Diagnostic value of multi-parameter ultrasound evaluation in sepsis complicated by acute kidney injury

BACKGROUND

This study aimed to discuss the diagnostic value of multi-parameter ultrasound evaluation in sepsis complicated with acute kidney injury (AKI).

METHODS

Patients were divided into an AKI group (n = 50) and a non-injury group (n = 50) based on the presence of AKI. The clinical characteristics were collected, and renal function parameters between the two groups were compared, including 24-h urine volume, serum creatinine, urea, serum cystatin C (CysC), renal parenchymal thickness (RPT), renal artery resistance index (RI), and multi-parameter ultrasound scoring (MPUS). Additionally, logistic regression analysis was conducted to determine the influencing factors of sepsis complicated with AKI. The prediction value was evaluated using a receiver operating characteristic (ROC) curve.

RESULTS

In the AKI group, creatinine, CysC, urea, MPUS score, RPT, and RI values were significantly higher, while the 24-h urine volume was lower than those in the non-injury group (p < 0.01). Moreover, multivariate logistic analysis indicated that high CysC and RI values were independent risk factors, whereas high 24-h urine volume and low MPUS were independent protective factors for sepsis-induced AKI. The ROC curve demonstrated that RI (AUC = 0.906) was more effective than 24-h urine volume (AUC = 0.797), CysC (AUC = 0.730), and MPUS (AUC = 0.794) in identifying sepsis-induced AKI.

CONCLUSION

High RI values increase the risk of sepsis-induced AKI, whereas low MPUS may reduce it. RI showed high diagnosis values for sepsis complicated with AKI.

Analyzing the application of dezocine combined with psychological care in the postoperative pain management of patients with hemifacial spasm

OBJECTIVE

To analyze the application of Dezocine combined with psychological care in the postoperative pain management.

METHODS

This is a retrospective study. A total of 186 HFS patients who underwent Microvascular Decompression (MVD) at First People's Hospital of Zunyi between January 2020 and January 2022 were selected as the study subjects. Patients were divided into two groups based on different treatment interventions. The control group (n = 93) received routine perioperative care without preemptive analgesia, while the observation group (n = 93) received preemptive analgesia and combined psychological care on the basis of the control group's intervention.

RESULTS

At 30 min post-laryngeal mask removal (T3), no significant difference in Ramsay Sedation Scale scores existed between control and observation groups (p > 0.05). The observation group showed significantly lower RSS scores at immediate mask removal (T2) and VAS scores at T3 compared to controls (p < 0.05). Following intervention, the observation group had notably lower SAS and SDS scores than controls (p < 0.05). Baseline (T0) and 5 min pre-removal (T1) exhibited no significant differences in mean arterial pressure (MAP) and heart rate (HR) values between groups (p > 0.05). However, at T2 and T3, the observation group displayed significantly lower MAP and HR values than controls (p < 0.05). No significant differences in pulse oxygen saturation (SpO2) values existed between groups at any time point (p > 0.05).

CONCLUSION

Compared to standard perioperative care alone, Dezocine combined with preemptive analgesia and psychological care effectively reduces postoperative pain during the awakening period, lowers the risk of immediate extubation-related agitation, and maintains stable hemodynamics in the postoperative period.

Summary of the application value of ultrasound imaging features in the clinical differential diagnosis of intramuscular capillary-type hemangioma and fibro-adipose vascular anomaly

Objective

To investigate the value of ultrasonography as a diagnostic aid in differentiating intramuscular capillary-type hemangioma (ICTH) from fibro-adipose vascular anomaly (FAVA).

Methods

A retrospective analysis was conducted of the clinical and ultrasound imaging data of 20 patients with ICTH and 45 patients with FAVA who were admitted to and pathologically confirmed in hospital between January 2013 and April 2023. The clinical and ultrasonographic appearances of the lesions in the two groups were compared and analyzed. A stepwise regression analysis was performed, and a joint diagnostic equation was constructed using the final variables selected. The receiver operating characteristic (ROC) curve and indicators, including sensitivity and specificity, were used to evaluate the efficacy of the joint diagnostic model.

Results

The two groups of patients suffering from ICTH and FAVA presented a statistically significant difference (P< 0.05) in terms of 'age', 'lesion size', 'fascial tail sign', 'presence of a fatty-tissue-like hyperecho around the lesion', 'blood flow' and 'presence of straight blood capillaries within the lesion'. Finally, the variables 'fascial tail sign' and 'presence of straight blood capillaries within the lesion' were selected to construct the model. The constructed joint diagnostic model had a sensitivity value of 70.0% (95% CI: 59.00-81.00), a specificity value of 98.0% (95% CI: 94.70-100.00) and a ROC curve value of 0.908, indicating the high efficacy of the combined diagnosis method.

