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RSS2021 Vol. 42, No. 11
2021, 42(11): 1-8.
doi: 10.12259/j.issn.2095-610X.S20211101
Abstract:
Objective To evaluate the triterpene chemical constituents in Poria cocos 95% ethanol extract by ultra-performance liquid chromatography ion trap time-of-flight mass spectrometry （UPLC-IT-TOF/MS） method. Methods UPLC was performed with the UHPLC XB-C18 and methanoic acid/water （0.05/100, v/v）-acetonitrile solution （gradient elution） was employed with a flow rate of 0.2 mL·min-1. The detection wavelength range was 190～400 nm. Triterpene chemical compositions in Poria cocos were qualitatively analyzed using ESI ion with electrospray positive and negative ions simultaneous detection, sodium trifluoroacetace correction and Shimadzu Composition Formula Predictor software. Results Through the analysis of the multistage tandem mass spectrometry, combined with the application of nitrogen rule and the Scifinder database search, 22 triterpenes with lanostan-8-en, lanostan-7, 9（11）-diene type and other lanostane triterpene were identified. Conclusion This study quickly analyzed the triterpenes in the Poria cocos ethanol extract via LC-MS, which provided the basis for the pharmacodyamic material basis and quality control.
2021, 42(11): 9-13.
doi: 10.12259/j.issn.2095-610X.S20211102
Abstract:
Objective To study the chemical constituents of the rhizomes of Trillium tschonoskii that cause uterine smooth muscle contraction. Methods The isolated rat uterine smooth muscle test method was used to screen the activity of different extracted parts of Trillium tschonoskii. Modern spectroscopy techniques were used to identify the main components of the effective parts. Results The main active part of T.tschonoskii that caused uterine smooth muscle contraction was screened, and three main components were identified as pennogenin saponins from this part. Conclusion T.tschonoskii has the effect of inducing uterine smooth muscle contraction, and the main active ingredient of this effect was pennogenin saponins.
2021, 42(11): 14-19.
doi: 10.12259/j.issn.2095-610X.S20211103
Abstract:
Objective To study the difference of fatty acid composition of lacquer oil obtained from different raw materials and extraction methods of lacquer seed in Nujiang Prefecture of Yunnan Province. Methods Black and white lacquer seed were used as experimental materials to extract the oil by selecting different parts and extraction methods. The fatty acids in the obtained oil were detected by gas chromatography-mass spectrometry. Results The results showed that there were abundant fatty acids in lacquer seed oil extracted from lacquer seed kernel by Soxhlet extraction. The content of unsaturated fatty acids was more than 70%, and the content of linoleic acid was about 60%. It was suitable for edible oil. The commercial edible lacquer seed oil and lacquer seed oil obtained from the whole lacquer seed by traditional pressing process and Soxhlet extraction are mainly saturated fat, with palmitic acid content of 60～70%. Due to improper packaging and storage, the types and content of unsaturated fatty acids in the commercial edible lacquer seed oil are reduced, resulting in lower nutritional value. The content of oleic acid and linoleic acid in white lacquer seed oil was higher than that in black lacquer seed oil, while the content of linolenic acid in black lacquer seed oil was higher （P < 0.05）. Black lacquer seed oil also contains about 1% palmitoleic acid. Therefore, the selection of raw materials and pressing technology has a great influence on the fatty acid composition and nutritional value of the obtained oil. Conclusion This study provides data reference for the development and utilization of lacquer seed resources.
2021, 42(11): 20-26.
doi: 10.12259/j.issn.2095-610X.S20211104
Abstract:
Objective To study the risk factors of depression in elderly inpatients and build a risk prediction model. Methods From September 2017 to July 2020, 525 elderly patients （≥60 years old） in the Department of Geriatrics of the First People’s Hospital of Yunnan Province were selected as the research objects. The comprehensive geriatric assessment system software independently developed by the geriatric medical department of the First People’s Hospital of Yunnan province was used for the comprehensive geriatric assessment, and the SDS scale in it was used to evaluate the depressive state of hospitalized patients. Binary Logistic regression analysis was used to explore the influencing factors of depression in the elderly, and a risk prediction model was established. The area under the ROC curve and the Hosmer-Lemeshow test were used to evaluate the prediction effect of the model. Results Among 525 newly admitted patients, there were 418 cases （79.6%） in the non-depressed group and 107 cases （20.4%） in the depressed group. There were statistically significant differences in age, gender, number of chronic diseases, MNA-SF, SAS, MMSE, BADL, ALS, MORSE and RomaⅢ scales between the two groups （P < 0.05）. The number of chronic diseases （OR = 1.473, 95%CI: 1.050 ～ 2.067, P = 0.025）, daily dysfunction （OR = 1.450, 95%CI: 1.073 ～ 1.958, P = 0.015）, anxiety （OR = 2.442, 95%CI: 1.829 ～ 3.259, P < 0.001）, cognitive dysfunction （OR = 1.488, 95%CI: 1.072～2.066, P = 0.018）, insomnia （OR = 1.620, 95%CI: 1.147～2.288, P = 0.006）, social support disorder （OR = 2.544, 95%, CI: 1.165～5.555, P = 0.019） were independent risk factors for depression in elderly inpatients. In addition, the ROC curve was drawn by using the prediction probability of the model as a new variable, the results showed that the AUC was 0.859, with a critical value of 0.595 （CI: 0.822～0.897, P < 0.001）, and the sensitivity and specificity of the prediction model were 0.818 and 0.782. Conclusion The state of senile depression is closely related to a variety of risk factors, and the risk prediction model based on the risk factors also has high accuracy.
2021, 42(11): 27-32.
doi: 10.12259/j.issn.2095-610X.S20211105
Abstract:
Objective To investigate the application of SPECT-CT radionuclide imaging in function examination of eustachian tube in otitis media patients. Methods 40 patients with chronic suppurative otitis media （group A）, cholesteatoma of the middle ear （group B） and traumatic tympanic membrane perforation （group C） admitted from April 2019 to May 2020 were divided into three groups, all of them underwent eustachian tube SPECT-CT radionuclide imaging and Valsalva examination. Results Comparison of eustaginal tube obstruction in group A, B and C with THE X2 test, P < 0.05, the difference was statistically significant. Comparison of group A, B and C with eustachian tube SPECT-CT radionuclide imaging （observation group） and Valsalva examination （control group） by X2 test, P < 0.05, the difference was statistically significant. Conclusions Eustachian tube obstruction is an important factor in the etiology and treatment of otitis media. Eustachian tube SPECT-CT radionuclide imaging can dynamically observe the degree of eustachian tube obstruction, help to judge the location of eustachian tube obstruction and provide clinical services.
