Objective: To investigate the effect of laparoscopic sacrocolpopexy in the treatment of moderate and severe uterine prolapse. Method: A total of 179 patients with moderate and severe uterine prolapse who were admitted to Zhangzhou Municipal Hospital from September 2019 to February 2022 were selected as the research objects, according to different surgical methods, they were divided into experimental group 103 cases (laparoscopic sacrocolpopexy) and control group 76 cases (laparoscopic sacral ligament shortening). The perioperative indexes, the severity of uterine prolapse, quality of life, sexual life and the changes of urinary fluidity were observed in the two groups. Result: The operative time, postoperative catheter indwelling time and postoperative hospital stay of the experimental group were shorter than those of the control group, and the intraoperative blood loss was less than that of the control group, the differences were statistically significant (P<0.05). After treatment, the total effective rate of experimental group was 94.17%, higher than 82.89% of control group (P<0.05). The quality of life scores of experimental group were lower than those of control group at 3 and 6 months after treatment (P<0.05). At 3 and 6 months after treatment, the sexual status scores of experimental group were higher than those of control group (P<0.05). After treatment, the maximum urine flow rate, average urine flow rate and maximum bladder volume in experimental group were higher than those in control group, while the residual urine volume was lower than that in control group, the differences were statistically significant (P<0.05). Conclusion: Laparoscopic sacrocolpopexy can reduce intraoperative blood loss in patients with moderate and severe uterine prolapse, shorten postoperative recovery time, improve the severity of uterine prolapse, improve their quality of life and sexual life, and improve urinary fluidity, which is worthy of clinical promotion.

2023 Vol. 20　(8):　1-5 [Abstract]（ 262 ） HTML (1 KB)  PDF  (926 KB)  ( 149 )

Objective: To investigate the effect of Dexmedetomidine combined with Hydromorphone application in hysteroscopic surgery under laryngeal mask without muscle relaxant general anesthesia. Method: From January to December 2021, 58 patients undergoing hysteroscopic surgery in Jiangyin People's Hospital under aryngeal mask without muscle relaxant general anesthesia were selected and randomly divided into Dexmedetomidine + Hydromorphone group (DH group) and Sufentanil group (SF group), 29 patients in each group. In the DH group, general anesthesia was induced with Dexmedetomidine 0.2 μg/kg intravenously (≥10 min) combined with Hydromorphone 0.02 mg/kg and Propofol 2.5 mg/kg intravenously. In the SF group, general anesthesia was induced with Sufentanil 0.3 μg/kg and Propofol 2.5 mg/kg intravenously, Propofol 6 mg/kg intravenous pump was used for anesthesia maintenance in both groups. Heart rate (HR) and mean arterial pressure (MAP) were recorded before induction of general anesthesia (T0), before the start of surgery (T1), 10 min after the start of surgery (T2) and at the end of surgery (T3) in both groups. Bispectral index (BIS) at T1, T2 and T3 were recorded in both groups, and the time of surgery, the time of recovery from the end of surgery and the occurrence of intraoperative body movements were recorded in both groups. Result: Compared with SF group, HR and MAP of DH group were higher than those of SF group at T1 and T2, BIS at T1 and T2 were lower than those of SF group, BIS at T3 was higher than that of SF group, the incidence of intraoperative body movement was lower than that of SF group, and the recovery time was shorter than that of SF group, the differences were statistically significant (P<0.05). Conclusion: The application of Dexmedetomidine 0.2 μg/kg intravenously (≥10 min) combined with Hydromorphone 0.02 mg/kg intravenously in hysteroscopic surgery under laryngeal mask without muscle relaxant general anesthesia is reasonable and effective, resulting in smooth intraoperative anesthesia and rapid awakening.

