1.Arthroscopic partial trapeziectomy and suture button suspensionplasty in the treatment of first carpometacarpal joint athrosis
Zhe ZHAO ; Hongli GENG ; Jianquan LIU ; Yongsheng LI ; Jianwen YIN ; Xiaoqiang CHEN ; Guanghui WANG ; Xiangyu CHENG ; Jiabei LI ; Zhiqin DENG ; Aozhengzheng DONG ; Manyi WANG ; Xiaofei ZHENG ; Wencui LI
Chinese Journal of Orthopaedics 2024;44(1):25-32
Objective:To analyze the clinic effects of arthroscopic partial trapeziectomy and suture button suspensionplasty in the treatment of first carpometacarpal joint (CMCJ) Eaton stage II/III arthrosis.Methods:A retrospective study was conducted on a total of 15 cases (16 hands) of patients including 5 males (1 bilateral) and 10 females with CMCJ stage II/III arthrosis who underwent surgical treatment at the first affiliated hospital of Shenzhen university from January 2020 to June 2022, with mean age of 56.7±6.4 years (range, 46-75 years). The duration from pain to treatment was 7.8±3.2 months (range, 4-14 months). X-ray showed narrowing of CMCJ with osteophytes and distal radial subluxation. All the patients were treated with arthroscopic partial trapeziectomy and suture button suspensionplasty. The preoperative and last postoperative follow-up radiographs, visual analogue scale (VAS), thumb's Kapandji scores, disabilies of the arm, shoulder, and hand (DASH) scores, grip and pinch strength and time to return to work were compared.Results:All cases were followed up for 19.6±6.3 months (range, 11-36 months). The postoperative X-ray showed all the CMCJs were reduced with a normal height of first metacarpal. The mean time for patients to return to their daily activities was 18.69±3.70 d and the mean time to return to work was 24.63±4.91 d. The average VAS score decreased from 6.56±1.15 preoperatively to 1.00 (0.75, 1.25). The preoperative Kapandji's score was 8.00±0.82 and the postoperative Kapandji's score was 8.00 (7.25, 9.00). The average DASH values improved from 24.06±3.19 to 4.00 (3.00, 5.00). The were significant differences except for Kapandji score ( Z=-4.905, P<0.001; Z=-0.121, P=0.905; Z=-4.846, P<0.001). The mean grip and pinch strength showed improvement from an average of 16.4 (14.13, 18.68) kg and 1.70±0.35 kg to 26.14±3.27 kg and 3.58±0.91 kg with significant difference ( Z=-4.617, P<0.001; t=-7.669, P<0.001). Conclusion:Arthroscopic partial trapeziectomy and suture button suspensionplasty is a minimally invasive surgery for the treatment of first CMCJ Eaton stage II/III arthrosis. By this technique, the patients' existing instability and pain problems can be solved.
2.Effect of nicorandil combined with rosuvastatin calcium in treatment of patients with slow coronary flow
Zhiqin FANG ; Huiqing LIANG ; Pengxiang ZHANG ; Kun ZHAO ; Yiping MA ; Yaling WANG ; Fangjiang LI ; Jun LI ; Pingping LI
Journal of Clinical Medicine in Practice 2024;28(15):70-75
Objective To investigate the effects of nicorandil combined with rosuvastatin calcium on monocyte-to-high density lipoprotein cholesterol ratio (MHR), systemic immune-inflammation index (SII), and cardiac function in patients with coronary slow flow (CSF). Methods A group case-control study was used to select 240 patients with CSF confirmed by coronary angiography, and they were randomly divided into observation group and control group, with 120 patients in each group. On the basis of conventional drug treatment, the control group was treated with rosuvastatin calcium, while the observation group was treated with nicorandil combined with rosuvastatin calcium for 6 months. Clinical efficacy, inflammatory markers[high-sensitivity C-reactive protein (hs-CRP), MHR, SII], corrected TIMI frame count (CTFC) of major coronary branches [left anterior descending branch (LAD), left circumflex branch (LCX), right coronary artery (RCA)], cardiac function indicators[left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), global longitudinal strain (GLS)], and the occurrence of major adverse cardiovascular events (MACE) were compared between the two groups. Results The total effective rate in the observation groupwas significantly higher than that in the control group (95.00% versus 80.00%,
3.Effects of alternating food restriction on blood glucose, body mass index and blood lipids in overweight or obesity patients with type 2 diabetes mellitus
