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2023 Vol. 20, No. 32 Published: 2023-11-15

	4	Screening of key genes for death in sepsis patients based on bioinformatics method
		TAN Mingming1 ZHANG Jinming1 DENG Yisi1 ZHAO Fengli2 LUO Yuanyuan2
		DOI: 10.20047/j.issn1673-7210.2023.32.01
		Objective To screen and analyze the key genes for death in sepsis patients by bioinformatics method, and to provide a new idea for the basic research of sepsis. Methods The gene pool related to sepsis was searched in GEO database by computer, and the database GSE54514 with peripheral blood gene profile of sepsis patients was selected, and then differential gene analysis, including GO and KEGG enrichment analysis, was performed. The protein protein interaction (PPI) network of differential genes was established using the STRING database, and finally Cytoscape software was used to analyze the interactions of differential genes and screen out the top ten genes that may be associated with death in sepsis patients. After that, the differential genes of sepsis patients and healthy people were screened through another sepsis gene profile GSE137342, and the common differential genes of the two parts of differential genes were found out, and then analyzed in detail. Results There were 184 differential genes (92 up-regulated genes and 92 down-regulated genes) between the patients who died of sepsis and those who did not die of sepsis detected by GSE54514, and the differences were statistically significant (P＜0.05). The results of GO enrichment analysis suggested that the biological processes of these differential genes were mainly concentrated in the generation of precursor metabolites and energy, negative regulation of protein complex assembly, ATP metabolism, and so on. The cell components were mainly concentrated in the adhesive plaque, cyst cavity, cytoplasmic cyst cavity, and so on. The molecular functions were mainly concentrated in cadherin binding, ribosome structural components, integrin binding, and so on. KEGG enrichment analysis indicated that these differential gene pathways were mainly enriched in diabetic cardiomyopathy, ribosome, and so on. The PPI network was used to identify the top ten key genes associated with death in patients with sepsis, including RPS17, RPS15A, RPL27, RPS27, FAU, etc. According to GSE137342, 623 differential genes (seven up-regulated genes and 616 down-regulated genes) were detected between sepsis patients and healthy people, and the differences were statistically significant (P＜0.05). The two databases shared 16 differential genes. Compared with the top ten key genes related to the death of sepsis patients, it was found that RPL27, RPS27, and FAU were the common differential genes. Conclusion RPL27, RPS27, and FAU may be involved in the pathophysiological process of sepsis development and prognosis, and are closely related to the death outcome of sepsis patients.
		2023 Vol. 20 (32): 4-10 [Abstract] ( 23 ) HTML (1 KB) PDF (2966 KB) ( 28 )

	11	Screening and bioinformatics analysis of meniscus differential genes in osteoarthritis based on GEO database
		XU Wenfei1 MING Chunyu2 MEI Qijie1 YUE Xing1 YUAN Changshen1 GUO Jinrong1 DUAN Kan1 LIANG Xiaohui3▲
		DOI: 10.20047/j.issn1673-7210.2023.32.02
		Objective To screen osteoarthritis meniscus-related differentially expressed genes (DEGs) based on the GEO database and bioinformatics, and to analyse their biological functions, with a view to providing new ideas and methods for the treatment of osteoarthritis. Methods The dataset (GSE98918) was downloaded from GEO database and divided into 12 cases in normal group and 12 cases in osteoarthritis group. The difference analysis of the data was conducted using R language to obtain DEGs. The GO and KEGG signaling pathways of DEGs were analyzed using DAVID 6.8 database. After that, STRING database and Cytoscape software were used for proteinprotein interaction (PPI) and key target genes were obtained. The expression of joint target genes was further verified by fluorescence quantitative PCR. Results The final score was 220 DEGs, including 114 up-regulated and 106 down-regulated DEGs. GO mainly involves extracellular region, extracellular space, collagen trimer, collagen fibril tissue, protein extracellular matrix, and other processes. KEGG was mainly related to signaling pathways such as complement and coagulation cascade, staphylococcus aureus infection, extracellular matrix receptor interaction, protein digestion and absorption, prion disease, etc. Five key target genes were identified by PPI analysis, including VEGFA, MMP9, COL1A1, SPI1, and ITGB1. The top five predicted miRNAs were hsa-miR-4728-5p, hsa-miR-6750-3p, hsa-miR-6727-3p, hsa-miR-6734-3p, and hsa-miR-6780b-3p. Conclusion Bioinformatics analysis is used to elucidate the potential characteristics of the differential genes between osteoarthritis and healthy joints, effectively analyze the pathogenesis, and provide a new direction for clinical treatment of osteoarthritis.
		2023 Vol. 20 (32): 11-16 [Abstract] ( 26 ) HTML (1 KB) PDF (1974 KB) ( 33 )

	17	Expression and clinical significance of minichromosome maintenance protein 8 in glioma
		ZHOU Chengying1 ZHAO Benhuo2 BAO Lei1 HUA Fang1 YANG Xinxin1
		DOI: 10.20047/j.issn1673-7210.2023.32.03
		Objective To analyze the clinical significance and expression of minichromosome maintenance protein 8 (MCM8) in glioma tissues. Methods MRNA data and the differential expression of MCM8 was extracted and analyzed from 17 glioma and four para-cancerous tissues involved in GSE19728, 156 glioma and five para-cancerous tissues involved in TCGA. China Glioma Genome Atlas analyzed the expressions of MCM8 in various pathological types of gliomas and para-cancerous tissues and the effects of MCM8 on the prognosis of glioma. Enrichment analysis of MCM8 co-expression genes in glioma was performed by DAVID. Interaction molecules of MCM8 were analyzed by STRING and PINA. Correlations between MCM8 expression and the immune infiltrations in the microenvironment of glioma were explored by TISIDB database. Results MCM8 expression in glioma was higher than para-cancerous tissues, the difference was statistically significant (P＜0.05). Expressions of MCM8 in gliomas of World Health Organization（WHO） grade Ⅲ and Ⅳ were higher than grade Ⅱ, the differences were highly statistically significant (P＜0.01). The survival rates of glioma patients with high MCM8 expression was lower than those with low expression, the differences were statistically significant (P＜0.05). MCM8 was involved in the regulation of intracellular DNA replication, response to damage stimulus and other processes. MCM8 was closely related to the members of the cell division control protein and DNA polymerase families. MCM8 expression level in glioma was negatively related to the infiltrating levels of activated T cell, B cell, natural killer cell, dendritic cell and macrophagocytes in the tumor microenvironment (r＜0, P＜0.05). Conclusion MCM8 is overexpressed in glioma and closely correlated with the progression and prognosis of glioma.
		2023 Vol. 20 (32): 17-21 [Abstract] ( 22 ) HTML (1 KB) PDF (1610 KB) ( 127 )

	22	Visualization of myocardial injury in sepsis treated with traditional Chinese medicine based on CiteSpace
		JIN Yueting1 LIU Fangyu1 DU Yuan1 YE Haoran1 HE Shasha2 GUO Yuhong1
		DOI: 10.20047/j.issn1673-7210.2023.32.04
		Objective To explore the research status and trend of traditional Chinese medicine in the treatment of myocardial injury in sepsis by CiteSpace software. Methods The published literatures on myocardial injury in sepsis were retrieved by computer from CNKI, Wanfang Data, VIP, and China Biomedical Literature Service System from inception to May 2023. The bibliometrics software CiteSpace 6.1.R3 was used to visually analyze the number of publications, authors, institutional cooperation, and keywords of the included literatures. Results A total of 292 literatures were included. Since 2006, the number of literatures showed an overall upward trend. There were 208 institutions, and the institution with the largest number of literatures was Guangzhou University of Traditional Chinese Medicine. Qian Fenghua and Hu Dandan had the largest number of papers published in this field, and the core authors with a high number of papers were Peng Xiaohong and others, form a core team of authors. Key words showed that the research in this field mainly focuses on the mechanism of action and clinical research of traditional Chinese medicine in the treatment of myocardial injury in sepsis. Among them, Xuebijing, inflammation, oxidative stress, ligustrazine, electroacupuncture and other high-frequency keywords were the research hotspots. Conclusion Traditional Chinese medicine treatment of myocardial damage in sepsis is still in the development stage. The mechanism and clinical research of traditional Chinese medicine treatment of myocardial damage in sepsis are the research trend. In the future, we should pay attention to the depth of research and carry out high-quality research.
		2023 Vol. 20 (32): 22-27 [Abstract] ( 21 ) HTML (1 KB) PDF (1996 KB) ( 51 )

