Observation Group Research Articles

Shengji ointment combined with bromelain promotes granulation of exposed tendons in diabetic foot ulcers: a multicenter, randomized, positive-controlled clinical trial

BackgroundExposed, infected and necrotic tendons often occur in the middle and late stages of diabetic foot ulcers (DFUs). The exposed tendon is both a potential source and route of infection, which prolongs the treatment period and affects recovery, leading to amputation and even death. Therefore, management of the exposed tendon in patients with DFU is the key to treatment. This study aimed to evaluate the clinical efficacy of Shengji ointment combined with bromelain in the treatment of DFU with tendon exposure and to provide clinical treatment options and evidence-based medicine. MethodsThis study was a multicenter, nonblinded, randomized, positive controlled clinical trial involving 180 patients with DFU with tendon exposure at five tertiary-grade A-class hospitals. The included patients were randomly assigned 1:1 to an observation group (n=90) that received Shengji ointment combined with bromelain and a control group (n=90) that received hydrocolloid dressing, with dressing changes once daily for 4 weeks. Patients in both groups continued with conventional treatments, such as blood glucose and blood pressure medication, lipid regulation, and antiplatelets. The primary outcome measure was wound coverage with granulation tissue. The secondary outcome measures included the wound healing rate, time to granulation, Maryland foot score, time to debridement of necrotic tendon tissue, and granulation tissue score. We performed measurements before enrollment and after the end of treatment for comparison. ResultsThere was no significant difference in the baseline data between the two groups before treatment (P > 0.05). After treatment, the primary outcome indicators of the two groups were compared, and the wound granulation tissue coverage rate of the treatment group was greater than that of the control group (P = 0.003). For the secondary outcome outcomes, the wound healing rate, time to granulation, Maryland foot function score, time to debridement of necrotic tendon tissue, and granulation tissue score in the treatment group were significantly better than those in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P = 0.444). ConclusionsShengji ointment combined with bromelain effectively promotes the removal of exposed necrotic tendons in patients with DFU, promotes the regeneration of healthy granulation tissue, accelerates wound healing, and protects the limb and its function. It also appears to be safe as an intervention for the treatment of patients with DFU. Trial registrationThe study protocol was registered in the Chinese Clinical Trial Registry (ChiCTR) under the code ChiCTR2000039327 on 23/10/2020. The public title is “Study on evidence-based evaluation and therapeutic mechanism of integrated Chinese and Western medicine for treatment of diabetic foot - An evidence-based evaluation of The combination of Rubber Shengji Paste and compound bromelain to promote the healing of the exposed wound of diabetic foot tendon”.

Clinical macular edema following uneventful cataract surgery in eyes without pre-existing fundus diseases: risk factors and treatment prognosis

BackgroundTo investigate the risk factors and prognosis of clinical pseudophakic cystoid macular edema (PCME) after uneventful phacoemulsification surgery in patients without pre-existing fundus diseases.MethodsThis was a retrospective case-control study. Medical records between August 2020 and August 2023 were reviewed for patients who had no previous fundus diseases and developed clinical PCME. A control group was randomly chosen and the risk factors for PCME was analyzed by binary logistic regression. Structure and visual prognosis of the PCME cohort were observed and compared among subgroups undergoing different treatment measures.ResultsForty-seven eyes of 47 patients with PCME were included. The development of PCME was associated with higher systolic blood pressure (OR, 1.048; 95%CI 1.002, 1.097; P = .042), no posterior vitreous detachment (OR, 0.215; 95%CI: 0.553, 0.887; P = .032) and shorter axial lengths (OR, 0.401; 95%CI 0.161, 0.997; P = .049) compared to controls. During a mean follow-up of 8.26 months, 36 eyes (76.6%) showed visual improvement with decreased macular thickness. Different treatment modalities, including observation, topical NSAIDs, and intervention therapy, have no significant differences on the visual prognosis (P = 1.000). However, the intervention group had a shorter recovery time compared to the observation group (28.6 vs. 45.9 days, P = .037).ConclusionPCME remains an encountered morbidity in patients without pre-existing fundus diseases. Shorter axial lengths, absence of posterior vitreous detachment, and higher systolic blood pressure are risk factors of PCME. Active intervention failed to improve the prognosis of PCME but could shorten the recovery time.