Wei LI ; Yuan TIAN ; Jinling ZHAO ; Lu LIANG ; Zhiqin TANG ; Shujiao ZHOU
Chinese Journal of Postgraduates of Medicine 2023;46(9):804-810
Objective:To explore the effect of alternating food restriction on blood glucose, body mass index (BMI) and blood lipids in overweight or obesity patients with type 2 diabetes mellitus.Methods:A prospective cohort study was used. Three hundred overweight or obesity type 2 diabetes mellitus patients with stable blood glucose control from December 2021 to February 2022 in Nanxiang Hospital, Jiading District of Shanghai City were selected. The patients were divided into alternating food restriction group (adopting alternating food restriction therapy, giving balanced meal plates, reducing 30% of calories intake every other day), low carbohydrate high protein group (adopting low carbohydrate and high protein therapy, giving low carbohydrate and high protein reduction meal plates, reducing 15% of calories intake every day) and balanced diet group (adopting balanced diet therapy, giving balanced meal plates) by random digits table method with 100 cases each. All three groups received intervention treatment for 6 months. The height and body mass before intervention and the end of intervention and 6 months after intervention were measured, and the BMI was calculated. The levels of glycosylated hemoglobin (HbA 1c), fasting blood glucose (FBG), 2 h postprandial blood glucose (2 h PBG), triacylglycerol (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were measured. Results:At the end, 280 cases were completed the study. There were 90 cases in the alternating food restriction group, 90 cases in the low carbohydrate high protein group, and 100 cases in the balanced diet group. There were no statistical differences in HbA 1c, FBG, 2 h PBG, BMI, TG, TC and LDL-C before intervention among the three groups ( P>0.05). At the end of the intervention, the HbA 1c and FBG in alternating food restriction group and low carbohydrate high protein group were significantly lower than those in balanced diet group: (6.50 ± 0.39)% and (6.67 ± 0.30)% vs. (6.79 ± 0.32)%, (6.47 ± 0.61) and (6.80 ± 0.30) mmol/L vs. (6.94 ± 0.37) mmol/L, the indexes in alternating food restriction group were significantly lower than those in low carbohydrate high protein group, and there were statistical difference ( P<0.05); the 2 h PBG and BMI in alternating food restriction group and the low carbohydrate high protein group were significantly lower than those in balanced diet group: (8.83 ± 0.63) and (8.81 ± 0.70) mmol/L vs. (9.45 ± 0.85) mmol/L, (25.99 ± 2.13) and (26.53 ± 2.16) kg/m 2 vs. (27.24 ± 2.24) kg/m 2, and there were statistical differences ( P<0.05), there were no statistical differences in 2 h PBG and BMI between alternating food restriction group and the low carbohydrate high protein group ( P>0.05). Six months after intervention, the HbA 1c, 2 h PBG and BMI in alternating food restriction group were significantly lower than those in low carbohydrate high protein group and balanced diet group: (6.62 ± 0.29)% vs. (6.79 ± 0.19)% and (6.84 ± 0.23)%, (9.21 ± 0.53) mmol/L vs. (9.48 ± 0.66) and (9.55 ± 0.51) mmol/L, (25.60 ± 1.67) kg/m 2 vs. (27.26 ± 2.42) and (27.79 ± 2.49) kg/m 2, and there were statistical differences ( P<0.05), there were no statistical differences in HbA 1c, 2 h PBG and BMI between low carbohydrate high protein group and balanced diet group ( P>0.05). At the end of intervention and 6 months after intervention, there were statistical differences in TG, TC and LDL-C among the three groups ( P<0.05); among them, the TG in alternating food restriction group was significantly lower than that in low carbohydrate high protein group and the balanced diet group: (1.67 ± 0.70) mmol/L vs. (1.99 ± 0.89) and (2.49 ± 0.94) mmol/L, (1.70 ± 0.71) mmol/L vs. (2.04 ± 0.96) and (2.53 ± 1.08) mmol/L, and there were statistical differences ( P<0.05), there was no statistical difference in TG between the low carbohydrate high protein group and balanced diet group ( P>0.05). Conclusions:The alternating food restriction therapy in overweight or obesity patients with type 2 diabetes mellitus can not only reduce blood glucose, improve blood lipids, but also reduce BMI, and the overall effect is better than that of low carbohydrate high protein therapy.
