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Quick Search     Advanced Search   2023 Vol.  20 No.  4 Published: 2023-08-25 Basic Medicine Clinical Medicine Preventive Medicine Nursing Science Invited Review Invited Review 1 LIANG Gaoshuang, PENG Jinying, LI Zhuan Advances on the study of pathogenesis and treatment of alcohol-associated liver disease Alcohol associated liver disease (ALD) has become a major cause of cirrhosis and liver failure across the world and its influence continues to increase. ALD encompasses a spectrum of diseases including asymptomatic liver steatosis, alcohol-associated hepatitis, alcohol associated fibrosis, cirrhosis, and even liver cancer. The progression of ALD involves in multiple cell types and even different organs including liver and gut. More importantly, there are very limited options for treatment of ALD currently due to the lack of effective diagnosis methods and clinical symptoms which resultes in patients with ALD are rarely diagnosed in the earlier phase of the disease spectrum. Therefore, it is of great strategic significance to deeply study the pathogenesis of ALD and clinical application value to develop effective diagnosis and treatment strategies. In present review, we discussed recent advances on the pathogenesis, current treatment options, and clinical trials of ALD. 2023 Vol. 20 (4): 1-10 [Abstract] ( 457 ) [HTML 1KB] [PDF 3371KB] ( 2299 ) Basic Medicine 11 CHEN Leigang, YANG Xiaojing, FENG Dongmei, WU Yuanhui, WANG Shining, GUO Baozhu Effect and mechanism of hyperhomocysteinemia induced podocyte injury in Henoch Schonlein purpura nephritis CBS+/- mice Objective To study the effect and mechanism of homocysteinemia (HHcy) - induced podocyte injury in Henoch Schonlein purpura nephritis (HSPN) cystathionine -β- synthase (CBS) heterozygous mutation (CBS+/-) mice. Methods HSPN model was established in wild type CBS (CBS+/+) mice and CBS+/-mice, then given conventional diet or high methionine diet respectively. The levels of serum Hcy, renal pathological and ultrastructural changes, serum creatinine (Scr), blood urea nitrogen (BUN), 24-hour urinary protein, the expression of podocin, nephrin and podocalyxin were compared. Results The renal pathological changes were found in the CBS+/++HSPN group and the high methionine diet CBS+/++HSPN group, and the levels of Scr, BUN and 24h urinary protein were higher than those in the conventional diet CBS+/+ group, but there was no significant difference in the renal pathological changes, Scr, BUN and 24h urinary protein levels between the high methionine diet CBS+/++HSPN group and the conventional diet CBS+/++ HSPN group. Renal pathological and ultrastructural changes were observed in conventional diet CBS+/-+HSPN group, Scr, BUN and 24h urinary protein levels were higher than those of conventional diet CBS+/- group, the expression of podocin, nephrin and podocalyxin were lower than those of conventional diet CBS+/- group; compared with conventional diet CBS+/-+HSPN group, renal athological and ultrastructural changes aggravated, Hcy, Scr, BUN and 24h urinary protein levels increased, the expression of podocin, nephrin and podocalyxin decreased of high methionine diet CBS+/- group; compared with high methionine diet CBS+/- group, renal athological and ultrastructural changes improved, Hcy, Scr, BUN and 24h urinary protein levels decreased, the expression of podocin, nephrin and podocalyxin increased in folic acid+ high methionine diet CBS+/- group. Conclusion HHcy can promote renal pathological changes and podocyte injury in HSPN CBS+/- mice, and inhibit the expression of transmembrane proteins podocin, nephrin and podocalyxin is a possible molecular mechanism. 2023 Vol. 20 (4): 11-17 [Abstract] ( 394 ) [HTML 1KB] [PDF 3413KB] ( 1949 ) 18 LI Zhaobao, LI Zhaojing, WANG Jing Kaempferol promotes the migration and osteogenic differentiation of human periodontal ligament mesenchymal stem cells by activating p38 MAPK signaling pathway Objective To investigate the effect of kaempferol (KFR) in the migration and osteoblast differentiation of human periodontal ligament-derived mesenchymal stem cells (HPL-MSC) on the basis of p38 mitogen-activated protein kinase (MAPK) signaling pathway. Methods HPL-MSC cell line was cultured in vitro and divided into several groups: KFR group (0, 0.01, 0.1, 1, 10, 100 μmol/L KFR treatment) , p38 MAPK inhibitor SB203580 group (SB203580 group; 10 μmol/L SB203580 treatment) , 0.1 μmol/L KFR + SB203580 group (0.1 + SB203580 group; 0.1 μmol/L KFR and 10 μmol/L SB203580 co-treatment) , and drug treatment was for 24 h or 48 h. After treatment for 48 h, cells were incubated in the osteoblast inducible medium for 7 days. Cell migration and invasion ability was determined by scratch wound and Transwell assays, and osteoblast differentiation and p38 MAPK activation levels were evaluated by Western blotting. Cell viability was assessed by cell counting kit-8 (CCK8) . Results Compared with the 0 μmol/L KFR group, after 24 h treatment, cell viability of the 1 μmol/L KFR group was higher, while that of the 100 μmol/L KFR group was lower; after 48 h treatment, cell viability of the 0.01, 0.1 and 1 μmol/L KFR groups was higher, while that of the 100 μmol/L KFR group was lower. Therefore, the 0, 0.01, 0.1 and 1 μmol/L KFR groups were selected for cell function analysis. Compared with the 0 μmol/L KFR group, after 48 h treatment, cell migration rate and the relative expression levels of osteopontin (OPN) , bone salivary protein II (BSP-II) , bone morphogenetic protein 2 (BMP2) , bone alkaline phosphatase (ALP) , Runt-related transcription factor 2 (RUNX2) and osterix (OSX) in the 0.01, 0.1 and 1 μmol/L KFR group were higher, and invasive cells in the 0.1 and 1 μmol/L KFR groups were increased. In addition, relative expression level of phosphorylated p38 (p-p38) protein in the 0.01, 0.1 and 1 μmol/L KFR group was significantly higher than the 0 μmol/L KFR group, and that in the 0.1 μmol/L KFR group was higher than the 0.1 + SB203580 group, and that in the SB203580 group was lower than the 0.1 + SB203580 group. Compared with the 0.1 + SB203580 group, cell migration rate and the relative expression levels of OPN, BSP-II, BMP2, ALP, RUNX2 and OSX were higher in the 0.1 μmol/L KFR group, but lower in the SB203580 group, and invasive cells were higher in the 0.1 μmol/L KFR group, but lower in the SB203580 group. Conclusion KFR can promote the migration and osteogenic differentiation of HPL-MSC, which may be achieved by activating the p38 MAPK pathway. 2023 Vol. 20 (4): 18-25 [Abstract] ( 396 ) [HTML 1KB] [PDF 4363KB] ( 2034 ) Clinical Medicine 26 TANG Yi, ZHU Wenyu, TAN Siyuan, ZHANG Min, XU Xiaoping, WANG Jiarui, PENG Jianqiang Dapagliflozin Improve Left Ventricular Structure and Function in Mice with Acute Myocardial Infarction Objective To explore the cardioprotective role of dapagliflozin on acute myocardial infarction mice and its possible mechanism. Methods Eight-week-old male ICR mice were used to construct an acute myocardial infarction model by ligation of the left anterior descending coronary artery and were randomly divided into five groups: (1) Sham group, (2) Model group: acute myocardial infarction group, (3) DAPA group: dapagliflozin treatment group, (4) VAL group: valsartan treatment group; (5) DAPA+VAL group: dapagliflozin combined with valsartan treatment group. After successful modeling, mice were given dapagliflozin valsartan or normal saline by intragastric administration. After 28 days, left ventricular function and structural indexes were measured, myocardial infarct size was measured, myocardial interstitial collagen and collagen volume fraction in infarct area were evaluated, and the expression of nucleotide binding dome-like receptor protein 3(NLRP3) and its related factors were detected. Results Compared with the Model group, dapagliflozin and valsartan significantly improved left ventricular structure and function, reduced myocardial infarct area, improved myocardial cell morphology, reduced inflammatory cell infiltration, and inhibited myocardial fibrosis in mice with myocardial infarction. Meanwhile, dapagliflozin and valsartan significantly decreased the expression of NLRP3, interleukin-1β, interleukin-6 in myocardial tissue. However, compared with valsartan alone, dapagliflozin combined with valsartan failed to further improve left ventricular structure and function after acute myocardial infarction as well as the indices mentioned above. Conclusion Dapagliflozin can improve left ventricular structure and function. However, the combination of dapagliflozin and valsartan did not further improve left ventricular structure and function compared with valsartan alone. 