Journal of Clinical Medicine Research

Journal Information
ISSN / EISSN : 2717-6088 / 2717-6096
Published by: Frontier Scientific Publishing Pte Ltd (10.32629)
Total articles ≅ 40
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Menglu Zhang, Xiaozhi Bai, Yuting Zhang, Xiaojuan Xie
Journal of Clinical Medicine Research, Volume 2; https://doi.org/10.32629/jcmr.v2i3.424

Abstract:
Objective — To investigate the occurrence and risk factors of postoperative delirium in patients with esophageal cancer. Methods — A review of 203 patients undergoing elective surgery for esophageal cancer from April 2019 to December 2020, including 122 males and 81 females. The incidence of postoperative delirium were evaluated through the use of the CAM and divided into delirium group (Group P) and non-delirium group (Group N) according to whether postoperative delirium occurred. Possible confounders and clinically important factors were included in the univariate analysis, and all variables with P-values less than 0.05 in the univariate analysis were included in the multivariate models. Results — A total of 38 cases (18.7%) of postoperative delirium occurred in 203 patients. Group P was significantly older than Group N (P=0.000<0.01). The Patient Health Questionnaire 9 (PHQ-9) scores (P=0.01<0.05) and the FRAIL Scale scores of Group P were significantly higher than those of the N group (P=0.001<0.05). The educational level (P=0.001<0.01) and Mini-Mental State Examination (MMSE) scores (P=0.004<0.01) of Group P were significantly lower than those of Group N. The use rate of sevoflurane in Group P (P=0.011<0.05), the incidence of intraoperative hypotension (P=0.002<0.05), and the rate of Porphyromonas gingivalis infection (P=0.012<0.05) were higher than those in Group N. Multivariate logistic regression analysis showed that age (OR=1.295, 95%CI 1.125 ~ 1.490) and Porphyromonas gingivalis infection (OR=2.898, 95%CI 1.055 ~ 7.959) were independent risk factors for postoperative delirium in patients with esophageal cancer. Conclusion — age and Porphyromonas gingivalis infection may be the independent risk factors for postoperative delirium in patients with esophageal cancer.
Shengting Huang, Shiying Huang
Journal of Clinical Medicine Research, Volume 2; https://doi.org/10.32629/jcmr.v2i3.469

Abstract:
Objective — To study the clinical efficacy of miglitol combined with insulin in the treatment of newly diagnosed type 2 diabetes mellitus. Methods — 96 newly diagnosed type 2 diabetes patients admitted to our hospital from January 2021 to September 2021 were selected as the subjects of this study. They were randomly divided into two groups by drawing lots. The control group was treated with acarbose combined with insulin glargine, and the observation group was treated with miglitol combined with insulin glargine. Fasting blood glucose, 2h postprandial blood glucose, glycosylated hemoglobin (HbA1c), blood glucose compliance time, occurrence of adverse reactions and quality of life score of 2 groups were measured before and after treatment. Results — After treatment, fasting blood glucose, 2h postprandial blood glucose and HbA1c in both groups were lower than before (P < 0.05), and there was no statistical significance in the difference between the two groups and the time of blood glucose reaching the standard (P > 0.05). The incidence of adverse reactions in observation group was lower than that in control group, and the quality of life score in observation group was better than that in control group (P < 0.05). Conclusions — Miglitol or acarbose combined with insulin glargine can effectively control blood glucose in patients with newly diagnosed type 2 diabetes, but miglitol combined with insulin glargine has fewer adverse reactions, which can be used as the first choice for clinical treatment of newly diagnosed type 2 diabetes.
Xijing Liao, Xueyan Yang
Journal of Clinical Medicine Research, Volume 2; https://doi.org/10.32629/jcmr.v2i3.459

Abstract:
CRISPR-Ca9 system is a newly developed gene-editing technology, which is widely used in biology and medical research. In this project, we want to knock-in a mutation found in a human pedigree into mice through CRISPR-Cas9 technology to validate its pathogenic effect. We download corresponding mice genomic sequences and design guide RNA and donor oligo sequences according to CRISPR-Cas9 target principles. Following experiments confirm that this set of sequences is effective in mice cell line.
Qing Wang
Journal of Clinical Medicine Research, Volume 2; https://doi.org/10.32629/jcmr.v2i3.468

