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Study on the correlation between NLRP3 inflammasome and IL-1β,TNF-α in acute attacks of gouty arthritis

Xiaoshuai ZENG ; Huihui LI ; Huiming WU ; Haifeng LIU

China Modern Doctor.2024;62(35):21-24. doi:10.3969/j.issn.1673-9701.2024.35.005

Objective To analyze the correlation between NOD like receptor pyrin domain containing 3(NLRP3)inflammasome and pro-inflammatory factors interleukin(1L)-1 β and tumor necrosis factor(TNF)-α in the pathogenesis of acute gouty arthritis.Methods From June 2023 to July 2024,76 patients in Wenzhou Hospital of Traditional Chinese Medicine with acute gouty arthritis were selected as case group,and 53 healthy individuals as control group.The mRNA expression levels of NLRP3 inflammasome,apoptosis-associated speck-like protein(ASC),Caspase-1,IL-1β,IL-18,TNF-α were monitored using real-time fluorescence quantitative real-time fluorescence quantitative(PCR),and concentrations of these proteins were determined using enzyme-linked immunosorbent assay(ELISA).Results Age,gender,and other data were similar between both groups(P＞0.05).levels of uric acid,C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)in case group were higher than those in control group(P＜0.001).Expression of NLRP3,ASC,and Caspase-1 were also higher(P＜0.001).Serum levels of IL-1β,IL-18,and TNF-α were higher in case group(P＜0.05).NLRP3 inflammasome activity correlated positively with IL-1β and TNF-α.Multivariate Logistic regression showed uric acid,CRP,ESR,NLRP3,ASC,Caspase-1,IL-1 β,IL-18,and TNF-α were important factors for acute gouty arthritis attacks(P＜0.05).Conclusion By inhibiting activation of NLRP3 inflammasome or release of downstream inflammatory factors,inflammatory response of gouty arthritis can be effectively reduced,thereby alleviating symptoms and preventing joint damage.

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Construction and application of artificial airway stability scheme for in-hospital transport of neurocritically ill patients

Qinhui HUANG ; Yeping ZHENG ; Qin ZHANG ; Hongyan WAN ; Genghuan WANG ; Jinjun ZHU

China Modern Doctor.2024;62(35):25-28. doi:10.3969/j.issn.1673-9701.2024.35.006

Objective To construct an artificial airway stability scheme for in-hospital transport of patients with severe neurological diseases,and to explore the application effect.Methods A total of 210 patients from June 2022 to September 2023 admitted to Jiaxing Second Hospital Neurosurgery Intensive Care Unit(NICU)completed in-hospital transport to examination area of artificial airway nerve severe were selected as the research object,104 patients from June 2022 to January 2023 as control group,received regular transport care,106 patients from February to September 2023 in intervention group received nosocomial transport artificial airway stability scheme.The incidence of airway-related adverse events,transit time and family satisfaction were compared between two groups.Results The incidence of airway-related adverse events in intervention group was lower than that in control group.The transit time in intervention group(19.08±3.17)min was faster than that in control group(25.50±4.84)min.The family satisfaction of intervention group was higher than that of control group,the difference was statistically significant(P＜0.05).Conclusion The implementation of NICU in-hospital transport artificial airway stability program can effectively reduce the incidence of airway-related adverse events and transit time,improve family satisfaction.

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Combined blood purification model in the application of symptoms and signs and sleep quality in middle-aged and elderly dialysis patients

Xuan LYU ; Chunhong LU ; Ling KONG ; Mingfeng ZHANG ; Mengya ZHANG

China Modern Doctor.2024;62(35):29-32,42. doi:10.3969/j.issn.1673-9701.2024.35.007