2023 Vol. 20 (4): 26-31 [Abstract] ( 383 ) [HTML 1KB] [PDF 7332KB] ( 1886 ) 32 PENG Juan, YANG Suiyao Effect of ganciclovir combined with gamma globulin on immunoglobulin, T lymphocyte subsets and inflammatory factors in children with adenovirus pneumonia Objective To observe the effect of ganciclovir combined with gamma globulin on immunoglobulin, T lymphocyte subsets and inflammatory factors in children with adenovirus pneumonia. Methods 86 children with adenovirus pneumonia admitted to our hospital from January 2018 to May 2022 were selected as the research object, and were divided into two groups by random number table. The control group was treated with ganciclovir, and the observation group was treated with ganciclovir combined with gamma globulin for 2 consecutive weeks. The efficacy related indexes and adverse reaction rate of the two groups were compared, and the changes of cellular and humoral immune functions and inflammatory related factors were detected. Results The antipyretic time, cough stopping time, lung moist rale disappearance time nd hospitalization time in the observation group were shorter than those in the control group. Before treatment, there was no significant difference between the two groups in terms of cellular and humoral immune function indexes and inflammatory related factors. After 2 weeks of treatment, the levels of CD3+, CD4+, CD4+/CD8+, immunoglobulin A (IgA) and immunoglobulin G (IgG) in both groups were higher than those before treatment, and tumor necrosis factor α (TNF- α) 、 Interleukin-1(IL-1), interleukin-2(IL-2), Clara cell secretory protein (CCSP), CD8+, and immunoglobulin M (IgM) were lower than those before treatment. After 2 weeks of treatment, CD8+, IgM, and inflammatory related factors in the observation group were lower than those in the control group, while CD3+, CD4+, CD4+/CD8+, IgA, and IgG were higher than those in the control group. The cumulative adverse reactions in the observation group were 13.95% and 9.30% in the control group, with no statistical difference. Conclusion Ganciclovir combined with gamma globulin can improve the cellular and humoral immune function of children with adenovirus pneumonia, inhibit the expression of inflammation, reduce symptoms, and help children recover. 2023 Vol. 20 (4): 32-35 [Abstract] ( 360 ) [HTML 1KB] [PDF 2087KB] ( 1930 ) 36 PENG Qianbao, HE Weixin, LI Yuan, ZHONG Haiyan, LIU Rushi, XU Zili Efficacy analysis of Masquelet technique combined with En bloc excision in the treatment of Cierny-Mader type IV B osteomyelitis Objective To investigate the therapeutic effect of Masquelet technique combined with en bloc resection on Cierny-Mader IV B osteomyelitis. Methods A retrospective study was performed on 8 cases of lower extremity osteomyelitis admitted from June 2017 to June 2021, with 5 male and 3 female patients. The age of the patient was 21-67 years old, the average age was (43.8±23.4） old, and the defect site was 1 case of femoral shaft, 6 cases of tibial shaft, and 1 case of calcaneus; Cierny-Mader classification selects type IV. B. Masquelet technology is combined with en bloc for staged treatment. Observe the patient's infection healing, bone and wound covering soft tissue healing, limb functional activities and complications. Results Eight patients were followed up for 6-18 months after surgery, and no recurrence was found during the follow-up. When the patient last reviewed inflammatory indicators, the data remained normal, such as white blood cells, PCT, CRP, etc. The two groups of data were compared before and after surgery, and the results were statistically significant. Infection clearance 100% (8/8). All patients were able to heal the fracture and the soft tissue covered by the wound 5-8 months after the operation, the average duration was (6.1±1.2) months, and finally be able to walk independently. The joint function of the 8 patients recovered well after surgery, and all of them had no complications. Conclusion Masquelet technique combined with en bloc resection can clear infection, promote the healing of fractures and wound covered soft tissues and restore limb function, and is a simple and effective method for the treatment of bone defects in Cierny-Mader IV B osteomyelitis. 2023 Vol. 20 (4): 36-42 [Abstract] ( 390 ) [HTML 1KB] [PDF 2790KB] ( 1796 ) 43 TAN Ruokun, HOU Zhanghua, CHEN Lijuan, LI Ya Evaluation of regional cerebral oxygen saturation combined with amplitude integrated electroencephalogram in neonates with hypoxic-ischemic encephalopathy Objective To investigate the changes of regional oxygen saturation (rSO2) and amplitude integrated electroencephalogram (aEEG) in neonates with hypoxic-ischemic encephalopathy (HIE) and their prognostic value. Methods Using prospective research, Collect data on HIE patients admitted to the Department of Neonatology and NICU of Chenzhou First People's Hospital from July 2018 to July 2021. Analyze the rSO2 detection and dynamic monitoring of aEEG results at 4 nodes of the pediatric patients at 6h, 12h, 24h, and 72h after birth. Conduct multivariate logistic regression analysis on the rSO2 detected at 4 nodes at 6h, 12h, 24h, and 72h after birth and the aEEG 5 variables dynamically monitored, and area under the diagnostic curve and perform ROC curve analysis. Results A total of 63 neonates with HIEs were included in the experimental group, including 30 mild HIEs (47.6%), 23 moderate HIEs (36.5%), and 10 severe HIEs (15.9%). The rSO2 levels at various time points in the mild to moderate HIE group were lower than those in the normal control group at 6h, 12h after birth, and in the severe HIE group; The rSO2 levels in children with moderate to severe HIE were lower than those in children with mild HIE; The severe HIE group was lower than the moderate HIE group. The area under the curve for rSO2 levels at 6 hours after birth, rSO2 levels at 24 hours after birth, aEEG monitoring, and their combined diagnosis were 0.891, 0.843, 0.705, and 0.950, respectively. At the optimal critical point, the corresponding sensitivity (specificity) were 0.926(0.822), 0.926(0.989), 0.667(0.700), and 0.960(0.925), respectively; The Receiver operating characteristic shows that the area under the curve obtained by the combined application of the three methods is the largest, and the comprehensive evaluation of its diagnostic sensitivity and specificity is better than that of a single monitoring method. Conclusion Under different degrees of HIE, when rSO2 is too low and abnormal brain function occurs, the degree of brain injury may be more severe. The methods of rSO2 at 6 hours after birth, rSO2 at 24 hours after birth, and aEEG play an important role in evaluating the severity of HIE, and the combined evaluation of the three can improve the accuracy of diagnosis. 