	28	Predictive value of plasma exosomal deleted in lymphocytic leukemia 1 level in immunotherapy response of epidermal growth factor receptor/anaplastic lymphoma kinase wild type advanced non-small cell lung cancer patients
		LIU Qiuxia JI Longfei HU Yanqin PAN Nannan QIANG Xinhua LI Yong
		DOI: 10.20047/j.issn1673-7210.2023.32.05
		Objective To investigate the clinical significance of plasma exosomal deleted in lymphocytic leukemia 1 (exo- DLEU1) in predicting immunotherapy response of epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK) wild type advanced non-small cell lung cancer (NSCLC) patients. Methods The blood samples of 91 patients with EGFR/ALK wild type advanced NSCLC who received immunotherapy in the First People’s Hospital of Huzhou, Zhejiang Province from June 2017 to February 2019 were collected and divided into response group (53 cases) and non-response group (38 cases) according to the response after immunotherapy. Plasma exosomes were extracted from the two groups before treatment, and exoDLEU1 expression was detected by real-time fluorescent quantitative PCR. The influencing factors of immunotherapy response in EGFR/ALK wild type advanced NSCLC patients were analyzed by logistic regression. Receiver operator characteristic (ROC) curve was plotted to evaluate the predictive value of plasma exoDLEU1 level in immunotherapy response. Results Under transmission electron microscopy, the vesicles had circular or elliptical membranes with diameters ranging from 30 to 150 nm, and the original concentration was 6.6×1010 particles /ml. Flow cytometry and Western blot showed that the extracts contained exosome markers CD63, CD9, CD81, and heat shock protein 70. Real-time fluorescence quantitative PCR results showed that the plasma exoDLEU1 level in the response group before treatment was lower than that in the non-response group, and the difference was statistically significant (P＜0.05). Analysis of influencing factors showed that plasma exoDLEU1 expression level was an independent influencing factor for immunotherapy non-response in EGFR/ALK wild type advanced NSCLC patients (OR=6.119, 95%CI: 2.768-13.526, P＜0.05). ROC curve analysis showed that plasma exoDLEU1 expression level predicted immunotherapy response of EGFR/ALK wild type advanced NSCLC patients with an area under the curve of 0.900 (P＜0.05). Conclusion The plasma exoDLEU1 level of EGFR/ALK wild type advanced NSCLC patients before immunotherapy can be used as an indicator to predict their treatment response, and help to screen out patients who are more likely to benefit from immunotherapy in the clinic.
		2023 Vol. 20 (32): 28-32 [Abstract] ( 27 ) HTML (1 KB) PDF (1037 KB) ( 27 )

	33	Expression of lncRNA XIST and miR-132-3p in endometrial cancer tissues and the relationship with pathological parameters and prognosis
		REN Xiaoxia1 XU Haibo2 WU Jinting3 WANG Chenyi4 HAN Yaqin1
		DOI: 10.20047/j.issn1673-7210.2023.32.06
		Objective To investigate the expression of long non-coding RNA X inactive specific transcript (lncRNA XIST), microRNA-132-3p (miR-132-3p) in endometrial cancer (EC) tissues and the relationship with pathological parameters and prognosis. Methods A total of 100 EC patients admitted to the Sixth People’s Hospital of Nantong and Nantong Tumor Hospital, Jiangsu Province from February 2016 to December 2019 were selected. qPCR was used to detect the expression of lncRNA XIST and miR-132-3p in cancer and paracancer tissues. The StarBase database predicted the relationship between lncRNA XIST and miR-132-3p, and Pearson correlation analysis was used to correlate the expression of lncRNA XIST and miR-132-3p. At three years follow-up, according to the average expression of lncRNA XIST and miR-132-3p in EC tissues, the patients were divided into high expression group and low expression group, and the survival curves of patients with different lncRNA XIST and miR-132-3p expression in EC tissues were plotted using the K-M method. Results lncRNA XIST expression in cancer tissue was higher than that in paracancerous normal tissue, and miR-132-3p expression was lower than that in paracancerous normal tissue (P＜0.05). There was a complementary sequence between lncRNA XIST and miR-132-3p, lncRNA XIST was negatively correlated with miR-132-3p expression in EC tissues (r =-0.694, P＜0.01). The expression of lncRNA XIST and miR-132-3p in EC tissues of different differentiation degrees, International Federation of Obstetrics and Gynecology (FIGO) stage, vascular invasion, and lymph node metastasis were statistically significant (P＜0.05). The 3-year cumulative survival rate of the lncRNA XIST high expression group was lower than that of the lncRNA XIST low expression group, and the 3-year cumulative survival rate of the miR-132-3p high expression group was higher than that of the miR-132-3p low expression group (P＜0.05). Conclusion The expression of lncRNA XIST is high and that of miR-132-3p is low in EC tissue, and its correlate with differentiation degree, FIGO stage, vascular invasion, and lymph node metastasis and prognosis.
		2023 Vol. 20 (32): 33-37 [Abstract] ( 20 ) HTML (1 KB) PDF (898 KB) ( 29 )

	38	Research progress of fecal bacteria transplantation in the treatment of slow transit constipation
		HU Lin1 TANG Xuegui2
		DOI: 10.20047/j.issn1673-7210.2023.32.07
		With the acceleration of the pace of life and the change of diet, chronic functional constipation has gradually become a common and frequently occurring disease, which seriously affects people’s daily life, with the highest incidence rate among the middle-aged and elderly. Slow transit constipation is one of the most common types. The occurrence of slow transit constipation is related to intestinal microbiota disorder, and fecal microbiota transplantation, as a new type of microecological preparation mainly composed of gut microbiota, can promote intestinal transportation and alleviate constipation symptoms by changing the quantity, structure, metabolites, and immune regulation of the gut microbiota, while ensuring effectiveness and safety. This article reviews the research progress of fecal bacteria transplantation in the treatment of slow transit constipation.
		2023 Vol. 20 (32): 38-42 [Abstract] ( 20 ) HTML (1 KB) PDF (788 KB) ( 102 )

	43	Research progress in the incidence and treatment of chemotherapy nausea and vomiting and their correlation with intestinal flora
		YANG Qiuyan1 XIAO Haijuan2 MA Yuyuan1 LI Yanan1 ZHAO Jingtao1 QIN Yue1
		DOI: 10.20047/j.issn1673-7210.2023.32.08
		Nausea and vomiting are common side effects of chemotherapy, which can also lead to poor quality of life, nutritional deficiency, inflammation, immunity, and other adverse consequences. At present, western antiemesis drugs have 5-hydroxytryptamine 3 receptor antagonists, neurokinin 1 receptor antagonists, glucocorticoids, and so on. Although they have certain effects, they will produce other adverse reactions. By reviewing relevant literatures, it is found that intestinal flora is closely related to the digestive tract reaction caused by chemotherapy and treatment. This paper reviews the western medicine mechanism of nausea and vomiting caused by chemotherapy, the correlation between traditional Chinese medicine theory and intestinal flora, and the regulation of intestinal flora through spleen-strengthening Chinese medicine prescriptions, and probiotics to treat nausea and vomiting caused by chemotherapy. Some suggestions are put forward for the problems in this research field so as to provide reference for clinical application and clinical trials.
		2023 Vol. 20 (32): 43-46 [Abstract] ( 19 ) HTML (1 KB) PDF (611 KB) ( 137 )

	47	Research progress on the relief of procedural pain in neonatal intensive care unit by the odor of mother’s milk
		WANG Jiaying1 LIN Mei2 XU Dongmei2 HUANG Ting1 HUANG Zhirong2 HUANG Liling1 LI Yujuan2
		DOI: 10.20047/j.issn1673-7210.2023.32.09
		Newborns possess olfactory function, and multiple studies have confirmed that breast milk olfactory stimulation is an effective non-pharmacological nursing method for relieving procedural pain in newborns. This article analyzes the mechanism of mother’s milk odor stimulation on neonatal procedural pain, and reviews the intervention methods and effects of mother’s milk odor in procedural pain in the neonatal intensive care unit, as well as the effects of mother’s milk odor olfactory stimulation and multi-sensory combined stimulation on alleviating procedural pain in the neonatal intensive care unit. And this article also analyzes the current shortcomings of these studies and proposes future research directions. This article aims to guide nurses in the neonatal intensive care unit to optimize clinical nursing practices for procedural pain, and provide reference for future research.
		2023 Vol. 20 (32): 47-50,55 [Abstract] ( 16 ) HTML (1 KB) PDF (701 KB) ( 91 )

	51	Research progress of circularRNA regulating microRNA axis in allergic rhinitis
		YAN Min1 NIU Ruibing2 DUAN Baosheng2
		DOI: 10.20047/j.issn1673-7210.2023.32.10
		Circular RNA are novel, stable non-coding RNA with gene expression and regulation functions. In recent years, it has been found that the abnormal expression of circularRNA is closely related to the pathogenesis of allergic rhinitis. CircularRNA regulate gene expression by binding to microRNA and affect immune response of allergic rhinitis. This article reviews the current status and progress of the research on regulating the expression of innate immune cells, adaptive immune response, transcription factors, and inflammatory factors by regulating the microRNA axis, and then regulating the production of inflammatory mediators in allergic rhinitis, in order to provide new ideas for the future treatment of allergic rhinitis.
		2023 Vol. 20 (32): 51-55 [Abstract] ( 23 ) HTML (1 KB) PDF (581 KB) ( 63 )

	56	Therapeutic role of caspase3 in the non-apoptotic progression of ovarian cancer
		ZHOU Juanhong1 CHEN Fan1 QIN Tiansheng2
		DOI: 10.20047/j.issn1673-7210.2023.32.11
		Ovarian cancer is often diagnosed at an advanced stage due to the lack of specific signs and symptoms. In recent years, the emergence of chemoradiotherapy resistance in ovarian cancer leads to high mortality of patients. The study of non-apoptotic procedures in ovarian cancer is essential to improve the survival rate of ovarian cancer. Caspase3 plays an important role in the non-apoptotic regulation of ovarian cancer, and is a major mediator of various anti-cancer therapies in ovarian cancer, such as cytotoxic drugs, radiotherapy, chemotherapy, and immunotherapy, etc. Exploring the role and value of caspase3-mediated non-apoptotic procedures in the treatment of ovarian cancer is important for improving the survival rate of patients. This article reviews the recent research progress of caspase3 in the treatment of ovarian cancer, in order to provide directions for the clinical treatment of ovarian cancer.
		2023 Vol. 20 (32): 56-59 [Abstract] ( 14 ) HTML (1 KB) PDF (453 KB) ( 139 )

