1.Safety and efficacy of immunoadsorption therapy for rheumatoid arthritis:a network meta-analysis and systematic review
Yin ZHENG ; Zhenhua WU ; Cheng ZHANG ; Kexin RUAN ; Xiaolin GANG ; Hong JI
Chinese Journal of Tissue Engineering Research 2026;30(5):1260-1268
OBJECTIVE:To evaluate the efficacy and safety of different immunosorbent columns in the treatment of rheumatoid arthritis through a network meta-analysis,and provide evidence-based basis for clinical diagnosis and treatment.METHODS:By computer,the databases of VIP,WanFang,CNKI,PubMed,CBM,CochraneLibrary,and Web of Science were searched for published cohort studies of immunosorbent column for the treatment of rheumatoid arthritis,with a time limit until August 2024.The quality of the included randomized controlled trials was assessed using the Cochrane5.4 manual.The quality of retrospective cohort studies were evaluated via the Newcastle-Ottawa Scale(NOS).Bayesian network meta-analysis was performed using R4.1.1 software.RESULTS:A total of 13 studies were included,with a total sample size of 891 cases,and 4 immunosorbent columns were included.The results of the network meta-analysis showed that the top three orders that reduce C-reactive protein level:HA280 adsorption column+conventional Western medicine>PH-350 adsorption column+conventional Western medicine>A protein adsorption column;the top three orders that reduce erythrocyte sedimentation rates:leukocyte adsorption column>HA280 adsorption column+conventional Western medicine>PH-350 adsorption column+conventional western medicine;the top three orders that reduce swollen joint count:leukocyte adsorption column>A protein adsorption column+conventional western medicine>PH-350 type adsorption column+conventional Western medicine;the top three orders that reduce tenderness joint counts:leukocyte adsorption column>A protein adsorption column+conventional western medicine>PH-350 adsorption column+conventional Western medicine;the top three orders that reduce patients' disease activity evaluation:PH-350 adsorption column+conventional western medicine>leukocyte adsorption column>A protein adsorption column;the top three orders that reduce visual analogue scale scores:PH-350 adsorption column+conventional Western medicine>A protein adsorption column>leukocyte adsorption column;the top three orders that reduce physician's disease activity assessment:PH-350 adsorption column+conventional Western medicine>leukocyte adsorption column>conventional Western medicine.CONCLUSION:Based on the 13 articles,in terms of reducing C-reactive protein level,HA280 adsorption column and conventional Western medicine are the preferred choice.In terms of reducing erythrocyte sedimentation rate,swollen joint count,and tender joint count,leukocyte adsorption column is the preferred choice.In terms of reducing patient's disease activity evaluation,physician's disease activity evaluation and visual analogue scale scores,PH-350 adsorption column and conventional Western medicine are the first choice.Different immunosorbent columns can be reasonably and accurately selected according to the patient's specific conditions.
2.Safety and efficacy of immunoadsorption therapy for rheumatoid arthritis:a network meta-analysis and systematic review
Yin ZHENG ; Zhenhua WU ; Cheng ZHANG ; Kexin RUAN ; Xiaolin GANG ; Hong JI
Chinese Journal of Tissue Engineering Research 2026;30(5):1260-1268
OBJECTIVE:To evaluate the efficacy and safety of different immunosorbent columns in the treatment of rheumatoid arthritis through a network meta-analysis,and provide evidence-based basis for clinical diagnosis and treatment.METHODS:By computer,the databases of VIP,WanFang,CNKI,PubMed,CBM,CochraneLibrary,and Web of Science were searched for published cohort studies of immunosorbent column for the treatment of rheumatoid arthritis,with a time limit until August 2024.The quality of the included randomized controlled trials was assessed using the Cochrane5.4 manual.The quality of retrospective cohort studies were evaluated via the Newcastle-Ottawa Scale(NOS).Bayesian network meta-analysis was performed using R4.1.1 software.RESULTS:A total of 13 studies were included,with a total sample size of 891 cases,and 4 immunosorbent columns were included.The results of the network meta-analysis showed that the top three orders that reduce C-reactive protein