Objective To evaluate the nursing effect of wenjing moxibustion with ginger in zhuang medicine to knee osteoarthritis (KOA), which can provide an effective nursing intervention for KOA. Methods Totally 80 cases were divided into two groups by random number table. There were 40 cases in zhuang moxibution group and 40 in traditional moxibution group. These two groups were taken the same nursing intervention and exercise. However zhuang group were spend 20 minutes and covered by ginger mud on zhuang xiguan point, and fire moxa on the ginger mud. Xuehai, Liangqiu, Neixiyan, and Waixiyan were chosen and fired moxa cone with ginger in traditional group that spent 20 minutes. It was observed the knee pain and swelling before and after 1 week during the treatment. 2 groups were compared with the cost of treatment. Results There was no different in pain and swilling before treatment (P>0.05), but there was significantly difference after 1 week in two groups (t=14.72、12.90;7.04, 2.73, P﹤0.01). It was significantly different in two groups after 1 week treatment (t=-5.06,-3.64, P﹤0.01). There was no significantly difference in the cost of treatment (F=0.041 6, P>0.05). Conclusions these two nursing intervention can release pain and swelling. However it is effective and no different in the cost of treatment when using wenjing moxibustion with ginger in zhuang medicine.

Objective To investigate the iodine nutritional status in the populations of Guizhou Province after implementation of a new standard of salt iodine and to provide a basis in formulating strategy for control of iodine deficiency disorders.Methods In 2011 and 2014,30 units were sampled in Guizhou Province using the sampling method of Probability Proportional to Size.One primary school was chosen in each unit,by the randomized sampling method,40 or 50 students in each school were sampled for examining their urinary iodine level and for testing their household salt iodine level;12 and 50 children were chosen before and after the adjustment,respectively,for testing their urinary iodine level;near the location of the primary school,1 township was chosen,15-20 pregnant women in each township were sampled to test their urinary iodine level.Results Totally 1215 salt samples were collected before adjustment,the median of salt iodine was 32.2 mg/kg;consumption rate of qualified salt was 96.63％;totally 364 urine samples of 8-10 children were collected,the median of urinary iodine (MUI)of children was 308.9 μg/L;450 urine samples of pregnant women were sampled,and their MUI was 216.5 μg/L,among these,121 below 150 μg/L,the proportion was 26.9％.Totally 1 538 salt samples were collected after the adjustment,the median of salt iodine was 26.6 mg/kg;consumption rate of qualified salt was 96.40％;totally 1538urinary samples of 8-10 children were collected,the MUI of children was 218.3 μg/L;and 601 urinary samples of pregnant women were collected,the MUI was 175.1μg/L,among these,241 below 150 μg/L,the proportion was 40.1％.As can be seen from the results,the percentage of sample below 150 μg/L after the adjustment was increased to 13.2％ compared to that before the adjustment,the difference was statistically significant (x2 =19.89,P ＜0.01).Conclusion After implementation of a new standard of salt iodine in Guizhou Province,the iodine nutrition is suitable in residents,but the iodine nutrition of pregnant women is in a trend of declining,which should be noticed.

Objective To investigate the value of platelet, serum sodium and serum creatinine levels in the prognosis of patients with liver failure. Methods The clinical data of 155 patients with liver failure were retrospectively analyzed, and the patients were divided into improvement survival group (87 cases) and deterioration died group (68 cases) according to the prognosis. The hospitalization time of every patient was divided into 4 roughly equal time period, and observed at 5 points of time:T1-T5. The levels and abnormal rates of platelet, serum sodium and serum creatinine were compared. Results The T3 - T5 serum creatinine levels in deterioration died group were significantly higher than those in improvement survival group: (102.14 ± 75.67) μmol/L vs. (78.21 ± 26.68) μmol/L, (116.45 ± 110.64)μmol/L vs. (78.77 ± 29.25) μmol/L, (161.43 ± 153.23) μmol/L vs. (76.40 ± 27.26) μmol/L, and the T1 - T5 serum sodium and platelet levels were significantly lower than those in improvement survival group:(135.05 ± 6.24) mmol/L vs. (137.52 ± 5.26) mmol/L, (137.01 ± 4.99) mmol/L vs. (139.00 ± 3.89) mmol/L, (134.80 ± 16.74) mmol/L vs. (139.15 ± 3.77) mmol/L, (134.40 ± 11.69) mmol/L vs. (138.30 ± 8.75) mmol/L, (133.30 ± 8.93) mmol/L vs. (139.01 ± 9.10) mmol/L, and (122.46 ± 72.59) × 109/L vs. (149.70 ± 71.70) ×109/L, (110.18 ± 65.10) × 109/L vs. (152.09 ± 82.79) ×109/L, (107.32 ± 70.49) ×109/L vs. (169.32 ± 100.65) ×109/L, (97.06 ± 58.15) ×109/L vs. (183.57 ± 112.68) ×109/L, (94.66 ± 57.00) × 109/L vs. (191.36 ± 118.64) ×109/L, and there were statistical differences (P<0.05). The abnormal rates of T3-T5 serum creatinine, T2 - T5 serum sodium and T1 - T5 platelet in deterioration died group were significantly higher than those in improvement survival group, the serum creatinine: 22.06%(15/68) vs. 6.90% (6/87), 27.49% (19/68) vs. 8.05% (7/87) and 42.65% (29/68) vs. 10.34% (9/87), the serum sodium: 32.35% (22/68) vs. 13.79% (12/87), 39.71% (27/68) vs. 14.94% (13/87), 48.53% (33/68) vs. 12.64%(11/87) and 60.29%(41/68) vs. 11.49%(10/87), the platelet:45.59%(31/68) vs. 21.84%(19/87), 55.88% (38/68) vs. 24.14% (21/87), 54.41% (37/68) vs. 25.29% (22/87), 55.88% (38/68) vs. 21.84%(19/87) and 61.76% (42/68) vs. 20.69% (18/87), and there were statistical differences (P<0.05). Abnormal rate of platelet was highest in each time point. Conclusions In the course of pathological changes in deterioration and dead patients, the platelet is the first and most easily affected compare with serum sodium and serum creatinine; the platelet may be a sensitive marker for predicting clinical outcome in patients with liver failure.

