Effectiveness of a whole-process health education model among inpatients with ascites type of advanced schistosomiasis / 中国血吸虫病防治杂志

Objective To evaluate the effectiveness of a whole-process health education model among inpatients with ascites type of advanced schistosomiasis. Methods A “admission-hospitalization-discharge” whole-process health education model was created, 101 inpatients with ascites type of advanced schistosomiasis were given the whole-process health education. The scores of schistosomiasis control knowledge, attitudes towards schistosomiasis control and healthy behaviors, and awareness of schistosomiasis control knowledge, correct rate of attitudes towards schistosomiasis control and correct rate of healthy behaviors were compared among inpatients with ascites type of advanced schistosomiasis before and after implementation of the whole-process health education. Results The scores of schistosomiasis control knowledge, schistosomiasis control attitudes and healthy behaviors were all significantly higher among inpatients with ascites type of advanced schistosomiasis after implementation of the whole-process health education than before implementation (Z = −7.688, −3.576 and −4.328, all P values < 0.01). In addition, the awareness of schistosomiasis control knowledge increased from 54.3% to 82.7% (χ2 = 188.886, P < 0.01), and the correct rate of attitudes towards schistosomiasis control increased from 88.4% to 98.0% (χ2 = 22.001, P < 0.01), while the correct rate of healthy behaviors increased from 48.2% to 59.7% (χ2 = 11.767, P < 0.01). Conclusions The whole-process health education model may remarkably improve the awareness of schistosomiasis control knowledge and promote the formation of positive attitudes towards schistosomiasis control and correct behaviors among inpatients with ascites type of advanced schistosomiasis, which is of great significance to facilitate patients’ cure.

Feasibility of enlarging the ventral space by using a drill under spinal endoscopy in the treatment of severe free lumbar disc herniation / 中国骨伤

OBJECTIVE@#To evaluate the clinical efficacy of spinal endoscopy in the treatment of severe free lumbar disc herniation and explore the feasibility and application of microscopic drills to expand ventral space.@*METHODS@#Thirty patients with severe free lumbar intervertebral disc herniation treated by spinal endoscopic technique from April 2019 to March 2021 were collected, including 19 males and 11 females;aged from 19 to 76 years with an average of (44.03±16.92) years old. All patients had a single segmental lesion with prolapse of the nucleus pulposus. Among them, there were 3 cases on L2,3, 3 cases on L3,4, 15 cases on L4,5, and 9 cases on L5S1. During operation, posterior bone of vertebral body and pedicle notch were removed by a drill under the endoscope to enlarge the ventral space. And the free nucleus pulposus was exposed and completely removed. The intraoperative blood loss, operation time, hospital stay and postoperative neurological complications were recorded, and Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index (ODI) and visual analogue scale (VAS) were compared before operation, 2 days, 3 months and 1 year after operation, and Macnab standard was used to evaluate clinical efficacy.@*RESULTS@#All operations were successful and the free nucleus pulposus was completely removed. Pain in the lower back and legs was significantly relieved on the day after operation. Two patients experienced transient pain and numbness in lower limbs after operation, and no serious nerve injury complications occurred. ODI and VAS at each time point after surgery were significantly lower than those before surgery (P<0.01), and JOA score was significantly higher than before surgery (P<0.01). The excellent and good rates of Macnab were 66.67% (20/30), 83.33% (25/30) and 90.00% (27/30) on 2 days, 3 months and 1 year after operation, respectively.@*CONCLUSION@#For severe free lumbar intervertebral disc herniation, using of a drill under endoscope to expand the ventral space can smoothly remove the free nucleus pulposus and avoid nerve damage.