2021, 42(11): 33-37.
doi: 10.12259/j.issn.2095-610X.S20211106
Abstract:
Objective To investigate the value of NLR and dNLR in prediction of HT in patients with AIS-LAA. Methods A retrospective study was conducted to analyze the clinical data of 151 patients with AIS-LAA, Department of Neurology, Beijing Friendship Hospital, from October 2020 to February 2021. They were divided into HT group （n = 19） and non-HT group （n = 132） according to the incidence of HT. General information and laboratory examination results were collected. The influencing factors of HT in patients with AIS were analyzed by multivariate Logistic regression analysis, ROC curve was drawn to analyze the predictive value of NLR and dNLR on HT in patients with AIS-LAA. Results （1） NIHSS and systolic blood pressure on admission in HT group were statistically significantly higher than that in non-HT group, the number of thrombolysis in HT group was statistically significantly higher than those in non-HT （P < 0.05）; （2） Multivariate Logistic regression analysis results showed that NLR [aOR = 1,441, 95% CI （1.154-1.798）, P = 0.001] and dNLR [aOR = 1.505, 95% CI （1.163-2.165）, P < 0.001] were independent influencing factors of HT in patients with AIS-LAA. （3） ROC curves demonstrated that the optimal cutoff value of dNLR for HT was 2.78 （sensitivity 83.3%, specificity 63.16%）, the area under the curve （AUC） value is 0.75 [95% CI （0.67-0.82）, P < 0.001]. For NLR, the optimal cutoff value was 4.61 （sensitivity 80.3%, specificity 63.16%）, the AUC value 0.71 [95% CI （0.63-0.78）, P = 0.004]. Conclusion NLR and dNLR are probably independent influencing factors of HT in patients with AIS-LAA, dNLR has relatively high value in prediction of HT in patients with AIS-LAA.
2021, 42(11): 38-44.
doi: 10.12259/j.issn.2095-610X.S20211107
Abstract:
Objective To elucidate the relationship between vaginal microbiota and premature rupture of membranes by analyzing the vaginal microbiota of normal pregnancy and pregnant women of premature rupture of membranes. Methods Gestational age meeting inclusion criteria was randomly collected （gestational age < 28 weeks; 28 to 34 weeks; 34 and 37 weeks; 37 to 39 weeks; each case was 10 at 39-41 weeks） , a total of 50 cases of vaginal secretions from pregnant women with premature rupture of membranes were used as the experimental group. Vaginal secretions were collected from 6 normal pregnant women at the above relative gestational age, and a total of 30 normal women were selected as the control group. The bacterial DNA of vaginal secretions was extracted by the second generation high throughput sequencing method, and the diversity index, microbial community structure and dominant species of vaginal microbiome were analyzed and compared between premature rupture of membranes and normal pregnant women. Results The P value of Wilcoxon test for Alpha diversity richness and evenness index among each group was > 0.05, The Stress value of nonmetric multidimensional scaling was = 0.02, less than 0.05, the difference was statistically significant. According to Venn diagram, the species diversity of preterm premature rupture of membranes was the highest （529）. The diversity of normal control group before term was the lowest （207）. Conclusions In normal pregnancy, vaginal microflora is stable, with small Alpha diversity and significant Beta diversity. Vaginal microbial community during pregnancy can be divided into five types, mainly L. crispatus , if the increase of L.iners, gardnella, prevotella,sneathia , ureaplasma and atopobium etc in the vagina during pregnancy, bacterial vaginosis and premature rupture of membranes are prone to occur.
2021, 42(11): 45-50.
doi: 10.12259/j.issn.2095-610X.S20211108
Abstract:
Objective To explore the correlation between different gestational age, biparietal diameter and fetal thyroid size by transabdominal two-dimensional ultrasound, and to provide the normal reference range of fetal thyroid for clinical evaluation of fetal thyroid function. Methods The diameter, circumference and area of the fetal thyroid were measured for 740 healthy pregnant women at 20～38 weeks, the 5th, 50th and 95th percentile was calculated. The correlation between the fetal thyroid with gestational age and biparietal diameter was analyzed respectively. Results The reference range of the diameter, circumference and area of fetal thyroid at 20-38 weeks were obtained. We found the 5th, 50th and 95th percentiles increased with the gestational age, and showed a high correlation with gestational age （r = 0.909, 0.904 and 0.913, respectively）, which was statistically significant （P < 0.01）; And also increased with biparietal diameter, highly correlated with the biparietal diameter （r = 0.922, 0.914 and 0.916, respectively）, which was statistically significant （P < 0.01）. Conclusion In this study, we established the reference range of fetal thyroid according to different gestational ages and biparietal diameter, which is not only helpful to monitor the size of fetal thyroid at high risk for early detection of fetal goiter dysfunction, but also can assess the effect of intrauterine therapy on goiter fetuses by monitoring fetal thyroid size.
2021, 42(11): 51-56.
doi: 10.12259/j.issn.2095-610X.S20211109
Abstract:
Objective To explore the clinical significance of HPV in oropharyngeal squamous cell carcinoma. Methods A total of 129 patients who were diagnosed and treated in Yunnan Tumor Hospital and met the inclusion criteria in oropharyngeal cancer from January 2010 to December 2019 were selected as the research subjects. The collected pathological specimens were detected using HPV16/18 DNA probes and HPV 6/11 DNA probes. SPSS 24.0 statistical software was used for data analysis. Results The positive rate of HPV in this study was 39.53%, all of which were high-risk HPV 16/18 infection. The positive rate was highest in tonsil area and tongue root area. The number of cases with the onset age less than 60 years （P = 0.041） and the early stage （P = 0.001） in the HPV positive group was significantly higher than that in the negative group. The number of long-term smoking cases in the negative group was significantly higher than that in the positive group （P = 0.012）. The treatment effective rate of patients in the HPV positive group is higher than that in the HPV negative group. Conclusion Compared with HPV-negative oropharyngeal squamous cell carcinoma, patients with HPV-positive oropharyngeal squamous cell carcinoma have a younger onset, early stage, fewer long-term smokers, and are more sensitive to radiotherapy and chemotherapy.
