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2024 Vol. 21 No. 3
Published: 2024-06-25
Basic Medicine
Clinical Medicine
Preventive Medicine
Nursing Science
Invited Review
Laboratory Medicine
Invited Review
1
HE Caimei, LIAO Zhuo'er, HE Zuping
Research advances in reprogramming somatic cells into stem cells and functional cells
Somatic cells could be reprogrammed into stem cells and functional cells. As an example, Sertoli cells can be reprogrammed into pluripotent stem cells and germline stem cells, and thus they have significant applications in both regenerative and reproductive medicine. Overexpression of specific genes initiates a regenerative process of cells, which provides novel approaches for reprogramming human somatic cells into stem cells and other cells. Somatic cells reprogramming controls the stemness maintenance of stem cells and fate determinations of these cells. In this review, we discuss the recent advances in reprogramming somatic cells into various kinds of stem cells and functional cells. We also address the applications in of stem cells and functional cells derived from somatic cells in translational medicine.
2024 Vol. 21 (3): 1-6 [
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Basic Medicine
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MA Yu, CHEN Wenxin, WU Wei, XU Boqun
Correlation between glycine and the pathogenesis of polycystic ovary syndrome
Objective
To investigate the association between glycine and the pathogenesis of PCOS.
Methods
Glycine levels were detected and correlation analysis was performed in 11 PCOS patients and 11 healthy women. Mouse models were constructed and divided into Ctrl group, Gly group, PCOS group, and PCOS+Gly group. Estrous cycle and ovarian morphology were observed. Sex hormone and lipid metabolism indicators were detected. RT qPCR was used to detect the mRNA levels of hormone synthase and sex hormone receptor in ovarian tissues.
Results
(1) Serum glycine levels in PCOS patients were decreased compared to the control group and the values of FAI, LH and LH/FSH levels in PCOS patients were increased, while SHBG were decreased. In the total sample population, glycine levels were positively correlated with SHBG and negatively correlated with FAI and LH/FSH ratio. Glycine reduced body weight and TC and LDL-C levels of PCOS mice. It also accelerated the recovery of estrus cycle, reduced the number of cystic follicles and hemorrhagic cysts, and downregulated the mRNA levels of CYP17A1, CYP19A1, FSHR, and LHR.
Conclusion
Serum glycine levels were positively correlated with SHBG, and negatively correlated with FAI and LH/FSH ratio. PCOS patients exhibited a decrease in glycine levels. Glycine improved the disorder of lipid metabolism in PCOS mice, restored normal estrus cycle, protected normal ovarian morphology and regulated sex hormone levels. Glycine may inhibit the occurrence and development of PCOS by regulating the expression of genes related to hormone synthesis.
2024 Vol. 21 (3): 7-15 [
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LIU Yan, LI Guoyan, CHEN Chao
Effect of lidocaine on the malignant biological behavior of glioma cells
Objective
To determine the effect of lidocaine on glioma in vitro and to investigate its mechanism.
Methods
The effects of lidocaine on glioma progression were investigated by methyl thiazolyl tetrazolium (MTT) assay, colony formation assay and Transwell assay. The expressions of CD133 and glial fibrillary acidic protein (GFAP) were analyzed by Western blotting to evaluate cell differentiation. The expressions of E-cadherin and N-cadherin were analyzed by Western blotting to evaluate cell metastasis. The activity of Sonic Hedgehog (SHH) /glial fibrillary acidic protein (GLI) family zinc finger 1(GLI) signaling pathway was analyzed by Western blotting.
Results
Lidocaine inhibited the proliferation, migration, invasion and differentiation induction of glioma cells in vitro, and decreased the protein expression of SHH and GLI, which was partially inhibited by SHH/GLI signaling pathway agonist (SAG) treatment.
Conclusion
Lidocaine inhibits the malignant progression of glioma by blocking the activity of SHH/GLI signaling pathway.
2024 Vol. 21 (3): 16-21 [
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FANG Qian, LI Yuqing, LI Keqing, DUAN Meiyu, LAI Sisi, TANG Zixing, YUAN Shishan, SHI Yan
Melatonin inhibits excessive mitophagy and improves cognitive impairment after stroke
Objective
This study aimed to investigate the protective effect and mechanism of melatonin (MT) in post-stroke cognitive impairment (PSCI).
Methods
Male C57BL/6J mice were randomly divided into Sham, Stroke, and Stroke+MT groups (n=7/group). Photothrombotic-induced stroke model mice were injected intraperitoneally with saline or MT (20 mg/kg) for 21 consecutive days after modeling. Behavioral tests were performed to examine the cognitive function of the mice, Nissl staining to detect neuronal damage, and Western blotting to detect apoptosis, synaptic plasticity and mitophagy.
Results
Compared with Sham mice, stroke mice showed a significantly reduction in the discrimination index in the novel object recognition test and the time spent in the novel arm of the Y maze. The number of neurons in the hippocampus and cortex were significantly reduced. The levels of proapoptotic proteins (Bax, cleaved Caspase-3) were upregulated, the levels of synapse-related proteins (PSD-95, Synaptophysin) were downregulated, and the levels of mitophagy-related proteins (PINK1, Parkin) were upregulated. MT significantly increased the discrimination index in the novel object recognition test and the time spent in the novel arm of the Y maze. The number of hippocampal and cortical neurons were significantly increased. The levels of proapoptotic proteins (Bax, cleaved Caspase-3) were downregulated, the levels of synapse-related proteins (PSD-95, Synaptophysin) were upregulated, and the levels of mitophagy-related proteins (PINK1, Parkin) were downregulated.
Conclusion
MT inhibited excessive mitophagy and ameliorated PSCI.
2024 Vol. 21 (3): 22-27 [
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Clinical Medicine
28
ZHU Liurong, HE Xuehua, YUAN Yonghua, XIA Xiaohui
Effects of gestational diabetes mellitus on neonatal heart disease and related influencing factors
Objective
To explore the effects of gestational diabetes mellitus on the neonatal heart and the risk factors for developing neonatal cardiac damage.
Methods
General data, maternal data and cardiac ultrasound data of 582 newborns in the First Affiliated Hospital of Hunan Normal University from 2018 to 2021 were retrospectively analyzed; Depending on whether the mother of the newborn is comorbid with gestational diabetes, were categorized into gestational diabetes group (GDM group) and non-gestational diabetes group (NGDM group), Comparing the differences between the two groups in terms of sex, gestational age, mode of delivery, birth weight, occurrence of cardiac damage, The distribution of the occurrence of cardiac damage in the two groups was counted; Further on whether the neonates in the GDM group had combined heart damage or not, they were categorized into cardiac and normal groups. To compare the differences in gender, gestational age, weight, neonatal birth glucose, mother's age, high-risk pregnancy complications, and mother's glycemic control patterns between the two groups in a univariate analysis, and further performed a multifactorial logistic regression analysis of risk factors for developing cardiac damage in neonates with gestational diabetes mellitus.
Results
There was no statistically significant difference between the GDM and NGDM groups in terms of sex, gestational age, and mode of delivery. Significantly more newborns developed cardiac damage and abnormal weight in the GDM group than in the NGDM group, and the difference was statistically significant; There were no statistically significant differences between the cardiac group and the normal group in terms of gender, age of the mothers, and mode of glycemic control of the mothers. But there was a statistically significant difference in the comparison of gestational age, birth weight, neonatal hypoglycemia and high-risk complications of pregnancy; Logistic regression analysis showed that mothers with gestational diabetes mellitus, when combined with high-risk complications of pregnancy, were at high risk for combined cardiac damage in their newborns (OR=1.796, 95% CI 1.045-3.086).
Conclusions
Newborns with gestational diabetes are more likely to develop heart damage. Among neonates with gestational diabetes mellitus, those with preterm, macrosomic and low-birth-weight infants, neonatal hypoglycemia, and high-risk complications of pregnancy are at greater risk for cardiac damage, in which high-risk complications of pregnancy are risk factors for neonatal heart damage.
