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RSS2024 Vol. 45, No. 4
2024, 45(4): 1-8.
doi: 10.12259/j.issn.2095-610X.S20240401
Abstract:
Inflammatory bowel disease （IBD） is a chronic condition characterised by recurrent inflammation of the intestines. Although the specific causes is not fully understood, it is generally believed to be caused by a combination of genetic factors, immune system abnormalities, environmental factors, and imbalances in the gut microbiota. The interaction of these factors may disrupt the intestinal environment, affecting the host's immune system, and ultimately triggering intestinal inflammation. This review discusses changes in the gut microbiota of IBD patients and explores corresponding treatment strategies.
Inflammatory bowel disease （IBD） is a chronic condition characterised by recurrent inflammation of the intestines. Although the specific causes is not fully understood, it is generally believed to be caused by a combination of genetic factors, immune system abnormalities, environmental factors, and imbalances in the gut microbiota. The interaction of these factors may disrupt the intestinal environment, affecting the host's immune system, and ultimately triggering intestinal inflammation. This review discusses changes in the gut microbiota of IBD patients and explores corresponding treatment strategies.
2024, 45(4): 9-16.
doi: 10.12259/j.issn.2095-610X.S20240402
Abstract:
Objective To construct a polygenic risk score based on the expression of epithelial cell markers to evaluate the prognosis of patients with ovarian cancer. Methods The single cell sequencing data of ovarian cancer were reduced and clustered to identify epithelial cell markers, malignant and non-malignant markers. Regression analysis was used to screen epithelial marker genes related to prognosis to construct a risk score model. Based on the risk score, patients were divided into high risk group and low risk group （H.Risk, L.Risk） to predict the prognosis of patients with ovarian cancer. Results A risk scoring model with four genes （EPCAM, CLDN4, CXCR4 and TIMP3） was constructed. Survival analysis showed that the OS of patients in H.Risk group was worse than that in L.Risk group in trial cohort and verification cohort （P < 0.05）. Pathway enrichment analysis showed that the differential genes between high and low risk groups were associated with immunosuppression and malignant progression, including cell adhesion, extracellular matrix, neuroactive ligand-receptor interaction, calcium signal pathway, transforming growth factor-β. Conclusion Through the comprehensive analysis of bulkRNA-seq and scRNA-seq data, a risk scoring model based on epithelial cell subsets marker genes is proposed, which may provide potential therapeutic targets for patients with ovarian cancer.
2024, 45(4): 17-25.
doi: 10.12259/j.issn.2095-610X.S20240403
Abstract:
Objective To construct a lipid metabolism-related prognostic model for ovarian cancer （OC）, and to investigate the role of lipid metabolism-related biomarkers and the degree of immune cell infiltration in prognosis prediction of OC. Methods Transcriptional data and clinical data of OC samples were downloaded from the TCGA database, and lipid metabolism-related genes （LMRGs） were obtained from the MSigDB database. The samples were randomly divided into training and validation sets at a 1∶1 ratio using the caret package. Univariate Cox analysis was used to identify LMRGs significantly associated with OC prognosis. LASSO-Cox analysis was performed to select model genes for building a prognostic model. The prognostic model was evaluated using Kaplan-Meier curves and receiver operating characteristic （ROC） curves, followed by internal validation using TCGA data. Finally, a column chart was constructed, and immune infiltration analysis was conducted using the CIBERSORT algorithm. Results An 8-gene prognostic model for ovarian cancer was established. Survival analysis showed significant differences in prognosis between the high-risk and low-risk groups （P < 0.05）. The AUC indicated that the model had moderate predictive efficacy. Multivariate Cox analysis demonstrated that LMrisk was an independent prognostic factor for ovarian cancer patients （P < 0.001）. Immune infiltration analysis revealed the association between LMrisk and immune response in ovarian cancer. Conclusion The prognostic model developed in this study can serve as a new tool for evaluating prognosis in ovarian cancer patients. LMrisk may be a robust prognostic biomarker with potential clinical application.
2024, 45(4): 26-34.
doi: 10.12259/j.issn.2095-610X.S20240404
Abstract:
Objective To compare the transdermal absorption of Bulleyaconitine A on normal rabbit intact skin, normal rabbit damaged skin, pathological damaged normal skin, and pathological damaged injured skin barrier models in vivo. Methods The rabbit model of pathological injury was obtained by intramuscular injection of 50% glycerol. The damaged skin was prepared by gently rubbing the skin surface with a wooden stick wrapped in No. 1 sandpaper until it turned light red. Four skin barrier models were topically treated with Bulleyaconitine A gel. Blood samples were collected at various time points after drug administration for normal skin （1 h, 2 h, 3 h, 4 h, 5 h, 6 h, 8 h, 10 h） and damaged skin （1 h, 2 h, 3 h, 4 h, 5 h, 6 h, 8 h, 10 h, 12 h, 24 h, 36 h）. HPLC-MS/MS was used to detect drug concentrations in rabbit models at different time points after Carbenoxolone administration. Drug pharmacokinetic parameters were calculated using DAS 3.2.0, and inter-group pharmacokinetic parameters were statistically analyzed using SPSS 23.0. Results The trends of three pharmacokinetic parameters, AUC（0-t）, AUC（0-∞）, and Cmax, in four skin barrier models of rabbits are consistent. They are as follows in size order: intact skin of normal rabbits > damaged skin from pathological injury > intact skin from pathological injury > intact skin of normal rabbits. Different external skin environments have a significant impact on the permeability of Bulleyaconitine A absorption. The permeability of damaged skin is significantly higher than that of normal skin （P < 0.05）. Pure pathological damage （internal injury）, with consistent skin conditions, shows no significant impact on the absorption and elimination of Chuanwu （ P > 0.05）. Compared to intact skin of normal rabbits, damaged skin from simulated external trauma, and damaged skin from internal and external trauma, the absorption of Bulleyaconitine A significantly increases and the elimination capacity significantly decreases （ P < 0.05）. Conclusion The barrier function of the stratum corneum is the main limiting factor for Bulleyaconitine A transdermal absorption. Bulleconitine A may accumulate in the body under the condition of trauma or internal or external injuries, which may affect drug safety. When conducting experiments on transdermal drug delivery formulations, it is advisable to simultaneously compare normal skin with damaged skin caused by simulated trauma or pathological damage from internal and external injuries. Studying the transdermal absorption under conditions simulating clinical muscle and skin injuries from internal and external trauma will help in a more comprehensive and accurate evaluation of the efficacy, pharmacokinetics, and toxicological properties of transdermal drug delivery formulations.