level:HA280 adsorption column+conventional Western medicine>PH-350 adsorption column+conventional Western medicine>A protein adsorption column;the top three orders that reduce erythrocyte sedimentation rates:leukocyte adsorption column>HA280 adsorption column+conventional Western medicine>PH-350 adsorption column+conventional western medicine;the top three orders that reduce swollen joint count:leukocyte adsorption column>A protein adsorption column+conventional western medicine>PH-350 type adsorption column+conventional Western medicine;the top three orders that reduce tenderness joint counts:leukocyte adsorption column>A protein adsorption column+conventional western medicine>PH-350 adsorption column+conventional Western medicine;the top three orders that reduce patients' disease activity evaluation:PH-350 adsorption column+conventional western medicine>leukocyte adsorption column>A protein adsorption column;the top three orders that reduce visual analogue scale scores:PH-350 adsorption column+conventional Western medicine>A protein adsorption column>leukocyte adsorption column;the top three orders that reduce physician's disease activity assessment:PH-350 adsorption column+conventional Western medicine>leukocyte adsorption column>conventional Western medicine.CONCLUSION:Based on the 13 articles,in terms of reducing C-reactive protein level,HA280 adsorption column and conventional Western medicine are the preferred choice.In terms of reducing erythrocyte sedimentation rate,swollen joint count,and tender joint count,leukocyte adsorption column is the preferred choice.In terms of reducing patient's disease activity evaluation,physician's disease activity evaluation and visual analogue scale scores,PH-350 adsorption column and conventional Western medicine are the first choice.Different immunosorbent columns can be reasonably and accurately selected according to the patient's specific conditions.
3.Effects of problem-based learning combined with mini-clinical evaluation exercise on the training of post competency of interns in the Department of Neurology
Ke XU ; Bao SU ; Xiaolin YANG ; Dan ZHU ; Peng ZHENG ; Qisi WU ; Ning WU ; Jinzhou FENG
Chinese Journal of Medical Education Research 2025;24(11):1534-1539
Objective:To explore the application value of problem-based learning (PBL) combined with mini-clinical evaluation exercise (Mini-CEX) in the development of post competency for interns in the Department of Neurology.Methods:A total of 56 interns rotating at the Department of Neurology of The First Affiliated Hospital of Chongqing Medical University from June 2023 to January 2024 were enrolled as the study subjects. They were randomly divided into a control group and an experiment group using the random number table method, with 28 interns in each group. The control group received traditional methods including small lectures and teaching rounds, while the experimental group received the PBL teaching method combined with Mini-CEX. The teaching effectiveness was evaluated through theoretical assessments, practical skill evaluations, teacher and student satisfaction surveys, and Mini-CEX scale assessments conducted at the beginning, middle, and end of the rotation for the experimental group. The data were analyzed using SPSS 23.0 software. For continuous data, the independent-samples t test or Mann-Whitney U test was used for comparison between groups. The chi-square test was used for categorical data and the Kruskal-Wallis H test for repeated-measurement data. Results:The theoretical scores [(45.36±2.67) vs. (42.00±4.29), P<0.01] and practical skill scores [(45.11±2.53) vs. (42.39±4.53), P<0.01] were significantly higher in the experimental group compared to the control group. The Mini-CEX score of the experimental group at the end of the rotation was notably higher than that at the beginning of rotation ( P<0.05), and their abilities improved continuously. The satisfaction rates of teachers and students in the experimental group were 71.43% (20/28) and 67.86% (19/28), respectively, which were significantly higher than those in the control group [39.29% (11/28) and 35.71% (10/28), P<0.05]. Conclusions:The teaching model integrating PBL and Mini-CEX can effectively enhance the post competency of interns in the Department of Neurology, thus offering a new perspective for clinical undergraduate teaching.
