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25 October 2024, Volume 21 Issue 5
    

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    Basic Medicine
  • Exploring the effects of acupuncture and moxibustion on a rat model of diarrhea-type irritable bowel syndrome based on IL-18 and ZO-1
    HE Yongjia, LAI Biyu, HONG Mengying, CHEN Yao, LI Xinwu, ZHANG Peiqin, ZHANG Shuiqing, SHE Chang
    Journal of Hunan Normal University(Medical Science). 2024, 21(5): 1-5.
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    Objective To explore the effect of acupuncture and moxibustion on the expression of zonula occludens-1(ZO-1), and blood interleukin-18(IL-18) and other related inflammatory factors in the intestinal tissues of rats with irritable bowel syndrome with predominant diarrhea(IBS-D). Methods Ten rats were randomly selected from 58 male SD rats as a control group. The remaining 48 were used to prepare the IBS-D model by acetic acid enema combined with restraint tail-clamping stress method. The remaining 48 rats were prepared by using acetic acid enema combined with the restraint tail-clamping stress method.40 rats that were successfully modeled were randomly divided into the model group, acupuncture group, moxibustion group, and western medicine group, with 10 rats in each group. In the acupuncture group, acupuncture was performed at the “foot-sanli” for 15 min each time, and the needle was twisted every 5 min for 20 s. In the moxibustion group, moxibustion was performed at the “foot-sanli” for 15 min each time, and in the western medicine group, pivoxyl bromide was administered by gastric lavage for 14 d. In the modeling group, the IBS-D models were randomly divided into the model group, moxibustion group and western medicine group, each of which had 10 animals. In the western medicine group, the rats were gavaged with pivacurium bromide tablets (Deshotep) for 14 d. Observations were made on the fecal character score and diarrhea index of the rats at the end of the modeling and the intervention, and the serum IL-18 level and the expression of ZO-1 in the colon tissues of the rats were analyzed and statistically analyzed at the end of the intervention. Results After modeling, the fecal character score and diarrhea index of rats in the other four groups were elevated compared with the control group. After intervention, fecal character score and diarrhea index of rats in the model group were elevated compared with those in the control group; fecal character score and diarrhea index of rats in the acupuncture, moxibustion, and western medicine groups were reduced compared with those in the model group, and fecal character score of rats in the acupuncture group was lower than that of rats in the western medicine group; ZO-1 expression in the colonic tissues of rats in the control group, acupuncture, moxibustion, and Western medicine (Pivacidium bromide ) ZO-1 expression was elevated to different degrees in rat colon tissues; compared with the model group, the serum IL-18 concentration values in the acupuncture group and control group were lower than those in the model group, and the IL-18 concentration levels in the moxibustion group and western medicine group were significantly lower than that in the model group. Conclusion Both acupuncture and moxibustion improved diarrhea symptoms in IBS-D model rats, and the mechanism may be achieved by regulating IL-18 levels, increasing ZO-1 protein expression, remodeling the tight junction structure, decreasing its tissue intercellular permeability, and repairing the damaged intestinal barrier.
  • Effect of berberine on NEK7/NLRP3 pathway in rat cerebral ischemia/reperfusion injured brain tissue
    TAN Huiqi, YANG Liping, XIE Liting, GAO Juhua
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 6-12.
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    Objective To observe the effect of berberine on NEK7/NLRP3 signaling pathway in cerebral ischemia reperfusion, and to explore the neuroprotective effect and mechanism of berberine in cerebral ischemia reperfusion injury. Methods A rat cerebral ischemia reperfusion injury model was established by the wire bolus method, and randomly divided into a sham operation group, an MCAO model group, a low-dose berberine group (25 mg/kg), a medium-dose berberine group (50 mg/kg), and a high-dose berberine group (100 mg/kg), and the area of cerebral infarction was determined by TTC staining, the morphological changes of brain tissue were observed by HE staining, and the neuroprotective effects and mechanisms of berberine in cerebral ischemia reperfusion injury were measured by ELISA. The morphology of brain tissues was observed by HE staining, alteration, serum IL-1β and IL-18 were measured by ELISA, and the mRNA and protein expression levels of NEK7, NLRP3, and Caspase-1 in brain tissues were detected by RT-qPCR and Western-blot. Results The volume of cerebral infarction was reduced in berberine group compared with the model group, and the volume of cerebral infarction was significantly smaller in the middle and high dose berberine group than that in the MCAO group. HE staining showed that the damage of cerebral cells in the berberine group was reduced compared with that in the model group. Compared with the MCAO group, the expression levels of IL-1β and IL-18 in the serum of rats in the berberine group were significantly decreased, and the mRNA and protein expression of NEK7, NLRP3, and Caspase-1 in the brain tissues of the berberine group differed significantly from that of the model group. Conclusion Berberine can significantly reduce the volume of cerebral infarction, attenuate the inflammatory response, and improve the symptoms of neurological deficits after CIRI, and its mechanism may be related to the NEK7/NLRP3 pathway.
  • Preparation of a dual functional biofilm and its role in tendon repair
    ZENG Fei, LI Songjian
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 13-19.
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    Objective Tendon adhesion and rupture are the main complications after tendon injury surgery. This article aims to develop a biofilm material that can simultaneously prevent tendon adhesion and promote tendon healing, reducing the complications after tendon injury surgery. Methods This study prepared a chitosan/silk fibroin (CS/SF)-sodium alginate (SA) composite biofilm, which is composed of a chitosan/silk fibroin layer and an alginate layer. The mechanical properties, hydrophilicity and biodegradability of the membranes were examined in this study, The biological characteristics of the bilayer membrane were tested through in vitro cytology experiments. Results CS/SF membrane has strong toughness and strength, with CS/SF 8: 2 membrane having the highest elongation at break (48.65%) and CS/SF 7: 3 membrane having the highest tensile strength (21.19 MPa); The contact angle of CS/SF blend film is around 70o, indicating its good hydrophilicity; In vitro degradation experiments showed that after 4 weeks of degradation, the residual mass of CS/SF blend membrane was 82% to 85%, and the residual degradation amount of SA membrane was 55%, indicating that the membrane can maintain overall structural integrity within 4 weeks. In vitro cytology experiments showed that tendon cells can rapidly proliferate on the CS/SF membrane, indicating their promoting effect on tendon cell proliferation; The slow proliferation of fibroblasts on the SA membrane suggests their ability to inhibit the growth of fibroblasts. Conclusion The biofilm has strong mechanical properties, good hydrophilicity, and suitable biodegradability. It has dual functions of promoting tendon regeneration and inhibiting fiber adhesion formation, and has certain application prospects in tendon injury repair.
    • Clinical Medicine
  • Efficacy of towel clamp olecranon traction combined with different Kirschner wire internal fixation in the treatment of traumatic Gartland type III supracondylar fracture of humerus in children
    LI Chengfei, LI Xiaoming, WANG Huiling, SHAN Weiqiang
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 20-23.
