Table of Content

28 November 2023, Volume 12 Issue 4 Previous Issue    Next Issue

Commentary

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Advances in systemic therapy of advanced renal cell carcinoma HU Qingyue, ZHAI Wei, ZHENG Junhua 2023, 12 (4):  237-242.  doi: 10.3969/j.issn.2095-378X.2023.04.001 Abstract ( 335 )   PDF (1253KB) ( 513 )   Save Renal cell carcinoma is a common type of urinary cancer with insidious onset and rapid progression. Advanced renal cell carcinoma has poor prognosis and primarily depends on systemic therapy which mainly composed of targeted therapy and immunotherapy. Recently, new targeted drugs, immuno-targeted combination therapy, HIF-2α inhibitors, and probiotic combination therapy provide more possible options for the treatment. In this review, we gave an overview of the advances in systemic therapy of advanced renal cell carcinoma, aiming to help make clinical decisions. References | Related Articles | Metrics

Original article

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Role of age in joint replacement surgery for degenerative osteoarthritis of knee in elderly patients YAN Laipeng 2023, 12 (4):  243-246.  doi: 10.3969/j.issn.2095-378X.2023.04.002 Abstract ( 102 )   PDF (1211KB) ( 317 )   Save Objective To investigate the role of age in the effect of joint replacement surgery on degenerative osteoarthritis of the knee in elderly patients. Methods A total of 68 elderly patients with knee degenerative osteoarthritis who received joint replacement surgery from June 2019 to August 2022 were selected as study subjects, including 35 patients ≤ 70 years old as the observation group, and 33 patients >70 years old as the control group. After joint replacement surgery, the recovery of the two groups of patients was observed. Results The observation group's joint range of motion （ROM） score and knee joint function HSS score were higher than the control group's at 6 months after surgery （P<0.05）. The Barthel index and 36-item Short-Form （SF-36） score of the observation group patients at 6 months after surgery were higher than those of the control group （P<0.05）. The incidence of complications in the observation group was lower than that in the control group （P<0.05）. The excellent and good rehabilitation rate of the observation group patients was higher than that of the control group （P<0.05）. Conclusion In the clinical treatment of elderly patients with degenerative osteoarthritis of knee joint, joint replacement surgery can effectively alleviate the pain symptoms and promote the recovery of their knee joint function. The choice of the timing of joint replacement surgery will affect the curative effect to some extent. Patients younger than 70 years of age have better functional recovery after joint replacement surgery than patients older than 70 years of age. References | Related Articles | Metrics

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Comparison of short-term effects of mitral valvuloplasty and mitral valve replacement on rheumatic mitral valve disease LUO Tongbo, CHEN Kaiming, LAI Fenghua, LIU Lang, ZHU Bowei 2023, 12 (4):  247-250.  doi: 10.3969/j.issn.2095-378X.2023.04.003 Abstract ( 77 )   PDF (1237KB) ( 271 )   Save Objective To explore the short-term effects of mitral valvuloplasty and mitral valve replacement for rheumatic mitral valve lesions. Methods A total of 400 patients with rheumatic mitral valve lesions admitted from July 2019 to June 2023 were selected as study subjects and divided into two groups， including 200 cases with mitral valvuloplasty （study group） and 200 cases with mitral valve replacement （control group）. The cardiac function， surgical indexes， hospital stay， mitral regurgitation， and complications were compared between the two groups. Results The preoperative left ventricular end-diastolic diameter （LVEDD）， left ventricular end-systolic diameter （LVESD）， left ventricular ejection fraction （LVEF）， and left atrial diameter （LAD） of the study group did not differ from those of the control group （P>0.05）， and the postoperative indicators of the study group were higher than those of control group （P<0.05）. The amount of intraoperative bleeding and hospitalization time of the study group were less than those of the control group， but the duration of extracorporeal circulation and the duration of operation of the study group were longer than those of the control group （P<0.05）. Moderate mitral regurgitation occurred in 3 cases and mild mitral regurgitation in 15 cases in the study group， and the incidence rate of mitral regurgitation of the study group was lower than that of the control group （P<0.05）. The rate of complications of the study group was lower than that of the control group （P<0.05）. Conclusion Mitral valvuloplasty is more effective in the treatment of rheumatic mitral valve lesions than mitral valve replacement by facilitating recovery with high safety and obviously improved cardiac function， and is worthy of clinical promotion. References | Related Articles | Metrics

