Email
RSS2022 Vol. 43, No. 12
2022, 43(12): 1-5.
doi: 10.12259/j.issn.2095-610X.S20221201
Abstract:
Objective This study aims to explore whether platelet （PLT） is involved in regulating the progression of anaplastic thyroid carcinoma （ATC） by secreting transforming growth factor β1 （TGFβ1）. Methods The levels of TGFβ1 protein and mRNA in the supernatant of ATC cells were detected by ELISA and Real-time PCR, respectively. Transwell, scratch wound test and Western Blot were used to analyze the effects of TGFβ1 on the invasive and migratory abilities of ATC cell lines and its mechanism. Results In the co-culture supernatant of PLT and ATC cells, the protein level of TGFβ1 was significantly up-regulated, but the mRNA level was unchanged. PLT or rhTGF-β1 significantly increased the number of ATC cells crossing the chamber （P < 0.001）, suggesting that PLT or rhTGF-β1 could significantly enhance the migration ability of ATC cells. Scratch wound assay also confirmed that rhTGF-β1 could significantly enhance the migration ability of ATC cells. Conclusion PLT can significantly promote the development of EMT in ATC cells by secreting TGFβ1, and then promote the invasion and migration of ATC cells, suggesting that TGFβ1 may be a potential target of ATC molecular targeted therapy.
2022, 43(12): 6-11.
doi: 10.12259/j.issn.2095-610X.S20221205
Abstract:
Objective To investigate the effect of interfering with the expression of VEGF-C on the radiosensitivity of the nasopharyngeal carcinoma CNE-2 cell transplanted tumor and related signaling pathways. Methods The mice with transplanted tumors of nasopharyngeal carcinoma CNE-2 were randomly divided into tumor body group, siRNA-NC group, siRNA-VEGF-C group; irradiation group; siRNA-NC+ irradiation group; siRNA-VEGF-C+irradiation group. Tumor growth was observed, and the protein expression of VEGF-C, ATM and P65 were detected by immunohistochemistry. Results Interference of VEGF-C expression in nasopharyngeal carcinoma CNE-2 cell transplanted tumors showed significantly slower tumor growth after irradiation. Immunohistochemical test results showed that after tumor transplantation of mice interfered with VEGF-C, VEGF-C and ATM were significantly decreased （P < 0.05）, while P65 was increased （P < 0.05）. After combined irradiation, VEGF-C and ATM were significantly decreased （P < 0.05）. Conclusion In mouse nasopharyngeal carcinoma CNE-2 cell transplantation tumors, interfering with VEGF-C gene affects downstream ATM by activating NF-kB signaling pathway, thereby increasing the sensitivity of radiotherapy.
2022, 43(12): 12-17.
doi: 10.12259/j.issn.2095-610X.S20221207
Abstract:
Objective To investigate the role of miR-582-5p in regulating Notch1 to protect myocardium, by detecting the expression changes of miR-582-5p and Notch1 after myocardial ischemia reperfusion and HR model of HL-1 cells in mice. Methods The mouse myocardial ischemia-reperfusion model and HL-1 cell OGD reoxygenation model were established. The expression of miR-582-5p and Notch1 in mouse IR and cell HR was detected by qPCR, and then the targeted binding sites of miR-582-5p and Notch1 were predicted by TargetScan. Inhibitor and mimics of miR-582-5p and Notch1 were transfected into cells, and the expression of miR-582-5p and Notch1 was detected again. Finally, CCK-8 assay was used to detect the cell viability of HL-1 cells transfected with inhibitor and mimics. Results After HR, the expression of miR-582-5p was significantly increased （P < 0.01） and the expression of Notch1 was significantly decreased in IR mouse and HL-1 cells （P < 0.001）. After transfection of inhibitor, the expression of miR-582-5p was significantly down-regulated （P < 0.001）, while Notch1 was significantly up-regulated （P = 0.017）, and the viability of cardiomyocytes was significantly increased （P = 0.006）, but the result was opposite after transfection of mimics. Conclusion miR-582-5p can protect myocardium against myocardial ischemia and hypoxia by regulating Notch1.
2022, 43(12): 18-22.
doi: 10.12259/j.issn.2095-610X.S20221204
Abstract:
Objective To explore the effect of hsa-miR-130b-3p on the reprogramming of human dental iPSCs. Methods LV3 （H1/GFP&Puro）-hsa-miR-130b-3p-mimics plasmid was designed and synthesized. The plasmid was transduced into human DPSCs by Lipofectamine 3000 kit according to the manufacturer’s instructions. Fluorescence microscopy was used to observe the cells and transfection efficiency was verified by RT-qPCR. Sendai reprogramming kit was used to induce two groups of DPSCs （miR-130b-3p-DPSCs in the experimental group and DPSCs in the control group） into iPSCs. The morphology and reprogramming efficiency were compared and the expression of Oct4/Nanog/KOS/Klf4/c-Myc was detected by RT-PCR in two groups of iPSCs. Results hsa-miR-130b-3p overexpression plasmid was significantly expressed in DPSCs 48h after transfection, indicating high transfection efficiency （P < 0.01）. The two groups of iPSCs obtained by Sev reprogramming showed flat and dense round clones with clear and smooth edges, uniform cell morphology and large nucleolus in the colonies. RT-PCR results showed that cells in both groups could express the specific markers of stem cells Oct4 and Nanog. At the same time, exogenous virus SeV or transcription factors KOS/Klf4/c-Myc were no longer expressed. RT-PCR showed that cells in both groups all expressed specific markers Oct4 and Nanog, while SeV or KOS/Klf4/ C-MYC were not detected. The reprogramming efficiency of the experimental group was higher than that of the control group （0.037% and 0.018% respectively, P < 0.05）. Conclusion hsa-miR-130b-3p could promote the reprogramming efficiency of human DPSCs. Our research provides theoretical foundation for dental iPSCs application in dental pulp regenerative therapy.
