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Quick Search     Advanced Search   2023 Vol.  20 No.  3 Published: 2023-06-25 Basic Medicine Clinical Medicine Nursing Science Invited Review Pharmacy Invited Review 1 LI Lei, ZHENG Haixia, DAI Ouyang, ZHAI Zongzhao The roles of lipid metabolism in Alzheimer’s Disease Alzheimer's disease (AD) is a neurodegenerative disease associated with cognitive and behavioral disorder due to the progressive loss of normal neuronal structure and function. It is mostly seen in the elderly over 70 years old, causing increased social burden. So far, there are no effective drugs to treat AD, and understanding the molecular mechanism causing AD has received intensive focus. Recent studies have pointed to a role of abnormal lipid metabolism in AD. This was supported by large Genome-Wide Association Studies, which have uncovered the changes of key lipid metabolism-associated processes and genes in the initiation and progression of AD. This review summarizes the current hypotheses on the pathogenesis of AD, details the changes in lipid metabolism associated with AD and further discusses the potential mechanisms by which abnormal lipid metabolism contributes to AD pathogenesis. With this, we hope to foster a comprehensive understanding of the AD pathogenesis. 2023 Vol. 20 (3): 1-9 [Abstract] ( 742 ) [HTML 1KB] [PDF 2600KB] ( 4667 ) Basic Medicine 10 ZHU Jianyu, XIA Hongzhuo, ZHENG Zhuomeng, PENG Xiaoning, DENG Xiyun, FU Shujun Glutamine Synthetase reduces the sensitivity of TNBC cells to paclitaxel by enhancing anti-apoptosis ability Objective Triple-negative breast cancer (TNBC) is characterized by strong drug resistance. So patients will be less sensitive to paclitaxel, which is the most commonly used chemotherapeutic drug in the clinic, resulting in poor treatment efficacy. Glutamine Synthetase (GS) is a key metabolic enzyme needed to synthesize glutamine, and its high expression can induce ovarian cancer cells to reduce their sensitivity to chemotherapeutic drugs. However, whether GS affects the sensitivity of TNBC cells to paclitaxel and its possible mechanism are still unclear. The purpose of this study was to investigate whether GS affects the sensitivity of TNBC cells to paclitaxel and its mechanism. Methods TNBC cell lines overexpressing and knocking down GS were constructed by plasmid transfection and lentivirus infection, respectively. The effect of GS on paclitaxel sensitivity in TNBC cells was analyzed by Western blot analysis, cell viability assay, colony formation assay and apoptosis detection. qRT-PCR was used to detect the expression of drug metabolic enzymes, drug transporters, and anti-apoptotic proteins in cells overexpressing GS. Results GS was highly expressed in breast cancer cells. The sensitivity of GSlow cells (MDA-MB-231) to paclitaxel was higher than that of GShigh cells (MDA-MB-468). Overexpression of GS decreased the sensitivity of TNBC cells to paclitaxel, enhanced the ability of clone formation and anti-apoptosis, knocking down GS could increase the killing effect of paclitaxel on TNBC cells, and the expression of anti-apoptotic protein BAG3 was significantly increased in TNBC cells overexpressing GS. Conclusions In TNBC cells, the overexpression of GS promotes cell proliferation, reduces apoptosis, and enhances the ability of clone formation in TNBC cells. The anti-apoptotic effect of GS was mediated by up-regulating the expression of BAG3, thus reducing the sensitivity of TNBC cells to paclitaxel. 2023 Vol. 20 (3): 10-15 [Abstract] ( 619 ) [HTML 1KB] [PDF 3102KB] ( 2677 ) 16 WU Muyao, LIU Yixian, ZHENG Chanjuan, FU Shujun, DENG Xiyun An Anoikis -Related Gene Signature Predicts Survival and Sensitivity to Tyrosine Kinase Inhibitors in Triple-Negative Breast Cancer Objective Anoikis is a distinct form of apoptosis that primarily takes place when cells become detached from the extracellular matrix, resulting in the loss of anchoring. It plays a crucial role in preserving the homeostasis of the in vivo environment. This study is aimed at developing a gene set and prognostic model associated with anoikis in triple-negative breast cancer (TNBC), which could also be utilized to predict effective therapeutic interventions for patients. Methods Univariate and multivariate Cox analyses were conducted on TNBC patients within the TCGA-BRCA dataset to identify the anoikis-related gene signature (ARGS). The Gene Expression Omnibus (GEO) dataset was employed for independent validation. Subsequently, a nomogram model was constructed by integrating ARGS with clinicopathological parameters. Multiple statistical methods were employed to assess the predictive capability of the model. The sensitivity to therapeutic agents was analyzed in stratified TNBC patients based on ARGS. To investigate the predicted drug susceptibility, CCK-8 cell viability assay and flow cytometry were performed. Results We constructed a seven-gene ARGS and calculated the risk score, stratifying TNBC patients into high-risk and low-risk groups. Significantly worse overall survival (OS) was observed in the high-risk group compared with the low-risk group. Subsequently, we generated a nomogram model exhibiting excellent performance and stratification of patient survival, predicting heightened sensitivity to tyrosine kinase inhibitors (TKIs) in high-risk TNBC patients. In addition, we found that the higher the risk score of the TNBC cell lines, the greater the sensitivity to TKIs. Conclusions An ARGS was established in TNBC to predict patient survival and drug sensitivity. Additionally, a nomogram model was constructed, incorporating clinicopathological parameters to further enhance the prediction ability of patient survival. 2023 Vol. 20 (3): 16-23 [Abstract] ( 648 ) [HTML 1KB] [PDF 5938KB] ( 2244 ) 24 CHEN Qiuxia, LIU Liu, CHEN Guimei, CHEN Anji, DUAN Boqing Effect of dexmedetomidine on inflammatory response in mice with acute lung injury induced by endotoxin Objective Effect of dexmedetomidine (DEX) on endotoxin induced acute lung injury in mice. Methods 32 healthy male C57BL/6 mice were randomly divided into 4 groups (8 mice/group), sham operation group (control group), endotoxin acute lung injury group (LPS group), high concentration DEX group (HD group), low concentration DEX group (LD group). Control group was injected with saline of equal volume; LPS group was intraperitoneally injected with LPS 3 mg/kg; In DEX+LPS group, DEX (40 μg/kg or 20 μg/kg). The inflammatory changes of lung tissue and the ratio of wet weight to dry weight (W/D) were measured by pathological sections; Detection of serum IL-6, IL-8 and IL-1β by enzyme-linked immunosorbent assay (ELISA) Change of content; The changes of miR-155 and miR-146a in lung tissue were detected by qRT-PCR. Results Compared with control group, LPS group and DEX group had significant lung inflammation, lung W/D ratio, IL-6, IL-8, and IL-1β the content and expression level of miR-155 increased, while the expression level of miR-146a decreased (*P<0.05); Compared with LPS group, lung inflammation, lung W/D ratio, IL-6, IL-8, and IL-1β in DEX group were significantly improved the content and expression level of miR-155 decreased, while the expression level of miR-146a increased (#P<0.05); Compared with LD group, lung inflammation, lung W/D ratio, IL-6, IL-8, and IL-1β in HD group were significantly improved the content and expression level of miR-155 decreased, while the expression level of miR-146a increased ($P<0.05). Conclusion Dextrmetomidine (DEX) can reduce the inflammatory reaction in mice with acute lung injury induced by endotoxin, which may be related to miR-146a and miR-155. 2023 Vol. 20 (3): 24-27 [Abstract] ( 637 ) [HTML 1KB] [PDF 4118KB] ( 2182 ) 28 TIAN Limin, YANG Sen, LI Wei, A Surui, HUYAN Xiaohui, YANG Yuenan Relationship between TRPV1-GRPR-JAK1STAT3 pathway expression and pruritus in allergic contact dermatitis Objective To investigate Transient receptor potential (TRPV1) - Gastrin releasing peptide receptor, GRPR) -JAK1STAT3 signaling mechanism on skin pruritus in allergic contact dermatitis. Methods The allergic contact dermatitis (ACD) model was induced by dibutyl cubic acid (SADBE) in mice, which were divided into normal group, SADBE group and TRPV1 knockout group. Detect skin thickness and serum immunoglobulin E (IgE). Immunofluorescence and FISH staining were used to detect the expression of Keratin (KRT14), TRPV1 and GRPR in antibody cells, analyze the correlation between their expression and the number of scratches in mice, and fluorescence quantitative polymerase chain reaction (qPCR) was used to detect the expression of TRPV1-GRPR-JAK1STAT3 signal in the spinal cord of ACD model mice. Results In the mouse ACD model induced by SADBE, prolonged skin itching was observed between 3 and 7 days. Elevated serum IgE levels, thickened epidermis, and increased spleen weight were observed also. Dual FISH studies of lumbar spinal cord sections in mice showed significant overlap between TRPV1 and GRPR, with increased expression of TRPV1, GRPR, JAK1, and STAT3 mRNA in the SADVE group compared with the normal group and decreased expression in the SADBE group after TRPV1 knockout. The number of scratches and epidermal thickness decreased in TRPV1 knockout group, and the difference was statistically significant (P<0.05). Conclusion ACD induced by SADBE resulted in increased pruritus in mice, while inhibition of TRPV1-GRPR-JAK1STAT3 signaling suppressed allergic contact dermatitis skin pruritus. 