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    Objective To investigate the clinical application of different internal fixation methods of Kirschner wire in children with traumatic supracondylar fracture of humerus (Gartland type III) based on the reduction of fracture fragments by using towel clamp olecranon traction, and to analyze the practicability of different regimens through imaging indicators. Methods From May 2021 to May 2022, 83 children with traumatic supracondylar fracture of humerus (Gartland type III) in the hospital were enrolled in the study. The above patients were grouped according to the reduction and internal fixation methods. All patients were treated with olecranon traction reduction with towel clamp and adopted internal fixation with different Kirschner wires [fan-shaped fixation group (traction + Kirschner wire fan-shaped fixation, n=39), cross-fixation group (traction + Kirschner wire cross-fixation, n=44) ]. The healing status, loss status of flexion and extension and carrying angle, ultrasonic blood flow parameters, neurological function recovery, joint function recovery and complications were observed. Results The postoperative callus formation time and fracture healing time in the fan-shaped fixation group were significantly shorter than those in the cross-fixation group. There were no significant differences in the loss of flexion and extension and the loss of carrying angle between the fan-shaped fixation group and the cross-fixation group. There was a significant difference in the resistance index (RI) between groups at 4 and 8 weeks after surgery, and the RI in the fan-shaped fixation group was lower, and the decrease of RI was different in the fan-shaped fixation group and the cross-fixation group. The recovery of neurological function in the fan-shaped fixation group was better than that in the cross-fixation group. No significant differences were shown in pain, stability, motor function, daily activities and total score of joint function between groups. There were no significant differences in the incidence of redisplacement, cubitus varus, infection and iatrogenic nerve injury between fan fixation group and cross fixation group. Conclusion For traumatic supracondylar humeral fractures (Gartland type Ⅲ) in children, both towel clamp olecranon traction combined with Kirschner wire fan-shaped fixation and cross Kirschner wire internal fixation can effectively maintain fracture reduction and restore joint function, but fan-shaped fixation may be relatively better in promoting healing and vascular nerve recovery.
  • Analysis of the Impact of Diabetes on Prostate Cancer Using Two-Sample Mendelian Randomization
    WANG Jin, ZOU Zhi, LIU Bang, NING Shuancheng, CHEN Xiangyu
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 24-30.
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    Objective This study aims to address the uncertainty regarding the causal relationship between diabetes mellitus (DM) and prostate cancer. By employing Mendelian randomization, we can eliminate potential confounding factors and clarify the causal link between DM and prostate cancer, which will aid in the prevention and treatment of these two diseases in clinical practice. Methods We utilized data from genome-wide association studies (GWAS) focused on type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and prostate cancer, all based on European populations. The T1DM dataset comprised 3, 428 patients with diabetes and 3, 428 healthy controls. The T2DM dataset included 148, 726 patients with diabetes and 965, 732 healthy controls. The prostate cancer dataset included 30, 945 patients with prostate disease and 368, 725 healthy individuals as controls. T2DM was used as the exposure variable, and we identified significantly associated and independent single nucleotide polymorphism (SNP) as instrumental variables. We employed a two-sample Mendelian randomization (2SMR) approach to evaluate the causal relationship between T1DM, T2DM, and prostate cancer. The analysis incorporated five methods: inverse variance weighting (IVW), Mendelian randomization regression (MR-Egger), weighted median, weighted mode, and simple mode, with IVW serving as the primary analytical method. Cochran's Q statistic was utilized to assess heterogeneity. Results The findings indicate that no causal effect was observed between T1DM and prostate cancer (IVW: OR=0.99; 95% CI: 0.99-1.001, P=0.18). In contrast, the presence of T2DM is associated with an increased incidence of prostate cancer in the overall population (IVW: OR=7.88, 95% CI: 6.95-8.93, P<0.05). Conclusion There is a causal relationship between T2DM and prostate cancer, and T2DM increases the risk of developing prostate cancer. However, no promotive relationship was found between T1DM and prostate cancer.
  • Diagnostic value of peripheral blood CXCL10-mRNA and QSOX1-mRNA expression levels combined with AFP detection in early hepatitis B virus-related hepatocellular carcinoma
    LI Zeng, LI Haisha, LONG Liyuan, XIE Ya, LI Zenghui, LI Jinqiang
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 31-35.
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    Objective To explore the clinical application value of serum alpha-fetoprotein (AFP), CXCL10-mRNA, and QSOX1-mRNA detection in the diagnosis of hepatitis B virus-related hepatocellular carcinoma (HBV-related HCC). Methods A total of 120 subjects were selected from hospitalized patients in the Department of Infectious Diseases and healthy individuals from the physical examination center at The First Hospital of Changsha from January 2022 to May 2023. The subjects included 50 patients with early HBV-related HCC, 40 patients with liver cirrhosis, and 30 healthy individuals. The expression levels of peripheral blood CXCL10-mRNA and QSOX1-mRNA were detected by RT-PCR, and the AFP level was measured using a radioimmunoassay. The differences in serum levels of CXCL10-mRNA, QSOX1-mRNA, and AFP among the three groups were compared. Receiver operating characteristic (ROC) curves were plotted, and the diagnostic value of CXCL10-mRNA, QSOX1-mRNA, and AFP markers in the early diagnosis of HBV-related HCC was analyzed. Results The positive rate of AFP detection in the peripheral blood of the hepatocellular carcinoma (HCC) group patients was higher than that in the liver cirrhosis group, and the difference was statistically significant (P<0.05). The expression levels of CXCL10-mRNA, QSOX1-mRNA, and AFP in the HCC group were higher than those in the liver cirrhosis group and the healthy control group (P<0.05). The serum levels of CXCL10-mRNA and QSOX1-mRNA in the liver cirrhosis group were significantly higher than those in the healthy control group (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for CXCL10-mRNA, QSOX1-mRNA, and AFP in the early diagnosis of HBV-related HCC was 0.881, 0.790, and 0.814 respectively. The AUC for the combined detection of the three markers was 0.957, with a sensitivity and specificity for diagnosing HCC of 0.860 and 0.971, respectively, which were higher than those for the individual markers, indicating higher diagnostic performance. Conclusion The levels of CXCL10-mRNA and QSOX1-mRNA are highly expressed in the serum of patients with HBV-related HCC and cirrhosis. Combined detection of these markers with AFP can improve the early diagnostic efficiency of HBV-related HCC.
  • Association between miR-133, CRP, TIM-4 and pulmonary infection disease grade and survival outcome
    JIANG Shenzhen, WU Chenghao, WANG Ran, ZHANG Caihong
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 36-40.
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    Objective To explore the association between microRNA133(miR-133), C-reactive protein (CRP), T-cell immunoglobulin and mucin domain 4(TIM-4) and the severity and survival outcomes of lung infections, and to provide a reference for clinical diagnosis and treatment. Methods A total of 200 patients with lung infection admitted to Ningxia Baoshihua Hospital from May 2020 to May 2023 were selected for infection classification [pneumonia severity index (PSI) score group I-III (85 cases), PSI score group IV (81 cases), PSI score group V (34 cases) ]. The expression of miR-133, CRP, and TIM-4 in peripheral blood of each group was analyzed. According to the 28-day survival status, the lung infection patients were divided into survival subgroup and death subgroup. The expression of each index in peripheral blood of the two subgroups in each group was compared, and the relationship between miR-133, CRP, and TIM-4 in peripheral blood, lung infection severity, and survival outcome was analyzed. Results ① There were differences in the expression levels of miR-133, CRP, and TIM-4 in peripheral blood at different time points. ② There were differences in the expression levels of miR-133, CRP, and TIM-4 in peripheral blood between the survival group and the death group, and the expression levels of miR-133, CRP, and TIM-4 in peripheral blood were lower in the survival group compared with the death group. ③ There were differences in the trends of changes in the expression levels of miR-133, CRP, and TIM-4 in peripheral blood between the survival group and the death group. Three days after admission, the levels of miR-133(OR=1.445, 95%CI: 1.037-2.014), CRP (OR=1.534, 95%CI: 1.082-2.174), and TIM-4(OR=1.516, 95%CI: 1.086-2.116) in peripheral blood were risk factors for mortality in patients with lung infection. Seven days after admission, the levels of miR-133(OR=1.550, 95%CI: 1.125-2.136), CRP (OR=1.649, 95%CI: 1.213-2.241), and TIM-4(OR=1.609, 95%CI: 1.175-2.202) in peripheral blood were also risk factors for mortality in patients with lung infection. On the day of admission, the levels of miR-133(r1=0.645, P<0.001), CRP (r2=0.726, P<0.001), and TIM-4(r3=0.671, P<0.001) in peripheral blood were positively correlated with the severity of lung infection. The AUC predicted by the combination of indicators three days after admission was 0.941, with a sensitivity of 92.59% and a specificity of 87.86%. The AUC predicted by the combination of indicators seven days after admission was 0.952, with a sensitivity of 88.89% and a specificity of 95.38%. Conclusion The expression levels of miR-133, CRP, and TIM-4 in peripheral blood are positively correlated with the severity of pulmonary infection. The combined prediction of the survival status of patients with pulmonary infection using these three factors has high performance. Patients with high levels of miR-133, CRP, and TIM-4 have a higher risk of mortality in pulmonary infection. Monitoring miR-133, CRP, and TIM-4 can provide guidance for clinical diagnosis and prognosis evaluation.