PRESERVING AND MANAGING CHINESE SETTLEMENT HERITAGE TOURISM IN LASEM, INDONESIA

This research examines Chinese settlements' preservation and management strategies as heritage tourism in Lasem, Rembang, Indonesia. Ancient houses in Chinatown settlements are vulnerable and require a social resilience strategy as a solution. This study used a qualitative approach and data collection techniques through observation, in-depth interviews, documentation, and focus group discussion (FGD). The informants were owners of ancient houses utilizing their buildings as heritage tourism destinations. The results of this study show that the community or owner in managing settlements or Chinese houses as tourist destinations should have three capacities in the social resilience perspective, namely 1) coping capacity, which includes resources, knowledge, skills, and learning; community as the main actor, community awareness, and social kinship system; 2) adaptive capacity which includes: community networks, human and environmental relations, and community participation; and 3) transformative capacity which includes community infrastructure, multi-stakeholder partnerships, technological innovation, diversity and economic innovation. This study concludes that the owners of ancient houses in Chinatown settlements who utilize their buildings as tourism destinations are quite resilient.

Diversity of Eucharistic Ritual in COVID-2019 Context

Discussing diversity in the celebration of the Eucharistic ritual in COVID-2019 contexts, this is a comparative study of CITAM (Christ is the Answer Ministries) Valley Road assembly and St. Andrew’s PCEA (Presbyterian Church of East Africa) in Nairobi, Kenya. COVID-2019 had a great impact on the order of worship in Christian churches across the world. Churches were closed down at times. Whereas CITAM Valley Road administered the Eucharist in the virtual space, St Andrew’s PCEA did not adopt virtual Eucharist and had to wait until the lockdown prohibiting church meetings was lifted. This ethnographic study was carried out in Nairobi County at CITAM Valley Road and St. Andrew’s PCEA over a period of six months from late 2021 to early 2022. The methodological approach taken by the researchers was a blend of ethnography and grounded theology. Data was collected through virtual ethnography, participant observation, interviews, and focus group discussions. Findings from the study demonstrated an emerging trend of administering the Eucharist digitally as the Church in Kenya navigated both continuity and change. The findings also revealed the fact that religious change advances not suddenly, or as a single complete change, but in specific expressions that are local and distinct. The researchers posit that in the PCEA, believers could not imagine themselves administering virtual Eucharist in their homes; in CITAM also some Christians felt that administering the Eucharist in the virtual space was different from when it was administered in the physical space.

PHOTOVOICE ANALYSIS OF INDUSTRIAL PRACTICE EXPERIENCE: A COLLABORATIVE AUTOETHNOGRAPHY STUDY

This study aims to examine the experience of implementing industrial practice with photovoice analysis through a collaborative autoethnography approach and reveal the factors that determine the success of industrial practice. This research is qualitative and uses a partial collaborative autoethnography approach. The source of research data is industrial practice activities. The sampling technique was carried out through purposive sampling. Data collection was carried out through critical autoethnography, observation, and Focus Group Discussion (FGD). The validity test technique used was FGD. Data analysis was carried out through content analysis. The results of this research include: first, the study of industrial practice learning experiences contained aspects of togetherness and cooperation (collaboration ability category); discussion (communication ability category); involvement, contribution, initiative, responsibility, and dedication (proactive category); implementation of knowledge, fast learning, self-development, obedience, and time management (adaptive category). Second, the factors determining the success of industrial practice include a supportive partner work environment, team solidarity, student competence, and student personality.

Snyder Hopes the Application of Theoretical Model of Nursing Intervention in Patients with Brain Malignancy Surgery

Explore the application value of nursing intervention based on Snyder hopes theory in patients with brain malignancy surgery. Methods The 110 cases of patients with brain malignancy who were treated in our hospital from January 2023 to January 2024 were selected as a study object. They were randomly divided into observation group and control group. The control group was received routine nursing. The hope theoretical intervention was performed on this basis in the observation group. The Herth hope index (HHI), self - rating anxiety scale (SAS), self - rating depression scale (SDS) and self-feeling burden scale (SPBS) scores of the two groups were compared before and after intervention. Both groups were followed up for 6 months, using the Concise Questionnaire for Psychological Adaptation of Cancer Patients (Min-MAC-19) and the Quality of Life Scale for Brain Tumor Patients (QOL-C30) to assess the improvement of patients' psychological adaptability and quality of life. Results After intervention, the SAS, SDS, and SPBS scores of the two groups were significantly reduced, and the HHI score was significantly increased. The SAS, SDS, and SPBS scores of the observation group were significantly lower than the control group, and the HHI score was significantly higher than the control group. The differences were statistically significant (P&lt;0.05); After 6 months of follow-up, the observation group Min-MAC-19 and QOL-C30 scores were significantly higher than the control group (P&lt;0.05). Conclusion Nursing intervention based on Snyder's hope theory can improve the mental state of patients after brain malignancy surgery, reduce the patient's self-experience burden, improve their hope level, psychological adaptability, and improve the quality of life of patients.