2023 Vol. 20 (4): 43-46 [Abstract] ( 397 ) [HTML 1KB] [PDF 3824KB] ( 1933 ) 47 LIU Shuchai, WANG Mei, ZHANG Nan The expression level and clinical significance of serum Th17 / Treg cytokines in patients with chronic periodontitis Objective To investigate the expression of T helper cell 17(Th17), T regulatory cells (Treg) and related cytokines in patients with chronic periodontitis (CP), and to analyze its clinical significance. Methods From January 2020 to June 2022, 90 CP patients and 45 periodontally healthy subjects were selected from the Department of Stomatology of our hospital. They were divided into control group (n= 45), mild group (n= 45) and moderate to severe group (n=45). The levels of Th17 and Treg in peripheral blood were detected by flow cytometry, and Th17/Treg was calculated. The levels of serum interleukin-6(IL-6), interleukin-17(IL-17), interleukin-10(IL-10), transforming growth factor-β (TGF-β), CC chemokine receptor 6(CCR6) and CC chemokine ligand 20(CCL20) were detected by enzyme-linked immunosorbent assay. The correlation between peripheral blood cells and related cytokines and periodontal clinical indicators were analyzed by Pearson correlation coefficient. Results The peripheral blood Th17 and Th17/Treg in the mild group and the moderate-severe group were higher than those in the control group, and Treg was lower than that in the control group. Th17 and Th17 / Treg in peripheral blood of moderate to severe group were higher than those in mild group, and Treg was lower than that in mild group. There were significant differences in serum cytokine levels among the three groups. The levels of IL-6, IL-17, CCR6 and CCL20 were the highest in the moderate and severe group, followed by the mild group, and the lowest in the control group. The levels of IL-10 and TGF-β were the highest in the mild group, followed by the control group, and the lowest in the moderate and severe group. Pearson correlation analysis showed that Th17, Th17/Treg, IL-6, IL-17, CCR6 and CCL20 were positively correlated with probing depth (PD) and attachment loss (AL). Treg was negatively correlated with PD and AL, while IL-10 and TGF-β were not correlated with PD and AL. Conclusion The imbalance of Th17/Treg cells in peripheral blood of CP patients is accompanied by abnormal expression of related cytokines. The changes of serum IL-6, IL-17, CCR6 and CCL20 concentrations are closely related to the severity of CP, which may promote the development of CP. 2023 Vol. 20 (4): 47-50 [Abstract] ( 336 ) [HTML 1KB] [PDF 3319KB] ( 2040 ) 51 WANG Mi, YANG Li, GUO Dan, LI Qiyong Efficacy of licorzinc combined with microecological preparation on viral diarrhea in infants and influence on serum levels of TNF-α, IL-6 and GAS Objective To study the efficacy of licorzinc combined with microecological preparation in the treatment of viral diarrhea in infants and its influence on serum tumor necrosis factor-α (TNF-α), interleukin-6(IL-6) and gastrin (GAS) levels. Methods 119 children with viral diarrhea who were diagnosed and treated in the hospital from June 2021 to August 2022 were selected and divided into control group (n=59, treated with microecological preparation) and study group (n=60, treated with licorzinc on the basis of control group) according to the random number table method. The efficacy, clinical recovery status, serum zinc element level, inflammatory factors and gastrointestinal hormones were compared between the two groups. Results The total effective rate of treatment in study group was 91.67% (55/60), which was higher than 77.97% (46/59) in control group. After treatment, the abdominal pain disappearance time, vomiting stop time, fever abatement time, stool recovery time, feeding time, virus negative conversion time and hospital stay in study group were shorter than those in control group. After 7 days of treatment, the levels of serum TNF-α and IL-6 in both groups were lower than those before treatment, and the above levels were lower in study group than those in control group, and the blood zinc level in study group was higher than that before treatment and higher than that in control group. The levels of serum GAS and plasma motilin (MOT) in both groups after 7 days of treatment were lower than those before treatment, and the levels in study group were lower compared with those in control group. The plasma somatostatin (SS) level in the two groups was higher than that before treatment, but there was no significant difference between the groups. Conclusion Licorzinc combined with microecological preparation in the treatment of viral diarrhea in infants can enhance the efficacy, relieve the symptoms and signs of fever, vomiting and diarrhea and increase the level of serum zinc element, and it has a good regulatory effect on serum inflammatory factors and gastrointestinal hormones. 2023 Vol. 20 (4): 51-54 [Abstract] ( 340 ) [HTML 1KB] [PDF 1900KB] ( 2070 ) 55 WANG Xin, WANG Lu, WANG Kai, FU Jie Application of advanced butorphanol combined with ultrasound guided multi-point block in knee replacement Objective To explore the application of advanced butorphanol combined with ultrasound guided multi-point block in knee replacement. Methods 108 patients who underwent knee replacement in our hospital from January 2020 to July 2022 were selected and divided into two groups (54 cases in the study group and 54 cases in the control group). Both groups were anesthetized by multi-point nerve block under the guidance of ultrasound, and the study group intravenous injection 20μg/kg butorphanol at 10 minutes before nerve block, but the equal amount of normal saline was implemented in the control group. The heart rate (HR) and mean arterial pressure (MAP) were compared before butorphanol injection (T0), 10min after butorphanol injection (T1), 15min after multi-point block (T2), 30min after multi-point block (T3) and at the end of operation (T4), and the onset and duration of pain nerve block and use of other anesthetics during operation were compared, and the scores of visual analogue scale (VAS) and Bruggrmann comfort scal (BCS) at different time points after surgery were compared, and the adverse events during and after operation were also compared. Results The HR and MAP at T1, T2 and T3 in the study group were lower than T0, which at T2 were lower than T1, and there was no statistically significant difference in pairs at other time points. The HR and MAP at T2 and T3 in the control group were lower than those at T0 and T1, but there was no statistically significant difference in pairs at other time points. There was no significant difference in HR and MAP between the two groups at each time point. Compared with the control group, the onset time of pain nerve block in the study group was short, and the duration of pain nerve block was long, while the use rate of fentanyl during operation was low. Compared with the control group, the resting VAS scores at 2h and 4h after operation in the study group were lower, while the BCS scores were higher. The rate of restlessness in the study group was lower compared with control group. Conclusion In the knee joint replacement operation, the use of butorphanol in advance combined with multi-point block under ultrasound guidance has stable blood flow during the operation and good analgesic effect, and it can reduce the short-term pain of patients after the operation, improve their comfort, and reduce restlessness during the awakening period. 2023 Vol. 20 (4): 55-59 [Abstract] ( 378 ) [HTML 1KB] [PDF 1912KB] ( 1693 ) 60 WANG Yuanyi, ZHANG Biming, HOU Zhengli, YANG Qian, QUE Zhengshu Infection situation and S gene mutation of occult hepatitis B virus infection among natural population in Changsha from 2018 to 2021 Objective To research the prevalence of the occult hepatitis B virus infection (OBI) among the natural population in Changsha from 2018 to 2021 and to explore the genotype distribution of virus strain and the mutation of amino acid sequence in S region , so as to provide an epidemiological and molecular biological basis for exploring the prevention and control of OBI in this region. Methods A total of 68, 513 serum samples from september 2018 to december 2021 were collected, Among them, OBI samples were screened, yield and their epidemiological characteristics were analyzed. Confirmed OBI samples will be tested for serology and high-susceptibility viral load testing, and were genetically amplified in the S region by nested PCR amplification and sequenced, HBV gentyping and amino acid mutation analysis in the S-region were performed using MEGA6.0 software. Results 27 OBI samples were confirmed , the detection rate of OBI was 0.039%; 5 OBI serological patterns were found, anti-HBc positive rate was 88.90% in all samples; HBV DNA nucleic acid quantitative ranged from 9.0 to 191.0(IU/mL) (median value of 19.0); 8 samples of those OBI donors