4.Characteristics and risk factors of portal hypertensive colopathy in patients with liver cirrhosis
Zhihui DUAN ; Shubo CHEN ; Tianyou SUN ; Yabing LIU ; Xiaolin JI ; Zheng QI ; Yurong MA ; Cuiping HAN ; Hui LI
Chinese Journal of General Surgery 2025;34(7):1421-1429
Background and Aims:Portal hypertensive colopathy(PHC)is a common complication of portal hypertension in patients with liver cirrhosis.It may lead to gastrointestinal bleeding,yet its underlying pathogenesis remains unclear,and systematic research in China is limited.This study aimed to analyze the colonoscopic features in cirrhotic patients and to explore their associations with relevant clinical factors.Methods:A retrospective analysis was conducted on 99 cirrhotic patients who underwent colonoscopy at Xingtai People's Hospital between July 2020 and December 2024.Colonoscopy,gastroscopy,and clinical data were reviewed.Differences between patients with PHC and those without were compared in terms of sex,Child-Pugh classification,platelet count,presence of ascites,and hepatic encephalopathy.Multivariate logistic regression was used to identify independent risk factors for PHC.Additionally,colorectal lesion detection rates were compared with those of a contemporaneous cohort of 444 participants undergoing national colorectal cancer(CRC)screening at the same center.Results:Among the 105 patients with cirrhosis,the detection rates of PHC,adenomatous polyps,and CRC were 32.32%,28.28%,and 3.03%,respectively,while only 37.37%had no abnormal findings.No serious colonoscopy-related complications were observed.The proportion of males in the PHC group was significantly higher than in the non-PHC group(78.13%vs.50.75%,P=0.009).The PHC group also showed significantly higher rates of Child-Pugh class B/C,and lower platelet count(all P<0.05).There was no statistically significant difference in the incidence of ascites and hepatic encephalopathy between the two groups(P>0.05).Multivariate analysis identified that male gender(OR=3.307,95%CI=1.219-8.971)and Child-Pugh class B/C(OR=2.867,95%CI=1.046-7.861)were independent risk factors for PHC.Compared to the CRC screening cohort,cirrhotic patients had a similar adenoma detection rate(28.28%vs.25.00%,P=0.499),and a slightly higher colorectal cancer detection rate that did not reach statistical significance(3.03%vs.0.68%,P=0.135).Conclusion:Colonoscopy revealed a high rate of abnormalities in cirrhotic patients,with PHC and adenomatous polyps being the most common findings.Routine colonoscopy is recommended for cirrhotic patients without contraindications,especially males,and patients with Child-Pugh class B/C,to facilitate early detection of PHC and precancerous lesions,thereby reducing the risk of lower gastrointestinal bleeding and missed diagnoses of malignancy.
5.The value of Hawk spectral CT in predicting lymph node metastasis in papillary thyroid carcinoma
Lili YE ; Renli ZANG ; Xiangfa HE ; Ming LIANG ; Xiaolin ZHENG
Journal of Practical Radiology 2025;41(6):928-932
Objective To investigate the value of multiple quantitative parameters derived from Hawk spectral CT in predicting lymph node metastasis in papillary thyroid carcinoma(PTC).Methods Preoperative Hawk spectral CT images of 57 cancerous foci from 44 PTC patients confirmed by surgery and pathology were retrospectively collected.All patients underwent lymph node dissection.Based on pathological results,the patients were categorized into metastatic group(26 patients with 35 cancerous foci)and non-metastatic group(18 patients with 22 cancerous foci).The CT morphological features of the primary PTC lesions included location,diameter,bite-cookie sign,and calcification,respectively.Quantitative parameters of Hawk spectral CT plain scan,arterial phase(AP)and venous phase(VP),including conventional CT values,virtual monoenergetic imaging(MonoE)CT values(40 keV,100 keV),effective atomic number(Zeff)and electron density(Rho),respectively.The rank sum test or chi-square test was used to compare the differences in CT morphological features and Hawk spectral CT quantitative parameters between the two groups.For parameters with significant differences,logistic regression was used to construct a combined model.Area under the curve(AUC),accuracy,sensitivity,and specificity were used to evaluate the effectiveness of the combined model.Results There was statistically significant difference in the diameter of the primary lesion between the metastatic group and the non-metastatic group(P<0.05),and the diameter of the primary lesion in the metastatic group was larger than that in the non-metastatic group.The conventional CT value,MonoE CT values(40 keV,100 keV),Rho and Zeff in plain scan,AP-Rho,and VP-MonoE CT value(100 keV)of the primary lesion in the metastatic group were all significantly lower than those in the non-metastatic group(P<0.05).The AUC,accuracy,sensitivity and specificity of the Hawk spectral CT plain scan parameter combination model were 0.765,0.754,0.800,and 0.682,respectively.The AUC,accuracy,sensitivity,and specificity of the Hawk spectral CT enhancement parameter combination model were 0.726,0.667,0.600,and 0.786,respectively.Conclusion Through the analysis of multiple quantitative parameters from Hawk spectral CT of PTC primary lesion,the primary lesion in the metastatic group exhibited significant differences from those in the non-metastatic group in multiple quantitative parameters,which can further improve the predictive efficacy for lymph node metastasis.