2024 Vol. 21 (3): 28-31 [
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PENG Zehong, ZHU Xi, WEN Jianglong, ZHU Lili, ZHU Wenzhuo, LIU Chao, CHENG Heng, ZHANG Qi
Effects and possible mechanisms of acute short-term plateau exposure on the heart in young and middle-aged men
Objective
To observe the changes of myocardial enzymology, neuroendocrine and cardiac function in healthy young and middle-aged men before and after acute short-term plateau exposure; and to explore the effects and possible mechanisms of acute short-term plateau exposure on cardiac tissue cell function and neuroendocrine.
Methods
50 healthy young and middle-aged male volunteers were randomly selected to collect physiological indices: heart rate (HR), respiratory rate (R), systolic blood pressure (SBP), diastolic blood pressure (DBP), and oxygen saturation (SaO2) at 7: 00 am 1 day before entering plateau (100 m above sea level), and 15 days after short-term exposure to plateau in an acute condition (3 000 m above sea level) in a fasting and seated position; cardiac enzymology and neuroendocrine function of cardiac tissues and cardiovascular function of cardiac tissues and cardiac cells were detected by using a fully automated biochemical analyzer. Neuroendocrine-related indexes: thyroid stimulating hormone (TSH), total thyroxine (TT4), free thyroxine (FT4), free tri-iodothyronine (FT3), total tri-iodothyronine (TT3), and cortisol (CORT); and color Doppler ultrasound diagnostic instrument was used to check the cardiac function indexes: right ventricular internal diameter (RV), right atrial internal diameter (RA), left ventricular diastolic internal diameter (LV), and left atrial internal diameter (LA). (LV), left atrial internal diameter (LA), aortic root internal diameter (AO), pulmonary artery internal diameter (PA), left ventricular long-axis shortening (LVFS), left ventricular ejection fraction (LVEF), stroke volume (SV), and left ventricular end-diastolic volume (LVEDV), comparing differences in indicators before and after acute short-term plateau exposure.
Results
Compared with before entering the plateau, the physiological parameter indicators of young and middle-aged men after 15 days of acute short-term plateau exposure: HR increased significantly, R increased, SBP increased, SaO2 decreased, DBP increased, and MAP increased, and the differences were statistically significant; cardiac enzyme indicators: LDH, CK-MB, CK, HBDH, IMA, Mb, cTnT, and hs-CRP were significantly elevated, and the differences were all statistically significant; neuroendocrine-related indices: TSH, TT4, FT4, FT3, TT3, and CORT were significantly elevated; and cardiac function indices: RV, RA, LV, LA, LVFS, LVEF, and SV, LVEDV were all decreased, and AO and PA were all increased, and the differences were all statistically significant.
Conclusion
Short-term acute plateau exposure can lead to acute plateau hypoxic myocardial injury, which is mainly manifested as oxidative stress, resulting in damage to myocardial cell membranes and outflow of relevant cardiac enzymes from myocardial cell membranes, which to a certain extent caused a decrease in cardiac compensatory capacity.
2024 Vol. 21 (3): 32-36 [
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ZHU Jian, CHEN Silou, AI Liang, WANG Xiaofeng
The efficacy of balloon compression and radiofrequency thermocoagulation in the treatment of primary trigeminal neuralgia
Objective
To investigate the efficacy of percutaneous balloon compression (PBC) and radiofrequency thermocoagulation (RFT) in the treatment of primary trigeminal neuralgia and its effect on serum neurotransmitters.
Methods
100 patients with primary trigeminal neuralgia admitted to the pain department of our hospital from January 2021 to December 2022 were selected as the research objects. According to the random number table method, the patients were randomly divided into two groups.50 patients treated with RFT were in the RFT group, and 50 patients treated with PBC were in the PBC group. The clinical efficacy [barrow neurological institute (BNI) pain intensity scale], pain (numeric rating scales, NRS), serum neurotransmitters [serum substance P (SP), β-endorphin (β-EP) and 5-hydroxytryptamine (5-HT) ], sleep status and recovery quality [pittsburgh sleep quality index (PSQI) and postoperative quality of recovery-40 que were compared between the two groups.
Results
There was no significant difference in the total remission rate between the two groups at 3 days and 3 months after operation. There was no significant difference in NRS scores between the two groups before operation, 3 days after operation, 1 month after operation and 3 months after operation. At 3 days after operation, SP in both groups decreased, and that in the observation group was lower. β-EP and 5-HT in both groups increased, and those in the observation group were higher. Three days after operation, the PSQL scores of the two groups decreased, and that of the observation group was lower than that of the control group. The QoR-40 scores of the two groups did not increase, and there was no difference between the two groups. The incidence of hypoesthesia/facial numbness and masseter weakness in the observation group was higher than that in the control group, and the incidence of corneal discomfort was lower than that in the control group.
Conclusion
The clinical efficacy of PBC and RFT in patients with primary trigeminal neuralgia is similar.
2024 Vol. 21 (3): 37-41 [
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OUYANG yunjie, LIU Limin, CHEN Nishichun, YIN Xia
Preliminary study on STMN1 participating in radiotherapy resistance of NSCLC through apoptosis
Objective
To investigate whether the expression of STMN1 is related to the prognosis of non-small cell lung cancer (NSCLC) and the effect of radiotherapy.
Methods
Immunohistochemical staining (IHC) was used to detect the expression of STMN1 in NSCLC and normal tissues. The correlation between STMN1 expression level and clinicopathological characteristics of patients was analyzed, and the correlation between STMN1 expression level and progression-free survival (PFS) was studied. STMN1 was identified as an independent prognostic factor for radiotherapy resistance in stage III-IV NSCLC by univariate and multivariate regression analysis. Constructing STMN1 overexpressing plasmids and interfering cell models of A549 and H1299 cells by a lentivirus infection method, verifying the expression of STMN1 and p-STMN1 by a protein immunoblot technology (Western-blot, WB), The effect of STMN1 on radiosensitivity of NSCLC cells was investigated by flow cytotoxicity analysis. The effect of STMN1 on cell invasion and migration was investigated by transwel1 invasion and migration assay.
Results
The expression level of STMN1 in NSCLC was significantly higher than that in normal lung. The expression level of STMN1 was significantly correlated with tumor differentiation and TNM staging in NSCLC patients, but not with age, sex and histopathological classification. The median PFS in STMN1 overexpression NSCLC was significantly lower than that in STMN1 underexpression. The local control rate of STMN1 overexpression NSCLC after 2 months of radiotherapy was significantly lower than that of STMN1 underexpression. Overexpression of STMN1 inhibited X-ray induced apoptosis of lung cancer cells. After STMN1 overexpression, the invasion and migration of A549 and H1299 cells were significantly enhanced.
Conclusion
The high expression of STMN is closely related to the low differentiation and TNM staging of tumor. Therefore, STMN1 can be used as an indicator of poor prognosis and resistance to radiotherapy in patients with NSCLC.
2024 Vol. 21 (3): 42-50 [
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TANG Huichao, LI Man, WANG Dongmei, ZHOU Yu, PANG Jiuyan, YANG Wei, LIU Xingyu
Effects of grid like photocoagulation in macular region combined with ranzumab on serum VEGF and IL-6 levels in patients with diabetes macular edema
Objective
To explore the effect of grid like photocoagulation in the macular region combined with Leizumab on serum Vascular endothelial growth factor (VEGF) and interleukin-6(IL-6) levels in patients with diabetes macular edema (DME).
Methods
Patients with DME 98 cases admitted to Chengdu 363 Hospital from January 2021 to January 2023 were selected and randomly divided into two groups using a single blind randomized control method based on a random number table, with 49 patients in each group. The patients in the control group were treated with macular grid photocoagulation, and the patients in the observation group were treated with macular grid photocoagulation combined with leizumab. There were compared two groups preoperative, postoperative 1 month and 6 TMV, CME and corrected best visual, before operation and 6 months after operation serum VEGF and IL-6, and 6 months after operation curative effect.
Results
Compared preoperative, TMV and CME of to groups were decreased at postoperative 1 month and 6 months and in the observation group were lower than those in the Compared preoperative, two groups best corrected visual acuity were increased of postoperative 1 month and 6 months; at postoperative 1 month and 6 months, observation group best corrected visual acuity higher control group. Compared preoperative, two groups serum VEGF and IL-6 levels were decreased of postoperative 6 months; at postoperative 6 months, observation group serum VEGF and IL-6 levels lower control group. At postoperative 6 months, observation group total effective rate was higher than control group.