Conclusions

Ultrasonography can be utilized to differentiate ICTH from FAVA, and the combined diagnosis method can further improve the technique's diagnostic efficacy.

Application value of self-management manual combined with case management superiority model in postoperative management of nasopharyngeal carcinoma after radiotherapy

OBJECTIVE

To explore the application value of the self-management manual combined with the case management model in postoperative management of nasopharyngeal carcinoma after radiotherapy.

METHODS

Eighty-four patients with nasopharyngeal carcinoma admitted to Yingtan People's Hospital from May 2020 to April 2022 were retrospectively included in this study. They were divided into the experimental group (receiving self-management manual combined with case management mode scheme, n=42) and the control group (receiving continuous management after conventional nasopharyngeal carcinoma radiotherapy, n=42) according to mode differences. The cancer-related fatigue [Cancer Fatigue Scale (CFS)], comfort status [General Comfort Questionnaire (GCQ)], self-management efficacy [Chinese Strategies Used by People to Promote Health (C-SUPPH)], self-care ability (self-care ability measurement), pain score [Visual analogue scale (VAS)], and quality of life [European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30)] were compared between the two groups after 4 weeks of radiotherapy. The adverse reactions of the two groups were recorded. Combined with periodic review and follow-up records, the prognostic factors of the two groups of patients were analyzed.

RESULTS

After treatment, the scores of physical fatigue (12.83±1.10), emotional fatigue (9.78±1.32), cognitive fatigue (5.62±1.31), and total score of CFS (28.24±2.26) in the experimental group were 12.83±1.10. The control group physical fatigue (13.90±1.25) points, emotional fatigue (10.55±1.40) points, cognitive fatigue (6.80±1.75) points, and total CFS (31.33±2.59) points in both groups were lower than before treatment. The experimental group was lower than the control group (ALL P<0.05). The physiological, psychological, spiritual, socio-cultural, and environmental scores of the experimental group were higher than those of the control group (all P<0.05). The scores of health knowledge, self-care skills, self-care responsibility, and self-concept score of patients in the experimental group were higher than the control group (all P<0.05). After intervention, the VAS score of the experimental group was lower than that of the control group (P<0.05). After intervention, the EORTC QLQ-C30 score of both groups increased significantly as compared with pre-intervention. The score in the experimental group was significantly higher than that in the control group [(80.05±10.72) vs (68.11±12.10), P<0.05]. Postoperative (various) adverse reactions in the experimental group were lower than the control group (all P<0.05). The factors influencing the prognosis of nasopharyngeal carcinoma patients were age, tumor stage, and intervention mode by Cox model analysis (all P<0.05).

CONCLUSION

The self-management manual combined with the case management mode can alleviate cancer fatigue, improve postoperative self-management ability, self-care ability, and quality of life of patients with nasopharyngeal cancer radiotherapy, reduce the occurrence of adverse reactions and improve the prognosis of patients. It is worth promoting in clinical settings.

Gamma globulin combined with acyclovir for children with infectious mononucleosis and their effect on immune function

BACKGROUND

Infectious mononucleosis (IM) is characterized by pharyngitis, cervical lymphadenopathy, fatigue and fever. IM is most commonly seen in primary Epstein-Barr virus (EBV) infection, with higher occurrence in children.

OBJECTIVE

To explore the value of gamma globulin combined with acyclovir for IM children and their impact on immune function.

METHODS

This prospective randomized controlled study recruited 111 children under 14 years old with IM from Anhui Provincial Children's Hospital during March 2019 and March 2022. Among them, 11 children dropped out, and 100 eligible children were randomized 1:1 into a control group and a study group. The control group received acyclovir, and the study group received additional gamma globulin. The baseline data, clinical efficacy, immune function, and adverse reactions were collected and compared.

RESULTS

The study group had a shorter antipyretic time, lymph node reduction time, pharyngitis improvement time, and hospital stay compared to the control group (P < 0.05). The study group yielded lower levels of total white blood cell count, alanine aminotransferase, and creatine kinase-MB than the control group (P < 0.05). After treatment, the levels of CD3+ and CD8+ were lower, and the levels of CD4+, CD4+/CD8+, IgA, and IgG were higher in the study group than those in the control group (all P < 0.05). The incidence of adverse reactions between the two groups was comparable (14.00% vs. 24.00%). The positive rates of EBV-specific antibody and nuclear antigen in the study group were lower than those in the control group (P < 0.05).

