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2025 Vol. 23, No. 5

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General Practice Forum
Research on the application of artificial intelligence technology based on ChatGPT in general medical services
TIAN Tian, ZHANG Fei, ZHANG Xuan, WANG Jiahe
2025, 23(5): 721-725. doi: 10.16766/j.cnki.issn.1674-4152.003988
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In the contemporary era, characterized by accelerated advancements in information technology, the field of artificial intelligence (AI) in healthcare has emerged as a prominent area of research focus. Conversational generative models, such as ChatGPT, offer innovative solutions to improve the efficiency and quality of medical services through their powerful information processing and natural language interaction capabilities. This study systematically investigates the potential of ChatGPT in general practice, exploring strategies and challenges for integrating it into the workflow of general practitioners, and evaluating its impact on optimizing healthcare service quality. The findings indicate that ChatGPT has advantages in medical knowledge updating, clinical decision support and patient health management. Specifically, the development of personalized medical information delivery systems and intelligent patient data processing platforms has the potential to alleviate the workload of general practitioners. The In-Context Learning (ICL) capability of ChatGPT has been demonstrated to align with physicians' needs with a high degree of precision, while its automated medical record summarization function has been shown to substantially improve diagnostic efficiency. In order to achieve effective integrations, it must adhere to principles of human. The emphasis is on the auxiliary role of AI, with particular reference to collaboration, date security and system sustainability. It is recommended that future research place a priority on the optimization of algorithms, the development of privacy protection mechanisms, and the establishment of interdisciplinary collaboration models. These measures are considered essential for the advancement of deep integration and precise application of AI technologies in general practice.
Guidelines and Consensus
Guidelines for the integrated diagnosis and treatment of polycystic ovary syndrome based on disease and syndrome differentiation
Endocrinology and Metabolism Committee of the Chinese Medical Doctor Association Integrated Traditional Chinese and Western Medicine Branch, Endocrinology Committee of the Beijing Association of Integrative Medicine
2025, 23(5): 726-736. doi: 10.16766/j.cnki.issn.1674-4152.003989
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The "Guidelines for the Integrated Diagnosis and Treatment of Polycystic Ovary Syndrome Based on Disease and Syndrome Differentiation" were developed by the Endocrinology and Metabolism Committee of the Chinese Medical Doctor Association Integrated Traditional Chinese and Western Medicine Branch and the Endocrinology Committee of the Beijing Association of Integrative Medicine, in collaboration with clinical experts from key endocrinology and gynecology departments nationwide. This guideline adheres to the principle of integrating disease and syndrome differentiation for diagnosis and treatment, and forms recommendations based on evidence-based medicine through consensus meetings. The guideline covers the integrated diagnosis of polycystic ovary syndrome, comprehensive treatment based on disease and syndrome differentiation, and rehabilitation strategies. The development of this guideline aims to provide a reference for the standardized diagnosis and treatment of polycystic ovary syndrome in China, and to enhance the level of integrated disease and syndrome differentiation in its management.
Special Topic/Research on Comorbidities in Hypertension
Establishment and verification of clinical prediction model of hypertension complicated with diabetes in elderly people in community
ZHU Xianshang, MAO Huabo, CHENG Hu, WANG Jiancheng, XU Yin juan
2025, 23(5): 737-741. doi: 10.16766/j.cnki.issn.1674-4152.003990
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  Objective  The objective of this study is two-fold: firstly, to analyze the risk factors associated with diabetes in elderly patients suffering from hypertension in the community, and secondly, to construct a prediction model. The ultimate aim of this study is to provide a reference for the prevention and management of diabetes in elderly patients suffering from hypertension in the community.  Methods  From April 2023 to March 2024, the clinical data of 1 859 elderly patients with hypertension aged 65 years and over who participated in chronic disease management in the Tuanjie Community Health Service Centre were collected for the purpose of the study. The data were randomly partitioned into a training set comprising 1 301 cases and a validation set consisting of 558 cases, at a ratio of 7∶3 by means of a simple random sampling method. The LASSO regression method was employed to reduce the dimensionality of the variables, while multivariate logistic regression analysis was conducted to investigate the risk factors associated with hypertension in conjunction with diabetes. Subsequently, a Nomogram prediction model was developed. The validation set was utilized for the purpose of internal validation. The receiver operating characteristic curve (AUC) was employed to evaluate the discrimination of the model, the calibration curve was delineated and the Hosmer-Lemeshow test was used to evaluate the consistency of the model, and the decision analysis was used to evaluate the validity of the model.  Results  In a study of 1 859 elderly hypertensive patients, 546 (29.37%) were found to have diabetes mellitus. Multivariate logistic regression analysis demonstrated that a family history of chronic diseases, fatigue, chest tightness and sugar addiction were independent risk factors for hypertension combined with diabetes. Nevertheless, superior cognitive function and the undertaking of daily exercise were found to be protective factors. The area under the curve (AUC) of the prediction model constructed from the training set was 0.873 (95% CI: 0.850-0.873). The calibration curve' s slope was close to 1, and the H-L goodness of fit test yielded a chi-squared value of 6.511, a P value of 0.260, and good consistency. The decision curve indicated a net benefit from the model.  Conclusion  The prevalence of hypertension in combination with diabetes is high among the elderly population in this community. The prediction model, which is based on six community-measurable clinical characteristics, demonstrates both good predictive ability and clinical application value in predicting the occurrence of hypertension in combination with diabetes.
Factors influencing hypertension comorbidity in community-dwelling patients with diabetes based on random forest model
LI Wentao, GAO Wenjuan, LIU Xinying, WANG Yue, WU Hao
2025, 23(5): 742-745. doi: 10.16766/j.cnki.issn.1674-4152.003991
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  Objective  To investigate the current situation of hypertension in community-dwelling patients with diabetes and to analyze its influencing factors, guide personalized health management for patients with diabetes.  Methods  A total of 2 591 health records of diabetes patients registered at the Fangzhuang Community Health Service Center in Fengtai District, Beijing, from January 2023 to January 2024, were included in a cross-sectional survey. Based on random forest model and LASSO regression, the influencing factors associated with hypertension in patients with diabetes were explored.  Results  The prevalence of comorbid hypertension in community-dwelling patients with diabetes was 87.42% (2 265 people). The results of random forest algorithm showed that the lowest error was observed when the lambda (λ) value was 0.003 9, corresponding to eight key influencing factors. The were TG/HDL-C, estimated glomerular filtration rate (eGFR), BMI, fasting blood glucose, age, duration of diabetes, systolic blood pressure, and education background. The results of the multivariate stepwise regression analysis indicated that eGFR (OR=0.980, 95% CI: 0.969-0.990), TG/HDL-C (OR=1.083, 95% CI: 1.022-1.147), BMI (24-28 group: OR=1.469, 95% CI: 1.140-1.893; >28 group: OR=2.340, 95% CI: 1.561-3.509), age (>75 years group: OR=1.844, 95% CI: 1.125-3.021), and systolic blood pressure (OR=1.053, 95% CI: 1.031-1.076) were influencing factors of comorbid hypertension in diabetic patients (P < 0.05).  Conclusion  The prevalence of hypertension was notably high among community-dwelling patients with diabetes. Elevated TG/HDL-C ratio, reduced eGFR, older age, and obesity were significantly associated with increased risk of hypertension. Effective management should include regular monitoring of TG/HDL-C levels, assessment of renal function, and personalized interventions focused on glycemic control, weight management, and health education tailored to the patient' s age and body mass index. This approach can help reduce the risk of hypertension in diabetic patients, decrease their long-term cardiovascular disease burden, and facilitate an upstream shift diabetes management.
Study on comorbid pattern in hypertension patients managed by Shanghai family doctors based on electronic health records
LI liping, ZHAO Yunshan, TIAN Juanjuan, PENG Hong, LIN Senlin, JIA Yingnan, FU Hua, WANG Fei, YE Jinghong
2025, 23(5): 746-749. doi: 10.16766/j.cnki.issn.1674-4152.003992
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  Objective  To analyze the multimorbidity and comorbidity patterns among hypertensive patients managed by family doctors in Shanghai, and to provide a theoretical basis for the precise management of hypertensive patients.  Methods  Based on the chronic disease integration management system, this study included 99 531 hypertensive patients managed by family doctors in Hongkou District, Shanghai, from October 2016 to December 2023. The Apriori algorithm and cluster analysis were used to explore the multimorbidity and comorbidity patterns, while the Web graph was used to visualize the non-random associations among chronic diseases.  Results  The proportion of hypertensive patients managed by family doctors in Shanghai was 93.93% (92 201 cases), with higher rates observed in women and older age groups (P < 0.001). A total of 76.00% (74 602 cases) patients had 2 to 6 comorbid conditions. Association rule mining showed that 12 strong association rules, primarily involving stroke, kidney disease, heart disease, diabetes disease, chronic lung disease, arthritis or rheumatism. There were 51 710 people in the main comorbidity pattern, and the top 3 patterns with higher incidence were: heart disease 50 185 people (97.05%), arthritis or rheumatism 36 250 people (70.10%), and chronic lung disease 31 590 people (61.09%).  Conclusion  The study highlights the importance of strengthening integrated chronic disease management for the community-based hypertension group. The study provides a reference for the improvement of assessment indicators in community management of hypertension, combination treatment of comorbidities and health management of comorbidities.