2024, 45(4): 35-40.
doi: 10.12259/j.issn.2095-610X.S20240405
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Objective To investigate the effect of cerebellar zinc finger structure 1 （ZIC1） gene overexpression on the proliferation and apoptosis of pleural mesothelioma cells （SMC-1 cells） and the corresponding molecular mechanism. Methods SMC-1 cells were transfected with lentivirus particles carrying ZIC1 gene as the experimental group, infected with empty lentivirus particles as the control group, and conventional cultured untransfected SMC-1 cells as the blank control group. Western blot was used to detect the expression of ZIC1 protein in the three groups. CCK-8 cell proliferation assay was used to detect the proliferation ability of each group, and Hoechst-PI double staining was used to detect the apoptosis of each group. The protein expression levels of P53, P21, MDM2 and P53 phosphorylation site Ser392 in P53-mediated apoptosis signaling pathway were detected by Western blot. Results Compared with the empty vector group and the control group, the expression of ZIC1 protein in the ZIC1 overexpression group was significantly increased, with a statistically significant difference （F = 4.665, P = 0.036）. Compared with the control group, the proliferation ability of SMC-1 cells in the ZIC1 overexpression group was significantly reduced, while the apoptosis of tumor cells was significantly increased, with a statistically significant difference （P < 0.05）. The main genes P53, P21, MDM2, and P53 Ser392 protein expression in the P53 signaling pathway in the ZIC1 gene overexpression group were significantly increased. Conclusion Overexpression of ZIC1 gene can inhibit the proliferation of pleural mesothelioma SMC-1 cells and promote their apoptosis. The possible mechanism is to activate the P53 gene mediated apoptosis signaling pathway by upregulating the expression of P53 gene phosphorylation sites.
2024, 45(4): 41-48.
doi: 10.12259/j.issn.2095-610X.S20240406
Abstract:
Objective To test the reliability and validity of the Chronic Gastritis Patient Reported Outcomes（PROISCD-CG） scale, and to provide the scientific basis for evaluating the reported outcomes of chronic gastritis patients. Methods A questionnaire survey was conducted on 297 patients with chronic gastritis in the gastroenterology department of two tertiary hospitals in Yunnan Province through convenient sampling. Internal consistency test was performed by calculating Cronbach's α coefficient of each dimension of the common module, the common module, the specific module and the total scale. The correlation of item dimensions was analyzed. Confirmatory factor analysis was used to analyze the construct validity, and the convergent validity, combined reliability and discriminant validity of the revised scale were tested. Results The Cronbach's α of the total scale is 0.86, the Cronbach's α of the common module is 0.82, the Cronbach's α of each dimension of the common module is 0.61 to 0.76, and the Cronbach's α of the specific module is 0.82. The correlation of item dimensions is good, and the correlation coefficients of the PHD, MHD, SHD, and SBD dimension scores with the scores of the common module were 0.78, 0.79, 0.77 and 0.66 （P < 0.05）. Validation factor analysis indicated that some of the entries of the original scale were of poor quality and had poor structural validity. The CMIN/DF of the revised scale is 2.91, the RMSEA value is 0.08, and the GFI, IFI, TLI, and CFI indices have increased to closer to 0.90, and the difference of each entry for the dimension to which it belonged was statistically significant （P < 0.05）. Convergent validity was moderate, composite reliability was moderate, and discriminant validity was moderate. Conclusion The overall reliability of the PROISCD-CG scale is good, and the dimensions of each item are reasonably divided. The structural validity of the original scale is average, but the structural validity of the revised scale has improved. Some items in the PROISCD-CG scale need to be revised and further validated.
2024, 45(4): 49-56.
doi: 10.12259/j.issn.2095-610X.S20240407
Abstract:
Objective To analyze the 2-year screening myopia rate in Lijiang City and Dali City during the COVID-19 pandemic and analyze the related influencing factors of myopia. Methods A total of 774 students were randomly selected as the research subjects. In October 2020 and September 2021, the eyes of the same study population were tested by desktop automatic computer refractometer, and the objective indicators of their eyes were obtained. Logistic regression was used to analyze the influencing factors of myopia. Results The overall screening myopia rates of 2-year primary and secondary school students in Lijiang City and Dali City were 55.0%, 62.8% and 45.7%, 51.4%, respectively. The results showed that in both cities the myopia rate of female students was higher than that of male students, and the myopia rate of junior middle school students was higher than that of primary school students （P < 0.05）. Compared with 2020, the daily multimedia teaching time of students in Lijiang City was getting longer, the daily homework time was decreasing, the number of students playing mobile phones before bed was increasing, and the outdoor activity time was increasing in 2021 （P < 0.05）; the daily multimedia teaching time of students in Dali City was getting longer, the daily homework time was decreasing, the outdoor activity time was increasing, and the ball game time was increasing in 2021（P < 0.05）. Logistic regression analysis showed that in Lijiang City in 2020,girls,junior high school students, recess in the teaching building, always eating animal liver, always eating sweets, always drinking sugary drinks were risk factors for myopia （P < 0.05）. In 2021, girls, junior high school students, outdoor activities >2 h, always eating sweets were risk factors for myopia （P < 0.05）. In Dali City in 2020, junior high school students, the earliest reading age was 5～6 years old, and neither parents were myopic were risk factors for myopia （P < 0.05）. In 2021,junior high school students, always eating sweets were risk factors for myopia （P < 0.05）. Conclusion During the epidemic period, the eye time of students in the two places was increasing, and the myopia rate was increasing, with gender and school stage differences. We should focus on the vision of junior high school students, especially girls. The influencing factors of myopia in students are complex.Outdoor activities > 2 h, recess in the teaching building, always eating animal liver, always eating sweets, always drinking sugary drinks, reading age of 5～6 years old, and neither parents were myopic were risk factors for myopia in students. According to the risk factors that are easy to change, we should strengthen the publicity of myopia prevention and treatment knowledge, and take intervention measures to prevent the occurrence and development of myopia.
