Table of Content

20 February 2024, Volume 39 Issue 2

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Effect of acceptance and commitment therapy on mental health and quality of life in cancer patients: A meta-analysis

Gong Caifang, Zhao Junyu, You Chuan

2024, 39(2):  101-107.  doi:10.3969/j.issn.1004-583X.2024.02.001

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Objective To systematically evaluate the effect of acceptance and commitment therapy (ACT) on the mental health and quality of life of cancer patients. Methods Randomized clinical trials (RCTs) reporting the influence of ACT on mental health and quality of life in cancer patients were searched in the CBM, WanFang, CNKI, VIP, PubMed, Cochrane Library, Web of Science and EMbase databases, and the retrieval time was from the time of building the database to November 2022. Literature screening based on inclusion and exclusion criteria, quality assessment and data extraction were performed by two investigators. A meta-analysis was conducted using Revman5.4 software. Results A total of 14 RCTs representing 1,063 cancer patients were enrolled. Meta-analysis results showed that ACT significantly improved anxiety (SMD=-1.04, 95%CI [-1.19, -0.89], P<0.01), depression (SMD=-0.73, 95%CI[ -0.88, -0.59], P<0.01), psychological flexibility (MD=-2.17, 95%CI[-2.77, -1.57], P<0.01) and quality of life in cancer patients (MD=5.27, 95%CI [3.57, 6.98], P<0.01). Conclusion ACT can relieve anxiety and depression, improve psychological flexibility and quality of life, and positively promoting physical and mental health of cancer patients.

Diagnostic of superb microvascular imaging for breast tumors: A meta-analysis

Chen Sihan, Xiong Hu, Shui Dianya, Gao Xiaozhan, Liu Zewei

2024, 39(2):  108-114.  doi:10.3969/j.issn.1004-583X.2024.02.002

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Objective The purpose was to evaluate the value of superb microvascular imaging (SMI) for benign and malignant breast tumors by a meta-analysis. Methods We searched PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), WanFang, VIP for literature on the diagnosis of SMI for benign and malignant breast tumors from the time of building the database to September 20, 2022. Two researchers screened literature and extracted information based on inclusion and exclusion criteria. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was performed to assess the quality of the included primary literature, Review Manager 5.3 was conduted to plot the literature quality assessment chart, Stata 17.0 was used to calculate SMI for sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) of breast tumors. The area under the curve (AUC) was obtained by summary receiver operating characteristic (SROC) curve. Funnel plot was applicated to evaluate publication bias. Results Fifteen meta-analyses representing 1769 cases of breast tumor patients were included, with 1912 lesions (916 malignant nodules and 991 benign nodules). The results of the meta-analysis showed that the SEN, SPE, PLR, NLR, DOR and AUC of SROC curves for SMI in the assessment of breast lesions were 0.82 (95%CI 0.79 to 0.84), 0.87(95%CI 0.85 to 0.89), 6.58(95%CI 4.58 to 9.43), 0.19(95%CI 0.16 to 0.24), and 39.47(95%CI 27.18 to 57.31), 0.93(95%CI 0.90 to 0.95). Conclusion SMI has a high diagnostic accuracy in evaluating the differentiation of benign and malignant breast lesions.

Correlation analysis of Non-HDL-C/HDL-C and NHR with the severity of coronary artery disease

Huang Yuling, Zhang Xinyue, Rong Pingping, Yang Wenqi, Cao Xinying, Xing Cainai, Wang Zhijun, Liu Ning