2023 Vol. 20　(8):　10-13 [Abstract]（ 258 ） HTML (1 KB)  PDF  (913 KB)  ( 24 )

Objective: To study the value of CT quantitative analysis in differentiating different pathological subtypes of pulmonary sub-solid adenocarcinoma. Method: From January 2020 to June 2022, 57 patients with sub-solid lung adenocarcinoma in Hai'an Hospital of Traditional Chinese Medicine were selected and divided into invasive adenocarcinoma cancer (IAC) and non-invasive adenocarcinoma cancer (n-IAC) according to their pathological subtypes. The clinical characteristics and CT quantitative analysis parameters of IAC patients and n-IAC patients were compared. The value of CT quantitative parameters in the differential diagnosis of pathological subtypes of sub-solid lung adenocarcinoma was analyzed by using the receiver operating characteristic (ROC) curve. Result: There were no significant differences in gender, age, nodule location, smoking history and family history between IAC patients and n-IAC patients (P>0.05); the diameter of nodules, the proportion of stage Ⅲ-Ⅳ, the proportion of poorly differentiated and the proportion of lymph node metastasis in IAC patients were all larger than those in n-IAC patients (P<0.05); the total nodule volume, solid component volume, three-dimensional average CT value, solid component volume ratio, total nodule mass, solid component mass and solid component mass ratio of IAC patients were all greater than those of n-IAC patients (P<0.05); ROC analysis showed that the cut-off value of solid component volume ratio and solid component mass ratio in differentiating pathological subtypes of lung sub-solid lung adenocarcinoma were 24.59%, 28.74%, AUC were 0.865, 0.928, sensitivity were 84.85%, 93.94%, specificity were 87.50%, 79.17%. Conclusion: CT quantitative analysis has a high value in differential diagnosis of pathological subtypes of pulmonary sub-solid adenocarcinoma.

2023 Vol. 20　(8):　18-22 [Abstract]（ 224 ） HTML (1 KB)  PDF  (1014 KB)  ( 61 )

Objective: To investigate the effect of modified posterolateral approach (PLA) to ankle joint combined with medial approach in the treatment of trimalleolus fracture. Method: The clinical data of 71 patients with trimalleolar fracture admitted to Jinnan Branch of Jinjiang Municipal Hospital from January 2019 to June 2021 were retrospectively analyzed, all patients received internal fixation reduction treatment, including 36 patients received traditional PLA to ankle joint combined with medial approach was traditional group and 35 patients received modified PLA to ankle joint combined with medial approach as the improved group. The efficacy, surgical and fracture healing, visual analog scale (VAS) scores, ankle function and postoperative complications were compared between the two groups. Result: There was no significant difference in efficacy between the two groups (P>0.05). The operation time and hospital stay of the improved group were shorter than those of the traditional group, and the intraoperative blood loss was less than that of the traditional group (P<0.05). There was no significant difference in fracture healing time between the two groups (P>0.05). VAS scores of the improved group were lower than those of the traditional group at 1, 2 and 3 d after surgery (P<0.05). At 3, 6 months and 1 year after surgery, ankle plantar flexion and dorsalflexion motion in the improved group were higher than those of the traditional group, and Baird-Jackson scores were higher than those of the traditional group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: Both modified PLA to ankle joint and traditional PLA to ankle joint combined with medial approach in the treatment of trimalleolus fracture during internal fixation reduction can achieve good curative effect, which is conducive to postoperative fracture healing, however, the advantages of the improved approach are that it can reduce intraoperative bleeding and operation time, accelerate postoperative discharge of patients, and alleviate early postoperative pain, but has no significant positive effect on reducing postoperative complications.

2023 Vol. 20　(8):　28-32 [Abstract]（ 245 ） HTML (1 KB)  PDF  (991 KB)  ( 7 )

Objective: To explore the efficacy of different doses of glucocorticoid combined with Propylthiouracil in the treatment of senile hyperthyroidism. Method: Sixty-six elderly patients with hyperthyroidism admitted to Gongan County People's Hospital from June 2021 to June 2022 were selected and divided into study group (33 cases) and control group (33 cases) according to random number table method. Both groups were treated with Propylthiouracil, while the control group was treated with high-dose glucocorticoid (Dexamethasone) and the study group was treated with low-dose glucocorticoid (Dexamethasone), the clinical efficacy of the two groups was compared. Result: The total effective rate and total cholesterol (TC) level in the study group were higher than those in the control group, after treatment, the incidence of adverse drug reactions, mean arterial pressure (MAP), heart rate (HR), fasting plasma glucose (FPG), adrenocorticotropic hormone (ACTH) and thyroid hormone (T4) levels were lower than those in the control group (P<0.05). Conclusion: The clinical effect of low-dose glucocorticoid combined with Propylthiouracil in the treatment of elderly hyperthyroidism is significant, which can effectively improve the relative care function and the balance of thyroid function indicators and glycolipid metabolism, and reduce the risk of adverse drug reactions, with better safety.