General Practice Research
Prediction of collapse in non-traumatic osteonecrosis of the femoral head based on serum exosome proteomics
XU Xilin, WANG Gang, KANG Boyuan, LIU Bo, ZHANG Zheng, JIANG Yichang
2025, 23(5): 750-755. doi: 10.16766/j.cnki.issn.1674-4152.003993
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  Objective  This study aimed to elucidate the molecular mechanisms underlying the progression of non-traumatic osteonecrosis of the femoral head (NONFH) and to identify potential biomarkers associated with femoral head collapse using bioinformatics and machine learning approaches.  Methods  Peripheral blood samples were collected from early-stage (n=11, ARCO Ⅰ stage) and collapsed-stage (n=9, ARCO Ⅲc-Ⅳ stage) NONFH patients treated at the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine between March 2022 and May 2023. Exosomes were isolated and purified from serum and characterized using transmission electron microscopy, nanoparticle tracking analysis, and Western blotting. Serum exosomal proteins were identified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Biomarkers associated with NONFH collapse were screened using bioinformatics, support vector machine-recursive feature elimination (SVM-RFE) algorithm, and least absolute shrinkage and selection operator (LASSO) regression model. Correlation analysis was performed between collapse-associated proteins and immune cells.  Results  (1) The cholesterol level in the collapsed-stage group [(1.52±0.36) mmol/L] was significantly higher than that in the early-stage group [(1.13±0.31) mmol/L, t=2.587, P=0.019]. However, no significant differences were observed in age, total cholesterol, low-density lipoprotein cholesterol, alkaline phosphatase, or triglyceride levels (P>0.05). (2) The area under the curve (AUC) values for the candidate biomarkers SAA1, C4A, and RPS8 were 0.66, 0.89, and 0.84, respectively, demonstrating good predictive potential. (3) Correlation analysis indicated that C4A, SAA1, and RPS8 might be involved in NONFH pathogenesis by regulating various immune cells.  Conclusion  C4A, SAA1, and RPS8 can serve as predictive biomarkers for predicting femoral head collapse in NONFH and may contribute to disease progression through immune cell modulation. These findings provide new insights into early intervention and clinical treatment strategies for NONFH.
Correlation between depression and serum 25-hydroxyvitamin D deficiency in patients with primary Sjögren' s syndrome
LI Hui, MENG Defang, WEI Hua, LIU Ying
2025, 23(5): 756-759. doi: 10.16766/j.cnki.issn.1674-4152.003994
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  Objective  To investigate the correlation between depression or anxiety and 25-hydroxyvitamin D (25(OH)D) deficiency in patients with primary Sjögren' s syndrome (pSS), aiming to provide a theoretical basis for early clinical identification and intervention.  Methods  A total of 58 pSS patients and 24 age- and sex-matched healthy controls were recruited from Northern Jiangsu People' s Hospital from January to June 2023. The levels of serum 25(OH)D were measured. Vitamin D receptor (VDR) expression in peripheral blood mononuclear cells was measured by RT-PCR. Clinical indicators were collected. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess patients' anxiety and depression, respectively. Multiple logistic regression analysis was used to analyze the factors associated with mood disorder occurrence in patients with pSS.  Results  Serum 25(OH)D levels were significantly different between pSS patients without mood disorders [62.67 (35.82, 83.00) ng/mL] and those with mood disorders [23.03 (15.33, 60.00) ng/mL, Z=-2.970, P=0.003]. Notably, patients with depression exhibited significantly lower levels [19.23 (13.18, 27.54) ng/mL] compared to those without mood disorders (Z=-3.844, P < 0.001). The VDR levels of pSS patients with depression were significantly decreased than that in the healthy control group (P < 0.05). 25(OH)D levels were negatively correlated with ESSPRI score (r=-0.473, P < 0.01), total globulin and IgG levels (P < 0.05). The incidence of depression and interstitial lung disease in pSS patients with 25(OH)D deficiency was significantly increased (P < 0.05), and the lower the 25(OH)D level, the higher the total globulin and IgG, the higher the probability of depression (OR>1). 25(OH)D (OR=0.958) and IgG (OR=1.268) levels were independent influencing factors for the development of depression (P < 0.05). The incidence of anxiety was not statistically increased in patients with 25(OH)D deficiency.  Conclusion  Depression in pSS patients is closely associated with 25(OH)D deficiency. 25(OH)D deficiency may help to predict depression in patients with pSS.
The effect of Bushen Zhuanggu Decoction on the extracellular matrix homeostasis of chondrocytes in osteoarthritis rats
ZHANG Liao, FU Keshang, DENG Yingping, JIN Yong, WU Quan, SHI Yanhong
2025, 23(5): 760-764. doi: 10.16766/j.cnki.issn.1674-4152.003995
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  Objective  To investigate the effect and mechanism of Bushen Zhuanggu Decoction on the imbalance of extracellular matrix homeostasis in chondrocytes of osteoarthritis (OA) rats.  Methods  Thirty-six rats were randomly divided into six groups using a random number table: sham group, model group, Bushen Zhuanggu Decoction low-dose, medium-dose, high-dose group, and positive control group, with six in each group. Histological changes in cartilage tissue were evaluated using HE and Safranin O staining. The expression of proteins and mRNA related to the Wnt/β-catenin signaling pathway and cartilage degradation was assessed using Western blotting and RT-PCR, respectively.  Results  The model group exhibited significant cartilage surface fibrosis and reduced chondrocyte numbers. In contrast, the low-, medium-, and high-dose Bushen Zhuanggu Decoction groups, as well as the positive control group, showed an orderly arrangement of chondrocytes, with the most pronounced pathological improvement observed in the high-dose group. Compared to the model group (12.49±1.34), the Mankin ' s scores significantly decreased in the low-dose (10.17±1.19), medium-dose (7.50±0.89), high-dose (3.99±0.45), and positive control groups (6.51±0.73). The expression levels of IL-1β, Wnt5α, β-catenin, GSK-3β, MMP-13, and ADAMTS5 proteins and mRNA in cartilage tissue were significantly reduced, while the expression of Axin, Collagen Ⅱ, and Aggrecan proteins and mRNA were significantly increased (P < 0.05).  Conclusion  Bushen Zhuanggu Decoction inhibits the degradation of the extracellular matrix in chondrocytes of OA rats and exerts therapeutic effects. Its mechanism may be related to the inhibition of the Wnt/β-catenin signaling pathway.
Prevalence and risk factors of Helicobacter pylori infection in the physical examination population in Chuzhou, Anhui Province
LI Qun, SHEN Jun, SHI Wanqing, LIN Ning, HOU Shiqiang
2025, 23(5): 765-767. doi: 10.16766/j.cnki.issn.1674-4152.003996
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  Objective  To analyze the prevalence and related risk factors of Helicobacter pylori (HP) infection in the physical examination population in Chuzhou, Anhui Province, and to provide a theoretical basis for the prevention and management of HP in the region.  Methods  The physical examination population (2 202 cases) who underwent carbon 14 breath test in the First People ' s Hospital of Chuzhou City from January to December 2023 was selected as the research object. According to the test results, they were divided into the HP-positive group (806 cases) and the HP-negative group (1 396 cases). Clinical parameters and living habits of the two groups were collected and analyzed by questionnaires, including age, sex, BMI, smoking, and drinking.  Results  The total infection rate of HP in the physical examination population was 36.60% (806/2 202). Infection rates of young people, middle-aged people, and elderly people were 34.85% (176/505), 36.76% (497/1 352), and 38.55% (133/345), respectively. The mean age of the HP positive group was (49.39±11.42) years, slightly higher than that of the HP-negative group [(48.56±11.93) years], but the difference was not statistically significant (t=1.603, P=0.109). The infection rates of HP by sex were 37.67% in males and 35.65% in females, respectively. The mean age of HP-positive males was higher than that of HP-negative males, but the difference was not statistically significant (P>0.05). The mean age of HP-positive women was higher than that of HP-negative women, but the difference was not statistically significant (P>0.05). Univariate analysis showed that several living habits significantly associated with HP infection, including not hand washing before meals (χ2=4.592, P=0.032), dining out (χ2=7.949, P=0.005), ordering take-out (χ2= 6.826, P=0.009), and eating irregularly (χ2=5.774, P=0.016). However, multivariate analysis showed that dining out (P=0.043) was an independent risk factor for HP infection.  Conclusion  The HP infection rate among physical examination population in Chuzhou, Anhui Province is 36.60%. Dining out is an independent risk factor for HP infection. Implementing targeted preventive measures can effectively reduce the HP infection rate.
Research on the coupling and coordination of traditional Chinese medicine service capacity and regional economic level in Xinjiang
LU Yang, Reshalaiti Abudukelimu, QIAO Xinyu, ZHANG Yanjun, HAN Siyu, LIU Yupeng, ZHANG Yanmin
2025, 23(5): 768-772. doi: 10.16766/j.cnki.issn.1674-4152.003997
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  Objective  To study the coupling and coordinated development of traditional Chinese medicine service capacity and regional economic level in Xinjiang and its spatial correlation characteristics, and to put forward policy suggestions to promote the coordinated development between the two systems.  Methods  The research constructs the evaluation index system of traditional Chinese medicine service capacity and regional economic level in Xinjiang, including 6 primary indicators and 14 secondary indicators, comprehensively uses the Coupling coordination degree, relative development degree, and spatial autocorrelation analysis to analyze the coupling and coordination degree, relative development status, and spatial agglomeration characteristics between the two subsystems of traditional Chinese medicine service capacity and regional economic level in 14 prefectures in Xinjiang in 2020.  Results  The coupling and coordination degree of the two subsystems was generally low, more than half of (8) prefectures were moderately dysfunctional, only the capital Urumqi was at the primary coordination level and developed synchronously, and the vast majority (13) prefectures were in a state of imbalance to varying degrees, among which 10 prefectures were lagging behind in traditional Chinese medicine service capacity, and the two subsystems showed obvious spatial negative correlation, weak spatial agglomeration, and no obvious regional linkage effect.  Conclusion  The problem of insufficient development of traditional Chinese medicine in Xinjiang is particularly prominent, and the differences between regions are small, and the room for improvement is huge. It is necessary to take the national project for the revitalization and development of traditional Chinese medicine as an opportunity to increase government investment, improve the medical service system of traditional Chinese medicine, strengthen the construction of Chinese medicine talent team, promote the expansion of high-quality traditional Chinese medicine medical resources, boost the coordinated development of Chinese medicine services and regional economy, give full play to the unique geographical advantages and characteristics of ethnic medicine, through measures such as the formation of traditional Chinese medicine alliances and traditional Chinese medicine medical groups, strengthen regional coordination to promote the development of traditional Chinese medicine in Xinjiang.