2024, 45(4): 57-61.
doi: 10.12259/j.issn.2095-610X.S20240408
Abstract:
Objective To study the correlation between the polymorphism of myeloperoxidase-463G/A gene and essential hypertension of Yi nationality in Yunnan Province. Methods The PCR-RFLP technique was used to detect the MPO-463G/A gene polymorphism in 86 Yi hypertensive patients and 100 normal Yi people in Shuanghe Township and Yunnan Province collected by the First Affiliated Hospital of Kunming Medical University from January 2007 to November 2008. The frequencies of the GG, GA, and AA genotypes and the G and A allele frequencies were calculated, followed by association analysis. Results The genotype frequencies of MPO gene-463G/A polymorphism in EH group and control group GG were 66.28%, 52.00%, GA+AA were 33.72%, 48.00%, respectively. The frequencies of allele G were 79.65% and 69.50%, and the frequencies of allele A were 20.35% and 30.50%, respectively. There were statistically significant differences in genotype frequency and gene frequency between the two groups（P < 0.05）. The genotype frequencies of GG and GA+AA were 74.50% and 49.30% in female EH group and 25.50% and 50.70% in femal control group. The allele frequencies of G and A were 85.50% and 69.00% in EH group and 14.50% and 31.00% in control group. The differences were statistically significant（P < 0.05）. The frequency of A gene in female EH group was significantly lower than that in female control group. There was no significant difference in genotype frequency and gene frequency between EH group and control group in Yi male（P > 0.05）. Conclusion MPO gene-463G/A polymorphism is related to essential hypertension in Yunnan Yi women and is a susceptibility gene for hypertension in Yi women. The expression of the A allele at this locus has a protective effect during the development of EH in Yi women.
2024, 45(4): 62-66.
doi: 10.12259/j.issn.2095-610X.S20240409
Abstract:
Objective To investigate the occurrence and related factors of depression, anxiety, and stress among oral medicine interns during their internship. Methods Using the DASS-21 scale, a survey was conducted among 120 undergraduate oral medicine students of a university. Assessments were done at the beginning, middle, and end of their internship using anonymous, online, closed-questionnaire methods. Results During the three phases of the internship, there was a statistically significant difference between the students’ depression scores in the late internship compared to the early internship （P < 0.05）. There was a statistically significant difference in anxiety and depression scores of female students in the late internship compared to the pre-internship stage （P < 0.05）. The difference in depression scores in the late internship period compared to the pre-internship period was statistically significant （P < 0.05） for students who interned in tertiary care hospitals and those who voluntarily chose their major, and the depression scores were higher in the late internship period than in the pre-internship period. Conclusion The psychological health of dental students during their internship is affected by a variety of factors, the more prominent of which is the high negative psychological scores in the late internship period. Among the female students, anxiety and depression scores were higher in the late internship period than in the early internship period. In addition, the depression-anxiety-stress profiles of dentistry interns in the three internship phases varied according to the level of the internship hospital.
2024, 45(4): 67-73.
doi: 10.12259/j.issn.2095-610X.S20240410
Abstract:
Objective To explore the short-term efficacy, safety, and prognostic factors affecting the overall survival （OS） of patients with recurrent high-grade glioma （HGG） treated with bevacizumab （BEV） alone and bevacizumab in combination with temozolomide （TMZ）. Methods According to the response assessment in neurooncology （RANO） criteria for the treatment of gliomas, objective response rate （ORR） and disease control rate （DCR） were used as indicators to retrospectively analyze the clinical medical records of 31 patients with recurrent HGG at Yunnan Cancer Hospital from August 2020 to July 2023. The patients were divided into a control group （BEV） and a treatment group （BEV+TMZ）, and the recent efficacy of the two groups was evaluated. Cox univariate and multivariate analysis methods were used to analyze the impact of group （control group vs. treatment group）, gender, age, disease grading, admission score, histopathological classification, etc., on the overall survival （OS） of 31 patients with recurrent HGG. Adverse reactions （ADR） between the two groups were compared using a chi-square test to evaluate the safety. Results The ORR of the treatment group was 63.16%, and the ORR of the control group was 16.67%. The difference was statistically significant （χ2 = 6.419, P = 0.011）. The DCR of the treatment group was 89.47%, and the DCR of the control group was 75.00%. There was no significant difference in DCR （χ2 = 0.320, P = 0.571）. The median survival time （mOS） in the control group was 7 months （95%CI: 3.605～10.395）, and the median survival time （mOS） in the treatment group was 14 months （95%CI: 3.853～24.147）. There was no significant difference in mOS between the two groups （χ2 = 0.829, P = 0.363）. There were significant differences in Cox univariate analysis admission score and histopathological classification among 31 patients with recurrent HGG （P < 0.05）, and statistically significant differences in histopathological classification by multivariate analysis （P < 0.05）. There was no significant difference in nausea, vomiting, fatigue and diarrhea between the two groups after treatment （P > 0.05）. There were statistically significant differences in the reduction rates of platelets and white blood cells （P < 0.05）, after symptomatic treatment, both groups of ADRs were alleviated. Conclusion The short-term curative effect of the treatment group was better than that of the control group in the treatment of recurrent HGG, the ADRs after recurrent HGG treatment in 2 groups were tolerable and safe, and the histopathological classification may be a prognostic factor affecting the OS of 31 patients with recurrent HGG.
2024, 45(4): 74-80.
doi: 10.12259/j.issn.2095-610X.S20240411
Abstract:
Objective To analyze the efficacy and safety of the three-in-one single-tablet regimen of bictegravir/emtricitabine/tenofovir alafenamide（BIC/FTC/TAF） in AIDS patients. Methods Newly treated patients who received a single tablet combination（BIC/FTC/TAF） between February 1, 2022 and June 1, 2022（the initial treatment group） and those who underwent treatment（the treated group） were included. The virological, immunological and biochemical indexes were statistically analyzed by means of prospective observational study. Results 249 patients were included at baseline , with 220 in the treated group and 29 in the newly treated group. At 48 weeks, the analysis showed that the virus suppression rate was 93.10% for the newly treated group and 98.55% for the treated group. Compared to the baseline, both groups showed increased CD4+ T lymphocyte counts and CD4+/CD8+ T cell ratios after 48 weeks of treatment（P < 0.001）. There were also significant increases in blood triglycerides, total cholesterol, total bilirubin, and blood creatinine compared to the baseline（P < 0.05）. Aspartate aminotransferase and alanine aminotransferase decreased compared to the baseline, with all differences being statistically significant except for alanine aminotransferase in the newly treated group（P > 0.05）. Additionally, the estimated glomerular filtration rate based on blood creatinine improved in the newly treated group compared to the baseline（P < 0.001）, while there were no significant changes in the treated group. Conclusion BIC/FTC/TAF can effectively inhibit virus replication, improve the immune function of patients, and has good safety. Bic /FTC/TAF can be one of the preferred treatment options for some specific clinical populations.