2024, 39(2):  115-120.  doi:10.3969/j.issn.1004-583X.2024.02.003

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Objective To investigate the correlation of non-high-density lipoprotein cholesterol to high density lipoprotein cholesterol ratio (non-HDL-C/HDL-C), neutrophil to high-density lipoprotein cholesterol ratio (NHR) with the severity of coronary artery disease. Methods A total of 284 patients who underwent coronary angiography for the first time in the Cardiology Department of North China University of Technology Affiliated Hospital from January 2022 to June 2023 due to chest tightness and pain were selected. According to the results of coronary angiography, they were divided into the coronary artery disease group (n=223) and control group (n=61). Clinical data (general data and laboratory data), non-HDL-C/HDL-C and NHR were compared between groups. According to the Gensini score, patients in the coronary artery disease group were divided into low-score subgroup (Gensini score<30) and high-score subgroup (Gensini score≥30). Laboratory data of the two subgroups were compared. Spearman correlation analysis of the two subgroups was performed to explore the correlation of Gensini score with non-HDL-C/HDL-C and NHR count. Multivariate logistic regression analysis was performed to explore the influencing factors of high Gensini scores in patients with coronary artery disease. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of non-HDL-C/HDL-C and NHR on high Gensini scores in patients with coronary artery disease. Results The levels of non-HDL-C/HDL-C and NHR in coronary artery disease group were significantly higher than those of control group (P<0.05). Non-HDL-C/HDL-C and NHR levels in patients with high-score subgroup were significantly higher than those of low-score subgroup (P<0.05). Correlation analysis showed that non-HDL-C/HDL-C and NHR were positively correlated with Gensini scores (P<0.05). Multivariate Logistic regression analysis showed that an elevated NHR increased the risk of high Gensini score in patients with coronary artery disease (OR=1.650, 95%CI: 1.262-2.158, P<0.05). ROC curve analysis showed that the area under the curve of non-HDL-C/HDL-C and NHR to predict the severity of coronary lesions was 0.657 (95%CI: 0.582-0.732, P<0.01) and 0.736 (95%CI: 0.666-0.807, P<0.01), respectively. Conclusion Non-HDL-C/HDL-C and NHR are positively correlated with the severity of coronary artery disease, and NHR is an independent predictor of high Gensini score in patients with coronary artery disease.

Efficacy and safety of rivaroxaban therapy in elderly patients with non-valvular atrial fibrillation who had a HASBLED score≥3

Wang Yihan, Qin Xuyan, Han Xuanze, Wang Yingjie, Gao Feifei, Chen Chunhong, Zhang Lingnan, Zhang Fang

2024, 39(2):  121-124.  doi:10.3969/j.issn.1004-583X.2024.02.004

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Objective The aim of this study was to prospectively evaluate the efficacy and safety of rivaroxaban in the treatment of elderly patients with non-valvular atrial fibrillation (NVAF) who had a HASBLED score≥3. Methods A total of 90 patients over 75 years old with NVAF (HASBLED score≥3) treated with rivaroxaban from February to September in 2023, they were divided into low dose group (10 mg/d) and conventional dose group (15 mg/d). A 6-month follow-up was performed, the end points of primary efficacy were ischemic stroke, peripheral arterial embolism. The major bleeding was as a safety end point, including clinically significant minor bleeding, small bleeding as subcutaneous congestion, gingival bleeding, hematuria, occult blood positive stool, conjunctival bleeding. Results The scores of CHA2DS2-VASc and HASBLED in low dose group were significantly higher than those in conventional dose group (P<0.05). There was no significant difference in coagulation index between the two groups before treatment (P>0.05). During the 6-month follow-up, no new ischemic stroke and peripheral embolic events were observed in the low dose group and conventional dose group. There were 3 cases of occult blood positive stool, 2 cases of gingival bleeding and 3 cases of subcutaneous ecchymosis in conventional dose group. Conclusion Low-dose rivaroxaban anticoagulation therapy is effective and safety in elderly NVAF patients who HASBLED score ≥3, which provides theoretical basis for clinical application.

Correlation between serum uric acid, homocysteine and cystatin C levels with motor symptoms and cognitive function in Parkinson's disease patients