Clinical application of the simultaneous surgical treatment for gallstones with common bile duct stones by ERCP/EST combined LC
CHEN Zhengmin, LIU Zixiang
2025, 23(5): 773-775. doi: 10.16766/j.cnki.issn.1674-4152.003998
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  Objective  To explore the clinical application of a combined approach involving endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) in conjunction combined with laparoscopic cholecystectomy (LC) for the simultaneous treatment of gallstones and common bile duct stones.  Methods  A retrospective analysis was conducted on the medical records of 34 cases of gallbladder stones combined with common bile duct stones treated in the Hepatobiliary Pancreatic Ward of the Second Affiliated Hospital of Bengbu Medical University from February 2022 to June 2024, ERCP bile duct stone extraction was completed under full intravenous anesthesia or intubation general anesthesia, followed by LC.  Results  A total of 31 cases in the entire group successfully completed ERCP/EST combined with LC simultaneous surgery. In addition, three cases were switched to laparoscopic common bile duct dissection (LCBDE) for different reasons, while in one instance, the intubation process was unsuccessful due to the presence of a nipple in the duodenal diverticulum. The LCBDE was promptly substituted, and a plastic stent was left in the bile duct following stone removal. This was followed by primary bile duct suturing. In the course of ERCP surgery, a particular instance of complexity was encountered in the process of crushing and extracting stones. Following the insertion of a nasobiliary drainage tube, the administration of LCBDE was promptly discontinued and the bile duct was sutured during the initial stage of the procedure, subsequent to the removal of the stone. In one instance of difficulty with ERCP intubation, the procedure was immediately transitioned to LCBDE. During the operation, bile turbidity was observed, accompanied by purulent flocculent material and significant edema of the bile duct wall. The T-tube was left in situ. Postoperatively, 9 patients developed hyperamylasemia. There were no severe complications such as perforation, cholangitis, pancreatitis or deaths.  Conclusion  The safety and feasibility of utilizing ERCP/EST in conjunction with LC for the concurrent surgical management of gallstones and common bile duct stones has been demonstrated, resulting in a streamlined simplifies the surgical process and reduced hospitalization duration. This approach merits further clinical promotion and implementation.
Correlation between baseline serum IL-6 levels and cardiovascular and cerebrovascular complications within 3 years in peritoneal dialysis patients
DANG Shan, MA Wenjing, CHEN Huixia, SHANG Ruihua, WANG Shulong
2025, 23(5): 776-779. doi: 10.16766/j.cnki.issn.1674-4152.003999
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  Objective  To investigate the serum baseline level of IL-6 in peritoneal dialysis patients and assess its potential as a biomarker for predicting the development of cardiovascular and cerebrovascular complications within 3 years.  Methods  A total of 170 patients with end-stage renal disease undergoing peritoneal dialysis and 60 healthy controls in Central Hospital of Jiaozuo Coal Group and the First Affiliated Hospital of Xinxiang Medical University between June 2019 and June 2020 were enrolled in the study. All patients with peritoneal dialysis were followed for 36 months. The patients were divided into the non-cardiovascular and cerebrovascular complications group (n=106) and the cardiovascular and cerebrovascular complications group (n=64). Risk factors for cardiovascular and cerebrovascular complications in peritoneal dialysis patients were analyzed, and the predictive efficacy of IL-6 was analyzed by ROC curve. The relationship between IL-6 expression levels and the median time to onset of cardiovascular and cerebrovascular complications was examined.  Results  The IL-6 expression level was significantly elevated in the peritoneal dialysis group compared to the control group (P < 0.001). In contrast with the non-cardiovascular and cerebrovascular complications group, the serum levels of hypersensitive C-reactive protein, uric acid, TG, TC, LDL-c, and IL-6 were significantly enhanced in the cardiovascular and cerebrovascular complications group (P < 0.05). The hypersensitive C-reactive protein, LDL-c, and IL-6 were identified as independent risk factors for cardiovascular and cerebrovascular complications in patients with peritoneal dialysis. The AUC for baseline serum IL-6 expression level in predicting cardiovascular and cerebrovascular complications in patients with peritoneal dialysis was 0.923, with a sensitivity of 93.25% and specificity of 95.87%. The median time to cardiovascular and cerebrovascular complications onset was shorter in the high IL-6 expression group (16 months) compared to the low IL-6 expression group (27 months, HR=1.688, 95% CI: 1.082-2.293, P < 0.001).  Conclusion  The serum IL-6 can serve as a valuable biomarker for predicting the cardiovascular and cerebrovascular complications in peritoneal dialysis patients.
General Clinical Research
Clinical observation of first-line treatment with Brentuximab Vedotin combined with chemotherapy in advanced classical Hodgkin lymphoma
LIU Lin, XIE Zhibin, WANG Meng
2025, 23(5): 780-784. doi: 10.16766/j.cnki.issn.1674-4152.004000
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  Objective  To evaluate the effect of Brentuximab Vedotin (BV) combined with doxorubicin (A), vindesine (V), and dacarbazine (D) (BV-AVD-regimen) as first-line treatment for advanced classical Hodgkin lymphoma (cHL).  Methods  Clinical data of 10 patients with advanced cHL admitted to the Department of Haematology, the First Affiliated Hospital of Bengbu Medical University, from August 2021 to January 2023 with first-line application of the BV-AVD regimen were retrospectively analyzed. Data reviewed included general characteristics [gender, age, pathological type, primary site, stage, international prognostic score (IPS), and immunohistochemistry], treatment response, follow-up outcomes, and adverse reactions.  Results  Among the 10 patients, 6 were male and 4 were female, with a mean age of (44.7±13.3) years. Pathologically, 6 cases were classified as nodular sclerosis type and 4 as mixed cellularity type. Eight patients initially presented with superficial lymphadenopathy, while abdominal pain and retrosternal pain were reported in one case each. Seven patients were diagnosed with stage Ⅳ disease, and 5 had an international prognostic score (IPS) of ≥4. B symptoms were observed in 5 cases at diagnosis. Immunohistochemical analysis revealed EBER positivity in 5 patients and CD163 positivity in 3. After 2 cycles of treatment, the objective response rate (ORR) was 100%, with a complete response (CR) rate of 80%. Among the 9 evaluable patients after 6 cycles, both the ORR and CR rates were 89%. The median overall survival (OS) and progression-free survival (PFS) were not reached during follow-up. Patients with CD163 positivity had significantly shorter OS and PFS compared to CD163-negative patients (P=0.007 and P=0.001, respectively). The most common adverse events included fatigue (8 cases), nausea (8 cases), neutropenia (7 cases), febrile neutropenia (6 cases), and peripheral neuropathy (6 cases). Grade 3 adverse events occurred in only 2 patients.  Conclusion  The short-term follow-up indicates that fist-line BV-AVD treatment is effective in patients with advanced cHL, with manageable adverse effects.
Establishment of a risk prediction model for secondary aspiration pneumonia in elderly stroke patients with dysphagia
LU Sujuan, LIN Min, SONG Li, CHEN Feifei, CHEN Xiufang
2025, 23(5): 785-788. doi: 10.16766/j.cnki.issn.1674-4152.004001
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  Objective  To analyze the risk factors of secondary aspiration pneumonia (AP) in patients with post-stroke dysphagia (PSD) and to establish a prediction model, aiming to provide a scientific basis for clinical prevention and intervention strategies.  Methods  Clinical data of elderly patients with PSD admitted to the First Affiliated Hospital of Wenzhou Medical University from February 2022 to February 2024 were retrospectively collected. The elderly patients with PSD were divided into an AP group and a non-AP group according to the presence or absence of secondary AP. The risk factors of secondary AP in PSD were analyzed by univariate and multivariate logistic analyses, and a prediction model was subsequently established. The predictive efficiency of the model was evaluated by receiver operating characteristic (ROC) curve analysis.  Results  Among the 82 patients with PSD, 31 developed AP, yielding an incidence rate of 37.80%. Univariate analysis showed statistically significant differences between the AP and non-AP group in age, smoking history, the National Institutes of Health stroke scale (NIHSS) score, Water swallow test results, high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), length of hospital stay, and tube feeding. Multivariate logistic regression analysis results identified age, NIHSS score, and water swallow test results as independent influence factors for secondary AP in patients with PSD (P < 0.05). Based on the logistic analysis results, a prediction model was constructed. ROC curve analysis showed that the AUC of this model was 0.845 (95% CI: 0.659-0.953). At a cut-off value of 0.39, the model achieved a sensitivity of 88.89% and specificity of 68.42%.  Conclusion  Advanced age, elevated NIHSS score, and high drinking water test level were independent risk factors for secondary AP in PSD patients. The prediction model based on these risk factors demonstrates good discriminative ability for predicting secondary AP in PSD patients.
The mediating role of hope level in the relationship between family caring degree and frailty condition among maintenance hemodialysis patients
JIN Yingying, GU He, CHENG Qiongyao, JIN Lingwei
2025, 23(5): 789-793. doi: 10.16766/j.cnki.issn.1674-4152.004002
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  Objective  The specific interrelationships among hope level, family caring degree, and frailty status in maintenance hemodialysis (MHD) patients remain understudied. The present study investigates the associations between the aforementioned factors in order to inform interventions aimed at mitigating or delaying the onset of frailty in this population.  Methods  From January 2023 to June 2024, MHD patients at the Second Affiliated Hospital of Wenzhou Medical University were selected by means of a convenient sampling method for the purpose of investigation and analysis. To analyze the mediating role of hope level in the relationship between family care and frailty status among MHD (Maintenance Hemodialysis) patients using Pearson correlation analysis, hierarchical regression analysis, and multiple regression analysis, the following approach can be taken.  Results  The Tilburg Frailty Indicator (TFI) score demonstrated a negative correlation with both the Family Adaptation, Partnership, Growth, Affection, and family APGAR index (APGAR) score and the Chinese version of the Herth Hope Index (HHI) score (all P < 0.05). Furthemore, a positive correlation was observed between the HHI score and the APGAR score (P < 0.05).The regression equation was constructed with the following variables: age, fall history, type of underlying disease, APGAR score, and HHI score. The regression equation, explained 64.9% of the TFI score of MHD patients. The findings of this study indicate that a family caring degree may serve as a predictor of both frailty status and hope level, with a statistical significance of P < 0.05. Following an increase in the hope level of the intermediate variable, the family caring degree and the hope level maintained a predictive effect on the frailty status. The present study hypothesized that hope level would have a mediating effect between family caring degree and debilitation status of MHD patients, and that this effect would account for 30.90% of the variance.  Conclusion  The frailty status of MHD patients is elevated, and the degree of frailty condition can directly affect the frailty status of patients, or indirectly affect the frailty status through the mediating role of hope level. This suggests that family participation of patients should be given consideration in order to improve the hope level of patients and reduce or delay the frailty status of patients.