2023 Vol. 20 (3): 28-32 [Abstract] ( 687 ) [HTML 1KB] [PDF 2566KB] ( 3047 ) 33 XIAO Shuang, HE Xiangling, GONG Cheng, WEI An Application value of ultrasound combined with clinical index prediction model in the diagnosis of hepatoblastoma Objective To explore the application value of the combined prediction model of ultrasound and clinical indicators in the diagnosis of hepatoblastoma (HB). Methods A retrospective analysis of 81 cases of focal liver lesions confirmed by surgical resection or biopsy in Hunan Provincial People's Hospital was conducted. Based on the pathological results, they were divided into HB group and non HB group. General clinical data, AFP, platelet concentration, maximum diameter of tumor, and ultrasound signs were recorded. Mann-Whitney U test, independent sample t-test, and chi-square test were used for comparison between groups, Using binary logic regression to analyze the influencing factors for the diagnosis of HB and establish a predictive model for indicators with inter group differences, the diagnostic efficacy of a single indicator and a joint predictive model were compared using receiver operating characteristic (ROC). Results There were significant differences in age, AFP, platelets, maximum tumor diameter, liquefaction, bleeding, metastasis, and vascular involvement between the groups (P<0.05). The binary logistic regression analysis showed that age, maximum diameter and liquefaction were independent influencing factors of HB, and the simplified equation was obtained by incorporating them into the prediction model. The ROC showed that the prediction model and the simplified equation had higher diagnostic efficiency than the single index. Conclusion The application value of ultrasound combined with clinical indicator prediction model in the diagnosis of hepatoblastoma is superior to that of a single indicator. The use of simplified equations is simple and fast, which can improve the detection rate of hepatoblastoma and provide a reference basis for clinical diagnosis of hepatoblastoma. 2023 Vol. 20 (3): 33-37 [Abstract] ( 591 ) [HTML 1KB] [PDF 2176KB] ( 3013 ) Clinical Medicine 38 JIA Meng, WANG Jianying, JI Ting, JIA Fei, LIU Jing Study on the role of circulating miR-101-3p in the diagnosis of gestational diabetes mellitus Objective To explore the differential expression of circulating miRNAs between healthy women and women with gestational diabetes mellitus (GDM), and to identify potential molecular markers related to GDM. Methods Plasma samples were taken from 53 pregnant women with GDM and 30 normal pregnant women with matched age and gestational weeks in Northwest Women's and Children's Hospital from January 2020 to June 2022. The miRNA high-throughput sequencing was used to screen circulating miRNAs related to GDM. Real-time quantitative PCR (RT-qPCR) was used to verify the differentially expressed candidate miRNAs identified from the mirna analysis experiment. Evaluating the expression level of circulating miR-101-3p by using receiver operating characteristic (ROC) curve to predict the value of GDM. Serum hs-CRP and TNF-α levels were measured by enzyme-linked immunosorbent assay. Results Compared with the healthy control group, pregnant women in GDM group had higher levels of triglyceride, hs-CRP, TNF-α and lower levels of HDL-C. Among the 2549 plasma mirnas detected, 267 mirnas showed 2 times or more difference in expression between the two groups. Enrichment of KEGG pathway revealed that miR-101-3p may be involved in glucose, inflammation regulation and lipid metabolism. PCR analysis showed that the plasma miR-101-3p of GDM pregnant women was significantly down-regulated compared with healthy subjects. ROC analysis showed that the sensitivity, specificity and AUC of miR-101-3p in distinguishing healthy control group from GDM group were 0.852, 0.737 and 0.845, respectively. Correlation analysis showed that the expression of plasma miR-101-3p was negatively correlated with blood glucose level, hs-CRP and TNF-α (r=-0.649, -0.602 and -0.735, all P<0.001). Conclusions MiR-101-3p may be involved in insulin resistance and the regulation of inflammatory factors in GDM patients. 2023 Vol. 20 (3): 38-42 [Abstract] ( 632 ) [HTML 1KB] [PDF 4209KB] ( 2181 ) 43 HUANG Xiaoli, WANG Lin, YANG Ting, LUO Lisha, ZHOU Yi, YANG Yi, MA Lihong Effects of nivolumab combined with pemetrexed on efficacy and prognosis in the treatment of advanced NSCLC Objective To analyze the efficacy of programmed death receptor-1(PD-1) /programmed death receptor ligand-1(PD-L1) inhibitor nivolumab combined with pemetrexed in the treatment of advanced non-small cell lung cancer (NSCLC) and its effects on prognosis. Method A total of 98 patients with advanced NSCLC treated in the hospital from January 2018 to January 2021 were recruited and divided into observation group (49 cases, pemetrexed+ nivolumab) and control group (49 cases, pemetrexed) by the random number table method. Both groups of patients were continuously treated until intolerance or disease progression occurred. The clinical efficacy after treatment (2 cycles of chemotherapy) and adverse reactions during treatment in the two groups were recorded. The immune function (CD3+, CD4+, CD8+, CD4+/CD8+), serum related factors [serum recombinant anterior gradient protein 2(AGR2), matrix metalloproteinase-9(MMP-9) ] and quality of life [Karnofsky Performance Status (KPS score) ] were compared between the two groups before and after treatment. Results There were no deaths in both groups within 2 cycles of chemotherapy, and the clinical objective response rate (ORR) of 57.14% in observation group was significantly higher than 36.73% in control group, and the absolute difference values of CD3+, CD8+, AGR2, MMP-9 and KPS score before and after treatment were significantly higher than those in control group while the absolute difference values of CD4+ and CD4+/CD8+ were significantly lower than those in control group. There were no significant differences in the adverse reactions between the two groups, and the patients with symptoms were well tolerated and controlled by 25%~50% down-regulated dose and symptomatic treatment. Conclusion Nivolumab combined with pemetrexed in the treatment of advanced NSCLC can improve the short-term relief effect, strengthen the body's immune function and enhance the quality of life, and it does not significantly increase the incidence rates of adverse reactions. 2023 Vol. 20 (3): 43-46 [Abstract] ( 741 ) [HTML 1KB] [PDF 1872KB] ( 2776 ) 47 ZHU Mingxin, HUANG Jianliang, XIA Mingkai, PENG Bo, LI Linjun, ZHANG Jianhui, WEN Fang, HU Linlin, LEI Mingsheng The clinical significance of CAD in patients with severe and critically-severe Omicron infections Objective The purpose of this study is to investigate the clinical significance of computer-aided diagnosis (CAD) in patients with severe and critically-severe Omicron infections in Zhangjiajie. The study aims to provide additional references for the treatment of these patients. Method From December 2022 to January 2023, we collected various clinical data such as qSOFA score, laboratory test results, and lung CT scans from patients who were hospitalized with severe and critically-severe Omicron infections. Additionally, in this study, we utilized computer-aided diagnosis to segment and reconstruct the lung CT, enabling us to accurately calculate the proportion of inflammation. Our objective was to compare the clinical characteristics and inflammation proportion of severe and critically-severe, with the aim of identifying any potential differences and exploring the relationship between inflammation proportion and critical illness. Results A total of 116 severe and critically-severe patients were included in this study, The median age of the patients was 73.0(ranging from 65.0 to 84.0) years, and 60.3% (n=70) of patients were admitted to the ICU. Among the patients, 86.2% (n=100) patients had underlying diseases. proportion of inflammation, qSOFA score, C-reactive protein, and D-dimer were higher in critically-severe patients than in severe patients (P<0.05). The higher the proportion of inflammation, the easier it is to develop critical illness (r=0.24, P=0.009). The sensitivity, specificity and accuracy of inflammation proportion in the diagnosis of progress to critically-severe were 0.656, 0.745 and 0.638, the cutoff value was 31.46%. Conclusion Computer-aided diagnosis has a certain value in evaluating the condition of patients with severe COVID-19 pneumonia. The higher the proportion of inflammation, the greater the possibility of the disease progressing to critical illness, it is hypothesized that if the proportion of lung inflammation is equal to or greater than 31.46%, the patient is at a high risk of progressing to critical illness. 