Objective To explore the application effect of combined blood purification mode in the symptoms and signs and sleep quality of middle-aged and elderly dialysis patients.Methods Convenient sampling method was used to select 80 patients who underwent regular dialysis at the Bblood Purification Center of the Jinling Hospital of Medical school of Nanjing University for a period of time.Patients were divided into only hemodialysis group and combined mode groups with 40 patients in each group.The only mode group received high-flux hemodialysis treatment 3 times a week,while combined mode group received high-flux hemodialysis twice a week and hemodiafltrationon once a week.Self-designed questionnaire and symptom index scale were used to compare incidence,frequency,severity and distress of symptoms between two groups.Patient sleep quality was assessed using Pittsburgh sleep quality index scale.Results Combined mode group was superior to only hemodialysis group in many symptoms and signs,especially pruritus,difficulty sleeping(P＜0.01),dry mouth and dry skin(P＜0.05).The sleep quality of combined mode group was significantly better than that of only hemodialysis group(P＜0.01).There were significant differences in subjective sleep quality,sleep latency,sleep disorder and daytime dysfunction between two groups(P＜0.05).Conclusion Combined blood purification mode has better effect on multi-dimensional symptoms,signs and sleep quality in middle-aged and elderly dialysis patients.

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Bioinformatics-based analysis of DNA methylation markers in ulcerative colitis

Shuangshuang HAI ; Yihong LIU ; Haibo ZHAO ; Ruimiao YU

China Modern Doctor.2024;62(35):37-42. doi:10.3969/j.issn.1673-9701.2024.35.009

Objective To analyze DNA methylation biomarkers of ulcerative colitis(UC)based on bioinformatics methods.Methods Chip data from Gene Expression Omnibus(GEO),specifically GSE81211,GSE75214,and GSE87466,were used to analyze differentially methylated sites and differentially expressed genes in UC.This led to the identification of differentially expressed genes with abnormal methylation modifications.These genes were then subjected to enrichment analysis and protein-protein interaction(PPI)network analysis.The expression levels of core genes were validated using the spectral chip GSE36807,and diagnostic efficacy of these core genes was verified by plotting receiver operating characteristic curves.Results A total of 42 genes with high methylation modifications and low expression,and 53 genes with low methylation modifications and high expression were identified.Functional enrichment analysis showed that these genes were mainly associated with innate immune responses,T cell receptor signaling pathways,and upregulation of extracelluar regulated kinase(ERK1)and ERK2 cascade reactions.The enriched signaling pathways of these genes involved cell adhesion molecules and metabolic pathways.Conclusion Seven differentially expressed genes with abnormal methylation modifications SELL,SLAMF1,FCGR2A,CD86,CTLA4,CCR7,and PTPRC may serve as potential biomarkers and therapeutic targets for UC.

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Meta-analysis of the effects of ERAS in the perioperative period in patients with valvular heart disease

Feng TIAN ; Yuan CHEN ; Shiqi CHEN ; Rongxiang ZHANG ; Chenyang ZHU

China Modern Doctor.2024;62(35):43-49. doi:10.3969/j.issn.1673-9701.2024.35.010

Objective To evaluate the perioperative application of enhanced recovery after surgery(ERAS)in patients with valvular heart disease systematically through Meta-analysis.Methods Randomized controlled trials investigating the use of ERAS protocols during the perioperative period in patients with valvular heart disease were searched,including China Knowledge Network,WanFang Database,and China Biomedical Literature Databas,eight databases spanning literature from January 2015 to June 2024.Two researchers conducted an independent review of the literature and extracted pertinent data.A Meta-analysis was conducted by using RevMan 5.4 software on the selected studies.Results A total of 26 studies,involving 2664 participants analyzed.The Meta-analysis revealed that patients in ERAS group experienced a significant reduction in postoperative time to first defecation and bowel movement,as well as a quicker time to first ambulation,reduced hospital stay duration,and fewer postoperative complications.Additionally,there was a notable improvement in patients'quality of life.Conclusion The application of ERAS protocols in patients undergoing heart valve surgery markedly promote recovery,reduce the frequency of complications,and improve overall standard of living.

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Correlational analysis of immune-inflammatory markers with the clinical outcomes of severe pneumonia