Study on therapeutic effect of modified Jichuanjian Decoction Jiawei on acute exacerbation of chronic obstructive pulmonary disease complicated with gastrointestinal function injury (constipation type due to yang deficiency)
JIN Yulan, WANG Jiao, HAN Yijiao, GONG Yuexian, ZHANG Ye
2025, 23(5): 794-797. doi: 10.16766/j.cnki.issn.1674-4152.004003
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  Objective  To explore the clinical efficacy and safety of Jichuanjian Decoction Jiawei in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with acute gastrointestinal function injury (AGI, constipation type due to yang deficiency).  Methods  Eighty patients with AECOPD complicated with AGI (constipation type due to yang deficiency) admitted to intensive care unit (ICU) of Dongyang Hospital of Traditional Chinese Medicine from July 2022 to December 2023, and they were divided into routine group (routine treatment of western medicine) and research group (addition of Jichuanjian Decoction Jiawei on the basis of routine group) according to the treatment methods, with 40 patients in each group. The comprehensive curative effect of AGI and gastrointestinal indexes were compared between groups.  Results  The comprehensive curative rate of AGI in the study group [87.50% (35/40)] was significantly higher than that in the routine group [60.00% (24/40), P < 0.05]. After 7 days of treatment, the intra-abdominal pressure and gastric residue in the study group were lower than those in the routine group, and the bowel sounds were higher than those in the routine group (P < 0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6) in the study group were lower than those in the routine group, and the scores of constipation, abdominal distension, cold limbs, and mental fatigue were lower than those in the routine group (P < 0.05). There was no significant difference in adverse reaction rate between the study group and the routine group [10.00% (4/40) vs.7.50% (3/40), P>0.05].  Conclusion  Treating AECOPD with AGI (constipation type due to yang deficiency) with Jichuanjian Decoction is helpful to improve the comprehensive curative effect of GI, improve gastrointestinal indicators and inflammatory factors, and relieve constipation, abdominal distension, cold limbs, and mental fatigue, with good security.
Prediction analysis of risk factors and TSP1, FOXP 3 levels in children with severe Mycoplasma pneumonia
ZHAO Hui, PAN Yule, Gulibaha Maimaiti, LIU Yu
2025, 23(5): 798-801. doi: 10.16766/j.cnki.issn.1674-4152.004004
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  Objective  In the onset process of children with severe Mycoplasma pneumonia, a certain proportion of children will have plastic bronchitis (PB). The aim is to explore the pathogenesis and analyzed the predictive value of thrombine-sensitive protein 1 (TSP1) and forked head spiral transcription factor 3 (FOXP3) levels for plastic bronchitis.  Methods  A total of 320 children with severe Mycoplasma pneumonia admitted to the First Affiliated Hospital of Xinjiang Medical University from June 2020 to June 2024 were selected and divided into PB group (120 cases) and non-PB group (200 cases). Univariate and multivariate factors were used to analyze the risk factors of PB in children with severe Mycoplasma pneumonia. TSP1 and FOXP3 levels were measured by ELISA. ROC evaluated the predictive value of TSP1 and FOXP3 for plastic bronchitis.  Results  Multivariate logistic regression analysis showed that fever duration ≥8 d, tachypnea, pleural effusion, white blood cell count ≥8.10×109/L, neutrophil ratio ≥68.10%, lymphocyte ratio < 30%, CRP ≥40 mg/L, LDH ≥450 U/L were the risk factors for PB in children with severe Mycoplasma pneumonia (P < 0.05). Compared with the non-PB group, the expressions of TSP1 [(54.68±9.00) ng/mL] and FOXP3 (3.08±0.51) were increased in PB group [(66.71±12.17) ng/mL and 3.92±0.69, P < 0.05]. ROC results showed that compared with the single diagnosis of TSP1 and FOXP3, the combination of the two had higher diagnostic value (P < 0.05).  Conclusion  The duration of fever, tachypnea, pleural effusion, white blood cell count, neutrophil ratio, lymphocyte ratio, CRP and LDH are risk factors for plastic bronchitis in children with severe Mycoplasma pneumonia. TSP1 and FOXP3 have high value in predicting plastic bronchitis.
Study on the mechanism of action of bifidobacterium quadruple active tablets combined with quadruple therapy in the treatment of Hp positive peptic ulcers in children
HE Lidan, WANG Hong, CAI Zhendang, CHEN Fujiang
2025, 23(5): 802-805. doi: 10.16766/j.cnki.issn.1674-4152.004005
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  Objective  To improve the therapeutic efficacy of Helicobacter pylori (Hp)-positive peptic ulcer (PU) in children, this study investigates the clinical outcomes and mechanistic effects of combining Bifidobacterium quadruple viable tablets with quadruple therapy, focusing on their impacts on intestinal immune function and cytokine levels.  Methods  A total of 160 children with Hp positive peptic ulcers admitted to Wenzhou Integrated Traditional Chinese and Western Medicine Hospital from December 2021 to January 2024 were included and randomly divided into a control group (80 cases) and an observation group (80 cases). The control group received quadruple therapy (including two kinds of antibiotics, a proton pump inhibitor, and a bismuth agent), while the observation group received treatment with Bifidobacterium quadruple live bacterial tablets in addition to quadruple therapy. The therapeutic effect level of peptic ulcers was evaluated. The levels of serum pepsinogen (PG), gastrin (GAS), and cytokines were measured before and after treatment. The T-helper 17 (Th17)/regulatory T cells (Treg) immune balance status were analyzed. The Hp conversion to negative and recurrence of peptic ulcers 6 months after treatment were statistical analysis. The adverse drug reactions were observed.  Results  The overall effective rate of treatment in observation group (93.75%, 75/80) was higher than control group (81.25%, 65/80, P < 0.001). After 2 weeks of treatment, the serum levels of PG Ⅰ, PG Ⅱ, GAS in the observation group were lower than those of control group (P < 0.001), and the contents of serum Th17, Treg, Th17/Treg, IL-17, and TGF in the observation group were lower than control group (P < 0.001). The Hp seroconversion rate in the observation group after treatment (88.75%, 71/80) was significantly higher than that in the control group (73.75%, 59/80), while the recurrence rate of peptic ulcers at 6 months after treatment (8.75%, 7/80) was significantly lower than that in the control group (22.50%, 18/80, P < 0.001). The difference in the incidence of adverse drug reactions between the two treatment groups was not statistically significant (P>0.05).  Conclusion  The combination of bifidobacterium quadruple active tablets and quadruple therapy can improve intestinal cellular immune function, alleviate and reduce the severity of intestinal inflammatory reactions by inhibiting the secretion of gastric protease and gastrin, thereby enhancing the therapeutic effect of Hp positive PU in children and promoting Hp negative conversion rate. It can also prevent and reduce the risk of PU recurrence with fewer adverse reactions.
Analysis on the present situation and countermeasures of combined medical and nursing services in Beijing suburb mountainous areas under the background of family doctor contract service
CHEN Jingjing, WANG Haili, PEI Ruotong, YANG Kaiwen, PENG Yingchun
2025, 23(5): 806-809. doi: 10.16766/j.cnki.issn.1674-4152.004006
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  Objective  To understand the current situation regarding healthcare integration services in mountainous areas in the suburbs of Beijing, it is necessary to firstly analyze the existing problems and propose countermeasures in terms of the services provided by the contracted family doctor service teams and the services demands of elderly residents and their caregivers.  Methods  A questionnaire survey was conducted on 133 elderly people over the age of 65, who had signed a contract in five townships and towns in the northern mountainous area of Huairou District, Beijing. Concurrently, a questionnaire survey was conducted on the medical staff of the family doctor contracted service teams of the five community health service centers to understand the situation of the provision of integrated medical care and nursing care services.  Results  Among the 133 elderly residents who took part in the survey, 128 (96.2%) said they wanted to continue living at home and in the community, and 102 (76.7%) said they mainly took care of each other with their husbands or wives; 75.2% (100/133) of the elderly residents went to the township health center or the village health center directly when they had a health problem, and 12.0% (16/133) of them first called their family doctor; 12.0% (16/133) of elderly residents first call their family doctors for advice and then seek medical treatment. In terms of service needs, 43 individuals (32.3%) expressed a demand for home-based medical services, while 41 (30.8%) requested financial support. Regarding service provision, the top three services offered were health management for the elderly, outpatient services, and in-home health assessments.  Conclusion  Home-based elderly care is the primary choice for older adults in mountainous suburban areas of Beijing, with community health service institutions and family doctors serving as the main providers of integrated medical and elderly care services. However, there remains a gap between service supply and demand, and the supporting mechanisms are still inadequate.It is recommended that, on the basis of implementing family doctor contract services, further efforts should be made to explore the role of family doctors in integrating services and coordinating resources for community-based home care. This will help comprehensively improve the quality and efficiency of integrated medical and elderly care services.