Increased Identification of Vaccines for Vaccine Safety Surveillance Through Linkage With the Minnesota Immunization Information Connection as of December 31, 2023.

The HealthPartners' Vaccine Safety Datalink (VSD) team maintains standardized files of vaccines from medical and pharmacy claims and electronic health records (established data sources) for safety surveillance. Since 2021, for selected vaccines, data from the Minnesota Immunization Information Connection (MIIC), Minnesota's immunization information system, have been added to the HealthPartners' VSD files. We examined how MIIC data have enhanced the identification of novel and routine vaccines. We describe the approach to incorporating MIIC data. We determined and compared the number and proportion of vaccines identified from established data sources with the additional capture of vaccine data identified from MIIC, in which age group and period of observation varied by vaccine. As of December 31, 2023, of 1 099 411 people in the HealthPartners' VSD cohort, 1 001 400 people (91%) were linked with an MIIC record. Across all data sources, for the full cohort, >2.7 million COVID-19 vaccine doses were recorded since 2020, >4000 mpox vaccine doses since 2022, >7.3 million influenza vaccine doses since 2004, >600 000 human papillomavirus (HPV) vaccine doses since 2006, and >1.1 million diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine doses since 2004. For COVID-19 vaccines, about 30% of vaccine doses were exclusively captured from MIIC, with the remaining 70% from established data sources. For the mpox vaccine, about 42% were exclusively from MIIC. For influenza, HPV, and DTaP vaccines, about 20%, 14%, and 17%, respectively, were exclusively identified from MIIC. Incorporation of data from state immunization information systems into existing vaccine data files can enhance monitoring on the safety of novel vaccines administered outside traditional health care settings and can enhance data quality for routine childhood and adult vaccines.

Application of traditional Chinese medicine nursing technology: Traditional Chinese medicine ironing combined with traditional Chinese medicine massage in improving functional constipation in elderly patients.

To explore the therapeutic effect of traditional Chinese medicine (TCM) nursing technology combined with TCM massage on elderly patients with functional constipation (FC). Ninety elderly patients with FC admitted to our hospital from January 2022 to February 2023 were selected and randomly divided into 3 groups. The control group was treated with conventional Western medicine, observation group 1 was treated with TCM massage on the basis of the control group, and observation group 2 was treated with medicine ironing combined with TCM massage on the basis of the control group. Compare 3 groups of TCM syndrome scores, clinical efficacy, complete spontaneous bowel movements (CSBM) per week, Bristol fecal trait scale, and safety. There was a statistically significant difference in clinical effective rates among the 3 groups (96.67%, 83.33%, 66.67%) (P < .05), and the observation group 2 was higher than the observation group 1 and higher than the control group. After treatment, the TCM syndrome scores of the 2 groups were lower than those of the observation group 1 and the control group; And observation showed that the TCM syndrome score of group 1 was lower than that of the control group (P < .05). After treatment, the increase in scores of CSBM and Bristol fecal traits in the 2 groups was higher than that in the observation group and control group, and the increase in scores of CSBM and Bristol fecal traits in the observation group was higher than that in the control group (P < .05). There was no statistically significant difference in the incidence of adverse reactions among the 3 groups (10.00%, 6.67%, 20.00%) (P > .05). The application of TCM nursing techniques such as TCM ironing and TCM massage in elderly patients with FC has a significant clinical effect, which can effectively improve clinical symptoms, defecation frequency, and fecal characteristics, and has high safety.