2023 Vol. 20　(8):　38-42 [Abstract]（ 172 ） HTML (1 KB)  PDF  (1025 KB)  ( 24 )

Objective: To investigate the effects of long protocol in early follicular phase, antagonist protocol and short-acting long protocol in luteal phase on endometrial receptivity and clinical pregnancy in infertile patients. Method: A total of 210 female patients with infertility who received in vitro fertilization-embryo transfer (IVF-ET)/intracytoplasmic sperm injection (ICSI) for the first time in reproductive center of Affiliated Hospital of Jinggangshan University were enrolled from May 2021 to May 2022. By means of randomized control method, the patients were divided into study group 1 (n=70, long protocol in early follicular phase), study group 2 (n=70, antagonist protocol) and control group (n=70, short-acting long protocol in luteal phase). The endometrial receptivity, ovarian stimulation, embryo status and clinical pregnancy rate were compared among the three groups. Result: Before intervention, endometrial thickness (ED), endometrial volume (EV), endometrial vascular index (VI) and vascular flow index (VFI) showed no differences among the three groups (P>0.05), and the ED, EV, VI and VFI in study group 1 after intervention were higher than those in study group 2 and control group (P<0.05), and which in study group 2 were higher than those in control group (P<0.05). After intervention, the dosage and the number of use days of Recombinant Human Follitropin Alfa Solution for Injection [Gonal-F (Gn)] in study group 1 were more than those in study group 2 and control group (P<0.05), but there were no differences between study group 2 and control group (P>0.05). The level of luteinizing hormone (LH) of study group 2 was higher than those of study group 1 and control group (P<0.05), but there was no difference in LH level between study group 1 and control group (P>0.05). No differences were shown in terms of serum estradiol (E2), progesterone (P) and cycle cancellation rate (P>0.05). The effective embryo rate and high-quality embryo rate after intervention in study group 1 were higher than those in study group 2 and control group (P<0.05), but the two indicators in study group 2 and control group were no significant differences (P>0.05), and the number of transferred embryos, the number of freshly transferred cycles, whole embryo freezing and normal fertilization rate in three groups had no differences (P>0.05). The clinical pregnancy rate of study group 1 was higher than those of study group 2 and control group (P<0.05), and the clinical pregnancy rate of study group 2 and control group was no significant difference (P>0.05), and there were no differences in the number of transferred pregnancy cycles, multiple pregnancy rate, abortion rate and ectopic pregnancy rate among the three groups (P>0.05). Conclusion: Long protocol in early follicular phase can help improve endometrial receptivity, oocyte quality and clinical pregnancy in female patients with infertility, but because its down-regulation time is long, as a result, the use time of Gn is prolonged and the dosage is increased.

2023 Vol. 20　(8):　47-52 [Abstract]（ 138 ） HTML (1 KB)  PDF  (1134 KB)  ( 100 )

Objective: To investigate the effect of ultrasound-guided ultra-fine percutaneous nephrolithotomy in the treatment of lower calyceal calculus. Method: A total of 80 patients with lower calyceal calculi who were admitted to the Wuxi Second Geriatric Hospital from November 2019 to October 2022 were selected and divided into an observation group (n=40) and a control group (n=40) according to the random number table method. The control group was treated with ultrasound-guided conventional percutaneous nephrolithotomy, and the observation group was treated with ultrasound-guided ultra-fine percutaneous nephrolithotomy. The operation-related indexes, renal function indexes, inflammatory factors indexes and the incidence of complications were compared between the two groups. Result: There were no significant differences between the two groups in the operation time and the first-stage stone clearance rate (P>0.05), and the hospitalization time of observation group was shorter than that of control group, hospitalization expenses was lower than that in the control group (P<0.05). Before operation, there were no statistically significant differences in the levels of serum creatinine (Scr), blood urea nitrogen (BUN) and neutrophil gelatinase-associated lipid transport protein (NGAL) between the two groups (P>0.05); after operation, Scr, BUN and NGAL in both groups increased, but those in the observation group were lower than those in the control group (P<0.05). Before operation, there were no significant differences in the levels of tumor necrosis factor-α (TNF-α), C reactive protein (CRP) and interleukin-6 (IL-6) between the two groups (P>0.05). After operation, all the above indexes in the two groups increased, but the observation group were lower than those in the control group (P<0.05). The incidence of complications in the observation group (2.50%) was lower than that in the control group (27.50%) (P<0.05). Conclusion: Ultrasound-guided ultra-fine percutaneous nephrolithotomy is safe and effective in the treatment of lower calyceal calculi, which can reduce renal function damage, inflammatory reaction and postoperative complications.

