摘要
Objective:To investigate the value of musculoskeletal ultrasound examination in the evaluation of rheumatoid arthritis.Methods:A total of 89 patients with rheumatoid arthritis who received treatment in Zhejiang Rongjun Hospital from January 2020 to January 2023 were included in this study. According to the Disease Activity Score-28 for Rheumatoid Arthritis, these patients were divided into a low activity group ( n = 32), a medium activity group ( n = 36), and a high activity group ( n = 21). An additional 32 healthy controls who concurrently underwent physical examinations in Zhejiang Rongjun Hospital were included in the control group. All participants underwent a musculoskeletal ultrasound examination. Serum interleukin-1β, interleukin-6, and interleukin-23 levels were determined by an enzyme linked immunosorbent assay. Results:In the rheumatoid arthritis group, semi-quantitative scores of musculoskeletal ultrasound in terms of joint effusion, bone erosion, synovial blood flow signal, synovial hyperplasia, and total scores were (1.53 ± 0.36) points, (1.70 ± 0.45) points, (1.75 ± 0.38) points, (1.98 ± 0.42) points, and (6.97 ± 1.43) points, which were significantly higher than (0.11 ± 0.03) points, (0.14 ± 0.02) points, (0.07 ± 0.03) points, (0.15 ± 0.04) points, and (0.47 ± 0.08) points in the control group ( t = 22.23, 19.55, 24.92, 24.54, 25.63, all P < 0.05). Serum interleukin-1β, interleukin-6, and interleukin-23 levels in the rheumatoid arthritis group were (66.49 ± 15.45) ng/L, (12.33 ± 3.27) ng/L, and (206.85 ± 24.37) ng/L], which were significantly higher than (15.42 ± 4.36) ng/L, (6.58 ± 1.39) ng/L, and (124.52 ± 18.29) ng/L in the control group ( t = 18.39, 9.62, 17.41, all P < 0.05). The semi-quantitative scores of musculoskeletal ultrasound in terms of joint effusion, bone erosion, synovial blood flow signal, synovial hyperplasia, and total scores in the high activity group were significantly higher than those in the medium activity and low activity groups, and the semi-quantitative scores of musculoskeletal ultrasound in terms of joint effusion, bone erosion, synovial blood flow signal, synovial hyperplasia, and total scores in the medium activity group were significantly higher than those in the low activity group (all P < 0.05). Serum interleukin-1β, interleukin-6, and interleukin-23 levels in the high activity group were significantly higher than those in the medium activity and low activity groups, and the scores in the medium activity group were significantly higher than those in the low activity group (all P < 0.05). According to Spearman analysis, the semi-quantitative total score of musculoskeletal ultrasound was positively correlated with the severity of disease activity, interleukin-1β, interleukin-6, and interleukin-23 ( r = 0.68, 0.57, 0.52, 0.62, P < 0.05). Conclusion:Musculoskeletal ultrasound is of good value in the evaluation of rheumatoid arthritis. Musculoskeletal ultrasound results are closely related to the degree of rheumatoid arthritis and inflammatory factors.
摘要
Objective:To explore the application effect of the health management mode based on symptom group management in the nursing of lung cancer patients after minimally invasive surgery.Methods:The lung cancer patients underwent minimally invasive surgery and were discharged from Shanghai Chest Hospital from April to August 2019 were selected as the study subjects. The patients were divided into control group and experimental group, with the intervention time of 1 month. Routine follow-up was carried out in the control group. The health management mode based on symptom group management was adopted in experimental group. According to the exploratory factor analysis method, three factors with characteristic value>1were extracted, and the symptoms with factor load≥0.5 were included in the symptom group, and post discharge nursing was carried out based on the symptom group, including establish health management archives, distribute symptom group manual, centralized teaching, WeChat communication, etc. Before and after nursing care, Anderson symptom evaluation form (Chinese version) was used to evaluate the symptom group score of patients and compare the interference of symptom group on daily life and the influence on quality of life.Results:A total of 40 cases (47.1%) in the control group and 45 cases (52.9%) in the experimental group were included. In the control group, 28 cases (70.0%) were male, 12 cases (30.0%) were female, the average age was (60.2±6.5) years, the average time of cancer was (8.0±2.0) months, and 21 cases (52.5%) had a history of smoking. In the experimental group, there were 30 (66.7%) males, 15 (33.3%) females, age (60.6±6.8), mean time of cancer (7.9±2.1) months, and 22 (48.9%) smokers. There was no significant difference in gender, age, average time of cancer and smoking history between the two groups (all P>0.05).There was no significant difference in factor load of those symptoms between the two groups before nursing, and there was no significant difference before and after nursing in the control group. After the intervention, the symptoms in the experimental group were less than before the intervention. The total scores of symptom group and disturbance of daily life in the experimental group were (32.4±10.3), (15.20±5.3), lower than those in the control group (44.3±11.5), (28.8±8.1), the quality of life score was (88.3±18.5), higher than that in the control group (64.2±16.5) (all P<0.05). Conclusion:The health management model based on symptom group management can improve the symptoms of patients with lung cancer after minimally invasive surgery, reduce the impact of symptom group on daily life and improve the quality of life.