Abstract:Objective:To explore the effect of vascular access core nursing team and Roy adaptation model interven-tion in hemodialysis(HD)patients.Methods:A total of 152 HD patients from October 2022 to February 2023 who were admitted to Xiamen University Affiliated First Hospital were selected,and randomly divided into observation group(n=7 6,vascular access core nursing team and Roy adaptation mode intervention)and control group(n=76,rou-tine intervention).Negative emotions,disease management ability,quality of life,and complications were compared in both groups.Results:The self rating anxiety scale(SAS)and self rating depression scale(SDS)in both groups was no statistically significant difference before intervention(P＞0.05).After intervention,the scores in both groups were de-creased,and in comparison of the control group,the intervention group was lower(P＜0.05).The disease management ability scores and short form of health survey(SF-36)score in both groups was no statistically significant difference before intervention(P＞0.05).After intervention,the scores in both groups were increased,and in comparison of the control group,the intervention group was higher(P＜0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion:The application of the vascular access core nursing team and Roy adaptation model intervention for HD patients,which can improve negative emo-tions,enhance disease management ability and quality of life,and reduce the occurrence of complications.

Abstract:Objective:To investigate the high risk factors of complicated anal fistula after incision and drainage in patients with perianal abscess.Methods:The clinical data of 102 patients with perianal abscess from December 2020 to December 2023 were analyzed retrospectively.They were divided into two groups based on whether complicated anal fistula.The basic data of age,sex,body mass index,course of disease,perianal abscess range,surgical incision,compli-cated diabetes,complicated hypertension,incision and drainage operation time,perianal abscess depth,complicated smoking history,preoperative use of antibiotics,complicated constipation were collected.Univariate analysis was per-formed first,and then Logistic regression analysis was performed to obtain the high-risk factors affecting postopera-tive anal fistula in patients with perianal abscess.Results:Among 102 patients,38 cases were complicated with anal fis-tula after operation,the incidence rate was 37.25％.Univariate analysis showed that the range of perianal abscess,sur-gical incision,complicated diabetes,incision and drainage operation time,perianal abscess depth of perianal abscess and complicated constipation were the influencing factors of postoperative anal fistula in patients with perianal abscess(P＜0.05).Multivariate analysis showed that two or more quadrants of perianal abscess,multiple surgical incisions,diabetes mellitus,incision and drainage time ≥15 min,deep perianal abscess and constipation were the high risk factors for post-operative anal fistula in patients with perianal abscess(P＜0.05 and OR＞1).Conclusion:The patients with perianal abscess are closely associated with 2 or more quadrants of perianal abscess,multiple surgical incisions,combined diabe-tes,incision and drainage operation time of 15 min,deep perianal abscess and constipation.It is also necessary to do tar-geted intervention to reduce the occurrence of anal fistula and reduce the pain of patients.

Abstract:Objective:To investigate the effect of home care intervention based on the model on elderly patients with essential hypertension(EH).Methods:Sixty elderly EH patients admitted to the hospital from April 2023 to April 2024 were divided into two groups,30 cases in each group.The control group was given routine care,and the observa-tion group implemented the home care intervention based on the knowing and trust model on the basis of the control group.Self-management behavior,coping style,compliance and quality of life were compared between the two groups.Results:After the intervention,the scores of the self-management behavior assessment scale(HPSMBRS)and the Chinese version of the medical coping style questionnaire(MCMQ)and the comprehensive quality of life assessment questionnaire(GQOLI-74)in the observation group were higher than those in the control group.The scores of avoid-ance and yield in MCMQ were lower than those in control group,and the difference was statistically significant.The to-tal compliance rate of the observation group was higher than that of the control group,with statistical significance(P＜0.05).Conclusion:The family care intervention based on the mode of knowing,trust and doing has a remarkable effect,which can enhance patients' treatment compliance,improve self-management behavior,change coping style,and im-prove their quality of life.