The role of jigsaw karyotype analysis in the teaching of chromosomal recognition / 中华医学遗传学杂志

Karyotype analysis is the basic method in cytogenetics, and is also recognized as the "gold standard" for diagnosing chromosomal disorders. The teaching and training for traditional karyotyping analysis is time-consuming and even boring. The individual's ability for mastering the chromosome morphology can vary greatly. Therefore, it is necessary to improve the teaching method. On the basis of the traditional method, we have added auxiliary analysis software during the teaching. This type of splicing karyotype teaching has increased the students' interest and improved their ability for karyotyping, allowing them to quickly remember the characteristic bands of chromosomes. Through enhanced memory of a large number of karyotypic images, the students' ability to recognize individual chromosomes has improved.

Application of the theory of equal emphasis on muscle and bone in percutaneous vertebroplasty of lumbar osteoporotic compression fracture / 中国骨伤

OBJECTIVE@#To explore the clinical efficacy of percutaneous vertebroplasty(PVP) combined with nerve block in the treatment of lumbar osteoporotic vertebral compression fractures under the guidance of traditional chinese medicine "theory of equal emphasis on muscle and bone".@*METHODS@#Total of 115 patients with lumbar osteoporotic vertebral compression fractures were treated by percutaneous vertebroplasty from January 2015 to March 2022, including 51 males and 64 females, aged 25 to 86 (60.5±15.9) years. Among them, 48 cases were treated with PVP operation combined with erector spinae block and joint block of the injured vertebral articular eminence (intervention group), and 67 cases were treated with conventional PVP operation (control group). The visual analogue scale(VAS) and Oswestry disability index(ODI) before operation, 3 days, 1 month and 6 months after operation between two groups were evaluated. The operation time, number of punctures and intraoperative bleeding between two groups were compared.@*RESULTS@#The VAS and ODI scores of both groups improved significantly after operation compared with those before operation(P<0.05). Moreover, the VAS and ODI scores of 3 days and 1 month after operation of the intervention group improved more significantly than that of the control group(P<0.05). The difference of VAS and ODI scores before operation and 6 months after operation between two groups had no statistical significances(P>0.05). There was no statistically significant difference in the number of punctures and intraoperative bleeding between the two groups (P>0.05).@*CONCLUSION@#Based on the theory of "equal emphasis on muscles and bones", PVP combined with nerve block can effectively relieve paravertebral soft tissue spasm and other "muscle injuries", which can significantly improve short-term postoperative low back pain and lumbar spine mobility compared to conventional PVP treatment, and accelerate postoperative recovery, resulting in satisfactory clinical outcomes.

Robot-assisted PVP for the treatment of osteoporotic fractures of the upper thoracic vertebra / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of "Tianji" orthopedic robot-assisted percutaneous vertebro plasty(PVP) surgery in the treatment of upper thoracic osteoporotic fracture.@*METHODS@#A retrospective analysis was performed on 32 patients with upper thoracic osteoporotic fracture who underwent PVP surgery in Shenzhen Hospital of Traditional Chinese Medicine from August 2016 to June 2022. There were 8 males and 24 females, ranging in age from 58 to 90 years old, with a mean of (67.75±12.27) years old. Fifteen patients were treated with robot-assisted PVP surgery (robot group), including 3 males and 12 females, with an average age of (68.5±10.3) years. Fracture location:1 case of T2 fracture, 1 case of T3 fracture, 3 cases of T4 fracture, 3 cases of T5 fracture, and 7 cases of T6 fracture. The follow-up period ranged from 1.0 to 3.0 months, with a mean of (1.6±0.7) months. Seventeen patients underwent routine PVP surgery (conventional group), including 5 males and 12 females, with an average age of (66.8±11.6) years old. Fracture location:1 case of T1 fracture, 5 cases of T4 fracture, 2 cases of T5 fracture and 9 cases of T6 fracture. The follow-up period ranged from 0.5 to 4.0 months, with a mean of (1.5±0.6) months. Preoperative and postoperative visual analogue scale(VAS) and Oswestry disability index(ODI) scores were compared between the two groups, and the number of punctures, perspective times, operation time, intraoperative blood loss, bone cement distribution, bone cement leakage, and intraoperative radiation dose were compared between the two groups.@*RESULTS@#Number of punctures times, perspective times, operation time, intraoperative blood loss, bone cement distribution, bone cement leakage and intraoperative radiation dose in the robot group were all significantly better than those in the conventional group(P<0.05). VAS of 2.03±0.05 and ODI of (22.16±4.03) % in the robot group were significantly better than those of the robot group before surgery, which were (8.67±0.25) score and (79.40±7.72)%(t=100.869, P<0.001;t=25.456, P<0.001). VAS of 2.17±0.13 and ODI of (23.88±6.15)% in the conventional group were significantly better than those before surgery, which were (8.73±0.18) score and (80.01±7.59)%(t=121.816, P<0.001;t=23.691, P<0.001). There was no significant difference in VAS and ODI between the two groups after operation (t=-3.917, P=0.476;t=-0.922, P=0.364).@*CONCLUSION@#Robot-assisted PVP in the treatment of upper thoracic osteoporotic fractures can further improve surgical safety, reduce bone cement leakage, and achieve satisfactory clinical efficacy.