CONCLUSION

The combined treatment of gamma globulin and acyclovir is a promising alternative for patients with IM compared to acyclovir alone. This combined regimen shortens the duration of clinical manifestations in children, promotes the recovery of laboratory indices, improves clinical efficacy, and enhances immune function. Furthermore, its safety profile is acceptable, warranting its further promotion.

The clinical application of ultrasonography with superb microvascular imaging-a review

Superb microvascular imaging (SMI) is among the latest doppler ultrasound methods. It uses an advanced clutter filter to eliminate artifacts caused by breathing, movement and retains the low-speed blood signals in microvessels. The great advantage of SMI is that it can intuitively detect very slow blood signals in microvessels, providing clinicians with more significant information about flow distribution in the target area. Therefore, it is speculated that SMI has important application value. The purpose of this article is to outline the application of SMI in different parts of the body.

Early diagonosis of ovarian cancer: serum HE4, CA125 and ROMA model

OBJECTIVE

To evaluate the diagnostic value of serum human epididymal protein 4 (HE4), carbohydrate antigen 125 (CA125), and risk of ovarian malignancy algorithm (ROMA) in early identification in ovarian cancer.

METHOD

A total of 50 patients with ovarian cancer and 50 patients with benign ovarian tumors admitted to our hospital from January 2019 to January 2020 were included in Group A and Group B, respectively, and 50 healthy adult females during the same period were assigned to the blank group. The serum levels of HE4 and CA125 in each group were determined, and the ROMA of them was calculated according to postmenopausal status. The sensitivity, specificity, and positive diagnosis rate of HE4, CA125, and ROMA were calculated, and ROC curves were drawn to compare the diagnostic value of the three.

RESULTS

Group A showed significantly higher serum levels of HE4 and CA125 and a significantly higher ROMA than Group B and the blank group (both P<0.05). No significant difference was found in the serum level of HE4 between Group B and the blank group (P>0.05). The serum level of CA125 and ROMA were significantly higher in Group B when compared with those of the blank group (both P<0.05). The diagnostic sensitivity and positive diagnosis rate of the three indexes, from high to low, were HE4+CA125+ROMA>ROMA>HE4>CA125 (all P<0.05). The diagnostic specificity and the area under the curve (AUC) of the three indexes, from high to low, were HE4+CA125+ROMA>HE4>ROMA>CA125 (all P<0.05). Histologic grading and lymph node metastasis were factors affecting the serum levels of HE4, CA125, and ROMA in patients with ovarian cancer.

CONCLUSION

The combined detection of HE4, CA125, and ROMA is more effective than diagnosis with any single indicator, so the combined diagnosis has a high application value in the early diagnosis of ovarian cancer.

Humanistic care interventions in patients with lower extremity arteriosclerosis obliterans

OBJECTIVE

This study was designed to investigate the application value of humanistic care interventions in patients with lower extremity arteriosclerosis obliterans (LEASO).

METHODS

We enrolled 98 LEASO patients undergoing interventional therapy in our hospital into this study, among whom 47 cases received conventional care interventions (the regular group) while the other 51 received humanistic care interventions based on conventional care interventions (the research group). The two groups were compared in negative emotions, complications, and quality of life of patients.

RESULTS

Scores of negative emotions were lower in the research group than in the regular group after care (P < 0.05). The pain intensity decreased in both groups after care, with a sharper decrease in the research group (P < 0.05). The incidence of complications was lower in the research group than in the regular group after care (P < 0.05). The pain-free walking distance (PFWD) increased remarkably in both groups after care, with a longer PFWD in the research group than in the regular group (P < 0.05). Scores of the 36-Item Short-Form Health Survey (SF-36) increased after care in both groups (P < 0.05), with higher SF-36 scores in the research group than in the regular group (P < 0.05). SF-36 reflects the quality of life of patients from four aspects including vitality, emotional state, social function, and role-emotional. The care compliance and satisfaction level with care of patients were higher in the research group than in the regular group (P < 0.05). The care compliance rate and patient satisfaction level with care were higher in the research group than in the regular group (P < 0.05).

CONCLUSION

Humanistic care interventions can reduce postoperative pain intensity and improve the quality of life in patients with LEASO.

Small incision phacoemulsification with topical anesthesia during perioperative period: nursing experience and its application

PURPOSE

To investigate the perioperative clinical nursing experience and application effect of small incision phacoemulsification with topical anesthesia.