Abstract:Objective:To explore the clinical efficacy of exploring the treatment of qi stagnation and blood stasis type lumbar intervertebral disc herniation(LDH)by fire dragon pot combined with lumbar spine massage.Methods:Ninety patients with LDH of qi stagnation and blood stasis type were included,all of whom were treated in our hospital from January 2023 to January 2025,and were divided into three groups using the randomized numerical table method.Group A(n=30)was treated with fire dragon cupping,Group B(n=30)was treated with lumbar massage,and Group C(n=30)was treated with fire dragon cupping combined with lumbar massage.All three groups were treated continu-ously for 4 weeks.The three groups were compared in terms of clinical efficacy,visual analog score(VAS),ability to perform activities of daily living(ADL)score,Japanese Orthopaedic Association(JOA)score,lumbar spine mobility,traditional Chinese medicine(TCM)evidence score and safety.Results:The total effective rate in group C was higher than that in group A and group B,and the difference was statistically significant(P＜0.05).After treatment,the VAS scores of the three groups were lower than those before treatment,and the ADL scores and JOA scores were higher than those before treatment(P＜0.05),the VAS score of group C was lower than that of group A and group B,and the scores of ADL and JOA were higher than those of group A and group B,with statistical significance(P＜0.05).After treatment,the lumbar mobility of the three groups was higher than that before treatment(P＜0.05),the lumbar mobil-ity of group C was greater than that of group A and group B,and the difference was statistically significant(P＜0.05).After treatment,the TCM syndrome scores of the three groups were lower than those before treatment(P＜0.05),the TCM syndrome score of group C was lower than that of group A and group B,and the difference was statistically sig-nificant(P＜0.05).No adverse reactions were observed in the three groups.Conclusion:The treatment of LDH pa-tients with qi stagnation and blood stasis with lumbar spinal acupressure combined with the fire dragon pot has good effect,which is beneficial to improve the function of lumbar spine and the ability of daily life,reduce the pain,and has good safety.

Abstract:Objective:To understand the knowledge status and health education needs of the main caregivers of chil-dren with type 1 diabetes(T1DM)in Bengbu area,so as to develop more accurate education strategies.Methods:Total-ly 185 primary caregivers of children with T1DM in the hospital from May 2021 to May 2024 were selected as investi-gation subjects.The questionnaire survey method was used to collect the general data,diabetes mellitusknowledge mas-tery and health education needs of the respondents.Binary Logistic regression model was used to analyze the related in-fluencing factors of diabetesmellitusknowledge level of primary caregivers of children with T1DM.Results:All 185 questionnaires were distributed in this study,but 180 valid questionnaires were recovered,with a recovery rate of 97.30％.Investigation results revealed that the total score and average score of diabetesmellitus knowledge levelof primary care-givers of children with T1DM were(18.74±2.15)points.The basic knowledge of diabetesmellitus urgently needed by the primary caregivers of children with T1DM included disease control and prognosis(87.22％),identification and pre-vention of complications(86.11％),and treatment method and effect(84.44％).The urgently needed nursing knowl-edge included blood glucose monitoring(93.89％)and dietary guidance(89.89％).The primary caregivers of children with T1DM mostly obtained health knowledge from medical staff(87.78％),followed by reading relevant publicity ma-terials for themselves(7.78％)and from friends or other family members(4.44％).As for health education methods(mainly including clinical teaching and health consultation),the primary caregivers of children with T1DM mostly ex-pected to receive one-to-one guidance from medical staff(93.33％),experience introduction of other primary caregivers(81.11％),collective listening to expert lectures(80.56％)and community health services(80.00％).Health consul-tation methods included community health services(80.00％),telephone consultation(77.78％)and hospital consulta-tion(76.67％).The primary caregivers of children with T1DM who have a college education or above,a monthly family income of＞5 000 yuan,multiple ways to acquire knowledge and are in urgent need of health education scored higher on diabetes knowledge(P＜0.05).The results of binary Logistic regression analysis showed that the education level of senior high school or below,family monthly income level ≤ 5 000 yuan,single access to knowledge,and general need or lack of health education were the influencing factors for the low level of diabetes knowledge of the main caregivers of children with T1DM(P＜0.05).Conclusion:The main caregivers of T1DM children in Bengbu area have low knowl-edge of diabetes and urgent needs for health education.The level of education,family monthly income,knowledge acqui-sition and health education needs are the main factors affecting their knowledge.Clinical practice should adopt diversi-fied education methods to meet their needs based on these factors.