Abstract:
Objective — To explore the diagnostic value of bedside transthoracic echocardiography combined with bedside lower extremity venous ultrasonography in patients with venous thromboembolism. Methods — Select 97 patients with high-risk Caprini scores and high-risk Padua scores from December 2019 to April 2021 in the Second Affiliated Hospital of Shandong First Medical University as the research objects, all of whom completed bedside transthoracic echocardiography combined with bedside lower limbs or upper extremity venous ultrasound examination; compare the results of different ultrasound examinations with spiral CT pulmonary angiography (CTPA); analyze the diagnostic value of bedside transthoracic echocardiography combined with bedside lower extremity venous ultrasound in patients with pulmonary embolism. Results — 97 patients with high-risk Caprini score and high-risk Padua score were confirmed by CTPA in 41 cases of pulmonary embolism; bedside transthoracic echocardiography, bedside lower extremity or upper extremity venous ultrasonography for venous thromboembolism were all positive in 35 cases; among them, 32 cases were confirmed by CTPA as pulmonary embolism, and the diagnostic compliance rate with the gold standard was 87.63%; bedside transthoracic echocardiography combined with bedside lower extremity venous ultrasonography had a diagnostic sensitivity of 78.05% and a diagnostic specificity of 94.64%; Conclusion — Bedside transthoracic echocardiography and bedside lower extremity venous ultrasonography combined for venous thromboembolism can improve the specificity of diagnosis, and it is worthy of popularization and application.
Zheng Yao
Journal of Clinical Medicine Research, Volume 2; https://doi.org/10.32629/jcmr.v2i3.458

Abstract:
Objective — To explore the effect of Huaier granule combined with transcatheter arterial chemoembolization (TACE) in the treatment of advanced liver cancer. Methods — From January 2017 to January 2020, 150 patients with advanced liver cancer admitted to our hospital were selected as clinical subjects for a prospective non-randomized controlled study based on different treatment schedules. Among them, 50 patients were distributed to TACE group with TACE treatment alone. Besides, 50 patients were assigned to chemotherapy group and received systemic chemotherapy with Folfox4 regimen alone. Among them, 50 patients were distributed as the observation group. The therapeutic effects of the three groups were compared. Results: The effective rate and disease control rate in observation group were significantly higher than those in TACE group and chemotherapy group (P < 0.05). The rate of adr in observation group and TACE group was significantly lower than that in chemotherapy group (P < 0.05). The survival rate of observation group was significantly higher than that of TACE group and chemotherapy group after 12 months follow-up (P < 0.05). Conclusion — The combined treatment of huaier granule and TACE can improve the therapeutic effect and survival rate of patients with advanced liver cancer.
Yifan Xue, Rui Xia, Dan Qiao
Journal of Clinical Medicine Research, Volume 2; https://doi.org/10.32629/jcmr.v2i3.467

Abstract:
Objective — To investigate the current situation of preoperative interview of standardized training anesthesiologists in Hebei province by online questionnaire. To understand the current situation of preoperative interview of standardized training anesthesiologists and screen out the main factors affecting the preoperative interview of standardized training anesthesiologists. Methods — The questionnaire is designed by the authors and is distributed through Wechat Mini Program. Questionnaire survey was conducted among standardized training anesthesiologists in several training bases in Hebei Province. Results — 313 valid questionnaires were collected. The standardized training anesthesiologists had problems such as lack of basic knowledge, lack of teacher's evaluation on their preoperative interview, and don't know how to improve. In addition, the number of preoperative interviews in neurosurgery and cardiothoracic surgery was relatively small, and the ability of preoperative interviews in specialized surgery was insufficient. Conclusion — To improve the quality of preoperative interviews, standardized training anesthesiologists need to improve the training and evaluation system and enhance teaching.
Yidong Hao, Rui Xia, Qifei Li, Xiaoyong Zhao, Xiangyu Liu
Journal of Clinical Medicine Research, Volume 2; https://doi.org/10.32629/jcmr.v2i3.470

Abstract:
Objective — To observe the effects of ropivacaine combined with ketorolac transverse abdominis plane (TAP) block on postoperative analgesia in patients undergoing gynecological laparoscopic surgery. Methods — 90 ASAⅠorⅡpatients, aged 18-65 years and weighting 40-80 kg, scheduled for gynecological laparoscopic surgery were recruited and divided into three groups using random number table:ropivacaine combined with ketorolac 15 mg/side for TAP block (KR group), ropivacaine for TAP block and 30 mg preoperatively intravenous ketorolac (KIVR group) and ropivacaine for TAP block alone (R group) with 30 patients in each group. Intraoperative opioid consumption, Bruggrmann comfort scale (BCS) scores at 2h (T1), 4h (T2), 8h (T3), 12h (T4), 16h (T5), 24h (T6) after surgery were recorded. Adverse reactions such as nausea and vomiting, respiratory depression, local anesthetic poisoning, gastrointestinal bleeding, and complications related to TAP block operation were recorded. Results — The total consumpsion of sufentanil was higher in the R group than that in the KIVR group and KR group (P < 0.05). The total dosage of remifentanil in R group was higher than that in KR group (P < 0.05). The BCS scores of the three groups at T3, T4, T5 and T6 were lower in R group than that in KR group (P < 0.05) while R Group was lower than KIVR group at T3 and T4 (P < 0.05), and KIVR group was lower than KR group at T5 and T6. There was no statistically differences in BCS score between the three groups at T1 and T2 (P > 0.05). No statistical differences in the incidence of adverse reactions among all groups were observed. Conclusion — Ropivacaine combined with ketolorac transverse abdominisplane block reduced the intraoperative opioid consumption, improved postoperative comfort score and do not increased the incidence of adverse reactions in gynecological laparoscopic surgery.
Xiangyi Xu, Chaohu Li
Journal of Clinical Medicine Research, Volume 2; https://doi.org/10.32629/jcmr.v2i3.457