METHODS

Retrospectively analysis of 126 patients who came to our hospital for small incision phacoemulsification with topical anesthesia from November 2018 to November 2019. These patients were randomly divided into a study group and a control group, with 63 patients in each group. Patients from both groups underwent small incision phacoemulsification with topical anesthesia. The control group used routine nursing care during the perioperative period, and the study group used comprehensive nursing care. The clinical intervention effects of the two groups were compared.

RESULTS

The visual acuity of the two groups of patients after intervention was significantly improved (P<0.001), and the visual acuity of the study group after intervention was significantly better than that of the control group (P<0.001); the astigmatism of the study group after intervention was obviously lower (P<0.001); the Self-rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores of the two groups of patients after intervention were significantly lower than those before the intervention, and the decrease of SAS and SDS scores of the study group were more significant (P<0.001); The clinical nursing satisfaction of the study group was significantly higher than that of the control group (P<0.05); the postoperative complication rate of the study group was significantly lower than that of the control group (P<0.05); the cataract knowledge scores of the two groups of patients after intervention were both significantly higher than before the intervention, and the increase of cataract knowledge score of the study group was more remarkable (P<0.001).

CONCLUSION

The comprehensive nursing mode used in small incision phacoemulsification with topical anesthesia for cataract extraction can effectively improve the patient's visual acuity, reduce the astigmatism, and have a lower incidence of postoperative complications, which has high clinical application value.

The application value of serum 25(OH)D3, uric acid, triglyceride, and homeostasis model assessment of insulin resistance in male patients with hyperuricemia combined with hypogonadism

BACKGROUND

The purpose of this study was to investigate the application value of serum 25(OH)D3, uric acid, triglyceride (TG), and homeostasis model assessment of insulin resistance (HOMA-IR) in male patients with hyperuricemia combined with hypogonadism.

METHODS

From August 2018 to August 2020, a total of 198 male patients with primary hyperuricemia were prospectively enrolled in our hospital for inpatient treatment in the department of Metabolism and Endocrinology. They are divided into normal gonadal function group (normal group, n = 117) and hypogonadal function group (hypogonadism group, n = 81), according to free testosterone (FT) level, International Index of Erectile Function (IIEF-5), and androgen deficiency in the aging male (ADAM) questionnaires. Laboratory indexes were compared between two groups. Multivariate logistic regression was applied to analyze the influencing factors of hypogonadism.

RESULTS

Among the 198 hyperuricemia patients, 40.91 % were hypogonadism. Compared with the normal group, the BMI, waist circumference (WC), and the prevalence of non-alcoholic fatty liver disease (NAFLD), hyperlipidemia (HLP), and obesity (OB) in the hypogonadism group were higher, and the difference was statistically significant (P < 0.05, respectively). The levels of fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), triacylglycerol (TG), serum uric acid (SUA), alanine transaminase (ALT) of hypogonadism group were higher than those of normal group, while the levels of TT, FT, E2, 25(OH)D3 of hypogonadism group were lower than those of normal group (P < 0.05, respectively). Pearson's linear correlation was used to analyze the correlation between the indicators with significant differences in general data and laboratory indicators and hypogonadism. BMI, WC, HOMA-IR, TG, SUA, TT, FT, 25(OH)D3, E2 were positively correlated with hypogonadism (r = 0.556, 0.139, 0.473, 0.143, 0.134, 0.462, 0.419, 0.572, 0.601, P = 0.012, 0.027, 0.018, 0.019, 0.028, 0.029, 0.030, 0.009, 0.003, respectively). Taking the above indicators as independent variables and hypogonadism as the dependent variable, logistic regression analysis found that the risk factors for hypogonadism were SUA, WC, BMI, HOMA-IR, TG, TT, FT, E2, and 25(OH) D3.

CONCLUSIONS

Serum 25(OH)D3, SUA, HOMA-IR, TG levels were positively correlated with male hyperuricemia patients with hypogonadism. They have important application value in the diagnosis of male hyperuricemia patients with hypogonadism.

Effect of all-in-one nursing model on ICU ventilator-associated pneumonia

OBJECTIVE

To study the effect of an all-in-one nursing model on ICU ventilator-associated pneumonia (VAP).

METHODS

A total of 100 ICU patients needing ventilator assistance who were admitted to our hospital from March 2018 to December 2019 were equally randomized into two groups by a lottery system, with 50 cases in each group. Patients in the control group received routine nursing, and patients in the experimental group received all-in-one nursing. The number of ICU VAP patients, time transferring from ICU to an ordinary ward, hospital stay, mechanical ventilation time, nursing efficiency, and the changes of blood pressure, heart rate and oxygen saturation during nursing was compared between the two groups.