2022, 43(12): 23-29.
doi: 10.12259/j.issn.2095-610X.S20221206
Abstract:
Objective To investigate the mechanism of miR-125b-5p regulating the proliferation and glycolysis of gallbladder cancer cells by HK2. Methods NC mimic, miR-125b-5p mimic, miR-125b-5p mimic+pcDNA-NC and miR-125b-5p mimic+pcDNA-HK2 were transfected into human gallbladder carcinoma GBC-SD cells, respectively. Real Time Quantitative Polymerase Chain Reaction （RT-qPCR） was used to detect the expression of miR-125b-5p and HK2 mRNA. The protein expressions of HK2, LDHA and PDK1 were detected by Western blot. Cell counting Kit-8 （CCK-8） was used to measure cell proliferation activity, and the glycolysis kit was used to measure lactic acid production, glucose consumption, and ATP production. Dual luciferase reporter assay was used to verify the targeting relationship between miR-125b-5p and HK2. Results The expression of miR-125b-5p was reduced in gallbladder carcinoma cell lines GBC-SD, NOZ （P < 0.0001） and tissues （P < 0.01）, and was lower in GBC-SD cells than in NOZ cells. Overexpression of miR-125b-5p significantly inhibited the proliferation of GBC-SD cells （P < 0.05）, glucose intake （P < 0.05）, the production of lactic acid （P < 0.001） and ATP production （P < 0.01）, and the expression of LDHA （P < 0.01）, PDK1 （P < 0.001）, and HK2 （P < 0.0001）. starBase database and dual luciferase experiments confirmed that miR-125b-5p targeted HK2 and negatively regulated its expression. Cell proliferation rate （P < 0.01）, glucose consumption （P < 0.05）, lactic acid （P < 0.01） and ATP production （P < 0.05）, and the expression of LDHA （P < 0.05）, PDK1 （ P < 0.05）、HK2 （P < 0.05）were significantly higher in the miR-125b-5p and HK2 overexpression groups. Conclusion Overexpression of miR-125b-5p inhibited the proliferation and aerobic glycolysis in human gallbladder carcinoma cell GBC-SD through targeting HK2.
2022, 43(12): 30-35.
doi: 10.12259/j.issn.2095-610X.S20221208
Abstract:
Objective To investigate the association between morning sickness and depression during pregnancy. Methods The pregnant women who underwent prenatal examination in 3 hospitals in Yunnan Province were selected. The information of pregnant women was collected by self-made questionnaire, and the Edinburgh Postpartum Depression Scale was used to assess depression in pregnancy. Chi-square test was used to describe the occurrence of pregnancy depression in pregnant women with different characteristics, and Logistic regression was used to analyze the correlation between morning sickness and prenatal depression. Results A total of 6075 pregnant women were included, and the detection rate of depression during pregnancy was 35.64%. Univariate analysis showed that there were statistically significant differences in pregnancy depression among pregnant women with different age, marital status, place of residence, occupational status, family annual income, educational level, gestational week, severity of morning sickness, duration of morning sickness, and whether the morning sickness is over （P < 0.05）. Multivariate results showed that pregnant women with severe morning sickness, lasting 10 weeks or more, and morning sickness that had not yet ended had an increased risk of depression during pregnancy. Conclusion The severity and duration of the morning sickness and whether it has ended are associated with depression during pregnancy. Health education on relevant infromation and knowledge should be strengthened to reduce the incidence of depression during pregnancy and improve the mental health of pregnant women.
2022, 43(12): 36-40.
doi: 10.12259/j.issn.2095-610X.S20221202
Abstract:
Objectives To investigate the infection status of reproductive tract chlamydia trachomatis （CT） in premarital examination population in Yunnan Province, and to provide basis for prevention and control measures and effect evaluation. Methods A cross-sectional survey was conducted among the premarital examination population in Baoshan City, Dehong Prefecture, Honghe Prefecture, Lincang City, Pu’er City and Xishuangbanna Prefecture of Yunnan Province, and the urine/cervical secretion samples were collected for CT nucleic acid detection. Results A total of 1671 individuals were enrolled in this study. The overall CT prevalence in this population was 6.64% （111/1671, 95% CI: 5.40%～7.80%）, the prevalence among male and female were 4.99% （42/841, 95% CI: 3.50%～6.50%）, and 8.31% （69/830, 95% CI: 6.40%～10.20%）, respectively. The CT positive rates among the individuals attending premarital examination in different prefectures were statistically different （P = 0.043）, which were relatively higher in Pu’er City （8.87%, 29/327）, Dehong Prefecture （8.64%, 26/301） and Lincang City （7.94%, 25/315） . Aged ≤ 20 years （AOR = 4.346, 95%CI: 1.468～12.707） and education level of junior middle school and below （AOR = 1.854, 95%CI: 1.071～3.211） were more likely to be infected with CT. Conclusion The prevalence of CT among the premarital examination population showed statistical difference when stratified by region, age and education level. The health education on STD prevention knowledge and the testing ability of STD should be strengthened. The effective control of CT infection should be achieved by increasing the intensity of screening, finding the source of infection and carrying out standardized treatment.
2022, 43(12): 41-46.
doi: 10.12259/j.issn.2095-610X.S20221203
Abstract:
Objective To analyze the prevalence of asthma and socioeconomic and lifestyle risk factors in rural areas of Yunnan Province. Methods A total of 7572 rural residents aged ≥35 years in Yunnan Province were selected by multi-stage stratified random sampling method, each participant received an on-site questionnaire survey. Structural Equation Modeling （SEM） was used to analyze the related influencing factors of asthma. Results The overall prevalence of asthma was 1.61% in rural areas of Yunnan Province. Males had a higher prevalence of asthma than females （1.98% and 1.25%, χ2 = 6.308, P = 0.012）, and prevalence of asthma increased with age （χ2 = 65.558, P < 0.001）. The results of SEM analysis showed that smokers, passive smokers, family history of asthma, male, ethnic minority groups and living in stone adobe houses had a higher risk of developing asthma than their counterparts. Specifically, smoking had the greatest direct impact on the prevalence of asthma, which the standardized regression coefficient was 0.15, followed by family history of asthma, age, passive smoking, gender, ethnicity and housing type, with the standardized regression coefficient of 0.13, 0.09, 0.08, 0.06, 0.03 and -0.02, respectively. Conclusion The prevalence of asthma is high in rural Yunnan province. Both socioeconomic and lifestyle factors have impact on the prevalence of asthma. Future health management strategies should more focus on males, elderly people, improving the living environment for residents with poor housing conditions, and increasing efforts of tobacco control, so as to reduce the incidence of asthma.