Abstract:Objective:To explore the risk factors and intervention strategies for post-adenoviral pneumonia(AP)obliterative bronchiolitis(BO)in children.Methods:A total of 120 pediatric patients diagnosed with AP during hospi-talization from February 2021 to January 2024 in hospital were selected as the study subjects.They were divided into BO occurrence group and BO non-occurrence group based on whether BO occurred.General clinical data from both groups were collected and analyzed,including age,gender,allergic constitution,history of wheezing,duration of fever,duration of mechanical ventilation,length of hospital stay,acute wheezing,chest X-ray showing unilateral lesion area exceeding 50％,and lactate dehydrogenase(LDH),glutamic-oxaloacetic transaminase(AST),procalcitonin(PCT)in-dicators.Univariate analysis was performed on these indicators,and those with statistical significance were included in the multivariate analysis.Results:Among the 120 pediatric patients,52 developed BO after AP,accounting for 43.33％(52/120).There were significant differences in age,wheezing history,duration of fever,duration of mechanical ventila-tion,hospitalization time,wheezing sound in acute phase and LDH index between the two groups(P＜0.05).The inde-xes with significant statistical differences in univariate analysis were included in multivariate analysis of BO after adeno-virus pneumonia in children.It was found that wheezing history(OR=1.166),long use time of mechanical ventilation(OR=10.476),wheezing in acute stage(OR=1.185)and high LDH index(OR=2.007)were the risk factors for BO after AP in children(P＜0.07).Conclusion:There is a certain risk of BO occurring after pediatric AP,and its occur-rence is associated with the child's history of wheezing,long duration of mechanical ventilation,presence of acute wheez-ing,and high LDH indicators.Intervention measures should be taken based on the specific condition of the child to re-duce the risk of BO occurrence.

Abstract:Objective:To explorethe application effect of tongue pressure resistance feedback training combined with stratified diet management in dysphagia after extubation.Methods:All 78 patients with swallowing disorders after en-dotracheal intubation admitted to Tianjin Fourth Central Hospital from March 2023 to October 2024 were randomly di-vided into two groups using a random number table method,with 39 patients in each group.Both groups were given stratified matching diet management.The control group was given conventional swallowing function training on this ba-sis,and the observation group was given tongue pressure resistance feedback training on this basis.Both groups were continuously intervened for 1 week.The swallowing function,feeding ability,complications and nutritional status of the two groups were compared.Results:After the intervention,the scores of each step and the total score of the standard swallowing function scale(SSA)in the two groups were lower than those before the intervention,and the observation group was lower than the control group,with statistical significance(P＜0.05).After the intervention,the scores of o-ral feeding function assessment scale(FOIS)and various nutritional indexes of the two groups were higher than those before the intervention,and the observation group was higher than that of the control group,with statistical significance(P＜0.05).The incidence of complications in the observation group was lower than that in the control group(P＜0.05).Conclusion:Tongue pressure resistance feedback training combined with layered dietary management can effective-ly promote the recovery of swallowing function in ICU patients with swallowing disorders after tracheal intubation and extubation,improve their feeding ability,reduce the risk of complications,and improve their nutritional status.