Objective To explore the aesthetic results of medial upper Iip repair for skin and soft tissue defects using local flap.Methods According to the location and the size of upper lip defect,the modified rhomboid flap of 60 ° above the defect was designed to repair the wound in philtrum;the O-L flap along philtral column to vermilion border was designed to cover the wound close to the peak and lateral to philtral column.Results Twenty-one postoperative patients that underwent pigmented nevus removal (12 female,9 male;ages 16-33 years) had defects in philtrum for 10 cases and close to the peak and philtral column for 11 cases.The diameter of the defect ranged from 0.5 cm to 1.0 cm.All flaps survived primarily without any complications and follow-up was for 1 to 18 months with excellent outcomes in all cases.All patients were satisfied with contour and functions.No pigmented nevus recurrence occurred.Conclusions The flap designed according to the aesthetic principle could be used to repair medial upper lip defect of medium-sized,which not only obtains functional reconstruction,but also satisfies aesthetic results,with aesthetic subunits saved and scar concealed.

Objective To systematically review the efficacy of multiple doses and single dose of perioperative dexamethasone on pain and recovery after total knee arthroplasty(TKA).Methods PubMed,Embase,Cochrane Library,Web of Science,CNKI,WanFang Data,SinoMed and VIP databases were electronically searched to collect randomized controlled trials(RCTs)on multiple doses and single dose of dexamethasone during perioperative period of TKA from inception of the databases to January 4,2024.Two reviewers independently screened the literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was performed by using RevMan 5.4 software.Results A total of 6 studies involving 674 patients were included,336 patients in single dose dexamethasone group and 338 patients in multiple dose dexamethasone group.The results of Meta-analysis showed that compared with single dose of dexamethasone,multiple doses of perioperative dexamethasone could significantly decrease the pain scores at rest at 48 h after TKA(SMD=-0.68,95%CI-1.05 to-0.30,P﹤0.001),the pain scores with movement at postoperative 48 h(SMD=-0.86,95%CI-1.37 to-0.34,P=0.001),C-reactive protein(CRP)levels at postoperative 48 h(MD=-4.43,95%CI-6.70 to-2.16,P﹤0.001)and CRP levels at postoperative 72 h(MD=-3.60,95%CI-5.53 to-1.67,P﹤0.001).There was no statistically significant difference between the two groups regarding pain scores at rest at postoperative 24 h and 72 h,pain scores with movement at postoperative 24 h and 72 h,incidence of postoperative nausea and vomiting(PONV),CRP levels at postoperative 24 h,length of hospital stay,and incidence of adverse drug reactions(P>0.05).The results of 5 studies showed that multiple doses of dexamethasone did not increase the dosage or patient proportion of remedial analgesics.Conclusion Current evidence shows that compared with single dose of dexamethasone,multiple doses of perioperative dexamethasone can significantly reduce pain scores at postoperative 48 h,CRP levels at postoperative 48 and 72 h after TKA,but it does not significantly reduce the incidence of PONV,hospital stay,or increase the risk of adverse drug reactions.