	60	Research progress on the mechanism of acquired drug resistance of epidermal growth factor receptor tyrosine kinase inhibitor and reversal in traditional Chinese medicine
		JIA Chunxin ZHANG Xin MOU Ruiyu JIA Yingjie
		DOI: 10.20047/j.issn1673-7210.2023.32.12
		Non-small cell lung cancer is one of the most common subtypes of lung cancer, and epidermal growth factor receptor mutations are key factor in its pathogenesis. Epidermal growth factor receptor tyrosine kinase inhibitor such as Erlotinib and Gefitinib provide more effective treatment for cancer patients. However, during treatment with epidermal growth factor receptor tyrosine kinase inhibitor, tumour cell develop resistance through mutations, activation of bypass or downstream signalling pathways, and changes in the levels of inflammatory factor and immune cell in the tumour microenvironment, limiting their long-term efficacy. Previous clinical and experimental studies have suggested that some monomers and compounds of traditional Chinese medicine can enhance body’s immune response to tumours by inhibiting multiple signalling pathways related to epidermal growth factor receptor and modulating the tumour microenvironment, thereby effectively inhibiting the progression of epidermal growth factor receptor tyrosine kinase inhibitor-resistant non-small cell lung cancer. This article reviews the reversal of acquired epidermal growth factor receptor tyrosine kinase inhibitor drug resistance in traditional Chinese medicine.
		2023 Vol. 20 (32): 60-63 [Abstract] ( 18 ) HTML (1 KB) PDF (1181 KB) ( 160 )

	64	Research progress on anti-breast cancer effect and mechanism of Jado-mycin and its derivatives
		MA Lanjing TAN Yuanjun ZHU Zhibo ZHANG Baihong
		DOI: 10.20047/j.issn1673-7210.2023.32.13
		Jadomycin and its derivatives are a new group of anthracycline antibiotics isolated from Streptomyces venezuelans, and have been receiving increasing attention because of their cytotoxicity to a variety of cancers, especially breast cancer. This article reviews the research progress of Jadomycin and its derivatives in relation to breast cancer. This review is divided into two parts, the first summaries the anti-breast cancer effect of Jadomycin and its derivatives; the second provides an overview of anti-breast cancer mechanisms of Jadomycin and its derivatives, including induced apoptosis, copper dependent reactive oxygen species generation, topoisomerase inhibition, and aurora kinase B inhibition, etc., which provided an overview of a potential new chemotherapy drug for clinicians.
		2023 Vol. 20 (32): 64-67 [Abstract] ( 33 ) HTML (1 KB) PDF (485 KB) ( 135 )

	68	Application progress of hydrogels in image-guided radiotherapy for pro-state cancer
		PANG Yongpeng TIAN Long ZHAO Xin
		DOI: 10.20047/j.issn1673-7210.2023.32.14
		With the development of image-guided technology, the accuracy of prostate cancer target location has been significantly improved. Accurate target location is a prerequisite for increasing the output dose of prostate cancer and reducing the toxicity of dangerous organs. The toxicity of most of dangerous organs in image-guided radiotherapy (IGRT) for prostate cancer has been effectively controlled, but there is still a certain probability of radiation proctitis. Hydrogel is a kind of adjuvant radiotherapy instrument that can effectively reduce the rectal toxicity of prostate cancer IGRT. Currently, hydrogel is widely used in foreign countries, but it is rarely used in China. The main contents of domestic and foreign application reviews are focused on the protective effect of hydrogels on rectum. This review introduces the latest progress in the application of hydrogels in prostate cancer IGRT, including the surgical procedure of combined gold benchmark markers and the safety evaluation of hydrogel injection. At the same time, the effect of hydrogel on reducing rectal toxicity is further summarized. It is hoped that this review will provide some theoretical reference for the further application of hydrogels in China.
		2023 Vol. 20 (32): 68-70,74 [Abstract] ( 20 ) HTML (1 KB) PDF (498 KB) ( 27 )

	71	Investigation on humanistic care ability and training demand of nursing staff in rehabilitation hospital
		ZHANG Yanchao1　LYU Chunmei2
		DOI: 10.20047/j.issn1673-7210.2023.32.15
		Objective To analyze the current situation of humanistic care ability of nursing staff in rehabilitation hospital and the demand for humanistic care training. Methods From April 17 to 22, 2022, a total of 118 clinical nurses in a third-level rehabilitation hospital were selected by convenient sampling method, and the general data scale, caring ability inventory (CAI) scale, and humanistic care ability training demand scale were used to investigate. Results The total score of 118 nurses’ caring ability evaluation scale was (183.33±23.24) points, and the scores of cognitive dimension, courage dimension, and patience dimension of the survey subjects were lower than the foreign norm, with statistical significances (P＜0.05). The top four items with the highest scores were in the patience dimension, and the bottom five items were in the courage dimension. The CAI total score of nursing staff with different educational background, professional title, and humanistic training were compared, and the differences were statistically significant (P＜0.05). The results of multiple linear regression analysis showed that different titles and humanistic training were the main influencing factors of humanistic care ability of nursing staff (P＜0.05). More than 80% of nurses said they needed training in human care, and the vast majority choose interpersonal communication. Conclusion The humanistic care ability of nurses in rehabilitation hospitals still needs to be improved, and nursing managers in hospitals should carry out various humanistic care training courses according to the needs of nurses, so as to comprehensively improve the humanistic care ability of clinical nurses.
		2023 Vol. 20 (32): 71-74 [Abstract] ( 20 ) HTML (1 KB) PDF (572 KB) ( 8 )

	75	Analysis of the effect and influencing factors of community integrated practice learning
		CAO Jun1 NIE Shengnan1 CHEN Mingxuan2 TUO Anxie3
		DOI: 10.20047/j.issn1673-7210.2023.32.16
		Objective To meet the training needs of medical students in the new medical background, to investigate the current situation and influencing factors of community interns’ practical abilities, and to provide reference for practical teaching of medical students. Methods Convenient sampling method and practical ability assessment scale were adopted. From March to May 2022, interns in community health service institutions in Shangrao and surrounding areas were selected as the observation group, and medical students who had not yet entered clinical practice were selected as the control group for questionnaire survey. Results A total of 468 questionnaires were sent out, and 436 were effectively collected, with an effective recovery rate of 93.16%, including 224 in the community practice learning group and 212 in the control group. The scores of clinical learning, clinical task, and practical ability in the practice learning group were higher than those in the control group, and the teaching environment was lower than that in the control group, with statistical significance (P＜0.05). Multivariate linear regression analysis showed that male students, undergraduate students, provincial capital cities, the number of practical teaching skills training (＞ four times), the working years of teaching teachers (＞10 years), the years of practical teaching units (＞ 10 years), and the overall teaching effect were all included in the regression equation, and could explain 26.5% of the total variation. Conclusion The practical ability of medical students in community practice has been significantly improved, and the practical ability of medical students is affected by gender, city where they live, training experience and other factors.
		2023 Vol. 20 (32): 75-78 [Abstract] ( 21 ) HTML (1 KB) PDF (547 KB) ( 6 )

	79	Visual analysis of literature on intermittent fasting and cardiovascular disease
		ZHANG Jingfang WENG Jieqiong YUAN Mengfei SHEN Xingchen WENG Yayi SHEN Xiaoxu
		DOI: 10.20047/j.issn1673-7210.2023.32.17
		Objective To conduct a visual analysis in the field of intermittent fasting (IF) and cardiovascular diseases and to explore the hot spots. Methods Literatures related to IF and cardiovascular diseases from the Web of Science database from January 2004 to November 2022 was retrieved and imported into CiteSpace software, and countries, institutions, authors and keywords were visually analyzed. Results A total of 513 literatures were included, and the number of literatures had increased rapidly from 2018 to 2022. The journal with the largest number of publications was Nutrients; Countries with a large number of literatures were the United States, China and Brazil; institutions include the University of Illinois, the University of California, San Diego, and the National Institutes of Health; the most prolific authors include Varady, Klempel, and others; the keywords related to cardiovascular disease include oxidative stress. Conclusion Through bibliometrics analysis, the relevant hot spots and development trends of IF in the cardiovascular field are intuitively displayed. Currently, this field is still in a period of rapid development, but the number of papers is not large, and it needs to be further improved in the future.
		2023 Vol. 20 (32): 79-83,92 [Abstract] ( 26 ) HTML (1 KB) PDF (1958 KB) ( 105 )