  • Influence of mild moxibustion combined with ball holding training on comfort, coagulation function and incidence rate of catheter-related venous thrombosis in patients receiving PICC catheterization for colon cancer
    ZHANG Mi, ZHANG Dahua, ZHANG Jie, HE Qing, MEI Yuwei
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 41-45.
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    Objective: To explore the influence of mild moxibustion combined with ball holding training on comfort, coagulation function and incidence rate of catheter-related venous thrombosis in colon cancer patients with PICC catheterization. Methods 80 patients with colon cancer who received PICC catheterization in the hospital were selected from January 2021 to January 2024, and they were divided into group A (single ball holding training, n=40) and group B (mild moxibustion on the basis of group A, n=40) by adopting random envelope method. The TCM syndromes scores, comfort [Visual Analogue Scale (VAS) ], quality of life [36-item Short-Form Health Survey Scale (SF-36) ], coagulation function [platelet count (PLT), prothrombin time (PT), plasma fibrinogen (FIB), D-dimer (D-D) ], hemorheological indexes [high shear whole blood viscosity (HBV), low shear whole blood viscosity (LBV), plasma viscosity (PV), hematocrit (HCT) ] and incidence rate of catheter-related venous thrombosis were compared between groups before and after intervention. Results Before intervention, there were no significant differences in scores of TCM syndromes, VAS score, SF-36 score, PLT, PT, FIB, D-D, HBV, LBV, PV and HCT between the two groups. After intervention, the scores of VAS and SF-36 and levels of PT, HBV, LBV, PV and HCT were increased in both groups, and the scores and levels in group B were higher than those in group A. The scores of TCM syndromes and levels of PLT, FIB and D-D in the two groups were decreased, and the scores and levels were lower in group B than those in group A. The incidence rate of catheter-related venous thrombosis in group A was 17.50%, which was higher than 2.50% in group B. Conclusion The application of mild moxibustion combined with ball holding training for colon cancer patients with PICC catheterization can effectively enhance the comfort and quality of life, improve the coagulation function and hemorheology, and reduce the incidence rate of catheter-related venous thrombosis.
  • Effects of SLIPA laryngeal mask with sufentanil and sevoflurane inhalation on anaesthetic analgesia and hemodynamics in patients after laparoscopic common bile duct exploration
    ZHANG Xueqin, WANG Dongyu, XING Yuan, XIN Zhichuan, ZHAO Chenyang
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 46-50.
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    Objective To explore the effects of streamlined liner of pharynx airway (SLIPA) laryngeal mask with sufentanil and sevoflurane inhalation on anaesthetic analgesia and hemodynamics in patients after laparoscopic common bile duct exploration. Methods A total of 116 patients undergoing laparoscopic common bile duct exploration in the hospital were enrolled between January 2022 and June 2023. According to envelope method, they were randomly divided into combination group and routine group, 58 cases in each group. The routine group was given sufentanil and propofol for anesthesia maintenance, while combination group was given sevoflurane inhalation for SLIPA laryngeal mask anesthesia on basis of routine group. The heart rate (HR), mean arterial pressure (MAP) and bispectral index (BIS) in the two groups were compared at different time points. The postoperative pain response [visual analogue scale (VAS) ], sedation degree [observer’s assessment of alertness/sedation (OAAS) ] and incidence of adverse anesthesia reactions in the two groups were recorded. Results At T1, T2, T3 and T4, HR in combination group was lower than that in routine group, MAP was higher than than that in routine group, but there was no significant difference in BIS between the two groups. At 12h and 24h after surgery, VAS scores under resting and motion states in combination group were lower than those in routine group, and OAAS scores were higher than those in routine group. The incidence of adverse reactions in combination group was lower than that in routine group. Conclusion Sufentanil combined sevoflurane inhalation for SLIPA laryngeal mask anesthesia can effectively stabilize hemodynamics, relieve postoperative agitation and enhance analgesia effect in patients during laparoscopic common bile duct exploration.
  • Application effect of risk pre-control combined with key link intervention in perioperative period of patients with acute cerebral infarction after vascular intervention
    MU Nan, ZHANG Yao, HAO Wanting, DANG Shuangshuang, GUO Jianying
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 51-54.
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    Objective To explore the application effect of risk pre-control combined with key link intervention in perioperative period of patients with acute cerebral infarction (ACI) after vascular intervention. Methods A total of 108 patients with ACI undergoing vascular intervention in the hospital were enrolled as the research objects between January 2022 and December 2023. They were randomly divided into observation group and control group, 54 cases in each group. The control group was given routine nursing, while observation group was given risk pre-control combined with key link intervention. The psychological state [SAS, SDS], blood pressure control (systolic blood pressure, diastolic blood pressure), nerve function [NHISS], cognitive function [MoCA score], vascular recanalization time, hospitalization time and postoperative complications were compared between the two groups. Results After intervention, scores of SAS and SDS in observation group were lower than those in control group. After 3d of surgery, systolic blood pressure and diastolic blood pressure were lower than those in control group, NIHSS score was lower than that in control group, while MoCA score was higher than that in control group, the vascular recanalization time and hospitalization time were shorter than those in control group. The total incidence of postoperative complications (cerebral hemorrhage, subcutaneous hematoma, cerebral embolism, deep vein thrombosis, high irrigation syndrome, etc) in observation group was lower than that in control group. Conclusion Risk pre-control combined with key link intervention can effectively improve perioperative psychological state and blood pressure fluctuation, improve nerve function and cognitive function, reduce postoperative complications, and accelerate postoperative recovery in ACI patients after vascular intervention.
  • Effect of airway clearance technique on curative effect and serum CGRP and MMP-9 levels in patients with stroke-related pneumonia
    CAO Xueping, XIONG Chencheng, ZHANG Wencai, LI Xiaofang
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 55-59.