Clinical effect of recombinant human brain natriuretic peptide in the treatment of heart failure in elderly patients

BackgroundHeart failure in elderly individuals poses significant challenges due to the decline in cardiac function associated with aging. This study aimed to investigate the clinical efficacy of recombinant human brain natriuretic peptide (rhBNP) for the treatment of heart failure, especially in elderly patients.MethodsThis was a retrospective case control study of the medical records of 60 elderly patients with heart failure admitted to our hospital between December 2020 and December 2023. Patients were divided into two groups based on treatment. The control group (n = 30) received diuretics, digitalis, and β receptor blockers, while the observation group (n = 30) received lyophilized rhBNP in addition to the control group treatment. Changes in BNP levels and clinical outcomes were compared between the two groups.ResultsPosttreatment BNP levels were significantly lower in the observation group than in the control group (p < 0.05), and the total clinical effective rate was greater in the observation group (p < 0.05). Additionally, the left ventricular diameter, left atrial diameter, left ventricular shortening fraction, diastolic flow signal and cardiac output in the observation group were lower than those in the control group (p < 0.05), while the thickness of the aortic root diameter in the observation group was greater than that in the control group (p < 0.05).ConclusionRhBNP demonstrated ideal clinical efficacy in elderly patients with heart failure, improving symptoms and indicating potential for widespread use in the future.

Effect of "He Tiao Du Ren An Shen Acupuncture" on restless leg syndrome: A randomized trial.

This study aimed to observe the clinical effects of "He Tiao Du Ren An Shen Acupuncture" (HTDRAS Acupuncture) for treating restless leg syndrome (RLS). We randomly divided 66 RLS patients into 2 groups: the observation group received "He Tiao Du Ren An Shen Acupuncture" and the control group received conventional acupuncture. All participants were treated once a day, 6 days a week, with 1 day off, for a total of 1 month. Clinical effectiveness of the 2 groups was compared, neurotransmitter levels, the International Restless Leg Syndrome Scale and the Hamilton Anxiety Scale were assessed in both groups. The curative effect in the observation group was better than that in the control group (P < .05). After treatment, the expression of 5-hydroxytryptamine in the observation group was higher than in the control group (P < .05). The International Restless Leg Syndrome Scale and Hamilton Anxiety Scale scores in observation group were lower than those in control group (P < .05). "He Tiao Du Ren An Shen Acupuncture" for RLS is significantly effective and safe. It can effectively improve the levels of 5-hydroxytryptamine in RLS patients, alleviate clinical symptoms and reduce anxiety. This treatment has a high clinical application value and is worthy of clinical promotion.

Pain and immune function in patients undergoing gastric cancer surgery following stellate ganglion block with total intravenous anesthesia.

Stellate ganglion block is a commonly used sympathetic nerve block technique that restores the balance of the sympathetic and vagal nervous systems of the body and inhibits sympathetic nerve activity. To analyze the effect of a stellate ganglion block combined with total diploma intravenous anesthesia on postoperative pain and immune function in patients undergoing laparoscopic radical gastric cancer (GC) surgery to provide a reference basis for the formulation of anesthesia protocols for radical GC surgery. This study included 112 patients who underwent laparoscopic radical surgery for GC between January 2022 and March 2024. There was no restriction on sex. The patient grouping method used was a digital random table method, and the number of cases in each group was 56. The control group was administered total intravenous anesthesia, and the observation group compounded the stellate ganglion block according to the total intravenous anesthesia protocol. Postoperative hemodynamics, pain levels, and immune indices were compared between the groups. The heart rate and mean arterial pressure in the observation group after intubation were lower than those in the control group (P < 0.05). Pain levels were compared between the two groups at 2 hours, 12 hours, 24 hours, and 48 hours after surgery (P > 0.05). The number of CD3+, CD4+, and CD4+/CD8+ cells at the end of surgery was higher in the observation group than in the control group, and the number of CD8+ cells was lower in the observation group than in the control group (P < 0.05). There were no significant differences between the two groups in terms of propofol dosage, awakening time, extubation time, or postoperative adverse reactions (P > 0.05). The application of a stellate ganglion block combined with total intravenous anesthesia had no significant effect on postoperative pain levels in patients undergoing laparoscopic radical GC surgery. However, it can safely reduce the effect of surgery on the immune function of patients and is worth applying in clinical practice.

