Objective To observe the value of ultrasonic parameters of diaphragm motion combined with BODE index for predicting acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods Eighty COPD patients were retrospectively collected and divided into stable group(n=45)and acute exacerbation group(n=35).Ultrasonic parameters of diaphragm motion,including diaphragm excursion(DE)under quiet breathing(QB)and deep breathing(DB),i.e.DEQB and DEDB were measured.The general data,ultrasound parameters of diaphragm motion,and BODE index scores were compared between groups.Then logistic regression analysis was used to identify factors which could be used to independently predict acute exacerbations of COPD.The predicting performance of ultrasound parameters of diaphragm motion,BODE index and their combination were evaluated with receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results Compared with stable COPD group,acute exacerbation group had higher BMI and BODE index scores(both P＜0.05),as well as larger DEQB but smaller DEDB(both P＜0.05).DEDB and BODE index were both independent predicting factors of acute exacerbation of COPD,while increased DEDB indicated decreased risk of acute exacerbation(OR[95％CI]=0.673[0.493,0.918],P＜0.05),whereas increased BODE index suggested higher risk(OR[95％CI]=3.678[1.061,12.746],P＜0.05).AUC for DEDB and BODE index alone for predicting acute exacerbation of COPD was 0.788 and 0.799,respectively,and of their combination was 0.979,significant higher than that of each alone(both P＜0.05).Conclusion Ultrasonic parameters of diaphragm motion could be used to evaluate diaphragm function in COPD patients.Combination of DEDB and BODE index had better performances in predicting acute exacerbation of COPD.

Objective:To compare the curative effect of local anesthesia Lichtenstein, modified Kugel and general anesthetic transabdominal preperitoneal(TAPP) hemioplasty in the treatment of primary unilateral inguinal hernia in elderly patients.Methods:Six hundred and twenty-one patients with unilateral primary inguinal hernia admitted at Second Hospital of Tianjin Medical University from January 2021 to December 2023 were randomly divided into 3 groups before operation: Lichtenstein group, Modified-Kugel group, TAPP group,207 patients in each group. The clinical data were compared.Results:The average operation time of the Lichtenstein and modified Kugel hernia repair groups was significantly shorter than that of TAPP group ( P<0.01), and the hospitalization cost was also significantly lower than that of TAPP group. The postoperative pain score, time spent in the ground and hospital stay in TAPP group were significantly lower than those in Lichtenstein and modified Kugel groups ( P<0.05). There were no serious complications in the 3 groups. Conclusions:Three kinds of hernia repair are all safe and effective in the treatment of elderly patients with unilateral primary inguinal hernia. TAPP has lighter postoperative pain and quicker recovery. Lichtenstein and Modified-Kugel hernia repair under local anesthesia are suitable for those who cannot tolerate general anesthesia.

Objective To compare the clinical efficacy of laparoscopic high ligation of the hernia sac combined with intraperitoneal onlay mesh(IPOM)and local anesthesia Lichtenstein repair for the treatment of inguinal hernia after total cystectomy in male patients.Methods A total of 59 male patients who underwent total cystectomy were included in this study and randomly divided into two groups:the laparoscopic high ligation of the hernia sac combined with IPOM group(IPOM group,30 cases)and the local anesthesia Lichtenstein repair group(local anesthesia group,29 cases).The patient age,surgical time,postoperative ambulation time,visual analogue scale score for pain on the 1st to 3rd days and 3 months after operation,time to first mobilization post-operation,pain scores on postoperative day 1,2 and 3,pain scores at 3 months post-operation were observed and compared between the two groups.Data of intraoperative blood loss,hospital stay,time to return to daily activities,total surgery costs,recurrence rates at 1 year after operation and complications were also observed and compared in two groups of patients.The results were analyzed to determine the optimal surgical method.Results The IPOM group demonstrated better outcomes in terms of surgical time,time to first mobilization,pain scores on postoperative days 1,2 and 3,pain scores at 3 months,intraoperative blood loss,hospital stay and time to return to daily activities compared to those of the local anesthesia group(P＜0.01).However,the total cost of the operation was higher in the IPOM group than those of the local anesthesia group(P＜0.01).There were no significant differences in postoperative complications between the two groups(P＞0.05).The recurrence rate of the IPOM group one year after surgery was better than that of the local anesthesia group(P＜0.05).Conclusion Laparoscopic IPOM with high ligation of the hernia sac is superior to the traditional Lichtenstein repair in reducing postoperative pain and recurrence rates.This surgical method should be the first choice when economic conditions permit.