2021, 42(11): 57-61.
doi: 10.12259/j.issn.2095-610X.S20211111
Abstract:
Objective To retrospectively analyze the characteristics of infection indicators of antituberculosis drug-related liver injury in patients with pulmonary tuberculosis combined with HIV versus those with pulmonary tuberculosis alone, and to assess clinical risk factors and correlations. Methods Patients with liver injury induced by antituberculosis drugs were collected, including 55 cases of pulmonary tuberculosis and 39 cases of pulmonary tuberculosis combined with HIV infection. Clinical data were recorded, fasting venous blood was collected, CD3+, CD4+ and CD8+ T cell ratios were detected by flow cytometry, and serum PCT, IL-6, CRP, SAA and ESR were detected by ELISA. Results There were no significant differences in age, gender composition, height, weight and body mass index between the two groups, and the immune function of the two groups were compared, the expression of CD4+ T lymphocytes and CD4%, CD CD4/CD8% were statistically different （P < 0.05）. The levels of CRP and SAA in inflammatory indexes were higher in patients with single pulmonary tuberculosis （P < 0.05）, and the degree of liver injury in patients with TB and HIV was lower than in the group of patients with TB alone, suggesting that the diseased population with normal immune function, which has a strong inflammatory response, is one of the risk factors leading to liver injury in the treatment of anti-tuberculosis drugs. Also this study showed that SAA was strongly correlated with the severity of liver injury in the tuberculosis group with anti-tuberculosis drug liver injury and the results were statistically significant （P < 0.05）. In the pulmonary TB with HIV infection group, IL-6 was closely associated with the severity of liver injury and the results were statistically significant （P < 0.05）. Conclusions Infection indicators are expressed differently in anti-tuberculosis drug liver injury with different types of patients. The increase of SAA and IL-6 is related to the severity of anti-tuberculosis drug liver injury in different types of patients.
2021, 42(11): 62-67.
doi: 10.12259/j.issn.2095-610X.S20211110
Abstract:
Objective To investigate the platelet function, coagulation function and fibrinolytic system in elderly patients with type 2 diabetes. Methods 193 patients were divided into type 2 diabetes group （group DM, 97 cases） and control group （group NC, 96 cases） according to WHO standard diagnostic criteria.The gender, age, duration of diabetes, smoking history, SBP, DBP, BMI, FPG, 2 h PG, HbA1c, FC, TC, TG, ACT, PF, and aggregation polymer were collected and compared among the patients. Pearson correlation analysis and multiple linear regression analysis were performed on the related factors of PF and D-2 polymer. Results （1） The levels of BMI, D-2 polymer and ACT in the DM group were higher than those in the control group （P < 0.05）. （2） Pearson correlation analysis: The value of D-2 aggregate was positively correlated with age, BMI, and duration of diabetes （P < 0.05）, and positively correlated with the percentage of glycosylated hemoglobin （P < 0.01）. PF had significant negative correlation with the levels of 2 h postprandial insulin and C peptide （P < 0.05）, and more significant positive correlation with fasting blood glucose （P < 0.01）. （3） Multiple linear regression analysis: age and percentage of glycosylated hemoglobin were positively correlated with D-2 polymer （P < 0.05）. There was a positive correlation between fasting blood glucose and PF, and a negative correlation between insulin and PF at 2 hours after meal （P < 0.05）. Conclusion There are abnormal platelet function, coagulation function and fibrous function system in elderly patients with type 2 diabetes mellitus, high state of blood glucose and poor function of isolated islets may be the main reasons.
2021, 42(11): 68-73.
doi: 10.12259/j.issn.2095-610X.S20211113
Abstract:
Objective To systematically evaluate the development of auditory and language in children with inner ear malformation after cochlear implantation, in addition, to compare and analyze the differences of auditory and language development between these children and children with normal inner ear structure. Methods The 52 children with unilateral cochlear implantation were retrospectively selected and analyzed, they were divided into abnormal inner ear structure group and normal inner ear structure group according to whether the inner ear structure was abnormal or not, with 26 cases in each group. The auditory and language development of the two groups were compared and analyzed before operation, the 1st month, 3rd month, 6th month and 12th month after operation. The auditory function was assessed with CAP and ITMAIS scales, while the language function was assessed with SIR and MUSS scales. Results At the 1st month, 3rd month, 6th month and 12th month after cochlear implantation, the scores of auditory and language development （CAP, ITMAIS, SIR and MUSS） were significantly different from those before cochlear implantation, which has showed a gradually increasing trend. The auditory function of normal inner ear structure group and abnormal inner ear structure group were compared before operation, the 1st month, 3rd month, 6th month and 12th month after operation, there was statistical significant difference （P < 0.001）. There was no significant difference between the normal inner ear structure group and the abnormal inner ear structure group in the preoperative language function SIR score （P = 0.303）, however, there were significant differences in language function between the two groups at the 1st month, 3rd month, 6th month and 12th month after operation （P < 0.05）. Conclusion Within one year after cochlear implantation, the auditory and language ability of children with inner ear malformation has been significantly improved, however, there are some differences between the children with abnormal inner ear structure and those with normal inner ear structure.
2021, 42(11): 74-80.
doi: 10.12259/j.issn.2095-610X.S20211114
Abstract:
Objective To study the relationship between calcitonin receptor （CTR）, vitamin D dreceptor （VDR） gene polymorphism and type 2 diabetesmellitus （T2DM） with osteoporosis in kunming area, and to explore the pathogenesis of T2DM with osteoporosis genetic susceptibility factors. Methods We selected 237 diabetic patients in the department of endocrinology of First People’ s hospital of Kunming from 2017 to 2019. （1） The enrolled patients were divided into T2DM without osteoporosis group （61 cases） , T2DM with osteopenia group （111 cases）, and T2DM with osteoporosis group （65 cases） by bone mineral density results. PCR - RFLP technique was used to test CTR and VDR genotypes, and the differences between the three groups of patients were compared in following indicators: CTR and VDR genotype and allele frequency, sex, age, duration of diabetes, blood pressure, height, weight, body mass index （BMI）, fasting plasma glucose （FPG）, glycosylated hemoglobin （HbA1c）, blood calcium, blood lipids, blood uric acid （UA）, the concentration of vitamin D, estrogen and testosterone levels, allergic C - reactive protein （Hs – CRP）, fibrinogen （FIB）, oral glucose tolerance （OGTT） – 0 h, 2 h; 0 h, 2 h-insulin （INS） level and insulin resistance index （HOMA-IR）. （2） The differences in the bone mineral density were compared between patients with CTR joint VDR of different genotype combinations. （3）Multiariable logistic regression analysis was performed on the indicators with statistically significant difference in CTR joint VDR genotype combinations. Results （1） Three groups of patients were compared, CTR system joint VDR had no statistically significant difference in the different genotype combinations （P > 0.05）. （2） Comparison of three genotype combination in CTR system joint VDR, the bone mineral density has no statistical significant difference （P > 0.05）. （3） Multi-factor logistic regression analysis showed that age entered the regression equation of system and CTR system joint VDR genotype combinations did not enter the regression equation. Conclusions （1） Age is an independent risk factor in the kunming area of T2DM patients with osteoporosis. （2）CTR system joint VDR genotype combinations has nothing to do with the genetic susceptibility to T2DM with osteoporosis in kunming area .