Conclusion
Macular grid photocoagulation combined with rezumab is effective in treating DME, it can effectively improve vision, and relieve macular edema, and reduce serum IL-6 and VEGF levels.
2024 Vol. 21 (3): 51-54 [
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SHANG Changqing, XU Ning, ZHANG Jian, LIU Haitao
Clinical Efficacy of Apremilast Combined with Hydroxychloroquine in the Treatment of Primary Sjögren's Syndrome
Objective
This study aimed to evaluate the clinical efficacy of Apremilast combined with Hydroxychloroquine in treating Primary Sjögren's Syndrome (PSS).
Methods
A retrospective study was conducted on 80 patients with primary Sjögren's Syndrome (PSS) treated at the Tongling City Hospital in Anhui Province from January 2019 to January 2023. Patients were divided into a combination therapy group (43 cases) who received treatment with Alramod combined with Hydroxychloroquine Sulfate tablets, and a control group (37 cases) who received Alramod alone. Clinical efficacy, salivary flow rate, tear secretion, Patient Reported Index in Sjögren's Syndrome (EULAR Sjögren's Syndrome Patient Reported Index, ESSPRI), Sjögren's Syndrome Disease Activity Index (EULAR Sjögren's Syndrome Disease Activity Index, ESSDAI), as well as levels of Erythrocyte Sedimentation Rate (ESR), C-reactive Protein (CRP), and Immunoglobulin G (IgG) were observed in both groups. Additionally, the incidence of adverse reactions in both groups was monitored.
Results
After treatment, the total effective rate of the combination group was higher than that of the control group; the saliva flow rate, tear secretion, ESSPRI, and ESSDAI scores of the combination group were better than those of the control group; the levels of ESR, CRP, and IgG in patients of the combination group were lower than those in the control group; there was no statistically significant difference in the incidence of adverse reactions between the two groups.
Conclusion
The combination of Elamod and Hydroxychloroquine Sulfate Tablets in the treatment of patients with primary Sjogren's Syndrome can significantly improve saliva and tear secretion, reduce inflammatory indicators, and has good safety, providing an effective combination therapy for the treatment of PSS.
2024 Vol. 21 (3): 55-58 [
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ZHANG Longhui, CHEN Min, ZHA Zhengjiang, LUO Bin, CHENG Shaowen, SHI Zhengsheng
Clinical effect of Enterprise stent combined with coil embolization in the interventional treatment of intracranial wide-necked aneurysms
Objective
To observe the clinical effect of Enterprise stent combined with coil embolization in the interventional treatment of intracranial wide-necked aneurysms (IWA).
Methods
The data of patients with IWA admitted to our hospital from September 2021 to June 2023 were retrospectively analyzed. According to the use of stents, they were divided into LVIS group (LVIS stent combined with coil embolization) and Enterprise group (Enterprise stent combined with coil embolization). The propensity score matching method (the caliper value was set to 0.01, and the two groups were matched by 1: 1. Finally, 54 patients with balanced baseline data were obtained in each group. The effect of aneurysm embolization (immediately after operation, 6 months after operation, postoperative complications (aneurysm rebleeding, vasospasm, stent thrombosis), prognosis [modified Rankin scale (mRs) ], quality of life (SF-36) were compared between the both groups.
Results
At 6 months after surgery, the embolization effect in LVIS group and Enterprise group revealed that there was no statistical difference by rank sum test compared with that immediately after surgery. Rank sum test showed no statistical significance in the embolization effect between groups immediately after surgery and at 6 months after surgery. There were no statistical differences in complications between groups. At discharge, chi-square test revealed no statistical significance in the prognosis between both groups. At 6 months after surgery, the prognosis in LVIS group and Enterprise group was better than that at discharge by chi-square test, but no statistical difference was shown in prognosis between groups at 6 months after surgery. At 6 months after surgery, SF-36 score in LVIS group and Enterprise group was risen compared to before surgery by paired t test, and the difference before surgery and at 6 months after surgery between groups showed no statistical difference by t test.
Conclusion
The effect of Enterprise stent combined with coil embolization and LVIS stent combined with coil embolization IWA is equivalent, which can significantly advance quality of life of patients, but the short-term effect of Enterprise stent assisted treatment is not as good as LVIS stent.
2024 Vol. 21 (3): 59-62 [
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GUO Wei, XIANG Liping, SONG Xiaoling
The anti-inflammatory role of Ruyi golden powder in skin and external diseases with Yang syndrome and its impact on NLRP1/Caspase-1 pathway
Objective
This study aims to explore the role of Ruyi Gold en Powder on inflammation and redness and swelling, heat and pain syndrome in skin and external diseases with Yang yndrome (SKDYS), and preliminarily reveal the influence of Ruyi Golden Powde on NLRP1/caspase-1 pathway in SKDYS. The findings in this study can provide strong clinical basis for following basic research.
Methods
A total of 105 patients with SKDYS admitted to the hospital from February 2021 to January 2023 were divided into control group receiving external application of fluoxetine (n=35) and observation group receiving external application of Ruyi Golden Powder (n=70) according the treatment method. Clinical efficacy of control and observation group was compared. Also, extent of redness and swelling, pain score, white blood cell level, neutrophil percentage, serum NLRP1, serum Caspase-1, and serum IL-1β and serum IL-18 of the two group before and after a 21-days of treatment were compared.
Results
Compared with before treatment, after 21 days of treatment both of two groups showed the significant decrease of the extent of redness and swelling, pain scores, white blood cell levels, neutrophil percentage, serum IL-1β, serum IL-18, serum NLRP1 and serum Caspase-1. After 21 days of treatment, compared with control group, observation group developed an increase in clinical efficacy, and the decreases in the extent of redness and swelling, pain score, white blood cell level, neutrophil percentage, and serum IL-1β, serum IL-18, serum NLRP1 and serum Caspase-1.
Conclusion
Ruyi Golden Powder effectively improved redness and selling and heat and pain of patients with SKDYS, and significantly inhibited the inflammatory response and NLRP1/Caspase-1 pathway in these patients. This study suggests the potential mechanism of Ruyi Golden Powder in treating SKDYS based on the NLRP1/Capase-1 pathway, providing a strong preliminary basis for following basic experiments.
2024 Vol. 21 (3): 63-68 [
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CHEN Yan, WANG Yanting, MA Yanan, SU Na, LI Xiaomin, LI Yingjie, JIANG Yuxi
Clinical application of 3D-SWE combined with BI-RDS-US classification in qualitative diagnosis of breast nodules
Objective
To investigate the value of three-dimensional shear wave elastography (3D-SWE) combined with ultrasonographic subcategorization of Breast Imaging Reporting and Data System (BI-RDS-US) in qualitative diagnosis of breast nodules.
Methods
A total of 120 female patients with breast nodules who were admitted to the hospital from January 2020 to March 2022 were selected. The properties of their lesions were confirmed by pathology, and all subjects underwent conventional ultrasound (US) examination. The Bi-MADS-US classification standard was used to judge benign and malignant nodules.3D-SWE was performed to measure the maximum elasticity (Emax) of the hardest part of the nodule and the elasticity ratio of surrounding adipose tissues (Eratio) on different planes of benign and malignant nodules. With pathological results as the golden standard, diagnostic efficacy of the two methods for breast nodules was comparatively analyzed.
Results
Pathological results showed that there were a total of 120 lesions in 120 patients with breast nodules, including 92 benign nodules and 28 malignant nodules. The results of BI-RADS-US classification showed that there were 85 benign nodules and 35 malignant nodules. Emax and Eratio on different planes of malignant nodules were higher than those of benign nodules. ROC curve analysis results showed that the sensitivity and specificity of BI-MADS-US classification for diagnosing benign and malignant breast nodules were 93.00% and 87.00%, respectively. The area under the curve (AUC) of sagittal Eratio in 3D-SWE for diagnosing benign and malignant breast nodules was the largest (0.884), and the corresponding cut-off value was 3.39 kPa. The sensitivity and specificity were 86.00% and 89.00%. The AUC, sensitivity and specificity of sagittal Eratio combined with BI-RDS-US classification were 0.960, 96.00% and 96.00%, which were higher than those of single diagnosis.