Abstract:
Ultrasound examination during pregnancy has become an important part of prenatal care in China and even the world, and it has a vital diagnostic role for malformations and lesions of various fetal systems. A variety of fetal malformations can be treated in utero after prenatal diagnosis or timely treatment after delivery. However, many congenital diseases cannot be confirmed by ultrasound diagnosis, or the prenatal ultrasound performance is inconsistent with the postpartum clinical outcome, which has become a shortcoming of ultrasound diagnosis during pregnancy. This article reviews the main points of ultrasound diagnosis of common fetal malformations.
Julia Chen Sun
Journal of Clinical Medicine Research, Volume 2; https://doi.org/10.32629/jcmr.v2i3.462

Abstract:
Idiopathic normal pressure hydrocephalus (iNPH) is an uncommon yet potentially reversible cause of dementia in the elderly. It is characterized by cognitive deterioration, urinary incontinence, ventriculomegaly (enlarged cerebral ventricles) and gait apraxia. The diagnosis and management of iNPH requires an organized approach, starting with a comprehensive history and neurologic examination, a review of neuroimaging, and an evaluation of diagnosis. It is important to treat comorbidities in patients prior to specific iNPH testing, which includes testing patient responses to temporary CSF removal and assessing CSF hydrodynamics. In carefully selected patients, all physiological and neurological symptoms improved with a ventriculoperitoneal (VP) shunt surgery, which allows for a gradual adjustment in pressure to prevent complications caused by over-drainage.
Jun Cao, Qianfeng Jiang, Mingliang Fang
Journal of Clinical Medicine Research, Volume 2; https://doi.org/10.32629/jcmr.v2i3.455

Abstract:
Objective — To investigate the effects of angiotensin 1-7 (Ang1-7) on plasma membrane ATPase isoform 1 (PMCA1) in salt-sensitive hypertensive rats. Methods — Thirty newborn male Wistar rats were selected to establish the salt-sensitive hypertensive rat model with sensory nerve injury, which were then randomly divided into 5 groups (n=5), including model group, Telmisartan group, Ramipril group, Ang1-7 group, and A-779 group. Another normal control group was established (n=5). After 4 weeks of intervention, the tail blood pressure of rats in each group was measured, and then the apical tissue of left ventricle was cut. The contents of AngⅡ and Ang1-7 in cardiomyocytes were detected by enzyme-linked immunosorbent assay. The expression of PMCA1 mRNA and protein in heart of salt-sensitive hypertensive rats were detected by RT-PCR and immunohistochemistry. Results — (1) Compared with the normal control group, the concentration of AngⅡ in the myocardium of salt-sensitive hypertensive rats increased (P < 0.05), which decreased after the intervention of Telmisartan and Ramipril (P < 0.05), and no change occurred after the intervention of Ang1-7 in concentration (P>0.05). (2) Compared with the normal control group, the concentration of myocardial Ang1-7 in salt-sensitive hypertensive rats decreased (P < 0.05), and increased after the intervention of telmisartan and ramipril (P < 0.05), and increased after the intervention of A-779 (P < 0.05). (3) The expression of PMCA1 mRNA and protein in salt-sensitive hypertensive rats was increased compared with the normal control group (P < 0.05), and the expression of Ang-(1-7), telmisartan and ramipril was decreased compared with the model group (P < 0.05). The expression of p38MAPK mRNA and p-p38MAPK protein in the myocardium of salt-sensitive hypertensive rats was increased compared with that in the normal control group (P < 0.05), and the expression of Ang-(1-7), Telmisartan and Ramipril was decreased compared with that in the model group (P < 0.05). Conclusion — Ang-(1-7) may be involved in the regulation of cardiac calcium pump, inhibiting its overcompensation and delaying the occurrence of calcium pump inhibition in the early stage of salt-sensitive hypertension. Ang-(1-7) can inhibit the activity of p38MAPK and protect the heart, and its regulation on PMCA1 may be mediated by the expression of p38MAPK pathway.
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