Effect of automated health monitoring based on rumination, activity, and milk yield alerts versus visual observation on herd health monitoring and performance outcomes

A primary objective of this randomized trial was to compare the percentage of cows that underwent clinical examination and were diagnosed with clinical health disorders (CHD) with a health monitoring program that relied only on automated monitoring system alerts vs a program that relied only on visual observation of clinical signs of disease to select cows for clinical examination. Another objective was to compare the effects of these health monitoring programs on milk yield, the herd exit dynamics (i.e., cows sold and dead), and first service reproductive outcomes. Lactating Holstein cows (n = 1,204) enrolled in the experiment were fitted with a neck-attached sensor of an automated monitoring system (HR Tags; Merck & Co., Inc.) that generated health alerts based on rumination time and activity. Milk yield was monitored 3 times per day by automated milk meters (MM27BC, DeLaval). Cows were blocked by parity, close-up period diet, and stratified by previous lactation milk yield, and then were randomly assigned within block to different programs for monitoring health from 3 to 21 d in milk (DIM). Cows in the visual observation group (VO; n = 597) were selected for clinical examination exclusively based on visual observation of clinical signs of disease, whereas cows in the automated health monitoring group (AHM; n = 607) were selected for clinical examination based on health alerts consisting of the following: a Health Index Score < 86 arbitrary units, daily rumination < 250 min, or a reduction of > 20% in daily milk yield. Once selected for examination, the clinical exam was the same for both treatment groups. Binary data such as the occurrence of CHD, herd exit, and pregnancies per AI were analyzed with logistic regression. Daily and weekly milk yield were analyzed using ANOVA with repeated measurements. More cows underwent a clinical examination, more cows were diagnosed with at least one CHD, and more cows received treatment in the AHM than the VO treatment group. Cows in the AHM treatment had more accumulated milk than cows in the VO treatment from 2 to 21 DIM. Cows in the AHM treatment diagnosed with at least one CHD produced more milk from 3 to 18 and 20 to 21 DIM than cows diagnosed with a CHD in the VO treatment. Fewer cows left the herd up to 21 DIM for the AHM than the VO treatment. Pregnancies per AI at first service were greater for the VO than the AHM treatment at 30 d but not at 50 d after AI and no difference in pregnancy loss was detected. In conclusion, a health monitoring strategy that used automated health alerts increased the risk of undergoing clinical examination and having CHD diagnosed compared with a program that selected cows for clinical examination based exclusively on visual observation. Cows monitored with the program that relied on automated alerts also had greater milk yield in the first 21 DIM. Thus, monitoring cow health based on automated behavior and milk yield alerts might be a more effective alternative for health monitoring than exclusive use of visual observation of clinical signs of disease.

Application effect of case management nursing based on patient safety in patients with prostate cancer.

Globally, prostate cancer has become a major threat to men's health, with an increasing incidence and causes serious effects on the quality and length of life of patients. Despite the rapid development of medical technology, which provides treatments, including surgery, radiotherapy, and endocrine therapy, the treatment of patients with prostate cancer, especially with endocrine therapy, has become a major challenge in clinical treatment owing to the lengthy course of treatment, side effects of drugs, and impact of the disease on the psychological and physiological functioning of the patient, producing poor treatment adherence and a decline in quality of life. To explore effects of nursing intervention prioritizing patient safety and case management in patients with prostate cancer undergoing endocrine therapy. Eighty patients with prostate cancer who received endocrine therapy at our hospital between January 2022 and January 2024 were divided into observation and control groups with 40 cases per group. The control group was treated using a routine nursing workflow while the observation group received case management nursing guidance prioritizing patient safety. Scores for anxiety and depression, prostate cancer symptoms, and quality of life and patient compliance and satisfaction were compared between the groups after three months of intervention. After the nursing intervention, the anxiety and depression scores of the observation group were significantly lower than those of the control group (P < 0.05). The quality of life score, sexual function, and hormone function were significantly higher than those in the control group (P < 0.05). Case management guidance based on patient safety effectively reduced anxiety and depression in patients undergoing endocrine therapy for prostate cancer and improved their quality of life, treatment compliance, and satisfaction.