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Therapeutic effect of tissue selective therapy combined with anal epithelial preservation surgery on severe prolapsed hemorrhoids LIU Yongning, LIU Jiarong, ZHOU Guangxing, FANG Dingling 2023, 12 (4):  251-254.  doi: 10.3969/j.issn.2095-378X.2023.04.004 Abstract ( 78 )   PDF (1240KB) ( 303 )   Save Objective To explore the therapeutic effect of tissue selective therapy （TST） combined with anal epithelial preservation surgery on severe prolapsed hemorrhoids. Methods A total of 120 patients with severe prolapsed hemorrhoids admitted from January to December 2021 were divided into two groups according to random number table method, with 60 cases in each group. The observation group underwent TST combined with anal epithelial preservation, and the control group underwent external stripping and internal ligation. The operation time, intraoperative blood loss, anal distention, therapeutic effect, anal function （using Wexner scale, Vaizey scale, Pescatori scale, and AMS scale）, postoperative pain, incidence of postoperative complications, and quality of life of the two groups were compared. Results The surgical time, intraoperative bleeding, and anal distension score in the observation group were lower than those in the control group （P<0.05）. The effective rate of treatment in the observation group was higher than that in the control group （P<0.05）. The Wexner scale, Vaizey scale, Pescatori scale, and AMS scale scores of the observation group were lower than those of the control group （P<0.05）. The postoperative pain score and incidence rate of complications in the observation group were lower than those in the control group （P<0.05）. The quality of life score of the observation group was higher than that of the control group （P<0.05）. Conclusion TST combined with anal epithelial preservation has a significant effect on severe prolapsed hemorrhoids, with reduced patient pain, improved anal function, decreased complications, and elevated comprehensive quality of life. It can be referenced and promoted in clinical practice. References | Related Articles | Metrics

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Effect of endoscopic radical thyroidectomy through chest breast approach on early papillary thyroid cancer and observation of patient stress indicators, thyroid function, and parathyroid function QIU Zhihua 2023, 12 (4):  255-257.  doi: 10.3969/j.issn.2095-378X.2023.04.005 Abstract ( 93 )   PDF (1216KB) ( 217 )   Save Objective To explore the effectiveness of endoscopic radical thyroidectomy （ERT） through the chest breast approach on early papillary thyroid cancer and its impact on patient stress indicators, thyroid function, and parathyroid function. Methods From January 2020 to January 2023, a total of 62 patients with early papillary thyroid cancer diagnosed and treated in the hospital were selected as study subjects. They were randomly divided into a control group and an observation group by random number table method, with 31 cases per group. The control group received routine surgical treatment, while the observation group received ERT treatment through the chest breast approach. The thyroid function, parathyroid function （thyroid stimulating hormone （TSH）, thyroid hormone （T4）, triiodothyronine （T3）, and parathyroid hormone （PTH））, and stress indicators （cortisol （Cor）, superoxide dismutase （SOD）, and norepinephrine （NE）） were compared between the two groups. Results After operation, the levels of T3, T4, PTH, and SOD in the observation group were higher than those in the control group （P>0.05）; the levels of Cor, NE, and TSH in the observation group were lower than those in the control group （P<0.05）. Conclusion The use of transthoracic breast approach ERT treatment for early papillary thyroid cancer can reduce stress response and maintain thyroid and parathyroid functions of patients. References | Related Articles | Metrics

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Effects of combined anterior and posterior segment surgery for macular hole combined with cataract on visual acuity, macular area morphology, and safety in patients ZHOU Yiling 2023, 12 (4):  262-265.  doi: 10.3969/j.issn.2095-378X.2023.04.007 Abstract ( 126 )   PDF (3220KB) ( 196 )   Save Objective To investigate the effects of combined anterior and posterior segment surgery for macular hole combined with cataract on patients' vision， macular area morphology， and safety. Methods A total of 150 patients with macular hole combined with cataract treated in our hospital from April 2019 to April 2022 were selected as study subjects， and underwent combined anterior and posterior segment surgery. The visual acuity and changes in the morphology and structure of macular area of patients were compared before and after treatment， and the occurrence of postoperative complications was recorded. Results After treatment， the patients' visual acuity was higher than before treatment， and the intraocular pressure level was lower than before treatment （P<0.05）. The distortion of macular area morphology and structure in 146 patients was restored， with a recovery rate of 97.33%. The total incidence rate of complications was 7.33%. Conclusion The combined anterior and posterior segment surgery for macular hole combined with cataract has a definite therapeutic effect， can actively improve visual acuity and macular area morphology， and is relatively safe. It is worth promoting and applying in clinical practice. References | Related Articles | Metrics