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    Objective To explore the effect of airway clearance technology on the curative effect and serum calcitoningene-relatedpeptide (CGRP) and matrix metalloprotein (MMP)-9 levels in patients with stroke related pneumonia. Methods 100 patients with stroke-related pneumonia treated in our hospital from June 2020 to December 2021 were selected as the research objects.100 patients were divided into experimental group and control group by random number table method, with 50 cases in each group. The patients in the control group were treated with routine treatment and intervention, and the patients in the experimental group were treated with airway clearance technology on the basis of the intervention measures in the control group. The curative effect, serum CGRP and MMP-9 levels were compared between the two groups. Results The effective treatment rate in the study group was 98.0%, which was significantly higher than that in the control group at 86.0%. Before the intervention, there were no significant differences between the two groups in terms of sputum expectoration, dyspnea scores, CPIS scores, CGRP levels, or MMP-9 levels. After the intervention, sputum expectoration scores, dyspnea scores, CPIS scores, and MMP-9 levels significantly decreased in both groups, while CGRP levels significantly increased. Additionally, the study group showed lower sputum expectoration scores, dyspnea scores, CPIS scores, and MMP-9 levels, and higher CGRP levels compared to the control group. Conclusion Airway clearance technology can significantly improve the curative effect of patients with stroke-related pneumonia, and significantly increase the level of serum CGRP and significantly decrease the level of MMP-9.
  • Value of ferritin and kidney injury molecule 1 in evaluating the condition and prognosis of lupus
    ZHU Xiaohong, JIANG Jiang, GUO Gang, DI ShiLin
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 60-65.
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    Objective To analyze the value of iron metabolism related indexes in evaluating the condition and prognosis of lupus nephritis (LN). Methods This was a single-center, cross-sectional, observational cohort study in our hospital. The study time was from January 2021 to June 2022, and the subjects were 101 patients with systemic lupus erythematosus (SLE) and 11 healthy controls. Baseline urinary ferritin level and kidney injury molecule 1(KIM-1) protein level were compared between SLE patients and control group, and correlated with clinical features and subsequent treatment response. Results Compared with patients with active non-nephritis (ANR), patients with active lupus nephritis (ALN) were younger, with higher female ratio, proteinuria, rSLEDAI and SLEDAI and lower hemoglobin (P<0.05). The urinary ferritin level in ALN group was significantly higher than that in other groups [ALN 8.96(4.15, 22.74) vs ANR 1.51(1.01, 3.14), inactive SLE(INA) 1.35(0.70, 3.10) and healthy controls 1.07(0.55, 1.42); H=43.57, P<0.05) ]. The urinary KIM-1 protein level in ALN group was significantly higher than that in ANR group and healthy controls [AlN 87.96(45.01, 185.90) vs ANR 16.48(4.91, 29.26), INA 9.62(3.13, 57.55) and healthy controls 9.78(3.13, 17.62); H=48.65, P<0.05) ]. Urinary ferritin and KIM-1 protein levels were positively correlated with proteinuria (correlation coefficient =0.385, 0.538, both P<0.05). Compared with the group with treatment response, the levels of serum inosine, urinary ferritin and KIM-1 protein in the group without treatment response increased significantly (P<0.05). The AUC values of urinary ferritin and KIM-1 protein in predicting the therapeutic response of ALN were 0.815(95%CI: 0.675-0.955) and 0.856(95%CI: 0.731-0.981), respectively. Conclusion Urinary ferritin and KIM-1 protein may be a promising candidate biomarker for predicting the therapeutic response of LN.
  • The clinical value of serum amyloid A, white blood cell and C-reactive protein in preterm premature rupture of membranes complicated with chorioamnionitis
    ZHOU Yan, ZHANG Chan, DING Caifeng, ZHANG hong, LIU Zhengyu, LI Piaopiao, REN Fangyuan
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 66-69.
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    Objective To investigate the clinical value of serum amyloid A (SAA), white blood cell and C-reactive protein (CRP) in chorioamnionitis (CA) in preterm premature rupture of membranes (PPROM). Methods A total of 80 patients with premature rupture of membranes were selected from January 2020 to December 2021 in Zhuzhou Central Hospital. According to the results of placental disease after delivery, they were divided into chorioamniotic infection group (n= 35 cases, including 18 cases in grade I group, 10 cases in grade II group, 7 cases in grade III group) and non-chorioamniotic infection group (n=45 cases). Normal pregnant women were selected as control group (n=40 cases). The levels of serum amyloid A (SAA), white blood cells and C-reactive protein were measured in all pregnant women at admission. ROC curve was used to find the diagnostic value of each index in premature rupture of fetal membrane complicated with chorionic amniotitis. Results There was a positive correlation between SAA and white blood cell count and C-reactive protein in chorioamniotic infection group. The comparison of SAA level in the groups was as follows: Grade III group>Grade II group>Grade I group. The values of SAA, leukocyte and C-reactive protein in chorioamniotic group were higher than those in non-chorioamniotic group and control group, and the non-chorioamniotic group was higher than control group. The cut-off values of various indexes in patients with preterm premature rupture of membranes combined with chorioamnitis were as follows: leukocyte13.28×109/L, C-reactive protein 14.28mg/L, serum amyloid A 13.46mg/L. The area under the curve of ROC of the three are 0.765, 0.706 and 0.820 respectively, and the area under the curve of the three combined is 0.830. Conclusion SAA is in direct proportion to the severity of chorionic amniotitis. The diagnostic value of SAA in premature rupture of fetal membrane combined with chorionic amniotitis is better than that of leukocyte and C-reactive protein.
  • Clinical study of functional endoscopic sinus surgery combined with dexamethasone nasal irrigation in patients with sinusitis
    LUO Xueyi, JIANG Di, CHEN Shunjin, FU Ming
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 70-74.
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    Objective To analyze the effects of functional endoscopic sinus surgery (FESS) combined with dexamethasone nasal irrigation on clinical symptoms, inflammatory response, specific immunoglobulin E (sIgE) and eosinophils (EOS) in patients with sinusitis. Methods A total of 150 patients with CRS in the hospital were enrolled as the research objects between October 2022 and October 2023. According to random number table method, they were divided into study group and control group, 75 cases in each group. On basis of FESS, control group was given normal saline, while study group was given dexamethasone for nasal irrigation. The improvement of clinical symptoms, inflammatory response before and after treatment, and the effects on sIgE and EOS were compared between the two groups. Results After treatment, clinical control rate of study group was higher than that of control group (97.33% vs 89.33%, P<0.05). After treatment, scores of nasal congestion, head/facial pain, olfactory disturbance and runny nose were decreased in both groups, which were lower in study group than control group (P<0.05). After treatment, levels of IL-5, IL-6 and IL-12 were decreased in both groups, which were lower in study group than control group. After treatment, levels of sIgE and EOS were decreased in both groups, which were lower in study group than control group. The incidence of postoperative complications in study group was lower than that in control group (13.33%% vs 29.33%, but there was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Dexamethasone nasal irrigation can improve clinical symptoms, effectively relieve inflammatory response, reduce sIgE, EOS and postoperative complications in patients with sinusitis after FESS.
  • Research on the Diagnosis of Breast Cancer Molecular Subtypes Based on Convolutional Neural Networks with Multimodal Ultrasound Features
    DENG Lizhen, WU Li
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 75-80.