Conclusion
3D-SWE combined with BI-RDS-US classification can improve the diagnosis of breast nodules, reduce unnecessary surgery or needle biopsy, and avoid overtreatment.
2024 Vol. 21 (3): 69-72 [
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CHEN Zhifu, DENG Jihong, LI Lijuan
Clinical Significance of the Changes of Plasma S100 Calcium Binding Protein A9 and Four Coagulation Parameters in Patients with Secondary Pulmonary Tuberculosis
Objective
To investigate the clinical significance of the changes of plasma S100 calcium binding protein A9(S100A9) and four coagulation parameters in patients with secondary pulmonary tuberculosis.
Methods
A total of 217 patients with secondary pulmonary tuberculosis diagnosed in Guang'an People's Hospital from March 2021 to March 2023 were selected, and they were given 6 months of anti-tuberculosis treatment. Plasma S100A9 and four coagulation parameters [fibrinogen (FIB), thrombin time (TT), activated partial thromboplastin time (APTT) and prothrombin time (PT) ] were compared before and after treatment. After 6 months of standard treatment, patients in the observation group were divided into negative conversion group and non-negative conversion group based on treatment outcomes. Clinical data, S100A9 level and four coagulation parameters were compared between the two groups. The influencing factors of treatment outcome were analyzed. The diagnostic value of S100A9, PT, APTT, TT, and FIB in secondary pulmonary tuberculosis was analyzed using the area under the receiver operating characteristic (ROC) curve (AUC).
Results
S100A9, PT, APTT and FIB level were significantly higher and longer before treatment than after treatment. TT was significantly shorter before treatment than after treatment. After 6 months of standard treatment, the results of sputum smear testing for mycobacterium tuberculosis showed that there were 196 patients with negative conversion and 21 patients without. There were statistically significant differences in age, S100A9, PT, APTT and TT between the two groups. Binary logistic regression analysis found that age >60 years, high S100A9 level, long PT, long APTT and high FIB level were independent risk factors for treatment outcomes of secondary pulmonary tuberculosis, while long TT was a protective factor. The AUC values of S100A9, PT, APTT, TT, and FIB were 0.838, 0.710, 0.833, 0.841, and 0.649, respectively.
Conclusion
There are significant changes of S100A9 and four coagulation parameters in patients with secondary pulmonary tuberculosis. These parameters are closely related to the outcome of anti-tuberculosis treatment, and can serve as laboratory indicators for auxiliary diagnosis of secondary pulmonary tuberculosis.
2024 Vol. 21 (3): 73-77 [
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LI Hongying, YANG Jing, YANG Bin, KUANG Jingjie, LONG Yan
Study on the effect of Shakubaqu Valsartan sodium on chronic heart failure with hypertension and ventricular remodeling in patients with different courses of disease
Objective
To investigate the effects of sacubatrovalsartan sodium on chronic heart failure with hypertension and ventricular remodeling in patients with different courses of disease.
Methods
A total of 128 patients with chronic heart failure and hypertension admitted to our hospital from October 2021 to October 2022 were prospectively selected and divided into long course group and short course group according to the different course of disease, 64 cases each. The long-term group consists of patients with chronic heart failure and hypertension who have a disease course of more than 3 years; The short course group refers to patients with chronic heart failure and hypertension who have a course of 3 years or less. Both groups of patients were treated with Sacubatrovalsartan sodium. Compare the clinical outcomes, ventricular remodeling, and quality of life between the two groups of patients before and after treatment, as well as the event free survival status at a follow-up of 12 months.
Results
The total effective rate in the short course group (98.44%) and the long course group (78.12%) was significantly higher. After treatment, the level of left ventricular ejection fraction (LVEF) in the short course group was higher than that in the long course group, while the levels of interventricular septum thickness (IVS), left ventricular end systolic diameter (LVSD), left ventricular posterior wall thickness (LVPW) and left ventricular end diastolic diameter (LVEDD) were lower than those in the long course group. After treatment, the scores of physical, emotional and other fields and the Minnesota Heart Failure Quality of Life Scale (MLHFQ) in the short course group were lower than those in the long course group. The 12-month event-free survival rate in the short course group (98.44%) was higher than those in the long course group(89.06%).
Conclusion
Compared with patients with chronic heart failure and hypertension with a course of more than 3 years, Sakubactril valsartan sodium significantly improved the clinical outcome of patients with chronic heart failure and hypertension with a course of less than 3 years, and significantly improved ventricular remodeling, quality of life and event-free survival at 12 months follow-up.
2024 Vol. 21 (3): 78-81 [
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HE Jia, WU Niansheng, WANG Dongxue, WANG Hui, ZHANG Yuedong
Application of ultrasound-guided transversal abdominis plane block combined with rectus sheath block during gynecological laparoscopic surgery
Objective
To explore the application of ultrasound-guided transversal abdominis plane block (TAPB) combined with rectus sheath block (RSB) during gynecological laparoscopic surgery.
Methods
80 patients with gynecological laparoscopic surgery who received treatment in Anqing First People’s Hospital of Anhui Medical University from March 2021 to March 2023 were included and randomly divided into single group and combined group with 40 cases in each group. The single group received total intravenous anesthesia, and the combined group was given total intravenous anesthesia + TAPB combined with RSB anesthesia. Surgical indicators were compared between the two groups, and the hemodynamics [heart rate (HR), mean arterial pressure (MAP), oxygen saturation (SpO
2
) ] before anesthesia (T0), immediately after skin resection (T1) and at the end of surgery (T2). stress response indicators [C-reactive protein (CRP), interleukin-6(IL-6), tumor necrosis factor-α (TNF-α) ] at T0 and at 12 hours after surgery and analgesic effect [Visual Analogue Scale (VAS) ] at 4, 8 and 12 hours after surgery were compared between the two groups of patients.
Results
The spontaneous breathing time, first ambulation time and first exhaust time in combined group were shorter than those in single group. HR at T0-T2 in both groups was increased first and then decreased, and HR at T1 in combined group was lower than that in single group, and MAP was decreased first and then increased, and MAP in combined group at T1 was higher than that in single group. The levels of CRP, IL-6 and TNF-α in the two groups at 12 hours after surgery were enhanced compared with those at T0, but the levels in combined group were lower than those in single group. VAS score in combined group was lower than that in single group at 4, 8 and 12 hours after surgery.
Conclusion
TAPB combined with RSB has a good analgesic effect during gynecological laparoscopic surgery, and can stabilize the hemodynamics and relieve the stress response and postoperative pain.
2024 Vol. 21 (3): 82-85 [
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86
HOU Lin, WU Xue, SUN Ziguo
Analysis of the application effect of dobutamine in septic shock patients
Objective
To explore the influence of dobutamine on blood lactic acid, cardiorenal function and tissue perfusion in patients with septic shock.
Methods
Patients with septic shock were retrospectively analyzed in our hospital from December 2020 to December 2023. Both groups were given conventional treatment, and were divided into a conventional group and a DOB group according to different treatment plans. The conventional group received norepinephrine treatment, while the DOB group received a combination of dobutamine treatment on this basis. After propensity matching to exclude confounding factors, 51 patients with no significant differences in baseline data were obtained in each group. The changes of heart rate (HR), blood pressure (BP), mean arterial pressure (MAP) and blood lactic acid (LAC) before treatment and on the 1
st
day, 3
rd
day and 7
th
day of treatment, changes of cardiac function [left ventricular ejection fraction (LVEF), cardiac index (CI), global end-diastolic volume index (GEDVI) ], renal perfusion [urine volume (UV), serum creatinine (Scr) ] and renal filtration function [filtered water excretion fraction (FEH
2
O), filtered sodium excretion fraction (FENa) ] before treatment and on the 7
th
day of treatment and mortality within 28 days were compared between groups.
