Objective To explore the clinical effect of cold treatment of replacement fluid in continuous blood purification(CBP)of patients with heat stroke.Methods Clinical data of 46 patients with heat stroke who were treated with CBP in Hainan Hospital of PLA General Hospital from July 2018 to September 2022 were retrospectively analyzed.The patients were assigned to control group(23 cases,conventional treatment for heat stroke and CBP with room temperature replacement fluid)and observation group(23 cases,conventional treatment for heat stroke and CBP with cooling replacement fluid).The body temperatures were compared between the two groups before treatment and 30 min,2 h,6 h,12 h and 24 h after treatment.The prothrombin activity(PTA),activated partial thromboplastin time(APTT),D-dimer(D-D),fibrinogen(FIB)and platelet count(PLT)before treatment and at 24 h(T1),3 d(T2)and 7 d(T3)after treatment,as well as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)score at 7 d after treatment were also compared between the two groups.Results There was no significant difference in temperature or coagulation function between the two groups before treatment(P>0.05).The temperature of the observation group was significantly different from that of the control group at 2 h,6h and 12h after treatment(P<0.05).After treatment,the levels of PTA,FIB and PLT in the observation group at T1,T2 and T3 were higher than those in the control group,while the level of D-D in the observation group was lower than that in the control group,and the APPT at T1 and T2 was significantly shorter than that in the control group(P<0.05).PTA,APPT,D-D,FIB and PLT of the two groups were improved after treatment(P<0.05).Conclusion The cold treatment of replacement fluid can quickly shorten the cooling time of patients with heat stroke during CBP,and significantly improve coagulation function.It is worthy of clinical promotion so as to improve the progrosis of patients with heat strok.

Objective:To explore the effects of the intervention of ginger baixiao moxibustion combined with probiotics on immune function, liver and kidney function of colorectal cancer patients after surgery, so as to provide a theoretical basis for clinical intervention methods to promote postoperative rehabilitation of patients.Methods:This study was a randomized controlled trial, and 180 patients with colorectal cancer radical resection from the Cancer Hospital of Guangxi Medical University were randomly divided into 4 groups, namely control group, probiotic group, ginger baixiao moxibustion group, and combination group, with 45 cases in each group. The control group was given routine nursing before and after surgery. In the probiotic group, probiotics were used for 3 d in routine preoperative care and 4 d from the first day after surgery. The preoperative routine care of the ginger baixiao moxibustion group was supplemented by ginger baixiao moxibustion for 3 d, and the intervention was carried out on the first day after surgery for 4 d. The combined group was treated with probiotics before and after surgery, and the specific intervention methods were the same as those of the probiotics group and the ginger baixiao moxibustion group. The differences in postoperative immune function, liver and kidney function and and other indexes among the four groups were compared.Results:Forty-five cases were ultimately selected from each of the 4 groups. There were 31 males and 14 females, aged (56.67 ± 10.13) years old in the control group. There were 27 males and 18 females, aged (55.33 ± 13.02) years old in the probiotic group. There were 20 males and 25 females, aged (57.87 ± 12.43) years old in the ginger baixiao moxibustion group. There were 26 males and 19 females, aged (57.67 ± 11.63) years old in the combination group. The IgA at 5 d after the operation in the control group, the probiotic group, the ginger baixiao moxibustion group and the combined group were (1.46 ± 0.42), (1.71 ± 0.49), (1.72 ± 0.58), (1.97 ± 0.72) g/L, and the IgM were (0.96 ± 0.20), (1.13 ± 0.33), (1.11 ± 0.35), (1.18 ± 0.52) g/L, and the IgG were (8.45 ± 1.68), (9.57 ± 1.71), (9.41 ± 2.14), (10.40 ± 2.16) g/L, and the differences among the four groups were statistically significant ( F=6.20, 10.64, 7.69, all P<0.05). The CD3 + values at 5 d after the operation in the control group, the probiotic group, the ginger baixiao moxibustion group and the combined group were 0.616 ± 0.094, 0.671 ± 0.101, 0.653 ± 0.119, 0.723 ± 0.091, and CD4 + were 0.408 ± 0.060, 0.444 ± 0.063, 0.441 ± 0.103, 0.483 ± 0.069, and CD4 +/CD8 + were 2.173 ± 0.715, 2.367 ± 0.963, 2.204 ± 1.137, 2.803 ± 1.064, and the differences among the four groups were statistically significant ( F=8.58, 7.43, 3.93, all P<0.05). The alanine aminotransferases at 5 d after the operation in the control group, the probiotic group, the ginger baixiao moxibustion group and the combined group were (16.22 ± 11.56), (15.87 ± 10.69), (12.91 ± 7.45), (11.31 ± 8.31) U/L, and the aspartate aminotransferases were (26.13 ± 7.97), (25.84 ± 7.89), (25.67 ± 10.85), (21.84 ± 5.51) U/L, and the differences among the four groups were statistically significant ( F=2.71, 2.70, both P<0.05). Conclusions:The combination of ginger baixiao moxibustion and probiotics intervention can effectively improve the immune function of colorectal cancer patients after surgery, and improve the liver function and other indexes of patients to a certain extent, so as to benefit patients.