RESULTS

Regarding the number of cases of VAP, the length of stay in the ICU, and the length of hospital stay, and the mechanical ventilation time, the experimental group was markedly shorter than that of the control group (P<0.05). With respect to the effective rates of nursing care, the experimental group (96%) was better than the control group (80%) (P<0.05). When considering the changes of hemodynamic indexes during the nursing process, the two groups exhibited no marked difference (P>0.05). After intervention, the control group was inferior in terms of the oxygen partial pressure and carbon dioxide partial pressure compared to the experimental group (P<0.05).

CONCLUSION

All-in-one nursing can reduce the incidence of VAP in ICU patients, significantly shorten the length of ICU stay, hospital stay and mechanical ventilation time, thus improving overall nursing efficiency.

The application value of oXiris-endotoxin adsorption in sepsis

OBJECTIVES

This study explored and analyzed the application value of oXiris- endotoxin adsorption technology in patients with sepsis.

METHODS

23 sepsis patients hospitalized from January 2018 to September 2019 in our ICU center and received oxiris-endotoxin adsorption were enrolled as the observation group, and another 30 sepsis patients hospitalized during the same period were selected as the control group who treated with routine continuous renal replacement therapy (CRRT). The heart rate, respiratory rate, norepinephrine (NE) dosage, lactic acid, procalcitonin (PCT), urine volume, and sofa scores that evaluate organ failure after systemic infection, as well as ICU stay, organ support duration, and incidence of cardiovascular events were compared between the two groups before and after treatment.

RESULTS

The heart rate, respiratory rate and NE dosage of the two groups post-treatment were dramatically lower than those pre-treatment (P<0.05), and these indexes in observation group after treatment were critically lower than those in control group (P<0.05). The lactic acid, PCT, urine volume and sofa scores of the two groups were dramatically lower than those before treatment (P<0.05), and the indexes in observation group after treatment were notably lower than those in control group (P<0.05). The degree of serum IL-6, IL-10 and endotoxin in two groups after operation decreased remarkably than that before treatment (P<0.05), and the observation group had obviously lower indicator degree than the control group (P<0.05). The ICU stay, organ support duration, and incidence of cardiovascular events in the observation group were notably lower than those in the control group (P<0.05).

CONCLUSION

compared with the traditional CRRT technology, the oXiris membrane based CRRT technology can effectively improve the hemodynamic indicators of patients with sepsis, reduce the level of inflammation, and improve the metabolic function of body, thereby improving the patients' organ function. It has good clinical application value in patients with sepsis.

Ultrasonic measurement of optic nerve sheath diameter in elderly patients with craniocerebral injury

OBJECTIVE

To explore the application value of ultrasonic measurement of optic nerve sheath diameter in elderly patients with craniocerebral injury.

METHODS

86 cases of elderly patients with craniocerebral injury treated in our hospital between January 2017 and December 2018 were included, all of whom had the invasive monitoring of intracranial pressure (ICP) and optic nerve sheath diameter (ONSD) in ultrasonic testing. According to ICP measurement results, patients were divided into a normal ICP group (n = 44) and an increased ICP group (ICP ≥ 20 mmHg stood for increased ICP, n = 42). Gender, age, systolic blood pressure, blood glucose, hospital stay, oxyhemoglobin saturation, ISS score, ONSD value, hematoma type, primary injury, associated injury and complications of the patients were compared.

RESULTS

The univariate analysis showed that the systolic blood pressure in the ICP increased group was significantly decreased while the blood glucose, ISS and ONSD values showed significant increase (P < 0.05). The multivariate analysis showed that associated injury, systolic blood pressure and ONSD value had a significant influence on the increase of intracranial pressure (all P < 0.05). ONSD is positively correlated with ICP (r = 0.855, P = 0.000). The areas of systolic blood pressure and ONSD value under the curve in diagnosis of increased intracranial pressure in elderly patients with craniocerebral injury were 0.717 and 0.780, respectively. When the ONSD value was 4.90 mm, the area under the curve was 0.780, the sensitivity and specificity were 89.00% and 91.00%, respectively. When the ONSD value predicted that the critical value of good/poor prognosis of patients was 4.70 mm, the area under the curve was 0.796, the sensitivity was 91.00%, and the specificity was 90.00%.

CONCLUSION

Ultrasound measurement of optic nerve sheath diameter can diagnose the increase of intracranial pressure in elderly patients with craniocerebral injury, and can better predict the prognosis.