4.Exploration and research on experiential and service-learning social practice activities of nursing undergraduates
Chinese Journal of Practical Nursing 2022;38(19):1448-1452
Objective:To carry out experiential and service-learning social practice activities among nursing undergraduates, and evaluate the effects.Methods:From September to December 2020, 21 junior college students were recruited from School of Nursing of Fudan University. They carried out 3 social practice services of rehabilitation training for autistic children under the guidance of professional rehabilitation teachers from the social practice base for special children. The effects of social practice were evaluated by summative evaluation, questionnaire survey and focus group interview at the end of the activity.Results:The nursing students provided a total of 66 times of volunteer services for autistic children and other special children, with a total length of 132 hours within a month. The final evaluation score of nursing students was (92.10 ± 2.10) points, 9 (42.9%) nursing students had a very satisfied sense of achievement, and 20 (95.3%) nursing students had a high overall satisfaction with social practice activities. There were two themes of practice harvest and practice reflection, of which practice harvest included three sub-themes of changing disease cognition, enhancing learning initiative and enhancing humanistic care concept, and practice reflection included three sub-themes of carrying out personalized rehabilitation training, improving practical service quality and establishing effective service evaluation system.Conclusions:It is necessary to change education and teaching concept, strengthen practice base construction, innovate practice teaching mode, and combine theoretical knowledge, professional skills with social service, so as to promote students′ all-round development of morality, intelligence, physique, aesthetics and labor.
5.Exploration and study on the modern distance education in traditional Chinese medicine colleges and universities
Zhiqin GUO ; Yang YANG ; Hailing ZHAO ; Meili ZHAO
Chinese Journal of Medical Education Research 2022;21(10):1285-1287
This article takes the modern distance education of Beijing University of Chinese Medicine for example, and analyzes the current situation and future development paths of modern distance education in traditional Chinese medicine (TCM) colleges and universities, which has provided references for other TCM colleges and universities to set up modern distance education, and laid the foundation for further improving the quality of distance education and social influence, optimizing the modern TCM talent cultivation system, and enhancing the quality of TCM talent cultivation.
6.Efficacy of wrist arthroscopic transosseous footprint repair technique for the treatment of triangular fibrocartilage complex injury
Zhe ZHAO ; Hongli GENG ; Jianquan LIU ; Yongsheng LI ; Jianwen YIN ; Xiangyu CHENG ; Xiaoqiang CHEN ; Guanghui WANG ; Jiabei LI ; Zhiqin DENG ; Manyi WANG ; Wencui LI
Chinese Journal of Trauma 2022;38(8):714-720
Objective:To investigate the clinical efficacy of wrist arthroscopic transosseous footprint repair technique for treating triangular fibrocartilage complex (TFCC) injury.Methods:A retrospective case series study was conducted to analyze the clinical data of 56 patients with TFCC injury admitted to Shenzhen Second People′s Hospital from July 2017 to September 2020, including 38 males and 18 females, aged 17-45 years [(33.5±3.6)years]. All patients had unilateral injury. Physical examination showed instability of the distal radioulnar joint, and MRI and arthroscopy confirmed deep ligament injury of TFCC. All patients underwent repair of deep insertion of the TFCC by using wrist arthroscopic transosseous footprint. The operation time, intraoperative blood loss, wound healing and postoperative complications were recorded. The flexion and extension range of motion of the wrist, radial and ulnal deviation of the wrist, rotation range of motion of the forearm, patient related wrist evaluation (PRWE) score, modified Mayo wrist score, visual analogue scale (VAS), and percentage of grip strength between the affected side and unaffected side were compared preoperatively, at 3 months postoperatively and at 1 year postoperatively.Results:All patients were followed up for 12-18 months [(13.4±5.2)months]. The operation time was (61.3±8.9)minutes, with the intraoperative blood loss of (2.4±1.2)ml. All wounds were healed by first intension. There was no wound infection or ulnar nerve irritation symptom after operation. Four patients experienced clicking on the ulnar side of the wrist in a short period of time post-operation, with spontaneous disappearance of the symptom. At 3 months postoperatively, the radial and ulnar deviation of the wrist was decreased from (52.5±5.9)° preoperatively to (42.6±5.9)°, and rotation range of motion of the forearm was decreased from (94.9±8.4)°preoperatively to (84.6±5.9)° (all P<0.01). The flexion and extension range of motion of the wrist was (93.1±17.4)° preoperatively, with insignificant difference compared with (89.4±5.8)° at 3 months postoperatively ( P>0.05). At 1 year postoperatively, the flexion and extension range of motion of the wrist, radial and ulnar deviation range of motion of the wrist, and rotation range of motion of the forearm were significantly increased to (101.3±13.6)°, (52.4±6.6)°, and (116.4±16.4)° when compared with those at 3 months postoperatively (all P<0.01). At 3 months postoperatively, the PRWE score was increased to (17.1±3.8)points from (10.6±3.2)points preoperatively ( P<0.01), modified Mayo wrist score was decreased to (70.3±6.7) points from (78.1±12.7)points preoperatively ( P<0.01), VAS was decreased to (4.4±1.7)points from (6.2±1.5)points preoperatively ( P>0.05), and percentage of grip strength between the affected side and unaffected side was decreased to (55.7±8.7)% from (74.4±15.2)% preoperatively ( P<0.01). At 1 year postoperatively, the PRWE score was increased to (2.0±0.9)points, modified Mayo wrist score was increased to (94.8±3.3)points, VAS was decreased to (2.1±1.1)points, and percentage of grip strength between the affected side and unaffected side was increased to (93.2±8.7)% when compared with those at 3 months postoperatively (all P<0.01). Conclusion:Wrist arthroscopic transosseous footprint repair technique can effectively treat deep ligament injury of TFCC, with advantages of significantly improving postoperative joint range of motion and functional score, relieving the pain on the ulnar side of the wrist and enhancing grip strength.