2022, 43(12): 47-52.
doi: 10.12259/j.issn.2095-610X.S20221210
Abstract:
Objective To investigate the risk factors of rupture of posterior communicating aneurysm and screen the morphologic and hemodynamic predictors. Methods A total of 78 patients with posterior communicating aneurysm diagnosed in the neurosurgery department of the Affiliated Suzhou Hospital of Nanjing Medical University, the First Affiliated Hospital of Soochow University from March 2019 to December 2021 with complete clinical data and meeting the inclusion criteria were retrospectively analyzed. 49 cases of ruptured aneurysm were in the observation group, and 29 cases of unruptured aneurysm were in the control group. Clinical data included sex, age, smoking history, history of hypertension, history of diabetes. Morphological data included aneurysm size, aspect ratio （AR）, size ratio （SR）, undulation index （UI）, nonsphericity index （NSI）, elliptic Index （EI）. The hemodynamic parameters include Wall Shear Stress （WSS）, Wall Shear Stress Gradient （WSSG） and Oscillatory Shear index （OSI）. Results There was no statistically significant difference between the two groups （P > 0.05） in age, sex, history of smoking, hypertension and diatetes. Morphological analysis showed that there were significant differences in maximum diameter, SR, UI and NSI between two groups （P < 0.05）. There were no significant differences in AR, NSI and EI （P > 0.05）. Morphological analysis showed that WSS （Pa） was significantly different between the two groups （P < 0.05）, WSSG （Pa/mm） and OSI had no significant difference （P > 0.05）. Conclusion Aneurysm size and irregular wall shape are closely related to aneurysm rupture. Low WSS may be an independent risk factor for posterior communicating aneurysm rupture.
2022, 43(12): 53-57.
doi: 10.12259/j.issn.2095-610X.S20221211
Abstract:
Objective To compare the clinical outcomes of PPOS protocal and mild-stimulation protocal in patients with diminished ovarian reserve function during assisted reproduction and pregnancy. Methods Patients with DOR who underwent the first and second generation of test-tube babies（IVF/ICSI） in the First Affiliated Hospital of Kunming Medical University from April 2021 to April 2022 were retrospectively analyzed. A total of 294 cycles were included and divided into 2 groups（group A: PPOS group, group B: mild-stimulation group）. The medication, embryo status and pregnancy outcomes were compared between the two groups. Results Initiation dose of Gn, total Gn dose, HCG dose on trigger day in group A were significantly higher than those in group B（P < 0.05）; LH on HCG day in group A was lower than that in group B（ P < 0.05）. The number of eggs, embryos and high quality embryos in group A were higher than those in group B（ P < 0.05）. Conclusion The clinical outcomes of the PPOS group were better than the mild-stimulation group.
2022, 43(12): 58-65.
doi: 10.12259/j.issn.2095-610X.S20221212
Abstract:
Objective To develop and validate a plasma osmolality prediction model for the risk of in-hospital death in critically ill patients with acute ST-segment elevation myocardial infarction. Methods By retrospective analysis of patients' electronic medical record data, patients with severe STEMI admitted to the Department of Cardiovascular Medicine, Affiliated Hospital of Yunnan University from January 2015 to December 2020 were selected. General information, laboratory examination, comorbid diseases and medications of the patients were extracted to screen the risk factors of in-hospital death of severe STEMI patients and establish a prediction model. Results LASSO regression and multivariate Logistic regression were used and identified albumin （ALB）, leukocyte （WBC）, platelet （PLT）, serum creatinine （Scr）, statins medication, angiotensin-converting enzyme inhibitors （ACEI） medication or angiotensin-converting enzyme receptor antagonists （ARB）, and plasma osmosis Pressure as independent predictor of in-hospital death in severe STEMI patients （P < 0.05）. A nomogram was drawn based on the 7 predictive variables. Model test results showed good differentiation and calibration, and decision curve analysis （DCA） showed a threshold probability of 5%-95%. Conclusion The prediction model has good discrimination and calibration, and can be used as a reference tool for assessing the risk of in-hospital mortality in critically ill patients with STEMI.
2022, 43(12): 66-74.
doi: 10.12259/j.issn.2095-610X.S20221213
Abstract:
Objective To explore the most appropriate total cumulative nedaplatin dose during chemotherapy for patients at the III-IVA stage after induced chemotherapy, and to analyze the effect of the total amount of nedaplatin on the prognosis of nasopharyngeal carcinoma patients after induction chemotherapy. Methods In this study, a total of 109 patients who were first diagnosed at Yunnan Cancer Hospital from 2013 to 2018 received induction chemotherapy （IC） plus concurrent chemoradiotherapy （CCRT）. According to the CND quartile, the patients were divided into three groups: low （≤120 mg/m2）, medium （121-200 mg/m2） and high dose （ > 200 mg/m2）. According to the response after tumor induction chemotherapy, the Nedaplatin group was divided into CR/PR and SD/PD subgroups, respectively. The effects of different cumulative dose of nedaplatin on the prognosis of patients after induction chemotherapy were analyzed to obtain the optimal CND. Results The difference in survival rates between the low, medium and high dose groups of CND were not statistically significant （P > 0.05）. According to the survival analysis of CR/PR and SD/PD groups, the cumulative OS rates were 77.2% and 50.0%, the 3-year OS rates were 98.2% and 62.9%, the cumulative PFS rates were 63.2% and 45.0%, and the 3 a PFS rates were 77.2% and 54.8%, respectively. The survival rate of CR/PR group was better than that of SD/PD group （P < 0.05）. According to the low, medium and high dose of CND, the two subgroups were analyzed respectively. The cumulative OS rate of CR/PR subgroup was 93.3%, 93.8% and 60.0% （P = 0.046）, and the 3 year OS rates were 100.0%, 93.8% and 100.0% （P > 0.05）. The cumulative PFS rates were 86.7%, 78.1% and 30.0% （P = 0.007）, and the 3 year PFS rates were 93.3%, 90.6% and 60.0% （P = 0.017）. The low-dose and medium-dose groups showed significant advantages in OS rate, PFS rate and 3year PFS rate. There was no significant difference in survival rate among SD/PD subgroups （P > 0.05）. In multivariate analysis, efficacy evaluation after IC （CR/PR&SD/PD） was an independent prognostic factor for OS, 3 year OS, PFS, and 3 year PFS in patients with stage III-IVA nasopharyngeal carcinoma （P < 0.05）. Conclusion The survival benefit of CR/PR patients with stage III-IVA nasopharyngeal carcinoma after IC is much better than that of SD/PD patients. Tumor response after IC （CR/PR&SD/PD） is an independent prognostic factor for stage III-IVA nasopharyngeal carcinoma patients. In the post-IC CR/PR subgroup of patients with stage III-IVA nasopharyngeal carcinoma, the survival rate of patients receiving low and medium CND improved significantly in the higher dose group. It seems that CND does not need to exceed 200 mg/m2 to achieve better survival results for these patients.