	84	Prognostic value of electrocardiogram T wave changes combined with ser-um homocysteine in patients with myocardial infarction after percutaneous coronary intervention
		JIN Mengxue ZHANG Qian▲
		DOI: 10.20047/j.issn1673-7210.2023.32.18
		Objective To explore the prognostic value of electrocardiogram T-wave changes combined with serum homocysteine (Hcy) in patients with myocardial infarction (MI) after percutaneous coronary intervention (PCI). Methods A total of 76 MI patients admitted to Suzhou Hospital of Integrated and Western Medicine from January 2017 to July 2022 were selected for PCI. According to the occurrence of major adverse cardiovascular events (MACE) within one year after surgery, they were divided into good prognosis group and poor prognosis group. The general data, electrocardiogram T-wave changes and serum Hcy levels of MI patients in the two groups were compared to analyze the factors affecting the prognosis of MI patients after PCI, and the receiver operating characteristic (ROC) curve was used to analyze the value of electrocardiogram T-wave changes combined with serum Hcy in evaluating the prognosis of MI patients after PCI. Results In 76 MI patients who underwent PCI, a total of 54 patients did not develop MACE and 22 patients developed MACE within one year after surgery. The proportion of T wave inversion and serum Hcy level in the poor prognosis group were higher than those in the good prognosis group, and the differences were statistically significant (P＜0.05). Logistic regression analysis showed that serum Hcy level and T wave inversion were independent risk factors for poor prognosis of MI patients after PCI (OR＞1，P＜0.05). ROC curve analysis showed that the AUC value of Hcy level and T-wave inversion in assessing the prognosis of MI patients after PCI was 0.773 (95%CI: 0.662-0.861) and 0.771 (95%CI: 0.660-0.860), respectively, and the AUC value predicted by the combination of the two was 0.904 (95%CI: 0.815-0.960). Conclusion The changes of electrocardiogram T wave and serum Hcy level have certain predictive value for the prognosis of MI patients after PCI, and the combined value is higher.
		2023 Vol. 20 (32): 84-87 [Abstract] ( 26 ) HTML (1 KB) PDF (560 KB) ( 15 )

	88	Clinical effect of xingnao kaiqiao acupuncture combined with repetitive transcranial magnetic stimulation on post stroke thalamic pain
		CHU Jiaxin1　PENG Fei2▲ LI Jiaojiao1 CUI Runhong1 LIANG Chunxu1 ZHAO Dong3
		DOI: 10.20047/j.issn1673-7210.2023.32.19
		Objective To explore the clinical effect of xingnao kaiqiao acupuncture combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of post stroke thalamic pain (PSTP). Methods A total of 198 patients with PSTP admitted to Liaoning Jinqiu Hospital from September 2018 to October 2022 were selected and they were divided into three groups according to random number table method, with 66 cases in each group. Control group 1 received rTMS treatment, control group 2 received xingnao kaiqiao acupuncture treatment, and combined group received xingnao kaiqiao acupuncture combined with rTMS treatment, all three groups were treated for six weeks. The clinical efficacy, pain degree, inflammatory factor level, and safety of the three groups after treatment were compared. Results The clinical effect of combined group was better than control group 1 and control group 2, and the difference was statistically significant the difference was statistically significant (P＜0.05). After treatment, visual analogue scale score, current pain intensity score and pain grading index score of the three groups were lower than those before treatment, and the combined group were lower than control group 1 and control group 2; serum levels of interleukin-6 and tumor necrosis factor-α in three groups were lower than those before treatment, and the combined group were lower than control group 1 and control group 2, the differences were statistically significant (P＜0.05). No significant adverse reactions were observed during the treatment of the three groups. Conclusion The clinical efficacy of xingnao kaiqiao acupuncture combined with rTMS in the treatment of PSTP is definite, which can significantly alleviate pain symptoms and reduce serum inflammatory factor levels.
		2023 Vol. 20 (32): 88-92 [Abstract] ( 25 ) HTML (1 KB) PDF (715 KB) ( 17 )

	93	Predictive value of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and platelet-to-neutrophil ratio in progressive ischemic stroke of large atherosclerosis
		PANG Weiping1 WANG Baoai2
		DOI: 10.20047/j.issn1673-7210.2023.32.20
		Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR) and platelet-to-neutrophil ratio(PNR) in the progressive ischemic(PIS) stroke of large atherosclerosis. Methods Clinical data of 327 patients with large atherosclerotic cerebral infarction admitted to Fenyang Hospital of Shanxi Province from January 2021 to December 2021 were retrospectively collected. They were divided into PIS group (56 cases) and non-PIS group (271 cases) according to whether the disease progressed within 72 hours. Two sets of general data were compared and the influencing factors of PIS were explored and the predictive value of NLR, PLR, and PNR for PIS were evaluated. Results Admission systolic blood pressure, admission diastolic blood pressure, admission National Institutes of Health stroke scale (NIHSS) score, white blood cell count, neutrophil count, NLR, and PLR in PIS group were higher than those in non-PIS group, and lymphocyte count and PNR were lower than those in non-PIS group, with statistical significances (P＜0.05). NLR (OR=1.150, 95%CI:1.048-1.261, P=0.003), PLR (OR=1.006, 95%CI:1.002-1.009, P= 0.002), and PNR (OR=0.978, 95%CI:0.958-0.997, P=0.024) were independent influencing factors of PIS. NLR predicted the area under receiver operating characteristic (ROC) curve of PIS was 0.707(95%CI:0.642-0.772, P＜0.001), the optimal cutoff value was 3.14, the sensitivity was 82.1%, and the specificity was 61.6%. The area under curve of ROC PLR predicted PIS was 0.662(95%CI:0.589-0.736, P＜0.001), the optimal cutoff value was 138.50, the sensitivity was 73.2%, and the specificity was 57.2%. The area under ROC curve of PNR predicted PIS was 0.604(95%CI:0.530-0.677, P=0.015), the best cutoff value was 44.28, the sensitivity was 64.3%, and the specificity was 59.4%. Conclusion NLR, PLR, and PNR are independent influencing factors of PIS, all of which have predictive value for progressive stroke of large atherosclerosis.
		2023 Vol. 20 (32): 93-97 [Abstract] ( 22 ) HTML (1 KB) PDF (722 KB) ( 26 )

	98	Comparison of application effect of mechanical thrombectomy and intra-arterial thrombolysis in patients with acute cerebral infarction
		WANG Liming YANG Dandan CHEN Jing CAI Dandan ZHANG Xueling▲
		DOI: 10.20047/j.issn1673-7210.2023.32.21
		Objective To explore the application effect of mechanical thrombectomy (MT) and intra-arterial thrombolysis (IAT) in patients with acute cerebral infarction. Methods A total of 120 patients with acute cerebral infarction admitted to Suqian Hospital Affiliated to Xuzhou Medical University from January 2021 to July 2022 were included in the study and they were divided into thrombectomy group and thrombolysis group according to different treatment methods, with 60 cases in each group. The thrombectomy group received MT and the thrombolysis group received IAT. The clinical efficacy of the two groups was recorded and compared, the vascular recirculation condition of the two groups was compared, and the levels of neurological function indicators (National Institutes of Health stroke scale [NIHSS] score, neuron specific enolase [NSE], S100β protein [S100β], brain-derived neurotrophic factor [BDNF]) before and after surgery of the two groups were measured and compared. Complications and prognosis of the two groups were recorded and compared. Results The clinical effect of thrombectomy group was better than that of thrombolysis group, and the difference was statistically significant (P＜0.05). The vascular condition of thrombectomy group was better than that of thrombolysis group, and the difference was statistically significant (P＜0.05). One week after surgery, the NIHSS score, NSE, and S100β levels of the two groups were decreased, while the BDNF level was increased, and the NIHSS score, NSE, and S100β levels of the thrombectomy group were lower than those of the thrombolysis group, while the BDNF level of the thromectomy group was higher than that of the thrombolysis group, and the differences were statistically significant (P＜0.05). The incidence of complications and mortality in thrombectomy group were lower than those in thrombolysis group, and the differences were statistically significant (P＜0.05). Conclusion The therapeutic effect of MT on patients with acute cerebral infarction is significantly better than that of IAT, which can effectively help vascular recanalization, improve postoperative neurological function of patients, and reduce complications and mortality.
		2023 Vol. 20 (32): 98-101 [Abstract] ( 23 ) HTML (1 KB) PDF (545 KB) ( 11 )