2023 Vol. 20　(8):　57-61 [Abstract]（ 181 ） HTML (1 KB)  PDF  (1072 KB)  ( 37 )

Objective: To investigate the effect of simultaneous radiotherapy and chemotherapy of Paclitaxel for Injection in the treatment of locally advanced esophageal carcinoma in the elderly. Method: A total of 100 elderly patients with advanced local esophageal carcinoma admitted to Hai'an Hospital of Traditional Chinese Medicine from February 2019 to February 2022 were selected and divided into a combined group of 50 cases and a conventional group of 50 cases according to random number table method. The conventional group was treated with Fluorouracil (500 mg/m2) and Cisplatin Injection (20 mg/m2) + concurrent radiotherapy, and the combined group was treated with Paclitaxel for Injection (100 mg/m2) on the basis of the control group, 14 days for 1 cycle, 6 cycles. Fasting venous blood was collected before and after treatment, and squamous cell carcinoma antigen (SCCA) and cytokeratin 19 fragment (CYFRA21-1) were compared between the two groups. After 6 cycles of treatment, the objective response rate of the two groups was compared. The occurrence of adverse reactions (general fatigue, nausea and myalgia) was compared between the two groups. Result: After treatment, serum CYFRA21-1 and SCCA levels in two groups were decreased (P<0.05), and the serum CYFRA21-1 and SCCA levels in combined group were lower than those in conventional group (P<0.05). The objective remission rate in combined group (68.00%) was higher than that in conventional group (44.00%), there was statistically significant difference in objective remission rate between the two groups (P<0.05), and the incidence of adverse reactions was 14.00% in the combined group and 12.00% in the conventional group, with no statistically significant difference between the two groups (P>0.05). Conclusion: The effect of concurrent radiotherapy and chemotherapy with Paclitaxel for Injection in the treatment of esophageal cancer is relatively obvious, which can effectively improve the objective remission rate of patients, reduce the level of tumor markers, and will not significantly increase the incidence of adverse reactions in patients, so it can be popularized and applied in the elderly patients with locally advanced esophageal cancer.

2023 Vol. 20　(8):　65-68 [Abstract]（ 140 ） HTML (1 KB)  PDF  (1054 KB)  ( 158 )

Objective: To observe and analyze the effect of acupuncture, massage and medical ironing method in the treatment of cervical spondylotic periarthritis of shoulder. Method: A total of 114 patients with cervical spondylotic periarthritis of shoulder admitted to Linglu Branch of Yongtai County General Hospital from May 2020 to April 2022 were selected, numbered according to the order in which the patients were treated, used random number table method as grouping tool they were randomly divided into control group and observation group, with 57 patients in each group. The control group was treated with acupuncture and massage therapy, and the observation group was treated with acupuncture and massage combined with medical ironing method. The clinical effect, visual analog scale (VAS), Constant-Murley shoulder joint function scale (CMS) scores, traditional Chinese medicine syndrome scores and inflammatory factors were compared between the two groups. Result: The total effective rate of observation group was higher than that of control group (P<0.05). After treatment, VAS score of observation group was lower than that of control group, CMS score was higher than that of control group, the differences were statistically significant (P<0.05). After treatment, the scores of joint pain, joint heaviness, joint distension and adverse flexion and extension of observation group were lower than those of control group (P<0.05). After treatment, the levels of interleukin-6 (IL-6), hypersensitive C reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) of observation group were lower than those of control group (P<0.05). Conclusion: The combined application of acupuncture, massage and medical ironing method in patients with cervical spondylotic periarthritis of shoulder has more obvious effects, which can achieve ideal anti-inflammatory and analgesic effects, which is helpful to promote the improvement of shoulder joint function of patients, and is of great significance for improving the quality of life of patients.

2023 Vol. 20　(8):　73-77 [Abstract]（ 214 ） HTML (1 KB)  PDF  (1154 KB)  ( 45 )

Objective: To study the effect of evidence-based intervention of ACE-star model on the mental state of patients after modified radical mastectomy. Method: A total of 200 patients admitted to the Department of Oncology of Ningde Hospital Affiliated to Ningde Normal University from January 2018 to March 2021 were randomly divided into control group (100 cases) and research group (100 cases). The control group underwent conventional intervention, and the research group performed ACE-star model evidence-based intervention on the basis of the control group. The postoperative recovery of the upper limb function of the affected side, the incidence of postoperative complications, and the psychological state of the two groups of patients were observed. Result: The maximum angles of extension, extension, and abduction of patients in two groups were larger than those before intervention (P<0.05), and the maximum angle of extension, extension, and abduction of the research group were greater than those of the control group (P<0.05). The postoperative complication rate (5.00%) in the research group was lower than that in the control group (17.00%) (P<0.05). After the intervention, the SAS and SDS scores of both groups were lower than those before intervention (P<0.05), and the SAS and SDS scores in the research group were lower than those in the control group (P<0.05). Conclusion: Evidence-based intervention of the ACE-star model is applied to patients after modified radical mastectomy, which can promote the functional recovery of the affected side of the patients' upper limbs, reduce the incidence of postoperative complications, and improve the psychological state of the patients.