Abstract:Objective:To explore the effect of Rosenthal effect based psychological nursing model on mental state and self-management behavior of elderly patients with chronic obstructive pulmonary disease(COPD).Methods:All 94 elderly patients with COPD admitted to xinyang huaxin shengde rehabilitation hospital from October 2022 to Decem-ber 2023 were selected as the study objects.The patients were divided into control group and observation group by ran-dom number table,with 47 cases in each group.The control group received routine nursing.The observation group im-plemented the psychological nursing model based on Rosenthal effect on the basis of the control group.The psychologi-cal status[self-rating anxiety scale(SAS),self-rating depression scale(SDS)],self-perceived burden scale(SPBS),treatment compliance[morisky medication compliance questionnaire(MMAS-8)],coping style(SCSQ)and self-management behavior of the two groups were analyzed and compared.Results:After the intervention,the scores of SAS,SDS and SPBS in the two groups were lower than those before the intervention,and the difference was statisti-cally significant(P＜0.05).After the intervention,the MMAS-8 score and self-management behavior score were higher than before,and the observation group was higher than the control group,the difference was statistically signifi-cant(P＜0.05).After intervention,the positive coping scores of the two groups were higher than those before inter-vention,and the observation group was higher than the control group,the score of negative coping was lower than that be-fore intervention,and the observation group was lower than that of the control group,with statistical significance(P＜0.05).Conclusion:Psychological nursing model based on Rosenthal effect can improve the psychological state of elderly pa-tients with COPD,reduce the burden of self-perception,enhance the enthusiasm of treatment,and improve the level of self-management behavior.

Abstract:Objective:To explore the impact of the combined standardized process of the Plan-Do-Check-Act(PDCA)cycle on the incidence of dental mobile phone oil pockets.Methods:Seven staff members and 1 864 dental handpieces who worked in the disinfection and supply center of panyu central hospital affiliated to guangzhou medical u-niversity from February 2024 to March 2024(before the implementation of PDCA cycle joint standardization process)and seven staff members and 1 952 dental handpieces from April 2024 to May 2024(after the implementation of PDCA cycle joint standardization process)were selected as the research objects.To compare the occurrence rate,cleanliness,packaging sterilization management quality and intangible achievements of dental mobile phone oil package before and after the implementation of PDCA circulation joint standardization process(the scores of PDCA tool application ability,teamwork ability and risk prediction ability of staff in disinfection supply center).Results:Compared with before the implementation of the PDCA cycle combined with the standardized process,the incidence of dental mobile phone oil packs after the implementation of the PDCA cycle combined with the standardized process management was lower(2.05％).Dental mobile phones have a relatively high level of cleanliness.The excellent and good rate of packaging sterili-zation management quality is relatively high.The scores of quality management ability,teamwork ability and risk pre-diction ability of team members were relatively high,and the differences were statistically significant(P＜0.05).Con-clusion:The PDCA cycle combined with the standardized process can significantly reduce the incidence of oil packets in dental mobile phones,improve the quality of disinfection supply,reduce equipment wear and tear,and has high clinical promotion value.