	102	Effect of sacral magnetic stimulation on prevention of urinary retention after cervical cancer surgery
		ZHU Wenhui1 LIU Lin2 WU Jie3 WANG Haihong4 SHI Zhenduo2 MENG Qi4 HAN Conghui5▲
		DOI: 10.20047/j.issn1673-7210.2023.32.22
		Objective To investigate the clinical effect of sacral magnetic stimulation on prevention of urinary retention after cervical cancer surgery. Methods A total of 108 patients who underwent radical hysterectomy in Xuzhou Central Hospital, Jiangsu Province from March to December 2022 were selected and divided into control group, electrical stimulation group, and magnetic stimulation group by random number table method, with 36 cases in each group. The three groups were given routine care. On the 8th day after surgery, pelvic floor muscle training was performed in the control group, low-frequency electrical stimulation was applied on the basis of pelvic floor muscle training for ten days in the electrical stimulation group, and sacral magnetic stimulation was applied on the basis of pelvic floor muscle training for ten days in the magnetic stimulation group. The residual urine volume, incidence of urinary retention, and urinary tract infection rate of the three groups were recorded, and the pelvic floor muscle strength, maximum urine flow rate, average urine flow rate, urinary volume, and urinary time of the two groups were compared before and after intervention. The occurrence of complications during the intervention was recorded in the two groups. After three months’follow-up, the scores of pelvic floor dysfunction questionnaire and quality of life questionnaire were compared between the two groups, and the recurrence and metastasis of the two groups were observed. Results During the study, one case fell off in the control group, and a total of 35 patients completed the study. The residual urine volume and the incidence of urinary retention in the magnetic stimulation group were lower than those in the control group and the electrical stimulation group, and the differences were statistically significant (P＜0.05). After intervention, the pelvic floor muscle strength, maximum urine flow rate, average urine flow rate, and urinary volume of the three groups were higher than before intervention, and those of magnetic stimulation group were higher than those of control group and the electrical stimulation group, the differences were statistically significant (P＜0.05). After intervention, the urination time of the three groups were shorter than those before intervention, and those of magnetic stimulation group were shorter than those of control group and the electrical stimulation group, the differences were statistically significant (P＜0.05). The scores of the pelvic floor dysfunction questionnaire and the pelvic floor dysfunction questionnaire in the magnetic stimulation group were lower than those in the control group and the electrical stimulation group, the differences were statistically significant (P＜0.05). No complications occurred in the three groups during the intervention period, and there were no signs of recurrence and metastasis during follow-up. Conclusion Sacral magnetic stimulation has a significant effect on the prevention of urinary retention after cervical cancer surgery, which can reduce residual urine volume, improve urinary dysuria, improve pelvic floor muscle strength, and improve the quality of life of patients.
		2023 Vol. 20 (32): 102-107 [Abstract] ( 26 ) HTML (1 KB) PDF (1005 KB) ( 125 )

	108	Value of serum apolipoprotein E combined with lipoprotein-associated phospholipase A2 levels in evaluating the severity of preeclampsia
		WU Quan CHENG Jin
		DOI: 10.20047/j.issn1673-7210.2023.32.23
		Objective To explore the value of serum apolipoprotein E (ApoE) combined with lipoprotein-associated phospholipase A2 (Lp-PLA2) levels in evaluating the severity of preeclampsia. Methods The clinical data of 101 cases of preeclampsia patients admitted to the First Affiliated Hospital of Anhui University of Science and Technology from January 2020 to October 2022 were collected. They were divided into mild group and severe group according to the severity of the disease. The serum ApoE and Lp-PLA2 levels of patients were detected; the factors affecting the severity of the preeclampsia patients were analyzed by logistic regression; the value of serum ApoE combined with Lp-PLA2 levels in evaluating the severity of preeclampsia was analyzed by receiver operating characteristic curve. Results Among the 101 cases of preeclampsia, 78 cases were mild, 23 cases were severe. The proportion of hypertension, serum ApoE and Lp-PLA2 levels in severe group were higher than those in mild group (P＜0.05). Serum ApoE and Lp-PLA2 levels were independent risk factors for the severity of preeclampsia (OR=3.282, 2.772, P＜0.05). The area under the curve of serum ApoE combined with Lp-PLA2 to assess the severity of preeclampsia was higher than that detected by each indicator alone. Conclusion Serum ApoE and Lp-PLA2 levels in patients with preeclampsia are related to the severity of the disease, and their combined diagnosis value is high.
		2023 Vol. 20 (32): 108-111 [Abstract] ( 17 ) HTML (1 KB) PDF (646 KB) ( 25 )

	112	Meta analysis of the clinical value of preservation of pelvic autonomic nervous system in total mesorectal resection surgery for middle and low rectal cancer
		LAI Suyu ZHAO Ziting REN Bing ZENG Yixian RUAN Mengyi WANG Xiaofeng
		DOI: 10.20047/j.issn1673-7210.2023.32.24
		Objective To evaluate the clinical value of preservation of pelvic autonomic nervous system in middle and low rectal cancer during total mesorectal resection. Methods Using RevMan 5.4 software, CNKI, VIP, Wanfang Database, SinoMed, Cochrane Library, PubMed, EMbase database, and Web of Science database were searched, randomized controlled trial (RCT) screening for pelvic autonomic nerve sparing treatment of middle and low rectal cancer during total mesorectal resection. The retrieval period was from the establishment of the database to April 2023. Meta-analysis was performed using RevMan 5.4 software. Results Finally, ten RCTs were included, including 899 patients. Data showed that the incidence of postoperative erectile dysfunction in the observation group was lower than that in the control group [RR= 0.46, 95%CI (0.38-0.58), P＜0.000 01], the incidence of postoperative ejaculatory dysfunction in the observation group was lower than that in the control group [RR=0.54, 95%CI (0.46, 0.65), P＜0.000 01], the effect of postoperative urination function in the observation group was lower than that in the control group [RR=0.38，95%CI (0.29-0.51), P＜0.000 01]; there was no significant difference in tumor recurrence rate between the two groups [RR=0.82, 95%CI (0.45-1.52), P=0.53]. Conclusion In the surgical treatment of middle and low rectal cancer, compared with traditional radical rectal cancer surgery, although total mesorectal excision +pelvic autonomic nerve preservation did not significantly improve the recurrence rate, it could protect postoperative sexual function and urination and improve the quality of life, which has clinical value.
		2023 Vol. 20 (32): 112-116 [Abstract] ( 22 ) HTML (1 KB) PDF (1325 KB) ( 10 )

	117	Network meta-analysis of Osimertinib combination therapy for advanced non-small cell lung cancer
		SANG Bulin1 HUANG Huiyuan2 WANG Xurao2 DONG Lixian2 XU Rong2 FAN Yuxin2 FENG Jin2 HE Jianchang2
		DOI: 10.20047/j.issn1673-7210.2023.32.25
		Objective To evaluate the efficacy of Osimertinib (OSI) combination therapy in the treatment of advanced non-small cell lung cancer (NSCLC) by network meta-analysis. Methods Cochrane Library, PubMed, CNKI, Wanfang Data, and China Biology Medicine Disc were searched for randomized controlled trials on OSI combination therapy of advanced non-small cell lung cancer from the inception to September 2022. Information extraction and quality evaluation were performed on the included studies. Stata 15.0 and Review Manager 5.3 software were used for network meta-analysis. Results A total of 25 literatures were included, involving 2 374 patients. The intervention measures included OSI alone and OSI combined with first-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), standard treatment (first-generation EGFR-TKI + platinum), Shenyi Capsules, Valmenin Capsules, Yiqi Yangyin Prescription, Bevacizumab, and chemotherapy, and the control measures included OSI, first-generation EGFR-TKI, standard treatment, chemotherapy, and chemotherapy combined with Bevacizumab. The top three interventions in the surface under the cumulative ranking curve (SUCRA) of objective response rate were OSI + Yiqi Yangyin Prescription (85.0%), OSI + Beizumab (72.4%), OSI+ standard treatment (71.6%), and OSI+ Shengyi Capsules (71.6%). The top three interventions in SUCRA in disease control rate were OSI+ Bevacizumab (88.7%), OSI+ Valmenin Capsules (86.2%), and OSI+ Yiqi Yangyin Prescription (76.0%). Conclusion In the treatment of advanced non-small cell lung cancer, the combination of OSI, Yiqi Yangyin Prescription, and Bevacizumab may be the best choice in the future.
		2023 Vol. 20 (32): 117-122 [Abstract] ( 21 ) HTML (1 KB) PDF (2024 KB) ( 39 )

	123	Occurrence of cardiac adverse events during Bortezomib treatment in patients with first-diagnosed multiple myeloma and risk factors analysis
		YU Yan1 SHEN Lian1 DING Xi2 CHEN Yamei1▲
		DOI: 10.20047/j.issn1673-7210.2023.32.26
		Objective To investigate the occurrence risk of cardiac adverse events during Bortezomib treatment in patients with first-diagnosed multiple myeloma and risk factors analysis. Methods The medical records of 100 patients with multiple myeloma admitted to Dongtai People’s Hospital of Jiangsu Province from February 2020 to February 2022 were retrospectively analyzed. All patients were treated with Bortezomib as the basic induction chemotherapy drug, and were also treated with Ifosfamide. According to the monitoring results of cardiac adverse events during Bortezomib treatment, the patients were divided into cardiac adverse events occurrence group and non-occurrence group, and the risk factors affecting the occurrence of cardiac adverse events during Bortezomib treatment were analyzed. Results The incidence of central adverse events in 100 patients with first diagnosed multiple myeloma was 18.00%. There were no significant differences in gender, age, body mass index, pathological classification, Durie-Salmon stage, abnormal plasma cell proportion, bone lysis destruction, and blood calcium between two groups (P＞0.05); the levels of cardiac troponin I (cTnI), hypersensitive C-reactive protein (hs-CRP), and serum creatinine (Scr) in occurrence group were higher than those in non-occurrence group, and the level of hemoglobin (HGB) was lower than that in non-occurrence group (P＜0.05). The levels of cTnI (OR= 3.554), hs-CRP (OR=1.237), Scr (OR=1.067), and HGB (OR=0.930) were the influential factors for cardiac adverse events during Bortezomib treatment (P＜0.05). Conclusion The incidence of cardiac adverse events during Bortezomib treatment for the first multiple myeloma is relatively high, and the expression of cTnI, hs-CRP, Scr, and HGB are related to the occurrence of this event.
		2023 Vol. 20 (32): 123-126 [Abstract] ( 21 ) HTML (1 KB) PDF (567 KB) ( 90 )