Penglei JI ; Weiwei GAO ; Jialin LI ; Daijian LIU ; Yulin WANG

China Modern Doctor.2024;62(35):50-54. doi:10.3969/j.issn.1673-9701.2024.35.011

Objective To compare and analyze the predictive value of different immune-inflammatory parameters for adverse outcomes in severe community-acquired pneumonia(SCAP).Methods A total of 196 severe pneumonia patients admitted to the Second Affiliated Hospital of Zhengzhou University from May 2021 to April 2024.Patients were divided into good prognosis group(n=107)and poor prognosis group(n=89)based on the 28-day hospital outcome.Laboratory indicators were collected and inflammatory indices such as neutrophil-to-lymphocyte ratio(NLR)and NLR to hemoglobin ratio(NLR/Hb)were calculated.Logistic regression analysis was used to identify independent risk factors for poor prognosis in SCAP and to construct a regression model.The diagnostic efficacy of NLR/Hb for adverse outcomes in SCAP was evaluated using the receiver operating characteristic curve.Results NLR during hospitalization in good prognosis group was higher than that in poor prognosis group.Hemoglobin(Hb)in good prognosis group was higher than that in poor prognosis group,and Hb value of admitted patients generally showed a downward trend.platelet(PLT)count in good prognosis group showed an overall upward trend during hospitalization,while poor prognosis group showed a downward trend.NLR/Hb at day 7 showed the most stable significance in multi-model multi-factor Logistic regression analysis(P＜0.001).The indicators with differences were included in multi-factor Logistic regression model.NLR/Hb at day 7,D-dimer,and invasive mechanical ventilation were risk factors for poor prognosis,and platelet count at day 7 was a protective factor for poor prognosis(P＜0.05).Conclusion Dynamic monitoring of blood routine is very necessary in clinical practice,and NLR/Hb is expected to become an effective indicator for judging the poor prognosis of severe pneumonia patients.

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Observation on the clinical application of integrative medicine in the management of non-dialysis patients with stage 3-5 chronic kidney disease

Wenjia XIE ; Jianing NI ; Shuyan ZHOU ; Tingting ZHANG ; Xudong CAI

China Modern Doctor.2024;62(35):17-20,28. doi:10.3969/j.issn.1673-9701.2024.35.004

Objective To explore the clinical effect of integrative medicine in the management of non-dialysis patients with stage 3-5 chronic kidney disease(CKD).Methods A total of 158 cases of non-dialysis patients with CKD3-5 treated in the Nephrology Department of Ningbo Municipal Hospital of Traditional Chinese Medicine from February to December 2022 were retrospectively collected,and be randomly divided into control group and test group,with 79 cases in each group.Control group underwent regular CKD outpatient management,test group underwent CKD integrative medicine management.Compare changes in blood uric acid,cholesterol,albumin,and subjective scale scores in two groups of patients before and after follow-up,as well as inter-group differences.Compare incidence of hyperkalemia,hyperphosphatemia,anemia,and renal function progression between two groups of patients.Results Blood uric acid and cholesterol levels in test group after 1 year's follow-up were lower than those before follow-up,and blood uric acid in test group was lower than that in control group(P＜0.05).The incidence of hyperkalemia,hyperphosphatemia,anemia,and renal function progression in test group were lower than those in control group(P＜0.05).Kidney disease knowledge survey score and 36-item short—form(SF-36)total score of test group were higher than those of control group,and total scores of traditional Chinese medicine syndrome was smaller than that of control group(P＜0.05).Conclusion The application of integrative medicine in the management of non-dialysis patients with CKD3-5 has a significant effect,which could effectively reduce risk factors for CKD progression,controll complications,delay renal function progression,and improve the quality of life for patients.

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Correlation analysis of NLR and late-onset sepsis in premature infants

Qijian SONG ; Shu ZHANG ; Xiaoyan LI ; Huiqin WANG

China Modern Doctor.2024;62(35):33-36. doi:10.3969/j.issn.1673-9701.2024.35.008

Objective To investigate relationship between neutrophil to lymphocyte ratio(NLR)and late-onset sepsis(LOS)in premature infants.Methods A total of 57 premature infants with LOS admitted to Maternal and Child Medical Center of Anhui Medical University neonatal department from January 2018 to April 2024 and 110 non-septicemic premature infants selected for the same period were retrospectively analyzed.Logistic regression model was used to analyze the association between NLR and LOS.Restricted cubic splines(RCS)were used to analyze the nonlinear association between NLR and LOS,and to analyze the difference between the inflammatory indicators of continuous monitoring.Results According to Logistic regression model,NLR was found to be an independent risk factor for LOS in premature infants.Based on RCS,we found that when NLR＜1.02,there was no significant correlation with LOS risk,and when NLR≥ 1.02,the risk with LOS increased exponentially.In terms of continuous monitoring,NLR is more valuable than C-reactive protein and procalcitonin in evaluating the effect of treatment.Conclusion NLR is an independent risk factor for LOS in premature infants.When NLR≥1.02,the risk of LOS in premature infants increases exponentially.Continuous monitoring of NLR is of high value in evaluating the treatment effect.