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Effect of laparoscopic common bile duct exploration on choledocholithiasis LI Mingli, WANG Caixia 2023, 12 (4):  266-268.  doi: 10.3969/j.issn.2095-378X.2023.04.008 Abstract ( 76 )   PDF (1225KB) ( 212 )   Save Objective To analyze the effect of laparoscopic common bile duct exploration （LCBDE） on common bile duct stones. Methods A total of 200 patients with choledocholithiasis treated from January 2018 to April 2023 were selected as study subjects. According to different surgical methods， they were divided into observation group （LCBDE） and control group （open surgery）， with 100 cases in each group. The intraoperative conditions， postoperative recovery indicators， and complications of the two groups were compared. Results Compared with the control group， the observation group showed a significant reduction in surgical time and bleeding volume （P<0.01）， and performed better in indicators such as bile drainage volume， anal exhaust recovery time， and hospital stay （all P<0.01）. In addition， the overall incidence of complications in the observation group was significantly reduced （P<0.05）. Conclusion LCBDE is a surgical method with less trauma， fast recovery， and few complications， and has a wide application prospect in the treatment of choledocholithiasis. References | Related Articles | Metrics

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Influencing factors for first cesarean section and impact of risk correction on reducing first cesarean section rate LI Meijiao, GU Xiulan, HU Chuxia 2023, 12 (4):  269-272.  doi: 10.3969/j.issn.2095-378X.2023.04.009 Abstract ( 94 )   PDF (1237KB) ( 189 )   Save Objective To explore the risk factors of first cesarean section and the impact of risk correction on first cesarean section rate. Methods A total of 705 women with cesarean section admitted to the hospital from January 2021 to December 2022 were selected as study subjects， and all potential factors affecting first cesarean section were recorded. Regression analysis was used to screen out risk factors and protective factors， and a logistic equation was established to test its accuracy. The actual cesarean section rate and risk-adjusted cesarean section rate were compared. Results The risk factors of cesarean section mainly included age of delivery， body mass index， gravidity， gestational weeks， multiple pregnancies， pregnancy comorbidities and complications， intrapartum complications， education level， occupation， and assisted reproductive technology （P<0.05）. Preterm delivery and multipara were protective factors for the rate of first cesarean section. In addition， the risk-adjusted first cesarean section rates from January to December 2021 and from January to December 2022 were significantly lower than the actual first cesarean section rates， with statistical significance （P>0.05）. The results of specificity test of regression equation of first cesarean section rate showed that the area under the curve （AUC） of receiver operating characteristic （ROC） was 0.763， the standard deviation was 0.033 （P<0.001）， and the 95%CI was 0.699-0.827. The actual rates of first cesarean section from January to August 2021， from September 2021 to April 2022， and from May to December 2022 were higher than the risk-adjusted rates （P<0.05）. Conclusion Delivery age， body mass index， gravidity， gestational weeks， multiple pregnancies， pregnancy comorbidities and complications， intrapartum complications， education level， occupation， assisted reproductive technology， fetal condition， and maternal birth canal， and psychological status are all risk factors for first cesarean section rate. Risk-adjusted first cesarean section rate provides favorable conditions for obstetrics to reduce cesarean section rate， and is a key indicator for evaluating obstetric quality. References | Related Articles | Metrics