Wang Jiuxue, Li Na, Jin Wei, Wang Shuo, Chang Yajun, Wang Tianjun

2024, 39(2):  125-129.  doi:10.3969/j.issn.1004-583X.2024.02.005

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Objective To investigate the correlation between serum uric acid (UA), homocysteine (HCY) and cystatin C (Cys C) with motor symptoms and cognitive function in Parkinson's disease (PD) patients. Methods A total of 200 PD patients admitted to Hebei General Hospital from January 2019 to August 2022 were enrolled. They were divided into tremor-dominant (TD) group(n=104) and non-tremor-dominant (NTD) group(n=96) according to first-onset motor symptoms. In addition, the PD patients were grouped also into cognitive normal(PD-CN) group(n=118) and cognitive impairment (PD-CI) group(n=82) according to Montreal Cognitive Assessment. The levels of serum UA, HCY and Cys C of the PD patients were compared. Multivariate logistic regression was used to analyze the risk factors of tremor and cognitive dysfunction in PD patients. Results The patients in TD group had significantly higher serum UA levels, significantly lower Hcy and Cys C levels compared with those of the NTD group (P<0.05). The results from multiple logistic regression analysis showed that UA, HCY, and Cys C were independent risk factors for tremor in PD patients. The patients in the PD-CN group pesented significantly higher serum UA levels, significantly lower HCY and Cys C levels relative to those of the PD-CI group (P<0.05). The results from multivariate logistic regression analysis verifyed that UA, HCY, and Cys C were independent risk factors for cognitive dysfunction in PD patients (P<0.05). Conclusion The serum levels of UA, HCY, and Cys C in PD patients are correlated with motor symptoms and cognitive function.

Effect of agomelatine combined with poker-based entertainment therapy on cognitive function in patients with first-episode major depressive disorder

Yuan Fengying, Ma Xiaoling, Qu Junmin

2024, 39(2):  130-133.  doi:10.3969/j.issn.1004-583X.2024.02.006

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Objective To observe the improvement effect of agomelatine combined with poker-based entertainment therapy on cognitive impairment in patients with first-episode major depressive disorder. Methods A total of 122 patients with first-episode major depressive disorder admitted to the Psychiatric Department of Laizhou Rongjun Hospital of Yantai City from June 2019 to May 2022 were enrolled. The patients were assigned into an observation group (n=61) and a control group (n=61) by a random number table method. The control group was treated with agomelatine alone, while patients in the observation group were additionally treated with agomelatine combined with poker-based entertainment therapy. The therapeutic effects of the two groups after 8 weeks of treatment were assessed. Results Attributable to treatment interruption, the actual number of patients completed in the control group and the observation group was 60 (1 shedding) and 59 (2 shedding), respectively. There was no statistically significant difference in general information (gender, age, years of education, marital status, etc.), 17-item Hamilton Rating Scale for Depression (HAMD-17) score, and Montreal Cognitive Assessment (MoCA) between groups before treatment (P>0.05). After 8 weeks of treatment, there was no statistically significant difference in HAMD-17 score between groups (P>0.05), but significantly elevated MoCA score and decreased relapse rate were detected in the observation group relative to the control group (P<0.05). Conclusion Agomelatine combined with poker-based entertainment therapy can significantly improve cognitive function and reduce relapse in patients with first-episode major depressive disorder.

Diagnostic value of laboratory indexes in patients with pulmonary tuberculosis complicated by pulmonary embolism

Liu Lei, Li Mingwu, Wan Rong

2024, 39(2):  134-139.  doi:10.3969/j.issn.1004-583X.2024.02.007

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Objective To investigate the diagnostic value of laboratory indicators in patients with pulmonary tuberculosis (PTB) complicated by pulmonary embolism (PE), and to provide evidence for the patients. Methods Sixty inpatients with PTB and PE in our hospital from January 2019 to December 2021 were selected as the observation group. In addition, 60 patients with simple PTB matched according to 1∶1 ratio were selected as the control group. The differences in general information and related laboratory data between the two groups were observed. Binary logistic regression was used to analyze the risk factors, and the receiver operating characteristic (ROC) curve was drawn for meaningful indicators to evaluate their diagnostic value. Results The levels of white blood cells, neutrophils, C-reactive protein and procalcitonin in the observation group were significantly higher than those of the control group (P<0.05). Biochemical indicators including D-dimer, fibrinogen, troponin I, myoglobin, N-terminal pro-brain natriuretic peptide (NT-proBNP) in the observation group were significantly higher than those in the control group (P<0.05). The lymphocyte, albumin, high density lipoprotein cholesterol, oxygen partial pressure and antithrombin Ⅲ in the observation group were significantly lower than those of the control group (P<0.05). The results from binary logistic regression analysis showed that D-dimer, antithrombin Ⅲ and NT-proBNP were risk factors for PTB with PE (OR=1.302, 0.957, 1.012). The area under the curve (AUC) of D-dimer, antithrombin Ⅲ and NT-proBNP was 0.858, 0.711 and 0.831, respectively. Conclusion D-dimer>1.29 mg/L, antithrombin Ⅲ<101.6%, NT-proBNP >99.79 ng/L have certain predictive value for PE in patients with PTB, which can be used as an important index to predict PE and evaluate the prognosis of patients with PTB.