2024, 45(4): 81-91.
doi: 10.12259/j.issn.2095-610X.S20240412
Abstract:
Objective To systematically evaluate the efficacy and safety of Jingangteng capsule combined with antibiotics in the treatment of chronic pelvic inflammatory disease. Methods Randomized controlled trials （RCTs） of Jingangteng capsule combined with antibiotics in the treatment of chronic pelvic inflammatory disease were searched from domestic and foreign databases. RevMan 5.4 software was used for Meta-analysis. Results Twenty-four studies of RCTs were finally included, with a total sample size of 2, 441 cases. Meta-analysis showed that the combination of antimicrobial drugs with Jingangteng capsule significantly increased the overall clinical effectiveness rate of patients with chronic pelvic inflammatory disease [RR=1.19, 95%CI （1.15, 1.23）, P < 0.001]. It also reduced the incidence of adverse events compared with treatment with antimicrobial drugs alone [RR=0.70, 95%CI （0.51, 0.95）, P < 0.05]. In addition, the treatment of chronic pelvic inflammatory disease with Jingangteng capsule combined with antimicrobial drugs improved in promoting the recovery of inflammatory factor, and lymphocytes compared with antimicrobial drug therapy alone （P < 0.05）, and also effectively shortened the symptomatic remission time and improved the hemorheological indexes （P < 0.05）. Conclusion Jingangteng capsule combined with antibacterial agents has good efficacy and safety in the treatment of chronic pelvic inflammatory disease, but in view of the quality of research evidence, it should be applied according to the actual clinical situation.
2024, 45(4): 92-98.
doi: 10.12259/j.issn.2095-610X.S20240413
Abstract:
Objective To evaluate the cost-effectiveness of nilotinib versus dasatinib in the second-line treatment of Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase. Methods Establish a Markov model for cost-effectiveness analysis, including four health states: chronic phase （CP）, accelerated phase （AP）, blast phase （BP）, and death. Clinical parameters related to progression-free survival rates, disease progression rates, overall survival rates, etc. for treatment with nilotinib and dasatinib are derived from previously published studies and expert opinions, while health state utility values are sourced from the literature. Using Treeage software, the incremental cost-effectiveness ratio （ICER） was used as an evaluation metric to assess the total output and total costs of the two schemes of nilotinib and dasatinib, and model stability is evaluated through univariate and probabilistic sensitivity analyses. Results Compared with using dasatinib for treatment, the ICER for using nilotinib treatment is 182487.71 yuan per QALY, which is less than 3 times the national per capita GDP in 2021. Sensitivity analysis showed that the main influencing parameters are the discount rate, dasatinib price, and nilotinib price, and the model results are stable. Conclusion Nilotinib has a cost-utility advantage over dasatinib in the treatment of Ph+CML-CP patients who are resistant or intolerent to imatinib.
2024, 45(4): 99-104.
doi: 10.12259/j.issn.2095-610X.S20240414
Abstract:
Objective To explore the clinical significance of coagulation function indexes in the diagnosis and treatment of elderly patients with novel coronavirus pneumonia. Methods This study retrospectively analyzed 68 elderly patients with novel coronavirus infection admitted to The Wuhu Hospital, East China Normal University from December 2022 to January 2023. Patients were divided into two groups according to clinical indicators: common group （n = 48） and severe group （n = 20）. The general condition, clinical symptoms, co-morbidity were analyzed. Coagulation index: D-dimer, plasma fibrinogen degradation products （FDP）, plasma fibrinogen （Fib）, prothrombin time （PT）, activated partial thromboplastin time （APTT） and thrombin time （TT） were measured. Results The study confirmed that D-dimer and FIB were prolonged in both the common and severe groups; D-dimer and FDP in severe group were significantly longer than those in common group （P < 0.05）. The proportion of patients with increased D-dimer and prolonged APTT and PT in severe group was higher than that in common group （P< 0.05） . Conclusion Monitoring coagulation parameters in elderly patients is helpful for clinical evaluation of the outcome or progression of the disease.
2024, 45(4): 105-112.
doi: 10.12259/j.issn.2095-610X.S20240415
Abstract:
Objective To investigate the effects of non-invasive ventilation in mean volumetric pressure support and automatic expiratory pressure （AVAPS-AE） mode on multichannel sleep monitoring （PSG） parameters, Epworth sleepiness Scale （ESS） score and comfort in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） complicated with obstructive sleep apnea （OSA）. Methods 75 patients with AECOPD complicated with OSA in our hospital from January 2020 to October 2022 were randomly divided into 3 groups, each with 25 cases, all of which were treated with non-invasive ventilation. Control group A was treated with AVAPS mode, control group B was treated with S/T mode, and observation group was treated with AVAPS-AE mode. Blood gas analysis indexes [arterial partial pressure of oxygen （PaO2）, arterial blood pH （pH）, arterial partial pressure of carbon dioxide （PaCO2）], PSG parameters [arousal index （MAI）, apnea hypopnea index （AHI）, minimum pulse oxygen saturation （miniSpO2）, sleep efficiency （TST/TRT）] and genioglossus muscle of the three groups were compared The variables of GGEMG （tonic, peak and phasic GGEMG during wakefulness and sleep NREM）, the incidence of man-machine confrontation, the rate of intubation at 48 hours, ESS, Brog, visual analogue scale （VAS） and health-related quality of life （HRQL） scores were compared before treatment and after 24, 48 and 72 hours of treatment. Results After 24 h, 48 h and 72 h treatment, PaO2 groups were compared: observation group > control group A > control group B （ P < 0.05）. Comparison between PaCO 2 groups: observation group < control group A < control group B （ P < 0.05）. Comparison of TST/TRT and miniSpO 2 groups: observation group > control group A > control group B （ P < 0.05）. Comparison between AHI and MAI groups: observation group < control group A < control group B （ P < 0.05）. Comparison of tension, peak value and phase GGEMG between awake and NREM sleep groups: observation group < control group A < control group B （ P < 0.05）. There was no significant difference in the incidence of man-machine confrontation and 48-h intubation rate among 3 groups （ P> 0.05）. ESS, Brog and VAS were compared between groups: observation group < control group A < control group B （P < 0.05）; Comparison of HRQL among groups: observation group > control group A > control group B （ P < 0.05）. Conclusion AVAPS-AE mode of non-invasive ventilation for AECOPD combined with OSA is beneficial to improve sleep, reduce daytime sleepiness, relieve dyspnea, and improve breathing comfort and quality of life.