Results
There were significant differences in HR, BP, MAP and LAC from the aspects of between groups. On the 1
st
day, 3
rd
day and 7
th
day of treatment, HR and LAC in DOB group were significantly lower than those in conventional group, and BP and MAP were significantly higher than those in conventional group. After 7 days of treatment, LVEF, CI and GEDVI in the two groups were increased significantly, and the DOB group had significantly higher LVEF, CI and GEDVI. UV in both groups after 7 days of treatment was risen significantly while Scr was declined significantly, and UV in DOB group was significantly higher while Scr was significantly lower compared to conventional group. After 7 days of treatment, FEH
2
O in both groups was significantly enhanced while FENa was significantly reduced, and FEH2O in DOB group was significantly higher than that in conventional groupwhile FENa was significantly lower. The number of dead cases within 28 days and average survival time were 11 cases (21.57%) and (24.96±6.37) d in conventional group and those in DOB group were 13.73% and (27.04±3.02) d. There was no significant difference in prognosis between the two groups.
Conclusion
Dobutamine can effectively improve cardiac function and renal function and enhance tissue perfusion in patients with septic shock.
2024 Vol. 21 (3): 86-90 [
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91
TAN Chuang, WU Chuanfang, SHU Ling, LU Zhi, ZHAO Hong, Rao Qin, Duan Lei
Effects of multicomponent exercise program on inflammatory factors and oxidative stress in frail elderly patients with pulmonary tuberculosis
Objective
The aim of this study was to evaluate the effect of multicomponent exercise program on inflammatory factors and oxidative stress in frail elderly patients with pulmonary tuberculosis.
Methods
66 frail elderly patients with pulmonary tuberculosis in Chest Center of Changsha hospital from April to October 2021 were selected by use of convenience sampling method, they were randomly divided into the intervention group (n=34) and the control group (n=32). In the control group, the routine care including tuberculosis care, nutritional guidance and exercise guidance was provided. In the intervention group, 12 weeks of multicomponent exercise in addition to routine care was provided. This study collected the baseline characteristics and compared the blood inflammatory biomarkers including interleukins 6(IL-6) and tumor necrosis factor-α (TNF- α) and C-reactive protein (CRP) and the superoxide dismutase (SOD) levels, frailty state
Results
After the intervention, the BMI of the intervention group was higher than that before and the control group, the weakness score was lower than that before and the control group, and the expression levels of serum IL-6, TNF-α, CRP and SOD were lower than that before and the control group.
Conclusion
Multicomponent exercise can effectively improve the elderly pulmonary tuberculosis patients’ frailty state, reduce expression of proinflammatory cytokines and superoxide dismutase levels.
2024 Vol. 21 (3): 91-95 [
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96
MA Qingchuan, MU Ni, WU Xi, YAN Liangliang
Relationship between CYP2C19 gene polymorphism and curative effect of butyphthalide in acute cerebral infarction
Objective
To explore the relationship between gene polymorphism of cytochrome P450 2C19(CYP2C19) and curative effect of butyphthalide in acute cerebral infarction (ACI).
Methods
A total of 216 patients with ACI were enrolled as the research objects between February and December 2023. All patients were treated with butyphthalide, and blood concentration of butyphthalide was detected after 7d of treatment. According to scores of National Institutes of Health Stroke Scale (NHISS), patients were divided into effective group (NHISS score decreased by ≥45%, n=112) and ineffective group (NHISS score decreased by <45%, n=104). CYP2C19 gene polymorphisms were detected by high-throughput genotyping technique. The effects of CYP2C19 gene polymorphisms on curative effect of butyphthalide in ACI patients were analyzed by multivariate Logistic regression analysis.
Results
After 7d of treatment, scores of NIHSS and mRS were decreased, and ADL score was increased. After 7d of treatment, blood concentration of fast-metabolism butyphthalide was higher than that in intermediate-metabolism and slow-metabolism butyphthalide. The frequencies of GG gene at CYP2C19*2 and CYP2C19*3 loci in effective group were higher than those in ineffective group. Binary Logistic regression analysis showed that atrial fibrillation (OR=2.366, P=0.019), NIHSS score before treatment (OR=2.358, P=0.016), CYP2C19*2(OR=4.423, P<0.001) and CYP2C19*3(OR=2.316, P=0.028) were all independent risk factors affecting the curative effect of butyphthalide in ACI patients.
Conclusion
The polymorphisms of CYP2C19 gene are related to the curative effect of butyphthalide in ACI, and curative effect is worse in patients with A allele.
2024 Vol. 21 (3): 96-99 [
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DENG Jiaying, LIN Lixia, HUANG Yuxin, CHEN Sida, SHEN Qiaopin, ZHANG Meijuan, LIU Buping
Meta-analysis and Trial Sequence Analysis of Hamilton Scale in the Treatment of Perimenopausal Depression Disorder by Acupuncture and Moxibustion
Objective
To systematically evaluate and sequentially analyze the efficacy of acupuncture and moxibustion in treating perimenopausal depressive disorder (PDD) with Hamilton Depression Scale (HAMD).
Methods
A comprehensive search for randomized controlled trials (RCTs) involving acupuncture and moxibustion for PDD published until December 1, 2022, was conducted in CNKI, VIP, CBM, WANFANG, PubMed, Cochrane Library and Embase . Improved Jaded score was used to evaluate the quality of evidence, . Meta-analysis was performed with Revman5.3, and TSA 0.9.5.10 Beta software was used for trial sequential analysis (TSA).
Results
39 literatures (2729 cases) were included. The effective rate of HAMD-17、HAMD-24 in acupuncture and moxibustion were higher than western medicine. HAMD-17and HAMD-24 score of acupuncture and moxibustion at 6 weeks, 8~12 weeks and follow-up were lower than that of western medicine alone. But there was no significant difference in the the effective rate of HAMD-21 and in decreasing HAMD-21 score. TSA confirms result of effective rate of HAMD-17, but which of HAMD-21 and HAMD-24 need further verification.
Conclusion
Acupuncture and moxibustion has advantages in improving HAMD-17、HAMD-24 score compared with Western medicine alone in PDD treatment.
2024 Vol. 21 (3): 100-109 [
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110
LI Xiaoning, TIAN Min, LIN Ting, JING Hua, XING Binyu, SHEN Cunyi, ZHANG Huilin, SU Juan
A study on the timing of liver transplantation in autoimmune hepatitis based on bilirubin and international standardized ratios
Objective
Application of bilirubin and international standardized ratio to predict the timing of liver transplantation in autoimmune hepatitis (AIH).
Methods
This was a retrospective cohort study conducted in our hospital from January 2018 to October 2022, and 52 AIH patients were selected as the research objects. The baseline international normalized ratio (INR), the change of INR and the change of total bilirubin within 3 days after starting corticosteroid treatment were recorded on the first day (D0) and the third day (D3) to calculate the SURFASA score. The performance of SURFASA in predicting the response to corticosteroid therapy was evaluated by the area under the operator characteristic curve (AUC) of subjects.
Results
Of the 52 patients, 38(73.1%) responded to corticosteroids, 10(19.2%) received liver transplantation, and 4(7.7%) died of infectious complications. SURFASA score of respondents[-4.40 (-4.82, -3.82)] was significantly lower than that of non-responders [-1.83 (-2.37, -1.84)]. INR (D3) [OR=6.85; 95%CI 2.23-7.06; P<0.001)] and SURFASA [OR=6.97; 95%CI 1.59-30.46; P<0.001) ] was independently related to corticosteroid unresponsiveness. SURFASA score (AUC=0.96, 95%CI 0.92-1.00) had excellent performance in predicting treatment response. The sensitivity, specificity, PPV and NPV of excluding corticosteroid response with a score higher than -2.6 were 85.7%, 100%, 100% and 95%, respectively.
Conclusions
SURFASA score has the highest AUC in early identification of unresponsiveness to corticosteroids in patients with AIH, indicating that it may be a valuable tool for rapid evaluation of liver transplantation.
2024 Vol. 21 (3): 110-114 [
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115
XU Jing, SUN Guangyang, ZHAO Jinfeng, ZHANG Yiwei
Effect of Xiaoxingnao acupuncture method combined with ultrasonic directional drug penetration therapy in the treatment of patients with post-stroke shoulder-hand syndrome (phlegm-stasis blocking collateral syndrome)
Objective
To observe the effect of Xiaoxingnao acupuncture method combined with ultrasonic directional drug penetration therapy in the treatment of patients with post-stroke shoulder-hand syndrome (phlegm-stasis blocking collateral syndrome).