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Impact of laparoscopic fallopian tube fenestration and embryo retrieval surgery on ovarian reserve function and re-pregnancy in patients with ectopic pregnancy LI Miaoli, LIAN Lishan 2023, 12 (4):  273-275.  doi: 10.3969/j.issn.2095-378X.2023.04.010 Abstract ( 127 )   PDF (1244KB) ( 225 )   Save Objective To analyze the clinical efficacy of laparoscopic fallopian tube fenestration and embryo retrieval surgery for ectopic pregnancy， and to explore its impact on ovarian reserve function and re-pregnancy in patients. Methods A total of 86 patients with ectopic pregnancy admitted from January 2020 to January 2023 were selected as research subjects， and divided into a control group （odd number） and an observation group （even number） with 43 patients in each group， based on their admission numbers. The control group underwent salpingectomy on the affected side， while the observation group underwent laparoscopic fenestration and embryo retrieval. The levels of serum anti-Mullerian hormone before and after surgery， the number of postoperative sinus follicles after surgery， and the rate of postoperative re-pregnancy were compared between the two groups of patients. Results Before surgery， there was no statistically significant difference in serum levels of anti-Mullerian hormone between the two groups of patients of different age groups （P>0.05）. At 3 months after surgery， the serum levels of anti-Mullerian hormone in the observation group aged 20-30 and 31-35 years were higher than those in the control group （P<0.05）. At 6 months after surgery， there was no statistically significant difference in the serum levels of anti-Mullerian hormone between the two groups of patients aged 20-30 and 31-35 years （P>0.05）. The number of sinus follicles in the observation group was higher than that in the control group at 3 and 6 months after surgery （P<0.05）. The intrauterine pregnancy rate in the observation group was higher than that in the control group at 12 months after surgery， and the infertility rate was lower （P<0.05）. Conclusion Laparoscopic fallopian tube fenestration and embryo retrieval surgery can protect ovarian reserve function and reproductive function in patients with ectopic pregnancy， and help improve the rate of intrauterine re-pregnancy after surgery. References | Related Articles | Metrics

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Healing effect of gluteus maximus pedicled myocutaneous flap combined with vacuum sealing drainage technology on bedsore wound repair JIAN Youyuan, ZHANG Jiandan, LU Zhanzhou 2023, 12 (4):  276-279.  doi: 10.3969/j.issn.2095-378X.2023.04.011 Abstract ( 76 )   PDF (1239KB) ( 184 )   Save Objective To explore the effect of vacuum sealing drainage combined with gluteus maximus pedicled myocutaneous flap on promoting the healing of bedsore wounds in patients. Methods A total of 60 cases of sacrococcygeal bedsore and skin and soft tissue defects were recruited in the study from June 2020 to March 2023. They were divided into two groups according to different treatment schemes： routine group （n=30） and study group （n=30）. The routine group received repair treatment of the upper gluteus maximus myocutaneous flap， and the study group received VSD combined with gluteus maximus pedicled myocutaneous flap treatment. Wound healing， occurrence of postoperative infections， wound healing time， number of dressing changes， use time of antibiotics， and length of hospital stay were recored of the two groups. Results Compared with the routine group， the study group had a higher grade A healing rate， less dressing changes， and shorter healing time， use time of anitbiotics， and length of hospital stay （P<0.05）. Conclusion In the repair of bedsore wounds， VSD combined with pedicled myocutaneous flap of gluteus maximus can elevate healing quality， facilitate wound recovery， and is worthy of clinical promotion and application. References | Related Articles | Metrics

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Effects of percutaneous vertebroplasty combined with external beam radiation therapy versus external beam radiation therapy alone on spinal metastasis： a meta-analysis ZENG Lingxiang, ZHANG Jingpei, YUAN Xiangwei 2023, 12 (4):  280-288.  doi: 10.3969/j.issn.2095-378X.2023.04.012 Abstract ( 67 )   PDF (2775KB) ( 168 )   Save Objective To evaluated the effect of external beam radiation therapy （EBRT） plus percutaneous vertebroplasty （PVP） versus EBRT alone on spinal metastasis by meta-analysis. Methods A systematic search of PubMed， Web of Science， Cochrane Library， Embase， Clinical Trials， CNKI， Wanfang， CBM， and VIP databases was conducted，and the retrieval period was from inception to July 1st， 2022 to identify the controlled trials of EBRT plus PVP versus EBRT alone for treating patients with spinal metastasis. Two reviewers screened the literature， extracted data， and assessed the risk of bias in the included studies independently. The obtained data were analyzed using Review Manager 5.4.1 software. Results There were 12 studies （1 randomized controlled trials and 11 cohort studies） involving 1138 patients. The results of meta-analysis showed that the Visual Analog Scale （VAS） scores at 1 d， 1， 3， 6， and 12 months after treatment， overall pain relief response rate at 1 and 3 months， spinal instability neoplastic score （SINS）， local progression/recurrence rate， incidence of spondythopathic fractures， Karnofsky Performance Status （KPS） improvement rate at 3 months， and ECOG physical status improvement rate were better in the EBRT plus PVP group than in those treated with EBRT alone （P<0.05）. No differences in KPS improvement rate at 1 month was observed between the EBRT plus PVP and the EBRT alone groups （P>0.05）. Conclusion EBRT plus PVP has a better analgesic effect and produces better quality of life， postoperative vertebral stability， and enhanced local anti-tumor effect than EBRT. References | Related Articles | Metrics