Abstract:Objective:To analyze the risk factors affecting the occurrence of osteoporosis in patients with systemic lupus erythematosus(SLE)based on bone metabolism biochemical indexes and pro-inflammatory cytokines,and to construct an early warning model.Methods:All 182 SLE patients admitted to the Laboratory Department of the Second Affiliated Hospital of Nanchang University from January 2021 to September 2023 were selected to collect their clinical related data,which were divided into occurrence and non-occurrence groups according to whether osteoporosis oc-curred or not,and their bone metabolism biochemical indexes[blood calcium,blood phosphorus,osteocalcin,bone alka-line phosphatase(BALP),and type Ⅰ pre-collagen amino-terminal pre-peptide(PINP)were detected,bone mineral density(BMD),25-hydroxyvitamin D]and pro-inflammatory cytokines[interleukin-6(IL-6),interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)].Univariate analysis and multifactorial logistic regression analysis were used to screen risk factors for osteoporosis in SLE patients.Results:Osteoporosis occurred in 54 patients out of 182 SLE pa-tients,with an incidence rate of 29.67％.The biochemical indexes of bone metabolism,including blood calcium,blood phosphorus,osteocalcin,25-hydroxyvitamin D and BMD in occurrence were lower than those in non-occurrence group,but none of the differences were significant(P＞0.05),while BALP and PINP were higher than those in non-occurrence group,and the differences were statistically significant(P＜0.05).TNF-α levels in occurrence were higher than non-occurrence group,but the difference in comparison of IL-6 and IL-1 levels was not significant(P＞0.05).The results of univariate analysis showed that age,coronary heart disease,history of hormone medication,BALP,PINP,and TNF-α were the single factors affecting the occurrence of osteoporosis in SLE patients.The results of multifactorial a-nalysis showed that age(＞50 years),comorbid coronary heart disease,and history of hormone medication and high-level BALP,PINP,TNF-α were independent risk factors affecting the development of osteoporosis in patients with SLE(P＜0.05).Hosmer～Lemeshow test:x2=8.141,P=0.420＞0.05,goodness of fit.The AUC of the ROC curve was 0.820(95％CI:0.753～0.888),sensitivity was 79.6％,specificity was 70.3％,and maximum Yoden index was 0.499,the model differentiation was good.Conclusion:The early warning model of osteoporosis in SLE patients constructed on the basis of bone metabolism biochemical indexes and pro-inflammatory cytokines in this study has a good clinical ear-ly warning value,which can help healthcare professionals to recognize the risk of osteoporosis in patients with SLE at an early stage.

Abstract:Objective:To explore the application effect of bamboo ring salt moxibustion combined with traditional Chinese medicine hot compress in patients with knee osteoarthritis(KOA).Methods:All 100 patients with KOA were included,all of whom received treatment in Ganzhou Traditional Chinese Medicine Hospital from October 2022 to Octo-ber 2024.They were randomly divided into two groups using a random number table,with 50 patients in each group.The control group received routine nursing care,while the observation group was treated with bamboo ring salt moxi-bustion combined with traditional Chinese medicine hot compress intervention.Both groups received continuous inter-vention for 10 days.The knee joint function,range of motion,stride length,pace,activity of daily living and quality of life were compared between the two groups.Results:After the intervention,the osteoarthritis index(WOMAC)and visual analogue scale(VAS)in the observation group were lower than those in the control group,while the joint mobili-ty,step length,walking speed and SF-36 scores were higher than those in the control group,with statistical signifi-cance(P＜0.05).Conclusion:The combination of bamboo ring salt moxibustion and traditional Chinese medicine hot compress can alleviate pain,improve knee joint function and range of motion in patients with knee osteoarthritis,and en-hance their quality of life.

Abstract:Objective:To evaluate the efficacy of midnight-noon ebb-flow acupuncture combined with banxia baizhu tianma decoction in treating headache during the recovery phase of ischemic stroke.Methods:Eighty-two pa-tients with post-ischemic stroke headache admitted to hospital from January 2024 to December 2024 were randomly divided into two groups,41 cases in each group.The control group received conventional symptomatic therapy and oral flunarizine hydrochloride,while the observation group received additional midnight-noon ebb-flow acupuncture and banxia baizhu tianma decoction for 20 days.Efficacy,pain intensity[visual analogue scale(VAS)],clinical symptom scores,and adverse reactions were compared.Results:The total effective rate of the observation group was higher than that of the control group,with statistical significance(P＜0.05).After treatment,the VAS score and clinical symptom score of the two groups decreased,and the difference was statistically significant(P＜0.05).There was no significant difference in adverse reactions between the two groups(P＞0.05).Conclusion:The combination of midnight-noon ebb-flow acupuncture and banxia baizhu tianma decoction effectively alleviates headache severity and frequency in post-ischemic stroke recovery patients,with a favorable safety profile.