Correlation between serum BDNF, mRNAs levels and pleasurable experience in young and middle-aged patients with schizophrenia
ZHANG Jinna, WANG Lu, FENG Caiqin
2025, 23(5): 810-813. doi: 10.16766/j.cnki.issn.1674-4152.004007
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  Objective  To analyze the correlation between serum brain-derived neurotrophic factor (BDNF), microRNA-21 (miRNA-21), and microRNA-181b (miRNA-181b) levels and pleasurable experience in young and middle-aged patients with schizophrenia, and to provide a theoretical basis for exploring the neurobiological mechanism underlying affective disorder in schizophrenia.  Methods  A total of 62 young and middle-aged patients with acute schizophrenia admitted to Shaoxing Seventh People ' s Hospital from April 2022 to June 2024 were selected as the case group. And 57 healthy individuals in the same period were selected as the control group. The scores of timed pleasurable experience scale (TEPS) and the levels of BDNF, miRNA-21, and miRNA-181b were measured and compared between the two groups. The correlations between TEPS scores and the above biomarkers in the case group were analyzed.  Results  The temporal experience of pleasure scale-anticipatory (TEPS-A) score in the case group (35.65±5.37) was significantly lower than that in the control group (41.35±4.49). The temporal experience of pleasure scale-consummatory (TEPS-C) score in the case group [29.00 (25.00, 33.00)] was significantly lower than that in the control group [36.00 (34.00, 38.50)]. The serum BDNF and miRNA-181b in the case group were significantly lower than those in the control group. Serum miRNA-21 [7.95 (7.46, 8.43)] was significantly higher than that in the control group [0.73 (0.52, 0.86)]. Spearman correlation analysis showed that TEPS-A score was positively correlated with serum BDNF (rs=0.782) and miRNA-181b (rs=0.649), and negatively correlated with miRNA-21 (rs=-0.755). TEPS-C score was positively correlated with serum BDNF (rs=0.789) and miRNA-181b (rs=0.715), and negatively correlated with miRNA-21 (rs=-0.671).  Conclusion  The levels of serum BDNF and mRNAs in young and middle-aged patients with schizophrenia were significantly positively correlated with pleasurable experience, suggesting their potential as quantitative indicators of pleasurable experience.
The effect of the teach-back method combined with WeChat whole process health education on the self-efficacy and medical compliance of diabetic patients
QING Xuelian, CHEN Xiaoyu, LIAO Juan, ZHANG Jiajia, LI Yuan
2025, 23(5): 814-818. doi: 10.16766/j.cnki.issn.1674-4152.004008
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  Objective  Self-efficacy and medical compliance are closely related to disease progression in diabetic patients, and the purpose of this study was to explore the effect of teach-back combined with WeChat whole process health education on self-efficacy and medical compliance in patients with type 2 diabetes mellitus (T2DM), and to provide a reference for their health education.  Methods  A total of 90 inpatients with T2DM admitted to Yongchuan Hospital of Chongqing Medical University from August to September 2023 were recruited as the study subjects, and they were divided into the experimental group and the control group by random number table method, with 45 cases in each group. The control group was given routine health education, and the experimental group was taught back combined with WeChat whole process health education on the basis of the control group. The fasting blood glucose levels, self-efficacy, and medical compliance before intervention, 1 month, 3 months, and 6 months were compared between the two groups.  Results  After the intervention, repeated measures data showed that there were statistically significant differences in fasting blood glucose levels, chronic disease self-efficacy scale (SEMCD-6), and chronic disease medical adherence scale between the two groups (P < 0.05). Simple effect analysis showed that after the intervention, the fasting blood glucose level in the experimental group [(6.82±1.13) mmol/L vs. (8.02±1.68) mmol/L], SEMCD-6 scores and total scores [(48.40±4.16) points vs. (40.67±6.00) points] and chronic disease medical compliance scale scores and total scores [134.0(129.0, 139.0) points vs. 118.0 (110.5, 126.0) points] in the experimental group were all better than those in the control group (P < 0.05).  Conclusion  Teach-back combined with WeChat whole process health education can effectively control the blood glucose level of patients with T2DM and improve their self-efficacy and medical compliance.
Correlation analysis of anxiety and depression with bisphosphonate treatment compliance and bone mineral density changes in perimenopausal population
ZHANG Aimu, LIU Sanwei, SHI Zhanhong, ZHOU Fan
2025, 23(5): 819-822. doi: 10.16766/j.cnki.issn.1674-4152.004009
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  Objective  To analyze the correlation between anxiety and depression in the perimenopausal population, compliance with bisphosphonate treatment and changes in bone mineral density (BMD), and to provide evidence for early intervention of anxiety and depression in women.  Methods  A total of 248 perimenopausal women diagnosed and treated in Wenzhou Central Hospital from February 2022 to February 2024 were selected by convenient sampling method, and their anxiety and depression were evaluated by Zung self-rating anxiety scale (SAS) and Zung self-rating depression scale (SDS). According to the results, they were divided into an anxiety and depression group (SAS score ≥50 and SDS score ≥53) and a non-anxiety and depression group. The general data, bisphosphonate treatment compliance, and BMD of the two groups were analyzed and compared, and the related factors affecting the patients ' anxiety and depression were analyzed by multivariate logistic regression. At the same time, the anxiety and depression group was divided into mild, moderate, and severe according to the SAS score and SDS score. Pearson test was used to analyze the correlation between anxiety and depression scores and bisphosphonate treatment compliance, and BMD changes in perimenopausal women.  Results  Among the 245 perimenopausal patients who completed the investigation, 71 cases developed anxiety and depression, with an incidence rate of 28.98%. By multivariate logistic regression analysis, high BMI, no spouse, and high perimenopausal symptom severity score were independent risk factors for anxiety and depression in perimenopausal women, while no chronic disease, high medication compliance, and high BMD were independent protective factors for anxiety and depression in perimenopausal women. Anxiety score of perimenopausal women was negatively correlated with bisphosphonate treatment compliance and BMD changes.  Conclusion  The incidence of anxiety and depression in the perimenopausal population is high, which is negatively correlated with the compliance of bisphosphonate treatment and the change in BMD.
Clinical value of NOC2L combined with SLFN11 detection in the evaluation of liver cancer condition and prognosis
HE Jianxin, ZHANG Hongbin, LOU Yunyan
2025, 23(5): 823-826. doi: 10.16766/j.cnki.issn.1674-4152.004010
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  Objective  NOC2L and SLFN11 are closely related to the pathogenesis of malignant tumors. The clinical value of NOC2L combined with SLFN11 detection in liver cancer was studied.  Methods  The expression of NOC2L and SLFN11 was detected in 95 patients with liver cancer (HCC group) and 51 patients with benign liver diseases (control group) treated in Yiwu Central Hospital from January 2020 to December 2021, and the relationship with prognosis and survival was analyzed.  Results  NOC2L in tumor tissue of HCC group was higher than that in adjacent tissue and control group (1.26±0.25 vs. 0.72±0.11, 0.69±0.13, F=264.577, P < 0.001), while SLFN11 was lower than that in adjacent tissue and control group (0.78±0.12 vs. 0.96±0.17, 0.98±0.15, F=46.396, P < 0.001). In the HCC group, NOC2L expression was positively correlated with pathological grade, primary tumor T stage, number of metastatic lymph nodes, distant metastasis, and TNM stage (all rs>0, P < 0.05), while SLFN11 expression was negatively correlated (all rs < 0, P < 0.05). The efficacy of SLFN11 combined with NOC2L detection in predicting poor prognosis of liver cancer was higher than that of NOC2L and SLFN11 alone (P < 0.05). NOC2L≥1.26 and SLFN11≤0.78 were independent risk factors for poor prognosis of liver cancer (P < 0.05). The median survival of patients with NOC2L≥1.26 and SLFN11≤0.78 was lower than that of patients with NOC2L < 1.26 or SLFN11>0.78 (log-rank χ2=14.618, P < 0.001).  Conclusion  The expression of NOC2L and SLFN11 in liver cancer can provide objective evidence for the evaluation of liver cancer disease and prognosis. The combination of the two can significantly improve the value of predicting disease and prognosis.
Diagnostic value of shear wave elastography combined with DeVita ultrasonic score in assessment of parotid gland lesions of Sjögren's syndrome
JIAO Lanlan, LI Yang, WANG Bing, WANG Xin, SUI Yang, MENG Feiyi
2025, 23(5): 827-830. doi: 10.16766/j.cnki.issn.1674-4152.004011
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  Objective  To investigate the clinical value of DeVita ultrasound scoring in collaboration with shear wave elastography (SWE) in parotid gland damage in primary Sjögren' s syndrome (pSS), and to analyze their correlation with anti-SSA and anti-SSB antibodies.  Methods  A total of 64 patients diagnosed with primary Sjögren' s syndrome (pSS) and admitted to the Department of Rheumatology and Immunology of the First affiliated Hospital of Bengbu Medical University, constituted the experimental group during the period from April 2023 to June 2024.In contrast, 30 healthy subjects were collected as the control group. The morphological characteristics of the parotid gland were obtained by means of routine ultrasound, after which ultrasound scoring was performed. The mean value of primary parotid Young ' s modulus (Emean) was obtained under SWE mode to evaluate the diagnostic value of parotid ultrasound score Emean alone and the combination of Emean in parotid damage of Sjögren ' s syndrome. Furthermore, the correlation between the above two groups of parameters and serological indicators of anti-SSA and anti-SSB antibodies expression was explored.  Results  A statistically significant discrepancy was identified in the ultrasound scores between the patients diagnosed with pSS and the subjects in control group (P < 0.05). A similar statistically significant discrepancy was identified in the parotid mean Emean values between the pSS patients and the control group (P < 0.05). ROC curve analysis revealed that the AUC of ultrasound score, SWE and the combined assessment of parotid lesions were 0.728, 0.884 and 0.904, respectively, and the AUC of the two was superior to that of ultrasound score and SWE. A significant correlation was identified between the expression of anti-SSA/SSB antibodies and ultrasound scores, as well as and SWE (P < 0.05).  Conclusion  The integration of SWE with ultrasound scoring has been demonstrated to possess a certain degree of clinical application value in the context of parotid lesions associated with of primary Sjögren' s syndrome.