Comparison of application value between conventional air insufflation and water infusion in colonoscopy

OBJECTIVE

To discuss the feasibility of water infusion colonoscopy and its difference with traditional air insufflation colonoscopy in application value.

METHODS

A prospective randomized controlled clinical study was designed to include 200 patients who underwent sedation-free diagnostic colonoscopy. Among them, 100 patients were treated with water infusion colonoscopy (observation group) and 100 patients were treated with air insufflation colonoscopy (control group). All operations were performed independently by the same experienced physician. The differences in colonoscopy related values, colon adenoma detection rate, and follow-up findings between the patients of two groups were compared.

RESULTS

There was no significant difference in the Boston bowel preparation scale (BBPS) score of the left hemicolon, transverse colon, right hemicolon, total BBPS scores, and bubble amount between the two groups (P>0.05). In the observation group, the scope-forward time, the time to reach the ileocecal junction, and the total operation time were significantly longer than that of the control group (P<0.01). The proportion of patients in whom the ileocecal junction was successfully reached was significantly higher in the observation group. The intraoperative abdominal pain visual analog scale (VAS) score, abdominal distension VAS score, the proportion of postural change, and the proportion of abdominal compression were all significantly lower in the observation group (P<0.05). There were no significant differences in the endoscope hardness adjustment rate, the scope withdrawal time, total detection rate of adenomas, and the size or location of colon adenomatous lesions between the two groups (P>0.05). Compared with control group, the incidence of abdominal pain and VAS scores were significantly lower in the observation group (P<0.05), and the willingness of patients to perform colonoscopy again was significantly higher (P<0.01).

CONCLUSION

Patients' tolerance and examination satisfaction are significantly better when using water infusion colonoscopy compared with traditional air insufflation colonoscopy, but the operation times are longer.

[Critical quality evaluation and application value of network Meta-analyses in traditional Chinese medicine]

To introduce the application status of network Meta-analysis( NMA) in the field of traditional Chinese medicine,and to discuss the application value of NMA in the field of traditional Chinese medicine,this study comprehensively reviewed the systematic reviews with application of NMA in the field of traditional Chinese medicine. CNKI,Wan Fang,Sino Med,VIP,Embase,PubMed and Cochrane Library and the reference list of previous studies were searched. The AMSTAR scale was used to evaluate the quality of literature methodology,and PRISMA-NMA checklist was used to measure the degree of report specification. Overall,122 articles were included,including 80 in Chinese and 42 in English. The included studies centered on cancer,bone and joint disease,cardiovascular disease,respiratory disease,mental disease and digestive disease. Additionally,the intervention can be categorized into three groups,traditional Chinese medicine injection,oral Chinese medicine or prescription,and traditional physical therapy including acupuncture.Nearly one-third of the researches&apos; intervention program is aimed at comparing the effect of Chinese and Western combined therapy and monotherapy. The overall methodology quality grade is medium and the report quality is average,with methodology reporting and result reporting especially need to be improved. The subgroup analysis shows that the methodology quality of the English literatures is evidently higher than Chinese literatures,and the quality of the literatures published after 2015 is higher than those published in or before 2015.This study indicates that the NMA can compare multiple treatments simultaneously,which accords with characteristics of the clinical practice in traditional Chinese medicine that is complex and individual. NMA in the field of traditional Chinese medicine is still in the process of development. With higher level of quality control and reporting as well as the improvement of the statistical methodology and the accumulation of original researches,NMA application in the field of traditional Chinese medicine will be promising.

Application value of laparoscopy in radical mastectomy and omental breast reconstruction

Application value of laparoscopy in radical mastectomy and omental breast reconstruction was explored. The medical records of 104 patients undergoing radical mastectomy and omental breast reconstruction from July 2015 to August 2017 in Inner Mongolia Xing'an League People's Hospital were retrospectively analyzed. Fifty-three patients undergoing laparoscopic surgery were the experimental group and 51 patients undergoing open surgery were the control group. The surgery conditions, upper limb function, postoperative complications, volume similarity between unilateral subcutaneous glands and autologous omentum, cosmetic excellent rate and treatment satisfaction were observed. The surgical duration of the patients in the experimental group was significantly longer than that in the control group, but the intraoperative blood loss was less and hospital stay was significantly shorter than that in the control group (P<0.05). The improvement of upper limb function in the experimental group was significantly better than that in the control group (P<0.05). The cosmetic excellent rate in the experimental group was significantly higher than that in the control group (P<0.001). The incidence of postoperative complications in the experimental group was significantly less than that in the control group (P<0.001). The satisfaction degree of patients in the experimental group was significantly higher than that in the control group (P<0.001). Filling the autologous omentum while excising the unilateral mammary gland is an equivalent replacement, which can make the appearance of the breast on the operation side similar to that on the healthy side, thus improving the excellent rate of breast beauty and patient satisfaction.