2022, 43(12): 75-80.
doi: 10.12259/j.issn.2095-610X.S20221214
Abstract:
Objective To investigate the ultransonic characteristics of conventional ultrasound （US）combined with Contrast-enhanced ultrasound （CEUS） in the pre-operative diagnosis effectiveness of lateral cervical lymph node metastasis （LCLNM）from papillary thyroid carcinoma （PTC）, and to evaluate its efficacy in preoperative diagnosis of PTC lateral cervical lymph node metastasis. Methods A total of 80 patients who received PTC surgery and lateral cervical lymph node dissection in the Second Affiliated Hospital of Kunming Medical University were selected, and 126 lymph node ultrasonography data were obtained. Postoperative pathology confirmed that 81 lymph nodes were metastatic PTC and 45 lymph nodes were non-metastatic. The ultrasonographic features of lymph node metastasis were observed by conventional ultrasound （US） and contrast-enhanced ultrasound （CEUS）. Compared with the pathological results, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of US, CEUS and combined application in the preoperative diagnosis of LCLNM in PTC patients were calculated. Results The ultrasonographic features of metastatic lymph nodes were mostly lymphatic portal disappearance or deviation. Cortical echo was non-uniform hypoecho, internal mass hyperecho and calcification, blood flow types were mostly peripheral type and mixed type, and blood flow grades were mostly Adler grade 2 and grade 3; compared with the non-metastatic group, the difference was statistically significant （P < 0.05）. The ultrasonographic characteristics of metastatic lymph nodes detected by CEUS were mostly centriotype and type Ⅱ, followed by type Ⅲ. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the combination of US and CEUS were superior to those of US or CEUS alone in the diagnosis of PTC lateral cervical lymph node metastasis. Conclusion Preoperative conventional ultrasound combined with CEUS can improve the diagnostic efficacy of lateral cervical lymph node metastasis from PTC.
2022, 43(12): 81-87.
doi: 10.12259/j.issn.2095-610X.S20221215
Abstract:
Objective To investigate the expression of lysoxygenase-like protein 2 （LOXL2） and Snail in the tissues of cholangiocarcinoma （CCA） and their association with clinicopathological features and postoperative survival. Methods 31 patients with cholangiocarcinoma who underwent surgical removal in the First People’s Hospital of Yunnan Province from 2014 to 2021 and their follow-up data were collected. The expression of LOXL2 and Snail in cancer tissues and adjacent normal tissues of patients was detected by immunohistochemical staining, and the association between the expression of the two proteins and clinicopathological data and prognosis was analyzed. Results The expression levels of LOXL2 and Snail in tumor tissues were significantly higher than those in adjacent tissues, and there was a positive correlation between LOXL2 expression and Snail expression （r = 0.430, P = 0.016）. Snail expression was associated with lymph node metastasis （P = 0.025）. Compared with patients with high expression of LOXL2 and Snail, patients with low expression of LOXL2 and Snail had higher overall survival rate （all P < 0.05）. Univariate survival analysis showed that high expression of Snail and lymph node metastasis were associated with worse prognosis in patients with cholangiocarcinoma （all P < 0.05）. Multivariate Cox survival analysis showed that lymph node metastasis might be an independent prognostic factor for patients with cholangiocarcinoma （P = 0.017）. Conclusion The expression of LOXL2 and Snail is increased in cholangiocarcinoma tissues, and the expression of LOXL2 and Snail is closely related. The overexpression of Snail may be more prone to lymph node metastasis and promote the invasive behavior of tumor cells, and lymph node metastasis may be an independent factor affecting the prognosis of cholangiocarcinoma patients. Patients with LOXL2 and Snail overexpression have a relatively low postoperative survival rate.Therefore, the combined detection of LOXL2 and Snail is of great significance for the prognosis of patients with cholangiocarcinoma.
2022, 43(12): 88-92.
doi: 10.12259/j.issn.2095-610X.S20221216
Abstract:
Objective To explore the efficacy of high-flow nasal cannula oxygen therapy on oxygenation in populations at altitudes above 2500 meters. Methods Participants were recruited from medium-altitude Kunming （about 1891 m above sea level） to quickly enter higher altitude Lhasa （about 3650 m above sea level）. Participants inhaled air using high-flow nasal cannula oxygen therapy in Lhasa. The pulse oxygen saturation （SpO2）, respiratory rate, heart rate and blood pressure were compared before and after the use of high-flow nasal cannula oxygen therapy . Results In high altitude area, the high flow nasal canula oxygen therapy went well and smoothly. After high-flow nasal catheter oxygen therapy, SpO2 improved and respiratory rate decreased with the increase of inhaled gas flow, the difference was statistically significant （P < 0.05）. After using high-flow nasal cannula oxygen therapy equipment for air inhalation, SpO2 improved and respiratory rate decreased with the increase of inhaled gas flow, the difference was statistically significant （P < 0.05）. Conclusion High-flow nasal cannula oxygen therapy not only improved participants’ oxygenation, it decreased the effort of breathing, and has potential clinical value in the treatment of high-altitude hypoxemia .
2022, 43(12): 93-98.
doi: 10.12259/j.issn.2095-610X.S20221218
Abstract:
Objective To explore the clinical significance of uterine artery and luteal flow Doppler parameters in pregnancy of uncertain viability. Methods A total of 64 women with pregnancy of uncertain viability in first trimester were selected as the research subjects. The uterine artery and luteal blood flow parameters were measured by transvaginal ultrasound. Based on the definite diagnosis after follow-up, non-viable intrauterine pregnancies were included in the study group, and viable intrauterine pregnancies were included in the control group. Results The mUAPI （2.16±0.50） and mUARI （0.82±0.07） in the non-viable pregnancy group were significantly lower than the mUAPI （2.93±0.48） and mUARI （0.89±0.05） in the viable pregnancy group, with statistically significant differences （P < 0.05）. The luteal blood flow PI （0.85±0.13） and RI （0.56±0.06） in the non-viable pregnancy group were significantly higher than the luteal blood flow PI （0.75±0.13）, luteal blood flow RI （0.50±0.06） in control group, with statistically significant （ P < 0.05）. Conclusion Uterine artery and corpus luteum blood flow Doppler parameters are useful for guiding clinical consultations in pregnancies of uncertain viability.