Abstract:Objective:By comparing the test results of the two test reagents,the correlation between the results of quantitative detection of hepatitis B virus nucleic acid(HBV-DNA)by a domestic reagent(reagent A)and an impor-ted reagent(reagent B)was explored,so as to select a more suitable reagent for laboratory project development and clinical disease monitoring and treatment.Methods:ALL 95 cases of patients with hepatitis B clinically diagnosed in Changzhou Third Peoples Hospital from May 2024 to October 2024 were collected,and two reagents A and B were used for parallel detection,respectively.The detection results were compared and the correlation and difference between the two reagents were analyzed.Results:The detection rates of reagent A(90.53％)was higher than B reagent(82.11％),and there was no significant difference between the quantitative results(P=0.706).The quantitative results of reagent A was well correlated with B reagent,and the correlation co-efficient was 0.987,respectively,and differences were statistically significant(P＜0.001).Conclusion:Reagent A has good correlation with reagent B.There is no significant difference in the quantitative results.They can be used for quantitative detection of HBV-DNA in clinical laboratories to meet the antiviral requirements of hepatitis B patients.and basic requirements for treatment monitoring.

Abstract:Objective:To explore the construction of a nomogram prediction model for refractoriness to platelet transfusion(RPT)in patients with hematologic diseases due to the production of platelet antibodies based on transfu-sion-related factors and immunological analysis,with a view to providing a reference for clinical work.Methods:A to-tal of 195 patients with hematological diseases from July 2021 to July 2024 in Henan Provinical Peoples Hospital were selected and divided into effective group(164 cases)and ineffective group(31 cases)according to the effect of platelet transfusion.The baseline data,transfusion-related and immune factors of the two groups were compared.Logistic re-gression was used to analyze the independent influencing factors of RPT,and a nomogram model of RPT was construc-ted,and the prediction efficiency of the model was tested.Results:There were significant differences in sex,age,female pregnancy history,blood diseases,active bleeding/disseminated intravascular coagulation(DIC)and drugs between the two groups(P＜0.05).There were significant differences in the number of transfusion and platelet antibody between the two groups(P＜0.05).Logistic regression analysis revealed that female pregnancy history,blood disease types such as ITP and MDS,active bleeding/DIC,medications,number oftransfusion＞5 times,and the presence of platelet anti-bodies were independent influencing factors for RPT(P＜0.05).Additionally,the Hosmer-Lemeshow x2=13.285 with P=0.182.A nomogram model was constructed,and the test results indicated that the model exhibited good pre-dictive performance for RPT,demonstrated good discrimination,and had a significant positive net benefit within a prob-ability threshold of 0.05 to 0.94.Conclusion:The RPT risk prediction model,constructed based on transfusion-related factors and immunological analysis,exhibits good predictive performance and positive clinical net benefit.It can serve as an effective model for clinical prediction of RPT,thereby guiding clinical prevention and treatment.

Abstract:Objective:To explore adverse drug reaction(ADR)signals of zanubrutinib,so as to provide reference for medication safety in the clinic.Methods:Reports of zanubrutinib isrimary suspect drug-related ADR were collected from the American food and drug administration(FDA)adverse event reporting system(FAERS)database from Janu-ary 1,2019 to September 30,2024.Reporting odds ratio(ROR)method and medicines and proportional reportingratio(PRR)were used for data mining.The preferred system organ classification(SOC)and preferred terminology(PT)in the ICH Medical Dictionary for Regulatory Activities(MedDRA)were used to describe,classify and analyze ADR.Re-sults:A total of 1 472 ADR reports related to zanubrutinib were retrieved.This signal mining involves 24 kind of SOC,which were general disorders and administration site conditions/injury,poisoning and procedural complications,skin and subcutaneous tissue disorders.Conclusion:Before the application of zanubrutinib,a clinical medication assessment must be conducted,and during the treatment period,special attention should be paid to the risks of bleeding,hematological system,second primary malignancies,and infections in patients to ensure the safety of the treatment.