were amplified for S region, all those are B genotype, which was shown amino acid mutation in MHR region of S gene, especially in HBV“a”epitope. Conclusion The OBI rate of natural population in Changsha is at low level in china (0.0106％-2.71％) from 2018 to 2021; The genotype of HBV is mainly type B, The mutation in MHR region of S gene, especially in HBV “a”epitope may be one of the important factors to cause OBI. 2023 Vol. 20 (4): 60-64 [Abstract] ( 386 ) [HTML 1KB] [PDF 1898KB] ( 1964 ) 65 YANG Jialu, YOU Qian, PENG Qian, WU Yi A meta-analysis of Krebs von den Lungen-6 to determine the severity of COVID-19 Objective Krebs von den Lungen-6(KL-6) is a glycoprotein mainly secreted by type II alveolar epithelial cells. Blood levels of KL-6 appear to be correlated with the severity of COVID-19 patients. Therefore, we conducted a meta-analysis in this paper to assess the role of serum KL-6 levels in determining the severity of COVID-19 patients. Methods The relevant literatures from December 2019 to December 2022 were searched in PUBMED, the Cochrane Library, CNKI and Wanfang Medical database. A total of 9 studies were included and pooled in the meta-analysis. Use RevMan 5.4 and Stata 17.0 for summary, integration and analysis. Results Serum KL-6 in severe patients was significantly higher than that in mild patients in 9 studies (SMD=1.14, 95%CI: 0.79-1.49). The composite diagnostic parameters calculated in the four studies were sensitivity 0.63(95% CI: 0.51 - 0.75), specificity 0.88(95% CI: 0.84 - 0.91), positive likelihood ratio 5.23(95% CI: 3.99- 6.85), negative likelihood ratio 0.42(95% CI: 0.30 - 0.57), and area under the receiver operating characteristic curve 0.87. Conclusion KL-6 levels were significantly elevated in patients with a more advanced course of COVID-19, suggesting that KL-6 may be an effective test for identifying risk in patients with severe COVID-19. 2023 Vol. 20 (4): 65-70 [Abstract] ( 390 ) [HTML 1KB] [PDF 3010KB] ( 1729 ) 71 ZHANG Xia, WANG Miaowei, WANG Renjie, LI Guo, WANG Ao, YIN Yuhan, WEI Quan Clinical application of human body composition analyzer combined with air circulation pressure in preventing and treating breast cancer related lymphedema Objective To explore the clinical application value of human body composition analyzer combined with air circulation pressure on preventing and treating breast cancer related lymphedema (BCRL). Methods 82 patients who underwent modified radical mastectomy + axillary lymph node dissection from May 2021 to April 2022 were selected as the study subjects and were divided into two groups by the random number table method. The routine group was given routine treatment and nursing after surgery, and the combined group was given human body composition analyzer combined with air circulation pressure treatment on the basis of the routine group. The upper limb-related indicators, postoperative lymphedema degree, human body composition indicators and shoulder range of motion were compared between the two groups before and after treatment. Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI) was used to evaluate the symptom severity of patients. Results After treatment, the upper arm volume difference was smaller in combined group than that in routine group. The edema degree in combined group was milder than that in routine group. The 50Hz resistance in combined group after treatment was higher than that in routine group, and the segment water and extracellular water were less than those in routine group, and the tissue water ratio was lower. The shoulder range of motion in combined group was larger than that in routine group after treatment. The BCLE-SEI scores after treatment in combined group were lower compared with those in routine group. No serious complications occurred in both groups after surgery. Conclusion The application of human body composition analyzer combined with air circulation pressure in postoperative treatment of breast cancer can alleviate the severity of BCRL and related symptoms, and enhance the shoulder range of motion. 2023 Vol. 20 (4): 71-74 [Abstract] ( 351 ) [HTML 1KB] [PDF 3071KB] ( 2026 ) 75 MAO Yangming, YI Dayong, YU Feiyue, ZHOU Dijun, YUAN Mingxia, JIANG Changwei Application value of dual-energy CT imaging in the clinical diagnosis of gout Objective To study the clinical application value of dual-energy CT (DECT) imaging in the diagnosis of gout. Methods 216 cases of clinically suspected gout patients admitted to our hospital from June 2020 to September 2022 were collected, and DECT was performed on the patients, who were divided into the observation group (with gout stones, n=108) and the control group (without gout stones, n=108) according to whether gout stones were present in the DECT results or not. The value of DECT in the detection of gout stones and the relationship between the detection rate of urate crystals and the blood uric acid level were analysed; the value of DECT in the diagnosis of gout and the evaluation of therapeutic efficacy was assessed by analysing the number of urate crystals detected by DECT before and after treatment and the blood uric acid level. Results In 216 patients with a clinical presumptive diagnosis of gout, 104 cases were finally clinically diagnosed with gout, and all were reviewed after treatment. In the observation group, 93 out of 108 cases were reviewed, and there was a significant positive correlation between the patients' blood uric acid level and the detection of urate crystals; the sensitivity of DECT for the diagnosis of gout was 89.42%, the specificity was 86.61%, and the accuracy of assessing efficacy was 100%. Conclusion DECT has very high sensitivity and specificity in the examination of tophi, so has basis of reference for clinical diagnosis of gout and evaluation of curative effect. 2023 Vol. 20 (4): 75-78 [Abstract] ( 351 ) [HTML 1KB] [PDF 4158KB] ( 1939 ) 79 ZHANG Bao, JIANG Bo Clinical Application of Left Hepatectomy with Hepatolithiasis Guided by Liver Fibrosis Border Objective To investigate the clinical effects of left hepatectomy with hepatolithiasis guided by liver fibrosis border and anatomical left hepatectomy with hepatolithiasis guided by the ischemic line. Methods Forty-five patients with hepatobiliary lithiasis in Hunan Provincial People's Hospital from June 2018 to September 2020 were retrospectively analyzed.23 cases in the experimental group and 22 cases in the conventional group. The patients in both groups were compared with thetotal bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and albumin (ALB) on the last 1 day before operation, on the 1st day and the 5th day after operation. operation time, intraoperative bleeding, Middle hepatic vein exposure, postoperative ambulation, postoperative intestinal function recovery time, postoperative eating time, postoperative hospital days and postoperative pain and other indicators on the last 1 day before operation, on the 1st day and the 5th day after operation. Results The two groups of patients were successfully completed surgery, postoperative recovery were good. T-tube Cholangiography confirmed the absence of residual stones after 2 months later. Comparing with thetotal bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and albumin (ALB) on the last 1 day before operation, on the 1st day and the 5th day after operation, there is no significant difference between the two group. In the operation time, intraoperative bleeding, the data suggest that there is statistical differences between the two groups. There is no significant difference with the Middle hepatic vein exposure between the two groups. The postoperative ambulation, postoperative intestinal function recovery time, postoperative eating time, postoperative hospital stay, Postoperative pain and other aspects of the two groups showed no significant difference. Conclusion The left hepatectomy with hepatolithiasis guided by liver fibrosis border based on the hepatic blood flow control technique of anatomical hepatectomy, relative to the characteristics of hepatolithiasis lesions, has a better clinical value in the left hepatectomy with significant hepatic atrophy and fibrosis in hepatolithiasis . 