2022, 43(12): 99-104.
doi: 10.12259/j.issn.2095-610X.S20221219
Abstract:
Objective MRI scanning technique was used to measure the thickness of the anterior and posterior angles of the medial and lateral compartments of the knee joint in normal adults, so as to provide technical means and parameters for the design of total knee replacement prosthesis and the optimization of artificial meniscus design. Methods The imaging data of MRI scanning of unilateral knee joint of adult patients in Yunnan Traditional Chinese medicine hospital from January 2020 to June 2022 were randomly selected. 248 cases without knee edema, obvious degeneration of meniscus, meniscus injury and tear in MRI films were taken as samples, including 137 women, 111 men, 18-80 years old, with a median age of 50 years. The sagittal MRI films of knee joint were observed, Three senior clinicians measured the meniscus anterior and posterior angle thickness of the medial compartment of the knee joint and the meniscus anterior and posterior angle thickness of the lateral compartment of the knee joint, and the average of the three measurements was taken as the final measurement result. The measurement results were statistically analyzed by spss27.0 statistical software package. Results The thickness of anterior horn of meniscus in the medial compartment was （3.65 ± 0.93）mm; the thickness of posterior horn of meniscus in the medial compartment was （5.25 ± 1.17）mm; the thickness of anterior horn of meniscus in the lateral compartment was （4.82 ± 1.08）mm; the thickness of posterior horn of lateral in the lateral compartmentwas （6.89 ± 1.03）mm. The t test of two independent samples showed that the thickness of the posterior angle of meniscus in the medial compartment was statistically significant between men and women （P < 0.05）. The anterior and posterior Angle thickness of the meniscus in the medial ventricle of the left and right knee joints was significantly different from that in the lateral ventricle （P < 0.05）. According to Pearson correlation analysis, there was a correlation between the anterior angle thickness of medial interventricular meniscus and the posterior angle thickness of medial interventricular meniscus in both sexes （P < 0.05）. There was a correlation between the thickness of anterior horn of lateral interventricular meniscus and the thickness of posterior horn of lateral interventricular meniscus in both sexes （P < 0.05）. Conclusion In this study, MRI imaging technology was used to reveal the morphological characteristics and changes of meniscus in normal adults through the measurement of meniscus morphology, which is conducive to the design of total knee replacement prosthesis and the optimization of artificial meniscus design, so as to better guide clinical treatment.
2022, 43(12): 105-110.
doi: 10.12259/j.issn.2095-610X.S20221220
Abstract:
Objective To explore the diagnostic significance of FNA-Tg for lymph nodes with suspected cervical thyroid papillary carcinoma metastasis on the basis of ultrasonic detection and guidance and accurate biopsy of FNA, and establish the threshold of FNA-TG. Methods 74 lymph nodes with suspected metastasis of thyroid cancer were evaluated by fine needle aspiration and analysed pathologically. Lymph nodes were evaluated by comparing FNA alone, FNA-TG value with serum Tg, and drawing ROC to obtain the best diagnostic value of FNA-TG, and the sensitivity, specificity and accuracy of positive results were evaluated. Results There were significant differences in calcification, cortex-medullary boundary, abnormal blood supply and aspect ratio in the diagnosis of cervical lymph node metastasis of papillary thyroid carcinoma （P < 0.05）. The above four indexes had the highest sensitivity in the diagnosis of lymph node metastasis of thyroid cancer. Calcification, multiple hyperecho, cystic changes and elastic imaging had higher hardness specificity, and the accuracy of cortex-medulla boundary and aspect ratio was the highest. The sensitivity, specificity and accuracy of FNA were 75%, 100% and 87.84%. The sensitivity, specificity and accuracy of FNA-Tg/ serum Tg value > 1 were 97.22%, 100% and 98.65%. ROC curve was drawn to obtain the optimal diagnostic threshold of FNA-Tg as 0.575 ng/mL. Conclusion FNA-Tg/ serum Tg > 1, as the diagnostic criteria for lymph node metastasis of papillary thyroid cancer, can better avoid the disadvantages caused by many factors and effectively reduce the error rate, and should be the first choice for the auxiliary diagnosis of lymph node metastasis of papillary thyroid cancer.
2022, 43(12): 111-116.
doi: 10.12259/j.issn.2095-610X.S20221221
Abstract:
Objective To explore the efficacy of Xinmailong injection on septic cardiomyopathy. Methods A randomized controlled, single-blind study was conducted. 36 patients diagnosed with septic cardiomyopathy were randomly divided into control group （n = 19） and cardiomyopathy group （n = 17）. All patients in the 2 groups were given standardized treatment according to the 2018 International Guidelines for the Management of Sepsis and Septic Shock, and hemodynamic monitoring was performed by PICCO monitor during treatment. The experimental group was treated with Xinmailong injection on the basis of standard treatment, and the control group was injected with 0.9% sodium chloride injection at the same time. Peripheral venous blood was extracted from patients before treatment, 24 h, 72 h and 120 h after treatment, respectively, to detect troponin I and B brain natriuretic peptide, Doppler echocardiography was used to evaluate cardiac function, and hemodynamic blood related indexes showed by PICCO were compared.The experimental data were statistically analyzed by SPSS 19.0 statistical software. Results Compared with the control group, the levels of Cardiac Troponin I and brain natriuretic peptide B in experimental groups were significantly decreased. Left ventricular ejection fraction （LVEF）, tricuspid annular plane systolic excursion （TAPSE）, E/A increased, E peak deceleration time decreased; Stroke volume index （SVI） and cardiac function index （CFI） increased, and the difference was statistically significant （P < 0.05）. Conclusion Xinmailong injection can improve the cardiac function of patients with septic cardiomyopathy.
