the two groups （P > 0.05）. Conclusion For patients with severe stroke complicated with atelectasis or respiratory distress syndrome, compliant lung recruitment intervention is effective in promoting stable hemodynamic parameters, improving brain tissue damage, and reducing prognosis. It is worthy of clinical application.
2021, 42(10): 167-171.
doi: 10.12259/j.issn.2095-610X.S20211013
Abstract:
Severe dentition is a kind of disease caused by loss of physiologic median jaw position, which is often seen in middle-aged and elderlypatients. Occlusal reconstruction refers to the reconstruction and re-establishment of the occlusal state of dentition by means of restoration, among which the temporary occlusal pad plays an important role in the restoration process. This paper summarized the harm of severe wear of dentition and the importance of temporary occlusal pad in restoration, so as to provide some guidance for clinical repair work.
Severe dentition is a kind of disease caused by loss of physiologic median jaw position, which is often seen in middle-aged and elderlypatients. Occlusal reconstruction refers to the reconstruction and re-establishment of the occlusal state of dentition by means of restoration, among which the temporary occlusal pad plays an important role in the restoration process. This paper summarized the harm of severe wear of dentition and the importance of temporary occlusal pad in restoration, so as to provide some guidance for clinical repair work.
2021, 42(10): 172-177.
doi: 10.12259/j.issn.2095-610X.S20211043
Abstract:
Objective To explore the application effect of Chest Pain Center in standardized training for cardiovascular practitioner. Methods Fifty-two students for cardiovascular practice were selected from 2020 July to September, they were randomly divided into the two groups with 26 cases in each group. The experimental group adopted the teaching method of Micro courses, mini CEX was used in the control group. The teaching achievement and teaching satisfaction between the two groups were compared. Results The Mini-CEX scale for interns in the experimental group were significantly higher than those when they were enrolled （P < 0.01）. The results of questionnaire survey on teaching performance and teaching satisfaction rate in the experimental group were significantly better than those in the control group, the differences were statistically significant （ P＜0.05）. Conclusion The application of Micro courses, Mini-CEX in cardiovascular medicine teaching can significantly improve students’satisfaction and practice teaching quality, and help medical students to establish clinical thinking and master professional knowledge and skills.
2021, 42(10): 178-184.
doi: 10.12259/j.issn.2095-610X.S20211004
Abstract:
Objective To establish a high-risk pressure Injury prevention case management model for the elderly inpatients, and evalutate the effect of the high-risk pressure injury prevention case management model for the elderly inpatients. Methods A case management and nursing plan for the prevention of high-risk stress injury in elderly hospitalized patients was developed through the Delphi method. 100 patients with high incidence of pressure injury in a third-A-grade hospital were selected from May to November 2018. The patients in each department were randomly divided into two groups, with 50 patients in each group. The control group implemented a routine care regimen.The experimental group implemented the high-risk pressure Injury prevention case management model for the elderly inpatients based on the routine nursing program. On the day of hospitalization, on the fourth day after hospitalization, and before the discharge, the nursing problems were found and improved, evaluated from three aspects of Knowledge-Behavior-Status （knowledge-behavior-status, K-B-S）. On the day of hospitalization, on the fourth day after hospitalization, and before the discharge, the investigators used Pressure Ulcer Scale for Healing （pressure ulcer scale for healing, PUSH）, the Braden evaluation form, Nutrition Risk Screening 2002 （NRS-2002） for evaluation. Observe the occurrence of pressure injury, hemoglobin （HB）, serum albumin （serum albumin, ALB） detection indicators. Results There were no significant differences in baseline data of age, sex, education, family economic income between the two groups （P > 0.05）. The experimental group had 503 nursing problems during hospitalization.There were 11 common nursing problems （incidence rate≥30%）. The experimental group performed better than the control group （P < 0.05）. Conclusions The research confirms that the case management model can analyze nursing problems, and objectively evaluate the effectiveness of interventions.The case management model can reduce the incidence of pressure injuries in elderly inpatients with high-risk pressure injuries.
Application Value of Medical Chlorhexidine Gluconate Cotton Tablets in Hemodialysis Catheter Nursing
2021, 42(10): 185-188.
doi: 10.12259/j.issn.2095-610X.S20211022
Abstract:
Objective To explore the clinical value of using medical chlorhexidine gluconate cotton tablets to nursing the central venous catheter connector of hemodialysis and reducing catheter-related infection. Methods 90 patients who received central venous catheterization in the hemodialysis room of Yunnan Third People’ s Hospital and Kunming Third People’ s Hospital from January 2018 to December 2020 were selected as the research objects. According to different disinfection methods of hemodialysis catheter connectors, 90 patients were randomly divided into observation group and control group, with 45 cases in each group. Routine iodophor cotton swabs were used to disinfect the catheter threaded joints in the control group, and chlorhexidine gluconate cotton tablets were used to wipe and disinfect the catheter threaded joints in the observation group. The incidence of catheter-related infection and nursing quality score of hemodialysis patients in the two groups were observed. Results There were 13 cases of catheter-related infection in the control group （28.9%） and 3 cases in the observation group （6.7%）. The difference was statistically significant （P < 0.05）; The score of nursing quality was 91.96±2.76 in the observation group and 87.16±2.99 in the control group （ P < 0.05）. Conclusion Using medical chlorhexidine gluconate cotton tablet to wipe and disinfect the threaded joint of hemodialysis catheter can reduce the incidence of catheter-related infection, improve the quality of nursing operation and infection prevention and control, and has clinical application value.