2023 Vol. 20 (4): 79-82 [Abstract] ( 368 ) [HTML 1KB] [PDF 1848KB] ( 1747 ) 83 LI Yunyan, ZHAO Guosheng, LIU Fengxia, QU Lin Analysis and treatment of blood diseases caused-weakenABOantigen Objective To explore the main causes of ABO blood group antigen reduction in patients with diseases and the method of blood group serological identification. Methods ABO blood group serological identification was performed on clinical specimens to be tested by automatic blood group analyzer. Blood samples of patients with positive and negative ABO type agglutination intensity < 3+ and negative ABO type agglutination intensity <2+ were identified by classical test tube method, such as ABO positive and negative stereotyping, saliva test, absorption and release test, affinity test and other blood group serological tests. the samples were genotyped by PCR-SSP genotyping assay kit; and exons 1-7 of the ABO gene were sequenced to confirm the mutation sites. Results Among 67 patients with ABO blood group antigen weakened due to disease, there were 30 patients with leukemia (44.7%), 26 patients with hematological diseases (38.9%), 9 patients with myelodyspllastic syndrome(MDS) (13.4%), 1 patient with non-Hodgkin lymphoma (1.5%), and 1 patient with chronic osteomyelitis (1.5%).43 cases (64.2%) with A antigen weakened, 23 cases (34.3%) with B antigen weakened, and 1 case (1.5%) with AB antigen weakened. There were 2 cases (2.98%) with enhanced H antigen, and the other intensities were unchanged. PCR-SSP genotyping and sequencing of exons 1-7 of theABOgene identified some new mutation sites, including 607G>A, 734C>T in exon 7, 259G>T, 261delG in exon 6, 239G>A in exon 5, and 18insTTGCA in exon 1. Conclusion Leukemia is the main cause ofABOblood group antigen weakening. By comprehensive analysis of clinical data and using blood group serology,ABO blood group can be distinguished from ABO subtype and correctly identified to ensure the safety of clinical transfusion. 2023 Vol. 20 (4): 83-86 [Abstract] ( 426 ) [HTML 1KB] [PDF 1833KB] ( 2099 ) 87 LI Jing, LIU Ying, CHEN Jie, DENG Zhonghua, YUE Yanghua, CAO Youde The diagnostic value of serum KL-6 levels in COVID-19 Objective To investigate the diagnostic value of serum Krebs von den Lungen-6(KL-6) in patients with COVID-19. Methods A total of 51 COVID-19 patients who were admitted to Hunan Provincial People's Hospital from January to February 2023 were enrolled and classified into severe group (n=27) and non-severe group (n=24) according to the clinical classification criteria of the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 10). In addition, 25 healthy individuals were included as the control group. Laboratory indicators were compared among the groups, and Pearson correlation analysis was used to evaluate the relationship between variables. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performance of KL-6 for COVID-19. Results In severe cases of COVID-19, procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6(IL-6) were significantly higher than in non-severe cases, while white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), and KL-6 were significantly higher in both non-severe and severe cases compared to the control group. In severe cases, WBC, NLR, and KL-6 were significantly higher than in non-severe cases. There was a significant positive correlation between WBC, NLR, and KL-6. The severity of COVID-19 was positively correlated with serum KL-6 levels. The cutoff value of serum KL-6 for diagnosing severe COVID-19 was 362.65 U/mL, with a sensitivity of 70.4%, specificity of 95.8%, and a Youden index of 0.662. Conclusion Serum KL-6 concentration can be used for the diagnosis, differentiation, and severity assessment of COVID-19. 2023 Vol. 20 (4): 87-90 [Abstract] ( 366 ) [HTML 1KB] [PDF 2330KB] ( 1842 ) 91 FENG Ying, JING Jiaona, WANG Jianshe, CHEN Lina Establishment of nomogram model of delirium after strabismus correction in preschool children Objective To establish the nomogram model of delirium in preschool children after strabismus correction under general anesthesia in order to identify risk factors early and take targeted measures. Methods 317 preschool children who were treated with strabismus correction under general anesthesia from January 2021 to October 2021 were selected as the study objects. Delirium and pain were evaluated during the awakening period of the children. Logistic regression was used to analyze the influencing factors of delirium in the awakening period, and R software was used to construct a nomogram model to predict the risk of delirium after strabismus correction under general anesthesia in preschool children. Results Among 317 children, 67(21.1%) had delirium in the awakening period, and were divided into delirium group (n=67) and non delirium group (n=250) according to whether they had postoperative delirium. The univariate results showed that children in the delirium group had higher proportion of aged≤3 years old, the American Association of Anesthesiologists (ASA) grade II, severe pain and longer operation duration than that in the non-delirium group; Logistic regression analysis showed that the age (OR=4.588, 95%CI: 2.401~8.768), ASA grade (OR=4.102, 95%CI: 2.125~7.922) and pain degree (OR=3.589, 95%CI: 2.358~5.463) of preschool children were the risk factors for delirium after strabismus correction. The nomogram was verified, and the calibration curve fit well, and the AUC (95%CI) was 0.841(0.789~0.894), the sensitivity and specificity were 80.80% (95% CI: 75.4%~85.5%) and 71.64% (95% CI: 59.3%~82.0%), respectively . Conclusion There is a certain risk of delirium in preschool children after strabismus correction. Low age group, higher ASA grade and moderate to severe pain are the risk factors for children to develop delirium in the awakening period. The nomogram model constructed on this basis has a good predictive value for the occurrence of delirium in children during awakening, which suggests that medical personnel need to provide personalized management in the perioperative period of children. 2023 Vol. 20 (4): 91-95 [Abstract] ( 409 ) [HTML 1KB] [PDF 2006KB] ( 2042 ) 96 CAO Xiangcuan, XIE Dan, BAI Qianrong Evaluation of the predictive value of serum HIF-1α and CXCL6 levels in the second trimester of pregnancy for preeclampsia and pregnancy outcome Objective To evaluate the predictive value of serum hypoxia inducible factor-1α (HIF-1α) and chemokine C-C motif ligand 6(CXCL6) levels in the second trimester of pregnancy for preeclampsia (PE) and pregnancy outcome. Methods A total of 140 PE patients (PE group) who delivered in northwest women's and children's hospital from January 2020 to January 2022 and had regular antenatal examination were included. They were further divided into mild group (66 cases) and severe group (74 cases) according to the severity of the disease.140 patients with simple hypertensive disorder complicating pregnancy (hypertensive disorder complicating pregnancy) were included. The control group consisted of 100 normal cases in the same period. The levels of serum HIF-1α and CXCL6 were detected by ELISA; the predictive value of serum HIF-1α, CXCL6 levels and their combination for PE and pregnancy outcome was evaluated by receiver operating characteristic (ROC) curve. Analysis of serum HIF-1α by Pearson method, CXCL6 level and correlation analysis with laboratory indicators; Logistic regression was used to analyze the influencing factors of PE pregnancy outcome. Results The levels of serum HIF-1α and CXCL6 in PE group were obviously higher than those in control group. Compared with the mild group, the diastolic blood pressure, systolic blood pressure, levels of TC, TG, LDL-C, IL-1β, IL-6, TNF-α, HIF-1α, CXCL6 in the severe group were obviously higher, while the level of HDL-C was obviously lower. ROC results showed that HIF-1α in serum, The level of CXCL6 and the AUC of the combined diagnosis of PE were 0.730, 0.751 and 0.858, respectively. The combined prediction of AUC was significantly higher than the two independent prediction of AUC (Z=3.367, 2.940, P<0.05). Compared with the good pregnancy outcome group, the diastolic blood pressure, systolic blood pressure, levels of TC, TG, LDL-C, IL-1β, IL-6, TNF-α, HIF-1α, CXCL6 with poor pregnancy outcome were obviously higher, while the level of HDL-C was obviously lower. HIF-1α in PE serum And the level of CXCL6 and IL-1βrespectively, IL-6, TNF-α There was a positive correlation (r=0.611, 0.639, 0.612, 0.569, P<0.05). The level of CXCL6 is different from IL-1β, IL-6, TNF-α There was a positive correlation (r=0.605, 0.584, 0.593, P<0.05). Multi-factor logistic analysis results show that IL-1β, TNF-α, HIF-1α, CXCL6 was an independent risk factor for poor pregnancy outcome in PE. ROC results showed that the AUC of serum HIF-1α, CXCL6 levels and their combination to predict the adverse pregnancy outcome of PE disease was 0.754, 0.775 and 0.854, respectively, the AUC of combined prediction was obviously higher than that of the two alone (Z=6.295, 6.912, P<0.05). Conclusion The levels of serum HIF-1α and CXCL6 in pregnant women with PE are increased, and are closely related to the severity of PE. They are expected to be predictive factors of PE and adverse pregnancy outcomes of pregnant women. 