2023 Vol. 20 (3): 47-53 [Abstract] ( 581 ) [HTML 1KB] [PDF 2756KB] ( 2551 ) 54 DUAN Xiaoju, JIANG Gang, SHI Lifang, LI Lingjiao, OUYANG Wen, ZHENG Zhaofen Clinical study of thrombotic load in acute intermediate-risk pulmonary thromboembolism Objective To investigate the clinical value of thrombotic load in acute intermediate-risk pulmonary thromboembolism (PTE). Methods A retrospective analysis was conducted on 128 patients admitted to Hunan Provincial People's Hospital who were diagnosed with acute intermediate-risk PTE by CT pulmonary angiography (CTPA) examination, and who were divided into intermediate-low-risk group and intermediate-high-risk group according to the risk stratification, including 62 cases in intermediate-high-risk and low risk group and 66 cases in intermediate-low-risk group, and who were analyzed in the general clinical data, right ventricular inner diameter (RV) and left ventricular inner diameter (LV) of echocardiography, RV and LV and thrombotic load/CT pulmonary artery occlusion index (PAOI) Qanadli score of CTPA. Qanadli score for thrombotic load and the RV/LV ratio of CTPA and echocardiography were compared. Receiver operating characteristic curve (ROC) was used to analyze the predictive ability of Qanadli score for acute intermediate-risk PTE. Results There were no statistical differences in age and sex of intermediate-low-risk group and intermediate-high-risk group. There were significant differences in shortness of breath, syncope and concomitant disease renal insufficiency, DVT in the two groups. Qanadli score, RV/LV ratios of CTPA and echocardiogram of patients in intermediate-low-risk group were significantly lower than those in intermediate-high-risk group. Qanadli score was positively correlated with RV/LV ratios of CTPA and echocardiographic. Qanadli score had good predictive value for intermediate-high-risk PTE, with an area under the ROC curve (AUC) of 0.814, a truncation value of 32.5%, a sensitivity of 77.3%, and a specificity of 77.4%. The result of univariate logsitic regression analysis showed that the high Qanadli scores (≥32.5%) were significantly more likely to be intermediate-high-risk than the low Qanadli scores (<32.5%) (OR=11.657). Conclusion Qanadli score was a predictor of risk stratification of intermediate-risk PTE, which provided a strong supplement for risk stratification, and reference value for clinicians who timely and accurately assessed the severity of the disease and personalized treatment. 2023 Vol. 20 (3): 54-57 [Abstract] ( 624 ) [HTML 1KB] [PDF 1903KB] ( 2478 ) 58 HUANG Jingying, LU Chaoling, QIN Shiyue, TANG Dixiong, ZHANG Yuancong Curative effect of ambroxol hydrochloride combined with bronchoscopic alveolar lavage and its influences on oxidative stress, inflammatory response and alveolar oxygenation function in elderly patients with severe pneumonia Objective To explore the curative effect of ambroxol hydrochloride combined with bronchoscopic alveolar lavage in elderly patients with severe pneumonia (SP). Methods A total of 100 elderly patients with SP treated in the hospital were enrolled and randomly divided into control group and treatment group between September 2020 and December 2022, 50 cases in each group. The control group was treated with ambroxol hydrochloride, while treatment group was additionally treated with bronchoscopic alveolar lavage. A total of 50 patients given routine treatment during the same period were enrolled as routine group. The clinical curative effect after treatment, oxidative stress response, inflammatory response and alveolar oxygenation function before and after treatment, and adverse reactions during treatment in the three groups were compared. Results After treatment, total response rate of treatment group was higher than that of control group and routine group. After treatment, the related indexes of oxidative stress response, inflammatory response and alveolar oxygenation function in treatment group were better than those in control group and routine group. During treatment, there was no significant difference in adverse reactions among the three groups (P>0.05). Conclusion Compared with routine treatment and ambroxol hydrochloride alone, ambroxol hydrochloride combined with bronchoscopic alveolar lavage can enhance clinical curative effect, reduce oxidative stress response and inflammatory response, and improve alveolar oxygenation function in elderly patients with SP, with good safety. 2023 Vol. 20 (3): 58-60 [Abstract] ( 599 ) [HTML 1KB] [PDF 1839KB] ( 2539 ) 61 JIANG Xiufang, BAI Lu, XU Wei, YI Hu, LUO Liu, XIONG Qiangqiang, MAO Xincheng, ZHENG Mingzhi, QI Mingming The clinical application of subanesthetic dose of esketamine in geriatric patients with painless bronchoscopy Objective To investigate the effect of flax intoxication dose of Ketamine on hemodynamics in painless fiberoptic bronchoscopy in geriatric patients. Methods A total of 100 geriatric patients undergoing painless bronchoscopy from November 2021 to May 2022 were selected and randomly divided into control group and experimental group. The experimental group was given intravenous injection of 0.15 mg/kg esmketamine hydrochloride, while the control group was given intravenous injection of equal volume of normal saline, and then the patients in both groups were given TCI pump injection of propofol and remifentanil for anesthesia induction and maintenance. When the patient's consciousness disappeared and the BIS value was less than 60, the laryngeal mask was placed and connected to the anesthesia machine for mechanical ventilation, and the BIS value was maintained at 40~60 during operation. The hemodynamic changes at different time points, the time standardized dosage of propofol and remifentanil, the incidence of adverse reactions, the use rate of vasoactive drugs, anesthesia time and postoperative recovery index monitoring scores of the two groups were observed. Results SBP and DBP in the two groups before laryngeal mask insertion (T1), during examination (T2), and at awakening (T3) were lower than those before induction of anesthesia (T0); The SBP and DBP of the experimental group at T1, T2 and T3 were higher than those of the control group at the same time. The HR of the control group at T1 and T2 was lower than that at T0; the HR of the experimental group at T1 was lower than that at T0, and the HR of the experimental group at T2 was slightly higher than that at T0. To the recovery period, the HR of the two groups was higher than that at T0; Compared with T0, SpO2 at T1, T2 and T3 increased in both groups; There was no difference in HR and SpO2 between the two groups at the same time. Conclusion Anesthesia dose of esmketamine used in geriatric patients with painless fiberoptic bronchoscopy has little impact on hemodynamics and high safety, which is worthy of promotion and application. 2023 Vol. 20 (3): 61-65 [Abstract] ( 706 ) [HTML 1KB] [PDF 1902KB] ( 3691 ) 66 HUANG Fengmei, HE Chun, YU Xiaoli, PENG Huabao, HOU ZhangHua, TAN Ruokun, ZHU Lihui Effects of non-invasive ventilation combined with shenfu injection on lung function, immune function, PCT, IL-17 and CRP in children with severe asthma complicated with respiratory failure Objective To investigate the clinical effect of Shenfu injection on children with severe asthma and respiratory failure under non-invasive ventilation. Methods Sixty children with severe asthma complicated with respiratory failure admitted to the hospital from January 2021 to December 2022 were randomly divided into group A (n=30) and group B (n=30). Group A received non-invasive ventilation treatment, and group B was treated with injection on the basis of group A. Pulmonary function indexes, immune function indexes, serum inflammatory indexes and blood gas indexes were compared between the two groups, and the total effective rate was compared between the two groups. Results After treatment, the levels of peak expiratory flow rate (PEF), maximum volume of exhaled air in the first second of exhalation (FEV1), forced vital capacity (FVC), immunoglobulin A (IgA), immunoglobulin M (IgM) and immunoglobulin G (IgG) in both groups were increased compared with those before treatment. The levels of PEF, FEV1, FVC, IgA, IgM and IgG in group B were higher than those in group A. Serum levels of procalcitonin (PCT), interleukin17(IL-17) and C-reactive protein (CRP) in 2 groups were lower than before treatment, and the levels of PCT, IL-17 and CRP in group B were lower than those in group A). Arterial partial pressure of oxygen (PaO2) increased and arterial partial pressure of carbon dioxide (PaCO2) decreased in both groups compared with before treatment, and PaO2 in group B was higher than that in group A and PaCO2 was lower than that in group A. There was no significant difference in the total effective rate between group B and group A. However, according to the rank sum test of different treatment grades, the clinical efficacy of group B was better, and the difference was statistically significant. Conclusion In the treatment of severe asthma complicated with respiratory failure with non-invasive ventilation, Shenfu injection can effectively improve lung function, regulate immune function, reduce serum inflammatory response, and has a good clinical effect. 