	127	Clinical study of Anlotinib combined with Irinotecan in the treatment of advanced extensive small cell lung cancer after Etoposide + Cisplatin regimen
		PEI Xiufeng HE Chuan LI Xiaofeng ZHAO Xiaofei HU Ping SHI Wanting LI Wenyan NIE Fang▲
		DOI: 10.20047/j.issn1673-7210.2023.32.27
		Objective To investigate the clinical study of Anlotinib combined with Irinotecan in the treatment of extensive small cell lung cancer (SCLC) after Etoposide + Cisplatin (EP) regimen. Methods A total of 80 patients with SCLC who progressed after EP regimen treatment admitted to Baotou Tumor Hospital of Inner Mongolia Autonomous Region from July 2020 to June 2022 were selected as the study objects. Random number table method was used to divide them into study group and control group, with 40 patients in each group. The study group was treated with Anlotinib combined with Irinotecan, while the control group was treated with Irinotecan, with a cycle of 21 days. The serum indexes of the two groups before and after four cycles of treatment were compared, and the occurrence of side effects and efficacy of the two groups were compared. Both groups were followed up for at least six months to observe the prognosis. Results After four cycles of treatment, matrix metalloproteinase 2, vascular endothelial growth factor, and transforming growth factor -β1 in two groups were lower than those before treatment, and those of study group were lower than those of control group, the differences were statistically significant (P＜0.05). The disease control rate of the study group was higher than that of the control group, and the difference was statistically significant (P＜0.05). There was no significant difference in the severity of side effects between the two groups (P＞0.05). The progression-free survival time (PFS) and overall survival time (OS) of the study group were longer than those of the control group (P＜0.05). Conclusion Anlotinib combined with Irinotecan has better clinical effect on patients with extensive SCLC after the progression of EP regimen than Irinotecan alone, and has a certain effect on prolonging PFS and OS.
		2023 Vol. 20 (32): 127-130 [Abstract] ( 22 ) HTML (1 KB) PDF (631 KB) ( 10 )

	131	Systematic review of risk prediction models for enteral feeding intolerance in intensive care unit patients
		LIU Tingting TANG Ling SUN Yan LU Jun LU Daozhen▲
		DOI: 10.20047/j.issn1673-7210.2023.32.28
		Objective To systematically review the research status of risk prediction models for enteral nutrition feeding intolerance in intensive care unit (ICU) patients. Methods PubMed, EMbase, Web of Science, Cochrane Library, CNKI, Wanfang Data, VIP, SinoMed were searched from the establishment of the inception to February 2023. Two researchers independently screened the literatures, extracted the data, and evaluated the quality of the included models using the prediction model risk of bias assessment tool. Results A total of ten literatures were included, including 14 prediction models. The area under the receiver operating characteristic curve of 12 models ranged from 0.60 to 0.94, and nine models had good accuracy. The model bias risk assessment results showed that the study had a high risk of bias and good applicability. Conclusion Future research should focus on the external validation and optimization of existing models, or the development of new models under the guidance of standardization to improve the applicability and feasibility of models in clinical application.
		2023 Vol. 20 (32): 131-134,143 [Abstract] ( 28 ) HTML (1 KB) PDF (714 KB) ( 89 )

	135	Application of continuous health management based on WeChat platform in patients with complex diffuse arteriovenous malformation
		ZHANG Fengmei1 YANG Liu2▲ LI Xiaona3 LI Kelei1 QIN Zhongping1
		DOI: 10.20047/j.issn1673-7210.2023.32.29
		Objective To explore the application effect of continuous health management based on WeChat platform in patients with complex diffuse arteriovenous malformation (AVM). Methods A total of 150 patients with complex diffuse AVM admitted to Linyi Cancer Hospital, Shandong Province from March 2021 to March 2022 were selected. They were divided into control group (75 cases) and study group (75 cases) by convenience sampling method. The control group was given conventional discharge guidance, while study group applied continuous health management based on WeChat platform. After 12 months of follow-up, the psychological status, self management, and quality of life of two groups were compared before and after intervention. Results After intervention, the scores of self-rating anxiety scale and self-rating depression scale in two groups were lower than those before intervention, and those in study group were lower than those in control group (P＜0.05). After intervention, the scores of exercise of self-care agency scale in both groups were higher than those before intervention, and those in study group were higher than those in control group (P＜0.05). After intervention, the scores of 36-item short form health survey in two groups were higher than those before intervention, and those in study group were higher than those in control group (P＜0.05). Conclusion The continuous health management based on WeChat platform has high application value, can improve the negative emotions of patients with complex diffuse AVM, improve the self management and quality of life of patients after discharge, and is worthy of promotion and application.
		2023 Vol. 20 (32): 135-138 [Abstract] ( 15 ) HTML (1 KB) PDF (640 KB) ( 47 )

	139	Model construction of driving factors and nursing intervention strategies for ventilator-associated pneumonia in elderly patients with chronic obstr- uctive pulmonary disease complicated with respiratory failure undergoing mechanical ventilation
		XU Li ZHANG Meng ZHANG Dongya
		DOI: 10.20047/j.issn1673-7210.2023.32.30
		Objective To establish driving factors model of ventilator-associated pneumonia (VAP) in elderly patients with chronic obstructive pulmonary disease (COPD) combined with mechanical ventilation of respiratory failure, and formulate nursing intervention strategies accordingly. Methods A total of 120 elderly patients with COPD combined with mechanical ventilation for respiratory failure admitted to the Department of Respiratory and Critical Care Medicine of Huaian First Hospital Affiliated to Nanjing Medical University from February 2019 to February 2022 were included in the study. According to the occurrence of VAP, the patients were divided into VAP group (26 cases) and non-VAP group (94 cases), and clinical data of the two groups were retrospectively collected. The factors influencing the occurrence of VAP in elderly patients with COPD combined with mechanical ventilation of respiratory failure were analyzed and the driving factors model was established according to logistic regression model, and the predictive value of receiver operator characteristics (ROC) curve was drawn to analyze the occurrence of VAP in patients. Results Age, proportion of consciousness disorder, proportion of mechanical ventilation time ＞five days, proportion of tracheotomy with mechanical ventilation tube, proportion of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score ＞15 points, proportion of repeated hospitalization due to COPD, proportion of serum albumin level ≤30 g/L, proportion of total vein of nutritional support, and the proportion of supine in VAP group were higher than those in non-VAP group, and the oxygenation index was lower than that in non-VAP group (P＜0.05). The results of multi-factor analysis showed that age, disturbance of consciousness, mechanical ventilation time ＞ five days, tracheotomy with mechanical ventilation tube, APACHEⅡ score ＞15, multiple hospitalizations due to COPD, serum albumin level ≤30 g/L, and total vein of nutritional support were the factors influencing the occurrence of VAP in elderly patients with COPD combined with mechanical ventilation of respiratory failure (P＜0.05). According to the results of multi-factor analysis, the driving factors model was established: logit (P) =-14.690- age×0.683+disturbance of consciousness×0.706+mechanical ventilation time ＞ five days×0.648+APACHEⅡ score ＞ 15 points×0.798+serum albumin level ＜ 30 g/L×0.564+nutritional support pathway was total vein×0.733, and the area under ROC curve was 0.892 (P＜0.05). Conclusion It is of high value to establish driving factors model to predict the occurrence of VAP in elderly patients with COPD combined with mechanical ventilation of respiratory failure, and it has certain reference value for the corresponding nursing intervention strategies of high-risk patients in clinic.
		2023 Vol. 20 (32): 139-143 [Abstract] ( 21 ) HTML (1 KB) PDF (758 KB) ( 17 )

	144	Professor Rao Xiangrong’s experience in treatment based on syndrome differentiation of type Ⅳ cardiorenal syndrome based on spleen, kidney, and heart
		LIU Chenxuan LIANG Yutian RAO Xiangrong
		DOI: 10.20047/j.issn1673-7210.2023.32.31
		Chronic kidney disease patients have a high incidence of cardiovascular events. Type Ⅳ cardiorenal syndrome is a clinical syndrome of cardiac damage and/or dysfunction caused by chronic kidney disease. Based on years of clinical experience in the prevention and treatment of chronic kidney disease, Professor Rao Xiangrong believes that kidney decay is the basis of type Ⅳ cardiorenal syndrome, dampness, blood stasis, turbidity and toxin are the causes of emergency symptoms. Professor Rao Xiangrong concluded “spleen, kidney, and heart decay, obstruction of sanjiao, blood stasis and water accumulation, endogenous turbidity and toxin” as the main pathogenesis of type Ⅳ cardiorenal syndrome. The treatment should be tailored to the urgency of the situation, to ensure the normal operation of qi, blood, and water in the slowly developing stage. While the acute events are due to turbidity and poison block the heart vessels and water attack the heart cause yang qi suppressed, thus to remove blood stasis, drain water, and descend turbidity at the acute phase. This paper aims to enrich the content of traditional Chinese medicine on the differentiation and treatment of type Ⅳ cardiorenal syndrome, and an effective case is attached.
		2023 Vol. 20 (32): 144-147 [Abstract] ( 44 ) HTML (1 KB) PDF (615 KB) ( 9 )