6.Effect of Serum Containing Zhenwutang on Apoptosis of Myocardial Mast Cells and Mitochondrial Autophagy
Wei TANG ; Meiqun ZHENG ; Xiaolin WANG ; Zhiyong CHEN ; Chi CHE ; Zongqiong LU ; Jiashuai GUO ; Xiaomei ZOU ; Lili XU ; Lin LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):11-21
ObjectiveTo explore the effect of serum containing Zhenwutang on myocardial mast cell apoptosis induced by angiotensin Ⅱ (AngⅡ) and the mechanism of the correlation between apoptosis and mitochondrial autophagy. MethodsIn this experiment, AngⅡ and serum containing Zhenwutang with different concentrations were used to interfere with H9C2 cardiomyocytes for 24 h, and the survival rate of H9C2 cardiomyocytes was detected by cell counting kit-8 (CCK-8) to screen the optimal concentration for the experiment. Enzyme-linked immunosorbent assay (ELISA) was used to detect the content of B-type natriuretic peptide (BNP) in cell culture supernatant, and immunofluorescence was used to detect the cell surface area to verify the construction of the myocardial mast cell model. Subsequently, the experiment was divided into a blank group (20% blank serum), a model group (20% blank serum + 5×10-5 mol·L-1 AngⅡ), low-, medium-, and high-dose (5%, 10% and 20%) serum containing Zhenwutang groups, an autophagy inhibitor group (1×10-4 mol·L-1 3-MA), and autophagy inducer group (1×10-7 mol·L-1 rapamycin). The apoptosis level of H9C2 cells and the changes of mitochondrial membrane potential were detected by flow cytometry. The lysosomal probe (Lyso Tracker) and mitochondrial probe (Mito Tracker) co-localization was employed to detect autophagy. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect Caspase-3, Caspase-9, B-cell lymphoma 2 (Bcl-2), Bcl-2-related X protein (Bax), and cytochrome C (Cyt C) in apoptosis-related pathways and the relative mRNA expression of ubiquitin ligase (Parkin), phosphatase and tensin homolog (PTEN)-induced kinase 1 (PINK1), and p62 protein in mitochondrial autophagy-related pathways. Western blot was used to detect cleaved Caspase-3, cleaved Caspase-9, Bax, Bcl-2, and Cyt C in apoptosis-related pathways, phosphorylated ubiquitin ligase (p-Parkin), phosphorylated PTEN-induced kinase 1 (p-PINK1), p62, and Bcl-2 homology domain protein Beclin1 in mitochondrial autophagy-related pathways, and the change of microtubule-associated protein 1 light chain 3 (LC3) Ⅱ/Ⅰ ratio. ResultsCCK-8 showed that when the concentration of AngⅡ was 5×10-5 mol·L-1, the cell activity was the lowest, and there was no cytotoxicity. At this concentration, the surface area of cardiomyocytes was significantly increased (P<0.01), and the content of BNP in the supernatant of culture medium was significantly increased (P<0.05). Therefore, AngⅡ with a concentration of 5×10-5 mol·L-1 was selected for the subsequent modeling of myocardial mast cells. Compared with the blank group, the model group and the autophagy inhibitor 3-MA group had a significantly increased apoptosis rate (P<0.01) and significantly decreased mitochondrial membrane potential (P<0.01). The results of immunofluorescence co-localization showed that compared with the blank group, the model group had a significantly decreased number of red and green fluorescence spots. The results of Real-time PCR showed that compared with that in the blank group, the relative mRNA expression of Bax, Caspase-3, Caspase-9, Cyt C, and p62 in the model group was significantly up-regulated (P<0.01), while the relative mRNA expression of Bcl-2, Parkin, and PINK1 was significantly down-regulated (P<0.01). In addition, the relative protein expression of Bax, cleaved Caspase-3, cleaved Caspase-9, Cyt C, and p62 was significantly up-regulated (P<0.01). The LC3Ⅱ/Ⅰ was significantly decreased, and the relative protein expression of Bcl-2, p-Parkin, p-PINK1, and Beclin1 was significantly down-regulated (P<0.01). Compared with the model group, the serum containing Zhenwutang groups and the autophagy inducer group had significantly decreased apoptosis rate (P<0.01), and the decrease ratio of mitochondrial membrane potential is significantly lowered (P<0.01) in a dose-dependent