2023 Vol. 20 (3): 66-70 [Abstract] ( 633 ) [HTML 1KB] [PDF 2695KB] ( 2855 ) 71 WU Shuai, ZENG Minhui, HE Jing, TIAN Xin, CHEN Keke, HE Xiangling Clinical features of SARS-CoV-2 Omicron variant infection in children after hematopoietic stem cell transplantation Objective To investigate the difference of clinical features between children who received hematopoietic stem cell transplantation and normal children without underlying diseases infected with Omicron variant of SARS-CoV-2(hereinafter referred to as Omicron). Methods Clinical data on Omicron-infected children from 2022-12-01 to 2023-1-20 were analyzed retrospectively. Eighty-one children who had received hematopoietic stem cell transplants were included in the transplant group, and 507 normal children without underlying medical conditions were included in the normal group. The differences in clinical characteristics between the two groups were compared. Results There were no significant differences in age or gender between the transplant group and the normal group. The main symptom of Omicron infection in both groups was fever, 64 cases (79.0%) in the transplantation group compared with 389 cases (76.7%) in the normal group. The second most common symptom was cough, 57 cases (70.4%) in the transplantation group were compared with 306 cases (60.4%) in the normal group. There was no statistical significance in fever and cough symptoms between the two groups. At the same time, there were no significant differences between the transplantation group and the normal group in high fever (34.6% vs 36.7%), dyspnea (4.9% vs 2.8%), nasal congestion (43.2% vs 46.5%), and sore throat (35.8% vs 28.4%). In addition, gastrointestinal discomfort (50.6% vs 27.2%), sepsis (3.7% vs 0.2%), respiratory support (3.7% vs 0%), and total disease duration over 2 weeks (43.2% vs 10.1%) in the transplant group were significantly higher than those in the normal group. Conclusion Omicron infection was mainly mild in both the transplant and normal groups, but the incidence of moderate to severe infection was higher in the transplant group than in the normal group, and the duration of the disease was longer. Infected children following hematopoietic stem cell transplantation should still be actively prevented from serious infections and serious adverse events. 2023 Vol. 20 (3): 71-74 [Abstract] ( 590 ) [HTML 1KB] [PDF 1856KB] ( 2400 ) 75 ZHOU Hongyan, HUANG Chunxia Analysis of diagnostic value of endoscopic ultrasonography combined with serum 5-HIAA and SAA1 on patients with early gastric cancer Objective To study the value of endoscopic ultrasonography (EUS) combined with serum 5-hydroxyindole acetic acid (5-HIAA) and serum amyloid protein A1(SAA1) in the diagnosis of early gastric cancer (EGC) and its infiltration depth. Methods 111 patients with suspected EGC in the hospital between April 2019 and April 2021 were selected for the cross-sectional study. EUS examination was performed and serum 5-HIAA and SAA1 were measured. Patients were divided into EGC group and non-EGC group according to pathological results. Patients with EGC were classified as PT1a group and pT1b group according to the tumor infiltration depth. The EUS examination results and levels of serum 5-HIAA and SAA1 were compared between EGC group and non-EGC group and between pT1a group and pT1b group. Receiver operating characteristic (ROC) curve was used to analyze the application value of EUS examination and serum 5-HIAA and SAA1 in the diagnosis of EGC and EGC invading submucosa (SM). Results EUS examination showed 52 EGC positive cases, including 41 cases (77.36%) in EGC group and 11 cases (18.97%) in non-EGC group. The levels of serum 5-HIAA and SAA1 in EGC group were higher than those in non-EGC group (P<0.05). Among 53 patients with EGC, there were 34 cases in pT1a group and 19 cases in pT1b group, and EUS examination displayed 35 patients of M-layer tumor infiltration, including 28 cases (82.35%) in pT1a group and 7 cases (36.84%) in the pT1b group. And the levels of serum 5-HIAA and SAA1 in pT1a group were lower than those in pT1b group (P<0.05). The AUC values of EUS examination and serum 5-HIAA and SAA1 in diagnosing EGC were 0.783, 0.698 and 0.709 respectively, and the accuracy rates were 79.28%, 69.37% and 68.47% respectively, and the AUC and accuracy rate of the three combined diagnosis were 0.920 and 87.39%. The AUC values of EUS examination and serum 5-HIAA and SAA1 in diagnosing the EGC invading SM layer were 0.728, 0.678 and 0.690 respectively, and the accuracy rates were 75.47%, 71.69% and 66.04% respectively, and the AUC and accuracy rate of the three combined diagnosis were 0.847 and 71.69%. Conclusion EUS combined with serum 5-HIAA and SAA1 has a good reference value for EGC diagnosis and evaluation of infiltration depth, and is of great significance for early diagnosis and treatment of gastric cancer. 2023 Vol. 20 (3): 75-79 [Abstract] ( 690 ) [HTML 1KB] [PDF 2320KB] ( 2828 ) 80 XIANG Zhong, CHEN Zhiwu, HU Guohuang Clinical study on the prevention of deep vein thrombosis by using Naquheparin calcium after lumbar spine surgery Objective To explore the safety and efficacy of low molecular Naqu heparin calcium in the prevention of deep vein thrombosis after lumbar spine surgery. Methods 78 Patients with lumbar spine surgery were randomly divided into observation group and control group. The patients of control group used physical prophylaxis to prevent deep vein thrombosis. The observation group used low-molecular Naqu heparin calcium to prevent DVT based on physical prophylaxis 12 hours after surgery. The amount of bleeding during the operation, the amount of drainage in the incision after the operation, the incisional bleeding and the occurrence of deep hematoma were recorded. The parameters of thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-dimer (DD) were recorded before and 3 and 7 days after operation. Ultrasonography was performed to record the thrombosis of the lower extremities before and 7-10 after the operation. Results There was no significant difference in the amount of blood loss during operation and the amount of wound drainage after operation between the two groups (P>0.05). There was no significant difference in the results of thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-dimer (DD) between the two groups before operation (P>0.05). There was no significant difference in prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) between the two groups at 3 days and 7 days post-operation (P>0.05). There were significant differences in fibrinogen (FIB) and D-dimer (DD) between observation group and control group at 3 days and 7 days post-operation, the levels of fibrinogen (FIB) and D-dimer (DD) in the observation group were significantly lower than those in the control group (P<0.05). In control group a DVT with symptom and two intermuscular vein thrombosis of shank with no symptom were taken place, and there was no DVT occur in observation group. Conclusion Using low-molecular Naqu heparin calcium does not increase the risk of intraspinal bleeding after lumbar spine surgery. it can reduce fibrinogen (FIB) and D-dimer (DD) levels, thus playing a role in preventing deep vein thrombosis in both lower limbs after lumbar spine surgery. 2023 Vol. 20 (3): 80-83 [Abstract] ( 645 ) [HTML 1KB] [PDF 1849KB] ( 2719 ) 84 MA Chunmei, DUAN Ling, DU Jing, LI Hongyong Value of non-invasive ventilator combined with acetylcysteine in the treatment of patients with type II respiratory failure and COPD Objective To explore the clinical value of non-invasive ventilator ventilation combined with acetylcysteine (NAC) solution aerosol inhalation on patients with type II respiratory failure (RF) complicated with chronic obstructive pulmonary disease (COPD). Methods 169 patients with COPD complicated with type II RF who were treated in the hospital from May 2020 to January 2022 were divided into the control group (84 cases) and the observation group (85 cases) according to the random number table method. The control group was given conventional treatment combined with non-invasive ventilation, while the observation group was treated with NAC solution for aerosol inhalation on the basis of the control group, and both groups were treated for 7 days. The clinical efficacy, as well as blood gas indicators, respiratory mechanics changes and pulmonary function before and after treatment were observed in the two groups. Results The total effective rate was 97.65% in the observation group, which was higher than 88.10% in the control group. After 7 days of treatment, the partial pressure of oxygen (PaO2), PH value and oxygen saturation (SpO2) in the observation group were higher while the partial pressure of carbon dioxide (PaCO2) was lower compared to the control group. The tidal volume (VT) and fractional inspiratory time (Ti/Ttot) were higher while the respiratory rate (RR) was lower in the observation group compared to the control group. The forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and maximum ventilation volume (MVV) in the observation group were higher than those in the control group. Conclusion Non-invasive ventilator ventilation combined with aerosol inhalation of NAC solution can enhance the clinical efficacy, and effectively improve the blood gas indicators, respiratory mechanics indicators and pulmonary function in patients with COPD and type II RF. 2023 Vol. 20 (3): 84-87 [Abstract] ( 653 ) [HTML 1KB] [PDF 1884KB] ( 2746 ) 88 QIN Yi, PENG Jie, WANG Tao Effectiveness of levocanidine in combination with metoprolol