Abstract:Objective:To explore the influence of different volume heparin saline sealing on coagulation function of dialysis catheter without tunnel and polyester sheath in patients with continuous renal replacement therapy(CRRT).Methods:All 108 cases of CRRT patients admitted to the First Hospital of Putian City from January 2021 to January 2024 were randomly divided into two groups,45 cases in each group.The control group was sealed with heparin solution with 100％lumen volume,while the observation group was sealed with heparin solution with 80％lumen volume.The coagulation indexes[prothrombin time(PT),activated partial thromboplastin time(APTT)and prothrombin time ac-tivity(PT A),fibrinogen(Fig)],blood indexes[hemoglobin(Hb),latelet count(PLT)]and the incidence of adverse prognosis events(catheter blockage,bleeding,bleeding tendency)of patients with catheter closure.Results:After tube sealing,the PT and APTT of the two groups were lower than those before tube sealing,while the PT and APTT levels of the observation group were lower than those of the control group,and the PT A and Fig levels were higher than those of the control group,with statistical significance(P＜0.05).The Hb and PLT in the control group were lower after tube sealing,and the difference was statistically significant(P＜0.05).However,there was no significant difference in the levels of Hb and PLT in the observation group before and after tube sealing(P＞0.05).The levels of Hb and PLT in the observation group were higher than those in the control group,and the difference was statistically significant(P＜0.05).After tube sealing,the incidence of bleeding and bleeding tendency in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05),but there was no statistical differ-ence in the incidence of catheter blockage between the two groups(P＞0.05).Conclusion:For CRRT patients who use dialysis catheter without tunnel and polyester sheath,the application of heparin solution with 80％lumen volume has a good effect,which can improve the coagulation function of patients more effectively,reduce the incidence of bleeding or bleeding tendency of patients,and will not increase the risk of catheter blockage.

Abstract:Objective:To evaluate the value of multi-stage dynamic enhanced scanning in the diagnosis of rich cell type uterine leiomyoma(CUL)and degenerative uterine leiomyoma(DUL).Methods:All 30 patients with CUL and 60 patients with DUL received in hospital from January 2021 to December 2023 were selected,and all patients underwent multi-phase dynamic enhanced magnetic resonance scanning.Results:The parameter values of volume transport con-stant(Ktrans),model rate constant(Kep),vascular(plasma)interstitial volume fraction(Vp)and extravascular extra-cellular volume ratio(Ve)of cell-rich uterine leiomyoma were higher than those of degenerative uterine leiomyoma(P＜0.05).CUL hysteromyoma can be better observed in the diagnosis of ET model value(ET)Ktrans.When the area un-der the curve reaches 0.956,the sensitivity and specificity can reach 1.000 and 0.867 respectively.In addition,when the area under the curve of Kep is 0.868 in ET model,the sensitivity and specificity can reach 1.000 and 0.756 respective-ly.Conclusion:Ktrans,Kep,Vp and Ve have higher differentiation efficiency in differentiating DUL from CUL hystero-myoma,which is helpful for doctors to accurately judge the patient's condition.