Recent advances in tools for assessing the treatment burden of multimorbidity
ZHOU Shan, LI Na, MA Li
2025, 23(5): 831-835. doi: 10.16766/j.cnki.issn.1674-4152.004012
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With the acceleration of aging, the prevalence of chronic noncommunicable diseases and multimorbidity is increasing, posing significant challenges for patients health management. Compared with healthy individuals or those with a single chronic disease, patients with multimorbidity need more medical resources, which affects their quality of life and places a heavy healthcare and economic burden on families and society. The treatment burden refers to the physical, emotional, and logistical demands patients undertake due to their healthcare needs, with varying degrees of treatment burden across individuals. It is important to identify the populations at the highest risk of significant treatment burden for designing healthcare services that meet their needs. Countries such as the United States, France, and the United Kingdom have developed assessment tools for treatment burden. Accurate and effective assessment tools are essential for helping patients understand their health status and challenges, providing a basis for personalized interventions and outcome evaluation. Active medical interventions have been significantly reduced treatment burden. It summarizes the assessment tools for treatment burden on patients with multimorbidity, detailing their contents, reliability, validity, advantages, and disadvantages. Key tools discussed include the treatment burden questionnaire, multimorbidity illness perceptions scale, living with medicines questionnaire, health care task difficulty, patient experience with treatment and self-management, medication-related burden quality of life, and the multimorbidity treatment burden questionnaire. The goal is to summarize the existing experience and models, innovate culturally appropriate assessment tools, and provide reference for healthcare professionals in selecting the relevant assessment tool.
Current status and advances in the treatment of lowering serum lipoprotein a levels
HE Xuechun, WEN Zhiying, ZHENG Yingying
2025, 23(5): 836-839. doi: 10.16766/j.cnki.issn.1674-4152.004013
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Cardiovascular disease (CVD) remains a serious burden in the global population, characterized by high morbidity and mortality. Despite the availability of multiple ways to manage cardiovascular risk factors, the incidence of residual cardiovascular risk has not improved, and the search for new targets for CVD risk intervention has become one of the new research hotspots. Lipoprotein metabolic disorder is the second most important attributable risk factor besides high blood pressure, with low-density lipoprotein cholesterol (LDL-C) as the main target, and there are several types of different drugs on the market to modulate LDL-C. However, as the fact that LDL-C has reached the targets recommended by clinical guidelines, the associated disease progression and the incidence of residual cardiovascular risk and major adverse cardiovascular events (MACE) have not improved. Lipoprotein(a) [Lp(a)] is structurally similar to LDL-C, but has stronger inflammatory and atherogenic properties than the latter, making it one of the most talked about lipid types in recent years. Although Lp(a) has been identified as an important risk factor for atherosclerotic cardiovascular disease (ASCVD), but the effects of most lipid-lowering drugs targeting LDL-C are unknown, and clinical trials of new drugs for Lp(a) are still underway. Research remains unclear for effective treatment of Lp(a), and this article provides an overview of the effects of the major lipid-lowering tools currently available in clinical and research settings on Lp(a) levels, and further discusses emerging therapies.
Research progress of antiparasitic drugs for malignant tumor treatment
YANG Liu, ZHOU Shijie, GAO Wencang
2025, 23(5): 840-843. doi: 10.16766/j.cnki.issn.1674-4152.004014
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Malignant tumors are one of the culprits threatening human lifespan and health worldwide. The mortality rate of malignant tumors ranks second due to multiple organ failure, secondary infections, massive bleeding, and immune system suppression caused by widespread tumor metastasis. At present, the treatment mode of malignant tumors mainly relies on traditional surgical treatment, chemotherapy, and radiation therapy, supplemented by newer types such as immunotherapy and targeted therapy. However, there are disadvantages such as incomplete tumor eradication, high risk metastasis and recurrence, and multiple adverse reactions. Parasitic diseases are also serious threats to human health, with severe destructive and widespread infectivity, causing millions of illnesses and deaths every year. Common parasitic infections include roundworm, Toxoplasma gondii, and other helminths. According to reports, about 70% of the global population has been infected with roundworms, about 30%-50% with Toxoplasma gondii, about 16% with other parasitic worms. Once inside the human body, parasites can spread to the respiratory, digestive, and even nervous systems, potentially cause complications such as meningitis and myocarditis, which may lead to organ failure and even death. In recent years, extensive research on parasitic diseases has confirmed a strong relationship between parasitic infections and the occurrence and development of malignant tumors. Parasites can promote the occurrence, progression, and metastasis of malignant tumors through direct both infection and indirect induction. Based on this, scholars worldwide have conducted extensive research on the anti-tumor properties of antiparasitic drugs. These antiparasitic drugs are expected to be promising for malignant tumors for clinical use. This article summarizes the research progress of antiparasitic drugs in the treatment of malignant tumors in recent years, aiming to provide safer and more effective treatment options for malignant tumors.
Advancements in the study of cuproptosis and copper metabolism in autoimmune diseases
GONG Xueyan, LIU Yang, SU Yazhen, ZHANG Liyun
2025, 23(5): 844-847. doi: 10.16766/j.cnki.issn.1674-4152.004015
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Autoimmune diseases (AIDs) are a group of disorders characterized by the abnormal attack of the body ' s immune system on its own tissues and cells. These diseases affect multiple organ systems and pose a significant threat to human health. Currently, AIDs affect approximately 5% of the global population, leading to significant economic burdens. However, the etiology of AIDs remains unclear, and existing treatment modalities are still limited in efficacy. Recent studies indicate a close association between AIDs and mitochondrial dysfunction. Cuproptosis, a newly characterized form of cell death closely related to mitochondrial respiration, suggests a potentially significant role in the onset and progression of AIDs. Since the first half of the 20th century, the biological roles of copper have remained a focal point of sustained scientific investigation in life sciences. Recent studies have shown that copper metabolism affects the functionality of the immune system and is associated with the progression of inflammation and immune responses. This paper provides a summary of the biological functions, intervention mechanisms, and bioinformatics research of cuproptosis and copper metabolism in AIDs. It systematically reviews their roles and mechanisms in AIDs such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and other diseases like osteoarthritis (OA), systematically examining the research progress of copper death and copper metabolism in AIDs. By thoroughly understanding the relationship of cuproptosis, copper metabolism, and AIDs, new therapeutic targets and approaches may be discovered, providing novel insights and possibilities for the treatment of AIDs.
Clinical study of acupuncture combined with TCM fumigation in the treatment of patients with peripheral facial paralysis
YE Yaxian, XU Lin, CHEN Xi, SONG Ziyu
2025, 23(5): 848-852. doi: 10.16766/j.cnki.issn.1674-4152.004016
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  Objective  To compare the curative effect of acupuncture combined with traditional Chinese medicine (TCM) fumigation and traditional Western medicine in patients with peripheral facial paralysis so as to provide more reference for clinical treatment.  Methods  A total of 104 patients with peripheral facial paralysis admitted to the First People ' s Hospital of Jiande were enrolled between January 2022 and February 2024. According to the random number table method, they were divided into a control group (western medicine) and an observation group (acupuncture combined with TCM fumigation), with 52 cases in each group. The clinical curative effect, scores of TCM syndromes, facial disability index (FDI) and facial nerve function [House-Brackmann (H-B)], trophic nerve indexes [glial cell line-derived neurotrophic factor (GDNF), nerve growth factor (NGF)], serum immunoglobulins (IgA, IgG, IgM) and quality of life [the MOS item shot form health survey (SF-36)] were compared between the two groups.  Results  The total response rate of the observation group was higher than that of the control group [94.23% (49/52) vs. 80.77% (42/52), P < 0.05]. Compared with the control group after 6 courses of treatment, scores of TCM symptoms and FDI social function, levels of NGF, IgA, IgG, and IgM were lower in the observation group (P < 0.05), and the score of FDI physical function, GDNF and scores of SF-36 (physiological limitation, vitality, overall health) were higher (P < 0.05). After 6 courses of treatment, H-B grading was better in the observation group than that in the control group (P < 0.05).  Conclusion  The curative effect of acupuncture combined with TCM fumigation is significant in patients with peripheral facial paralysis, as it can improve symptoms, FDI scores, facial nerve function, and immunoglobulins, promote the repair of damaged nerves, and enhance quality of life.
Clinical study on self-made Bushen Yanggan Decoction combined with Dingkundan in the treatment of premature ovarian failure
HE Ju, SHEN Dan
2025, 23(5): 853-857. doi: 10.16766/j.cnki.issn.1674-4152.004017
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  Objective  To explore the effect of self-made Bushen Yanggan Decoction combined with Dingkundan on the changes of sex hormones and glucose and lipid metabolism in patients with premature ovarian insufficiency, and analyze its role in improving the quality of life of patients.  Methods  A total of 97 cases of premature ovarian insufficiency treated in Shaoxing Hospital of Traditional Chinese Medicine from June 2022 to March 2024 were selected as the research object, and divided into western medicine (WM) group (48 cases) and traditional Chinese medicine (TCM) group (49 cases) according to the treatment regimen taken. The WM group received hormone therapy from western medicine, while the TCM group was treated with Dingkundan combined with self-made Bushen Yanggan Decoction. The curative effect of TCM syndrome, changes of sex hormones, glucose and lipid metabolism level and quality of life were compared between the two groups after treatment.  Results  The total effective rate of TCM group was higher than that of WM group [91.84% (45/49) vs. 75.00% (36/48), χ2=4.990, P=0.025]. HbA1c [(4.84±0.80)% vs. (5.18±0.73)%, P < 0.05] and other glucose and lipid metabolism levels in TCM group were lower than those in WM group. The luteinizing hormone/follicular stimulating hormone ratio of TCM group (1.93±0.65 vs. 3.00±0.91) was lower than that of WM group (P < 0.001). The quality of life scores in TCM group were significantly higher than those in WM group at 4 weeks [(69.22±7.21) points vs. (64.29±8.02) points], 8 weeks [(80.29±8.63) points vs. (70.63±6.34) points], and 12 weeks [(86.39±4.15) points vs. (72.33±4.38) points] after treatment (P < 0.05).  Conclusion  Self-made Bushen Yanggan Decoction combined with Dingkundan has obvious and sustained benefits in improving sex hormones, glucose and lipid metabolism and quality of life in patients with premature ovarian failure, and it is safe and worthy of clinical promotion.