in the treatment of dilated cardiomyopathy in children and the effect on serum s ST2, TGF-β and cardiac function Objective: To analyze the effect of levocarnitine combined with metoprolol in the treatment of children with dilated cardiomyopathy, as well as the influence on serum soluble ST2 protein (s ST2), transforming growth factor (TGF) and cardiac function-related indicators. Methods From January 2019 to November 2022, 22 children with Dilated cardiomyopathy admitted to Yulin Red Cross Society Hospital and 70 children with Dilated cardiomyopathy admitted to West China Second Hospital of Sichuan University were selected as research subjects, and divided into experimental group (n=47) and control group (n=45) by the random number table approach. Metoprolol was administered to the control group, while levocarnitine and metoprolol were administered to the experimental group. The clinical efficacy, vital signs, serum s ST2, TGF-β, left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), adverse reactions were compared between the two groups. Results After 4 weeks of treatment, the total effective rate of treatment in experimental group was higher than that in control group (89.36% vs 71.11%). After treatment, the systolic blood pressure and diastolic blood pressure with (114.87±7.16) mmHg and (86.12±5.02) mmHg in experimental group were higher than (110.72±8.04) mmHg and (83.46±5.35) mmHg in control group while the heart rate with (100.34±9.24) beats/min was lower than (105.59±10.63) beats/min in control group. The levels of serum s ST2 and TGF-β in experimental group after treatment were (0.07±0.01) ng/mL and (131.12±10.07) ng/L, which were lower than (0.16±0.04) ng/mL and (185.46±7.41) ng/L in control group. After treatment, the LVESD and LVEDD with (30.71±7.12) mm and (63.28±9.18) mm in experimental group were lower than (36.89±6.56) mm and (70.79±10.56) mm in control group while the LVEF with (49.63±3.35) % was higher compared with (43.29±2.51) % in control group. After treatment, the 6 minutes walking distance with (399.64±59.97) m in experimental group was longer than (309.64±48.79) m in control group, and NT-proBNP with (2411.08±1108.15) ng/L was lower than (3451.14±1567.59) ng/L in control group. There was no significant difference in the incidence of adverse drug reactions. Conclusion Levocarnitine combined with metoprolol has a significant effect on children with dilated cardiomyopathy, and it can effectively improve the vital signs, serum s ST2, TGF-β and cardiac function, without increasing adverse reactions. 2023 Vol. 20 (3): 88-91 [Abstract] ( 682 ) [HTML 1KB] [PDF 2133KB] ( 2889 ) 92 ZHANG Xiaobo, RONG Guoling Status of blood lipids in elderly patients with coronary heart disease and the influence of secondary prophylactic medication on blood lipid levels Objective To investigate the status of blood lipids and secondary prophylactic medication in elderly patients with coronary heart disease, and analyze the influence of secondary prophylactic medication on blood lipid control. Methods An epidemiological cross-sectional study from January 2020 to March 2023 was conducted. The general information, blood lipids and secondary prophylactic medication of elderly patients with coronary heart disease admitted to the hospital were investigated to identify the factors affecting blood lipid control of elderly patients with coronary heart disease. Results A total of 536 elderly patients with coronary heart disease were enrolled, including 265(49.44%) patients with hypercholesterolemia, 207(38.62%) patients with hypertriglyceridemia, 274(51.12%) patients with mixed hyperlipidemia, 198(36.94%) patients with low HDL-C, 354(66.04%) patients with inadequately controlled blood lipids, and 182(33.96%) patients with standard blood lipid control. The proportions of patients treated with antiplatelet drugs, β-blockers, lipid-lowering drugs, and ACEI/ARB drugs were 58.40%, 51.49%, 29.29%, and 49.63%. There were significant differences between the inadequately controlled blood lipids group and the standard blood lipid control group in terms of the course of coronary heart disease, diabetes history, the usage rate of lipid-lowering statins, compliance with secondary prophylactic medication, and duration of secondary prophylactic medication. The course of coronary heart disease ≥5 years, diabetes history, no use of lipid-lowering drugs and poor compliance with secondary prophylactic medication were independent risk factors for blood lipid control failure in elderly patients with coronary heart disease. The variance inflation factor (VIF) was under 3. Conclusion Blood lipid abnormalities are common in elderly patients with coronary heart disease, and the status of blood lipid control is not optimistic. Reasonable secondary prophylactic medication, especially standard use of lipid-lowering statins, can lower blood lipid levels in elderly patients with coronary heart disease, which is conducive to obtaining standard blood lipids. 2023 Vol. 20 (3): 92-95 [Abstract] ( 587 ) [HTML 1KB] [PDF 1841KB] ( 2786 ) 96 ZHU Zhichun, WANG Ge, XIANG Junhua, HU Minjuan, HUANG Weiwei, TAN Ping Bibliometric and Visual Analysis of Platelet-Rich Plasma Treatment for Low Back Pain Objective To visually analyze the research on Platelet-Rich Plasma (PRP) therapy for low back pain in the past 10 years on WoS, analyze its research hotspots and evolutionary trends, provide guidance for exploring the frontier and development direction of this field. Methods The Web of Science Core Collection database was used as the source of literature, and the records of PRP-related literature on low back pain published between 2012 and 2022 were taken as the research object. The search strategy was TS= (platelet rich plasma* OR PRP) and TS= (low back pain* OR LBP) with a time span of 2012-2022. Visual analysis and discussion were conducted using CiteSpace software. Results From 2012 to 2022, 169 related papers were published. The most frequently cited paper was authored by Tuakli-Wosornu YA and published in PM&R in 2016. Research hotspots are concentrated on mesenchymal stem cells, nucleus pulposus cells, growth factors, etc. , while intradiscal injection and hyaluronic acid are currently hot topics within this field. Presently, research on PRP treatment for low back pain is primarily focused on degenerative disc disease and its structural repair, related regenerative medicine and pain rehabilitation. Conclusion The research on PRP treatment for low back pain is continuously increasing in popularity. Cooperation between researchers and institutions needs to be strengthened to produce high-quality research. Currently, researchers can focus on hotspots such as mesenchymal stem cells, nucleus pulposus cells, and growth factors, while intradiscal injection and hyaluronic acid may become future research hotspots. 2023 Vol. 20 (3): 96-101 [Abstract] ( 600 ) [HTML 1KB] [PDF 2765KB] ( 2324 ) 102 LI Limin, TANG Shifu, LI Yehua, LIU Xin, ZHENG Jinjian, ZHANG Lanzuo Effects of Yixuesheng capsule combined with iron supplement on iron metabolism indexes, red blood cell-related indexes and maternal-infant outcomes of iron-deficiency anemia during pregnancy Objective To explore the effects of Yixuesheng capsule combined with iron supplement in the treatment of iron deficiency anemia during pregnancy on iron metabolism indexes, red blood cell-related indexes and maternal-infant outcomes. Methods 300 patients with iron deficiency anemia during pregnancy from April 2020 to April 2022 were divided into three groups (iron supplement group, Yixuesheng capsule group and combined group) by the random number table method. The iron supplement group was given iron supplement treatment, and the Yixuesheng capsule was treated with Yixuesheng capsule, and the combined group was given iron supplement combined with Yixuesheng capsule. All patients and neonates were followed up until 3 months after the end of pregnancy. The therapeutic efficacy, neonatal growth and development as well as iron metabolism indexes and red blood cell indexes before and after treatment were compared among the three groups. Results The total effective rate of treatment in combined group was higher than that in iron supplement group and Yixuesheng capsule group. Serum ferritin, iron level and ferritin saturation after treatment in combined group were higher than those in iron supplement group and Yixuesheng capsule group, and the above indexes in iron supplement group were higher than those in Yixuesheng capsule group. The hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration after treatment were higher in combined group than those in iron supplement group and Yixuesheng capsule group. The birth weight at birth was heavier in combined group than that in iron supplement group and Yixuesheng capsule group. The incidence rate of adverse maternal-infant pregnancy outcomes in combined group was lower compared with that in iron supplement group and Yixuesheng capsule group (4.00% vs 14.00%, 12.00%). Conclusion Yixuesheng capsule combined with iron supplement has high effective rate in the treatment of iron deficiency anemia during pregnancy, and it can improve the iron metabolism and red blood cell function, relieve the degree of anemia, promote the fetal growth and development, and lower the adverse pregnancy outcomes. 