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    Objective This study aimed to investigate the application of convolutional neural networks (CNN) based on multimodal ultrasound features in the diagnosis of molecular subtypes of breast cancer, and to assess its potential in improving diagnostic performance. Methods By integrating features from conventional ultrasound, strain elastography, and shear wave elastography, CNN models were built using different combinations of ultrasound modalities. The CNN models were trained and validated through 5-fold cross-validation, and model performance was assessed using accuracy, recall, F1 score, and area under the curve (AUC) metrics, along with subtype prediction confusion matrix analysis. Results A total of 90 cases were collected. The CNN model based on three types of ultrasound modalities achieved satisfactory performance in terms of accuracy, recall, F1 score, and AUC indicators for the classification of molecular subtypes of breast cancer (0.914, 0.923, 0.91, and 0.942, respectively), which was significantly higher than the CNN models based on a single ultrasound modality or any two combined ultrasound modalities. Confusion matrix analysis showed that the CNN model based on three types of ultrasound modalities had the highest predictive accuracy for each subtype. Conclusion The CNN model based on multimodal ultrasound features has great potential in the diagnosis of molecular subtypes of breast cancer and can provide strong support for the precise diagnosis and treatment of breast cancer.
  • Clinical study of ezetimibe and evolocumab combination trerapy in patients with hypercholesterolemia and coronary heart disease
    XIN Hongwei, LI Jingrui, DING Yuanyuan, WANG Chunying, SUN Yanxia, ZHANG Baihui, WU Xiaojie
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 81-85.
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    Objective To observe the therapeutic effect of combined treatment with ezetimibe and evolocumab on patients with hypercholesterolemia and coronary heart disease (CHD), and the impact on blood lipid levels, cardiac function, and serum homocysteine (HCY), oxidized low-density lipoprotein (ox-LDL) and high-sensitivity C-reactive protein (hs-CRP) levels. Methods A total of 130 patients with hypercholesterolemia and CHD who were treated in the hospital from April 2023 to April 2024 were selected, and randomly assigned to the control group and the experimental group, with 65 cases in each group. Both groups received conventional treatment, with the control group receiving ezetimibe in addition to conventional treatment, and the experimental group receiving a combination of erlotinib and ezetimibe in addition to conventional treatment. Therapeutic effects, blood lipid levels, cardiac function, and serum HCY, ox-LDL and hs-CRP levels were observed, and evaluate its therapeutic safety. Results After treatment, therapeutic effect on CHD and lipid-lowering effect in the experimental group were significantly better compared to the control group. After treatment, the levels of total cholesterol (TC), triacylglycerol (TG) and low-density lipoprotein cholesterol (LDL-C) in the two groups decreased, and the levels of high-density lipoprotein cholesterol (HDL-C) increased. Meanwhile, the levels of TC, TG and LDL-C were lower, and the level of HDL-C was higher in the experimental group. Left ventricular ejection fraction (LVEF) in the two groups was significantly increased, and left ventricular end diastolic diameter (LVEDd) and left ventricular end systolic diameter (LVESd) were significantly reduced. LVEF in the experimental group was significantly higher. LVEDd and LVESd in the experimental group were significantly smaller. After treatment, the levels of HCY, ox-LDL and hs-CRP in the two groups were significantly reduced, and the levels were significantly lower in the experimental group. During the treatment period, no significant difference was found in the incidence of adverse reactions between the two groups. Conclusion The combined treatment with ezetimibe and evolocumab can achieve better therapeutic effects on patients with hypercholesterolemia and CHD. It can effectively improve patients’ blood lipid levels and cardiac function, and lower serum HCY, ox-LDL and hs-CRP levels, and the treatment has high safety.
  • Influence of different uses of Sizi powder on gastrointestinal function recovery after colonoscopy under general anesthesia
    ZHU Peipei, CHEN Linling, JING Shan, JIA Jie, FENG Juan
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 86-91.
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    Objective To explore the application effect of different uses of Sizi powder on postoperative gastrointestinal function recovery, abdominal pain and abdominal distension symptoms and comfort in patients with colonoscopy under general anesthesia. Methods A total of 150 patients who received general anesthesia colonoscopy in the hospital were selected from February 2022 to February 2024, and were divided into three groups: group A(n=50, conventional basic intervention), group A(n=50, conventional basic intervention + Sizi powder hot compress umbilical intervention) and group C(n=50, conventional basic intervention + Sizi powder Renyanbao meridian acupoint selection intervention). The gastrointestinal function, abdominal distension degree, waist circumference, abdominal pain degree and comfort at different time points and intervention effect were compared among the three groups. Results Finally, 48 patients in group A, group B and group C were enrolled respectively. The complete remission time of abdominal distention in group C and group A was shorter than that in group A, and the time in group C was shorter than that in group A. The number of cases with 0-5 times bowel sounds per minute was higher in group C and group A than that in group A, and the number was higher in group C than that in group A. At 2 h and 4 h after intervention, the abdominal distention degree score in group A and group C was lower than that in group A, and the score was lower in group C than that in group A. There was no significant difference in waist circumference among the three groups before intervention and at 1 h, 2 h and 4 h after intervention. At 2 h and 4 h after intervention, the numerical rating scale (NRS) score in group A and group C was lower than that in group A, and the NRS score in group C was lower than that in group A. At 1 h, 2 h and 4 h after intervention, the general comfort questionnaire (GCQ) score was higher in group A and group C than that in group A, and the GCQ score in group C was higher compared to group A. The abdominal distention intervention effect in group A and group C was better than that in group A, and group C had better abdominal distention intervention effect than group A. Conclusion Sizi powder Renyanbao meridian acupoint selection intervention is an effective traditional Chinese medicine appropriate intervention technique to promote the recovery of gastrointestinal function after general anesthesia colonoscopy, improve the symptoms of abdominal pain and abdominal distension and enhance the comfort.
  • Correlation analysis of disease perception and social support among family caregivers with schizophrenia
    LIU Zhiying, ZHAO Rong, YANG Hongxiu, DAI Jinjun, ZHU E, DENG Peipei, SHI Xiaomao, LI Chuan
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 92-97.
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    Objective To analyze the correlation between disease perception and social support among family caregivers with schizophrenia, and provide reference for intervention measures for family caregivers. Methods This study is a cross-sectional survey, using a cluster sampling method to select 290 family caregivers with schizophrenia who met the inclusion criteria from a tertiary hospital as the survey subjects. The survey was conducted using a general data collection questionnaire, the Schizophrenic Disease Perceived Relatives Scale (IPQS), and the Social Support Assessment Scale (SS-A), Use Sperman correlation analysis to analyze the correlation between disease perception and social support among family caregivers. Results The correlation between disease perception and social support among family caregivers of schizophrenia: The periodic timeline of disease perception (r=-0.423, P<0.05), consequences relatives (r=-0.306, P<0.05), consequences patients (r=-0.472, P<0.05), personal blame patients (r=-0.443, P<0.05), disease consistency (r=-0.359, P<0.05), emotional representation (r=-0.312, P<0.05), symptom recognition (r=-0.376, P<0.05), and social support total score are negatively correlated. There is a positive correlation between personal control patient (r=0.429, P<0.05), treatment/control (r=0.386, P<0.05), and total social support score. Objective social support is negatively correlated with outcome relative (r=-0.383, P<0.05) and positively correlated with treatment/control (r=0.465, P<0.05). Multivariate analysis results show that outcome patient (OR=0.320, 95% CI: 0.184-0.562) is negatively correlated with social support, while treatment/control (OR=2.572, 95% CI: 1.465-4.516) is positively correlated with social support. Conclusion The social support of family caregivers for schizophrenia is mainly negatively correlated with the perceived consequences of the disease-patients; Social support is positively correlated with treatment/control.
  • Evaluation of the effect of different smoke removal devices on smoke purification in the operating room
    YU Ke, ZHOU Dai, DENG Fengliang, HU Jiale, LIU Xiulan, GAO Jianxin, BAI Li
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 98-100.