2022, 43(12): 117-124.
doi: 10.12259/j.issn.2095-610X.S20221222
Abstract:
Objective To investigate the influences of abdominal regional block combined with patient-controlled intravenous analgesia （PCIA） and patient-controlled epidural analgesia （PCEA） on postoperative analgesia, anxiety, nausea, vomiting and inflammatory mediator release in elderly patients underwent laparoscopic inguinal hernia repair. Methods 90 elderly patients with laparoscopic inguinal hernia repair under general anesthesia and endotracheal intubation treated in Kunming Second People’s Hospital from February 2021 to June 2022 were randomly divided into nerve block group （S group） and epidural analgesia group （Y group）, with 45 cases in each group. Patients in group Y received epidural puncture and intubation at T12～L1 level, and PCEA was connected to determine the epidural block level. After the epidural block level was above T8～L1, the operation was completed under rapid induction of general anesthesia and endotracheal intubation. PCEA was used for postoperative analgesia after operation. In group S, the patients underwent ultrasound-guided lateral ilioabdominal/ilioinguinal nerve block （IINB） and bilateral rectus abdominis sheath block （RSB）. The regional block level was measured and confirmed above T8～L1 at the operation side and abdominal medline. And the operation was completed under rapid induction of general anesthesia and endotracheal intubation. Postoperative analgesia was performed in combination with PCIA. The scores of NRS, BAI, HMGB1 and PONV were compared between the two groups. Results There was no significant difference in gender, age, ASA, BMI and operating time in the two groups （P > 0.05）. The length of stay in group S was less than that in group Y （P < 0.05）. There was no significant difference in NRS between the two groups at 0.5h after tracheal tube removal （P > 0.05）. The NRS of group S at 12 h and 24 h after operation were lower than those of group Y （P < 0.05）. There was no significant difference in NRS between the two groups at 48 h after operation （P > 0.05）. There was interaction between the two groups （P < 0.05）. The BAI of group S at 12 h and 24 h after operation were lower than those of group Y （P < 0.05）. There was no significant difference in BAI between the two groups at 48 h after operation （P > 0.05）. At any time point of 12 h, 24 h and 48 h after operation, there were significant differences in BAI between the two groups （P < 0.05）, and the BAI decreased gradually. There was no significant difference in HMGB1 between the two groups at 12 h before operation （P > 0.05）. HMGB1 in group S was lower than that in group Y at 12 h and 24 h after operation （P < 0.05）. There was no significant difference in HMGB1 between the two groups at 48 h after operation （P > 0.05）. HMGB1 at 12 h, 24 h and 48 h after operation in both groups was higher than that at 12 h before operation （P < 0.05）. The incidence of PONV at 12 h, 24 h and 48 h after operation in group S was lower than that in group Y （P < 0.05）. The incidence of PONV at 12 h, 24 h and 48 h after operation in the two groups had significant difference （P < 0.05）. Conclusion Compared with epidural block analgesia, preoperative abdominal block combined with PCIA multimodal analgesia has a more positive effect on reducing the postoperative pain and anxiety of elderly patients underwent laparoscopic inguinal hernia repair under general anesthesia, reducing the incidence of postoperative nausea and vomiting, and reducing the concentration of HMGB1 in venous blood, and has a more lasting effect on reducing the incidence of postoperative nausea and vomiting, which is conducive to the postoperative recovery of elderly patients.
2022, 43(12): 125-130.
doi: 10.12259/j.issn.2095-610X.S20221223
Abstract:
Objective To investigate the application of pneumoperitoneum transvaginal natural orifice endoscopic surgery in ectopic pregnancy and the related factors affecting the operation time in the initial stage. Methods A total of 23 patients who were admitted to Kunming First People’s Hospital from July 2020 to November 2021, with stable vital signs, indicating for ectopic pregnancy surgery, and estimated internal bleeding < 800 mL, were selected as the study subjects. v-NOTES pregnancy tubal resection without air was performed. Another 23 patients who underwent peritoneal porous peritoneoscope tubal resection were selected as the control group. Results 23 patients in observation group were successfully resected without complications such as infection and rectal injury. The operation time of observation group was significantly longer than that of control group （P < 0.001）. There was no significant difference in postoperative exhaust time and hospital stay between the observation group and the control group （P > 0.05）. The NRS score and the first time out of bed after operation in the observation group were lower than those in the control group, and the differences were statistically significant （P < 0.05）. Further analysis of the operation time of pregnancy tubal resection under v-NOTES showed that the operation time under the laparoscope was significantly longer than the time of establishing the approach and suturing the vaginal mucosa, and the difference was statistically significant （P < 0.001）, and the time of laparoscopic operation gradually shortened with the increase of the number of cases undergoing surgery. The time to establish the approach and suture the vaginal mucosa was different according to the previous delivery mode, and those with a history of vaginal delivery had the shortest time, （P > 0.05）and the difference was not statistically significant. Conclusion v-NOTES salpingectomy is safe and effective for the surgical treatment of ectopic pregnancy. Patients with stable vital signs, less pelvic effusion, and no severe pelvic adhesions should be selected for surgery. Pneumoperitoneum v-NOTES reduces the difficulty of surgery by avoiding the risk of pneumoperitoneum, and is beneficial to intraoperative anesthesia management. It increases the safety of surgery by avoiding the use of disposable port, which does not increase the economic burden of patients, and is suitable for primary hospitals. The initial operation time was correlated with the patient’s previous delivery history, the volume of pelvic effusion, and the number of surgical cases.
2022, 43(12): 131-136.
doi: 10.12259/j.issn.2095-610X.S20221224
Abstract:
Objective To study the curative effect of bidirectional fold mirror multidimensional spatial sensory stimulation in the treatment of unilateral neglect after stroke. Methods 50 patients with unilateral neglect after stroke were randomly divided into control group （n = 25） and experimental group （n = 25）. The patients in the control group received daily unilateral neglect rehabilitation therapy, while the experimental group received bidirectional folding mirror multidimensional spatial sensory stimulation therapy on top of the conventional rehabilitation therapy, 40min/time, 5 times/week, for 4 consecutive weeks. Before treatment, 2 weeks and 4 weeks after treatment, patients were evaluated for attention time of affected limb, Fugl-Meyer balance assessment （FMA）, sensation, midline offset angle, drawing test, and activities of daily living （ADL）. Results There was no difference in the degree of neglect, ADL, and other evaluations of unilateral neglect before treatment （P > 0.05）. The data of each treatment time point were significantly different （P < 0.01）. The time factors of 2 weeks and 4 weeks of treatment varied with the group （P < 0.01）. After 4 weeks of treatment, the evaluation indicators in the experimental group were significantly improved compared with those before treatment （P < 0.01）, and the evaluation indicators in the control group were also significantly improved （P < 0.05）, after treatment, the two groups were compared in various evaluations and found that the difference was more significant （P < 0.05）. Conclusion Bidirectional folding mirror multi-dimensional sensory stimulation therapy can improve the degree of neglect and activities of daily living in patients with unilateral neglect.