7.Influence of high-density lipoprotein cholesterol on the prognosis of patients with alcohol-related hepatocellular carcinoma after radical treatment
Rui ZHANG ; Xiujuan CHANG ; Jiamin CHENG ; Zhiqin ZHAO ; Yinyin LI ; Yinying LU ; Zhen ZENG
Journal of Clinical Hepatology 2021;37(3):621-626
ObjectiveTo investigate the association of high-density lipoprotein cholesterol (HDL-C) with the prognosis of patients with alcohol-related hepatocellular carcinoma (HCC) after radical treatment. MethodsA retrospective analysis was performed for the clinical data of 43 patients with alcohol-related HCC who were admitted to The Fifth Medical Center of Chinese PLA General Hospital and underwent radical treatment from January 2008 to July 2015, and according to HDL-C level, the patients were divided into normal group with 26 patients and abnormal group with 17 patients. The two groups were compared in terms of basic information, laboratory markers, imaging indices, Barcelona Clinic Liver Cancer tumor stage, and Child-Pugh class of liver function. The t-test test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves and the log-rank test was used for comparison between groups. Univariate and multivariate Cox proportional hazards models were used to analyze independent risk factors for prognosis. ResultsThere was a significant difference in prealbumin between the two groups (162.38±60.86 mg/L vs 120.06±64.08 mg/L, t=2.184, P=0.035). Number of tumors (hazard ratio [HR]=2.839, 95%confidence interval [CI]: 1.120~7.200,P=0.028), tumor size (HR=2.634, 95%CI: 1.062~6.529,P=0037), and HDL-C level (HR=2.400, 95%CI: 1.040~5.537,P=0.040) were independent risk factors for the overall survival of patients with alcohol-related HCC. There were significant differences in 1-, 3-, and 5-year cumulative survival rates between the normal group and the abnormal group (88.5%/72.4%/55.7% vs 70.6%/43.7%/17.5%, χ2=5.881, P=0.015). ConclusionThe reduction in HDL-C level might indicate poor prognosis of patients with alcohol-related HCC.
8.Role of long non-coding RNA MALAT1 in the development and progression of hepatocellular carcinoma
Yongkang SUN ; Xuebo YAN ; Zemin ZHU ; Dingcheng SHEN ; Zhiqin XIE ; Zhijian ZHAO ; Caixi TANG
Journal of Clinical Hepatology 2021;37(3):704-708
Hepatocellular carcinoma (HCC) has the features of high incidence rate, low survival rate, poor treatment outcome, and complex pathogenesis. In recent years, many studies have shown that long non-coding RNA (lncRNA) MALAT1 is upregulated in HCC and can promote the proliferation, invasion, and metastasis of HCC cells, and it can also guide the diagnosis, prognostic evaluation, and treatment of HCC in clinical practice. This article reviews the current status of research on lncRNA MALAT1 in HCC and discusses its expression pattern, mechanism of action, and clinical significance in predicting and monitoring the progression of HCC, so as to gain a deep understanding of the role of lncRNA MALAT1 in the progression of HCC. It is pointed out that lncRNA MALAT1 is expected to become a potential biomarker for the diagnosis and prognostic evaluation of HCC and may be used as a therapeutic target in clinical practice.