2021, 42(11): 81-86.
doi: 10.12259/j.issn.2095-610X.S20211116
Abstract:
Objective To explore the effect of probiotics combined with enteral nutrition on gastrointestinal function and inflammatory factors in patients with severe acute pancreatitis. Methods The 205 patients with severe acute pancreatitis admitted to Kunming Third People’s Hospital from August 2017 to August 2020 were collected and divided into 102 observation group and 103 control group according to the digital random table method. The control group was given enteral nutrition support on the basis of routine treatment. The control group on the basis of conventional therapy, enteral nutrition therapy, the observation group in the control group based on the combined use of probiotics intensive treatment, after treatment with a course of a month. Observe the changes in the Glasgow （GCS） scores of the two groups of patients before and after treatment, immunoglobulin A （IgA）, immunoglobulin G （IgG）, immunoglobulin M （IgM）, serum D-lactic acid, procalcitonin（PCT） , Endotoxin, prealbumin（PA）, albumin （ALB）, transferrin （TF）, tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6）, interleukin- 35 （IL-35） changes, and the probability of sepsis, multiple organ dysfunction syndrome （MODS） and acute respiratory distress syndrome （ARDS）. Results After intensive treatment, the GCS scores of the observation group were higher than those of the control group; the levels of IgA, IgG, and IgM of the observation group were higher than those of the control group; The serum D-lactic acid, PCT, and endotoxin levels of the observation group were lower than those of the control group; the prealbumin （PA）, albumin （ALB） and transferrin （TF） levels of the observation group were higher than those of the control group;Serum TNF-α and IL-6 levels were lower than those of the control group, and serum IL-35 levels were higher than those of the control group; the incidence of sepsis, MODS, and ARDS in the observation group were lower than those of the control group; the above differences All were statistically significant （P < 0.05）. Conclusion Probiotics can enhance enteral nutrition support, improve gastrointestinal function, immune function and inflammatory response in patients with severe acute pancreatitis, and reduce the incidence of sepsis, MODS and ARDS, which is worth clinical promotion.
2021, 42(11): 87-92.
doi: 10.12259/j.issn.2095-610X.S20211115
Abstract:
Objective To analyze and discuss the clinical characteristics and prognostic risk factors of 80 patients with tetanus in our hospital,and to provide a basis for tetanus in clinical diagnosis and treatment, early identification of risk factors and reduction of mortality . Methods The clinical case data of 80 tetanus patients were collected from our hospital from January 2013 to December 2020. A database of 20 factors that may affect the prognosis of tetanus was established, its clinical characteristics were summarized, and its prognostic risk factors were analyzed. Results Among the 80 patients, the main clinical manifestations were closed teeth （97.5%）, dysphagia （92.5%）, spasms and convulsions of extremities （77.5%）, and the common complications were respiratory failure （32.5%） and myocardial damage （30%）.The following 8 factors: ICU patients, mechanical ventilation, fever, concurrent respiratory failure, limb spasm and convulsions, Apache Ⅱ score, Ablett classification, length of hospitalization, the difference between the death group and the survival group was statistically significant （P < 0.05）.The logistic regression analysis suggested that Hospital stay, mechanical ventilation and Ablett classification were risk factors for prognosis of tetanus （P < 0.05）. Conclusions The awareness of tetanus for manual workers should be strengthened. Complete debridement early after trauma and timely artificial immunization are the key measures to prevent tetanus; If patients with tetanus have long hospitalization time, mechanical ventilation and high Ablett grade, clinical management should be strengthened..
2021, 42(11): 93-98.
doi: 10.12259/j.issn.2095-610X.S20211117
Abstract:
Objective To investigate the expression of intercellular adhesion molecule-1 （ICAM-1）, matrix metalloproteinase-9(MMP-9） and NF-κB in cholangiocarcinoma and the relationship between CD14+CD11b+HAL-DR-MDSC in peripheral blood. Methods From December 2018 to December 2019, 60 patients with cholangiocarcinoma were selected. Immunohistochemistry was used to detect ICAM-1 protein, MMP-9 protein and NF-κB protein in cholangiocarcinoma and adjacent normal tissues, and flow cytometry was used to detect the ratio of CD14+CD11b+HAL-DR-MDSC in patients’peripheral blood. The expression of ICAM-1 protein, MMP-9 protein and NF-κB protein in cholangiocarcinoma and adjacent tissues were compared; the expression of ICAM-1 protein, MMP-9 protein and NF-κB protein in different pathological features and the ratio of CD14+CD11b+HAL-DR-MDSC in peripheral blood were compared; the expression of ICAM-1 protein, MMP-9 protein and NF-κB protein was correlated with the ratio of CD14+CD11b+HAL-DR-MDSC in peripheral blood. Results The positive rates of ICAM-1 protein, MMP-9 protein and NF-κB protein in cholangiocarcinoma were higher than those in normal group （P < 0.05）. There was no significant difference in the expression of ICAM-1 protein in different gender, age, pathological grade and lymph node metastasis （ P > 0.05）; the positive rate of ICAM-1 protein expression in stage III-IV was higher than that in stage I-II （ P < 0.05）. There was no significant difference in the expression of MMP-9 between different genders, ages, pathological grades and clinical stages （ P > 0.05）; the positive rate of MMP-9 in lymph node metastasis was higher than that in non lymph node metastasis （ P < 0.05）. There was no significant difference in the expression of NF-κB protein between different genders, ages, pathological grades and lymph node metastasis （ P > 0.05）; the positive rate of NF-κB protein expression in stage III-IV was higher than that in stage I-II （ P < 0.05）. There was no significant difference in the proportion of CD14 +CD11b+HAL-DR-MDSC in different sex, age, pathological grade and lymph node metastasis （P > 0.05）; the proportion of CD14 +CD11b+HAL-DR-MDSC in stage III-IV was higher than that in stage I-II （P < 0.05）. The expression of ICAM-1, MMP-9 and NF-κB was positively correlated with the ratio of CD14 +CD11b+HAL-DR-MDSC. Conclusion ICAM-1 protein, MMP-9 protein and NF-κB protein are highly expressed in cholangiocarcinoma, the ratio of CD14+CD11b+HAL-DR-MDSC in peripheral blood is increased, and the expression of ICAM-1 protein, MMP-9 protein and NF-κB protein is positively correlated with the ratio of CD14+CD11b+HAL-DR-MDSC.