manner. Additionally, both red and green fluorescence spots became more in these groups. In the 3-MA group, the number of red and green fluorescence spots decreased significantly. The relative mRNA expression of Bax, Caspase-3, Caspase-9, Cyt C, and p62 was significantly down-regulated (P<0.05, P<0.01), while that of Bcl-2, Parkin, and PINK1 was significantly up-regulated (P<0.01). In the serum containing Zhenwutang groups, the relative protein expression levels of Bax, cleaved Caspase-3, cleaved Caspase-9, Cyt C, and p62 were significantly down-regulated (P<0.05,P<0.01). The LC3Ⅱ/Ⅰ was significantly increased, and the relative protein expression levels of Bcl-2, p-Parkin, p-PINK1, and Beclin1 were significantly up-regulated (P<0.01). ConclusionThe serum containing Zhenwutang can reduce the apoptosis of myocardial mast cells and increase mitochondrial autophagy. This is related to the inhibition of intracellular Bax/Bcl-2/Caspase-3 apoptosis pathway and regulation of Parkin/PINK1 mitochondrial autophagy pathway.
7.Analysis of Changes on Volatile Components of Ligusticum sinense cv. Chaxiong Rhizome Before and After Wine Processing Based on Electronic Nose and HS-GC-MS
Wen ZHANG ; Peng ZHENG ; Jiangshan ZHANG ; Xiaolin XIAO ; Zaodan WU ; Li XIN ; Wenhui GONG ; Jinlian ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):173-181
ObjectiveBy comparing the composition and content of volatile components in raw products, wine-washed products and wine-fried products of Ligusticum sinense cv. Chaxiong rhizome(LSCR), to investigate the influence of wine processing on the volatile components of LSCR, in order to provide a basis for the development of quality standards for LSCR and its processed products. MethodsElectronic nose was used to identify the odors of LSCR, wine-washed and wine-fried LSCR, and their volatile components were detected by headspace gas chromatography-mass spectrometry(HS-GC-MS), and the relative mass fractions of these components were determined by peak area normalization method. Principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were performed on the obtained sample data by SIMCA 14.1 software, and the differential components of LSCR, wine-washed and wine-fried LSCR were screened according to the variable importance in the projection(VIP) value>1. Pearson correlation analysis was used to explore the relationship between volatile differential flavor components and electronic nose sensors. ResultsElectronic nose detection results showed that there were significant differences in the odors of LSCR, wine-washed and wine-fried LSCR, mainly reflected in the sensors S2, S4, S5, S6, S11, S12, S13. And a total of 62 compounds were identified from LSCR and its wine-processed products, among which 46, 50 and 51 compounds were identified from LSCR, wine-fried and wine-washed LSCR, respectively. There were 21 differential components between the raw products and wine-fried products, of which 10 components were increased and 11 were decreased after processing. There were 20 differential components between the raw products and wine-washed products, of which 11 constituents increased and 9 decreased after processing. There were 17 differential components between the wine-wash products and wine-fried products. Compared with the wine-washed products, the contents of 13 components in the wine-fried products increased, and the contents of 4 components decreased. The increasing trend of the content of phthalides in the wine-washed products was more obvious than that in the wine-fried products, but the content of total volatile components was higher in the wine-fried products than the wine-washed products. Correlation analysis showed that there were different degrees of correlation between the 7 differential sensors of electronic nose and 24 differential volatile components, mainly phthalides and olefins. ConclusionThe odor and the content of volatile components in LSCR changed obviously after wine processing, and n-butylphthalide, Z-butylidenephthalide and E-ligustilide can be used as the candidate differential markers of volatile components in LSCR before and after wine processing.