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    Objective To evaluate the air purification effect of laminar ventilation system and central negative pressure suction device for the scientific use of the device. Methods A portable air quality detector was used to measure the air concentration of PM2.5 and CO2 in the operating room of a tertiary hospital in Hunan Province, and to evaluate the air purification effect of the exhaust device. Results The concentration of PM2.5 and CO2 increased significantly at the time of surgery; the concentration of PM2.5 and CO2 in the “laminar ventilation” operating room was lower than in the ordinary operating room; in the open surgery and endoscopic surgery, the smoke removal effect of “laminar ventilation + central negative pressure device” was better than the “laminar ventilation” device. Conclusion “Laminar ventilation system” can reduce the concentration of PM2.5 and CO2 in surgical smoke, and the combined use of “laminar ventilation system” and “central negative pressure suction device” is better.
  • Constructing a Nomogam model for predicting prognosis based on multicenter data from early screening of severe mycoplasma pneumonia in children
    TAO Hong, GUO Jiang, ZHENG Jing, YANG Mei, ZHANG Shuiying, SONG Yue
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 101-106.
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    Objective To construct a Nomogam model for predicting prognosis based on multicenter data from early screening of severe mycoplasma pneumoniae pneumonia (MPP) in children. Methods A total of 400 children with severe MPP admitted to Chengdu Seventh People's Hospital, Panzhihua Central Hospital, and Wenjiang Maternal and Child Health Hospital from December 2022 to January 2024 were gathered. Patients were randomly grouped into a modeling group (280 cases) and a validation group (120 cases) in a 7∶3 ratio (random number table method). According to the prognosis of the patients, the modeling group was separated into a good prognosis group and a poor prognosis group. The influencing factors for poor prognosis of severe MPP in children were analyzed using multiple logistic regression analysis. R software was applied to build the Nomogam model. ROC curve was plotted to evaluate the discrimination of the Nomogam model. Model consistency was applied to draw calibration curves for evaluation. Decision Curve Analysis (DCA) was applied to evaluate the clinical application value of the model. Results Out of 280 children, 79 had poor prognosis, with an incidence rate of 28.21%. There were differences in age, PCT, IL-6, NLR, LDH, CRP, and IgM between the two groups. Multivariate logistic regression analysis showed that age, PCT, IL-6, NLR, LDH, CRP, and IgM were risk factors for poor prognosis of severe MPP in children. The AUC of the modeling group and validation group was 0.974 and 0.967, and the slope of the calibration curve was close to 1, the H-L test showed χ2=7.021 and 6.984, P=0.742 and 0.698, indicating good consistency. DCA curve showed that when the probability of high-risk threshold was between 0.03 and 0.91, the model had high clinical value in predicting poor prognosis of severe MPP in children. Conclusion Age, PCT, IL-6, NLR, LDH, CRP, and IgM are factors influencing poor prognosis in children with severe MPP, and the column-line diagram model constructed in this way has good discrimination and consistency, and can be used to screen the risk of poor prognosis in children with severe MPP at an early stage.
  • The diagnostic value of linkage imaging mode for small sessile serrated lesions in the colon
    JIN Lei, LI Chunshuang, CHEN Liping, CHEN Chuanrong
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 107-110.
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    Objective This study aims to investigate the value of link color imaging (LCI) compared with Narrow Band Imaging (NBI) in the diagnosis of minute serrated lesions in the colon and rectum. Methods A prospective study was conducted from January to July 2024, including 664 patients who underwent colonoscopy at the Second Affiliated Hospital of Wannan Medical College. Patients were randomly divided into the LCI group and the NBI group. The study compared the detection rates of minute polyps in the colon and rectum, the detection rates of polyps in different parts of the intestine, the detection rates of different Sanada typing of polyps, and the corresponding pathological comparison between the two groups. Results The overall detection rate of minute polyps in the LCI group was higher than that in the NBI group (P<0.05), and the detection rate of minute polyps in the right hemicolon was higher in the LCI group than in the NBI group; especially in the detection rate of Sanada type I lesions, the LCI group was significantly higher than the NBI group (P<0.001). In terms of pathological results, the number of inflammatory polyps and sessile serrated lesions detected in the LCI group was higher than that in the NBI group (P<0.05). Conclusion LCI technology has a significant advantage in improving the detection rate of minute polyps in the colon and rectum, especially minute polyps in the right half of the colon and sessile serrated lesions, which has important clinical significance for the prevention of colorectal cancer.
  • The relationship between postoperative delirium in elderly patients and changes in perioperative inflammatory factors and related factors
    YAO Yizhen, TANG Jun, ZHENG Yuqi, WANG Fang, LI Yanyan
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 111-115.
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    Objective To investigate the relationship between postoperative delirium and perioperative inflammatory factors in elderly patients. Methods 260 elderly patients undergoing elective surgery in our hospital from August 2023 to May 2024 were collected. They were randomly divided into general anesthesia group (group G) and regional anesthesia group (group L), 130 cases in each group. The incidence of postoperative delirium, serum interleukin-6(IL-6), tumor necrosis factor-α (TNF-α) and central nervous system specific protein (S100-β) were compared between the two groups; Logistic regression model was used to analyze the univariate and multivariate factors affecting postoperative delirium. Results The incidence of postoperative delirium in group G was 23.84%, which was higher than that in group L (17 cases, 13.08%), and the difference was statistically significant; Serum IL-6, TNF-α and S100-β 3d after operation in the two groups were significantly higher than those before operation; There was no significant difference in IL-6, TNF-α and S100-β 3d after operation between the two groups; The preoperative MMSE score of patients with postoperative delirium was lower than that of patients without delirium, ASA grade, operation time, postoperative VAS score, IL-6, TNF-α And S100-β, proportion of elderly people were higher or longer than those in patients without delirium after operation; Logistic univariate analysis results: ASA classification, preoperative MMSE score, operation time, postoperative IL-6, TNF-α, S100-β, Anesthesia method, advanced age was related to postoperative delirium; Logistic multivariate analysis results: anesthesia mode (general anesthesia), preoperative MMSE score, postoperative IL-6, TNF-α And S100-β It was a risk factor for postoperative delirium. Conclusion Postoperative delirium in elderly patients and anesthesia methods, preoperative MMSE score, postoperative serum IL-6, TNF-α And S100-β, advanced age was monitoring the above factors can provide reference for the prevention and treatment of postoperative delirium.
  • The clinical efficacy of UBE and TESSYS on lumbar spinal stenosis with central obesity
    LUO Xiao, LEI Chao, HE Yiliang, DUAN Xianyu, FAN Bin
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 116-122.