2021, 42(11): 99-104.
doi: 10.12259/j.issn.2095-610X.S20211118
Abstract:
Objective To explore the risk factors and early clinical characteristics of neonatal necrotizing enterocolitis （NEC）, so as to improve the early warning of NEC and early intervention, so as to improve the prognosis of NEC. Methods A total of 95 children diagnosed with NEC in our NICU from November 22, 2017 to November 22, 2020 were collected, and 95 non-NEC children in the same period were selected as the control group according to the 1∶1 matching ratio. The univariate variables were screened by χ2 test, and then multivariate Logistic regression analysis was performed. The count data were analyzed by t test and rank sum test, and the rank data were analyzed by Spearman rank correlation test, α= 0.05. Results It suggested that premature birth, low birth weight, infection and mechanical ventilation were independent risk factors for NEC, and abdominal distention and gastric retention were the main clinical manifestations in the early stage. There was no significant correlation between leukocytes and neutrophils and the severity of NEC, while C-Reactive Protein and procalcitonin were positively correlated with the severity of NEC. Lymphocytes and platelets were negatively correlated with the severity of the disease, （P < 0.05 ）. Abdominal orthostatic X-ray had no obvious specificity for the early diagnosis of NEC. Conclusion When the children have the premature birth, low birth weight, infection and mechanical ventilation risk factors, abdominal distension and poor feeding performance, accompanied by the increase of C-reactive protein and procalcitonin, it is necessary to be alert to the occurrence of NEC, and dynamic abdominal orthostatic X-ray and abdominal ultrasound can be performed to improve the early diagnosis rate.
2021, 42(11): 105-110.
doi: 10.12259/j.issn.2095-610X.S20211119
Abstract:
Objective To explore the value of color Doppler ultrasonography （CDU） signs, fine needle aspiration cytology （FNA-C） of lymph nodes, and the level of thyroglobulin in lymph node fine needle aspiration eluate （FNA-Tg） in the diagnosis of cervical lymph node metastasis of papillary thyroid carcinoma （PTC）. Methods Firstly, CDU signs of cervical lymph nodes, FNA-C, FNA-Tg level, preoperative serum Tg level, and postoperative pathological results of patients with PTC were retrospectively analyzed and the specificity and positive prediction rate of them were also analyzed. Then, the receiver operating characteristic （ROC） curve and the optimal diagnostic threshold of FNA-Tg levels were determined. After that, the correlation between preoperative serum Tg, thyroid-stimulating hormone （TSH）, serum Tg antibody （TGAB） and lymph node FNA-Tg level were analyzed. Results As a result, in patients with typical ultrasound signs of cervical lymph node metastasis, the diagnostic rate of FNA-Tg was 100%, which is better than CDU and FNA-C. the cortical thickness of cervical lymph nodes is uneven and is ≥ 2mm, the diagnostic rate of FNA-Tg was 88.9%. The threshold value of FNA-Tg level in lymph nodes for diagnosing cervical lymph node metastasis of PTC was 2.57 ng/ml. There was no correlation between lymph node FNA-Tg and serum Tg level, serum TGAB （P > 0.05）, while there was a correlation between lymph node FNA-Tg and TSH （P < 0.05）. Conclusions For PTC patients with typical signs of cervical lymph node metastasis showed by CDU, the combination of CDU signs, lymph node FNA-C and FNA-Tg can accurately diagnose cervical lymph node metastasis. Attention should be paid to PTC patients with atypical signs of cervical lymph node metastasis （uneven cortical thickness ≥ 2 mm） showed by CDU, Lymph node lymph node FNA-C and FNA-Tg can significantly improve the diagnostic rate and form an important basis for clinical treatment of cervical lymph node metastasis in PTC patients.
2021, 42(11): 111-116.
doi: 10.12259/j.issn.2095-610X.S20211120
Abstract:
Objective To investigate the prognostic value of eGFR and serum NT-proBNP in patients with chronic heart failure complicated with atrial fibrillation. Methods From January 2018 to December 2019, 139 hospitalized patients with chronic heart failure complicated with atrial fibrillation were selected. The serum creatinine and NT-proBNP of the patients were measured, and the estimated glomerular filtration rate （eGFR） of the patients was calculated according to theequationofModification of Diet in Renal Disease. All-cause deaths after discharge were followed up. Logistic regression was used to analyze the risk factors of all-cause death in chronic heart failure complicated with atrial fibrillation during the follow-up period. ROC curve was used to analyze the prognostic value of eGFR and serum NT-proBNP in patients with chronic heart failure complicated with atrial fibrillation.Kaplan-meier method was used to draw the survival curve, and log-rank test was used for survival analysis. Results During the follow-up, 65 patients were found dead. The incidence was 46.76%. The area under the curve of eGFR-in predicting the absence of all-cause death in patients with chronic heart failure and atrial fibrillation was 0.651 （95%CI: 0.562 ～ 0.740）.The sensitivity was 57.70%, and the specificity was 69.20%. The area under the curve of serum NT-proBNP for predicting all-cause death in patients with chronic heart failure complicated with atrial fibrillation was 0.720 （95%CI: 0.638 ～ 0.803）.The sensitivity was 69.20%, and the specificity was 67.30%. The cumulative survival rate of patients in the low-eGFR group was significantly lower than that in the high-eGFR group during follow-up. The Log-rank value was 9.21, P = 0.002. During the follow-up, the cumulative survival rate of patients in the high level of NT-proBNP group was significantly lower than that in the low level of NT-proBNP group. The statistical value of Log-rank test was 16.91, P < 0.001. Conclusion eGFR and serum NT-proBNP have certain predictive value for the short-term prognosis of patients with chronic heart failure complicated with atrial fibrillation.
2021, 42(11): 117-121.
doi: 10.12259/j.issn.2095-610X.S20211121
Abstract:
Objective To explore the effects of autonomous breakthrough nursing on postoperative activities, pain and recovery in patients with complex ankle fracture and dislocation. Methods A total of 90 patients with complex ankle fractures and dislocations who admitted in our hospital for treatment from January 2018 to November 2018 were selected and randomly divided into observation group and control group, with 45 cases in each group. The control group received conventional orthopedic nursing and rehabilitation, and the observation group received independent breakthrough rehabilitation method. The postoperative rehabilitation effect and pain condition of the two groups were compared and analyzed. Results The total effective rate and rehabilitation degree of the observation group were significantly higher than those of the control group, and the incidence of complications and pain were significantly lower than those of the control group （χ2 = 6.944, 12.600, 8.389, 6.480, P < 0.05）. The VAS scores of patients in the observation group were significantly lower than those in the control group at 12 hours, 1 day and 2 days after operation （t = -9.354, -6.934, -6.911, P < 0.001）. The time of getting out of bed, complete weight-bearing, hospitalization and fracture healing were significantly shorter than those in the control group （t = -13.094, -9.615, -14.795, -7.857, P < 0.001）. The operation time, the amount of bleeding and the number of postoperative infections in the observation group were significantly lower than those in the control group （t = 2.247, 4.115, χ2 = 5.215, P < 0.05）. Conclusions Autonomous breakthrough nursing can effectively reduce the pain of patients with complex ankle fracture and dislocation. It has good clinical efficacy and rehabilitation effect, and patient satisfaction is high.