2024, 45(4): 113-119.
doi: 10.12259/j.issn.2095-610X.S20240416
Abstract:
Objective To explore the application of otoscopic and microscopic tympanoplasty in the treatment of chronic suppurative otitis media （CSOM） in young and middle-aged patients, and provide a reference for clinical treatment. Methods A total of 104 young and middle-aged patients with CSOM admitted to Chengdu Office Hospital of the People’ s Government of the Xizang Autonomous Region from April 2020 to June 2022 were randomly divided into an Ear endoscopy group （52 cases） and a Microscope group （52 cases）. The two groups were compared in terms of pre- and post-operative hearing conditions, vascular permeability-related factors [platelet activating factor （PAF）, fibronectin （Fn）], pain intensity （visual analogue scales, VAS score）, sleep quality （Pittsburgh Sleep Quality Index, PSQI score）, inflammatory status [transforming growth factor-β1 （TGF-β1）, transforming growth factor-β2 （TGF-β2）, interleukin-8 （IL-8）, soluble interleukin 2 receptor （sIL-2R）], and complications. Results There was no significant difference in air bone gap （ABG） at each frequency between the two groups at 1 month and 3 months after surgery. （P > 0.05）. The VAS and PSQI scores in the Ear endoscopy group were lower than those in the Microscope group 1 month and 3 months after surgery （ P < 0.05） . The PAF level in the Ear endoscopy group was lower and the Fn level was higher than that in the Microscope group 1 month and 3 months after surgery （ P < 0.05）; serum TGF-β1, TGF-β2, IL-8, and sIL-2R levels were lower in the Ear endoscopy group than in the Microscope group 1 month and 3 months after surgery （ P < 0.05）. There was no significant difference in the incidence of complications between the Ear endoscopy group and the Microscope group （ P > 0.05）. Conclusion Both surgical methods are safe and reliable treatment options for young and middle-aged patients with CSOM. Compared with microscopic surgery, otic endoscopic tympanoplasty has a shorter recovery time, facilitates pain relief, improves quality of life, and improves vascular permeability, reducing the body's inflammatory response.
2024, 45(4): 120-127.
doi: 10.12259/j.issn.2095-610X.S20240417
Abstract:
Objective To explore the effect of precise liver pedicle dissection technique assisted laparoscopic hepatectomy on inflammatory immune stress and liver function. Methods A total of 114 patients with primary liver cancer in Dazhou Central Hospital from October 2019 to June 2022 were selected and divided into 57 patients each according to random number table method. Both groups underwent laparoscopic hepatectomy for liver cancer. The conventional group underwent routine liver resection, while the precision group underwent precise liver pedicle dissection. The surgical indicators, inflammatory-immune indicators [interleukin-6 （IL-6）, C-reactive protein （CRP）, tumor necrosis factor-α （TNF-α）, immunoglobulin A （IgA）, IgM, IgG], liver function [alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, γ-glutamyltranspeptidase （γ-GT）, total bilirubin （TBIL）], tumor factors [alpha-fetoprotein （AFP）, carbohydrate antigen 19-9 （CA19-9）, thymidine kinase 1 （TK1）], complication rate were compared between the two groups, and follow-up was conducted for 1 year. The recurrence rate and survival rate were statistically analyzed for both groups. Results There was no significant difference in operation time and positive rate of resection margin between the two groups （P > 0.05）. The intraoperative blood loss and postoperative drainage volume in the precision group were less than those in the conventional group, and the postoperative extubation time and hospital stay were shorter than those in the conventional group （P < 0.05）. After 1 day, 3 days, and 7 days post-operation, the levels of serum IL-6, CRP, TNF-α, ALT, AST, γ-GT, and TBIL showed a decreasing trend after an initial increase. The precision group had lower levels compared to the standard group. The serum levels of IgA, IgM, and IgG showed an increasing trend after an initial decrease, with the precision group having higher levels than the standard group （P < 0.05）. After 3 months, the serum levels of AFP, CA19-9, and TK1 were lower than pre-operation levels, with the precision group showing lower levels compared to the standard group （P < 0.05）. The precision group had a lower complication rate of 5.26% （3/57） compared to the standard group's 17.54% （10/57） （P < 0.05）. During a 1-year follow-up, 2 cases were lost to follow-up in the precision group, while 1 case was lost in the standard group. The precision group had a recurrence rate of 25.45% （14/55） after 1 year, lower than the standard group's 44.64% （25/56）, with a survival rate of 85.45% （47/55） higher than the standard group's 62.50% （35/56） （P < 0.05）. Conclusion The application of precise liver pedicle dissection techniques in laparoscopic hepatectomy for primary liver cancer can optimize surgical conditions, reduce inflammatory immune stress and liver function injury, reduce complications, significantly inhibit tumor factor expression, reduce recurrence rate, and improve survival rate.
2024, 45(4): 128-134.
doi: 10.12259/j.issn.2095-610X.S20240418
Abstract:
Objective To analyze the changes of immunoglobulin （Ig） during the process of transcatheter arterial chemoembolization （TACE） for hepatocellular carcinoma （HCC） and predict the value of treatment efficacy. Methods A total of 100 HCC patients in Hebei Armed Police Corps Hospital from January 2022 to January 2023 were selected as the liver cancer group, 50 patients with benign liver disease were selected as the benign group, and 50 healthy volunteers were selected as the control group. The general data, serum Ig （IgA, IgG, IgM） and conventional tumor markers [alpha-fetoprotein （AFP）, cytokeratin 19 （CK19）, Golgi protein 73 （GP73）], and the correlation between serum Ig and conventional tumor markers in the HCC group was analyzed. The serum levels and changes of Ig and conventional tumor markers in patients with different efficacy after TACE treatment in the liver cancer group were compared before and after treatment. The correlation between the changes of serum Ig and conventional tumor markers and the efficacy of ACE was analyzed, and the predictive value of ACE prediction scheme with or without Ig was compared. Results The levels of IgA, IgG and IgM in liver cancer group were lower than those in benign group and control group; the levels of AFP, CK19 and GP73 in liver cancer group were higher than those in benign group and control group; the levels of IgA, IgG and IgM in benign group were lower than those in control group; the levels of AFP, CK19 and GP73 in benign group were higher than those in control group （P < 0.05）. Serum IgA, IgG and IgM levels were negatively correlated with serum AFP, CK19 and GP73 levels in HCC group （P < 0.05）. The serum levels of IgA, IgG and IgM in patients with poor TACE treatment were lower than those in patients with good efficacy before and after treatment, the levels of AFP, CK19 and GP73 were higher than those in patients with good efficacy, and △IgA, △IgG, △IgM, △AFP, △CK19 and △GP73 were lower than those in patients with good efficacy （P < 0.05）. △IgA, △IgG, △IgM, △AFP, △CK19, △GP73 were positively correlated with the therapeutic effect of TACE （P < 0.05）. The area under the curve （AUC） of △IgA, △IgG, △IgM, △AFP, △CK19 and △GP73 for predicting poor TACE efficacy in HCC patients were 0.777, 0.784, 0.793, 0.779, 0.710 and 0.746, respectively. Compared with the non-IG prediction scheme （△AFP, △CK19, △GP73 combined prediction）, the AUC with Ig prediction scheme （△IgA, △IgG, △IgM, △AFP, △CK19, △GP73 combined prediction） was significantly increased in predicting poor TACE efficacy in HCC patients. Both NRI and IDI were > 0 （P < 0.05）. Conclusion The levels of serum IgA, IgG and IgM in HCC patients increased during TACE treatment, and the changes of each index can provide a reliable basis for clinical prediction of TACE efficacy.