	148	Effect of acupoint stimulation combined with breast massage on improving postpartum breast deficiency of caesarean section parturients
		SONG Yingying JIANG Lina▲
		DOI: 10.20047/j.issn1673-7210.2023.32.32
		Objective To observe the clinical effect of acupoint stimulation combined with breast massage on improving postpartum breast deficiency in caesarean section parturients. Methods From January 2019 to December 2020, 150 parturients who received caesarean section delivery in the Department of Obstetrics, Zibo First Hospital of were included in the study. According to the random number table method, they were divided into the observation group and the control group, with 75 cases in each group. The control group adopted routine postpartum care, while the observation group adopted acupoint stimulation combined with breast massage on the basis of the control group. The scores of milk secretion, traditional Chinese medicine score, and serum prolactin level were compared between the two groups before and after nursing. Neonatal breastfeeding rates and Newcastle nursing satisfaction scale (NSNS) scores were compared between the two groups after discharge. Results Intra-group comparison: there was statistical significance in the score of milk secretion between the two groups at each time point (P＜0.05). Inter-group comparison: one, two and three days after intervention, the scores of maternal milk secretion in observation group were higher than those in control group (P＜0.05). The scores of breast filling degree, milk siltation degree, and milk viscosity degree in two groups were lower than before intervention, and those in the observation group were lower than control group (P＜0.05). After discharge, the neonatal breastfeeding rate in the observation group was higher than that in the control group (P＜0.05). After intervention, the maternal NSNS score in observation group was higher than that in control group (P＜0.05). Conclusion Acupoint stimulation combined with breast massage can effectively improve the symptoms of breast deficiency of parturients after cesarean section, improve their breast filling and viscosity, reduce the degree of milk stasis, and improve the rate of breast feeding of newborns.
		2023 Vol. 20 (32): 148-151 [Abstract] ( 20 ) HTML (1 KB) PDF (572 KB) ( 14 )

	152	Professor Yang Wei’s experience in treating perianal eczema with dampness-heat diffusing downward type based on dispelling evil and regulating viscera method
		XU Jiachun YANG Qiqi MEI Zubing QU Yin YANG Wei
		DOI: 10.20047/j.issn1673-7210.2023.32.33
		Perianal eczema is one of the common diseases of anorectal diseases. It is a disease of allergic and anaphylactic reactions caused by a variety of factors in perianal skin. At present, the etiology and pathogenesis of western medicine are not clear, and the disease cannot be effectively eradicated and the treatment is difficult. With many years of clinical experience, Professor Yang Wei put forward the method of dispelling evil and regulating viscera method with “dampness toxicity” and “heat toxicity” as external causes and five viscera disorders as internal causes. That is, to clear heat and dry dampness, cool blood detoxicating and removing external evil, internal regulation of the five viscera as the treatment principle, to agreement Perirectal Eczema Prescription, combined with Fuzhiqing Ointment external application, with prevention and nursing education, in order to give full play to the internal and external treatment of traditional Chinese medicine, prevention before disease onset characteristics. Remarkable clinical effect is obtained, and typical medical records are attached to elaborate the experience of diagnosis and treatment.
		2023 Vol. 20 (32): 152-155 [Abstract] ( 22 ) HTML (1 KB) PDF (722 KB) ( 36 )

	156	Summary of Professor Sun Liping’s experience in treating children with tic disorder by “treating from gallbladder， taking into account heart and kidney”
		JIANG Xinheng1 SUN Weifang1 LIN Haijiao1 GUO Lei2 SUN Liping2
		DOI: 10.20047/j.issn1673-7210.2023.32.34
		As a chronic neuropsychiatric disorder, children with tic disorder is the most common motor disorder in childhood, and its incidence is increasing year by year. The pathogenesis of this disease is not clear in western medicine. traditional Chinese medicine mainly analyzes and treats this disease from liver hyperactivity, external wind, phlegm heat, and yin deficiency, etc., and treats this disease from the methods of liver calming, wind-thinning, phlegm cleaning, yin nourishing, and so on. Professor Sun Liping believes that “gallbladder deficiency” is one of the common pathogenesis of the disease, and put forwards the diagnosis and treatment idea of “treating from gallbladder, taking into account heart and kidney”, focusing on warming gallbladder and calming nerves, and calming the mind, and tonifying kidney and assisting yang as methods, selecting prescription drugs to take products for warming gallbladder, calming heart, and benefiting kidney. The satisfactory efficacy has been achieved in clinical application.
		2023 Vol. 20 (32): 156-159 [Abstract] ( 22 ) HTML (1 KB) PDF (601 KB) ( 16 )

	160	Textual research on the history of Crotonis Fructus processing
		SUN Liyan1* LIU Penghui2* DOU Guoyi1 BAO Guihua3 FU Hong1 DOU Zhiying4 MAO Yuquan5
		DOI: 10.20047/j.issn1673-7210.2023.32.35
		Crotonis Fructus is a commonly used drug for purgation in clinical practice, which is listed as the lower grade in the Shennong Bencao Jing. Modern literature pays more attention to the clinical application and physicochemical research of Crotonis Fructus, but there is little research on the history of its processing. The author has consulted 64 references related to Crotonis Fructus since the Han Dynasty, including herbs, medical classics, and ancient prescriptions, and summarized 48 processing methods for Crotonis Fructus, such as shelling, boiling, grinding, oil frying, pressing, charring, simmering, Menthae Haplocalycis Herba juice boiling, rice frying, frost making, wine making, and vinegar making, and so on. According to the characteristics of different historical development stages of Chinese medicine processing, the changes of Crotonis Fructus processing methods in different periods are sorted out. The processing history of Crotonis Fructus is reviewed, the modern processing technology of Crotonis Fructus is summarized by referring to the Chinese pharmacopoeia, the national traditional Chinese medicine processing standard, and periodical literature. This paper aims to provide ideas and references for further study on Crotonis Fructus processing and following the ancient processing.
		2023 Vol. 20 (32): 160-163 [Abstract] ( 20 ) HTML (1 KB) PDF (555 KB) ( 19 )

	164	Common medical statistics concepts and sample size estimation in drug clinical trial
		QIAN Zhenzhen1 WU Hongli1 YU Yanan1 LYU Xia2▲ JING Zhiwei1▲
		DOI: 10.20047/j.issn1673-7210.2023.32.36
		Sample size estimation is a key part of new drug development and clinical promotion in drug clinical trial. Too large or too small sample size will have different degrees of adverse effects on clinical trial, and reasonable sample size is an important guarantee for obtaining high-level clinical research evidence. By combing the relevant literature, this paper sorts out the terminology concepts involved in sample size estimation (such as: null hypothesis and alternative hypothesis, one-sided test and two-sided test, type Ⅰ error and type Ⅱ error, etc.), calculation method (validity test, equivalence test, or non-inferiority test, etc.), and consideration factors (such as σ, δ, α, β, Zα, Zβ, etc.), such as according to different test purposes and test methods, corresponding parameter selection, and sample size estimation formulas are different, standardize the sample size estimation basis in clinical research protocols. Make the research design more scientific and reasonable, so as to improve the research quality of clinical research projects and improve the ability of relevant researchers to analyze and solve problems.
		2023 Vol. 20 (32): 164-167 [Abstract] ( 25 ) HTML (1 KB) PDF (537 KB) ( 137 )

	168	Effect of graded preventive nursing on lower limb deep venous thrombosis in patients with mechanical ventilation in ICU under risk assessment of thrombosis
		XU Shaohong1 HU Jing1 ZHUANG Yan1▲ WANG Yilian2
		DOI: 10.20047/j.issn1673-7210.2023.32.37
		Objective To evaluate the effect of graded preventive nursing on lower limb deep vein thrombosis (DVT) in patients with mechanical ventilation in intensive care unit (ICU) under risk assessment of thrombosis. Methods A total of 89 patients with mechanical ventilation treated in the ICU of the Second People’s Hospital of Lianyungang, Jiangsu Province from May 2020 to May 2022 were selected, and they were divided into control group and study group by random number table method, with 45 cases in each group. The control group received routine thrombus preventive nursing intervention, and the study group received thrombus hierarchical preventive nursing under risk factor assessment. The peak blood flow velocity, blood flow index, coagulation function, and the occurrence of DVT were compared between the two groups before and after nursing. Results After nursing, the average blood flow velocity and peak blood flow velocity of femoral vein in both groups were higher than those before nursing, and the study group was higher than the control group, the differences were statistically significant (P＜0.05). Plasma viscosity and D-dimer index levels were lower than those before nursing, and the study group was lower than the control group, the differences were statistically significant (P＜0.05). The incidence of DVT in study group was lower than that in control group, and the difference was statistically significant (P＜0.05). Conclusion Graded preventive nursing under thrombus risk assessment is helpful to improve the level of hemorheology and coagulation function, and reduce the incidence of DVT in lower limbs.
		2023 Vol. 20 (32): 168-171 [Abstract] ( 21 ) HTML (1 KB) PDF (634 KB) ( 26 )