2021, 42(11): 122-127.
doi: 10.12259/j.issn.2095-610X.S20211122
Abstract:
Objective To explore the status quo, correlation and influencing factors of social support and medication adherence in patients with psoriasis. Methods Convenient sampling method was used to select 206 inpatients admitted to dermatology & STD of a general hospital in Chengdu from May 2021 to June 2021. General information questionnaire, Social Support Rating Scale and Morisky Medication Adherence Scale were used for questionnaire survey. Results The median score of social support and medication adherence was 25.00 and 1.75 respectively. There were significant differences in the level of social support among patients of different ages, marital emotional status, income level, place of residence, payment, type of psoriasis, location of skin lesions, bleeding of skin lesions, pruritus of skin lesions and family history （P < 0.05）. There was significant difference in medication adherence between first onset patients and recurrent patients （P < 0.05）. The results of logistic regression equation showed that the possibility of low level of social support in patients with family history was 5.384 times higher than that in patients without family history （P = 0.002）.The possibility of poor medication adherence in recurrent patients was 14.417 times higher than that in first-episode patients （P < 0.01）. There was a positive correlation between social support and medication adherence. Conclusions Patients with psoriasis have moderate level of social support, but poor medication adherence. Clinical medical staff should focus on the elderly patients with low income, family history and recurrent disease in rural areas, so as to help improve their social support level and medication adherence.
2021, 42(11): 128-133.
doi: 10.12259/j.issn.2095-610X.S20211124
Abstract:
Objective To investigate the changes of peripheral blood cells and their derived parameters and coagulation function in patients with adenomyosis, and to study the diagnostic value and clinical significance of the changes in adenomyosis. Methods The clinical data of 116 patients with adenomyosis （adenomyosis group） and 106 patients with benign ovarian cyst （control group） admitted to the Affiliated Hospital of Yunnan University from January 2010 to December 2020 are selected to compare the two groups Changes in peripheral blood cells, systemic immune inflammatory index （SII）, system-wide inflammatory response index （SIRI）, blood coagulation function and serum carbohydrate antigen 125 （CA125） and CA199 in patients’ peripheral blood cells, and plotting receiver operating characteristics （ROC） curve, calculate the area under the curve （AUC） of each parameter, and analyze its clinical significance in adenomyosis. Results （1） The uterine volume of adenomyosis group is （331.86±237.20） cm3 higher than that of control group （50.30±23.74） cm3 （P < 0.05）; （2）The levels of WBC, neutrophils, platelets, SII and SIRI in adenomyosis group [（6.65±2.41）×109/L; （4.31±2.10）×109/L; （298.33±80.09）×109/L; （802.45±622. 22）; 1.34±1.70] is significantly higher than the control group [（5.93±1.30） x109/L, （3.60±0.89） x 109/L, （222.42±41.59） x 109/L, 456.36±138.98; 456.36±138.98]（P < 0.05）; （3）The levels of CA125 （139.96±119.42KU/L） and CA199 （73.93±123.66KU/L） in peripheral blood of patients with adenomyosis are significantly higher than those in control group （10.98±8.72）; 14.30±7.98） （P < 0.05）; （4）Prothrombin time （PT） （11.11±0.67s） and activated partial thromboplastin time （APTT）（24.78±3.52s） in adenomyosis group are shorter than those in control group （11.34±0.65s）; 27.4±2.79s） （P < 0.05）; （5） AUC of WBC, NEU, PLT, SII, SIRI, CA125, CA199, PT and APTT are 0.5658, 0.5629, 0.7901, 0.7307, 0.5836, 0.9569, 0.7971, 0.6082, 0.7596 respectively. Conclusions The number of peripheral blood inflammatory cells in adenomyosis patients is increasing, and there are abnormal blood coagulation function. CA125 has high diagnostic value for adenomyosis.PLT, SII, CA199 and APTT also have certain accuracy in the diagnosis of adenomyosis.
2021, 42(11): 134-139.
doi: 10.12259/j.issn.2095-610X.S20211125
Abstract:
Objective To investigate the effect of tenofovirdipivoxil combined with Ganshuang granules on hemodynamics of portal venous system in hepatitis B liver cirrhosis. Methods 180 patients with hepatitis B cirrhosis were randomly divided into three groups: 60 cases in tenofovir disoproxil fumarate combined with Ganshuang granule group （group A）, 60 cases in tenofovir disoproxil fumarate combined with Compound Biejia Ruangan Tablet group （group B） and 60 cases in tenofovir disoproxil fumarate alone group （Group C）, treatment 6 Months. Before and after treatment, we collected the gender, age, blood biochemical indexes, liver stiffness, hemodynamic indexes of portal vein system, portal vein diameter （DPV）, portal vein mean blood flow velocity （VPV）, splenic vein diameter （Dsv）, spleen Mean venous blood flow velocity （Vsv）, portal vein blood flow （Qpv）, splenic vein blood flow （Qsv）, etc. Results The blood biochemical indexes, hemodynamic indexes and liver hardness of the three groups were significantly improved after treatment. After treatment, the recovery of blood biochemical indexes, liver hardness and hemodynamic indexes in group A and B were better than those in group C （P < 0.05）; After treatment, compared with group B, ALT and AST decreased, liver hardness decreased, and some portal hemodynamic indexes （DPV, VPV, qpv） recovered better in group A than in group B. Conclusions Tenofovir disoproxil fumarate combined with Ganshuang granule could better improve the liver function, fibrosis and hemodynamic indexes of portal vein system in hepatitis B cirrhosis. The curative effect is significantly better than that of tenofovir disoproxil fumarate alone or combined with Compound Biejia Ruangan Tablet.