Abstract:Objective:To evaluate the efficacy and safety of remazolam combined with ropivacaine in intraspinal an-esthesia for elderly patients undergoing lower extremity fracture surgery.Methods:A total of 80 elderly patients sched-uled for intraspinal anesthesia for lower limb fracture surgery were randomly divided into two groups using a random number table:the control group(n=40)received intraspinal anesthesia with propofol and ropivacaine,while the study group(n=40)received intraspinal anesthesia with remazolam and ropivacaine.The anesthetic effect,respiratory and circulatory parameters,and incidence of adverse reactions were compared between the two groups.Results:The propor-tion of patients with vigilance/sedation observation(OAA/S)score ≥3 was significantly higher in the study group than in the control group(P＜0.05).The observation time and extubation time in the post-anesthesia care unit were shorter in the study group compared to the control group(P＜0.05).Respiratory rate(RR)and oxygen saturation(SpO2)decreased significantly at t2 but gradually increased at t3-t5;There was no significant difference in RR and SpO2 levels between the two groups at t1-t5(P＞0.05).There was no significant difference in the levels of mean arte-rial pressure(MAP)and heart rate(HR)between the two groups at t1(P＞0.05).They all decreased significantly at t2,increased at t3,and then decreased gradually.The levels of MAP and HR in the observation group were better than those in the control group at t2-t5(P＜0.05).The incidence of adverse reactions was significantly lower in the study group than in the control group(P＜0.05).Conclusion:Intraspinal anesthesia with remazolam combined with ropiva-caine provides superior anesthetic effects,faster recovery,shorter extubation times,stable hemodynamic parameters,and fewer anesthetic-related adverse reactions in elderly patients with lower extremity fractures.

Abstract:Objective:To study the efficacy Tianmeng oral liquid as an adjunctive therapy for fluvoxamine in the treatment of adolescent depression.Methods:The clinical data of 100 patients with depression admitted to Anyang Peo-ple's Hospital from August 2022 to December 2024 were selected and divided into observation group(n=52,treated with Tianmeng Oral Liquid combined with fluvoxamine)and control group(n=48,treated with fluvoxamine)according to different treatment methods.The treatment effect,depression degree,sleep quality,quality of life and adverse reac-tions were compared between the two groups.Results:There was no significant difference in clinical efficacy and inci-dence of adverse reactions between the two groups(P＞0.05).After 4 and 8 weeks of treatment,the scores of depres-sion and sleep quality in the observation group were lower than those in the control group,and the scores of quality of life were higher than those in the control group,with statistical significance(P＜0.05).Conclusion:The application of Tianmeng oral liquid combined with fluvoxamine in the treatment of adolescent depression patients can improve the de-gree of depression,and improve sleep quality and quality of life.

Abstract:Objective:To analyze whether the predicted endotracheal diameter of the subglottic transverse diameter measured by ultrasound is consistent with the clinically optimal endotracheal inner diameter compared with the multiva-riate formula measurement,and to evaluate the accuracy of ultrasound measurement of subglottic transverse diameter in predicting the model of adult endotracheal tube.Methods:According to the inclusion and exclusion criteria,patients who underwent orotracheal intubation in the department of critical care medicine of mianyang central hospital from June 2022 to June 2023 were selected as the research objects.According to the random number table method,the research objects were randomly divided into an ultrasound group and a formula group.In the ultrasound group,the model of the catheter was predicted by measuring the subglottic transverse diameter with ultrasound,and the inner diameter of the catheter was recorded as T1.The formula group predicts the model of the catheter according to the multivariate calcula-tion formula,and the inner diameter of the catheter is recorded as T2.The respiratory therapist determines the most suitable catheter model through cuff leakage test,and the inner diameter of the catheter is marked as T.The accuracy of tracheal catheter model selection and the incidence of complications such as hypoxemia,laryngeal edema and reflux aspi-ration after tracheal intubation were recorded.Results:A total of 224 patients were included,including 120 in the for-mula group and 104 in the ultrasound group.The accuracy rate of one-time tracheal intubation in the ultrasound con-trol group was 8 2.7％,and that in the formula control group was 68.3％,the difference was statistically significant(P＜0.05).The incidence of laryngeal edema and hypoxemia in ultrasound group was lower than that in formula group,and the difference was statistically significant(P＜0.05).Conclusion:The use of ultrasound to measure the sub-glottic transverse diameter has a high accuracy in predicting the type of endotracheal tube,which is helpful to select the appropriate type of endotracheal tube and reduce the occurrence of hypoxemia,laryngeal edema,regurgitation and aspi-ration after tracheal intubation.