	172	Influence of cardiac rehabilitation program based on weight theory on prognosis of patients with acute coronary syndrome after percutaneous coronary intervention
		LONG Huiping1 LI Gang2▲ GAO Songtao2
		DOI: 10.20047/j.issn1673-7210.2023.32.38
		Objective To explore the influence of cardiac rehabilitation program based on weight theory on prognosis of patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods A total of 110 patients with ACS admitted to the Dingzhou People’s Hospital, Hebei Province from August 2019 to July 2020, according to random number table method, they were divided into control group and observation group, with 55 cases in each group. The control group received routine care, while the observation group received cardiac rehabilitation based on weight theory. The cardiac function and motor function of the two groups were observed before and after intervention, and the levels of serum N-terminal brain natriuretic peptide precursor (NT-proBNP), soluble CD40 ligand (sCD40L); and inflammatory factors were compared between the two groups; self-care ability and quality of life before and after intervention were compared. Results After three months of intervention, left ventricular end diastolic dimension (LVEDD) and left ventricular end systolic diameter (LVESD) in both groups were lower than before intervention, and E/A value was higher than those before intervention; LVEDD and LVESD in observation group were lower than the control group, and E/A value in observation group was higher than that control group, and the differences were statistically significant (P＜0.05). The 6 min walking distance (6-MWD) of the two groups was longer than that before intervention, and the ten-sitting-stereo-position tests (STS-10) was shorter than before intervention, the 30 s arm curt test (30-ACT) was longer than before intervention, and the 6-MWD of the observation group was longer than that of the control group, the STS-10 of the observation group was shorter than that of the control group, and the 30-ACT of the observation group was longer than that of the control group, and the differences were statistically significant (P＜0.05). The levels of serum NT-proBNP, sCD40L, and C-reactive protein in two groups were lower than those before intervention, and the observation group was lower than the control group, the differences were statistically significant (P＜0.05). The scores of China questionnaire of Quality of life in cardiovascular patients and positivity activation measure scores in two groups were higher than before intervention, and the observation group was higher than the control group, the differences were statistically significant (P＜0.05). Conclusion The cardiac rehabilitation program based on weighted theory can effectively improve cardiac and motor function of patients with ACS after PCI, and improve its prognosis.
		2023 Vol. 20 (32): 172-175 [Abstract] ( 17 ) HTML (1 KB) PDF (617 KB) ( 15 )

	176	A case of pharyngeal pain and dysphagia caused by diffuse idiopathic skeletal hyperostosis by ultrasound-guided acupotomy
		LIU li1 ZONG Shaojie2 WANG Li3 ZHANG Fengshan4 LI Zhiqiang5 MENG Xiuli1▲
		DOI: 10.20047/j.issn1673-7210.2023.32.39
		Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by the presence of osteophytes on the anterolateral margin of at least four contiguous vertebral bodies. When the osteophyte is too large to pressure the esophagus, patients may appear pharyngeal pain, neck pain, dysphagia, and other clinical symptoms. This paper reports an elderly patient with cervical DISH with underlying disease. The main reasons for the patient’s medical treatment were pharyngeal pain and progressive dysphagia, the patient underwent ultrasound-guided acupotomy to release the muscular fascia in the affected area, once a week, ten times in total. After treatment, the visual analog score of patients with pharyngeal pain decreased from five points before treatment to one point after treatment, the score of eating assessment tool-10 swallowing screening scale decreased from ten points before treatment to three points after treatment, at five months of follow-up, the patient’s symptoms did not recur. The treatment process of this case showed that ultrasound-guided acupotomy release is a feasible and effective treatment for pharyngeal pain and dysphagia caused by DISH in the cervical spine.
		2023 Vol. 20 (32): 176-179 [Abstract] ( 8 ) HTML (1 KB) PDF (691 KB) ( 31 )

	180	A case of SAPHO syndrome treated with Modified Siteng Yixian Decoction
		LU Lijie LI Juxiang SHI Lei LI Xiaohong CHEN Xiaowei
		DOI: 10.20047/j.issn1673-7210.2023.32.40
		SAPHO syndrome is an inflammatory disease mainly involving bone, joint, and skin, with low clinical incidence and easy misdiagnosis. Western medicine has not yet developed a systematic and perfect treatment plan. This study describes the traditional Chinese medicine diagnosis and treatment process of a patient with SAPHO syndrome, the patient with systemic bone and joint pain as the main symptom, traditional Chinese medicine syndrome differentiation for bone impediment, it is considered that the deficiency of liver and kidney, weakness of spleen and stomach is the basis, qi stagnation, dampnesss and heat, blood stasis is the standard, and the symptoms and root causes are treated with dispelling wind and removing dampness, nourishing blood and dredging channels, tonifying both liver and kidney, strengthening spleen and soothing liver, the famous old Chinese medicine Mr. Shi Jinmo’s experience prescription- Siteng Yixian Decoction were choosed, the symptoms of bone pain were significantly relieved after treatment. In this study, the diagnosis and treatment process of traditional Chinese medicine is detailed and accurate, giving full play to the overall concept of traditional Chinese medicine and the advantages of syndrome differentiation and treatment, and the clinical effect is good, providing clinical ideas for the treatment of SAPHO syndrome.
		2023 Vol. 20 (32): 180-183 [Abstract] ( 26 ) HTML (1 KB) PDF (642 KB) ( 9 )

	184	Report of two cases of macrocy-sticmicrocolon-intestinal hypoperistalsis syndrome and literature review
		YANG Wenqiang1 ZHANG Ning2 CHENG Lingxi2 LUO Yanmei2 YANG Xinghai2
		DOI: 10.20047/j.issn1673-7210.2023.32.41
		Megacystismicrocolon-intestinal hypoperistalsis syndrome (MMIHS) is a rare pseudoileus syndrome, the clinical manifestations are large bladder, small colons, and gastrointestinal motility disorders caused by non-mechanical obstruction, which can occur in the neonatal period. This paper reports two cases of MMIHS, one case was a one day-old newborn. Abdominal distension was the main clinical manifestation, and the diagnosis of MMIHS was confirmed by imaging and histological examination. Although the patient received gastrostomy, anti-infection, intravenous nutrition, and other treatment, but did not achieve a good effect, and eventually died due to multiple organ failure. The other case was diagnosed as MMIHS by prenatal MRI and was recommended to terminate pregnancy, which was confirmed by pathological examination after induction of labor. In this paper, the clinical manifestations, diagnosis, and treatment of the patients were reported, and the relevant literatures were reviewed in order to improve the understanding of the disease and reduce misdiagnosis or missed diagnosis.
		2023 Vol. 20 (32): 184-187 [Abstract] ( 25 ) HTML (1 KB) PDF (700 KB) ( 17 )

	188	Text analysis of occupational disease prevention and control policies based on policy tools
		FENG Wen1 GONG Yanhua1 LIU Jingbo2 LIN Shaofang2 MA Dong1▲
		DOI: 10.20047/j.issn1673-7210.2023.32.42
		Objective To analyze occupational disease prevention and control policy texts based on policy tools, taking Hainan Province as an example. Methods Using “occupational disease”, “occupational health”, and “pneumoconiosis” as keywords, the relevant policies from May, 2002 to December, 2022 were searched in the Hainan Provincial People’s Government, Hainan Provincial Health Commission, Hainan Provincial Emergency Management Department (Work Safety Administration) and Peking University’s Talisman database to construct a three-dimensional framework of policy tool-policy subject - tertiary prevention for quantitative analysis. Results A total of 386 codes were included in 32 policy texts, and the supply, environment and demand policy tools accounted for 19.17%, 71.24%, and 9.59%, respectively. Among the policy subjects, administrative organs, employers, industries, workers, and society accounted for 69.17%, 20.47%, 3.37%, 3.37%, and 3.63% respectively. Among the tertiary prevention, primary prevention, secondary prevention, and tertiary prevention accounted for 74.87%, 17.62%, and 7.51% respectively. Conclusion Optimize the structure of policy tools and appropriately increase the frequency of use of demand-type and supply-type policy tools; pay attention to the coordination of policy subjects, and appropriately strengthen the frequency of employers, industries, employees and social subjects; strengthen the combination of occupational disease prevention and control, and further coordinate the tertiary prevention measures.
		2023 Vol. 20 (32): 188-192 [Abstract] ( 21 ) HTML (1 KB) PDF (491 KB) ( 139 )

	193	Quantitative research on Chinese health finance policy
		XUAN Tianhui QIU Jiayu LIU Liming LI Shiqi JIANG Yan ZHAO Liying CHENG Wei
		DOI: 10.20047/j.issn1673-7210.2023.32.43
		Objective To provide a theoretical basis and decision-making reference for formulating, implementing, and adjusting policies of evaluation study of health financial policy. Methods This study used a policy modeling consistency (PMC) index model to conduct an empirical study of 15 selected health financial policies at the central level. Results Based on text mining, content analysis, expert argumentation, and relevant policy research results, this study constructed a PMC index model consisting of nine primary indicators and 40 secondary indicators. The empirical study found that the evaluation results of health financial policies were generally good, including 10 excellent and five qualified. Conclusion The health financial policies of China take into account various elements needed in the policy formulation process, including a rich variety of policy types, the use of multiple policy tools, and a high degree of policy standardization. However, there is still room for optimization. Therefore, this study puts forward relevant recommendations for the subsequent development and implementation of policies in China to be more scientific and effective.
		2023 Vol. 20 (32): 193-封三 [Abstract] ( 21 ) HTML (1 KB) PDF (777 KB) ( 28 )

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