2024, 45(4): 135-139.
doi: 10.12259/j.issn.2095-610X.S20240419
Abstract:
Objective To investigate the clinical efficacy of single-port and double port video-assisted thoracoscopic lobectomy in the treatment of lung cancer. Methods Patients who underwent thoracoscopic lobectomy in Beijing Armed Police Corps Hospital from January 2016 to January 2023 were randomly selected and divided into two groups （n = 50, double port group; n = 50, single port group） according to different resection plans. The surgical indexes, pulmonary function indexes, complications and related test indexes were compared. Results The amount of intraoperative blood loss, thoracic drainage, hospital stay and operation time in the single-port group were lower than those in the double-port group （P < 0.05）, and the operation time was higher than that in the double-port group. There was no significant difference in the number of lymphatic dissection and pulmonary function before and after surgery （P > 0.05）. The complication rate of single-port group was lower than that of double-port group （P < 0.05）. There was no significant difference in EGFR, TGF-α, IGA and IGM before operation （P > 0.05）. After intervention, EGFR and TGF-α in double-port group were higher than those in single-port group, IGA and IGM were lower than those in single-port group （P < 0.05）. Conclusion The two protocols have similar effects on the number of lymphatic clearance and postoperative pulmonary function recovery, but the single-port surgical operation is safer, with a lower complication rate, lower inflammatory reaction, and facilitates postoperative recovery, which is of positive clinical use value.
2024, 45(4): 140-145.
doi: 10.12259/j.issn.2095-610X.S20240420
Abstract:
Objective To investigate the correlation between the levels of intestinal flora, serum endotoxin （ET）, and procalcitonin （PCT） in patients with sepsis and their disease severity and prognosis. Methods A total of 373 patients with sepsis in Jincheng University Hospital from January 2016 to December 2022 were selected and divided into sepsis group （n=261） and sepsis shock group （n=112） according to the severity of sepsis. The general data, intestinal flora, serum ET and PCT levels were compared between the two groups, and the serum ET and PCT levels were compared among patients with different degrees of intestinal flora disturbance. The relationship between serum PCT and ET levels and the degree of intestinal flora disturbance in sepsis was analyzed.The prognosis of patients for 28 days was statistically analyzed, and the intestinal flora, serum ET, and PCT levels at the time of admission were compared between dead and alive patients to analyze the value of intestinal flora, serum ET, and PCT levels in predicting prognosis. Results Patients in the septic shock group had lower counts of bifidobacteria and lactobacilli compared to the sepsis group, while counts of Escherichia coli, enterococci, as well as serum levels of ET and PCT were higher in the septic shock group. The severity of disruption in gut microbiota was associated with higher serum levels of ET and PCT, with level III patients having higher levels than level II and level I patients. The levels of ET and PCT in septic patients were positively correlated with the severity of disruption in gut microbiota. Upon admission, deceased patients had lower counts of bifidobacteria and lactobacilli compared to surviving patients, while counts of enterococci, Escherichia coli, as well as serum levels of ET and PCT were higher in deceased patients. The predictive value for prognosis of death for bifidobacteria, enterococci, Escherichia coli, lactobacilli, ET, and PCT were 0.788, 0.782, 0.787, 0.768, 0.791, and 0.776 respectively. The combined predictive value had the highest AUC of 0.928. Conclusion The intestinal flora, serum ET, and PCT levels in patients with sepsis are closely related to the severity of the disease and have good application value in predicting prognosis.
2024, 45(4): 146-151.
doi: 10.12259/j.issn.2095-610X.S20240421
Abstract:
Objective To study the efficacy and adverse reactions of vonoprazan fumarate tablets and esomeprazole magnesium enteric-coated tablets in the treatment of non-erosive reflux disease（NERD）. Methods A total of 124 patients with NERD were selected and divided into treatment group（62 cases） and control group（62 cases） by random number table method. Treatment group received vohoprazan fumarate tablet, while control group received esomeprazole magnesium enteric-coated tablet, and the course of treatment was 4 weeks. HP was eradicated in helicobacter pylori（HP）-positive patients. The clinical efficacy, reflux disease questionnaire（RDQ ）score, pittsburgh sleep quality index score, changes of esophageal pH before and after treatment、HP eradication rate and incidence of adverse reactions were compared between the two groups. Results The treatment group showed a higher overall effectiveness compared to the control group（P < 0.05）. After treatment, the RDQ scores in the treatment group were lower than those in the control group（P < 0.05）. Similarly, the PSQI scores in the treatment group were lower than those in the control group（P < 0.05）. Additionally, the treatment group exhibited fewer reflux episodes with pH < 4, reflux episodes lasting > 5 minutes, and a lower total time with pH < 4 compared to the control group（P < 0.05）. The eradication rate of HP in the treatment group was higher than that in the control group（P < 0.05）. There was no significant difference in the overall rate of adverse reactions between the treatment group and the control group（P > 0.05）. Conclusion In the treatment of non-erosive reflux disease, compared to esomeprazole magnesium enteric-coated tablets, vonoprazan fumarate tablets show significant efficacy, improve sleep quality, provide stronger acid suppression, increase the eradication rate of Helicobacter pylori（HP）, and do not increase adverse reactions.
2024, 45(4): 152-156.
doi: 10.12259/j.issn.2095-610X.S20240422
Abstract:
Objective To analyze the risk factors of persistent infection of high-risk human papillomavirus after radical hysterectomy for early cervical cancer. Methods A total of 159 early-stage cervical cancer patients who underwent radical hysterectomy or laparoscopic radical hysterectomy at the Kunming Maternal and Child Health Hospital between January 2021 and November 2023 were selected. Based on the postoperative 1a follow-up visit for HR-HPV persistent infection status, they were divided into two groups: HR-HPV positive group （n = 41） and HR-HPV negative group （n = 118）. The general data, vaginal microbiota status, surgical approach, postoperative pathology results, etc., of the two groups of patients were analyzed to study the risk factors associated with postoperative HR-HPV persistence in early-stage cervical cancer patients. Results Univariate and multivariate regression analysis showed that the HR-HPV persistent positive group and HR-HPV negative group, the risk factors of HR-HPV persistent positivity in patients with early cervical cancer after operation were menopause, late stage of operation, vaginal microecological disorder/sub-disorder （P < 0.05）, but laparoscopic minimal invasive surgery was not. OR of vaginal microecological abnormality was 12.574, OR of menopause was 3.510. Conclusion Menopausal and vaginal microecological disorders are important risk factors for HR-HPV clearance in patients with radical hysterectomy for early cervical cancer.