Advances of metal nanoadjuvant for cancer immunotherapy / 药学学报

Immunotherapy has become another effective tumor treatment after surgical resection, chemotherapy, radiotherapy and targeted therapy. However, due to the low immunogenicity of tumor cells and immunosuppressive tumor microenvironment, antigen-presenting cells inefficiently process and present tumor antigens, thus leading to insufficient activation of cytotoxic T lymphocytes and tumor infiltration, which significantly affects the effectiveness of tumor immunotherapy. In recent years, it has been demonstrated that multiple metal ions exhibit distinguished modulatory effects in activating innate immune stimulation and conquering acquired immune tolerance. Based on this, scientists have designed a series of nano-adjuvant delivery systems with metal ions or metal nanoparticles to enhance the targeted accumulation of metal ions in tumor tissues or lymphoid organs for efficiently inducing immunogenic cell death or directly activating antigen-presenting cells to initiate anti-tumor specific immune response. This review briefly outlines the role of various metal ions in anti-tumor immunomodulation, summarizes the research progress in using metal nanoadjuvant delivery systems to achieve efficient anti-tumor immunotherapy, and provides foresight on the main challenges and potential directions in this field.

Recurrent abdominal pain, peritoneal effusion, and eosinophilia in a boy aged 17 years / 中国当代儿科杂志

A boy, aged 17 years, was admitted again due to abdominal pain, diarrhea, and eosinophilia for 3 years, which worsened for 3 days. Three years ago, the boy suffered from abdominal pain and diarrhea after eating yogurt; color Doppler ultrasound showed a large amount of peritoneal effusion, and routine blood test, bone marrow cell morphology, and ascites histological examination showed a large number of eosinophils. Three days ago, he was admitted again due to abdominal pain and diarrhea. The gastrointestinal endoscopy showed eosinophil infiltration in the angle of stomach. The boy was diagnosed with eosinophilic gastrointestinal disease (eosinophilic gastroenteritis). He was improved after the treatment with glucocorticoids and dietary avoidance, and no recurrence was observed during the one-year follow-up. It is concluded that for children who attend the hospital due to gastrointestinal symptoms such as abdominal pain and diarrhea, if there is an increase in peripheral blood eosinophils, it is necessary to consider the possibility of eosinophilic gastrointestinal disease, and eosinophil infiltration and abnormal eosinophil count in gastrointestinal tissue based on endoscopic biopsy may be the key to diagnosis.