2022, 43(12): 137-141.
doi: 10.12259/j.issn.2095-610X.S20221225
Abstract:
Objective To investigate the efficacy of lauromacrogol foam sclerosant and lauromacrogol injection in patients with internal hemorrhoids. Methods A total of 94 patients with internal hemorrhoids treated in Kunming Second People’s Hospital from February 2020 to August 2021 were randomly selected and divided into study group and control group by number table method. The control group （n = 47）was treated with lauromacrogol injection, and the study group （n = 47）was treated with lauromacrogol foam sclerosant. The total effective rate, clinical indicators （total course of treatment, operation cost, dosage of lauromacrogol ）, intraoperative bleeding, postoperative pain and complications. Results The total effective rate of the study group was higher than that of the control group, and the difference was statistically significant （P < 0.05）. The total duration of treatment, operation cost and dosage of lauromacrogol in the study group were lower than those in the control group, and the differences were statistically significant （ P < 0.05）. The intraoperative local blood loss and postoperative pain in the study group were lower than those in the control group, and the differences were statistically significant （ P < 0.05）. The incidence of complications in the study group was lower than that in the control group, and the difference was statistically significant （ P < 0.05）. Conclusion Lauromacrogol foam sclerosant is better than lauromacrogol injection in the treatment of patients with internal hemorrhoids, and can shorten the length of hospital stay, reduce the dosage of lauromacrogol, hospitalization costs, complications, and is worthy of promotion and application.
2022, 43(12): 142-146.
doi: 10.12259/j.issn.2095-610X.S20221226
Abstract:
Objective To compare the difference of cutaneous nociceptive block plane of three commonly used nerve blocks （thoracic paravertebral block, erector spinae plane block and serratus anterior plane block） in thoracic surgery, and to identify the optimal nerve block combined with postoperative analgesia for thoracic surgery patients. Methods A total of 75 thoracic patients who underwent thoracoscopic surgery in our hospital were selected and randomly divided into three groups: Thoracic paravertebral nerve block group （T group）, erector spinae plane block group （E group） and serratus anterior plane block group （S group）. Group T: local anesthesia was injected into T7 paravertebral space; Group E: local anesthesia was injected into the fascia layer between the lateral erector spinae muscle and the intercostal muscle of the transverse process of T6 and T7. Group S: local anesthesia was injected into the fascial spaces of the latissimus dorsi and serratus anterior at ribs 6 and 7 in the posterior axillary line. All patients in the three groups were injected with 0.5% ropivacaine hydrochloride （15±3） mL under the guidance of ultrasound to ensure the correct position of the needle tip. After 20 minutes of local anesthetic injection, the anesthetic block effect and plane were measured by needle pricking. Results The block plane of the chest wall （midclavicular line and anterior axillary line） in group T was more extensive than that in group E and group S, the mean values of T group were 12.04 （P < 0.05）, 9.76 （P < 0.05）; while the block range of the thoracic wall （midaxillary line and posterior axillary line） in group S was more extensive, the mean values of S group were 9.8 （P < 0.05）, 10.48 （P < 0.05）. Conclusion For patients undergoing thoracic surgery, especially thoracoscopic surgery, it is more reasonable to use thoracic paravertebral nerve block as an auxiliary method for intraoperative anesthesia and postoperative analgesia. Serratus anterior plane block may be more suitable for breast surgery.
2022, 43(12): 147-152.
doi: 10.12259/j.issn.2095-610X.S20221227
Abstract:
Objective To investigate the quality of life of AIDS patients on different antiretroviral regimens in Kunming. Methods From December 2021 to March 2022, questionnaire survey and Chinese version of WHOQOL-HIV-BREF scale were used in Kunming Third People’s Hospital to investigate the quality of life of AIDS patients taking different antiviral treatment regimes. Multiple linear regression analysis was used to analyze the factors influencing the total score of patients’ quality of life. The total score of quality of life is shown in mean ± standard deviation. Results The results of one-way ANOVA showed that, total score for quality of life in male （67.67±9.86）, Han （67.22±9.74）, education level （69.12±10.07）, city of residence （67.66±9.74）, no drinking within 3 months （67.52±10.01）, under 30 years old （68.15±10.58）were higher than that of female （66.53±9.45）, ethnic minorities （66.57±9.60）, low education （64.43±8.51）, rural （65.97±9.56）, drinking within 3 months （65.81±7.76）, over 30 years old （64.25±6.77）, the difference was statistically significant （P < 0.05）. The quality of life was higher in the unmarried than in the married and divorced/widowed. The total quality of life score of patients with high CD4 level （CD4≥500） was higher than that of patients with low CD4 level. The quality of life score of MSM population was higher than that of heterosexual and drug abuse population, and the differences of the above factors were statistically significant （P < 0.05）. Quality of life scores of patients taking antiviral medication containing integrase inhibitors were higher than those taking antiviral therapy containing non-nucleoside analogues and protease inhibitors, and the difference was statistically significant （P < 0.05）. Multiple linear regression analysis showed that alcohol consumption, education, route of infection, and type of medication were correlated with the total quality of life score. Drinking habit （β = -1.670） was negatively correlated with the total score of quality of life; MSM transmission （β = 4.790）; university degree or above （β = 2.320）; patients taking integrase inhibitors such as DTG regimen （β = 7.014）, FTC/TAF/EVG/c （β = 8.765）, BIC/FTC/TAF （β = 13.141） were positively correlated, and the differences were statistically significant （P < 0.05）. Conclusion The quality of life of AIDS patients with different antiretroviral treatment regimens in Kunming is mainly influenced by various factors such as the type of antiretroviral drugs taken, alcohol consumption, and education.
2022, 43(12): 153-158.
doi: 10.12259/j.issn.2095-610X.S20221228
Abstract:
Amanita is a genus of mushrooms that can cause acute poisoning, and more than 90% of wild mushroom poisoning deaths are caused by its toxins. α-amanitin （α-AMA） is the most toxic component, and the liver is the major target of its toxicity. Transcriptional inhibition of RNA polymerase Ⅱ （RNA polⅡ） is a recognized mechanism of α-amanita toxin-induced hepatocyte injury, but other possible toxicological mechanisms are yet to be identified. The article reviews the toxic mechanisms of α-amanitin induced apoptosis, autophagy, inflammation and oxidative stress in hepatocytes, and the clinical treatment after poisoning, aiming to provide new directions for the research and prevention of Amanita poisoning.