2023 Vol. 20　(8):　82-85 [Abstract]（ 147 ） HTML (1 KB)  PDF  (1126 KB)  ( 55 )

Objective: To explore the effects of acceptance and commitment therapy on psychological stress response, coping modes and psychological flexibility of intensive care unit (ICU) patients' family members. Method: A total of 70 ICU patients were selected from June 2021 to June 2022 in Nanping Second Hospital, and 70 family members who were responsible for the medical decisions of the patients were taken as the research subjects. The 70 family members were divided into the control group and the observation group according to the random number table method, with 35 cases in each group. The control group was given routine psychological care, and the observation group was given routine psychological care + acceptance and commitment therapy. The psychological stress response, coping modes and psychological flexibility were compared between the two groups. Result: After 2 weeks of nursing, the each dimensions and total scores of stress response questionnaire (SRQ) in the observation group were significantly lower than those in the control group (P<0.05). After 2 weeks of nursing, the each sub-scale and total scores of the medical coping modes questionnaire (MCMQ) in the observation group were significantly better than those in the control group (P<0.05). After 2 weeks of nursing, the scores of the acceptance and action questionnaire-second edition (AAQ-Ⅱ) in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: Acceptance and commitment therapy for ICU patients' family members is helpful to reduce their psychological stress response, improve their positive coping modes and improve their psychological flexibility.

2023 Vol. 20　(8):　91-95 [Abstract]（ 240 ） HTML (1 KB)  PDF  (1168 KB)  ( 199 )

Objective: To explore the effect of staged extended individualized cardiac rehabilitation exercise program on cardiac function and quality of life in patients with chronic heart failure (CHF). Method: A total of 85 patients with CHF admitted to Jinxi People's Hospital of Kunshan City from May 2019 to May 2021 were selected, they were divided into control group and study group according to different cardiac rehabilitation intervention methods. The control group (43 cases) received routine cardiac rehabilitation exercise program intervention, and the study group (42 cases) added staged extended individualized cardiac rehabilitation exercise program on the basis of routine intervention. The improvement of cardiac function, exercise tolerance, quality of life and the incidence of re-hospitalization were compared between the two groups. Result: Before intervention, there were no significant differences in left ventricular ejection fraction (LVEF), left ventricular diameter (LVD) and left ventricular fraction shortening (LVFS) between the two groups (P>0.05); after intervention, the levels of LVEF and LVFS in both groups were higher than those before intervention, those in the study group were higher than those in the control group, LVD levels in both groups were lower than those before intervention, that in the study group was lower than that in the control group (P<0.05). Before intervention, there was no significant difference in 6 min walking distance between the two groups (P>0.05); after intervention, the 6 min walking distance in both groups were longer than those before intervention, that in the study group was higher than that in the control group (P<0.05). Before intervention, there were no statistically significant differences in Minnesota life heart failure quality questionnaire (MLHFQ) scores in all fields between the two groups (P>0.05); after intervention, MLHFQ scores in all fields in both groups were lower than those before intervention, those in the study group were lower than those in the control group (P<0.05). The incidence of readmission in the study group was lower than that in the control group (P<0.05). Conclusion: Interventions with staged extended individualized cardiac rehabilitation exercise program for patients with CHF showed significant improvements in cardiac function, exercise tolerance, and quality of life, as well as a significant reduction in the occurrence of rehospitalization, with better clinical outcomes.