Analysis of the Clinical Efficacy of Glimepiride Combined with Insulin in the Treatment of Elderly Diabetes

Objective: To explore the clinical efficacy and incidence of hypoglycemia in the treatment of elderly diabetes with glimepiride combined with insulin. Methods: A total of 100 patients diagnosed with diabetes in Qinghai Red Cross Hospital from January 2018 to January 2019 were selected and divided into an observation group and a control group according to the order of their visits, with 50 patients in each group. The observation group was treated with glimepiride combined with insulin, while the control group was treated with insulin alone. The blood sugar indicators, including glycated hemoglobin (HbA1c), fasting blood glucose (FBG), and 2-hour postprandial blood glucose (2h PBG), were compared between the two groups. Additionally, the incidence of hypoglycemia was compared, and the causes of hypoglycemia were analyzed and summarized, proposing corresponding countermeasures. Results: The glycated hemoglobin value of the observation group was lower than that of the control group, and the statistical analysis showed a significant difference (t = 3.54, P &lt; 0.05). The fasting blood glucose value in the observation group was lower than that in the control group, with statistically significant differences (t = 4.08, P &lt; 0.05). The 2-hour postprandial blood glucose value in the observation group was also lower than that in the control group, with a significant difference (t = 3.82, P &lt; 0.05). The incidence of hypoglycemia in the observation group was 10%, while it was 56% in the control group, with a statistically significant difference between the two groups (χ2 = 5.813, P &lt; 0.05). Conclusion: The efficacy of glimepiride combined with insulin in the treatment of elderly diabetes is significantly higher than that of insulin alone, with a lower incidence of hypoglycemia.

A Study on the Work Process-Based Practical Training Model for Basic Nursing Skills in Vocational Colleges

Objective: To explore and analyze the work process-based practical training teaching model for basic nursing skills in vocational colleges and its implementation effects. Methods: A total of 82 nursing students from our school were selected for the study, which was conducted from April 2023 to April 2024. Using a random number table method, the students were divided into an observation group and a control group, each with 41 students. The control group received conventional practical training teaching, while the observation group followed the work process-based practical training model for basic nursing skills. The assessment scores and teaching satisfaction of the two groups were compared. Results: The comparison of assessment scores showed that the observation group performed significantly better than the control group (P &lt; 0.05). The comparison of teaching satisfaction also indicated that the observation group had significantly higher satisfaction than the control group (P &lt; 0.05). Conclusion: The work process-based practical training teaching model for basic nursing skills in vocational colleges can improve students’ assessment scores and enhance teaching satisfaction, demonstrating its value for wider application.

Study on the Clinical Application of Nutritional Management Combined with Clinical Monitoring of Glycated Albumin in Diabetic Nephropathy Dialysis Patients

Objective: To explore the clinical application of nutritional management combined with clinical monitoring of glycated albumin (GA) in diabetic nephropathy (DN) dialysis patients. Methods: A total of 20 diabetic nephropathy dialysis patients admitted to the People’s Hospital of Guandu District from January 2022 to February 2023 were included in the study. They were randomly divided into a conventional group (n = 10) and an observation group (n = 10). The study evaluated the blood glucose control, nutritional status, dialysis efficacy, and quality of life scores of both groups. Results: Before the intervention, there were no significant differences in fasting plasma glucose (FPG), GA, serum albumin, body mass index (BMI), dialysis efficiency values, urea clearance rate, or quality-of-life scores between the two groups (P &gt; 0.05). After the intervention, the observation group showed significantly lower FPG and GA levels, higher serum albumin, dialysis efficiency values, urea clearance rate, and improved quality-of-life scores compared to the conventional group (P &lt; 0.05), with no difference in BMI (P &gt; 0.05). Conclusion: Nutritional management combined with clinical monitoring of glycated albumin has a significant effect on the clinical application of diabetic nephropathy dialysis patients. It can effectively improve patients’ blood glucose control and nutritional status, reduce the risk of complications, and enhance the quality of life, demonstrating clinical value for broader application.