Clinical characteristics and etiological analysis of severe pneumonia complicated with acute respiratory failure in children before and after COVID-19

Huang Saihu, Long Zhongjie, Wu Shuiyan, Bai Zhenjiang

2024, 39(2):  140-143.  doi:10.3969/j.issn.1004-583X.2024.02.008

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Objective To investigate the clinical characteristics and etiological analysis of severe pneumonia complicated with acute respiratory failure (SP-ARF) in children before and after the coronavirus disease 2019 (COVID-19) outbreak in Suzhou. Methods This study retrospectively analyzed the medical records of all SP-ARF children admitted to the Children’s Hospital of Soochow University from January 2018 to December 2021, and they were divided into pre-epidemic group (January 2018 to December 2019) and post-epidemic group (January 2020 to December 2021) according to the outbreak time. The clinical data and etiological results of the two groups were analyzed. Results There were 141 cases in the pre-epidemic group and 127 cases in the post-epidemic group. The month-age of children with SP-ARF in the post-epidemic group were older than those of pre-epidemic group (P<0.05), and with a higher proportion of combined underlying diseases (P<0.05). The peak period of SP-ARF was from October to December every year regardless of before or after the epidemic. The positive rate of etiological examination in pre-epidemic group was 82.27%(116/141). The top 4 bacteria were in order of Gram-negative bacteria (36.88%), Gram-positive bacteria (26.95%), viruses (26.95%), and mycoplasma pneumoniae (9.22%). The positive rate of etiological examination in posr-epidemic group was 85.83% (109/127), and the top 4 bacteria were in order of Gram-negative bacteria (37.80%), virus (28.35%), Gram-positive bacteria (22.83%), and Mycoplasma pneumoniae (9.45%). Conclusion After the epidemic, the proportion of children without underlying diseases developing SP-ARF decreased, SP-ARF occurred frequently from October to December every year regardless of before or after the epidemic. The pathogens of the two groups were mainly bacteria, with highest proportion of Gram-negative bacteria.

Predictive value of red cell distribution width in thoracic aorta calcification in patients with different dialysis modalities

Zhang Feng, Jiang Hongying, Yang Jiao, Li Ruihe, He Ting, Li Meng

2024, 39(2):  144-148.  doi:10.3969/j.issn.1004-583X.2024.02.009

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Objective To analyze the risk factors of thoracic aortic calcification (TAC) in maintenance dialysis patients, and to explore the predictive value of red cell distribution width (RDW) in TAC of patients with hemodialysis and peritoneal dialysis. Methods Clinical data of 190 patients on long-term maintenance dialysis in the Second Affiliated Hospital of Kunming Medical University from January 2022 to June 2022 were collected. According to the finding of TAC on chest X-ray scans, patients were divided into calcification group (n=48) and non-calcification group (n=142). Risk factors of TAC in dialysis patients were analyzed by binary logistic regression analysis. The receiver operating characteristic (ROC) curve was applied to analyze the predictive value of RDW in TAC of patients with different dialysis modalities. Results The proportion of TAC was 25.3%. The RDW was significantly higher in the calcification group than that of the non-calcification group (P<0.01). Multivariate Logistic regression analysis showed that RDW (OR=1.541, 95%CI: 1.145, 2.074, P=0.004), age (OR=1.041, 95%CI: 1.008, 1.075, P=0.014), duration of dialysis (OR=1.016, 95%CI: 1.002, 1.031, P=0.025) and serum phosphate (OR=2.172, 95%CI: 1.109, 4.253, P=0.024) were independent risk factors for TAC in dialysis patients. The area under the curve (AUC) of RDW in predicting TAC in hemodialysis patients was larger than that in peritoneal dialysis patients (0.719 vs 0.661). Conclusion RDW is an independent risk factor for TAC in dialysis patients, and it has a better predictive value in hemodialysis patients than that in peritoneal dialysis patients.