2024, 45(4): 157-162.
doi: 10.12259/j.issn.2095-610X.S20240423
Abstract:
Objective To analyze the immunological indicators of TB patients co-infected with COVID-19, clarify their immune status, and explore the relationship and characteristics of relevant indicators with immune status. Methods The study group consisted of TB patients infected with COVID-19 admitted to the Third People's Hospital of Kunming City （n = 111）, while TB patients who were not infected with COVID-19 during the same period were selected as the control group （n = 1649） for the analysis of serum immunological indicators. Results After excluding confounding factors such as age and gender through PSM propensity matching, the TB-COVID group showed lower levels of CD19+, CD3+, CD4+, lymphocyte, and IL-8 compared to the TB group, while IL-10, IL-17, and IL-6 were higher in the TB-COVID group, with statistically significant differences （P < 0.05）. ROC curve analysis of the above differing indicators was performed to analyze the immune risk factors of TB-COVID. The sensitivity and specificity of CD19+, IL-10, and IL-6 for TB infection with COVID-19 were 71.4% and 56.7%, 59.1% and 77.0%, 59.1% and 77.7%, respectively. The AUC values were 0.659 （95%CI: 0.583～0.736, P < 0.05）, 0.645 （95%CI: 0.558～0.732, P < 0.05）, and 0.649 （95%CI: 0.564～0.734, P < 0.05）. When comparing subgroups based on age, in the TB-COVID group, IL-1β, IL-2, IL-4, IL-8, TFN-α, and IL-12p70 sharply increased in the 21-40 age group far beyond the TB group, and gradually declined with increasing age. Conclusion TB patients have a weakened immune system after being infected with COVID-19, with multiple immune indicators lower compared to TB patients. This is related to cell immunity and cytokine storm, so we need to pay more attention to TB-COVID cases.
2024, 45(4): 163-169.
doi: 10.12259/j.issn.2095-610X.S20240424
Abstract:
Objective To investigate the clinical implications of lung function index, serum lactate dehydrogenase（LDH）, cysteine protease inhibitor C（CysC） and platelet/white blood cell ratio（PWR） in patients with lung cancer. Methods From January 2023 to June 2023, 72 patients with lung cancer in the Fourth People's Hospital of Changzhou were selected as the observation group, and 72 patients with benign lung diseases during the same period were selected as the control group. LDH, CysC, PWR and tumor markers [carcinoembryonic antigen（CEA）, neuron-specific enolase（NSE）, cytokeratin fragment 19（CYFRA21-1）] were compared between the two groups, and the correlation between LDH, PWR, CysC and tumor markers was analyzed. The levels of LDH, CysC and PWR in patients with lung cancer with different pathological characteristics were compared, and the correlation between the levels of LDH, PWR, CysC and pathological characteristics in patients with lung cancer was analyzed. The diagnostic value of LDH, CysC, PWR combined with CEA, CYFRA21-1 and NSE in lung cancer was evaluated. Results The PWR of the observation group was lower than that of the control group, and the LDH, CysC, CEA, CYFRA21-1 and NSE were higher than those of the control group（P < 0.05）. PWR was negatively correlated with tumor markers CEA, CYFRA21-1 and NSE（ P < 0.05）, LDH and CysC were positively correlated with tumor markers CEA, CYFRA21-1 and NSE（ P < 0.05）. There was no significant difference in LDH, CysC and PWR between lung adenocarcinoma and lung squamous cell carcinoma（ P > 0.05）. In terms of clinical stage, PWR of stage Ⅰ- Ⅱ patients was higher than that of stage Ⅲ-Ⅳ patients, LDH and CysC were lower than those of stage Ⅲ-Ⅳ patients（ P < 0.05）. In terms of lymph node metastasis, the PWR of patients without lymph node metastasis was higher than that of patients with lymph node metastasis, and LDH and CysC were lower than those of patients with lymph node metastasis（ P < 0.05）. LDH, PWR and CysC in lung cancer patients were not correlated with pathological type（ P > 0.05）, PWR was negatively correlated with clinical stage and lymph node metastasis（ P < 0.05）, LDH and CysC were positively correlated with clinical stage and lymph node metastasis（ P < 0.05）. The ROC curve showed that the area under the curve（AUC） value of the combination of LDH, CysC and PWR in the diagnosis of lung cancer was 0.910, and the AUC value of the combination of CEA, CYFRA21-1 and NSE was 0.923. Further use of LDH, CysC, PWR combined with CEA, CYFRA21-1, NSE diagnostic AUC value was the highest, 0.940, the sensitivity and specificity were 93.06% and 87.33%, respectively. Conclusion The PWR of lung cancer patients is decreased, and the levels of LDH and CysC are increased, and their levels are closely related to tumor markers, clinical stage and lymph node metastasis, which can assist tumor markers in the diagnosis of lung cancer, in order to improve the diagnosis rate of early lung cancer.
2024, 45(4): 170-176.