Objective: To investigate the prevalence and resistance changes of carbapenem-resistant Enterobacteriaceae (CRE) strains isolated from children patients of Chinese Bacterial Resistance Surveillance Network (CHINET) from 2005 to 2017. Methods: Antimicrobial susceptibility testing was carried out by disk diffusion method (KB method) and automated systems. Results were analyzed according to the Clinical and Laboratory Standards Institute (CLSI) 2017 edition standards. Results: Among the 4 481 CRE clinical strains, the overall prevalence of CRE in children was 6.4%, including 8.8% in neonatal period, 7.3% in infancy, 3.8% in early childhood, 4.0% in preschool, 4.7% at school age and 7.4% of puberty. The CRE prevalence of citrobacter spp. remained stable in 2005-2017, whereas other bacteria showed an upward trend, which was higher than that of the adult group (P<0.01). Among the 4 481 CRE strains, there were 2 905 strains of Klebsiella spp. (64.8%), 813 strains of Escherichia coli (18.1%), 549 strains of Enterobacter spp.(12.3%), and 65 strains of Citrobacter spp.(1.5%). Among the 4 481 CRE strains, 20.7%, 13.3%, and 11.8% were from the intensive care unit (ICU), neonatal department and internal medicine wards, respectively. Specimens were distributed as respiratory (42.8%), urine (26.3%), and blood (14.9%). The results of antimicrobial susceptibility testing exhibited that the CRE strains were highly resistant to most commonly used antimicrobial agents in clinical practice, such as imipenem, meropenem and ertapenem, as well as penicillins and cephalosporins, etc. Conclusion The prevalence of CRE strains in children is increasing year by year, and their antimicrobial resistance to common antibacterial agents in clinical practice is extremely serious, to which serious attention needs to be paid. According to the results of antimicrobial susceptibility testings, the antibacterial agents should be rationally selected to effectively control the spread of CRE.

Objective:To investigate the oral health knowledge awareness, attitude and behavior of children in endemic fluorosis areas of Guizhou Province, and evaluate the effectiveness of health education, so as to provide a scientific basis for improving oral health.Methods:In September 2020, 6 counties (cities and districts) were selected as survey sites from the historical fluorosis medium and severe areas in Guizhou Province. One township/village primary school was selected from each survey site to carry out health education activities for one school year. A questionnaire survey was conducted among students from grades 1 to 6 to analyze the changes in children's oral health knowledge, attitude, and behavior before and after health education and their influencing factors.Results:Before and after health education, the awareness rate of children's oral health knowledge increased from 79.22% (7 744/9 775) to 94.38% (9 169/9 715), the recognition rate of children's importance of oral health increased from 89.26% (3 490/3 910) to 95.88% (3 726/3 886), and the formation rate of children's oral health behavior increased from 62.59% (6 118/9 775) to 80.38% (7 809/9 715), with an increase of 15.16, 6.62 and 17.79 percentage points, respectively, the differences were statistically significant (χ 2 = 975.62, 15.17, 756.29, P < 0.001). The analysis of influencing factors showed that whether to stay, gender, and ethnic characteristics could significantly affect the overall score ( t = - 3.94, - 3.86, - 3.62, P < 0.001). Conclusion:The implementation of oral health education in endemic fluorosis areas in Guizhou Province has significantly improved the health knowledge, attitude and behavior of oral health among children in endemic fluorosis areas.

Objective:To investigate the awareness of iodine deficiency disorders prevention and control knowledge among residents in Guiyang City, as well as the behavioral and attitude characteristics of iodized salt consumption, and to determine the focus and direction of future health education on iodine deficiency disorders.Methods:From 0 : 00 to 24 : 00 on May 15, 2021 (the National Day for Prevention and Control of Iodine Deficiency Disorders), through the "Guizhou Disease Control" WeChat official account, the questionnaire was randomly distributed to the residents of Guiyang City who paid attention to the official account in the form of award-winning contest and returned. The survey content included general demographic data, iodine deficiency disorders prevention and control knowledge among residents and the behaviors and attitudes towards iodized salt consumption. The awareness rate of iodine deficiency disorders prevention and control knowledge among residents and the correct rate of their behaviors and attitudes towards iodized salt consumption were calculated.Results:A total of 3 078 valid questionnaires were collected in this survey. The awareness rate of iodine deficiency disorders prevention and control knowledge among residents was 51.3% (9 467/18 468), with a score of (51.26 ± 14.30) points; the correct rate of behavior and attitude towards iodized salt consumption was 93.0% (11 446/12 312), with a score of (92.97 ± 13.13) points. There was a statistically significant difference in the awareness rate of iodine deficiency disorders prevention and control knowledge among residents of different age groups (χ 2 = 23.03, P < 0.001). There were statistically significant differences in the correct rates of behavior and attitude towards iodized salt consumption among residents of different ages, ethnic groups, and professions (χ 2 = 9.66, 4.88, 24.73, P < 0.05), with lower correct rates in the ≥61 years old group, Han minority people and students. The main channels for obtaining knowledge on iodine deficiency disorders prevention and control were promotional materials (59.3%, 1 825/3 078), newspapers and magazines (56.8%, 1 747/3 078), television (56.6%, 1 743/3 078), and the internet (56.2%, 1 731/3 078). Conclusions:The correct rate of behavior and attitude towards iodized salt consumption among residents in Guiyang City is relatively high, but the awareness rate of iodine deficiency disorders prevention and control knowledge is low. We should strengthen health education for residents, especially the elderly, ethnic minorities, and students, and attach importance to promoting the safety of iodized salt and the necessity of long-term iodine supplementation.