2023 Vol. 20　(8):　100-104 [Abstract]（ 180 ） HTML (1 KB)  PDF  (1198 KB)  ( 22 )

Objective: To explore the clinical value of maternal serum alpha fetoprotein (AFP) combined with ultrasound screening for fetal neural tube defects in the second trimester of pregnancy, so as to provide reference for clinical diagnosis and treatment of fetal neural tube defects. Method: A prospective study was conducted on pregnant women who were screened for neural tube defects in the second trimester (16-27 weeks of gestation) in Yichun Yuanzhou Modern Hospital from January 2019 to January 2022. All of them underwent ultrasound examination, and the maternal serum AFP level was detected at the same time. The screening was confirmed by autopsy after induction of labor or follow-up after birth for fetuses with neural tube abnormalities, and confirmed by telephone or outpatient follow-up for healthy fetuses. The results of induction of labor or follow-up after birth were the "gold standard", the pregnant women were divided into positive group and negative group, and the maternal serum AFP levels of the two groups were compared. The results of ultrasound examination and imaging manifestations were analyzed. At the same time, the relationship between the results of ultrasound examination and serum AFP level was analyzed, the value of maternal serum AFP combined with ultrasound in screening fetal neural tube defects in the second trimester was analyzed. Result: A total of 7 694 pregnant women were screened in this study, of which 12 were lost to follow-up. Finally, 7 682 pregnant women were included in this study. A total of 19 fetuses were diagnosed with neural tube defects, accounting for 2.47‰ (19/7 682). Ultrasound correctly diagnosed fetal neural tube malformation in 17 cases, including 7 cases of anencephaly, 1 case of open brain malformation, 1 case of encephalocele, and 8 cases of spina bifida. The maternal serum AFP level of positive group was higher than that of negative group (P<0.05). Point-biserial correlation analysis showed that the positive rate of ultrasonography was positively correlated with maternal serum AFP (r=0.532, P=0.019). The area under the curve (AUC) of maternal serum AFP combined with ultrasound in screening fetal neural tube defects in the second trimester was the largest, 0.910, and the sensitivity and specificity were 89.50% and 98.80% respectively. Conclusion: Maternal serum AFP combined with ultrasound has certain value in screening neural tube defects in the second trimester of pregnancy.

2023 Vol. 20　(8):　109-114 [Abstract]（ 204 ） HTML (1 KB)  PDF  (1606 KB)  ( 65 )

Objective: To explore the changes of serum matrix metalloproteinase-9 (MMP-9) concentration in patients with acute cerebral infarction in anterior and posterior circulation and its correlation with the severity of the disease. Method: A retrospective study was conducted in 88 patients with acute cerebral infarction who were admitted to the Department of Neurology, Shanghai Baoshan District Renhe Hospital from January 2013 to July 2018. There were 46 cases with anterior circulation infarction and 42 cases with posterior circulation infarction. According to the prognosis of the patients, they were divided into a death group (n=35) and a survival group (n=53). Meanwhile, 50 healthy people were selected as the control group. The level of MMP-9 was detected by ELISA, and the baseline data of patients were collected for statistical analysis. Result: The level of MMP-9 in cerebral infarction group was significantly higher than that in control group (P<0.05). The serum MMP-9 level in the anterior circulation group was significantly lower than that in the posterior circulation group, the difference was statistically significant (P<0.05). The NIHSS score in the anterior circulation group was (12.29±2.26), which was lower than (19.38±4.32) in the posterior circulation group, the difference was statistically significant (P<0.05). The NIHSS scores in the anterior circulation group and posterior circalation group were positive correlated with serum MMP-9 (r=0.651, 0.591, P<0.001). The proportion of smoking, drinking, lipid metabolism disorder, cerebral artery stenosis and posterior circulation acute cerebral infarction in the death group were significantly higher than those in the survival group, the level of MMP-9 was lower than that in the survival group, and the levels of WBC and hs-CRP were higher than those in the survival group (P<0.05). MMP-9, hs-CRP, WBC, acute cerebral infarction in posterior circulation, lipid metabolism disorder, drinking history and cerebral artery stenosis were all independent risk factors that affect the prognosis of patients (P<0.05). Conclusion: The level of MMP-9 in patients with acute cerebral infarction is significantly increased, which is positive correlated with the NIHSS scores. The level of serum MMP-9 in patients with acute cerebral infarction in posterior circulation is higher than that in patients with acute cerebral infarction in anterior circulation, and the level of MMP-9 is a prognostic factor.