F-type forceps for assisted reduction in femoral shaft fractures surgery

To explore clinical efficacy of F-type forceps for assisted reduction in femoral shaft fracture reduction. Forty-five patients with femoral shaft fracture treated with intramedullary nail and internal fixation from January 2019 to December 2021 were retrospectively analyzed and divided into two groups according to different reduction methods. In observation group, there were 21 patients, included 15 males and 6 females, aged from 27 to 92 years old with an average of (53.38±18.81) years old;9 patients on the left side, 12 patients on the right side;7 patients were type A, 8 patients were type B and 6 patients were type C according to AO fracture classification;the time from injury to operation ranged from 7 to 13 days with an average of (4.62±3.34) days;reduction was assisted by F-shaped forceps. In control group, there were 24 patients, including 17 males and 7 females, aged from 20 to 92 years old with an average of (51.96±20.43) years old;12 patients on the left side, 12 patients on the right side;11 patients were type A, 8 patients were type B and 5 patients were type C according to AO fracture classification;the time from injury to operation ranged from 2 to 13 days with an average of (6.29±3.04) days;traditional reset mode was adopted. Operative time, intraoperative blood loss, intraoperative fluoroscopy times, intraoperative open reduction ratio, clinical healing time of fracture, postoperative complications, hospital stay, hospital cost and Lysholm score of knee joint at 6 and 12 months after surgery were compared between two groups to evaluate clinical effect. All patients were followed up for 12 to 24 months with an average of (16.60±3.45) months. In observation group, operative time, intraoperative blood loss, intraoperative fluoroscopy times, open reduction cases, and clinical healing time of fractures were (58.19±7.93) min, (88.10±44.45) ml, (25.29±5.54) times, 0 case, (4.76±0.77) months, respectively;while in control group was (79.33±22.94) min, (222.92±144.45) ml, (47.46±26.25) times, 5 cases, (7.13±1.80) months, and the difference between two groups were statistically significant (P<0.05). There were no significant difference in postoperative complications, length of stay and hospitalization cost between two groups (P>0.05). At 6 months after surgery, Lysholm score of knee joint in observation group (88.62±4.48) was better than that in control group (79.21±8.91) (F=21.948, P=0.000). There were no significant difference in support use, pain and squat score between two groups (P>0.05). At 12 months after surgery, Lysholm scores of stair climbing and pain in observation group were (9.62±1.20) and (19.76±1.92), which were better than those in control group (7.83±2.04) and (21.88±2.88) (P<0.05). There were no significant difference in scores and total scores of other items between two groups (P>0.05). Compared with traditional reduction method, F-type forceps instrument could shorten operation time, reduce intraoperative blood loss, reduce intraoperative fluoroscopy times, accelerate clinical healing of fracture, and promote earlier functional recovery of knee joint.

Analysis of the therapeutic effect of pestle needle and EEG biofeedback and methylphenidate in the treatment of attention-deficit/hyperactivity disorder.

This research aimed to analyze the therapeutic effect of the pestle needle combined with electroencephalogram (EEG) biofeedback and methylphenidate in the treatment of attention-deficit/hyperactivity disorder (ADHD) in children. Seventy-eight children with ADHD were selected and randomized into a control group and an observation group (n = 39 each). The control group received EEG biofeedback and methylphenidate treatment, whereas the observation group received pestle needle therapy on this basis. Both groups received continuous treatment for 3 mo. The clinical efficacy, scores of Conners Parents Symptom Questionnaire (PSQ), Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), and Pittsburgh Sleep Quality Index (PSQI), EEG θ/β changes in values, serum indicators such as adrenocorticotropic hormone (ACTH) and cortisol (CORT), and incidence of adverse reactions were compared in the two groups. The total effective rate of the observation group was 92.31% (36/39), which was higher than the control group's 69.23% (27/39) (P < 0.05). After treatment, reduced PSQ scores, PSQI scores, EEG θ/β values, and ACTH levels and elevated IVA-CPT and CORT levels were observed in both groups; the observation group had the best improvement effect after treatment (P < 0.05). Pestle needle combined with EEG biofeedback and methylphenidate in the treatment of ADHD children can elevate the IVA-CPT score, improve EEG waves and sleep quality, regulate serum indicators such as ACTH and CORT, reduce behavioral problem scores, and have high efficacy and safety.NEW & NOTEWORTHY The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can elevate the IVA-CPT score. The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can improve EEG waves. The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can improve sleep quality. The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can regulate serum indicators.

Acute angle-closure glaucoma before, during, and after the outbreak of COVID-19 in China

