Analysis of related factors for postoperative recurrence of antrochoanal polyps in children / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the correlation between nasal resistance and lung function in children with allergic rhinitis（AR）, and explore whether AR children with increased nasal resistance are accompanied by potential lower respiratory tract involvement. Methods:A total of 88 children diagnosed with AR from December 2021 to December 2022 were selected as the study group, while 20 normal children were selected as the control group during the same period. Both the study group and the control group children underwent lung function tests, bronchodilator tests, and nasal resistance measurements. Spearman correlation analysis and multiple linear regression analysis were performed on the results of nasal resistance and lung function tests to explore the relationship and influencing factors between the two groups.According to the results of nasal resistance measurement, children with increased nasal resistance and abnormal lung function were divided into a mild increase in nasal resistance with abnormal lung function group and a moderate to severe increase in nasal resistance with abnormal lung function group. The degree of increased nasal resistance was analyzed to determine whether it would affect lung function. Results:The FEF25, FEF50, and FEF75 levels in the study group were significantly lower than those in the control group（P<0.05）. The FEV1of children with moderate to severe increase in AR nasal resistance was significantly lower than that of children with mild increase in AR nasal resistance（P<0.05）. There was a correlation between nasal resistance and FEV1/FVC, R20 in AR children, and FEV1/FVC, R20 were the influencing factors of nasal resistance in AR children（P<0.05）. There was no correlation between total serum IgE, lung function, and bronchodilation test in AR patients（P>0.05）. Conclusion:The nasal ventilation function of AR patients has changed, and there is a downward trend in small airway function. Children with moderate to severe increase in AR nasal resistance have a more significant decrease in lung ventilation function than those with mild increase. The nasal resistance of AR children is influenced by FEV1/FVC and R20, and FEV1/FVC and R20 decrease as the nasal resistance value increases. The improvement rate of lung function and FEV1 are not influencing factors for the elevation of total serum IgE.

The comparison of the application effect of labor analgesiabetween acupoint pressure pill massage combined with salt pack hot compress and free body position alone / 中国医师进修杂志

Objective:To explore the effect of acupoint pressure pill massage combined with salt pack hot compress and free body position alone for labor analgesia.Methods:One hundred and eighty pregnant women hospitalized in the Sixth People′s Hospital of Huizhou from January 2019 to December 2020 were selected and randomly divided into the control group and the observation group, each group with 90 patients. The control group received free body position to relieve labor pain. On the basis of the control group, the observation group used acupoint pressure pill massage combined with salt pack hot compress to relieve labor pain. The effects of the two methods on patients′ pain and the visual analogue scale (VAS) during different stages of labor and the outcome of the two groups were compared.Results:The rate of labor analgesia efficacy in the observation group was better than that in the control group : 98.89%(89/90) vs. 92.22%(86/90), the difference was statistically significant ( χ2 = 4.71, P<0.05). The scores of VAS in the observation group during the first, second and third stages of labor were lower than those in the control group ( P<0.01). The time of the first, second and third stages of labor and the total time of labor in the observation group were all lower than those in the control group ( P<0.01). At the end of the first stage of labor, the levels of β-endorphin and norepinephrine in the observation group were higher than those in the control group: (173.98 ± 32.87) ng/L vs. (139.43 ± 38.94) ng/L, (80.43 ± 10.98) nmol/L vs. (72.02 ± 11.21) nmol/L; the levels of dopamine were lower than those in the control group: (1.04 ± 0.23) mg/L vs. (1.23 ± 0.25) mg/L, the differences were statistically significant ( P<0.01). The rate of natural delivery in the observation group was higher than that in the control group: 95.56%(86/90) vs. 86.67% (78/90), χ2 = 4.39, P<0.05. Conclusions:Acupoint pressure pill massage combined with salt pack hot compresscan effectively alleviate the pain of child birth, reduce their pain, but also shorten their labor process, promote them to deliver rapidly.

Epidemiological characteristics of pulmonary tuberculosis among students in Wuhan from 2011 to 2020 / 中国学校卫生

Objective@#To analyze the epidemiological characteristics of pulmonary tuberculosis among students in Wuhan from 2011 to 2020, and to provide a basis for the scientific development of interventions and strategies.@*Methods@#Epidemiological distribution, time of onset and treatment, as well as treatment outcomes of student tuberculosis in Wuhan from 2011 to 2020 registered in the national tuberculosis information management system were described.@*Results@#During 2011-2020, 4 337 student tuberculosis patients in Wuhan were registered. The average annual incidence rate was 22.44/10 million, and the annual decreasing rate of 7.86% The incidence of male and female patients was 1.76:1, and the incidence rate of male was higher than that of female( χ 2=184.18, P <0.01). Most of patients aged 19-22 years old, accounting for 47.89%; Tuberculosis reports were highest during March to May, and September to November, and lowest during January to February, and July to August. Student patients were mainly concentrated in Hongshan District, Jiangxia District and Wuchang District, where schools were more distributed in Hongshan District, Dongxihu District, Wuchang District and Xinzhou District. The median duration from tuberculosis onset to treatment was 9(3, 21) days, which varied significantly by region, age, nationality, and patient residence ( Z =-9.25, 47.14, 9.88,43.96, P <0.01). The treatment and outcome of student tuberculosis patients were varied significantly by year and nationality( P <0.05).@*Conclusion@#The incidence of student tuberculosis in Wuhan City showed a slow downward trend. Most of student tuberculosis are college and high school students. Time and place of case detection are relatively fixed. The time of treatment and the outcome of treatment vary significantly. Tuberculosis prevention and control strategies should be formulated according to the local conditions according to the tuberculosis distribution characteristics, as well as enhancing surveillance, health promotion, active discovery and supervision management of tuberculosis in school settings.