2023 Vol. 20 (3): 102-106 [Abstract] ( 619 ) [HTML 1KB] [PDF 2337KB] ( 2847 ) 107 YUAN Yuan, WANG Qianyun, LIU Chunhui, YANG Hairong, WANG Xiangchuan The relationship between chronic renal insufficiency and pulmonary artery pressure and its related factors Objective To investigate the relationship between glomerular filtration rate and pulmonary artery pressure, and to analyze the risk factors for CKD progression. Methods The patients with CKD who visited the 921st Hospital of the Joint Logistics Support Force between January 2019 and December 2021 were retrospectively analyzed, and the variation characteristics of pulmonary artery pressure under different glomerular filtration rate (eGFR) were analyzed, and the effects of various factors on patients with chronic renal insufficiency were compared. Results As the CKD staging increased, the pulmonary artery pressure showed a gradual increase trend. Among the 119 patients with CKD, there were 18 cases with combined pulmonary hypertension, 0 cases including 1-2 stage, 4 cases in stage 3, 6 cases in stage 4, and 8 cases in stage 5. At the same time, with the decrease of eGFR (glomerular filtration rates), the patient's hemoglobin (Hb) and platelet (PLT) decreased, and the D2 polymer increased. Conclusion There is an inverse relationship between pulmonary artery pressure and eGFR, that is, when eGFR decreases, cardiovascular risk increases, and early CKD patients actively treat anemia, reducing pulmonary artery pressure can aueviate the progression of kidney disease. 2023 Vol. 20 (3): 107-109 [Abstract] ( 610 ) [HTML 1KB] [PDF 1968KB] ( 2774 ) 110 CHEN Yusi, CHENG Shuanghua, CHEN Shigao Expression of miR-552 in colorectal cancer tissues and its relationship with clinicopathological characteristics Objective To investigate the expression of miR-552 in colorectal cancer tissues and its relationship with clinicopathological characteristics. Methods 147 patients with colorectal cancer who were examined in our hospital from January 2020 to December 2022 were selected as the study subjects. The levels of miR-552 in tumor tissues and adjacent normal tissues were compared. According to the expression of miR-552, the subjects were divided into high expression group (miR-552 expression level was 1.28 or higher) and low expression group (miR-552 expression level was lower than 1.28). The risk factors affecting miR-552 expression were analyzed, and the correlation between miR-552 and pathological characteristics was discussed. Results The level of miR-552 in tumor tissue of patients with colorectal cancer (9.86±1.22) was higher than that in adjacent normal tissues. The proportions of TNM stage III and IV, tumor diameter ≥5 cm, serosal layer infiltration and lymph node metastasis in the high expression group were higher than those in the low expression group. Logistic regression analysis showed that TNM stage III and IV, tumor diameter ≥ 5cm, serosal layer infiltration and lymph node metastasis were independent influencing factors of high miR-552 expression. TNM stage, tumor diameter, invasion depth and lymph node metastasis were positively correlated with miR-552 expression. Conclusion The expression level of miR-552 in colorectal cancer tissue is higher than that in adjacent tissues, and TNM stage, tumor diameter, serosal layer infiltration, and lymph node metastasis are influencing factors for miR-552 expression level, which is significantly correlated with miR-552 expression level. . 2023 Vol. 20 (3): 110-113 [Abstract] ( 610 ) [HTML 1KB] [PDF 1905KB] ( 2842 ) 114 MA JingPing, LI Jiaxiang, QIU Fang, TAN Yongcai Early diagnosis and operational reserarch of tumor lysis syndrome after c-TACE operation for massive hepatocellular carcinoma Objective To investigate the clinical early diagnosis and operational reserarch of tumor lysis syndrome (TLS) after c-TACE operation on patients with primary massive hepatocellular carcinoma. Methods The clinical data of 11 patients with primary massive hepatocellular carcinoma c-TACE complicated by tumor lysis syndrome operation from August 2016 to May 2021 were collected for retrospective analysis. Results All the 11 patients developed TLS within 72h after operation, accompanied by hyperuricemia in 11 cases (100%), hyperkalemia in 9 cases (81.8%), hyperphosphatemia in 8 cases (72.7%), hypocalcaemia in 4 cases (36.3%), increased creatinine in 4 cases (36.3%), and elevated lactate dehydrogenase in 11 cases. The main clinical manifestations are nausea, vomiting, chest tightness, wheezing, reduced urine volume, edema, tetany, most patients after timely replenishing hydration, correcting electrolyte disorders, reducing uric acid, hemodialysis and other treatment, abnormal indicators are most restored to the normal range within 1 week; One case died without treatment; One case died of acute renal failure, abnormal coagulation function and intracranial hemorrhage. Conclusion Patients with massive hepatocellular carcinomar are prone to TLS in the early postoperative period of c-TACE, TLS is a highly fatal disease, and laboratory indicators such as blood electrolytes, uric acid, renal function and urine output should be closely monitored during treatment. If diagnosed in time and effective therapeutic measures are implemented, the incidence of TLS and mortality can be reduced. 2023 Vol. 20 (3): 114-118 [Abstract] ( 618 ) [HTML 1KB] [PDF 1894KB] ( 3001 ) 119 YUAN Pu, XU Han, NIE Wenchen, GU Weiguo, ZHU Zongjin, LIU Baohua, LIU Houqiang Risk factors of complications after interventional neurosurgery for Intracranial aneurysm Objective To study the risk factors of neurological complications after Neurointerventional interventional neurosurgery for Intracranial aneurysm. Methods Fourteen patients with unruptured cystic Intracranial aneurysms who had neurological complications after undergoing neurointerventional surgery in our hospital from January 2018 to March 2021 were included as the neurological complications group, and 121 patients with unruptured cystic Intracranial aneurysm who had received neurointerventional surgery at the same time but had no neurological complications were selected as the non neurological complications group. Collect general data from two groups of patients and use multivariate logistic regression analysis to evaluate the independent risk factors for neurological complications after neurological intervention surgery in patients. Results Previous history of transient ischemic attack or cerebral infarction (OR=3.505, 95%CI=1.852~6.633), cardiovascular complications (OR=3.294, 95%CI=1.527~7.106), maximum diameter of aneurysms (OR=3.572, 95%CI=1.870~6.823), wide-necked aneurysms (OR=2.883, 95%CI=1.510~5.504), and no aneurysms. Regular shape or presence of ASCUS (OR=2.194, 95%CI=1.140~4.222) were independent risk factor for neurological complications in patients with Intracraniall aneurysm after neurointervention (P<0.05). Conclusion There are many risk factors for neurological complications in patients with Intracranial aneurysms after neurointerventional, including previous transient ischemic attack or cerebral infarction history, cardiovascular complications, aneurysms with a maximum diameter of>10mm, wide-necked aneurysms, irregular shape of the aneurysm or the presence of sacs, which should be paid enough attention in clinical practice. 2023 Vol. 20 (3): 119-123 [Abstract] ( 588 ) [HTML 1KB] [PDF 1857KB] ( 2530 ) 124 LIU Hongyan, FANG Yuqi, WU Xianlin, XIANG Qiuhong Complications of the VAP and PICC in breast cancer patients: a Meta-analysis Objective To compare the risk of common complications between implantable venous port (VAP) and peripheral puncture central catheter (PICC) in breast cancer patients undergoing chemotherapy by meta-analysis. Methods CNKI, Wanfang database, CBM, VIP database, Cochrane Library, PubMed, and embase were searched for randomized controlled trials and cohort studies published before April 2022 about the comparison between VAP and PICC in breast cancer patients. RevMan5.3 software was used for meta-analysis. Results With 20 articles and total of 5715 patients included, Meta-analysis showed that compared with PICC, VAP could reduce the incidence of venous thrombosis [0.23, (95%CI: 0.14-0.39), P< 0.01] and phlebitis [0.16, (95%CI: 0.11-0.23) , P< 0.01], the incidence of catheter displacement or prolapse [0.12, (95%CI: 0.07-0.23), P< 0.01], the incidence of infection [0.23, (95%CI: 0.16-0.34), P< 0.01], the incidence of tube blocking [0.28, (95%CI: 0.17-0.47), P< 0.01], and the difference was statistically significant. There was no significant difference in the incidence of one-time successful catheterization [1.49, (95%CI: 0.86-2.59), P> 0.05]. Conclusion For breast cancer patients who require long-term chemotherapy, the incidence of common complications from VAP is lower than PICC. The incidence of intravenous port venous thrombosis, phlebitis, catheter displacement or prolapsion, infection and tube blocking is lower than that of PICC, but there is no statistical difference in the one-time successful catheterization between them. Compared with PICC, VAP is a safer and more comfortable venous pathway. 