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Effects of remimazolam on hemodynamics and postoperative stress in patients undergoing general anesthesia for laparoscopic cholecystectomy YANG Fuliu 2023, 12 (4):  289-291.  doi: 10.3969/j.issn.2095-378X.2023.04.013 Abstract ( 80 )   PDF (1204KB) ( 202 )   Save Objective To explore the effect of remimazolam on hemodynamics and postoperative stress of patients with general anesthesia for laparoscopic cholecystectomy （LC）. Methods A total of 68 patients who received LC treatment from January 2021 to January 2023 were selected as observation subjects. They were randomly divided into M group （n=34） and R group （n=34） using the envelope method. During anesthesia induction in the M group, midazolam, fentanyl, and cisatracurium besilate were used; during anesthesia induction in the R group, remimazolam, fentanyl, and cisatracurium besilate were used. The hemodynamic indicators, adverse reactions, and postoperative stress levels were compared between the M group and the R group at different time points. Results There were no statistically significant differences in heart rate （HR） and mean arterial pressure （MAP） between the two groups before induction （P>0.05）. At the time points before intubation, immediately after intubation, and 1 min after intubation, the HR and MAP in the R group were significantly lower than those in the M group （P<0.05）. At 24 h after operation, the levels of norepinephrine, cortisol, insulin, and C-peptide in the R group were significantly lower than those in the M group （P<0.05）. The incidence of dizziness and headache in the R group was significantly lower than that in the M group （P<0.05）. Conclusion When patients undergo LC treatment, using remimazolam for general anesthesia can effectively maintain the anesthesia effect, reduce their physiological stress level, and have high safety. References | Related Articles | Metrics

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Effect of inguinal iliac fascia block combined with general anesthesia on signs and postoperative delirium in elderly patients with hip replacement HUANG Guangyong, ZHENG Jianyu, HUANG Minzhen 2023, 12 (4):  292-295.  doi: 10.3969/j.issn.2095-378X.2023.04.014 Abstract ( 72 )   PDF (1251KB) ( 205 )   Save Objective To evaluate the effect of inguinal iliac fascia block combined with general anesthesia on sign fluctuations and postoperative delirium in elderly patients undergoing hip arthroplasty. Methods The study was conducted among 126 elderly patients who underwent hip replacement surgery from March 2020 to December 2022. They were randomly divided into a control group and an observation group using random number table method, with 63 patients in each group. The control group received routine general anesthesia, while the observation group received inguinal iliac fascia block combined with general anesthesia. Vital sign indicators [heart rate （HR）, mean arterial pressure （MAP）] at entry （T0）, intravenous infusion （T1）, and intraoperative 30 min （T2）, preoperative and postoperative C-reactive protein （CRP）, postoperative consciousness status [confusion assessment method （CAM-CR）], delirium occurrence, and adverse reactions were compared between the two groups. Results The HR and MAP at T1 in the observation group were higher than those in the control group, while the HR and MAP at T2 were lower （P<0.05）. The postoperative CRP in the observation group was lower than that in the control group （P<0.05）. The CAM-CR score and the incidence rate of delirium of the observation group were lower than those of the control group （P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion The use of inguinal iliac fascia block combined with general anesthesia can effectively prevent postoperative delirium in elderly patients undergoing hip arthroplasty. References | Related Articles | Metrics