ObjectivesAcute angle-closure glaucoma (AACG) is a major cause of irreversible and severe visual function loss. Robust rise in AACG was observed in the ophthalmic outpatient clinics concomitant with the outbreak of COVID-19 infection in China after the relaxing of “zero-COVID policy” in early December 2022. Here we compared the demographic and clinical profiles of patients with AACG before, during and after the COVID-19 outbreak. Underlying mechanisms were tentatively investigated. MethodsThis is a retrospective comparative study. Consecutive cases with newly diagnosed AACGs in a tertiary eye hospital were retrospectively collected during December 17, 2022 to January 8, 2023. Data from the same period in 2018–2019 and 2019–2020, 2020–2021 and 2021–2022, and 2023–2024 were collected as pre-pandemic, pandemic-control, and post-pandemic control, respectively. For the patients in 2022–2023 outbreak group, COVID-19 infection was confirmed by reversed transcriptase-polymerase chain reaction or antibody test for severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) from nasopharyngeal swabs. Ocular parameters, serum electrolytes and coagulative parameters were compared between COVID-19 positive and negative AACGs in observational group. SARS-CoV-2 nucleic acid in the aqueous humor was detected. ResultsA total of 106 AACG cases were diagnosed during the outbreak period in 2022–2023. In contrast, 18 (in 2018–2019) and 22 (in 2019–2020) cases were included during pre-pandemic period, and 21 (in 2023–2024) during the post-pandemic period. Only 13 and 4 newly onset AACG were included in 2020–2021 and 2021–2022 during the pandemic-control period, respectively. Younger age and higher proportion of bilateral involvement were detected in COVID-19 outbreak group than that of other groups (p = 0.034 and p = 0.080). Sixty-eight (64.2 %) patients in the outbreak group had a confirmed COVID-19 infection. Intervals between infection and AACG attack was 52 ± 85h (0-15d). Fifty-three patients (77.9 %) reported the applications of ibuprofen or other antipyretic medications and 25 (36.8 %) reported large volume water intake before AACG attack. COVID-19-positive AACG patients had higher level of D-dimer than their negative counterparts (1.13 ± 2.60 mg/L vs. 0.46 ± 0.43 mg/L, p = 0.083). No difference in IOP, serum electrolytes, and coagulative parameters other than D-dimer was observed between COVID-19 positive and negative cases. SARS-CoV-2 were negative in the aqueous humor from 14 COVID-19 positive and 8 negative patients. ConclusionCOVID-19 infection surged the onset of AACG in patients at risk. Mental stress, water intake, increased choroidal thickness due to SARS-CoV-2 induced ACE receptor activation, and hyper-coagulation, may contribute to the disease onset. Ocular involvement should not be ignored in both routine and new systemic emergent conditions.

Clinical features of gastrointestinal symptoms in women with recurrent course of deep infiltrative endometriosis

Background. Endometriosis is a chronic multifactorial disease that affects more than 170 million women of reproductive age worldwide, causing pelvic pain syndrome, dyspareunia, and symptoms of gastrointestinal dyspepsia, thereby having a negative impact on the psycho-emotional state of patients. Despite a wide range of medical and surgical treatments, the relapse rate reaches 50%, which is a global economic and social problem.The purpose of the study. To determine the spectrum of clinical features of the gastrointestinal tract in women with recurrent deep infiltrative endometriosis.Materials and methods. The study included 113 patients of reproductive age who underwent surgical treatment of common forms of external genital endometriosis. The main group consisted of 32 patients who underwent repeated surgical treatment due to relapse of deep infiltrative endometriosis, the comparison group — 51 patients without relapse of the disease one year after the primary operation, the control group — 30 patients of reproductive age who did not suffer from external genital endometriosis. An analysis of the somatic anamnesis was carried out, as well as questionnaire data on pelvic pain on a visual analogue scale (VAS) and functional bowel disorders in patients with deep infiltrating endometriosis, depending on the status of relapse of the disease.Results and discussion. Patients of the main group suffered significantly more often from functional diseases of the gastrointestinal tract (71.9% (23/32) versus 51.3% (26/51) in the comparison group; p = 0.006, the spectrum of which was represented by chronic gastritis and irritable bowel syndrome. In the main group, the clinical manifestations of gastrointestinal dyspepsia before surgical treatment correspond to a moderately severe degree of 17.706 (4.601) points. A significantly higher initial level of functional intestinal disorders was established during subjective assessment in the main observation group: 17.706 (4.601) points versus 10.66 (3.61) points in the comparison group; p=0.001. In women of the main observation group, one month after surgical treatment, there was a significant decrease in subjective assessment of the severity of functional intestinal disorders (from 17.71 (4.60) points to 9.86 (4.73) points; p = 0.001). The integral VAS pain score in the main group was 6.65 (1.53) points, which is significantly higher than in patients in the comparison group without relapse of the disease.Conclusions. The identified clinical and anamnestic predictors of the recurrent course of deep infiltrative endometriosis will allow us to formulate a personalized approach at the pre- and postoperative stage, aimed at preventing relapse of the disease, which will directly improve the psycho-emotional state and quality of life of women.