8.Research on a SECURE nursing pathway based on action research method in preventing MDRPI
Litian LIU ; Wenli ZHAO ; Xuelian SONG ; Xiaolin ZHENG ; Yingxiao LI ; Yu LI ; Lei ZHANG ; Feifei ZHANG
China Medical Equipment 2025;22(1):90-95
Objective:To explore the applied effectiveness of the Skin and/or tissue,Education,Cooperation,Understanding,Report and Evaluate (SECURE) nursing pathway based on action research method in the prevention process of medical device-related pressure injuries (MDRPI) of patients in the Intensive Care Unit (ICU). Methods:The SECURE nursing pathway based on action research method included the establishment of a skin care team to identify problems,and the formulation of conducting intervention plan,and the development of targeting nursing interventions to prevent the occurrence of MDRPI. A total of 84 patients hospitalized in the ICU of Hebei General Hospital from March 2022 to March 2023 were selected,and they were randomly divided into a control group and an observation group,with 42 patients in each group. The control group implemented routine method to prevent MDRPI during ICU treatment,while the observation group implemented SECURE nursing pathway based on action research method to conduct prevention. The MDRPI incidence,the quality scores of ICU nursing,the scores of the Short Form Health Survey-36 (SF-36) of patients,the assessment of the improvement of MDRPI patients,and the satisfaction of patients for nursing care were compared between the two groups. Results:The MDRPI incidence during ICU treatment in the observation group was 4.76% (2/42),which was significantly lower than that in the control group,with a statistically significant difference (x2=11.052,P<0.05). The average scores for device usage,prevention assessment,positioning management and preventive nursing after nursing intervention in the observation group were respectively (88.45±2.05),(89.36±2.11),(89.25±2.15) and (91.45±2.25),all of which were significantly higher than those in the control group,with statistically significant differences (t=11.425,12.052,10.052,13.478,P<0.05). After nursing intervention,the average scores for physical function,social function,psychological function and material life as the SF-36 scale in the observation group were (85.47±2.05),(86.48±2.05),(88.46±2.15) and (90.25±2.44),respectively,which were respectively higher than those in the control group,with statistically significant differences (t=12.414,11.045,10.252,10.478,P<0.05). The occurrence time,improvement time of wound and ICU treatment time of presenting MDRPI patients in the observation group were respectively (4.05±0.54) days,(3.45±0.15) days,and (8.12±2.14) days. Compared to the control group,the occurrence time of the observation group was longer,while both the improvement time of wound and ICU treatment time of the observation group were shorter,with statistically significant differences (t=8.485,10.012,13.001,P<0.05). The satisfaction degree of nursing care of patients in the observation group was 95.24% (40/42),which was significantly higher than that in the control group (x2=12.054,P<0.05). Conclusion:The SECURE nursing pathway based on action research method,which prevents MDRPI of ICU patients,can reduce the MDRPI incidence rate of ICU patients,and enhance the work quality of nursing care for MDRPI. It is helpful to the recovery of ICU patients,which can also shorten the treatment time of ICU patients.