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    Objective To explore the effects of unilateral bi-channel endoscopic technique (UBE) and transforaminal endoscopic lumbar discectomy (TESSYS) on lumbar spinal stenosis with central obesity, as well as their impact on traumatic stress and complications. Methods Based on a 1∶1 matching principle, a retrospective study was conducted using the propensity score matching method. A total of 51 patients with central obesity and lumbar spinal stenosis who underwent UBE surgery in our hospital from September 2021 to June 2023 were included in the UBE group. Meanwhile, another 51 patients with central obesity and lumbar spinal stenosis who underwent TESSYS surgery during the same period were included in the TESSYS group. The study compared the surgical implementation and postoperative recovery indicators, trauma stress [reactive oxygen species, glutathione peroxidase (GSH-Px), interleukin-1β (IL-1β), interleukin-8(IL-8) ], visual analog scale (VAS) scores for back pain and leg pain, Oswestry Disability Index (ODI), Schizas standard classification, excellent and good rate, and complications between the two groups. Results The operation time of UBE group was shorter than that of TESSYS group, the intraoperative bleeding and postoperative drainage were lower than that of TESSYS group, and the postoperative operation and discharge time were earlier than that of TESSYS group. The reactive oxygen species, IL-1β and IL-8 of UBE group were lower than those of TESSYS group 1 and 3 days after operation, and GSH-Px of UBE group was higher than that of TESSYS group. The VAS scores of back pain and leg pain at 3 days and 1 month after surgery and ODI at 1 month after surgery in UBE group were lower than those in TESSYS group. There was no significant difference in the standard grades of Schizas 1 month after surgery between UBE group and TESSYS group. The excellent and good rate of UBE group (98.04%) was higher than that of TESSYS group (82.35%). There was no significant difference in complications between the two groups. Conclusion Compared with TESSYS, UBE surgery has advantages in surgical implementation, reducing traumatic stress, promoting early postoperative recovery, symptom improvement, and functional prognosis in the treatment of lumbar spinal stenosis with central obesity.
  • The clinical value of Caprini model in predicting postpartum venous thrombosis in elderly parturients
    CHEN Jie, HUANG Hao
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 123-127.
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    Objective To investigate the validity and clinical value of Caprini model in predicting the occurrence of venous thromboembolism (VTE) in advanced maternal age (AMA). Methods A retrospective case study was conducted to select 35 AMAs born in our center from January 2020 to October 2023 with postpartum diagnosis of VTE as the obervation group, and 70 AMAs born in our center during the same period with postpartum diagnosis of non-VTE as the control group according to the principle of 1: 2. Various clinical data of the two groups of patients were collected, and then the Caprini venous thrombosis risk prediction model was used to score various risk items for the two groups of patients. The differences in Caprini score between the two groups were compared by T-test, and the risk factors and risk stratification under this model were evaluated by Chi-square test and Logistic regression analysis. The independent risk factors of postpartum VTE and the relationship between risk stratification and the risk of VTE were analyzed. Results The average Caprini score of the observation group was significantly higher than that of the control group. Based on the single factor analysis of Caprini model entries, there is no statistically significant difference in six factors: bed time, abnormal lung function, family history of VTE, history of abortion (including unknown cause or habitual), history of inflammatory bowel, and laparoscopic surgery ; Patients in the observation group had a higher proportion in age over 40 years old, central venous access indentation, minor surgery, major open surgery, leg swelling, varicose veins, and history of VTE disease ; The observation and control groups were not comparable in terms of BMI, severe lung disease, malignancy, oral contraceptives or estrogen, and pregnancy or 1 month postpartum. Logistic analysis results showed that indentable central venous access, leg swelling, and varicose veins were independent risk factors for VTE in advanced maternal age. Conclusion Caprini venous thrombosis risk prediction model can effectively stratification the perinatal risk of VTE in elderly women. When patients have central venous access indentation, leg swelling, and varicose veins, it indicates that the risk of perinatal VTE in elderly women will increase significantly, this study provides a new scientific clue for the prevention and treatment of perinatal VTE in advanced maternal age.
  • Predictive value of human circulating T immune index and platelet parameters on the therapeutic effect of systemic lupus erythematosus
    WANG Jing, YANG Xiaofei
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 128-133.
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    Objective To analyze the changes of CD4+CD28null T cells and platelet-bound complement cleavage products (PC4d) in patients with active and inactive systemic lupus erythematosus (SLE) and normal controls, and evaluate their significance as biomarkers for judging disease activity and therapeutic effect. Methods This was a single-center, observational cohort study in our hospital. The study time is from January 2021 to June 2022. The subjects were 90 SLE patients aged 15-70 and 22 healthy controls. Calculate systemic lupus erythematosus disease activity index (SLEDAI) to evaluate the overall disease activity; Patients with SLEDAI score>4 were regarded as active SLE, and the rest were classified as inactive SLE. The levels of CD4+CD28null T cells and PC4d were analyzed by flow cytometry. Results Compared with the healthy control group, the patients in active SLE group were younger, and the levels of CD4+CD28null T and PC4d were higher. The differences in WHO classification, SLEDAI, and CD4+CD28null T cells between patients with active SLE and those with inactive SLE were statistically significant. The levels of CD4+CD28null T and PC4d were positively correlated with SLEDAI (r=0.214, P<0.05; r=0.410, P<0.05). The difference in the percentage of CD4+CD28null T cells across different WHO classifications was statistically significant. and the percentage of CD4+CD28null T cells in WHO grade 5 was significantly higher than that in other grades. Compared with the group with treatment response, the levels of CD4+CD28null T and PC4d in the group without treatment response increased significantly. ROC curve showed that the AUC values of CD4+CD28null T and PC4d in predicting the treatment response of SLE in active stage were 0.759(95%CI: 0.604-0.914) and 0.923(95%CI: 0.832-1.000), respectively. Conclusion The expansion of CD4+CD28null T cell and the increase of PC4d level are closely related to the disease activity of SLE patients, and they can be used as potential candidate biomarkers to predict the treatment response of active SLE patients.
  • Observation of the therapeutic effect of acupuncture combined with acupoint massage at meridian points and low-intensity focused ultrasound therapy on acute lactational mastitis.
    LI Jingjing, DENG Liming, XIANG Juan, JIANG Linghui, FANG Jun, ZHANG Hong
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 134-138.
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    Objective To explore the clinical efficacy of acupuncture combined with acupoint massage at meridian point and low intensity focused ultrasound therapy in the treatment of acute lactational mastitis. Methods A total of 150 patients with acute mastitis during lactation who received treatmnet at the Breastfeeding Clinic of Xiangya Third Hospital, Central South University, from June 2021 June to 2023 were selected as the research subjects. According to the patients’ treatment plans, They were divided into a control group (n=70) and an observation group (n=80). The control group received conventional anti-inflammatory treatment with cefixime, while the observation group received acupuncture combined with acupoint massage at meridian points and low intensity focused ultrasound (LIFU) treatment. After 7 days of continuous treatment, the recovery of mammary gland tissue and levels of inflammatory cytokines before and after treatment were compared between the two groups. Traditional Chinese medicine syndrome scores, Visual Analog Scale (VAS) scores, SF-36 scores, and treatment satisfaction scores were compared between the two groups. Clinical efficacy was evaluated based on symptoms, signs, and indicators of inflammatory response. Results After treatmnet, The mammary gland tissue structure in both groups wass basically normal, with clear boundaries, full edges, and homogennous interstitial echoes. The observation group showed better results. The area of ultrasound hypoechoic irregularity was significantly reduced after treatment compared with that before treatment, and the difference between the observation group and the control group after treatment was statistically significant. The white blood cell count (WBC), neutrophil percentage (NE%), interleukin-8(IL-8), and C-reactive protein (CRP) levels were significantly decreased in both groups after treatment, with the observation group showing lower levels than the control group. After treatmnet, The traditional Chinese medicine clinical symptom score and Visual Analog Scale (VAS) scores in both groups were significantly reduced, with the observation group showing lower scores than the control group, and the differences were statistically significant. The total effective rate in the observation group was 96.25%, which was higher than the total effective rate of 85.71% in the control group, and the difference was significant. Conclusion The combination of acupuncture combined with acupoint massage at meridian points and low intensity focused ultrasound shows significant efficacy in the treatment of acute lactational mastitis. This finding has certain guiding significance and practical application value.