Application of artificial intelligence in flipped teaching of undergraduate Pain Science
LIU Yang, TANG Sanhui, QIU Jun, ZHANG Liuyi, LIAO Qian, FANG Yi
2025, 23(5): 858-861. doi: 10.16766/j.cnki.issn.1674-4152.004018
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  Objective  To apply the artificial intelligence joint flipped teaching mode in undergraduate Pain Science clinical teaching, explore the application prospect of this method in clinical teaching, and analyze its practical value.  Methods  Full-time undergraduate students of grade 2021 (43) and grade 2022 (42) of general practice at Nanhua University were randomly selected as the study subjects. Class 2021 was the control group (teaching with flipped teaching mode), and class 2022 was the observation group (teaching by integrating artificial intelligence on the basis of the control group). The learning scores of the two groups of students on the content of Pain Science learning before and after class were compared, the evaluation of the two groups of students on the fun, innovation and practicality of teaching as well as the final theoretical examination results were analyzed, and statistically assessing the forms of communication between teachers and students and the mode of teaching was counted.  Results  The acceptability of the teaching content of pain science, the diagnostic ability of pain diseases and the interest in learning in the observation group after the lesson were [(96.7±3.3) points, (96.5±2.1) points, (96.3±3.2) points], which were higher than those in the observation group before the lesson [(85.7±1.2) points, (86.5±4.1) points, (82.2±6.8) points] and in the control group after the lesson [(93.6±2.8) points, (93.8±6.2) points, (92.7±4.7) points, P < 0.05], the recognition of the form of teacher-student communication and teaching mode of the observation group was significantly higher than that of the control group (P < 0.05), and the scores of the observation group's students' teaching interest, innovation, practicality, and final theoretical examination scores were [(96.3±2.4) points, (95.5± 1.7) points, (96.9±1.5) points, and (93.5±4.6) points], which were higher than those in the control group [(75.5±14.7) points, (76.6±13.9) points, (82.1±10.2) points, and (82.8±6.1) points, P < 0.05].  Conclusion  Based on flipped teaching and incorporating artificial intelligence, it can significantly improve the efficiency and teaching effect of pain clinical teaching, and is worthy of further promotion and application in Pain Science clinical teaching.
Teaching experience of surface positioning technology for transforaminal endoscopic puncture guided by C-arm
ZHAO Jiagui, ZHANG Rongyi, HU Jun, LU Yao
2025, 23(5): 862-866. doi: 10.16766/j.cnki.issn.1674-4152.004019
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  Objective  This study aims to explore the surface positioning technology of percutaneous transforaminal endoscopic lumbar discectomy under C-arm X-ray fluoroscopy in teaching, and to evaluate the effect of this technology in the teaching of transforaminal endoscopic lumbar discectomy in spinal surgery and pain department, especially the practical experience of how beginners can quickly master the positioning puncture skills.  Methods  Thirty-six patients with lumbar disc herniation who received percutaneous transforaminal endoscopic lumbar discectomy in the Department of Pain, the First Affiliated Hospital of Anhui Medical University from November to December 2024 were selected and divided into YESS technology group, THESS technology group and visualized foraminoplasty group according to the different technologies used, with 12 cases in each group. The puncture point was located by C-arm X-ray fluoroscopy, and different technologies were used for surface positioning and puncture. The number of fluoroscopy, puncture time, and teaching satisfaction of the trainees in each group were evaluated.  Results  The puncture time [(8.6±2.0) min] and the number of fluoroscopy [(6.0±1.9) times] of the group using visual foraminoplasty were significantly lower than those of the YESS group [(12.6±2.6) min and (9.6±2.1) times] and the THESS group [(13.1±5.1) min and (10.7±2.6) times, P < 0.05]. In addition, the trainees ' teaching satisfaction score for visual foraminoplasty (93.8±4.3) was significantly higher than that of the YESS group (71.1±11.0) and the THESS group (63.3±7.1, F=47.590, P < 0.001).  Conclusion  The percutaneous foraminoscopic puncture technique under the guidance of C-arm X-ray fluoroscopy has important clinical value in the treatment of lumbar disc herniation and significantly reduces the puncture time. Through the simplified puncture positioning method, beginners can master the technique in a short time, significantly reducing the number of fluoroscopy and operation time, while improving the learning satisfaction of trainees. Therefore, this method has a high promotion value, reducing the radiation exposure of patients and promoting the application of this technology in the clinical practice of spinal surgery and pain medicine.
Implementation effect and optimization study of standardized training of resident doctors based on satisfaction survey and Gibbs Reflection Cycle mode
XU Yue, ZHU Hongwei, CHEN Jing, LIU Tingting, WANG Wei, JIA Zhengong, ZHANG Yuling, CHEN Hui
2025, 23(5): 867-870. doi: 10.16766/j.cnki.issn.1674-4152.004020
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  Objective  To compare the application effects of standardized teaching based on the Gibbs Reflective Cycle model with traditional practical training in the standardized residency training program, and provide a basis for the reform of teaching methods.  Methods  This study employed a randomized controlled trial design. A total of 300 residents participating in the standardized training program at the First Affiliated Hospital of Bengbu Medical University from September 2021 to August 2024 were selected and randomly divided into a control group and an observation group, with 150 participants in each group. The control group received traditional training, including theoretical lectures, departmental rotations, and regular assessments. The observation group adopted the Gibbs Reflective Cycle model, incorporating group discussions and reflective sessions into theoretical teaching, and requiring residents to engage in self-reflection during clinical practice, with instructors guiding in-depth analysis. The teaching satisfaction and annual assessment scores of the two groups were compared.  Results  The observation group significantly outperformed the control group in teaching satisfaction, learning interest, practical skills, knowledge comprehension, comprehensive abilities, and total scores (P < 0.05). In terms of the annual assessment results, the theoretical knowledge of the observation group [(93.68±2.33)points vs. (83.85±2.24) points], clinical skills [(92.69±2.44) points vs. (81.36±2.21) points], the scores of case analysis [(91.63±2.16) points vs. (80.41±2.02) points] were significantly higher than those of the control group (P < 0.001).  Conclusion  Standardized teaching based on the Gibbs Reflective Cycle model demonstrates significant advantages in residency training, comprehensively enhancing the competencies of residents. It is recommended to promote this approach and refine training content and assessment standards according to hospital-specific conditions to meet the demands of healthcare reform and cultivate high-quality medical professionals.
The effects of non-pharmacological interventions on sleep quality of kidney transplant recipients: a network meta-analysis
LI Xiangru, LIU Hongxia, ZHAO Ying, LIN Keke, ZHANG Shuping, LIN Xiaohong
2025, 23(5): 871-875. doi: 10.16766/j.cnki.issn.1674-4152.004021
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  Objective  To evaluate the effects of different non-pharmacological interventions on sleep quality of kidney transplant recipients, and to provide evidence-based non-drug interventions for nursing practice.  Methods  Randomized controlled trials on the effects of non-pharmacological interventions on sleep quality of kidney transplant recipients were systematically searched from CNKI, Wanfang database, VIP database, Chinese Biomedical Literature Database, PubMed, Embase, and Cochrane Library. The search time limit was from the establishment of the database to August 2024. Network meta-analysis was performed using RStudio and Review Manager 5.4 software.  Results  Sixteen studies were ultimately included, including a total of 11 interventions, with a total of 1 262 kidney transplant recipients. Compared with the usual care group, rankings of interventions which showed significant effects on sleep quality of kidney transplant recipients were attribution training (SMD=-3.64, 95% CI: -4.34 to -2.93), tune therapy combined with point massage (SMD=-3.53, 95% CI: -4.31 to -2.75), high-quality care (SMD=-1.95, 95% CI: -2.84 to -1.06), mindfulness-based cognitive therapy (SMD=-1.68, 95% CI: -2.35 to -1.01), cognitive behavioral therapy (SMD=-1.52, 95% CI: -2.04 to -0.99). The area under the cumulative ranking probability map showed that attribution training is the best non-pharmacological intervention to improve the sleep quality of kidney transplant recipients.  Conclusion  Non-pharmacological interventions can improve the sleep quality of kidney transplant recipients, and it is suggested that clinical measures such as attribution training should be preferred to improve the sleep quality of kidney transplant recipients. And the characteristics of each intervention measure can be integrated to build a personalized and comprehensive intervention plan.
The application of integrated information management model for chest pain center in pre hospital emergency treatment of STEMI patients
CHEN Wenjuan, DING Yadi, WANG Yadan, XIE Songjuan, TANG Oushan
2025, 23(5): 876-880. doi: 10.16766/j.cnki.issn.1674-4152.004022
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  Objective  To analyze the application effect of the integrated information management model of chest pain center in pre hospital emergency treatment of ST segment elevation myocardial infarction (STEMI) patients, and explore its impact on the rescue efficiency, hospitalization time, and nursing satisfaction of STEMI patients.  Methods  Convenience sampling was used to select 182 STEMI patients admitted to the Medical Community General Hospital of Shaoxing Second Hospital from May 2020 to October 2023. The 92 STEMI patients admitted from May 2020 to July 2021 were set as the control group, and the 90 STEMI patients admitted from August 2021 to October 2023 were set as the observation group. The control group received routine pre hospital emergency care, while the observation group received pre hospital emergency care based on the integrated information management model of the chest pain center in addition to the control group. The rescue efficiency and success rate of two groups of patients [onset arrival time at the hospital gate (S2D), onset first medical contact time (S2FMC), first medical contact first electrocardiogram (FMC2ECG), first medical contact balloon dilation time (FMC2B), entry balloon dilation time (D2B)] were compared, and the length of hospital stay, hospitalization costs, and the nursing satisfaction of two groups of patients and the recognition of medical staff were calculated.  Results  The rescue efficiency and time indicators of the observation group were shorter than those of the control group, and the success rate of rescue in the observation group was 93.3% (84/90), higher than 82.6% (76/92) in the control group, with statistical significance (P < 0.05). The length of hospital stay and hospitalization expenses of the observation group were lower than those of the control group (P < 0.05). The nursing satisfaction rate of the observation group was 96.4% (81/84), which was higher than that of the control group [86.8% (66/76), χ2=4.912, P=0.027]. The recognition of management mode by medical staff in the observation group was significantly higher than that in the control group (P < 0.05).  Conclusion  The integrated information management model of chest pain center can shorten the pre hospital emergency and hospitalization time of STEMI patients, improve the success rate of patient rescue, reduce the economic burden of patients, and improve nursing satisfaction.