Preparation of discharge readiness scale for patients with enterostomy and reliability and validity test / 中国实用护理杂志

Objective:To prepare a discharge readiness scale suitable for patients with enterostomy and to test the reliability and validity, so as to provide an effective measurement tool for the assessment of discharge readiness of patients.Methods:On the basis of the existing Chinese version of the discharge readiness scale, items related to enterostomy nursing problems were added to form the scale entry pool, and a draft of the scale was formed by expert consultation. 132 patients with preventive enterostomy admitted to the Affiliated Hospital of Qingdao University were pre-investigated with the original scale to test the reliability and validity.Results:The discharge readiness scale of enterostomy patients contained 18 items. The content validity of the scale was 0.969, and the content validity of each item was 0.824 - 1.000. Four common factors were extracted from the scale, and the cumulative variance contribution rate was 79.503%. Cronbach alpha coefficient of the total scale was 0.923, and each dimension was 0.806 - 0.947.Conclusions:The discharge readiness scale of patients with enterostomy has good reliability and validity, which can be used as an evaluation tool for patients at discharge.

Misdiagnosic analysis and treatment of pyriform sinus fistula in children / 中华耳鼻咽喉头颈外科杂志

Objective@#To discuss the misdiagnosis of pyriform sinus fistula and to better understand this kind of illness.@*Methods@#The analysis was based on twenty-eight patients with congenital pyriform sinus fistula aged from 11 months to 14 years, with the median age of 5 years, and who were surgically treated from January 2013 to January 2017 in Kunming Children′s Hospital.Twenty patients were misdiagnosed in other hospital.After the routine examination of neck ultrasound and enhanced CT, internal fistula was found by self-retaining laryngoscope, traced by methylene blue, and excised by high ligation.@*Results@#Twenty patients were misdiagnosed.The misdiagnosis time ranged from 6 months to 3 years.Under self-retaining laryngoscope, piriform fossa fistula were found in all patients.Nineteen fistula were found in the left and 1 in the right.The fistula in patients was unilateral.Seven cases were misdiagnosed as suppurative lymphadensitis, undergone abscess incisional drainage many times.Three cases were misdiagnosed as thyroglossal duct cyst and performed excision of thyroglossal duct cyst.One case was treated by extended Sistruck operation again because the doctor considered that excision of middle segment of hyoid bone was not enough and the fistula was not ligated completely.One case was misdiagnosed as second branchial cleft fistula on the right side of the neck.Nine cases were misdiagnosed as hyroid-associated diseases including 2 cases suppurative thyroiditis, 2 cases subacute thyroiditis and 5 cases thyroid neoplasms.Among them, 2 cases underwent partial thyroidectomy.All the patients were treated with high ligation of fistula under general anesthesia.The operation was smooth, and no hoarseness, bucking and pharyngeal fistula occurred after the operation.Postoperative follow-up time ranged from 12 months to 4 years and the median follow-up was 18 months without recurrence.The diagnosis was confirmed pathologically.@*Conclusions@#Pyriform sinus fistula in children was uncommon and easily misdiagnosed in clinic.The majority of physician including some otolaryngologists were lack of understanding of the disease.It should be regarded as one of the important differential diagnosis of neck mass in children.Children with recurrent left neck infection and/or abscess should be highly suspected.Self-retaining laryngoscopic examination can make a definite diagnosis and high ligation of the fistula through the external neck approach can achieve good therapeutic effect.