Clinical application value of brain CT perfusion imaging in the treatment of acute ischemic stroke thrombolytic therapy

Clinical application value of CT perfusion (CTP) imaging in the treatment of acute ischemic stroke (AIS) thrombolytic therapy was investigated. Retrospective analysis of 185 suspected AIS patients in Liaocheng Brain Hospital from April 2012 to December 2017 were involved. We observed the non-contrast CT (NCCT) and CTP in the diagnosis of AIS patients, and recorded as well as compared CTP parameters of AIS patients. The National Institute of Health Stroke Scale (NIHSS) rating was conducted, and the correlation between the prognosis of NIHSS scores and CTP parameters was investigated. A total of 177 patients were diagnosed with AIS. The sensitivity levels of CTP examination for diagnosis of AIS patients was significantly higher than that of the NCCT examination (P<0.050). The diagnostic compliance rates of CTP examination was significantly higher than that of the NCCT examination (P<0.050). The cerebral blood volume (CBV) in the abnormal perfusion area was significantly lower than that in the mirror side zone (t=21.160, P<0.001). The prognostic NIHSS score was negatively correlated with CBV in patients with thrombolytic therapy (r=−0.912, P<0.001). The cerebral blood flow (CBF) in the abnormal perfusion zone was significantly lower than that in the mirror side zone (t=19.170, P<0.001). The prognosis of patients with thrombolytic therapy was negatively correlated with CBF (r=−0.915, P<0.001). The mean transit time (MTT) in the abnormal perfusion zone was higher than that in the mirror side zone (t=13.480, P<0.001). NIHSS scores were obtained 3 months after thrombolytic therapy and found that the prognostic NIHSS scores were positively correlated with MTT (r=0.887, P<0.001). The results indicated that brain CTP has a high diagnostic value for intravenous thrombolytic therapy in AIS and there was a significant correlation between the prognosis scores of patients. Thus, it is worthy of being promoted in the clinical diagnosis and treatment of AIS patients.

Application value of procalcitonin, C-reactive protein and interleukin-6 in the evaluation of traumatic shock

Procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) were detected to explore the value of these inflammatory markers in the assessment of traumatic shock patients. The clinical data of 80 patients with traumatic shock and infections in Zhangzhou Municipal Hospital of Fujian Province from January 2014 to December 2017 were collected as the experimental group. During the same period, 80 acute trauma patients who did not suffer from traumatic shock were regarded as the control group. According to the prognosis outcomes, the experimental group was divided into 56 patients with good prognosis and 24 patients with poor prognosis. Also the PCT, CRP and IL-6 levels in serum of patients at admission (T1), 12 h after admission (T2), three days after admission (T3) and on day 7 (T4) were detected. The differences between the three inflammatory indicators, the pre-admission injury severity score (ISS score), the acute physiology and chronic psychological score (APACHE II score) were compared between the good prognosis and the poor prognosis group. The serum CRP at the T4 time period was significantly lower than both the T1 and T2 time periods (P<0.05). There were differences in serum PCT, CRP and IL-6 between the good prognosis and the poor prognosis group at the time of T1-T4 (P<0.05). The expression levels of PCT, CRP and IL-6 in the serum of patients with poor prognosis were higher than those with good prognosis (P<0.05). Pre-admission ISS scores and APACHE II scores in patients with good prognosis were lower than those with poor prognosis (P<0.05). Detection of PCT, CRP and IL-6 expression levels in serum of the patients has an important reference value for assessing the condition of patients with traumatic shock.

A study of the application of TAP combined with transvaginal ultrasound in the diagnosis of early-stage endometrial cancer