Methods
A total of 120 patients with post-stroke shoulder-hand syndrome (phlegm-stasis blocking collateral syndrome) who were admitted to Zhangjiakou First Hospital from June 2021 to February 2022 were enrolled in this study. They were randomly assigned to two groups.60 patients in the control group were given ultrasonic directional drug penetration therapy, while 60 patients in the experimental group were treated with Xiaoxingnao acupuncture method combined with ultrasonic directional drug penetration therapy. The two groups were compared on therapeutic effects, traditional Chinese medicine syndrome scores, upper limb motor function, activities of daily living, and serum levels of substance P (SP) and calcitonin gene-related peptide (CGRP).
Results
The response rate of the experimental group was 95.00%, higher than 81.67% of the control group. After treatment, traditional Chinese medicine syndrome scores of both groups decreased, and the experimental group had lower scores. The Fugl-Meyer Assessment Scale (FMA) scores for motor function, Barthel index scores in different dimensions and total scores of both groups increased. Compared with the control group, the experimental group had higher scores. After treatment, there were decreases in serum SP levels in both groups, and serum SP level in the experimental group was lower than that in the control group. There were increases in CGRP levels, and CGRP level in the experimental group was higher than that in the control group.
Conclusion
Xiaoxingnao acupuncture method combined with ultrasonic directional drug penetration therapy can significantly improve the therapeutic effect on patients with post-stroke shoulder-hand syndrome (phlegm-stasis blocking collateral syndrome), improve traditional Chinese medicine syndrome scores and upper limb motor function, enhance activities of daily living, and improve serum SP and CGRP levels.
2024 Vol. 21 (3): 115-119 [
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120
YANG Kun, LIU Yingchao, LIU Yanhui
Correlation studies of endoplasmic reticulum stress markers in placental dysfunction in gestational diabetes mellitus
Objective
To investigate the role of endoplasmic reticulum stress markers in peripheral blood mononuclear cells (PBMCs) of patients with gestational diabetes mellitus (GDM) in placental dysfunction.
Methods
Select 100 singleton patients with 30-32 weeks of pregnancy who received outpatient or inpatient treatment at our hospital from January 2022 to June 2023. Among them, 50 outpatient patients were the control group with normal blood glucose regulation during pregnancy.50 hospitalized patients with GDM during mid pregnancy (24-28 weeks of pregnancy) were selected as the study group to achieve blood glucose control through diet or insulin therapy. Expression of endoplasmic reticulum stress (ERs) pathway related biomarkers, including activating transcription factor 4(ATF4) and enhancer binding protein homologous protein (CHOP), analyzed by PCR
Results
Compared with the control group, fasting blood glucose, blood glucose at 2 hours after 75 g glucose loading, sFlt-1 and sFlt-1/PLGF ratio in GDM group increased significantly, and PLGF level decreased significantly. Compared with the control group, the expression of ATF4 and CHOP genes in monocytes in GDM group increased significantly. For the whole cohort, the expression of ATF4 and CHOP genes in peripheral blood monocytes increased with the increase of sFlt-1/PLGF ratio (F=60.79, 25.58, all P<0.001). Correlation analysis showed that the expression of ATF4 and CHOP genes was positively correlated with the ratio of sFlt-1/PLGF. According to ROC analysis, it was found that the AUC of ATF4 in predicting GDM was 0.801, the sensitivity was 92.1%, and the specificity was 76.0%. The AUC of CHOP for predicting GDM was 0.738, and it had a sensitivity of 75% and a specificity of 80%.
Conclusions
GDM has adverse effects on placental function. ATF4 and CHOP may be potential markers for early detection of placental endothelial dysfunction in the fetus.
2024 Vol. 21 (3): 120-125 [
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126
LIU Silan, HUANG Han, ZHONG Lili, PENG Li, LIN Lin, WEI Sangzi
Relationship between IFN -λ1 expression level and adenovirus load in children with adenovirus pneumonia
Objective
To study the expression of IFN-λ1 in respiratory epithelial cells infected with human adenovirus (HAdV).
Methods
143 children hospitalized with adenovirus pneumonia from January to December, 2019 were selected as the HAdV group, and 35 patients with negative sputum culture and seven respiratory antigens were selected as the control group. Nasopharyngeal swabs were collected to extract nucleic acids, and the viral load, IFN-λ1mRNA expression level and HAdV sequencing typing were detected by fluorescence quantitative PCR.
Results
The expression levels of IFN-λ1mRNA in HAdV group and HAdV group at different ages, simple infection group, mixed infection group, severe group, non-severe group, HAdV-3 group and HAdV-7 group were lower than those in the control group (P<0.05). The HAdV load in severe group was higher than that in non-severe group (P<0.05). The expression level of IFN-λ1mRNA in HAdV group, severe group and HAdV-7 group was correlated with viral load (P<0.01).
Conclusion
The severity of adenovirus pneumonia in children is related to the viral load but not to the expression of IFN-λ1, and the expression level of IFN-λ1 is decreased, suggesting that IFN-λ1 may be involved in the disease process of adenovirus infection.
2024 Vol. 21 (3): 126-131 [
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132
WANG Xiaoqiong, YIN Xiaomei, ZHANG Beibei, FANG Xialing
The value of Galectin-9 in children with sepsis complicated with acute respiratory distress syndrome
Objective
To explore the clinical value of galectin -9(Gal-9) in differentiating acute respiratory distress syndrome (ARDS) from sepsis in children.
Methods
This study was a retrospective analysis. From March 2020 to May 2022, pediatric patients aged from 1 month to 18 years in PICU of the First Affiliated Hospital of Xi
'
an Jiaotong University were recruited as the research object. Patients were divided into sepsis group without ARDS (n=60) and sepsis group with ARDS (n=60). The levels of plasma Gal-9 and inflammatory molecules IL-6, TNF-α and IL-1β were analyzed by ELISA kit. Spearman correlation coefficient was used to analyze the correlation between plasma Gal-9 and inflammatory molecules. The diagnostic value of plasma Gal-9 in sepsis complicated with ARDS was analyzed by ROC curve. Patients were divided into two groups according to the Gal-9 critical value, and the survival curves of the two groups were compared.
Results
Compared with sepsis without ARDS, the levels of Gal-9, IL-6, TNF-α and IL-1β in sepsis with ARDS increased significantly. The level of plasma Gal-9 was positively correlated with the levels of TNF-α, IL-6 and IL-1β (r=0.391, 0.427 and 0.296, all P<0.05). When the critical value of Gal-9 was 265 pg/ml, the AUROC of Gal-9 was 0.804(95%CI 0.684-0.883, P<0.001). The sensitivity and specificity of plasma Gal-9 level in predicting sepsis with ARDS were 0.853 and 0.600, respectively, and the PPV, NPV and Youden indexes were 69.1%, 81.8% and 0.367, respectively. In patients with sepsis and sepsis complicated with ARDS, the 28-day survival rate was significantly lower when the Gal-9 level was ≥265 pg/mL than when the Gal-9 level was <265 pg/mL.
Conclusions
Gal-9 can be used as a biomarker for early prediction of ARDS in septic patients, and it is helpful to predict the survival rate.
2024 Vol. 21 (3): 132-136 [
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137
PENG Yue, LI Cuiying, ZU Yue'e, TAN Kuiling, LIU Jiaojiao, XIONG Lifang, ZHANG Shusheng
Application effect of Waff core exercise in postpartum rectus abdominis separation
Objective
This study aims to investigate the clinical efficacy of Waff core exercise in treating postpartum rectus abdominis separation, with the goal of improving patients’ morphological abnormalities, alleviating postpartum pain, and addressing other related issues.
Methods
From January 2022 to April 2023, a total of 80 patients with rectus abdominis separation were recruited from our hospital. The participants were randomly divided into two groups: control group (n=40) and observation group (n=40). The control group received low-frequency electrical stimulation and manual massage treatment, while the observation group underwent Waff exercise for rectus abdominis treatment. Each group completed a full course of treatment consisting of 10 sessions within a period of 2 months. After completion, changes in abdominal circumference and rectus abdominis separation, relief from waist and abdominal pain (measured using visual analogue scale VAS score), as well as improvements in quality of life (assessed by SF-36-PF) were compared between the two groups.