Intracranial infection of varicella zoster virus in adults: Clinical analysis of 5 cases

Liu Wanqi, Fan Shuqin, Zhuang Ruixue, He Feng, Liu Zhenchuan, Xie Zhongxiang

2024, 39(2):  149-154.  doi:10.3969/j.issn.1004-583X.2024.02.010

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Objective To investigate the clinical features, cerebrospinal fluid (CSF) examination, imaging findings, treatment and outcome of intracranial infection of varicella zoster virus (VZV), thus providing reference for clinical diagnosis and treatment. Methods Clinical data of 5 VZV patients admitted to the Department of Neurology of Linyi People's Hospital from April 2019 to April 2023 was retrospectively summarized for the assessments of clinical manifestations, auxiliary examination, treatment and prognosis. Results Among the five patients with intracranial infection of VZV, males were more than females, with the mean age of (53.6±10.9) years, and acute onset and a history of preinfection. Clinical manifestations of all patients with intracranial infection of VZV were headache, fever and focal neurological deficits. Imaging findings showed there were no obvious abnormalities or involvement of brain parenchymal in the 5 patients. The lesion infiltrated supratentorially and infratentorially with hemorrhage when the infection involved the brain parenchyma. Metagenomic next-generation sequencing (mNGS) of CSF suggested that 5 cases of increased leukocytes (399.4±84.20)×10⁶/L, 4 cases of decreased chloride (107.65±7.17) mmol/L, 5 cases of significantly increased protein content (2.85±1.33) g/L, 4 cases of CSF/plasma glucose ratio <0.6, (0.52±0.05). Five patients were confirmed by mNGS of CSF. The prognosis of antiviral therapy was good. Conclusion The onset of intracranial infection of VZV is seen in middle-aged and elderly, with a younger trend. The severity of clinical symptoms depends on whether the infection involves the brain parenchyma. The CSF manifestations associated with intracranial infection of VZV were similar to those of tuberculous meningitis. The mNGS detection can improve the sensitivity and accuracy of the identification. The prognosis of most patients is relatively good with early treatment on the cause and symptoms.

Colonic telangiectasia combined with bleeding: A case report and literature review

Ren Huaijing, Tao Jianan, Ma Zhenqi, Wang Xuehong

2024, 39(2):  155-159.  doi:10.3969/j.issn.1004-583X.2024.02.011

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Objective To explore the clinical characteristics and diagnostic and therapeutic strategies of colonic telangiectasia. Methods A retrospective analysis was conducted on the clinical data of a patient with colonic telangiectasia who presented with repeated gastrointestinal bleeding and anemia, and relevant literature was reviewed. Results A 56-year-old female patient presented with recurrent black stools and alternating fresh bloody stools. Colonoscopy showed extensive network-like, dendritic, and spider nevus-like capillary dilation in multiple locations around the mucosa from the cecum to the descending colon, with the maximum of approximately 5mm × 5mm. She was finally diagnosed with colonic telangiectasia. Conclusion Colonic telangiectasia, also known as colonic vascular dysplasia, is more common in elderly patients. It is mostly asymptomatic, and gastrointestinal bleeding is an occasional symptom. Electronic colonoscopy is an important diagnostic method for colonic telangiectasia, and lesions are more common in the right colon. Asymptomatic patients do not require treatment, and those with concurrent bleeding may consider medications or local hemostasis under endoscopy.

Mitochondrial mutation m.3243A> G associated with diabetes mellitus: One case report and literature review

Lv Shasha, Song Jinlan, Shi Jian

2024, 39(2):  160-163.  doi:10.3969/j.issn.1004-583X.2024.02.012

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Objective To investigate the screening and treatment of mitochondrial diabetes mellitus (MDM). Methods In this retrospective analysis, the clinical data and treatment process of one patient with m.3243A>G mutation-related MDM were analyzed, and relevant literature was reviewed. Results The 42-year-old female patient was admitted to the hospital due to poor blood glucose control and limb numbness. Combined with testing for mitochondrial gene, the patient received insulin combined with empagliflozin. Blood glucose control was improved and insulin dosage was reduced. Conclusion MDM has insulin resistance.Insulin combined with with SGLT-2 inhibitors can be treated, and its potential benefits need more comprehensive research.