Objective To compare the clinical efficacy and safety between the improved ligation method and the traditional ligation method in the treatment of internal hemorrhoid. Methods Double blind and randomized study were made in 86 patients with internal hemorrhoid. The traditional method was performed by ligation of internal hemorrhoidal body, and the improved method was to ligate rectal mucous membrane above internal hemorrhoidal radicles. Results The improved method has better effect than the traditional method. The clinical symptoms of internal hemorrhoid such as bleeding,pain,constipation,edema,itching and erosion in the patients treated by the improved method were significantly improved compared with the patients treated by the traditional method(P

Objective To probe into the effects of applying standardized nursing ward round in nursing management.Method The nursing ward round was regularly conducted to analyze and discuss the difficulties in intensive care.Results After formulating the nursing ward round,the qualification rate of the basic nursing,specific nursing,the nursing of critical paitents,nursing records and the patient's satisfaction were higher than those before the use of nursing ward round(P<0.05).Conclusion The standardized nursing ward round may strengthen the training of nurses' core ability and the initiative of studying,reduce medical disputes,and improve the satisfaction of patients together with the quality of nursing.

Objective To explore the clinical value of bedside gastrointestinal ultrasound exacerbations in evaluating gastro-intestinal function in patients with chronic obstructive pulmonary disease(AECOPD).Methods A total of 128 patients with AECOPD hospitalized in the Department of Intensive Care and Respiratory Medicine of Lanzhou First People's Hospital from June 2019 to December 2021 were selected and divided into mild to moderate group(63 cases without invasive respiratory sup-port treatment)and severe group(65 cases with invasive respiratory support treatment)according to the severity of their condi-tions.Fifty-four healthy subjects were selected during the same period.The general data,gastric emptying time(GET),anstral contraction frequency(ACF),anstral contraction amplitude(ACA),anstral motility index(MI),small intestine diameter,colon diameter,intestinal peristalsis,intestinal mucosal thickness,and colon mucosal thickness were compared among these pa-tients.Logistic regression analysis was performed to determine whether these indicators were associated with gastrointestinal function in patients with AECOPD.ROC curve and Jorden index were used to define the diagnostic threshold of these indica-tors,so as to evaluate the value of gastrointestinal ultrasound in the diagnosis of gastrointestinal dysfunction in AECOPD pa-tients.Results There was no significant difference in the general data among the three groups(P＞0.05).Compared with the healthy group,the GET of AECOPD patient was significantly prolonged,ACF was significantly reduced,ACA was significantly reduced,MI was significantly decreased,small intestine diameter and colon diameter were significantly increased,intestinal peri-stalsis was significantly slowed down,and intestinal mucosal thickness and colon mucosal thickness were significantly reduced(P＜0.01).Compared with normal group and light-medium group,GET was significantly longer,ACF was significantly lower,ACA was significantly reduced,MI was significantly decreased,small intestine diameter and colon diameter were significantly in-creased,intestinal peristalsis was significantly slowed down,and intestinal mucosal thickness and colon mucosal thickness were significantly reduced(P＜0.01)in severe group.These indexes were also associated with the degree of AECOPD(P＜0.01).Lo-gistic regression analysis showed that GET,ACF,ACA,MI,small intestine diameter,colon diameter and intestinal peristalsis were significantly correlated with gastrointestinal function in AECOPD patients.ROC curve analysis was performed in the indi-cators related to gastrointestinal function in AECOPD patients,and the area under ROC curve of all of them was greater than 0.5(P＜0.05).The comprehensive evaluation of gastrointestinal function by these indexes had a good diagnostic value,with good sensitivity and specificity.Conclusion Gastrointestinal ultrasound can be used to evaluate gastrointestinal motility dys-function in patients with AECOPD.Gastrointestinal ultrasound measurements of GET,ACF,ACA,MI,small intestine diame-ter,colon diameter and intestinal peristalsis can be used for early detection of gastrointestinal dysfunction in patients with AE-COPD.

Objective:To investigate the correlation between the clinical features and endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) in patients with cirrhosis.Methods:A total of 148 patients with cirrhosis and portal hypertension who underwent EUS-PPG measurement at the Third Xiangya Hospital of Central South University from March 15, 2022 to June 20, 2023 were selected. The clinical data of patients collected before EUS-PPG measurement were analyzed. Variations in the EUS-PPG across different clinical data subgroups were analyzed. Multivariate linear regression analysis was used to explore the independent factors influencing EUS-PPG.Results:The EUS-PPG was significantly elevated in patients exhibiting red signs (16.62±5.33 mmHg VS 13.44±5.34 mmHg, t=3.616, P<0.001), gastroesophageal varices (15.78±5.30 mmHg VS 9.70±4.77 mmHg, t=4.247, P<0.001), hepatic encephalopathy (20.83±7.52 mmHg VS 14.92±5.35 mmHg, t=2.606, P=0.010), thrombocytopenia (15.66±5.39 mmHg VS 13.29±5.83 mmHg, t=2.136, P=0.034), hypoproteinemia (16.13±5.86 mmHg VS 14.12±5.03 mmHg, t=2.230, P=0.027), and an increased international normalized ratio (16.25±6.00 mmHg VS 14.40±5.11 mmHg, t=2.022, P=0.045). Conversely, the EUS-PPG was significantly reduced in patients with a history of splenectomy and devascularization (13.17±5.88 mmHg VS 15.73±5.34 mmHg, t=-2.379, P=0.019). The EUS-PPG in patients with varying degrees of ascites (no VS slight VS moderate or severe: 13.40±5.48 mmHg VS 15.90±5.49 mmHg VS 16.69±5.17 mmHg, F=5.188, P=0.007) and different Child-Pugh classifications (A VS B VS C: 14.07±5.05 mmHg VS 15.69±5.74 mmHg VS 17.64±5.99 mmHg, F=3.066, P=0.049) increased gradually. Multivariable linear regression analysis showed that red signs ( β=2.44, t=2.732, P=0.007), gastroesophageal varices ( β=4.45, t=2.990, P=0.003), ascites ( β=1.75, t=2.368, P=0.019), and hepatic encephalopathy ( β=5.82, t=2.644, P=0.009) were independent factors for the elevated EUS-PPG. Conclusion:There is a significant correlation between EUS-PPG and the clinical features related to the severity of cirrhotic portal hypertension, which indicates the feasibility of EUS-PPG in evaluating cirrhotic portal hypertension.