2023 Vol. 20 (4): 96-101 [Abstract] ( 377 ) [HTML 1KB] [PDF 2494KB] ( 2039 ) 102 TANG Leting, DONG Liping, ZHAO Mingyi Bibliometric Analysis of Trace Elements and Immunity Based on CiteSpace and VOSviewer Objective This study aims to employ bibliometric methods for a visual analysis of the intersection between trace elements and immunity. It investigates the research hotspots and development trends in this field and offers a reference for clinical practice and future research. Methods We retrieved publications on micronutrient immunology from the Web of Science Core Collection for the period between January 2000 and December 2022. The bibliometric and visualization analysis was conducted using CiteSpace and VOSviewer. Results Through screening, we identified a total of 1392 relevant publications, with a consistent increase in the publication count over the years, particularly post-2019. China and the Chinese Academy of Sciences emerged as the most productive country and institution, respectively, in this research area. However, their influence was comparatively lower than that of Europe and the United States. Collaboration between authors and institutions from different regions was found to be weak. The journal Biological Trace Element Research exhibited significant activity in this field. Our analysis resulted in the classification of research areas into 9 clusters, including nutritional support, COVID-19, vitamins, selenium, inflammatory bowel disease, liver disease, the elderly, systemic inflammation, and pathogenesis. The research frontiers encompass gut microbiota, inhibition, and human health. Conclusion The results of our bibliometric analysis suggest promising prospects for the development of micronutrient immunology. Current research endeavors focus on the impact of gut microbiota on immune response, the role of trace elements in the immunotherapy of COVID-19, systemic inflammation, and cancer, as well as the influence of dietary nutrition on human health. 2023 Vol. 20 (4): 102-108 [Abstract] ( 373 ) [HTML 1KB] [PDF 5323KB] ( 2232 ) 109 WEN Qianqian, XING Yadan, CAO Muyuan, DU Caifeng, WANG Li, ZHAO Yong Meta-analysis of the clinical effect of traditional Chinese medicine technique intervention in female perimenopausal insomnia Objective To systematically describe and analyze the effectiveness of traditional Chinese medicine technique in the intervention of perimenopausal insomnia, and to provide some reference for clinical practice. Methods The databases of PubMed, Web of science, Cochrane Library, China Biomedical Database, CNKI, Wanfang and VIP were searched by computer from January 2003 to December 31, 2022. Randomized controlled trials on the intervention of TCM techniques in perimenopausal insomnia were included, and statistical analysis was performed using RevMan5.3 software. Results A total of 21 articles were included, involving 1809 patients. The results of meta-analysis showed that the clinical efficacy of Chinese medicine intervention in perimenopausal insomnia in the experimental group and the control group was significantly improved (OR=4.01, 95%CI: 2.89-5.57, P<0.05), and Pittsburgh sleep quality (MD=-2.52, 95%CI: There were significant effects in -3.29~ -1.75, P<0.05], anxiety (SMD=-0.69, 95%CI: -0.90~-0.48, P<0.05), depression (MD=-6.56, 95%CI: -8.10~-5.02, P<0.05). There were no significant differences in E2(MD=2.21, 95%CI: -1.62~6.03, P>0.05) and FSH (MD=0.20, 95%CI=-0.43~0.03, P>0.05). Conclusion Chinese medicine technology can improve the sleep quality of perimenopausal insomnia patients, and also has a certain effect on the anxiety and depression of perimenopausal insomnia women, and Chinese medicine technology is safe, worthy of clinical promotion. 2023 Vol. 20 (4): 109-115 [Abstract] ( 393 ) [HTML 1KB] [PDF 4262KB] ( 1829 ) 116 XU Yanfeng, ZHANG Lihua, GE Meng, ZUO Yan Influence of core stability rehabilitation exercise on musculoskeletal ultrasound determination of patients with low back pain Objective To study and confirm the influence of core stability rehabilitation exercise on the muscle thickness and cross-sectional area of multifidus muscle in patients with low back pain. Methods A total of 102 patients with chronic nonspecific low back pain who were treated in our hospital from November 2021 to December 2022 were selected and divided into 2 groups according to random number table method, with 51 cases in each group. Patients in the control group received routine rehabilitation training, mainly in the prone position, lateral position and supine position suspended state training. The test group underwent core stability training, including warm-up, stretching and core training. Before and after treatment, musculoskeletal ultrasonography was performed to compare the multifidus muscle thickness and cross-sectional area of the two groups before and after treatment, and to evaluate the therapeutic effect and lumbar motion of the two groups. Results The multifidus muscle thickness and cross-sectional area were measured continuously before treatment, and the reliability of measurement was 0.89-0.96, indicating good reliability. After treatment, the thickness of bilateral L4/L5 multifidus muscle increased in both groups, and the thickness of bilateral L4/L5 multifidus muscle in experimental group was greater than that in control group, and the cross-sectional area of bilateral L4/L5 multifidus muscle increased in both groups after treatment. The cross-sectional area of L4/L5 multifidus muscle in experimental group was larger than that in control group. After treatment, the motion of flexion, extension and lateral flexion in both groups was increased, and the motion of flexion, extension and lateral flexion in the observation group was higher than that in the control group. After treatment, the total effective rate of the experimental group was 84.32%, and that of the control group was 62.75%. The total effective rate of the experimental group was higher than that of the control group. Conclusions Core stability rehabilitation exercises can improve the muscle thickness and cross-sectional area of multifidus muscle in patients with chronic nonspecific low back pain, and musculoskeletal ultrasound can effectively evaluate the changes in the muscle thickness and cross-sectional area of multifidus muscle in patients with chronic nonspecific low back pain. 2023 Vol. 20 (4): 116-119 [Abstract] ( 405 ) [HTML 1KB] [PDF 2136KB] ( 2019 ) 120 LIU Siyan, WANG Xiangchuan Retrospective analysis of the influential factors of hypersensitive troponin I in 256 non-dialysis patients with chronic kidney disease Objective To explore the related influencing factors of hs-cTnI level in non-dialysis patients with chronic kidney disease, and to provide help for early screening and identifiCation of Cardiovascular event risk groups in patients with chronic kidney disease. Methods A single-center retrospective analysis