A path analysis of impacts of social support and coping styles on posttraumatic growth of patients with ostomy / 中国实用护理杂志

Objective To explore the effect of social support and coping style on posttraumatic growth of ostomy patients. Methods A total of 237 patients with ostomy from Affiliated Hospital of Qingdao University were investigated using General questionnaire, Perceived Social Support Scale, Medical Coping Modes Questionnaire and Posttraumatic Growth Inventory by cross-sectional survey method from September 2017 to March 2018. The path of social support and coping style on post-traumatic growth was established by correlation analysis and structural equation model. Results The total score of posttraumatic growth in patients with ostomy was (66.76±12.20) points, which was at the upper-middle level. Correlation analysis showed that posttraumatic growth was positively correlated with comprehension of social support (r=0.551, P<0.01), positively correlated with face style (r=0.580, P<0.01), negatively correlated with avoidance style and resignation style (r=-0.334, P<0.01;r=-0.449, P<0.01). Structural equation model showed social support had directly positive effect on posttraumatic growth, path coefficient were 0.44. Face style, avoidance style, and resignation style had a partial mediating effect between social support and posttraumatic growth, and mediation effects account for 20.01％, 5.21％, 9.25％of the total effect, respectively. Conclusions The posttraumatic growth level of patients with ostomy needs to be improved. Medical staff should strengthen social support for patients and guide patients to adopt the positive coping styles, reduce the avoidance and resignation coping styles, and promote patients to get more posttraumatic growth, furthermore, improve their social adaptability and quality of life.

Influence of acupuncture point massage combined with limb function exercise on ABI and PWV of patients with CHD / 现代临床护理

Objective To explore the influence of acupuncture point massage combined with limb function exercise on ankle brachial index (ABI) and pulse wave velocity (PWV) in patients with coronary heart disease (CHD). Methods According to scores by grace score scale, 180 CHD patients were divided into three groups: low risk group (n=58), moderate risk group (n=68) and high risk group (n=54). Within the three groups, the patients were divided into the experiment group and the control group by using the random digital table. The control group was treated with routine nursing intervention , while the experiment groups accepted acupuncture point massage and limb function exercise training on the basis of control groups. We collected the values of ABI and PWV at four points-in-time: before intervention, 7 days after intervention, 30 days after intervention and 90 days after intervention. Results Repeated measurement data analysis of the experiment group and control group suggested that:in the moderate and high risk groups, there was statistically significant difference (P 0.05) in time and group interaction effect. The difference between the experiment group and control group was statistically significant (P0.05) in ABI&PWV interaction effect at the four time points between the experiment group and control group. In the low-risk group,the differences in time points compared with the main effect were insignificant (all P>0.05). In comparison of main effect at all the four time points, there was significant different in the moderate and high risk group (P0.05) of ABI&PWV before and 90-days after intervention. Conclusion Acupuncture point massage combined with limb function exercise can effectively improve the peripheral artery blood supply in CHD patients, lower ABI and promote PWV.

Adenoviral short hairpin RNA targeting phosphodiesterase 5 attenuates cardiac remodeling and cardiac dysfunction following myocardial infarction in mice / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the impact of PDE5shRNA on cardiac remodeling and heart function following myocardial infarction in mice.</p><p><b>METHODS</b>Myocardial infarction (MI) was induced in mice by left coronary artery ligation. Mice were randomly assigned to sham group (n = 6), PDE5shRNA group (n = 12), common adenovirus group (n = 15) and DMEM group (n = 8). Four weeks post-MI, the survival rate was evaluated. Cardiac function was examined by echocardiography. HE staining and Masson staining were used to evaluate the myocardial infarction size and fibrosis. The number of blood vessels was evaluated by immunohistochemistry, PDE5 protein expression in the left ventricular was detected using Western blot, level of cGMP or PKG activity in the left ventricle was evaluated with ELISA.</p><p><b>RESULTS</b>Four weeks post-MI, all mice survived in the sham group, 3(37%) mice died in the DMEM group, 1 (8%) died in the PDE5shRNA group and 5 died in the common adenovirus group (33%). Infarct size was significantly reduced in PDE5shRNA group compared with the common adenovirus group and DMEM group [(25.4 ± 2.9)% vs. (42.0 ± 3.2)% and (43.4 ± 2.6) %, P < 0.05]. Cardiac function was significantly improved in PDE5shRNA group compared to common adenovirus group and DMEM group[LVFS: (21.1 ± 3.7)% vs. (14.2 ± 2.9)% and (14.22 ± 2.91)%, all P < 0.05; LVEF: (48.2 ± 7.1)% vs. (34.6 ± 6.2)% and (38.1 ± 2.8)%, all P < 0.05; LVESD: (3.87 ± 0.45) mm vs.(4.91 ± 0.62) mm and (4.63 ± 0.37) mm, all P < 0.05]. The blood vessel density was also higher in PDE5shRNA group compared with common adenovirus group (infarct area:14.3 ± 2.0 vs. 6.6 ± 1.2, P < 0.05; periinfarct area: 23.6 ± 2.1 vs. 13.7 ± 2.4, P < 0.05). Compared with common adenovirus group, level of PDE5 was significantly downregulated and level of cGMP or PKG was significantly upregulated in PDE5shRNA group (all P < 0.05).</p><p><b>CONCLUSIONS</b>Present study suggests PDE5shRNA improves cardiac function and attenuates cardiac remodeling through reducing infarction size and cardiac fibrosis and these beneficial effects are possibly mediated by activating cGMP/PKG signaling pathway.</p>