Objective:To explore the effectiveness of teach-back method-based health education in patients with oral fungal infections.Methods:Convenience sampling was used to select patients with oral fungal infections who attended the Dental Clinic of the First Affiliated Hospital of Zhengzhou University from June to December 2023 for the study. The patients were divided into control group and observation group according to the randomized numerical table method. Control group received conventional oral care health education, and observation group was treated with the teach-back method-based health education. Treatment adherence, oral health self-management ability, and oral health were compared between the two groups before and after the intervention. Finally, 62 patients were included in control group and 59 patients in observation group.Results:After the intervention, the treatment adherence score and the oral health care knowledge, oral health care attitude, oral health care behavior scores and total scores of oral health self-management ability in observation group were higher than those of control group, and the differences were statistically significant ( P<0.05). After the intervention, the Chinese version of the Oral Health Impact Profile-49 (OHIP-49) of observation group was lower than that of control group, and the difference was statistically significant ( P<0.05) . Conclusions:The teach-back method-based health education improves adherence, enhances self-management, and promotes oral health in patients with oral fungal infections.

Objective To compare the clinical efficacy of laparoscopic high ligation of the hernia sac combined with intraperitoneal onlay mesh(IPOM)and local anesthesia Lichtenstein repair for the treatment of inguinal hernia after total cystectomy in male patients.Methods A total of 59 male patients who underwent total cystectomy were included in this study and randomly divided into two groups:the laparoscopic high ligation of the hernia sac combined with IPOM group(IPOM group,30 cases)and the local anesthesia Lichtenstein repair group(local anesthesia group,29 cases).The patient age,surgical time,postoperative ambulation time,visual analogue scale score for pain on the 1st to 3rd days and 3 months after operation,time to first mobilization post-operation,pain scores on postoperative day 1,2 and 3,pain scores at 3 months post-operation were observed and compared between the two groups.Data of intraoperative blood loss,hospital stay,time to return to daily activities,total surgery costs,recurrence rates at 1 year after operation and complications were also observed and compared in two groups of patients.The results were analyzed to determine the optimal surgical method.Results The IPOM group demonstrated better outcomes in terms of surgical time,time to first mobilization,pain scores on postoperative days 1,2 and 3,pain scores at 3 months,intraoperative blood loss,hospital stay and time to return to daily activities compared to those of the local anesthesia group(P＜0.01).However,the total cost of the operation was higher in the IPOM group than those of the local anesthesia group(P＜0.01).There were no significant differences in postoperative complications between the two groups(P＞0.05).The recurrence rate of the IPOM group one year after surgery was better than that of the local anesthesia group(P＜0.05).Conclusion Laparoscopic IPOM with high ligation of the hernia sac is superior to the traditional Lichtenstein repair in reducing postoperative pain and recurrence rates.This surgical method should be the first choice when economic conditions permit.