Amanita is a genus of mushrooms that can cause acute poisoning, and more than 90% of wild mushroom poisoning deaths are caused by its toxins. α-amanitin （α-AMA） is the most toxic component, and the liver is the major target of its toxicity. Transcriptional inhibition of RNA polymerase Ⅱ （RNA polⅡ） is a recognized mechanism of α-amanita toxin-induced hepatocyte injury, but other possible toxicological mechanisms are yet to be identified. The article reviews the toxic mechanisms of α-amanitin induced apoptosis, autophagy, inflammation and oxidative stress in hepatocytes, and the clinical treatment after poisoning, aiming to provide new directions for the research and prevention of Amanita poisoning.
2022, 43(12): 159-163.
doi: 10.12259/j.issn.2095-610X.S20221229
Abstract:
Bladder cancer is one of the common malignant tumors of urinary system, which can be divided into two categoties, non-muscle-invasive bladder cancer and muscle-invasive bladder cancer. Radical cystectomy is the treatment of choice for muscle-invasive bladder cancer. At present, orthotopic neobasical bladder surgery has become the preferred method of urinary diversion after radical cystectomy. Due to the use of different intestinal segments during surgery, different metabolic complications may occur after surgery, which also become one of the reasons for reducing the quality of life of patients after surgery. This article reviews the main types and management progress of metabolic complications after orthotopic neobasical bladder surgery.
Bladder cancer is one of the common malignant tumors of urinary system, which can be divided into two categoties, non-muscle-invasive bladder cancer and muscle-invasive bladder cancer. Radical cystectomy is the treatment of choice for muscle-invasive bladder cancer. At present, orthotopic neobasical bladder surgery has become the preferred method of urinary diversion after radical cystectomy. Due to the use of different intestinal segments during surgery, different metabolic complications may occur after surgery, which also become one of the reasons for reducing the quality of life of patients after surgery. This article reviews the main types and management progress of metabolic complications after orthotopic neobasical bladder surgery.
2022, 43(12): 164-170.
doi: 10.12259/j.issn.2095-610X.S20221230
Abstract:
Swallowing disorders seriously affect people’s physical and mental health and has become a major clinical and public health problem. GERD is one of the common complications in patients with dysphagia and has a very significant correlation with swallowing dysfunction. Risk factors of GERD in patients with dysphagia should be identified, so as to detect the high-risk population of GERD early, and actively take preventive measures in the process of clinical nursing, which has important clinical significance and value to reduce the incidence of GERD in patients with dysphagia. At present, there are no epidemiological studies on GERD caused by swallowing dysfunction, and there are few studies on the mechanism of GERD and the influencing factors of aspiration caused by GERD. To review the risk factors of gastroesophageal reflux disease （GERD） in patients with dysphagia so as to provide a reference for early clinical prevention. At present, there are no epidemiological studies on GERD in swallowing disorder patients, and there are few studies on the mechanism of GERD and the influencing factors of aspiration. This paper reviews the risk factors of GERD in patients with dysphagia, and provides reference for early clinical prevention.
Swallowing disorders seriously affect people’s physical and mental health and has become a major clinical and public health problem. GERD is one of the common complications in patients with dysphagia and has a very significant correlation with swallowing dysfunction. Risk factors of GERD in patients with dysphagia should be identified, so as to detect the high-risk population of GERD early, and actively take preventive measures in the process of clinical nursing, which has important clinical significance and value to reduce the incidence of GERD in patients with dysphagia. At present, there are no epidemiological studies on GERD caused by swallowing dysfunction, and there are few studies on the mechanism of GERD and the influencing factors of aspiration caused by GERD. To review the risk factors of gastroesophageal reflux disease （GERD） in patients with dysphagia so as to provide a reference for early clinical prevention. At present, there are no epidemiological studies on GERD in swallowing disorder patients, and there are few studies on the mechanism of GERD and the influencing factors of aspiration. This paper reviews the risk factors of GERD in patients with dysphagia, and provides reference for early clinical prevention.
2022, 43(12): 171-176.
doi: 10.12259/j.issn.2095-610X.S20221231
Abstract:
Objective To explore the application effect of TBL combined with PBL in the cultivation of scientific research ability of undergraduate nursing students. Methods Convenience sampling method was adopted to select nursing undergraduates from Kunming Medical University who had internship in a third-class hospital in Kunming City from July 2020 to May 2021 as the research objects. They were divided into experimental group （n = 35） and control group （n = 35） by random number table method. The experimental group received the scientific research training of TBL combined with PBL on the basis of routine clinical practice arrangement, the control group received routine clinical practice arrangement. The research ability and innovation efficiency of the two groups of nursing students before and after intervention and the score of the graduation thesis after intervention were compared. Results After intervention, the total score of scientific research ability and other 6 dimensions of nursing students in experimental group were higher than those in control group, and the total score of innovation efficiency, scores of each dimension and graduation thesis scores were higher than those in control group, with statistical significance （P < 0.05）. Conclusion TBL combined with PBL can effectively improve the scientific research ability and innovation efficiency of undergraduate nursing students, and provide practical guidance for nursing educators to cultivate the scientific research and innovation ability of nursing students.
2022, 43(12): 177-180.
doi: 10.12259/j.issn.2095-610X.S20221232
Abstract:
Objective To study the nursing effect of enhanced recovery after surgery nursing among Gynecological patients with myomectomy. Methods A total of 111 patients were selected with myomectomy admitted to the Gynecology of the Third People’s Hospital of Yunnan Province from January 2020 to March 2021, and who were divided into 55 control group and 56 experimental group by non-random convenient sampling method. The control group was given routine Gynecological perioperative nursing measures, and the experimental group was given enhanced recovery after surgery nursing. Results The experimental group was superior to the control group in terms of postoperative water intake[（384.22±84.78）mL、（196.90±95.07）mL], exhaust time[（17.29±3.69）h、（22.45±4.77）h], getting out of bed activity time[（15.19±5.30）h、（21.67±3.86）h] and postoperative pain score[（4.08±2.04）、（5.69±2.33）], and the difference was statistically significant（P < 0.05）. Conclusion Effective enhanced recovery after surgery nursing for patients with myomectomy have obvious effect, so it is widely promoted in clinical.