2023 Vol. 20　(8):　118-121 [Abstract]（ 244 ） HTML (1 KB)  PDF  (1223 KB)  ( 23 )

Objective: To explore the predictive value of serum angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) ratio on the prognosis of elderly patients with severe community-acquired pneumonia (SCAP). Method: A retrospective analysis was performed on 155 patients diagnosed with SCAP and treated with complete data from December 2018 to December 2020 in General Hospital of the Northern Theater of the Chinese People's Liberation Army, taking 28 d of treatment as the observation period, the patients were divided into survival group and death group according to the conditions after treatment, with 121 cases in survival group and 34 cases in death group. General data such as sex, age and disease history were collected and recorded, white blood cell (WBC) count, C reactive protein (CRP), procalcitonin (PCT), Ang-1, and Ang-2

2023 Vol. 20　(8):　125-130 [Abstract]（ 145 ） HTML (1 KB)  PDF  (1394 KB)  ( 34 )

Objective: To study the effect of the timing of labor analgesia under spinal block anesthesia on labor course and maternal and infant outcomes. Method: A total of 120 puerperae in the Obstetrics Department of the First Hospital of Nanchang from June 2021 to May 2022 were selected and randomly divided into four groups by digital table method, with 30 cases in each group. In group A and group B, intraspinal analgesia was performed when cervical dilation ≤3 cm. Group A stopped analgesia after dilation of the cervix; group B continued analgesia after dilation; group C and group D received intraspinal analgesia when the dilation of the cervix was greater than 3 cm. Group C stopped analgesia after dilation; group D continued analgesia after dilation. The duration of labor and maternal and infant outcomes were recorded in each group. Result: There were statistically significant differences in the time spent in the first stage of labor, the second stage of labor and the total stage of labor among the groups (P<0.05). There was no significant difference in the duration of the third stage of labor among the groups (P>0.05). Pairwise comparison between groups: the first stage of labor and total labor time in group A and group B were significantly longer than those in group C and group D; the second stage of labor in group A and group C were significantly shorter than those in group B and group D, the differences were statistically significant (P<0.05). There were no significant difference in the first stage of labor and total labor time between group A and group B, group C and group D (P>0.05). There were no significant differences in the duration of the second stage of labor between group A and group C, group B and group D (P>0.05). The vaginal delivery rates of group C and group D were 93.33% and 93.33%, respectively, which were higher than 70.00% and 70.00% of group A and group B. The use of Oxytocin in group C and group D was 33.33% and 26.67%, respectively, which were lower than 56.67% and 53.33% of group A and group B, the differences were statistically significant (P<0.05). There were no significant differences in vaginal delivery rate and oxytocin usage rate between group B and group A, group D and group C (P>0.05). There were no significant differences in neonatal asphyxia rate, postpartum hemorrhage volume at 2 hours, and neonatal Apgar scores at 1, 5, 10 minutes between the groups (P>0.05). There was no significant difference in the incidence of complications such as lower extremity numbness, urinary retention, pain and itching, fever and nausea among the groups (P>0.05). Conclusion: The whole process of intraspinal labor analgesia is a more appropriate analgesic method when the cervix is ..dilated >3 cm, and it can shorten the labor process, and has little effect on maternal and infant outcomes.

2023 Vol. 20　(8):　134-138 [Abstract]（ 109 ） HTML (1 KB)  PDF  (1361 KB)  ( 41 )

Objective: To investigate the effect and clinical value of early comprehensive rehabilitation treatment in patients complicated with dysphagia after stroke. Method: A total of 120 patients complicated with dysphagia after stroke were included in the study. They were all admitted to the Department of Neurology, Shihezi People's Hospital from January 2021 to January 2022, and were randomly divided into groups using digital table extraction method. The 60 cases of control group were treated with routine rehabilitation treatment, and the 60 cases of observation group were treated with early comprehensive rehabilitation treatment. The total effective rate, swallowing function, immune function indexes, nutritional status indexes and incidence of complications were compared between the two groups. Result: The total effective rate in the observation group (96.67%) was higher than that in the control group (83.33%) (P<0.05). After treatment, the scores of water swallow test in the observation group decreased more significantly than that in the control group (P<0.05). After treatment, immunoglobulin G (IgG) and immunoglobulin M (IgM) in the observation group decreased more significantly than those in the control group (P<0.05). After treatment, the serum total protein, hemoglobin and albumin in the observation group increased more significantly than those in the control group (P<0.05). The incidence of complications in the observation group was lower than that in the control group (P<0.05). Conclusion: Patients complicated with dysphagia after stroke pay attention to early comprehensive rehabilitation treatment, which can improve the total effective rate, enhance swallowing function, improve immune level, improve the nutritional status of the body, and reduce the incidence of complications, which is of great development value.