Objective To observe the value of ultrasonic parameters of diaphragm motion combined with BODE index for predicting acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods Eighty COPD patients were retrospectively collected and divided into stable group(n=45)and acute exacerbation group(n=35).Ultrasonic parameters of diaphragm motion,including diaphragm excursion(DE)under quiet breathing(QB)and deep breathing(DB),i.e.DEQB and DEDB were measured.The general data,ultrasound parameters of diaphragm motion,and BODE index scores were compared between groups.Then logistic regression analysis was used to identify factors which could be used to independently predict acute exacerbations of COPD.The predicting performance of ultrasound parameters of diaphragm motion,BODE index and their combination were evaluated with receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results Compared with stable COPD group,acute exacerbation group had higher BMI and BODE index scores(both P＜0.05),as well as larger DEQB but smaller DEDB(both P＜0.05).DEDB and BODE index were both independent predicting factors of acute exacerbation of COPD,while increased DEDB indicated decreased risk of acute exacerbation(OR[95％CI]=0.673[0.493,0.918],P＜0.05),whereas increased BODE index suggested higher risk(OR[95％CI]=3.678[1.061,12.746],P＜0.05).AUC for DEDB and BODE index alone for predicting acute exacerbation of COPD was 0.788 and 0.799,respectively,and of their combination was 0.979,significant higher than that of each alone(both P＜0.05).Conclusion Ultrasonic parameters of diaphragm motion could be used to evaluate diaphragm function in COPD patients.Combination of DEDB and BODE index had better performances in predicting acute exacerbation of COPD.

Objective:To explore the effectiveness of teach-back method-based health education in patients with oral fungal infections.Methods:Convenience sampling was used to select patients with oral fungal infections who attended the Dental Clinic of the First Affiliated Hospital of Zhengzhou University from June to December 2023 for the study. The patients were divided into control group and observation group according to the randomized numerical table method. Control group received conventional oral care health education, and observation group was treated with the teach-back method-based health education. Treatment adherence, oral health self-management ability, and oral health were compared between the two groups before and after the intervention. Finally, 62 patients were included in control group and 59 patients in observation group.Results:After the intervention, the treatment adherence score and the oral health care knowledge, oral health care attitude, oral health care behavior scores and total scores of oral health self-management ability in observation group were higher than those of control group, and the differences were statistically significant ( P<0.05). After the intervention, the Chinese version of the Oral Health Impact Profile-49 (OHIP-49) of observation group was lower than that of control group, and the difference was statistically significant ( P<0.05) . Conclusions:The teach-back method-based health education improves adherence, enhances self-management, and promotes oral health in patients with oral fungal infections.

Objective:To compare the curative effect of local anesthesia Lichtenstein, modified Kugel and general anesthetic transabdominal preperitoneal(TAPP) hemioplasty in the treatment of primary unilateral inguinal hernia in elderly patients.Methods:Six hundred and twenty-one patients with unilateral primary inguinal hernia admitted at Second Hospital of Tianjin Medical University from January 2021 to December 2023 were randomly divided into 3 groups before operation: Lichtenstein group, Modified-Kugel group, TAPP group,207 patients in each group. The clinical data were compared.Results:The average operation time of the Lichtenstein and modified Kugel hernia repair groups was significantly shorter than that of TAPP group ( P<0.01), and the hospitalization cost was also significantly lower than that of TAPP group. The postoperative pain score, time spent in the ground and hospital stay in TAPP group were significantly lower than those in Lichtenstein and modified Kugel groups ( P<0.05). There were no serious complications in the 3 groups. Conclusions:Three kinds of hernia repair are all safe and effective in the treatment of elderly patients with unilateral primary inguinal hernia. TAPP has lighter postoperative pain and quicker recovery. Lichtenstein and Modified-Kugel hernia repair under local anesthesia are suitable for those who cannot tolerate general anesthesia.

Objective To observe the value of ovarian-adnexal reporting and data system ultrasound 2022 version(O-RADS US v2022)and it combined with risk of malignancy index 4(RMI4)for differential diagnosis of benign and malignant adnexal tumors.Methods Data of 126 patients with adnexal tumors confirmed by surgical pathology were retrospectively analyzed.O-RADS US v2022 was used to classify:1-3 as benign lesion and 4-5 as malignant lesion.RMI4 classification took 450 as the critical value.And classification was performed based on the two combination.Taking pathological results as gold standard,receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of O-RADS US v2022 and RMI4 alone or combination for the differential diagnosis of benign and malignant adnexal tumors.Results Among 126 cases,94 were benign and 32 were malignant tumors.The sensitivity,specificity,accuracy and area under the curve(AUC)of O-RADS US v2022 were 78.13％,80.85％,80.16％and 0.795,respectively.The diagnostic results of RMI4 were 71.88％,84.04％,80.95％and 0.780,respectively.The specificity and accuracy of the combination of the two(93.62％,92.06％)were higher than those of O-RADS US v2022(x2=7.322,5.967,P=0.007,0.015)or RMI4(x2=4.625,5.331,P=0.032,0.021),while no significant difference in sensitivity and AUC(87.50％,0.906)was found with O-RADS US v2022 or RMI4(all P＞0.05).Conclusion O-RADS US v2022 could effectively differentiate benign and malignant adnexal tumors,and combined with RMI4 could improve the diagnostic specificity and accuracy.