The aim of the study was to investigate the application of tumor abnormal protein (TAP) combined with transvaginal ultrasound in the diagnosis of early-stage endometrial cancer. A total of 248 patients with suspected endometrial cancer who were admitted to the Gynecology Department of the Second People's Hospital of Liaocheng from September 2013 to September 2015 were selected and randomly divided into the control (n=124) and the observation group (n=124). The control group received conventional ultrasound examination, while the observation, underwent TAP combined with conventional ultrasound examination. Differences in the definite diagnostic results of the two diagnostic methods and curettage were compared, and the application of TAP combined with transvaginal ultrasound in the diagnosis of early-stage endometrial cancer was studied. Among 248 patients receiving hysteroscopy and diagnostic curettage examination, there were 75 patients with early-stage endometrial cancer, and 173 benign patients. The total diagnostic accordance rate of conventional ultrasound for endometrial lesions was 87.90% (n=218), and the accordance rate for early-stage endometrial carcinoma was 90.67% (n=68); the total diagnostic accordance rate of TAP combined with vaginal ultrasound for endometrial lesions was 94.35% (n=234), and for early-stage endometrial cancer was 94.67% (n=71); of TAP combined with conventional ultrasound for endometrial lesions and endometrial cancer were higher than those of simple conventional ultrasound (P<0.05). The area under the curve (AUC) of conventional ultrasound in the diagnosis of endometrial cancer was 0.754 [95% confidence interval (CI): 0.211-2.534]. The AUC of TAP combined with vaginal ultrasound in the diagnosis of endometrial cancer was 0.814 (95% CI: 0.517-0.932), and a comparison between the two groups was statistically significant (P=0.011). The accuracy rate of TAP combined with transvaginal ultrasound in the diagnosis of early-stage endometrial cancer is relatively high, and it is worthy promoting and applying in clinical practice.

Clinical study of the use of gastroscopy as oral choledochoscopy

Clinical value and safety of the use of gastroscopy as oral choledochoscopy in the treatment of biliary diseases was explored. Clinical data of 55 patients with biliary diseases who underwent gastroscopy were retrospectively analyzed. The types of gastroscopy, size of duodenal papilla incision, balloon dilatation, the success rate of gastroscopy entry, depth of gastroscopy entering into bile duct, endoscopic diagnosis and postoperative complications were recorded. Simple insertion-by-hand was performed, and insertion into common bile duct was successfully achieved in 53 cases, and the overall technical success rate was 96.4%. Residual bile duct stones in 25 patients (45.5%) after endoscopic retrograde cholangio-pancreatography (ERCP) were removed through endoscopy. Nine cases of benign stenosis and 2 cases of malignant stenosis were confirmed as ‘cholangiocarcinoma’ or ‘duodenal papilla well-differentiated adenocarcinoma’ by biopsy. Balloon oppression under intraoperative endoscopy was performed for 2 cases (3.6%) with biliary hemorrhage, and argon ion coagulation was successfully performed. No obvious abnormalities were found in 13 cases (23.6%) through gastroscopic biliary exploration. Complications occurred in 15 patients with a complication rate of 27.3%, including 2 cases of cholecystitis (3.6%), 8 cases of amyloidosis (14.6%) and 4 cases of acute pancreatitis (7.3%), and all those complications were cured. One case (1.8%) had perforation of biliary tract and was discharged after conservative treatment. The use of gastroscopy as oral choledochoscopy is safe as effective. However, this technique causes some rare and serious complications. Therefore, further studies are needed to improve this technique.

Confocal laser endoscopy in the diagnosis for abdominal lymph node metastasis of gastric cancer

Confocal laser endoscopy (CLE) diagnostic criteria for lymph node metastasis of gastric cancer was established and evaluated to provide a basis for CLE clinical application in the diagnosis of abdominal lymph node metastasis. CLE scanning (surface scanning and sectional scanning) and pathology examination were conducted in gastric cancer tissues and lymph nodes of 5 cases. Characteristics of lymphatic metastasis in CLE imaging were observed and summarized in combination with pathology. The diagnostic criteria were corroborated in 124 lymph nodes of another 14 cases and CLE detection time needed for diagnosis was recorded. The CLE diagnostic criteria were tested and evaluated, and the effect of lymph node size on the diagnosis accuracy was determined. All the 19 participants were confirmed as gastric cancer. Sectional scanning can get comprehensive observation for internal structures of lymph nodes, in which abnormal large heterocyst appeared with special structural changes. CLE scanning could detect 88.75% of the positive metastasis and 68.18% of the negative metastasis examined by the pathology methods based on the established CLE diagnostic criteria. In comparison with pathological diagnosis, specificity, sensitivity and accuracy of CLE diagnosis were 88.75%, 68.18% and 81.45%, respectively. Accuracies of CLE diagnosis on the lymph nodes grouped by size were 85.29%, 77.78% and 88.89%, respectively, with no significant difference between groups (P > 0.05). Complete internal structures of lymph nodes can be observed clearly by CLE sectional scanning. The size of lymph nodes had no effects on diagnosis accuracy. CLE shows better sensitivity and specificity than traditional pathological diagnosis.