A review on the status quo and implementation methods of ethics education in standardized training for resident doctors in medical genetics department / 中华医学遗传学杂志

Clinical practice of Medical Genetics involves application of various genetic techniques for the diagnosis of genetic disorders and subsequent genetic counseling and treatment. The principles of Medical Ethics must be fully taken into account when applying genetic knowledge for medical practice. Medical Ethics education is therefore essential for the standardized training of resident doctors in medical genetics department. With a basic system of Medical Genetics Physician Training established, our hospital has made a preliminary exploration for the development of Medical Ethics teaching in resident training through various teaching practices including seminar, network teaching, case study, scene teaching and outpatient teaching, with an aim to strengthen Medical Ethnics knowledge, professionalism and communication skills, and implement Medical Ethics principles throughout clinical practice.

Analysis on clinical effects of two surgical approaches in percutaneous spinal endoscopy for LS disc herniation / 中国骨伤

OBJECTIVE@#To analyze the clinical effects, complications and operational key points of the percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID) in treating LS disc herniation.@*METHODS@#The clinical data of 158 patients with L5S1 disc herniation treated from July 2015 to March 2018 were restospectively analyzed. According to different surgical approaches, the patients were divided into PETD group or PEID group, 79 cases in each group. In PETD group, there were 41 males and 38 females, with an average age of (41.38±6.25) years and course of disease of (10.06±3.14) months. In PEID group, there were 43 males and 36 females, with an average age of (41.18±5.78) years and course of disease of (9.99±2.83) months. The operation length, intraoperative blood loss, intraoperative fluoroscopy times, days of hospital stay, and complications were recorded between two groups. Visual analogue score (VAS), Japanese Orthopedic Association(JOA) score, Oswestry Disability Index(ODI), modified Macnab criteria were used to assessed clinical effects after operation.@*RESULTS@#All patients completed surgery and were followed up for more than 1 year. (1) There were no significant differences in the intraoperative blood loss or hospitalization length between two groups(>0.05). The operation length and intraoperative fluoroscopy times in PETD group were significantly higher than in PEID group (0.05). (3)The excellence rate was 89.87% (71 / 79) in PETD group and 87.34% (69 / 79) in PEID group at the latest follow-up, with no statistical significance(>0.05). (4)Complications occurred in 2 cases in PETD group and in 3 cases in PEID group, with no significant differences between two groups.@*CONCLUSION@#The short term efficacy of the PETD is equal to that of the PEID for the LS disc herniation, but PEID is superior in the operation length, the access of stereotaxic puncture and intraoperative fluoroscopy times. The complications can be effectively reduced by following the indications, mastering the endoscopic technique, operating carefully and being familiar with the key points of common complications.

Effect of rational emotive therapy on negative emotion in advanced schistosomiasis patients with repeated hospitalization / 中国血吸虫病防治杂志

Objective To examine the effect of rational emotive therapy on negative emotions among advanced schistosomiasis patients with repeated hospitalizations. Methods A total of 97 advanced schistosomiasis patients with anxiety and depressive emotions that were hospitalized in Xiangyue Hospital of Hunan Institute of Schistosomiasis Control for three times or more were enrolled, and given rational emotive therapy for 4 weeks in addition to routine nursing care. The scores for anxiety, depression and quality of life were estimated in patients before and after the rational emotive therapy using the Self-Rating Anxiety Scale (SRS), the Self-Rating Depression Scale (SDS) and WHOQOL-BREF Form. Results The SAS and SDS scores were significantly lower 4 weeks following rational emotive therapy than before the intervention (SAS score, 45.40 ± 7.77 vs. 59.25 ± 9.29, t = 14.021, P < 0.01; 51.48 ± 8.01 vs. 63.93 ± 9.59, t = 12.991, P < 0.01). The percentages of patients with moderate and severe anxiety and depression were significantly lower 4 weeks following rational emotive therapy than before the intervention (P < 0.01), and the scores for each item in the quality of life were all significantly greater 4 weeks following rational emotive therapy than before the intervention (P < 0.01). Conclusion Rational emotive therapy may improve the negative emotions and the quality of life of advanced schistosomiasis patients with repeated hospitalizations.