Objective:To explore the expression and significance of integrin subunit β6 (ITGB6) in gastric cancer.Methods:The expression levels of ITGB6 were measured in 408 gastric cancer tissues and 211 adjacent normal tissues in the gene expression profiling interactive analysis (GEPIA) database. The relationship between the expression of ITGB6 and the survival rate of the patients was determined using the Kaplan-Meier method. The glass sections of gastric cancer tissues and adjacent normal tissue wax blocks from the gastric adenocarcinoma patients (78 cases) who underwent radical tumor resection in the Department of Gastrointestinal Surgery of the Second Hospital of Tianjin Medical University from October 2013 to October 2019 were collected. The expression of ITGB6 in gastric cancer tissues and adjacent normal tissues was examined by immunohistochemical staining, and the relationship between the expression of ITGB6 and clinicopathological features of gastric cancer patients was analyzed. MGC-803 and AGS cells were selected, and the expression of ITGB6 gene was inhibited by silencing ITGB6 gene by transfection of lentiviral vectors and control vectors with short hairpin RNA (shRNA). The relative expression levels of mRNA and protein of ITGB6 were detected by real-time reverse transcription-PCR (RT-qPCR) and Western blotting, respectively. The effect of ITGB6 on the proliferation of MGC-803 and AGS cells in vitro was detected by clonal formation assay and MTT assay, and the effects of ITGB6 on tumor volume in mice were further verified by animal experiments. Results:The relative expression level of ITGB6 in gastric cancer tissues was higher than that in normal tissues, and the difference was statistically significant ( P<0.05). High expression of ITGB6 was significantly associated with shorter disease-free survival of patients ( P=0.006 5). Immunohistochemical staining showed that the expression level of ITGB6 was higher in gastric cancer tissues than that in adjacent normal tissues. Compared with the low expression group, ITGB6 expression in the high expression group was positively correlated with tumor differentiation ( χ2=4.468, P=0.035) and tumor stage ( χ2=6.056, P=0.014). In MGC-803 and AGS cells, the relative expression levels of ITGB6 mRNA in transfection group (0.4±0.1, 0.5±0.1) were lower than those in control group (1.0±0.1, 1.0±0.1), and the differences were statistically significant (all P<0.05). The relative expression levels of ITGB6 protein in transfection group (0.3±0.1, 0.3±0.1) were lower than those in control group (1.0±0.1, 1.0±0.1), and the differences were statistically significant (all P<0.05). In MGC-803 and AGS cells, the numbers of cloned cells in transfection group [(26±2, 29±3) unit] were lower than those in control group [(93±9, 112±10) unit], and the differences were statistically significant (all P<0.05). The absorbance ( A) values in the transfection group (0.3±0.1, 0.4±0.1) were lower than those in the control group (1.0±0.2, 1.0±0.1), and the differences were statistically significant (all P<0.05). The tumor volume in transfection group [(184±14) cm 3] was smaller than that in the control group [(252±26) cm 3], and the difference was statistically significant ( P<0.05). The relative level of ITGB6 protein expression in the transfection group (0.3±0.1) was lower than that in the control group (1.0±0.2), and the difference was statistically significant ( P<0.05). Conclusions:The expression of ITGB6 is increased in gastric cancer tissues, and the proliferation of gastric cancer cells can be inhibited by knocking down ITGB6.