was performed on 256 non-dialysis patients diagnosed with CKD who were hospitalized in a certain hospital of the People's Liberation Army from January 2018 to January 2019. Patients were divided into normal hs-cTnI group (n=183) and elevated hs-cTnI group (n=73) with hs-cTnI concentration of 0.034 ng/mL. General data and laboratory indicators (serum creatinine, myocardial enzyme, blood urea nitrogen, homocysteine, β2 microglobulin, hypersensitive C-reactive protein, parathyroid hormone, hs-cTnI) were compared between the two groups. Color Doppler ultrasound was performed for each patient, and relevant statistical methods were used to analyze the affecting factors of hs-cTnI in the patients. Results There were statistically significant differences in coronary heart disease history, systolic blood pressure, eGRF, Scr, BUN, β2 microglobulin, PTH, P, hemoglobin (Hb), left ventricular mass index (LVMI) and N terminal-pro brain natriuretic peptide (NT-proBNP) between the two groups. The results of multiple linear stepwise regression analysis showed that coronary heart disease history, Hb, NT-proBNP, LVMI, P and PTH were the influencing factors of hs-cTnI. The coronary heart disease history of non-dialysis patients with CKD showed a decrease in Hb. The increase of P, PTH, NT-pro BNP and LVMI Can lead to the increase of hs-cTn I level. Conclusion A history of coronary heart disease, anemia, elevated NT-proBNP, left ventricular hypertrophy, hyperparathyroidism, and hyperphosphatemia in non-dialysis CKD patients can cause hypersensitive troponin I to increase. 2023 Vol. 20 (4): 120-123 [Abstract] ( 363 ) [HTML 1KB] [PDF 1861KB] ( 1933 ) 124 RONG Xuesong, YAO Chao, HONG Qingqing Application of nucleic acid time-of-flight mass spectrometry in the identification of mycobacterium tuberculosis or non-tuberculosis and drug resistance Objective To evaluate the clinical value of nucleic acid time-of-flight mass spectrometry for the identification of mycobacterium tuberculosis (TB) or non-tuberculosis (NTM) and drug resistance detection. Methods A total of 199 patients with thoracic infectious diseases (excluding viral and fungal infections) admitted to our hospital from March 2020 to May 2022 were prospectively included. Sputum or bronchoalveolar lavage fluid were extracted for acid fast staining, colony culture and drug test, and nucleic acid mass spectrometry analysis, respectively, then to compare the diagnostic performance. Results According to clinical symptoms, imaging findings, colony culture and PCR results, 113 cases were confirmed to be TB positive, 51 cases were NTM positive and 35 cases were both negative. A total of 130 TB positive, 59 NTM positive and 10 negative were detected by nucleic acid mass spectrometry. The positive accuracy rate of TB detection by nucleic acid mass spectrometry was 88.4% [ (110+66) /199], sensitivity was 97.3% (110/113), specificity was 76.7% (66/86), positive predictive value was 84.6% (110/130), and negative predictive value was 95.7% (66/69). The positive accuracy of NTM detection was 92.0% [ (47+136) /199], sensitivity was 92.2% (47/51), specificity was 91.9% (136/148), positive predictive value was 79.7% (47/59), and negative predictive value was 97.1% (136/140). Compared with the other two detection methods, the failure rate of nucleic acid mass spectrometry was significantly lower, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of TB positive and NTM positive were significantly higher, and the detection time was significantly shorter (P<0.05). Nucleic acid mass spectrometry detected TB was mycobacterium tuberculosis complex, 9 kinds of NTM, 80 cases of TB resistance (70.8%, 80/113). Conclusion As a new technology for rapid identification of TB or NTM infection, nucleic acid mass spectrometry has a higher accuracy, sensitivity and specificity, which could provide detailed information of bacterial subtypes and drug resistance spectrum, and is of great significance in guiding clinical formulation of appropriate drug intervention programs and reducing the production of multi-drug resistant bacteria. 2023 Vol. 20 (4): 124-128 [Abstract] ( 379 ) [HTML 1KB] [PDF 2390KB] ( 1997 ) 129 LIU Yan, DAI Li, HUANG Qian, CAI Li, XIAO-LI Yan Short-term efficacy of pegaspargase in the treatment of children with acute lymphoblastic leukemia and its effect on adverse reactions in children Objective To investigate the short-term efficacy of pegaspargase in the treatment of children with acute lymphoblastic leukemia and its effect on the adverse reactions of children. Methods In this study, 86 children with ALL who were scheduled to undergo chemotherapy in our hospital from January 2018 to January 2021 were prospectively selected as the research objects, and all the children were randomly divided into the control group and the study group, with 43 cases in each group, The control group received vincristine + daunorubicin + L-asparaginase + prednisone combined chemotherapy (VDLP scheme); The study group received vincristine + daunorubicin + domestic pegaspargase + prednisone combined chemotherapy (VDPAP scheme). Hemoglobin, percentage of immature cells, platelet count, coagulation function, liver and kidney function were compared between the two groups. The clinical remission rate, average length of hospital stay, number of medication and event-free survival rates at 6 months and 1 year of treatment were compared between the two groups. The adverse reactions of the two groups were compared. Results After 3 months of treatment, the percentage of immature cells in the study group was significantly decreased, and the hemoglobin and PLT in control group were significantly increased. Compared with control group, the values of ALT, BUN, PT, APTT and TT in study group were significantly increased, while ALB and FIB were significantly decreased. The clinical remission rate in study group was higher than in control group. The hospitalization time and medication times of study group were significantly less than those of control group, and there was no significant difference in the event-free survival rate between the two groups at 6 months and 1 year of treatment. The number of gastrointestinal reactions, allergic reactions and in study group was significantly higher than that in control group. There was no significant difference in other indicators between the two groups. Conclusion Peaspargase has obvious advantages in the treatment of children with ALL. It can not only greatly reduce the myelosuppression of children with ALL, promote lymphocyte maturation, but also significantly improve the coagulation function and clinical remission rate of children with ALL, and greatly reduce adverse reactions reaction, However, relatively speaking, pegaspargase has a certain effect on liver function, and it is necessary to further improve the treatment method to reduce the damage rate of liver cells. 2023 Vol. 20 (4): 129-133 [Abstract] ( 373 ) [HTML 1KB] [PDF 1869KB] ( 2197 ) 134 LI Zhuang, YANG Ting, GAO Ao, LIU Yang, ZHAO Yan, CAO Lei Study on the effect of Shengxian decoction on infrared characteristics of xu li and du meridian in patients with chronic fatigue syndrome Objective To explore the changing rule of infrared thermal imaging features of deficiency inner part, chest and head and face in patients with Qi-deficiency CFS treated by Shenglu Decoction. Methods 110 patients with Qi-deficiency CFS were collected and divided into control group and treatment group by random number table method. The control group took multidimensional element tablets orally. In the treatment group, multidimensional element tablets and Shengxian decoction were taken orally for a course of 4 weeks. Chronic fatigue Scale 14 was used to collect the fatigue degree of patients. Medical infrared thermography was used to collect the infrared temperature of patients' Xuli, chest and head and face, and the data were collected and entered. SPSS 20.0 data analysis software was used to analyze the correlation between the improvement degree of fatigue and infrared temperature of Xuli, chest and head and face. Results In the treatment group, 43 cases were effective, 11 cases were effective, 1 case was ineffective, and the total effective rate was 98.4%; in the control group, 20 cases were effective, 29 cases were effective, and 6 cases were ineffective, and the total effective rate was 89.1%. After treatment, the score of fatigue scale-14 in the two groups decreased compared with that before intervention, and the score in the treatment group was higher than that in the control group. There were statistically significant differences in the temperature of virtual inner part and head and face in the treatment group, and the improvement of patients' symptoms was correlated with the increase of virtual inner part temperature and head and face temperature. Conclusion Shengxian decoction is effective in treating CFS with Qi deficiency, and can significantly increase the infrared temperature of the inner part of the deficiency, chest and head and face of the patients. 