2023 Vol. 20 (3): 124-129 [Abstract] ( 669 ) [HTML 1KB] [PDF 2073KB] ( 2755 ) 130 LIU Geng, WANG Cong, LIU Xuejiao Logistic regression analysis of pulmonary infection after elderly hip fracture surgery and detection value of serum immune inflammatory factors Objective To study the risk factors of pulmonary infection after elderly hip fracture surgery and the predictive value of immune inflammatory factors on infection. Methods 283 patients with hip fracture surgery in the hospital from January 2020 to December 2021 were selected as samples to conduct a retrospective study. The medical records of patients were sorted out and the related data were collected in detail, and the patients were divided into infection group and control group according to whether pulmonary infection occurred within 28 days after surgery. The various indicators were compared between the two groups and the risk factors of pulmonary infection were analyzed, and then the predictive value of immune inflammatory factors on pulmonary infection and relationship with infection degree were discussed. Results Among 283 elderly patients with hip fractures, 46 cases (16.25%) developed pulmonary infection after surgery. Age, number of complications≥3, time from fracture to hospital admission, intensive care unit (ICU) admission and systemic immune inflammation index (SII) were independent risk factors of postoperative pulmonary infection in elderly patients with hip fractures (P<0.05). Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and SII all had certain reference value on predicting pulmonary infection (P<0.05). NLR, PLR and SII showed increasing trends with the increase of pulmonary infection degree, and the differences between both groups were statistically significant (P<0.05). The NLR, PLR and SII were significantly positively correlated with PCIS score in elderly patients with hip fractures and postoperative pulmonary infection (r=0.372, 0.633, 0.574, P<0.05). Conclusion The risk factors of postoperative pulmonary infection in elderly patients with hip fractures include age, number of complications≥3, time from fracture to hospital admission, ICU admission and SII. The detection of NLR, PLR and SII can provide reference for determining the risk and severity of pulmonary infection. 2023 Vol. 20 (3): 130-134 [Abstract] ( 630 ) [HTML 1KB] [PDF 1984KB] ( 2897 ) 135 LONG Yanfei, LI Jia, DENG Fanghui, YAO Jiahuan, WANG Mingming Study on the correlation between quality of life, psychological status and social support in patients with acute pancreatitis 0bjective The study was aimed to investigate the incidence and influencing factors of quality of life in patients with acute pancreatitis, and explore its relationship with psychological status and social support. Methods According to the inclusion criteria, acute pancreatitis patients who were treated in the Hepatobiliary Department of Hunan Provincial People’s Hospital from January 2022 to December 2022 were enrolled in the study. A general information questionnaire, Self-rating Anxiety Scale, Self-rating Depression Scale, Social Support Rating Scale and the MOS item short from health survey were used to conduct the survey. Results The score of SAS for patients with acute pancreatitis was (40.68 ± 9.51), the score of SDS was (45.84 ± 10.06), the score of social support was (43.92 ± 7.57), and the score of total quality of life was (337.83 ± 195.79). Anxiety and depression were negatively correlated with quality of life (r=-0.605, r=-0.608, P<0.01), and social support is positively correlated with quality of life (r=0.339, P<0.01). Classification of acute pancreatitis (β′=-0.247, 95% CI: -79.024~-21.1), the score of SAS (β′=-0.496, 95% CI: -13.255~-7.172), the score of objective support (β′=0.185, 95% CI: 3.065~22.148), and complications (β′=-2.371, 95% CI: -131.026~-11.730) were influencing factors of quality of life (P<0.05). Conclusion The quality of life of patients with acute pancreatitis has decreased. It was related to pancreatitis classification, anxiety, reduction of objective support and complications. Effective treatment to reduce severity and Complications, relieve anxiety and improve objective support are beneficial for improving the quality of life of patients. 2023 Vol. 20 (3): 135-139 [Abstract] ( 675 ) [HTML 1KB] [PDF 1894KB] ( 2782 ) 140 YANG Shaohua, TANG Zixi, TANG Xinjun, WU Qingling Analysis of clinical efficacy of Bushen Lishi Huayu decoction combined with levofloxacin on chronic prostatitis Objective To explore the clinical efficacy of Bushen Lishi Huayu decoction combined with levofloxacin in the treatment of chronic prostatitis. Methods 80 patients with chronic prostatitis from March 2020 to March 2022 were divided into two group by random number table method. The control group was given levofloxacin treatment, and the observation group was given Bushen Lishi Huayu decoction The clinical efficacy was compared between the two groups. The severity of prostatitis inflammation was evaluated by National Institutes of NIH-CPSI, and the urination function, semen routine indexes, inflammatory factors and immune function indexes were compared. Results The total effective rate of treatment in observation group was higher than that in control group （92.50%vs 75.00%）. The NIH-CPSI score, maximum urine flow rate, average urine flow rate and CD4+/CD8+ in observation group after treatment were higher than those in control group[（10.62±1.91) scores, (21.58±2.92) mL/s, (12.91±0.86) mL/s, (1.52±0.12) vs (14.35±1.74) scores, (19.06±2.30) mL/s, (12.47±0.81) mL/s, (1.39±0.15)], while the levels of interferon-γ (IFN-γ) and tumor necrosis faction-α (TNF-α) in serum and prostatic fluid after treatment were lower than those in control group [ (22.39±4.24) mg/L, (28.31±5.18) mg/L, (95.06±9.31) mg/L and (80.31±8.09) mg/L vs (25.16±3.95) mg/L, (32.59±5.02) mg/L, (110.34±9.85) mg/L and (91.62±8.24) mg/L]. The sperm liquefaction time in observation group after treatment was shorter than that in control group[（27.62±3.41) min vs (29.13±3.06) min]. There were no adverse reactions in both groups during treatment. Conclusion Bushen Lishi Huayu decoction combined with levofloxacin has high effective rate in the treatment of chronic prostatitis. It can relieve the prostatitis symptoms, reduce the levels of body's inflammatory factors, and improve the urination function and immune function. 2023 Vol. 20 (3): 140-142 [Abstract] ( 613 ) [HTML 1KB] [PDF 1816KB] ( 2814 ) 143 CHEN Yueying, WANG Nan, LI Fang, SHU Lingxia, LIU Jia Analysis of depression symptoms and its influencing factors in middle-aged and elderly diabetic patients Objective The aim of this study was to investigate the important factors influencing depressive symptoms among middle-aged and elderly diabetic patients in rural and urban areas of China. Method Seven hundred and thirteen middle-aged and elderly diabetic patients from the 2018 China Health and Aging National Tracking Survey (CHARLS) project were selected as the study population, and depressive symptoms in the study population were assessed using the Depression Self-Assessment Scale (CES-D). Significant variables influencing depressive symptoms were screened and ranked by the random forest algorithm. Based on this, multi-factor logistic regression analysis was used to explore the factors associated with depressive symptoms affecting middle-aged and elderly diabetic patients in rural and urban areas. Results The results of random forest algorithm showed that the top 10 important variables among the 18 indicators were income, age, sleep duration, life satisfaction, health satisfaction, nap duration, somatic pain, marital satisfaction, child satisfaction, and air satisfaction. The results of multifactorial logistic regression analysis showed that female, short sleep duration, poor life satisfaction, poor health satisfaction, poor child satisfaction, and somatic pain were associated with depressive symptoms in middle-aged and elderly diabetic patients. Conclusion 41.65% of rural and urban middle-aged and elderly diabetic patients had depressive symptoms, and the state and government should pay more attention to the mental health status of diabetic patients in rural and urban areas in the future. 2023 Vol. 20 (3): 143-148 [Abstract] ( 681 ) [HTML 1KB] [PDF 1917KB] ( 2888 ) 149 LUO ZuoHeng, TAO MeiYi, QIN YueLan Visualization analysis of hot spots and frontiers of diabetes case management in China Objective To analyze and track the hot spots and frontiers in the field of diabetes case management through literature analysis of diabetes case management studies published in domestic journals. Methods The relevant studies on diabetes case management published on CNKI, Wanfang and VIP databases from the establishment of the database to October 15, 2022 were retrieved. CiteSpace visualization tool was used to analyze the hot spots and frontiers of diabetes case management studies in terms of authors, institutions, high-frequency keywords and emergent words. Results 248 literatures on diabetes case management were included and published in 137 journals. Wu Liping, Yao Ping and Zhang Shuai had 4 papers each. The Affiliated People’s Hospital of Jiangsu University and the Affiliated Hospital of Nantong University had 3 papers each. According to the high-frequency keywords and cluster analysis, research hotspots and development frontiers in this field are as follows: the study population gradually changed from type 2 diabetes in the elderly to gestational diabetes and type 1 diabetes in children; The leading members of diabetes case management are mainly specialist nurses; The main research types were intervention studies of diabetes case management. The quality of patient care was the main effect evaluation index of diabetes case management intervention. Application of Internet information technology in continuous care service of diabetes case management. Conclusion It is suggested to strengthen cross-regional cooperation in the future, and at the same time, we can carry out diabetes case management work from the aspects of training diabetes case managers actively, including economic evaluation indicators, carrying out qualitative research, and building continuity nursing mode of diabetes case management suitable for Chinese national conditions. 