2021, 42(11): 140-147.
doi: 10.12259/j.issn.2095-610X.S20211127
Abstract:
Objective To investigate the correlation between antimicrobial drug use and bacterial drug resistance, and to provide reference basis for clinical rational use of antimicrobial drugs. Methods DDDs and AUD of antimicrobial in Anning First People’ s Hospital from 2016 to 2019 were analyzed. WHONET5.6 software was used to calculate the drug resistance rate of bacteria isolated from clinical samples in the same period, and SPSS 23.0 software was used to analyze the correlation between the frequency of antimicrobial use and bacterial resistance. Results The usage of three generations of cephalosporins and quinolones in our hospital ranked the top, and the top 5 pathogens detected in clinical specimens were Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Staphylococcus epidermidis and Acinetobacter baumannii. The drug resistance rate of Escherichia coli was correlated with the DDDs of amikacin （r = -0.959, P = 0.041）, Klebsiella pneumoniae was correlated with ceftazidime DDDs （ r = 0.999, P = 0.001）, Acinetobacter baumannii and Pseudomonas aeruginosa resistance rates were correlated with DDDs of imipenancetastatin （r = 0.999, P = 0.001 and r = 0. 967 , P = 0.033）, Streptococcus pneumoniae resistance rates were correlated with DDDs of moxifloxacin （r = 0.989, P = 0.011）. Conclusions There is a correlation between the amount of antimicrobial agents and bacterial drug resistance, so it is necessary to select antimicrobial agents according to the results of drug sensitivity test to reduce the bacterial resistance.
2021, 42(11): 148-152.
doi: 10.12259/j.issn.2095-610X.S20211035
Abstract:
Objective Through retrospective analysis of the inconsistency of the two blood type identification results of blood samples before and after the implementation of the “comprehensive blood transfusion quality management” in our hospital, the reasons were investigated and analyzed, and improvement measures were proposed to ensure the safety of clinical blood use. Methods We performed a comparative analysis of the 2 blood type identification results of blood samples which were tested in the first three years （January 2015 to December 2017） and the later three years （January 2018 to December 2020） in our hospital after implementation of “Comprehensive Blood Transfusion Quality Management” Results From 2015 to 2020, a total of 12,023 cases of blood type identification were performed twice, and a total of 46 blood samples were identified with inconsistent results. The incidence rate was 0.038%, including 34 cases （0.061%） in the first three years and 12 cases （0.019%） in the later three years （P < 0.05）. The related factors were investigated and analyzed. In the first three years after the implementation of “Comprehensive Blood Transfusion Quality Management”, the main reason was the wrong identification of patients, and the main responsibility was the nurse. In the later three years after the implementation of “Comprehensive Blood Transfusion Quality Management”, the main reason was that patients borrow other people’ s information, and the main responsibility was the patient. Conclusion The risk of blood transfusion can be effectively reduced by carrying out “Comprehensive Blood Transfusion Quality Management”, strictly implementing the operating procedures, and comparing the test results of two blood samples of the same patient’ s blood type and cross matching.
2021, 42(11): 153-158.
doi: 10.12259/j.issn.2095-610X.S20211126
Abstract:
Objective To compare the efficacy of four methods on removal of calcium hydroxide in root canals. Methods Forty simulated resin root canals with 45° curvature were randomly divided into four groups. After root canal preparation, the apical foramen were sealed with glass-ionomer cement, the root canals were filled with calcium hydroxide, and the root canal orifices were sealed with hard wax. After being placed in a constant temperature water bath at 37 ℃ for 14 days, four methods including needle irrigation, Er: YAG laser irrigation, EDDY working tip irrigation and ultrasonic irrigation were used to remove the calcium hydroxide. The resin root canals before and after calcium hydroxide removal were scanned by cone-beam CT, and the scanning results were imported into Mimics software. Three-dimensional reconstruction of each root canal was performed by Mimics software, and the volume of calcium hydroxide in each root canal was calculated. The volume of calcium hydroxide was V1 before removal and V2 after removal, and the clearance rate was （V1-V2）/V1 * 100%. Rank sum test was used for statistical analysis. Results There was no significant difference in the initial volume of calcium hydroxide paste among the groups before removal （P > 0.05）. After removal, the residual volume of calcium hydroxide paste in Er: YAG laser group was 0.1296 （0.0920, 0.1743） mm3, which was less than the other three groups, and the difference was statistically significant （P < 0.05）. The reduction rate of calcium hydroxide paste was 99.63 % （99.53%, 99.70%） in Er: YAG laser group, which was higher than the other three groups, and the difference was statistically significant （P < 0.05）. The reduction rates of EDDY group and ultrasonic group were 99.08% （98.85%, 99.19%） and 99.04% （98.51%, 99.15%）, respectively. There was no significant difference between the two groups （P > 0.05）, but they were higher than needle group 74.99% （64.43%, 88.07%） （P < 0.05）, and the difference was statistically significant. Conclusions In this study, Er: YAG laser-activated irrigation, EDDY irrigation and ultrasonic irrigation have better removal effects on calcium hydroxide paste in root canals than traditional needle irrigation. Compared with other four methods, Er: YAG laser-activated irrigation has the highest removal efficiency, EDDY irrigation and ultrasonic irrigation have similar removal efficiency, but none of the four methods could completely remove calcium hydroxide paste from the curved root canals.
2021, 42(11): 159-165.
doi: 10.12259/j.issn.2095-610X.S20211128
Abstract:
Objective To investigate the influence of opportunistic infectious pathogens on the distribution of peripheral blood T lymphocyte subsets in newly acquired AIDS patients during efficient antiretroviral therapy. Methods A total of 220 AIDS patients who were first diagnosed and not performed with antiviral treatment in Infectious Disease Department I of Kunming Third People's Hospital from January 1, 2019 to June 30, 2020 were collected. According to clinical diagnosis, out of 220 patients, 33 patients had AIDS combined with mycobacterium tuberculosis, 30 patients had AIDS combined with hepatitis C virus, 31 patients had AIDS with Talaromyces marneffei, 45 patients had AIDS combined with 1 pathogens, 30 patients had AIDS with 2 pathogens, and 51 patients had AIDS with 3 or more pathogens. The treatment regimen was Tenofovir disoproxil fumarate tablets + lamivudine + EFV （TDF + 3TC + EFV）. Anticoagulant samples were collected before treatment, 3, 6 and 12 months after treatment. The peripheral blood T lymphocyte subsets were detected by flow cytometry. The distribution of peripheral blood T lymphocyte subsets in each group during antiviral treatment was compared and analyzed. Results The counts of CD3+, CD8+ and CD4+T lymphocyte in 3 groups of patients including the patients with AIDS combined with mycobacterium tuberculosis （AIDS/TB）, the patients with AIDS combined with hepatitis c virus （AIDS/HCV） and the patients with AIDS combined with Talaromyces marneffei （AIDS/TM） were significantly increased after 3 months treatment, and the differences were of statistical significance （P < 0.05）. As for AIDS/TM group, the CD4+T lymphocyte count increased significantly after 6 months of treatment; As for the other two groups, there was no obvious change of 3 indexes in the subsequent treatment, and the difference was statistically significant. （P > 0.05）. There was no significant difference in the count of CD3+ and CD8 + T lymphocytes in the three groups after 1 year of treatment, and the difference was of no statistical significance （P > 0.05）; The CD4 + T lymphocyte count in AIDS/HCV group was higher than that of the other two groups, and the difference was statistically significant （P < 0.05）. The CD3+ and CD8+T lymphocyte counts increased significantly after 3 months of antiviral treatment in the group of AIDS with 1 pathogen （AIDS/1）, and the difference was statistically significant （P < 0.05）. There was no significant change in CD4+T lymphocyte count during the whole treatment period, and the difference was no statistically significant （P > 0.05）. The CD8+T lymphocyte counts after treatment for 6 months and the CD3+ lymphocyte counts after treatment for 3 months in the group of AIDS with 2 pathogens increased significantly, and the difference was statistically significant （P < 0.05）. The CD3+ and CD8+T lymphocyte counts increased significantly after 6 months of treatment in the group of AIDS with 3 or more pathogens （AIDS/≥3）; The CD4+T lymphocyte count of AIDS/2 and AIDS/≥3 groups increased significantly after 3 and 6 months of treatment, and the difference was statistically significant （P < 0.05）. After one year of treatment, there was no significant difference in CD3+ and CD8+T lymphocyte counts among the three groups, and the difference was no statistically significant （P > 0.05）; The CD4+T lymphocyte count of AIDS/1 group was higher than that of the other two groups, and the difference was statistically significant （P < 0.05）. The ratio of CD4+/CD8+ in 6 groups was less than 1. Conclusions After the standardized efficient antiretroviral therapy, the counts of CD3+ and CD8+T lymphocytes in the peripheral blood of AIDS patients can be restored to the same level, regardless of the type and quantity of opportunistic pathogens. The distribution level of T lymphocyte subsets in the AIDS patients before and after treatment and the type and quantity of opportunistic pathogens will affect the recovery rate and level of CD4+T lymphocyte count during treatment. Three months before the efficient antiretroviral treatment is the key period to evaluate the therapeutic effect, while CD4/CD8 is not an ideal evaluation index.