2023 Vol. 20 (4): 134-136 [Abstract] ( 377 ) [HTML 1KB] [PDF 3945KB] ( 1816 ) 137 CHEN Mengxin, WANG Huilun, JIE Zihan, CAO Xinyu, ZHAO Minhan, WU Xinle, OUYANG Haijing, QIN Lulu, ZHOU Ziyang A Randomized Controlled Trial of Reading Therapy as a Narrative Medicine Approach for Bidirectional Interactive Reading Intervention in Patients with Mental Disorders Objective Exploring the feasibility and therapeutic effects of combining bidirectional interactive reading therapy under the narrative medicine model with conventional treatment for clinical management of mental disorders in patients. Methods This study was a randomized controlled trial involving 376 patients with mental disorders who were randomly assigned to either the control group or the experimental group. The control group received conventional medication therapy and health education, while the experimental group received conventional medication therapy, health education, and bidirectional interactive reading therapy for a duration of 6 months. Pre-treatment and post-treatment assessments were conducted using a general information questionnaire, the Patient Health Questionnaire-9(PHQ-9) for depressive symptoms, the Generalized Anxiety Disorder-7(GAD-7) Scale for generalized anxiety, the Sleep Rating Scale (SRSS) for sleep quality, the Chinese version of the 8-item Morisky Medication Adherence Scale (MMAS-8) for medication adherence, and a treatment satisfaction scale. Results After intervention, there was a significant improvement (P<0.05) in depression and anxiety symptoms among patients with depression, schizophrenia, bipolar disorder, and anxiety disorders. The experimental group showed significant improvements (P<0.05) in sleep conditions, medication adherence, and treatment satisfaction compared to the control group in all four disease categories, with the experimental group showing more pronounced improvements (P<0.05). Conclusion The narrative medicine approach of bidirectional interactive reading therapy under the narrative medicine model significantly improves patients' depression, anxiety, and sleep conditions, enhances medication adherence, and increases treatment satisfaction. 2023 Vol. 20 (4): 137-141 [Abstract] ( 371 ) [HTML 1KB] [PDF 3665KB] ( 2157 ) Preventive Medicine 142 WANG Wei, CHEN Ying, CHEN Xuhong, LI Rong, ZHOU Limin, YE Xiangli, LEI Lifang The application of MoCA Changsha version for mild cognitive dysfunction screening in Xiangtan urban and rural communities Objective To investigate the prevalence of mild cognitive impairment (MCI) in the elderly in the urban and rural communities of Xiangtan city, Hunan Province, and to explore the feasibility of Montreal cognitive assessment Changsha version (MoCA-CS) in the screening of mild cognitive impairment in the elderly in the communities of Xiangtan city. Method A multi-stage stratified cluster sampling method was used to conduct a questionnaire survey among the elderly over 65 years old in urban and rural communities of Xiangtan City, and the Changsha version of MoCA was adopted for cognitive function screening. Combined with clinical diagnosis and receiver operator characteristic curve (ROC) analysis, the ideal demarcation score of MCI screening was explored. Results Among 822 elderly people in the urban and rural communities of Xiangtan city, the positive rate of MCI screening was 28.22%. According to ROC curve analysis, the area under the curve of MoCA score for the differential diagnosis of MCI was 0.945, the critical value was 21.5, the sensitivity and specificity were 95.67% and 82.06%, respectively. There were significant differences in MoCA scores between people with different education levels; According to the ROC curve analysis, the area under the curve of MoCA score for the diagnosis of MCI in the illiterate group was 0.946, the cut-off value was 17.5, and the sensitivity and specificity were 85.71% and 90.91%, respectively. In primary school group, the area under the curve of MoCA score for the diagnosis of MCI was 0.898, the critical value was 20.5, and the sensitivity and specificity were 94.64% and 72.73%, respectively. The area under the curve of MoCA score for the diagnosis of MCI in the junior high school group was 0.983, the critical value was 21.5, the sensitivity and specificity were 96.72% and 91.47%, respectively. The area under the curve of MoCA score for the diagnosis of MCI in high school and above group was 0.984, the critical value was 22.5, and the sensitivity and specificity were 90.00% and 96.35%, respectively. Conclusions The prevalence of MCI is high in the residents of the urban and rural communities of Xiangtan city. The cut-off value of MoCA Changsha version should be adjusted according to the education level when used in the screening of the elderly in the urban and rural communities of Xiangtan City. 2023 Vol. 20 (4): 142-147 [Abstract] ( 337 ) [HTML 1KB] [PDF 1993KB] ( 1840 ) Nursing Science 148 LIU Weili, CHU Fang, GUO Wansheng, XU Pingying, YAO Xin, LIU Yujia Analysis of sleep quality status and influencing factors of stroke rehabilitation patients Objective To explore the status quo and influencing factors of sleep quality in stroke rehabilitation patients. Methods A total of 123 patients with stroke who received rehabilitation treatment in our hospital from March, 2020 to June, 2021 were selected as the research objects. Pittsburgh Sleep Quality Index (PSQI), Rosenberg Self-esteem Scale, Body Image Scale and Hospital Anxiety and Depression Scale were used to evaluate the sleep quality, body image, self-esteem and anxiety and depression status of patients. Pearson correlation coefficient was used to analyze the correlation between sleep quality and body image, self-esteem, anxiety and depression, and multivariate Logistic regression equation was used to analyze the influencing factors of poor sleep quality in stroke rehabilitation patients. Results Among 123 patients, 52.84% (65/123) had PSQI subjective sleep quality, 55.28% (68/123) had long sleep latency, 42.28% (52/123) had short sleep time, and 47.15% (58/123) had low normal sleep efficiency. Pearson correlation coefficient analysis showed that the total score of PSQI was positively correlated with HADS-A, HADS-D, BID and RSES. Multivariate Logistic regression analysis showed that the payment methods of medical expenses (OR= 2.071, 95% CI: 1.874~2.908), HADS-A (OR= 1.296, 95% CI: 1.060 ~ 1.586) and HADS-D (OR= 1.483, 95% CI: 1.081 ~ 1.869) and rses (OR=0.682, 95% CI: 0.524 ~ 0.888) are the influencing factors of poor sleep quality in stroke rehabilitation patients. Conclusions Most stroke rehabilitation patients have poor sleep quality, and the sleep quality of stroke rehabilitation patients is significantly correlated with patients' body image, self-esteem, anxiety and depression, and payment methods of medical expenses. When managing stroke rehabilitation patients, it is necessary to consider the patient's body image, self-esteem, anxiety and depression, and the payment method of medical expenses, so as to improve the sleep quality of patients 2023 Vol. 20 (4): 148-152 [Abstract] ( 357 ) [HTML 1KB] [PDF 1895KB] ( 2111 )

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