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Effect of Jinfeng pills combined with drospirenone and ethinylestradiol tablets on endometrial repair and hemodynamics after artificial abortion

Feng JIN ; Xianhua HAN ; Chunnian ZHANG ; Wenji HE

China Modern Doctor.2024;62(35):55-58. doi:10.3969/j.issn.1673-9701.2024.35.012

Objective To analyze effects of Jinfeng pills combined with drospirenone and ethinylestradiol tablets on endometrial repair and hemodynamics in patients after artificial abortion.Methods A total of 106 patients who underwent artificial abortion in Ganzhou People's Hospital from July 2021 to July 2022 were selected.The patients were divided into Control group and observation group by a random number table method,53 cases in each group.Control group was treated with drospirenone and ethinylestradiol tablets after operation,and observation group was treated with drospirenone and ethinylestradiol tablets combined with Jinfeng pills after operation.The curative effect,traditional Chinese medicine(TCM)syndrome score,endometrial thickness and hemodynamics index were compared between two groups.Results After treatment,scores of TCM syndromes in observation group were lower than those in control group(P＜0.05).The total effective rate of observation group was higher than that of control group(P＜0.05).The postoperative vaginal bleeding time and the first menstrual time in observation group were shorter than those in control group,and postoperative vaginal bleeding volume was less than that in control group(P＜0.05).After treatment,uterine artery pulsatility index and resistance index in observation group were lower than those in control group,end-diastolic blood flow velocity and peak systolic velocity were higher than those in control group,and endometrial thickness was greater than that in control group(P＜0.05).The total incidence of postoperative complications in observation group was lower than that in control group(P＜0.05).Conclusion Jinfeng pills combined with drospirenone and ethinylestradiol tablets can effectively repair endometrium,promote hemodynamic improvement and reduce complications in patients with artificial abortion after operation.

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Observation of the therapeutic effect of less invasive surfactant administration on respiratory distress syndrome in extremely premature infants

Yuan HE ; Shujie YANG ; Ying ZENG ; Haiying YI ; Jie HUANG ; Bin GAN ; Xian WEI ; Yanlin TANG

China Modern Doctor.2024;62(35):59-63. doi:10.3969/j.issn.1673-9701.2024.35.013

Objective To observe clinical efficacy and safety of less invasive surfactant administration(LISA)in treatment of respiratory distress syndrome(RDS)in extremely premature infants.Methods A total of 65 cases premature infants diagnosed with RDS admitted to neonatal intensive care unit of Xiaogan Central Hospital from January 2021 to December 2023,with gestational age of 28+0～31+6 weeks.They were divided into LISA group(n=33)and intubation administration of surfactant extubation(InSurE)group(n=32)using a random number table method.The incidence of adverse events,blood gas analysis before and after administration,pulse oxygen saturation(SpO2),changes in blood pressure,clinical efficacy,complications,and outcomes were compared between two groups.Results There was no statistically significant difference in the incidence of drug reflux,bradycardia,apnea,or SpO2＜80％between two groups of operations(P＞0.05).During the operation,SpO2 of LISA group was lower than that of InSurE group,and blood pressure monitoring at the 2nd and 4th minutes were lower than those of InSurE group at the corresponding time points,with statistically significant differences(P＜0.05).After 1 hour of treatment,arterial partial pressure of oxygen in LISA group was higher than that in InSurE group,and arterial partial pressure of carbon dioxide was lower than that in InSurE group,with statistically significant differences(P＜0.05).The mechanical ventilation ratio and oxygen therapy time within 72 hours in LISA group were lower than those in InSurE group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in reuse rate of pulmonary surfactant(PS),and hospitalization time between two groups(P＞0.05).The incidence of grade 3-4 periventricular intraventricular hemorrhage,P-IVH in LISA group was lower than that in InSurE group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in the incidence of other complications between two groups(P＞0.05).Conclusion Less invasive PS treatment for extremely premature infants with RDS can reduce the incidence of mechanical ventilation,shorten oxygen therapy time,and reduce the occurrence of severe P-IVH.

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