doi: 10.12259/j.issn.2095-610X.S20240425
Abstract:
Objective To observe the levels of uric acid, Smad1 protein, and urine microalbumin in patients with type 2 diabetic nephropathy, and to analyze the correlation between these three factors and the effectiveness of dapagliflozin in treating type 2 diabetic nephropathy. Methods From June 2021 to September 2022, 170 patients with type 2 diabetic nephropathy in our hospital were included in the diabetic nephropathy group. Another 120 patients with only type 2 diabetes during the same period were included in the simple diabetes group. All patients underwent blood UA, Smad1 protein, and urine mALB tests upon admission, and the levels of these three indicators were compared between the diabetic nephropathy group and the simple diabetes group. All type 2 diabetic nephropathy patients were treated with dapagliflozin and followed up for three months to observe the treatment effect. Based on the treatment effect, they were divided into the effective group （n = 142） and the ineffective group （n = 28）. The blood UA, Smad1 protein and urine mALB contents of the effective group and ineffective group were compared, and the correlation between the three indexes and the therapeutic effect of Dapagliflozin on type 2 diabetic nephropathy was analyzed. A receiver operating characteristic curve （ROC） was plotted to analyze the predictive value of the above three indicators for the effect of dapagliflozin treatment for type 2 diabetic nephropathy. Results Diabetic nephropathy group had higher levels of blood UA, Smad1 protein, and urine mALB compared to the simple diabetic group （t = 8.843, 12.097, 8.858, P < 0.05）. After 3 months of treatment, out of 170 type 2 diabetic nephropathy patients, 142 cases were effectively treated （83.53%）, while 28 cases were not （16.47%）. The ineffective group had higher levels of blood UA, Smad1 protein, and urine mALB compared to the effective group （t = 3.508, 4.622, 3.563, P < 0.05）. Correlation analysis showed that blood UA, Smad1 protein, and urine mALB levels were negatively correlated with the efficacy of Dapagliflozin treatment for type 2 diabetic nephropathy （r = -0.261, -0.336, -0.265, P < 0.05）. Logistic regression analysis indicated that elevated levels of blood UA （95%CI: 1.001～1.021）, Smad1 protein （95%CI: 1.167～1.610）, and urine mALB （95%CI: 1.011～1.048） were risk factors for the ineffectiveness of Dapagliflozin treatment for type 2 diabetic nephropathy （OR=1.011, 1.371, 1.029, P < 0.05）. The receiver operator characteristic curve （ROC） analysis showed that blood UA （95%CI: 0.622～0.793）, Smad1 protein （95%CI: 0.685～0.841）, and urine mALB （95%CI: 0.630～0.803） levels had some predictive value for the efficacy of Dapagliflozin treatment for type 2 diabetic nephropathy （AUC = 0.707, 0.763, 0.716）, with higher predictive value when combined （95%CI: 0.734～0.881, AUC = 0.808）. Conclusion The levels of serum UA, Smad1 protein and urine mALB are closely related to the therapeutic effect of Dapagliflozin on type 2 diabetic nephropathy, which can be used to predict its therapeutic effect.
2024, 45(4): 177-183.
doi: 10.12259/j.issn.2095-610X.S20240426
Abstract:
After lung cancer surgery, lung function impairment is an unavoidable issue in clinical practice, with factors such as surgical methods, resection sites, and individual differences leading to variations in the extent of lung function loss and recovery time points. This article summarizes the introduction and role of lung function tests, the effects of different surgical methods, resection sites, and physical rehabilitation training on lung function. The aim is to compare the extent of lung function loss in patients undergoing different surgical methods and resection sites, providing a reference for developing personalized exercise rehabilitation care plans for patients.
After lung cancer surgery, lung function impairment is an unavoidable issue in clinical practice, with factors such as surgical methods, resection sites, and individual differences leading to variations in the extent of lung function loss and recovery time points. This article summarizes the introduction and role of lung function tests, the effects of different surgical methods, resection sites, and physical rehabilitation training on lung function. The aim is to compare the extent of lung function loss in patients undergoing different surgical methods and resection sites, providing a reference for developing personalized exercise rehabilitation care plans for patients.
2024, 45(4): 184-191.
doi: 10.12259/j.issn.2095-610X.S20240427
Abstract:
Surgery is the main treatment for thyroid cancer, with features good postoperative prognosis, high survival rate, and long life expectancy. With the development of society and medical level, patients not only seek to cure the disease but also have higher requirements for postoperative quality of life. The development of endoscopic thyroid surgery has brought more choices to thyroid cancer patients. However, there are various ways of surgical approaches, each with its own advantages and disadvantages. This article provides a comprehensive review of endoscopic thyroid surgery approaches based on relevant literature at home and abroad.
Surgery is the main treatment for thyroid cancer, with features good postoperative prognosis, high survival rate, and long life expectancy. With the development of society and medical level, patients not only seek to cure the disease but also have higher requirements for postoperative quality of life. The development of endoscopic thyroid surgery has brought more choices to thyroid cancer patients. However, there are various ways of surgical approaches, each with its own advantages and disadvantages. This article provides a comprehensive review of endoscopic thyroid surgery approaches based on relevant literature at home and abroad.
2024, 45(4): 192-196.
doi: 10.12259/j.issn.2095-610X.S20240428
Abstract:
Objective To evaluate the effectiveness of the "WeChat + scenario simulation" interactive teaching mode in the practice of nutrition counseling and education, and to provide reference for the cultivation of undergraduate students' competence in the workplace. Methods Experimental group and control group were set up. "WeChat + situational simulation" interactive teaching mode and "situational simulation" teaching mode were applied to the two groups respectively. Results The initiative and enthusiasm, team cooperation ability, problem-solving ability, communication ability, professional knowledge and skill application ability of the experimental group were better than those of the control group（all P < 0.05）. In doctor-patient communication, the ability of preparation, information giving and understanding patients in the experimental group were better than those in the control group（all P < 0.05）. The learning completion, chapter test scores and total score of formative assessment in the experimental group were higher than those in the control group（all P < 0.05）. Conclusion The interactive teaching mode of "wechat + scenario simulation" has a good effect on improving the practical ability of undergraduates in nutrition, and can provide a reference for the training of undergraduates' post competence.
2024, 45(4): 197-202.
doi: 10.12259/j.issn.2095-610X.S20240429
Abstract:
Objective To explore the improvement effect of Triangle hierarchical management+LEARNS model on blood sugar level, renal function level and psychological status of patients with diabetes nephropathy in nursing care. Methods A total of 74 diabetic nephropathy patients admitted to the Third People's Hospital of Yunnan Province from February 2022 to January 2023 were randomly selected as study subjects. The control group （n=37, receiving routine care during treatment） and the observation group （n=37, receiving Triangle hierarchical management+LEARNS care） were randomly sorted by Excel table. The improvement of blood pressure and renal function were evaluated. Results Comparing the blood sugar levels before and after the intervention in 2 groups, the postprandial 2-hour blood sugar and fasting blood sugar were lower in the observation group than in the control group after the intervention, with statistically significant differences （P < 0.05）. Comparing the quality of life of patients, there was no difference before the intervention, but after the intervention, the observation group had higher scores on the QOLIE-31 scale compared to the control group, with statistically significant differences （P < 0.05）. Comparing the negative emotional scores of patients, there was no difference in BAI and BDI scores before the intervention, but after the intervention, the observation group had lower scores than the control group, with statistically significant differences （P < 0.05）. Comparing the kidney function levels of patients, the observation group had higher kidney function levels than the control group after the intervention, with statistically significant differences （P < 0.05）. Comparing the self-management abilities of the 2 groups, the observation group was higher than the control group after the intervention, with statistically significant differences （P < 0.05）. Conclusion The implementation of Triangle hierarchical management +LEARNS model in the nursing of patients with diabetic nephropathy can improve the blood glucose and renal function of patients, relieve the negative emotions of patients during treatment, and help patients recover.