Results
Both treatments could effectively reduce the abdominal circumference and improve the separation of rectus abdominis muscle, and there were significant differences in the umbilical, umbilical and subumbilical abdominal circumference. In addition, compared with electrical stimulation and massage, Waff core exercise shows a more significant healing effect, which can effectively relieve lumbar and abdominal pain while strengthening core strength and improve the quality of life of postpartum women.
Conclusion
Rehabilitation through Waff exercise significantly improves postpartum rectus abdominis separation when compared to traditional conventional treatments. It also provides additional benefits for postpartum women suffering from waist and abdominal pain. Therefore, it is recommended for promotion and application in clinical settings.
2024 Vol. 21 (3): 137-140 [
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Laboratory Medicine
141
CAI Xiuyi, WANG Hongbo, TAN Zhixia, LIU Yuanqi, LIU Jiaxin, CAO Xiaomei, ZHANG Biming, YE Xiangli
Analysis of bacterial distribution and drug resistance of 526 patients with diabetes mellitus complicated by urinary tract infection in a hospital of Hunan
Objective
To study the pathogenic bacteria distribution and drug resistance of urinary system infection in inpatients with diabetes, and to provide scientific basis for clinical screening of antibiotics to guide rational drug use.
Methods
526 midcourse urine samples from inpatients with diabetes complicated with urinary system infection in a hospital of Hunan Province from January 2021 to May 2023 were selected, and then isolation culture and drug sensitivity experiments were carried out to observe and compare the distribution of pathogenic bacteria and drug resistance rates among patients of different genders and ages.
Results
A total of 609 strains of bacteria were isolated and cultured. The main strains of Gram-negative bacteria (G
-
) were Escherichia coli and Klebsiella pneumoniae, and the main strains of Gram-positive bacteria (G
+
) were Enterococcus faecium and Enterococcus faecalis. The resistance rate of Escherichia coli to levloxacin and ciprofloxacin was 77.83% and 66.02%, respectively, and it was highly sensitive to tigacycline and colistin. The resistance rate of Klebsiella pneumoniae to levofloxacin was the highest (60.27%). Among the main G
+
bacteria, Enterococcus faecium had high resistance rates to penicillin, ampicillin, ciprofloxacin, levofloxacin and erythromycin (98.17%, 92.66%, 88.07%, 93.58%, 93.58%), and was sensitive to quinuptidine/dafoptidine, linezolid, vancomycin, tetracycline and tigacycline, respectively. Enterococcus faecalis had high resistance rates to erythromycin, tetracycline, quinuptine/Dafoptene (96.67%, 96.67%, 76.67%, respectively), and was highly sensitive to penicillin, ampicillin, ciprofloxacin, levofloxacin, vancomycin and tigacycline. Escherichia coli accounted for the highest proportion in different gender groups, and the isolation rate of Escherichia coli in female patients was significantly increased. In different age groups, with the increase of host age, the sensitivity of Escherichia coli to different antibiotics showed different trends.
Conclusion
The main pathogenic bacteria in patients with diabetes complicated with urinary system infection are gram-negative bacteria, and the resistance rate of these pathogenic bacteria to commonly used antibiotics is significantly different, and it changes with the difference of gender and age. This study provides a basis for the rational clinical use of drugs in Hunan Province, the prevention of the spread of drug-resistant bacteria, and the active exploration and research of new treatments to deal with the increasingly severe situation of bacterial resistance.
2024 Vol. 21 (3): 141-145 [
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146
LI Duo, LI Min, GUO Jingwei, LIU Miao, Tan Yunhong, HUANG Haowen, YUAN Shishan
Detection of Mycobacterium tuberculosis CFP10 with visual biosensor based on Aptamer and AuNCs
Objective
A visual biosensor based on aptamer of CFP10 and AuNCs mimetic enzyme was established to detect Mycobacterium tuberculosis CFP10 in serum of tuberculosis patients and provide a new strategy for assisting tuberculosis diagnosis.
Methods
The colloidal solution of AuNCs was prepared by glutathione reduction method and the peroxidase like catalytic activity of AuNCs was confirmed by the TMB colorimetric method; The binding ability of CFP10 aptamer modified by sulfhydryl to AuNCs was verified by using the biotin-avidin-HRP system; The CFP10 was captured by the microwell plate coated with the CFP10 polyclonal antibody and then capture aptamer-AuNCs to construct a gold nanocluster visual biosensor for detecting CPF10; The sensitivity, specificity, negative predictive value, positive predictive value and diagnostic efficiency of the visual biosensor were evaluated.
Results
The synthesized AuNCs exhibit peroxidase like activity and does not affect their activity when coupled with aptamers. Compared with the control group, the presence of CFP10 caused the color of GNPs to turn blue. As the concentration of CFP10 increases, this change process can be clearly observed with the naked eye. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic efficiency of the visual biosensor for detecting serum CFP10 in diagnosing Mycobacterium tuberculosis infection were 94.74%, 75.86%, 83.72%, 91.67%, and 86.56%, respectively.
Conclusion
The Visual biosensors based on Aptamer and AuNCs can detect CFP10 and assist the diagnosis of Mycobacterium tuberculosis infection.
2024 Vol. 21 (3): 146-151 [
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Preventive Medicine
152
JIANG Xiu, YANG Wanying, ZHU Shanshan
Survey of Mental Health Knowledge and Attitude to Mental Disorder In the general Residents in Chengdu Pidu District
Objective
Understand the status of residents
'
awareness of mental health knowledge and attitude towards mental diseases in Chengdu Pidu district, and analyze relevant factors affecting awareness rate and residents attitude, in order to provide scientific basis for in-depth development of community mental health work.
Method
A multi-stage random sampling method was used to select 1520 residents aged 15 and above for a household questionnaire survey. The awareness rate and total questionnaire scores of different demographic characteristics were described using aχ
2
test and t-test; The analysis of influencing factors was conducted using a multi factor ordered logistic regression model.
Results
The awareness rate of mental health knowledge among residents in Pidu District is 70.15%. Gender, urban-rural differences, and educational background are all influencing factors for the awareness rate of mental health. The awareness rate of urban residents is higher than that of rural residents (P<0.05), and the awareness rate of women is higher than that of men. The population with a graduate degree or above is the highest (P<0.05). The total score of residents
'
attitudes towards mental illness was (34.94±5.68), and urban-rural differences and marital status were the influencing factors for attitudes towards mental illness. Urban residents scored higher than rural residents, and divorced individuals scored the highest.
Conclusion
The awareness rate of mental health knowledge among residents in Pidu District is average.
2024 Vol. 21 (3): 152-156 [
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Nursing Science
157
PENG Xiaoxiao, TONG Zhong, PAN Aihong
Application of enhanced recovery after surgery combined with phenomenological analysis-based health intervention in perioperative period of patients with hepatobiliary and pancreatic diseases
Objective
To explore the application effect of enhanced recovery after surgery (ERAS) combined with phenomenological analysis-based health management in perioperative period of patients with hepatobiliary and pancreatic diseases.
Methods
161 patients with hepatobiliary and pancreatic disease surgery from January 2021 to January 2023 were selected and classified into control group (76 cases, routine intervention) and intervention group (85 cases, ERAS combined with phenomenological analysis-based health intervention) by the non-randomized clinical concurrent control study and voluntary principle of patients. The first defecation time, ambulation time, hospital stay, hospitalization cost, postoperative pain degree [visual analogue scale (VAS) ], complications, psychological distress degree and satisfaction rate were compared between groups.
Results
The first defecation time, ambulation time and hospital stay in intervention group were shorter, and the hospitalization cost was less compared to control group. The VAS scores in intervention group at 3 and 8 days after surgery were lower than those in control group. The intervention group had lower total incidence rate of postoperative complications. The proportion of moderate-severe psychological distress degree was lower in intervention group at 1 month after surgery. At 1 month after surgery, the total satisfaction rate in intervention group was higher compared with that in control group.
Conclusion
ERAS combined with phenomenological analysis-based health intervention has a significant application effect in perioperative period of patients with hepatobiliary and pancreatic diseases, and it can promote the postoperative recovery, alleviate the treatment economic burden, relieve the postoperative pain and adverse psychological status, and reduce the incidence rates of postoperative complications, and it has high satisfaction rate.