9.Research on a SECURE nursing pathway based on action research method in preventing MDRPI
Litian LIU ; Wenli ZHAO ; Xuelian SONG ; Xiaolin ZHENG ; Yingxiao LI ; Yu LI ; Lei ZHANG ; Feifei ZHANG
China Medical Equipment 2025;22(1):90-95
Objective:To explore the applied effectiveness of the Skin and/or tissue,Education,Cooperation,Understanding,Report and Evaluate (SECURE) nursing pathway based on action research method in the prevention process of medical device-related pressure injuries (MDRPI) of patients in the Intensive Care Unit (ICU). Methods:The SECURE nursing pathway based on action research method included the establishment of a skin care team to identify problems,and the formulation of conducting intervention plan,and the development of targeting nursing interventions to prevent the occurrence of MDRPI. A total of 84 patients hospitalized in the ICU of Hebei General Hospital from March 2022 to March 2023 were selected,and they were randomly divided into a control group and an observation group,with 42 patients in each group. The control group implemented routine method to prevent MDRPI during ICU treatment,while the observation group implemented SECURE nursing pathway based on action research method to conduct prevention. The MDRPI incidence,the quality scores of ICU nursing,the scores of the Short Form Health Survey-36 (SF-36) of patients,the assessment of the improvement of MDRPI patients,and the satisfaction of patients for nursing care were compared between the two groups. Results:The MDRPI incidence during ICU treatment in the observation group was 4.76% (2/42),which was significantly lower than that in the control group,with a statistically significant difference (x2=11.052,P<0.05). The average scores for device usage,prevention assessment,positioning management and preventive nursing after nursing intervention in the observation group were respectively (88.45±2.05),(89.36±2.11),(89.25±2.15) and (91.45±2.25),all of which were significantly higher than those in the control group,with statistically significant differences (t=11.425,12.052,10.052,13.478,P<0.05). After nursing intervention,the average scores for physical function,social function,psychological function and material life as the SF-36 scale in the observation group were (85.47±2.05),(86.48±2.05),(88.46±2.15) and (90.25±2.44),respectively,which were respectively higher than those in the control group,with statistically significant differences (t=12.414,11.045,10.252,10.478,P<0.05). The occurrence time,improvement time of wound and ICU treatment time of presenting MDRPI patients in the observation group were respectively (4.05±0.54) days,(3.45±0.15) days,and (8.12±2.14) days. Compared to the control group,the occurrence time of the observation group was longer,while both the improvement time of wound and ICU treatment time of the observation group were shorter,with statistically significant differences (t=8.485,10.012,13.001,P<0.05). The satisfaction degree of nursing care of patients in the observation group was 95.24% (40/42),which was significantly higher than that in the control group (x2=12.054,P<0.05). Conclusion:The SECURE nursing pathway based on action research method,which prevents MDRPI of ICU patients,can reduce the MDRPI incidence rate of ICU patients,and enhance the work quality of nursing care for MDRPI. It is helpful to the recovery of ICU patients,which can also shorten the treatment time of ICU patients.
10.Application of different repair methods for defects after Mohs micrographic surgery for malignant tumors of the external nose.
Huilin LI ; Mei ZHENG ; Xiaolin WANG ; Huan QI ; Zhifei ZHANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(9):830-835
Objective:To observe the effects of different repair methods in the defects after Mohs surgical excision of malignant nasal tumors. Methods:Twenty-two cases of external nasal malignant tumor surgery from January 2021 to May 2024 were selected as the research. The tumors were resected using Mohs surgical technique, and the defects were repaired using forehead axial flap, bipedicle flap, nasolabial flap, free full-thickness skin graft from the groin, forehead axial flap, facial kite flap, and composite flap of earlobe cartilage and perichond. The postoperative flap survival, external nasal morphology, and tumor recurrence were observed. Results:Among the 22 cases, there were 1 case of Kaposis sarcoma(KS), 2 cases of squ cell carcinoma, and 19 cases of basal cell carcinoma. Tumors were located at the nasal root in 3 cases, the nasal dorsum in5 cases, the nasal tip in 2 cases, the ala in 8 cases, both the ala and the nasal dorsum in 2 cases, nasal columella, the nasal tip, and the ala in 1 case, the nasal tip, the nasal dorsum, the ala, and paranasal area in 1 case. The size of the defects ranged from 1.2 cm×1.4 cm to 3.7 cm×4.8 cm. Three cases were repaired with forehead axial flaps, four cases with bilobed flaps, thirteen cases with nasolabial groove flaps, one case with free full-thickness skin grafts from the inguinal region, and one case with a combination of forehead axial flaps and facial kite flaps plus a composite of earlobe cartilage and perichondrium. All flaps survived well after surgery. Patients were followed up for 6 months to 3 years after surgery, during which no tumor recurrence was observed, and most patients were satisfied with appearance of their nose. Conclusion:Mohs surgery is used to excise the malignant tumor of the external nose, and satisfactory surgical results can be obtained by using different repair methods based the location and size of the postoperative defect.
Humans
;
Mohs Surgery/methods*
;
Nose Neoplasms/surgery*
;
Surgical Flaps
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Skin Transplantation
;
Male
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Carcinoma, Basal Cell/surgery*
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Skin Neoplasms/surgery*
;
Female
;
Middle Aged
;
Plastic Surgery Procedures/methods*
;
Nose/surgery*
;
Aged
;
Adult
;
Carcinoma, Squamous Cell/surgery*

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