9.Effect of leukocyte-depleted suspended red blood cells storaged for different time on patients with hematologic diseases and malignant tumors
Fengmian ZHAO ; Ying CHANG ; Xiaomin NIU ; Jianhui LIU ; Xiaoliang REN ; Xiaoran ZHANG ; Yanhua ZHANG ; Cuiping AN ; Zhiqin WANG ; Jiangtao XING
Chinese Journal of Blood Transfusion 2021;34(10):1094-1098
【Objective】 To investigate the effect of leukocyte-depleted suspended red blood cells (lds-RBCs) storaged for different time on blood transfusion effect of patients with hematologic diseases and malignant tumors, as well as to evaluate the storage quality of lds-RBCs in blood stations. 【Methods】 Seven hospitals (4 tertiary-A hospitals and 3 secondary-A hospitals), applying for blood from our blood center, were selected. Blood transfusion cases (medical record) and related data (indicators) of patients with blood diseases and malignant tumors in those hospitals from December 2018 to May 2019 were collected, including disease diagnosis (type) before transfusion, demographic characteristics, date of solo transfusion of lds-RBCs, units of lds-RBCs [(1~2)U/bag, 1 U=200 mL whole blood], different storage duration (1~5 weeks) (bar code), and hemoglobin (Hb) 48 h before and after transfusion. The efficacy of lds-RBCs (storaged for different time) transfusion in patients with hematologic diseases and malignant tumors was evaluated by statistical analysis. 【Results】 A total of 3 557 patients with hematologic diseases and malignant tumors were enrolled in this study. No significant changes were noticed in transfusion efficacy by blood transfusion unit, gender and previous transfusion history (P > 0.05). The effective rate of lds-RBCs in patients with blood diseases and malignant tumors, stratified by storage duration, i. e. storaged for >1~2 weeks, >2~3 weeks, >3~4 weeks and more than >4~5 weeks, was 78.77% vs 77.68% vs 75.06% vs 70.37%, and 79.32% vs 76.73% vs 72.79% vs 67.65%, respectively(P<0.05), with lds-RBCs of 4-5 storage weeks presenting the lowest transfusion efficacy in both groups of patients. 【Conclusion】 The storage time of most lds-RBCs supplied by our center is moren than 3 weeks, and the transfusion effect of lds-RBCs stored for 5 weeks needs further observation. In order to ensure and improve the efficacy of blood transfusion, evidence-based medicine and information management are needed to help the clinical gasp the advantageous time of blood products and shorten the storage-to-transfusion time of red blood cells.
10.Effects of the doctors, nurses and patients responsibility linkage nursing plan in the out-of-hospital rehabilitation management of enterostomy patients
Zhiqin ZHANG ; Lianxiang ZHANG ; Hairong ZHAO
Chinese Journal of Modern Nursing 2021;27(21):2896-2900
Objective:To explore the effect of the doctors, nurses and patients responsibility linkage nursing plan in the out-of-hospital rehabilitation management of patients with enterostomy.Methods:From January 2016 to August 2020, convenience sampling was used to select permanent colorectal cancer stoma patients admitted to Qinghai Provincial People's Hospital as research objects. According to the order of admission, patients were divided into the control group and the intervention group, with 76 cases in each group. The control group carried out routine nursing, and the intervention group implemented the doctor, nurse and patient responsibility linkage nursing plan. The scores of the Stoma Self-care Scale and the incidence of stoma complications were compared between the two groups of patients after the intervention, and the scores of the Chinese Version of City of Hope Quality of Life-Ostomy Questionnaire (C-COH) of patients with stoma before and after the intervention were compared between the two groups.Results:After the intervention, patients in the intervention group had an item average score of (4.25±0.61) on the Stoma Self-care Scale, and an item average score of (7.60±1.26) on C-COH, which were higher than those [ (3.69±0.67) and (6.95± 1.35) ]in the control group, the differences were statistically significant ( t=5.387, 3.068; P<0.05) . The incidence of stoma complications in the intervention group after the intervention was 7.8% (6/76) , which was lower than 19.7% (15/76) in the control group, and the difference was statistically significant ( χ2=4.475, P<0.05) . Conclusions:The application of the doctors, nurses and patients responsibility linkage nursing plan in the out-of-hospital rehabilitation management of patients with enterostomy can improve the self-care ability of patients, reduce the incidence of complications, and improve the quality of life, which is worthy of promotion.


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