Analysis of nursing cost composition and application of RBRVS and TDABC in ICU sepsis
MA Yingzhi, LI Ling, LIU Haifeng, HOU Ming, XIAO Jiangqin, GUO Junchuan, LI Jie
2025, 23(5): 881-885. doi: 10.16766/j.cnki.issn.1674-4152.004023
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  Objective  With advancements in medical technology, the demands for sepsis-related nursing and nursing cost are increasing. In order to effectively reduce the total cost of nursing and improve the efficiency and quality of medical services, it is necessary to explore factors influencing nursing cost composition and to evaluate the application of the resource-based relative value scale (RBRVS) and time-driven activity-based costing (TDABC) models in the care of ICU patients with sepsis.  Methods  The clinical data from 218 patients with sepsis admitted to the People's Hospital of Xinjiang Uygur Autonomous Region between January and June 2023 were retrospectively analyzed. According to relevant data, content of nursing services and operating frequency were recorded. The costs of sepsis-related nursing were calculated by RBRVS and TDABC. The composition ratios of total nursing costs were calculated, and the differences between total costs and actual charges were analyzed to assess the cost recovery rate. The main factors influencing nursing costs were analyzed by multiple linear regression analysis.  Results  In terms of different nursing cots, proportions of labor, material, and indirect costs were 73.10%, 13.29%, and 13.61%, respectively. The average total cost of sepsis-related nursing services was 72 861.174 yuan, while the actual charge was 21 181 yuan, resulting in a cost recovery rate of 29.07%. Significant differences in nursing costs were observed across groups based on age, ICU stay duration, mechanical ventilation modes, and presence of pressure injuries (P < 0.05). Multiple linear regression analysis identified age, ICU stay duration, mechanical ventilation mode, pressure injuries, and cost-awareness among nursing staff as factors influencing nursing cost (P < 0.05).  Conclusion  The factors influencing the cost of sepsis nursing services include patients age, ICU stay duration, mechanical ventilation modes, presence of pressure injuries, and cost-awareness among nursing staffs. RBRVS and TDABC can effectively facilitate the accounting of related costs, reflecting that actual charge is much lower than the accounting results. Pricing institutions should establish reasonable charging standards based on cost accounting and enhance the management of labor, material, and indirect cost allocations.
Application of nursing intervention based on ERAS-MDT model in laparoscopic abdominal incision hernia surgery
LAI Liya, FAN Xufei, CHEN Jicai, WU Dazhou
2025, 23(5): 886-889. doi: 10.16766/j.cnki.issn.1674-4152.004024
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  Objective  To investigate the effectiveness of ERAS combined with multidisciplinary collaboration (MDT) nursing intervention in improving postoperative outcomes in patients undergoing laparoscopic abdominal incision hernia surgery.  Methods  A total of 110 patients scheduled for laparoscopic patch repair of abdominal incision hernia at the First Affiliated Hospital of Wenzhou Medical University from January 2022 to January 2024 were enrolled. Patients were randomly divided into a control group and an observation group, with 55 cases in each group. The two groups were given routine nursing intervention and nursing intervention based on ERAS-MDT model, respectively. Postoperative recovery indexes, hospitalization costs, pain scores, anxiety, sleep quality, incidence of adverse events, and nursing satisfaction were compared between the two groups.  Results  In the observation group, the time of anal exhaust after operation [(6.99±1.11) h], the time of first feeding [(9.31±1.02) h], the time of getting out of bed [(9.45±1.24) h], and the time of hospitalization [(6.77±1.01) day] were shorter than those in the control group [(9.23±1.37) h, (11.45±1.34) h, (12.56±2.09) h, and (8.45±1.47) d, respectively (P < 0.05)]. The hospitalization cost was also lower than that in the control group (P < 0.05). The VAS scores at days 1, 3, and 5 after surgery were lower than those in the control group (P < 0.05). The scores of anxiety scale (SAI) and Pittsburgh sleep quality index (PSQI) were lower than those in the control group, respectively (P < 0.05). Additionally, the incidence of adverse events was lower than that in the control group (P < 0.05). While the nursing satisfaction score was higher than that in the control group (P < 0.05).  Conclusion  Nursing intervention based on ERAS-MDT model can relieve postoperative pain, improve anxiety and sleep quality of patients, reduce the risk of adverse events, reduce hospitalization costs, and promote early recovery of patients after laparoscopic abdominal incision hernia surgery.
The impact of binary coping theory combined with IMB model nursing intervention on the quality of life of patients with chronic heart failure
SUN Hui, WU Jian, DING Hongying
2025, 23(5): 890-894. doi: 10.16766/j.cnki.issn.1674-4152.004025
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  Objective  To construct a nursing intervention plan for patients with chronic heart failure combined the theory of binary coping and the Information Motivation Behavioral Skills (IMB) model, and analyze its impact on patients' quality of life.  Methods  A total of 126 patients with chronic heart failure admitted to the Medical Community General Hospital of Shaoxing Second Hospital from September 2023 to June 2024 were selected as the study subjects and randomly divided into a control group and an observation group, with 63 patients in each group. The control group received routine nursing care, while the observation group received nursing intervention using the binary coping theory combined with the IMB model. The intervention period was 3 months, and the cardiac function indicators, self-management level, and quality of life of the two groups of patients were compared before and after the intervention.  Results  After the intervention, both groups of patients showed improvement in cardiac function indicators, but the LVEF and 6MWT in the observation group were higher than those in the control group, and the level of NT-proBNP was lower than that in the control group (P < 0.05). The self-management level of both groups of patients improved, however, the total score of the self-management scale for the observation group of heart failure patients was (120.43±13.46) points, which was higher than that of the control group [(101.35±15.92) points, P < 0.05]. The quality of life of both groups of patients improved, but the total score of the Minnesota heart failure quality of life questionnaire (MLHFQ) in the observation group was (50.73±6.37) points, which was lower than that of the control group [(56.82±8.74) points, F=8.137, P < 0.001].  Conclusion  The combination of binary coping theory and IMB model nursing intervention is beneficial for improving the cardiac function and self-management level of patients with chronic heart failure, while also improving their quality of life, and is worthy of clinical application.
Application value of FMEA theory in collaborative nursing in femoral trochanteric fracture
ZHOU Minjie, LING Lejie, LI Yujie, LUO Guogang
2025, 23(5): 895-898. doi: 10.16766/j.cnki.issn.1674-4152.004026
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  Objective  Trochanteric fracture of femur is one of the common clinical diseases with an increasing incidence and incidence rate. Early surgical treatment is the main means, and scientific postoperative management is the key measure to promote functional recovery of fracture and reduce the risk of complications. In order to further optimize perioperative management measures of trochanteric fracture of femur, This study investigated the effects of collaborative nursing based on failure modes and effects analysis (FMEA) theory on functional recovery and complications of femoral trochanteric fracture.  Methods  A total of 80 patients with femoral trochanteric fracture admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to June 2023 were selected and divided into 2 groups according to the random number table method, with 40 cases in both control group and observation group. Patients who received routine rehabilitation nursing interventions served as the control group, and the observation group received routine rehabilitation nursing interventions and collaborative nursing based on FMEA theory on top of the control group. The compliance of rehabilitation exercise between the two groups was compared, and hip function and complications (pressure sores, infection, venous thrombosis of lower limbs) were evaluated by the Harris score system (HHS).  Results  The compliance of rehabilitation exercise in the observation group was higher than that in the control group (P < 0.05). After intervention, the scores of pain, function, joint motion, and deformity in the observation group were higher than those in the control group (P < 0.05). The complication rate of the observation group was 2.50% (1/40), which was significantly lower than that of the control group [20.00% (8/40), χ2=4.507, P=0.034].  Conclusion  The implementation of FMEA theory can promote the rapid recovery of joint function in patients with femoral trochanteric fracture, improve the compliance of rehabilitation exercise, and reduce the occurrence of complications.
Venetoclax combined with azacitidine in treatment of acute myeloid leukemia secondary to multiple myeloma: report of 1 case and review of literature
CHEN Yang, WEI Junan, FENG Youfan, FU Yuan, CHEN Qiaolin, ZHANG Qike, WEI Xiaofang
2025, 23(5): 899-902. doi: 10.16766/j.cnki.issn.1674-4152.004027
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We retrospectively analyzed the clinical data of a patient of acute myeloid leukemia secondary to multiple myeloma treated with venetolclax combined with azacidacidin in Gansu Provincial People's Hospital and reviewed the relevant literature. This patient, a 67-year-old man, was diagnosed multiple myeloma (IgA-κ, DS Ⅲ, ISS Ⅱ, R-ISS Ⅰ), after VRD induction and autologous stem cell transplantation, achieved complete remission and then lenalidomide maintenance therapy. In a state of continuous complete remission, the patient developed acute myeloid leukemia (high-risk group) 4 years and 4 months after diagnosis, then given venetolclax combined with azacidacidin. After the first course of treatment, the patient had complete morphologic remission of acute myeloid leukemia, MRD was negative, and the clinical symptoms improved significantly. After a total of 3 courses of the same treatment, the myeloid morphology of acute myeloid leukemia persisted in remission, but the proportion of abnormal plasma cells increased significantly, multiple myeloma recurred, and the patient abandoned treatment.

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