    • Preventive Medicine
  • Logistic regression analysis of prognostic factors in adults patients with actue liver failure
    XU Zheng, ZHANG Yujing, LI Yuhang, LIU Sulai, LV Yuan
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 139-142.
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    Objective To investigate the prognostic factors of adult patients with acute liver failure through a retrospective cross-sectional study. Methods Retrospectively collected A three armour hospital of hunan province from 2020 to 2023 were analyzed the clinical data of patients with acute liver failure. By t test and chi-square test and rank and inspection to the single factor analysis of indicators, and Logistic regression analysis was carried out on the differences of indicators. Results Among the 139 patients, 80 patients were improved and 59 patients were not improved. The age of the patients ranged from 19 to 79 years. Univariate analysis showed that the total bile acid, direct bilirubin, and glomerular filtration rate in the improved group were higher than those in the non-improved group, and the creatinine, uric acid, cystatin C, potassium, phosphorus, prothrombin activity, international standard ratio, and activated partial thromboplastin in the improved group were lower than those in the non-improved group. Logistic regression analysis showed that creatinine (OR=2.92, 95%CI: 1.13-7.54), total bile acid (OR=0.23, 95%CI: 0.05-0.95), international standard ratio (OR=8.73, 95%CI: 2.25-33.86) were the independent influencing factors for acute liver failure. The abnormal increase of creatinine and international standard ratio may increase the risk of disease deterioration, and the increase of total bile acids may reduce the risk of disease deterioration. Conclusion Creatinine ratio, total bile acid, international standard is independent impact factors for acute liver failure. Abnormal creatinine and the ratio of international standard rise may increase the risk of progression of the disease patients, patients with the increase of total bile acid could reduce the risk of deterioration.
  • China’s elderly population identification model of metabolic syndrome-a study based on CHARLS database
    ZENG Yiqun, LI Wei, CHEN Ruipeng, LIANG Chenzhao, LIANG Yanfang, LIU Chongmei
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 143-150.
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    Objective The incidence of Metabolic syndrome (MetS) is increasing year by year, which is threatening human health worldwide. The aim of this study is to construct a simple and efficient metabolic syndrome identification model. Methods This study used anthropometric data from the China Health and Retirement Longitudinal Survey (2011). A total of 7552 subjects aged 45 years and over were included and randomly divided into training set and validation set according to the ratio of 7∶3. Multivariate stepwise logistic regression analysis was used to construct a MetS identification model and a nomogram. The screening performance of the nomogram was evaluated by the area under the ROC curve, and the net benefit of the model was calculated by decision curve analysis. Results The age-standardized prevalence of MetS was 42.22% among Chinese middle-aged and elderly people over 45 years old. The model showed that female, hyperlipidemia, diabetes, smoking, high systolic blood pressure, fast pulse, wide waist circumference, and high BMI were risk factors for MetS. The C-index of the model was 0.864. The optimal threshold probability of the nomogram was 0.407. The AUC of ROC curve in training set was 0.864(0.854-0.874), and the AUC of ROC curve in validation set was 0.857(0.842-0.873). When the threshold probability was set to 0.407, the sensitivity of the model was 80% (95%CI: 78.35%-81.67%), and the specificity was 78% (95%CI: 76.57%-79.51%). Decision curve analysis showed that 33 persons per 100 persons could be exempted from unnecessary MetS confirmatory tests when MetS screening was performed by using this model. Conclusion The prevalence of MetS is high in middle-aged and elderly people in China. The identification model constructed in this study is helpful for the early screening of mets in Chinese people over 45 years old.
    • Nursing Science
  • Construction of an accelerated recovery position management plan for patients after cesarean section
    TAN Mei, YANG Xiuchun
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 151-157.
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    Objective To construct a postoperative patient position management plan for cesarean section based on Accelerated Rehabilitation Surgery (ERAS). Methods According to the concept of accelerated rehabilitation surgery and clinical experience, the study group scientifically screened the literature, extracted and collected the evidence, and drew up the first draft of the postoperation Posture Management Plan for cesarean section patients. Through the expert meeting, verify the scientific nature of the proposal and revise the final draft. Results A total of 11 articles were screened out, 24 best evidences were extracted, and the postural management program was established by expert meeting, including 7 Management Timing, 7 management goals and 36 management content. The effective recovery rate of the expert meeting questionnaire was 100%, the expert authority coefficient (CR) was 0.94, and the Kendall coordination coefficient was 0.24(χ2=26.10, P<0.05). Conclusion The management plan of accelerating recovery posture for patients after cesarean section is reliable, the expert authority coefficient is high, the expert opinion tends to be consistent, and the contentis scientific and practical, it can provide reference for clinical nurses to guide patients’ early activities after cesarean section, and promote the application of ERAS in obstetrics.
  • The chain mediating effect of proactive personality and leisure crafting in ICU nurses on spiritual climate and innovative behavior
    ZHANG Zhenwei, QIN Hanzhi, CHEN Yejun
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 158-164.
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    Objective To explore the multiple mediating effects of proactive personality and leisure crafting on the influence of spiritual climate on innovative behaviors of ICU nurses. Methods A total of 428 ICU nurses from 15 hospitals in Anhui province were selected by convenience sampling method in May, 2023. By using General Data Questionnaire, spiritual climate scale, proactive personality scale, leisure crafting scale and innovation behavior scale, the chain mediation model was constructed and tested. Results The total score of spiritual climate, proactive personality, leisure crafting and innovative behavior of ICU nurses were (69.50±19.75), (53.80±7.24), (32.51±5.89) and (35.85±6.93) respectively. The indirect effect of spiritual climate on innovation behavior was established, the total indirect effect was 0.248; the specific intermediary effect of proactive personality accounted for 37.50% of the total indirect effect; The specific mediating effect of leisure crafting accounted for 36.69% of the total indirect effect; The chain mediating effect of proactive personality and leisure crafting in spiritual climate and innovative behavior accounted for 25.81% of the total indirect effect. Conclusion The innovative behavior of ICU nurses is in the upper middle level. The mediating role of proactive personality and leisure crafting in the spiritual climate and innovative behavior of ICU nurses is established. It is suggested that nursing managers should improve the working environment and organizational culture, enhance nurses' work enthusiasm, and create favorable conditions to increase their leisure crafting, so as to promote nurses' innovative behavior level.
  • A qualitative study on the factors affecting the psychological stress of donors unrelated to hematopoietic stem cell transplantion
    ZENG Qingling, LI Fang, WAN Huan, JIANG Si, XIAO Shan, CHEN Jianjun
    HuNan ShiFan DaXue XueBao(YiXueBan). 2024, 21(5): 165-170.
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    Objective Understand the influencing factors of psychological pressure of donors related to hematopoietic stem cell transplantation, and provide a basis for clinical nursing workers to formulate targeted psychological intervention strategies. Methods Using the purpose sampling method, 15 unrelated donors who completed hematopoietic stem cell donation within a week were selected as the research object, and the data were collected by face-to-face semi-structural interview method, and the data were analyzed through the phenomenological analysis method. Results The interview content is summarized into six themes: lackof knowledge, negative emotional experience (including five sub-themes, respectively, guilt, loss, fear, pain, anxiety ), family economic support, family member attitude, socialorganization support and policy support. Conclusions In the process of donation, unrelated donors often bear the psychological pressure brought by body, life and work. Medical staff should improve their health education, enhance donation awareness; guide positive emotions, do a good job in symptom management; encourage family members to participate, improve family support, increase publicity; and create a positive donation atmosphere to promote the development of hematopoietic stem cell transplantation.
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