Objective:To observe the clinical outcomes of continued pregnancy in pregnant women with cesarean scar pregnancy (CSP).Methods:A retrospective analysis was performed on the pregnancy outcomes of 55 pregnant women who were diagnosed with CSP at the Second Affiliated Hospital of Army Medical University during the first trimester of pregnancy from August 1st, 2018 to October 31st, 2021 and strongly requested to continue the pregnancy.Results:Of the 55 pregnant women, 15 terminated the pregnancy in the first trimester, 1 underwent hysterotomy at 23 weeks of gestation due to cervical dilation, and 39 (71%, 39/55) continued pregnancy to the third trimester achieving live births via cesarean section. The gestational age of the 39 pregnant women delivered by cesarean section was 35 +6 weeks (range: 28 +5-39 +2 weeks), of whom 7 cases at 28 +5-33 +6 weeks, 20 cases at 34-36 +6 weeks, and 12 cases at 37-39 +2 weeks. The results of pathological examination were normal placenta in 3 cases (8%, 3/39), placenta creta in 4 cases (10%, 4/39), placenta increta in 9 cases (23%, 9/39) and placenta percreta in 23 cases (59%, 23/39). Among the 36 pregnant women who were pathologically confirmed as placenta accreta spectrum disorders (PAS) after surgery, the last prenatal ultrasonography showed placenta previa in 27 cases (75%, 27/36) and not observed placenta previa in 9 cases. The median intraoperative blood loss, autologous blood transfusion, and allogeneic suspended red blood cell infusion of 39 pregnant women during cesarean section were 1 000 ml (300-3 500 ml), 300 ml (0-2 000 ml) and 400 ml (0-2 400 ml), respectively. The uterine preservation rate was 100% (39/39), and only 1 case received cystostomy due to intracystic hemorrhage. The birth weight of the newborn was 2 580 g (1 350-3 800 g), and 1 case of mild asphyxia. Conclusions:Pregnant women with CSP who continue pregnancy under close monitoring after adequate ultrasound evaluation and doctor-patient communication could achieve better maternal and infant outcomes, but pregnant women with CSP are highly likely to continue pregnancy and develop into PAS. Effective hemostasis means and multidisciplinary team cooperation are needed in perinatal period for ensuring maternal and fetal safety.

Objective To understand the thyroid stimulating hormone (TSH) level of neonates and iodine nutritional status of pregnant women and children in Guizhou Province.Metheds From 2016 to 2017,a city (district,county) in government location in Guizhou Province was selected as the urban survey site,and a county (city,district) whose economy was relatively backward and farther from the city (prefecture) in government location was selected as the rural survey site.In each survey site,300 salt samples were collected for determination of salt iodine;300 blood samples in the heel of neonates after birth 72 hours were taken for measurement of TSH.The Wodd Health Organization,United Nations International Children's Emergency Fund,and the International Committee for the Control of Iodine Deficiency (WHO/UNICEF/ICCIDD) recommend that when the proportion of neonates (TSH levels ＞ 5 mU/L) is ＜ 3％,the area is non-iodine-deficient.In other words,the 97th percentile (P97) value should be ≤5 mU/L.The normal reference value of the kit is ≤9 mU/L.And urinary iodine of 150 children aged 8-10 and 150 pregnant women was determined.Results A total of 5 400 edible salt samples were tested,the median of salt iodine was 27.9 mg/kg,and the consumption rate of qualified iodized salt was 94.89％ (5 124/5 400);5 400 neonatal heel blood samples were collected,the median of TSH was 2.62 mU/L,TSH P97 was 6.91 mU/L,and samples proportion with TSH ＞ 5 mU/L was 10.67％ (576/5 400),and ＞ 9 mU/L (the cut-off value of kit) was 1.00％ (54/5 400).Among 3 588 cases of children aged 8 to 10 years,the median of urinary iodine was 212.3 μg/L,those with urinary iodine ＜ 50 μg/L was 2.81％ (101/3 588),and ＜ 100 μg/L was 12.76％ (458/3 588).Among the 2 695 pregnant women,the median of urinary iodine was 163.1 μg/L,and 44.04％ (1 187/2 695) were ＜ 150 μg/L.Conclusions The quality of iodized salt is stable in Guizhou,the iodine nutrition status of children and pregnant women are good.The neonatal TSH and nutritional status of pregnant women should be monitored in the future.