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Value of PVP intraoperative acupuncture and medicine combined with postoperative fumigation in treatment of osteoporotic vertebral compression fracture CHEN Shengqiu, MENG Yeping, DENG Xuezhen 2023, 12 (4):  296-299.  doi: 10.3969/j.issn.2095-378X.2023.04.015 Abstract ( 59 )   PDF (1242KB) ( 217 )   Save Objective To explore the effect of intraoperative acupuncture and medication combined with postoperative fumigation treatment on patients with osteoporotic vertebral compression fractures in percutaneous vertebroplasty. Method A total of 76 patients with osteoporotic compression fractures admitted from July 2021 to July 2022 were selected and divided into a control group and an observation group by random number table method, with 38 cases in each group. All patients were treated with PVP surgery. The control group received intraoperative acupuncture and medication combined with traditional Chinese medicine fumigation placebo, while the observation group received intraoperative acupuncture and medication combined with postoperative fumigation treatment. The levels of vital indicators, traditional Chinese medicine symptom scores, pain scores, and ODI index were compared between the two groups. Results There was no difference in the levels of mean arterial pressure （MAP）, heart rate （HR）, and oxygen saturation （SpO2） between the two groups before treatment （P>0.05）. After treatment, the levels of MAP [（100.32±10.12） mmHg], HR [（73.18±6.23） beats/min], and SpO2 （99.65%±0.35%） in the observation group were lower than those in the control group, with significant differences between the groups （P<0.05）. There was no difference in the score of traditional Chinese medicine symptoms before treatment between the two groups （P>0.05）. The score of traditional Chinese medicine symptoms in the observation group after treatment （2.74±0.65） was lower than that in the control group （4.74±0.56）, with a significant difference between the groups （P<0.05）. There was no difference in pain score and ODI index between the two groups before treatment （P>0.05）. The pain score （1.18±0.45） and ODI index （8.42±1.32） of the observation group were lower than those of the control group after treatment, and the difference between the groups was significant （P<0.05）. Conclusion The combination of acupuncture and medication therapy during PVP surgery with postoperative fumigation treatment has a significant effect such as improving the patient's vital signs, decreasing their traditional Chinese medicine symptom scores, alleviating pain, and alleviating their functional impairments. It can be used for reference and promotion in clinical practice. References | Related Articles | Metrics

Medical instrument

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Cost-benefit analysis of disposable visible bronchoscopes based on multiple centers YANG Kun, SHAO Lei 2023, 12 (4):  300-301.  doi: 10.3969/j.issn.2095-378X.2023.04.016 Abstract ( 136 )   PDF (1138KB) ( 225 )   Save By comparing existing conventional reusable bronchoscopes and disposable visible bronchoscopes in multicenter intensive care units, this study conducted a cost-benefit analysis on disposable visual bronchoscopes from a series of cost issues such as procurement cost, clinical use effect, cleaning and disinfection, and the occurrence of cross infection. References | Related Articles | Metrics

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Design and application of a moving wheel anti-hair winding cover CHENG Wen, CHEN Qi, SHI Jun, XIE Xiongbing, CHENG Xiaohong, DING Ren 2023, 12 (4):  302-305.  doi: 10.3969/j.issn.2095-378X.2023.04.017 Abstract ( 55 )   PDF (4545KB) ( 174 )   Save Objective To design an anti-hair entanglement cover on mobile wheels to solve the problem that the equipment cannot move normally due to hair being twined around the wheels in departments of obstetrics and gynecology. Methods The moving wheel cover comprised fixed top plates and hair blocking covers. The fixed top plates were connected with the moving wheels of corresponding sizes. The hair blocking covers were a side-erected circular enclosure, which isolated hair from the wheels and effectively prevented hair entanglement on the wheels. Results After the completion of the wheel cover, there was no need to replace the fixed top plates after the initial installation, but the worn hair blocking covers needed to be replaced regularly. The clinical test showed that the use of wheel cover effectively prevented the moving wheels from winding hair and subsequent occurrence of wheel jam. Conclusion The anti-hair winding cover on mobile wheels is convenient to install and use, cheap, and can effectively prevent the inconvenience of hair twining on the wheels of the equipment, which improves the working efficiency of clinical departments and reduces the replacement costs by worn moving wheels. Therefore, it is worth popularizing. References | Related Articles | Metrics