2024 Vol. 21 (3): 157-160 [
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161
HE Susu, CHEN Minghong, LIU Guangzhi, LIU Zhiying, Song Xiaohua, CHEN Hongtao
A Longitudinal Study of the Trajectory of Post-traumatic Growth and Disease Perception in Surgical Patients with Laryngeal Cancer and Its Influencing Factors
Objective
To explore the potential categories and influencing factors of post-traumatic growth and disease perception in surgical patients with laryngeal cancer.
Method
92 cases with laryngeal cancer treated in a first-class hospital in Hunan province from September 2018 to December 2021 were selected as the research object using convenient sampling method. The general data questionnaire, post-traumatic growth scale, disease awareness scale in preoperative were used for follow-up evaluation before surgery, 1 month after discharge, 3 months after discharge and 6 months after discharge. Latent category growth model and multi-category Logistic regression analysis were used.
Results
According to the relevant indicators of the model, the development trajectory of laryngeal cancer patients could be divided into three potential categories: high score growth group (16/92, 17.4%), medium growth group (55/92, 59.8%) and low steady growth group (21/92, 22.8%). Compared with the low steady growth group, the patients with partial laryngectomy were more likely to enter the high score growth group (OR=0.88, P=0.006). The development trajectory of disease perception was divided into rapid decline group (26/92, 28.3%), steady decline group (42/92, 45.6%), slow decline group (24/92, 26.1%).
Conclusion
From preoperative to 6 months after discharge, post-traumatic growth and disease perception of laryngeal cancer patients show three different trajectories, and there are individual differences among groups. Medical staff can identify the population with low post-traumatic growth by surgical methods and predict the dynamic changes of post-traumatic growth. It is suggested that clinical medical staff should formulate targeted individualized intervention programs according to the development trajectory types and influencing factors of disease perception and post-traumatic growth of laryngeal cancer patients.
2024 Vol. 21 (3): 161-166 [
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167
GUO Hongyan, ZHAI Yujia, WANG Wenting, ZHU Juhong, CHEN Chen
Risk model of phlebitis in children with home intravenous indwelling needles based on decision tree
Objective
To investigate the risk factors of phlebitis in children with home intravenous catheter, and establish a decision tree model of phlebitis in children with home intravenous catheter.
Methods
A total of 350 children with home intravenous indent needles who were admitted to the hospital from January 2023 to October 2023 were selected as the study object. According to the occurrence of phlebitis, the children were divided into the phlebitis group and the non-phlebitis group. Logistic regression analysis was used to screen the risk factors for phlebitis in children with home intravenous indent needles, SPSS Modeler software was used to build a decision tree model for phlebitis in children with home intravenous indent needles, and the prediction efficiency of the decision tree model for phlebitis in children with home intravenous indent needles was analyzed.
Results
Among 350 children with intravenous indwelling needle at home, 62 cases developed phlebitis, and the incidence of phlebitis was 17.71% (62/350). Logistic regression analysis showed that the risk factors for phlebitis in children with home intravenous indentation were not successful puncture, input of stimulant drugs, indentation time >5d, daily infusion volume >250mL, family maintenance delay and saline tube sealing. The decision tree model of phlebitis in children with intravenous indenture at home selected six clinical characteristics as nodes of the model, including one successful puncture, family deferred maintenance, daily infusion volume, type of incoming drugs, indenture time and tube sealing fluid, among which one successful puncture was the most important predictor. The AUC of the decision tree model for phlebitis in children with home intravenous indent needles was 0.814(95%CI: 0.785~0.843), the sensitivity was 78.60%, and the specificity was 84.20%. The AUC of the Logistic regression model for phlebitis in children with home intravenous indent needles was 0.756(95%CI: 0.785~0.843) .
Conclusion
The risk factors for phlebitis in children with home intravenous indentation are not successful once, the infusion of stimulant drugs, indentation time >5 d, daily infusion volume >250 mL, delayed maintenance by family members, and saline tube sealing. The prediction model constructed by the above factors has certain reference value for predicting phlebitis in children with home intravenous indentation needles. In order to reduce the risk of phlebitis, targeted nursing interventions can be conducted for children with intravenous indwelling needles at home.
2024 Vol. 21 (3): 167-172 [
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HUANG Xueqin, GONG Fanghua, ZOU Jiajing, YANG Dan
Effectiveness of microvideo combined with teach-back method after autologous arteriovenous endovascular fistula in patients with chronic kidney disease
Objective
To explore the application effect of microvideo combined with teach-back method of education in patients after autologous arteriovenous endovascular fistula surgery.
Methods
76 cases of chronic kidney disease patients who were hospitalized and underwent autologous arteriovenous endovascular fistula surgery in the Department of Nephrology of Hunan Provincial People's Hospital from October 2022 to August 2023 were selected and randomly divided into 38 cases each in the experimental group and the control group. The control group implemented routine care, oral plus paper version of the mission, the experimental group will be made into a micro-video of the content of the mission, and combined with the teach-back method to implement a six-week intervention. After the intervention, we compared the differences in functional exercise compliance, self-management ability and health education satisfaction between the two groups.
Results
37 cases in the test group and 36 cases in the control group completed the study. After the intervention, the patients' functional exercise compliance and self-management ability and health education satisfaction in the experimental group were higher than those in the control group, and the difference was statistically significant.
Conclusion
The microvideo combined teach-back method can improve the adherence to functional exercise of patients after autologous arteriovenous endovascular fistula surgery, and improve patients' self-management ability and patients' satisfaction with health education.
2024 Vol. 21 (3): 173-178 [
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DAI Xuan, LI Zhen, QIN YueLan, XIONG Mao, TAO MeiYi
A qualitative study of the exercise decision-making experience of patients with type 2 diabetes mellitus
Objective
To understand the real-life experience of exercise decision-making in people with type 2 diabetes to inform the development of targeted decision-aid programs.
Methods
A phenomenological research method was used to conduct semi-structured interviews with 13 inpatients with type 2 diabetes mellitus, and Colaizzi analysis was used to analyze the interview data.
Results
Three themes and eight sub-themes were summarized: Exercise decision-making needs are differ significantly (decision-making cognitive differences, inconsistent decision-making participation, situational constraints on decision-making behavior), and exercise decision-making support is unsystematic (ineffective informational support, absent emotional support, Inadequate communication between healthcare professionals and patients, time and financial pressures, and peer effect orientation) Exercise decision-making outcomes are not clear.
Conclusion
Healthcare professionals should provide effective decision support to improve the decision-making experience for the different needs of patients with type 2 diabetes mellitus, encourage patients to participate in exercise decision-making, and improve exercise adherence.
2024 Vol. 21 (3): 179-183 [
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WANG Zimei, LI Yue'e, HU Meide
The effect of perceived workplace rudeness on job adjustment among new nurses: the chain mediating role of self-efficacy and job engagement
Objective
To explore the chain mediating role of self-efficacy and work engagement in the perceived rudeness of new nurses in the work environment (hereinafter referred to as "perceived rudeness") and occupational adaptation.
Methods
From September to November 2022, 416 new nurses from 6 Class III and Class A general hospitals in Hunan Province were investigated with the workplace disrespect scale, the general self-efficacy scale, the work engagement scale and the nurse workplace adaptation scale.
Results
The average score of the new nurses' rude behavior perception item was (1.64±0.57), the average score of self-efficacy item was (2.65±0.60), the average score of work engagement item was (3.61±0.92), and the average score of occupational adaptation item was (3.87±0.62); The indirect effect of rude behavior perception on occupational adaptation is established, and the total indirect effect is -0.151; The mediating effect of self-efficacy or work engagement accounted for 12.8% and 11.9% of the total effect respectively; The chain mediating effect between self-efficacy and work involvement in the perception of rude behavior and occupational adaptation accounted for 7.7% of the total effect.
Conclusion
The professional adaptation ability of new nurses is at the middle and upper level, and the multiple mediating effects of self-efficacy and work engagement in the mechanism of the impact of rude behavior perception on the professional adaptation of new nurses are established. Nursing managers and new nurses themselves can reduce the perception of rude behavior, and improve the occupational adaptation status by enhancing self-efficacy and work engagement.
2024 Vol. 21 (3): 184-188 [
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