Objective:To identify species type and analyze the homology of Brucella in a family cluster infection. Methods:Two patients with brucellosis from the same family who were treated at the First People's Hospital of Lianyungang City, Jiangsu Province in May 2022 were selected as the research subjects. Brucella strains (H4LYG01 and H2LYG02) were isolated through blood culture. The isolated strains were identified for species type and homology analysis using a fully automated microbial mass spectrometry detection system. Molecular typing of the isolated strains was performed using multiple locus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST). Results:H4LYG01 and H2LYG02 were both Brucella Maltese, and the credibility scores were 9.745 and 9.627, respectively, and the homology was 100%. The MLVA results showed that the gene loci of H4LYG01 and H2LYG02 were completely identical, with the same genotype. The MLST results showed that the sequence type (ST) of H4LYG01 and H2LYG02 were both ST8 types. Conclusion:The two isolated strains of Brucella from a family with clustered infections are both Brucella Maltese and from the same source.

Objective To search and integrate relevant evidence of Traditional Chinese Medicine rehabilitation care during recovery of stroke patients with limb dysfunction,and to provide the evidence for clinical practice.Methods We systematically search domestic and foreign guideline websites,professional association websites,and databases such as Cochrane Library,PubMed,Embase,CNKI,CBM for evidence on Chinese medicine rehabilitation care for limb dysfunction following stroke.The search included guidelines,clinical decisions,evidence summaries,systematic reviews,expert consensuses,and randomized controlled trials,with the search timeframe spanning from the inception of the respective databases to May 2023.The literature was evaluated and rated for quality by 2 researchers independently.Results A total of 17 articles,including 7 guidelines,4 systematic reviews,1 evidence summary and 5 randomized controlled trials were included to summarize 28 pieces of evidence on Traditional Chinese Medicine rehabilitation care for stroke patients with limb dysfunction.The evidence can be categorized into 4 areas,including evaluation,Traditional Chinese Medicine nursing technology,health education and precautions.Conclusion Traditional Chinese Medicine nursing technology for stroke patients with limb dysfunction have various forms and rich contents.Appropriate Traditional Chinese Medicine nursing techniques should be selected according to the actual situation and the willingness of patients to promote the rehabilitation of their limb functions.

Diabetic retinopathy (DR) is one of the most serious complications of diabetes mellitus. Severe diabetic macular edema or proliferative retinopathy may lead to impaired vision or even blindness in diabetic patients. The glucagon-like peptide-1 receptor agonist (GLP-1RA) is now commonly used as novel glucose-lowering agents in the clinical management of type 2 diabetes, but the rapid glycaemic changes associated with the use of the GLP-1RA may aggravate the risk of an increase in the occurrence of short-term potential DR. Potential effects and mechanisms of DR include oxidative stress, vascular endothelial growth factor, inflammation, retinal neurodegeneration, and other cytokines.Whether GLP-1RA leads to the increased risk of DR remains controversial. More basic and clinical studies are needed with the aim of further clarifying the correlation between GLP-1RA and DR risk.

Objective:To study the genotyping characteristics of Brucella strains isolated from Lianyungang City (non-brucellosis epidemic area) of Jiangsu Province. Methods:Preliminary identification of 13 suspected strains of Brucella isolated from blood culture in Clinical Microbiology Laboratory of the First People's Hospital of Lianyungang City in 2018 was conducted; at the same time, the specific gene bcsp31 and insertion sequence IS-711 of Brucella were detected by quantitative real-time PCR (Real-time PCR), and the identification results were rechecked and typed. Multiple locus variable-number tandem repeat analysis (MLVA) was applied for genotyping, and the sequencing results were edited by Mega 4.0 software. Results:All the 13 strains were identified as Brucella by preliminary identification. Real-time PCR confirmed that all the 13 strains were Brucella melitensis. The results of MLVA showed that 13 strains of Brucella melitensis were divided into 12 genotypes and clustered in the "middle Mediterranean cluster". Among 13 strains of Brucella melitensis, 3 strains were biovar 1, 2 strains were biovar 2 and 8 strains were biovar 3. Conclusion:All the Brucella strains isolated from Lianyungang City are Brucella melitensis and the MLVA cluster is in the "middle Mediterranean cluster".