2023 Vol. 20 (3): 149-154 [Abstract] ( 637 ) [HTML 1KB] [PDF 2654KB] ( 3399 ) Pharmacy 155 YANG Changhua, HU Wengsheng, LI Shuhua, DENG Chunlei Synthesis of novel (-) -huperzine A derivatives and the effects on nerve cell viability Objective To synthesize novel (-) -huperzine A derivatives and explore their neuroprotective effects. Methods A series of (-) -huperzine A derivatives were synthesized through the reaction of (-) -huperzine A with multiple substituent sulfonyl chloride. Their structural information was extensively characterized by using melt point, ESR-MS and HRMS. Aβ25-35 was used to induce the nerve cell SH-SY5Y injury and apoptosis, and the neuroprotective effects of (-) -huperzine A and its novel derivatives was also evaluated on SH-SY5Y cells in vitro by using an MTT-assay. Results Eight novel (-) -huperzine A sulfonyl substituted derivatives HA-1 ~ HA-8 were synthesized. The (-) -huperzine A, HA-4, Ha-6 and HA-7 can reverse the injury of Aβ25-35 on SH-SY5Y cells. The activities of derivatives HA-4 and HA-7 were better than (-) -huperzine A. Conclusion The (-) -huperzine A derivatives HA-4 and HA-7 show better neuroprotective effects than (-) -huperzine A. 2023 Vol. 20 (3): 155-157 [Abstract] ( 605 ) [HTML 1KB] [PDF 1883KB] ( 2830 ) Nursing Science 158 LI Cai, LI Jiayin, QIN Lulu Study on the Head Nurse Leadership and Its Influencing Factors in Hunan Province of China Objective To investigate and analyze the current situation of nurses' perceived servant leadership behaviors of nurse leaders and their influencing factors to provide reference for hospitals to improve nursing management. Methods Through cluster sampling, two hospitals were selected from the secondary hospital and tertiary hospital in Hunan Province, respectively. The general information questionnaire, the Servant Leadership Behavior Scale for Nurse Leaders were used to survey the nurses working in the four hospitals. Results The mean of total score of nurse-reported head nurse leadership was 82.97±16.02. The single factor analysis showed that there were statistically significant differences in the perception of servant leadership behaviors of nurse leaders among different hospital levels, personnel status, and overtime (P<0.05). Over-long working time, employment status and hospital level were the independent influencing factors of nurse-reported head nurse leadership. Conclusion The nurse-reported head nurse leadership is at a medium level. Strengthening the stability of nurses’ employment status and reducing overtime work are helpful to improving the nurse-reported head nurse leadership. 2023 Vol. 20 (3): 158-163 [Abstract] ( 624 ) [HTML 1KB] [PDF 1897KB] ( 2704 ) 164 TENG Zhiyu, TAO Meiyi, GUO Chenxi, LI Ling, HE Caiyun Correlation analysis on eHealth literacy and self-management behavior among CHD patients in Changsha Objective To investigate the status quo of e-health literacy and self-health management behavior in patients with coronary heart disease, and to explore the correlation between e-health literacy and self-health management behavior in patients with coronary heart disease. Methods From June 2022 to September 2022, 287 inpatients with CHD in the Department of Cardiology of a Grade-A hospital in Hunan Province were selected by convenient sampling method. General situation questionnaire, electronic health literacy Scale and self-management behavior scale were used to conduct questionnaire survey, and Pearson correlation analysis was used to explore the correlation between electronic health literacy and self-health management behavior in patients with coronary heart disease. Results The scores of e-health literacy and self-management behavior were (21.37±6.29) and (49.73±11.77) respectively. The score of e-health literacy was positively correlated with the total score of self-management ability and scores of all dimensions (P<0.05). The results of stepwise regression analysis showed that the two dimensions of e-health literacy, application ability and evaluation ability, had statistical significance on self-health management ability (P<0.05). Conclusion The self-health management behavior and e-health literacy of patients with coronary heart disease are low, and clinical medical staff should pay attention to the positive effect of e-health literacy of patients with coronary heart disease on their self-health management behavior, and formulate personalized intervention strategies in order to improve patients'e-health literacy, so as to improve the status quo of patients＇ self-health management. 2023 Vol. 20 (3): 164-168 [Abstract] ( 784 ) [HTML 1KB] [PDF 1863KB] ( 3097 ) 169 CHEN Le, LIU Jie, GAO Zhe, XIE Xing, FU Jingjing, LI Guifei Mediating Effect of Empathy between Professional Identity and Humanistic Literacy among Nursing Students Objective To explore the mediating effect of empathy between professional identity and humanistic literacy among nursing students, in order to provide a reference for nursing educators taking targeted measures to improve their humanistic literacy. Methods A total of 347 nursing students from 3 comprehensive tertiary hospitals in Hunan were recruited by convenience sampling. The questionnaires include a general information questionnaire, a Self-Rating Scale of Nurses’ Humanistic Literacy, Professional Identity Questionnaire for Nurse Students and the Jefferson Scale of Empathy for Nursing Students. Effective questionnaires were obtained from 288 individuals (Effective recovery rate: 83.1%). Results The scores of humanistic literacy, professional identity, and empathy of nursing students were (224.98±33.11), (62.83±12.04), and (98.91±17.43). Professional identity was positively correlated with humanistic literacy (r=0.594, P<0.01), and was positively correlated with empathy (r=0.555, P<0.01). Empathy was positively correlated with humanistic literacy (r=0.513, P<0.01). Professional identity can not only directly affect humanistic literacy of the nursing students, but also indirectly affect humanistic literacy of the nursing students through the mediating effect of empathy, with the mediating value accounted for 44.49% of the total effects effect. Conclusion Humanistic literacy among nursing students is at a medium and above level. Empathy is an mediating variable between professional identity and humanistic literacy in nursing students. Nursing educators should pay attention to the cultivation and development of professional identity and empathy of nursing students, so as to improve their humanistic quality and the overall humanistic nursing level of nursing. 2023 Vol. 20 (3): 169-173 [Abstract] ( 747 ) [HTML 1KB] [PDF 1909KB] ( 3412 ) 174 WANG Hengxu, CHEN Xi, LIU Lihua, SONG Caini, ZHENG Mingxiang CiteSpace-based analysis of international disease stigma hotspots Objective To explore the research hotspots of stigma at home and abroad, and analyze the future development trend of stigma, provide a reference for subsequent related research. Methods Web Of Science and CNKI database were searched for literature on stigma research from 2017 to 2021, and Excel and CiteSpace 5.8. R3 software were used to visualize the number of publications, national and regional cooperation, keyword co-occurrence, keyword clustering, and emergent word analysis. Results A total of 7013 English literature and 702 Chinese literature were included. Internationally, the United States was the most centrality country, China ranks fifth; And the country with the largest centrality is the Netherlands. The results of high-frequency keywords and keyword clustering showed that influencing factors, coping methods, quality of life, health, and psychological nursing was the main research hotspots at home and abroad. The frontier of international research in the field of stigma is self-stigma and model construction; the Internalized stigma of the patient’s family, social function, and research on the progress of stigma will become a new trend of stigma research in China. Conclusion By comparing the hot spots and trends of stigma research at home and abroad, domestic stigma research can strengthen international exchanges and cooperation in the future, and pay more attention to public stigma research and intervention research. 2023 Vol. 20 (3): 174-180 [Abstract] ( 654 ) [HTML 1KB] [PDF 2632KB] ( 3110 )

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