2023 Vol. 20　(8):　143-146 [Abstract]（ 197 ） HTML (1 KB)  PDF  (1165 KB)  ( 54 )

Objective: To study the effect of percutaneous transluminal angioplasty (PTA) under the guidance of ultrasound in the treatment of stenosis of autogenous arteriovenous fistula, and analyze the influencing factors of the treatment effect. Method: The data of patients with stenosis of autogenous arteriovenous fistula who received PTA surgery in the First Hospital of Nanchang from January 2020 to December 2021 were analyzed retrospectively. The clinical effects of PTA surgery were summarized, and the patients were divided into success group and failure group according to the therapeutic effects. The baseline data of the two groups were recorded and compared, and the related factors influencing the failure of ultrasound guided PTA in the treatment of arteriovenous fistula stenosis were analyzed by regression analysis. Result: The failure rate of PTA under ultrasound guidance was 19.05%. There were no significant differences in sex, age, body mass index, primary disease, hypercholesterolemia, location of autogenous arteriovenous internal fistula, stenosis type, internal fistula use time, original autogenous arteriovenous internal fistula operation style, time from finding stenosis to PTA, platelet, D-dimer between the failure group and the success group (P>0.05). The prevalence of hypertension, diabetes and vascular calcification in the failure group were higher than those in the success group, and the level of serum high-sensitivity C reactive protein was higher than that in the success group, with statistical significance (P<0.05). logistic regression analysis showed that hypertension, diabetes, vascular calcification and high level of high-sensitivity C reactive protein were the relevant influencing factors for the clinical effect of ultrasound-guided PTA in the treatment of arteriovenous fistula stenosis (P<0.05). Conclusion: Ultrasound guided PTA surgery for autogenous arteriovenous fistula stenosis has a high risk of failure, which is related to hypertension, diabetes, vascular calcification, and high level of high-sensitivity C reactive protein.

2023 Vol. 20　(8):　151-155 [Abstract]（ 207 ） HTML (1 KB)  PDF  (1426 KB)  ( 93 )

Objective: To explore the effect of pelvic floor myoelectric stimulation biofeedback combined with Kegel training in patients with postpartum pelvic floor dysfunction. Method: A total of 94 patients with postpartum pelvic floor dysfunction who were admitted to Putian Hanjiang Hospital from February 2021 to February 2022 were selected, they were divided into two groups according to the random number table method, with 47 cases in each group. The control group was given Kegel training, and the observation group was given pelvic floor myoelectric stimulation biofeedback intervention based on Kegel training, both groups continued the intervention for 4 weeks. The pelvic floor muscle strength, stress urinary incontinence improvement and quality of life were compared between the two groups. Result: Before intervention, there was no significant difference in the latest international female sexual function index (FSFI) scores between the two groups (P>0.05); after intervention, the FSFI score of the observation group was higher than that of the control group (P<0.05). After intervention, pelvic floor strength and urinary incontinence grading of the observation group were better than those of the control group, the total effective rate of stress urinary incontinence improvement was 95.74%, which was higher than 82.98% of the control group (P<0.05). Conclusion: Pelvic floor myoelectric stimulation biofeedback combined with Kegel training intervention in postpartum patients with pelvic floor dysfunction can improve the pelvic floor muscle strength, promote the improvement of stress urinary incontinence symptoms, and improve the quality of life of patients.

2023 Vol. 20　(8):　159-162 [Abstract]（ 162 ） HTML (1 KB)  PDF  (1201 KB)  ( 198 )

Chronic kidney disease (CKD) is highly prevalent but poorly understood, and the disease is difficult to treat. Cardiovascular disease (CVD) is a common complication and a major cause of death in patients with CKD. CKD is also closely related to the development of CVD. There are still difficulties regarding the pathogenesis, associated risk factors and precise treatment of CKD combined with CVD now. This article provides a review of the interaction between the heart and kidney, the non-traditional risk factors of CKD combined with CVD and the aspects of prevention and treatment.

2023 Vol. 20　(8):　168-173 [Abstract]（ 204 ） HTML (1 KB)  PDF  (1583 KB)  ( 74 )

The fixation of femoral neck fracture in adults is an enormous challenge in traumatic orthopedics. Although traditional internal fixation methods such as cannulated compression screw internal fixation and dynamic hip screw internal fixation have been widely used in clinical practice and have achieved specific efficacy, however, the incidence of postoperative complications such as fracture nonunion and femoral head necrosis is still high. Therefore, some new types of internal fixation have emerged, such as the femoral neck system and dynamic compression locking system. In this paper, the results of clinical and biomechanical studies about the new internal fixation modalities will be compared with the previous internal fixation modalities to provide some references in selecting treatment modalities for adult patients with femoral neck fractures.

2023 Vol. 20　(8):　179-183 [Abstract]（ 196 ） HTML (1 KB)  PDF  (1514 KB)  ( 103 )