Nursing

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Application of negative pressure drainage ball in closed thoracic drainage of newborns ZHANG Jingjing, WU Xia, GAO Dandan 2023, 12 (4):  306-309.  doi: 10.3969/j.issn.2095-378X.2023.04.018 Abstract ( 86 )   PDF (1254KB) ( 149 )   Save Objective To investigate the clinical effect of closed thoracic drainage with negative pressure drainage ball on neonatal pneumothorax. Methods From June 2021 to June 2022, a total of 44 children with pneumothorax undergoing thoracic closed drainage in the Neonatal Intensive Care Unit of our hospital were selected. According to different drainage methods, they were divided into a central venous catheter group （n=19, diameter 2.0-2.4 mm） and a negative pressure drainage ball group （n=25, diameter 5.3 mm）. The general condition, catheter placement time, drainage time, mechanical ventilation time, and the incidence of complications were compared between the two groups. Results There were no significant differences in sex, gestational age, birth weight, and lung compression ratio between the two groups （P>0.05）. In the negative pressure drainage ball group, the drainage time was （2.08±0.47） d, the hospital stay was （9.37±2.10） d, and the cure rate was 100.0%. In the central venous catheter group, the drainage time was （6.50±0.93） d, the hospital stay was （16.00±2.59） d, and the cure rate was 89.5%; all the differences of the indicators between the two groups were statistically significant （P<0.05）. There was a significant difference in the incidence of other postoperative complications between the two groups （P<0.05）, except 1 case of incision infection in the negative pressure drainage ball group. Conclusion The use of negative pressure drainage ball for thoracic closed drainage in the treatment of neonatal pneumothorax has a good drainage effect, shortens drainage time, is not easy to induce tube blockage, safe and effective, worthy of clinical application. References | Related Articles | Metrics

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Effects of rapid rehabilitation surgical nursing on postoperative recovery and complications in children undergoing laparoscopic acute appendicitis surgery WU Shunying, JIANG Xiaoqin 2023, 12 (4):  310-313.  doi: 10.3969/j.issn.2095-378X.2023.04.019 Abstract ( 55 )   PDF (1253KB) ( 182 )   Save Objective To explore the impacts of rapid rehabilitation surgical nursing on postoperative recovery and complications in children undergoing laparoscopic acute appendicitis surgery. Methods A total of 360 children with acute appendicitis who underwent laparoscopic surgery from August 2019 to November 2022 were selected and divided into two groups by random number table method, with 180 cases in each group. The control group received routine nursing, while the observation group received rapid rehabilitation surgical nursing. Both groups received nursing until 5 d after surgery. Postoperative recovery indicators, inflammatory reactions, postoperative complications, and nursing satisfaction were compared between the two groups. Results The observation group had earlier postoperative first exhaust time, defecation time, and time of out-of-bed activity than the control group, as well as shorter hospitalization time （P<0.05）. The observation group had lower postoperative white blood cell count, C-reactive protein, and procalcitonin, lower postoperative complication rate, and higher overall nursing satisfaction than the control group （P<0.05）. Conclusion Rapid rehabilitation surgical nursing can reduce the postoperative recovery time for children undergoing laparoscopic acute appendicitis surgery, significantly reduce inflammatory reaction and complication rates, and improve nursing satisfaction. References | Related Articles | Metrics

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Therapeutic effect of traditional Chinese medicine directional penetration therapy combined with ear point nursing on lumbar disc herniation HONG Qing, DONG Qiu'an, GUO Songming 2023, 12 (4):  314-316.  doi: 10.3969/j.issn.2095-378X.2023.04.020 Abstract ( 65 )   PDF (1226KB) ( 171 )   Save Objective To analyze the curative effect of traditional Chinese medicine directional penetration therapy combined with auricular point nursing on lumbar disc herniation. Methods From January 2019 to June 2022, a total of 84 patients with lumbar disc herniation complicated with lumbago and leg pain were selected and randomly divided into a control group and an observation group by random number table, with 42 cases in each group. The observation group was treated with acupuncture plus traditional Chinese medicine directional penetration therapy combined with auricular point nursing intervention, while the control group was treated with routine acupuncture intervention. The angle of straight leg raise, Visual Analogue Scale （VAS） scores, Japanese Orthopaedic Association （JOA） scores, time of getting out of bed, and hospital stay before and after intervention were compared between the two groups. Results After treatment, the straight leg raise and JOA score of the observation group were higher than those of the control group, and the VAS score, time of getting out of bed, and hospital stay of the observation group were lower （P<0.05）. Conclusion Conventional acupuncture plus traditional Chinese medicine directional penetration therapy combined with auricular point nursing can alleviate the clinical symptoms of patients with lumbar disc herniation complicated with low back and leg pain. References | Related Articles | Metrics