2021, 42(11): 166-170.
doi: 10.12259/j.issn.2095-610X.S20211129
Abstract:
The goals of orthodontic treatment are balance, stability and aesthetics, an important physiological foundation for achieving the above goals is a good occlusal relationship, which includes static and dynamic occlusion. The evaluation of occlusal efficacy involves the static occlusal indicators such as overbite, overjet, midline and molar relationship at the intercuspal position （ICP）, as well as the dynamic occlusion during the centric and non-centric excursions. The PAR index represents the degree of deviation from the ideal occlusion, and the occlusal alternations can be quantitatively evaluated by comparing the differences in PAR index before and after orthodontic treatment. The T-scan digital occlusal system can be used to evaluate the dynamic occlusion because of its characteristics of “force and time” correlation. In this paper, the advantages of PAR index combined with T-SCAN occlusal system in evaluating the occlusal efficacy of orthodontic treatment were reviewed.
The goals of orthodontic treatment are balance, stability and aesthetics, an important physiological foundation for achieving the above goals is a good occlusal relationship, which includes static and dynamic occlusion. The evaluation of occlusal efficacy involves the static occlusal indicators such as overbite, overjet, midline and molar relationship at the intercuspal position （ICP）, as well as the dynamic occlusion during the centric and non-centric excursions. The PAR index represents the degree of deviation from the ideal occlusion, and the occlusal alternations can be quantitatively evaluated by comparing the differences in PAR index before and after orthodontic treatment. The T-scan digital occlusal system can be used to evaluate the dynamic occlusion because of its characteristics of “force and time” correlation. In this paper, the advantages of PAR index combined with T-SCAN occlusal system in evaluating the occlusal efficacy of orthodontic treatment were reviewed.
2021, 42(11): 171-175.
doi: 10.12259/j.issn.2095-610X.S20211130
Abstract:
Gastric cancer is the second most common malignant tumor in the world in terms of morbidity and mortality. It is a serious threat to human health.In recent years, with insulin resistance as the core of a group of metabolic disorder syndrome - the metabolic syndrome （metabolic syndrome, MetS） and the relationship between gastric cancer high-profile, a large number of studies had shown that various factors in the MetS and its complications could affect the occurrence and development of gastric cancer, the possible mechanism including hyperglycemia, obesity, insulin factors such as single or multiple factors synergy, this article aims to surrounding related research in recent years, were reviewed from aspects of the epidemiology, the pathogenesis of various metabolic factors associated with MetS and complications associated with stomach cancer.
Gastric cancer is the second most common malignant tumor in the world in terms of morbidity and mortality. It is a serious threat to human health.In recent years, with insulin resistance as the core of a group of metabolic disorder syndrome - the metabolic syndrome （metabolic syndrome, MetS） and the relationship between gastric cancer high-profile, a large number of studies had shown that various factors in the MetS and its complications could affect the occurrence and development of gastric cancer, the possible mechanism including hyperglycemia, obesity, insulin factors such as single or multiple factors synergy, this article aims to surrounding related research in recent years, were reviewed from aspects of the epidemiology, the pathogenesis of various metabolic factors associated with MetS and complications associated with stomach cancer.
2021, 42(11): 176-180.
doi: 10.12259/j.issn.2095-610X.S20211131
Abstract:
Objective To explore the effect of cluster nursing on the curative effect of negative pressure sealing drainage （VSD） combined with myocutaneous flap transplantation in the repair of stage ⅲ and ⅳ pressure ulcer. Methods 60 patients with stage III and IV pressure sores who underwent VSD combined with myocutaneous flap transplantation in xinkunhua Hospital of the first people’s Hospital of Yunnan Province from September 2019 to March 2021 were selected by convenient sampling method. The subjects were randomly divided into observation group and control group. The control group was given routine nursing, and the observation group was given cluster nursing on the basis of the control group. The change of wound area, tissue type and exudation were evaluated by push scale, and the healing time and treatment efficiency of the two groups were compared. Results After 7 days of intervention, there was no significant difference in push score between the two groups （P > 0.05）. At 14 and 21 days of intervention, the push score of the observation group was lower than that of the control group （P < 0.05）. There was significant difference in push score at each time point in the observation group （P < 0.05）. There was no significant difference between the 14 days of intervention and the 21 days of intervention in the control group （P > 0.05）; The healing time in the observation group （29.2 ± 8.6） d was lower than that in the control group （35.7 ± 13.7） d （P < 0.05）; After 21 days of intervention, the effective rate of the observation group was higher than that of the control group （P< 0.05）. Conclusion Cluster nursing for patients with stage III and IV pressure ulcer repaired by VSD combined with myocutaneous flap transplantation can effectively promote the recovery of pressure ulcer and can be popularized in clinical practice.
