Table of Content

20 December 2024, Volume 39 Issue 12

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Rehabilitation effect of transcranial direct current stimulation on unilateral spatial neglect in stroke patients: a network meta-analysis

Zhang Qi, Sun Zengxin, Zhao Yue, Yuan Ye, Qin Xiaolu, Lyu Hongxiang, Yin Yu, Zhang Yawen

2024, 39(12):  1061-1072.  doi:10.3969/j.issn.1004-583X.2024.12.001

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Objective To compare the rehabilitation efficacy of transcranial direct current stimulation (tDCS) with different stimulation modes on unilateral spatial neglect (USN) in post-stroke patients with unilateral spatial neglect (USN) by a network meta-analysis. Methods Randomized controlled trials (RCTs) and randomized cross-over experiments (RCEs) reporting post-stroke patients with USN were searched in CNKI, Wanfang Data, VIP, PubMed, Embase, Cochrane Library, Web of Science, and ProQuest databases. The search time was from the establishment of the database to May 2024. Patients in the control group were given sham stimulation or conventional physical therapy, and those in the experimental group were treated with tDCS via different stimulation methods. Two researchers screened the literature and extracted the data. RevMen5.3 and Stata 14.0 software were used for data analysis. Results Eleven studies representing 462 patients were included. The results showed that the Line Bisection Test (LBT) and the Star Cancellation Test (SCT) scores after multi-target stimulation, anodic stimulation and cathodic stimulation were significantly higher in the experimental group than those of the control group. The Behavioral Inattention Test (BIT) score in post-stroke patients with USN was significantly improved by the anodic and multi-target stimulation in comparison to the cathodic stimulation. The largest surface under the cumulative ranking curve (SUCRA) of stimulation modes in improving the LBT score in post-stroke patients with USN was observed in multi-target stimulation (84.4%), followed by anodic stimulation (82.4%), cathodic stimulation (77.8%), dual-channel stimulation (76.3%), sham stimulation (52.5%), dual-channel stimulation combined with physical therapy (30.3%), anode combined with physical therapy (22.7%), multi-target stimulation combined with physical therapy (17.9%) and physical therapy (5.8%). The largest SUCRA of stimulation modes in improving the SCT score in post-stroke patients with USN was observed in the multi-target stimulation (67.1%), followed by anodic stimulation (66.7%), dual-channel stimulation (56.0%), anodic stimulation combined with physical therapy (47.7%), cathodic stimulation (43.2%), sham stimulation (41.6%), and multi-target stimulation combined with physical therapy (27.7%). The largest SUCRA of stimulation modes in lowering the BIT score in post-stroke patients with USN was observed in the multi-target stimulation (99.7%), followed by anodic stimulation combined with physical therapy (61.1%), multi-target stimulation combined with physical therapy (59.8%), anodic stimulation (59.4%), sham stimulation (20.0%) and cathodic stimulation combined with physical therapy (0.0%). Conclusion The available evidence shows that on the basis of sham stimulation and conventional control, multi-target stimulation and anodic stimulation are better than cathodic stimulation and various stimulation combined with physical therapy in improving USN in post-stroke patients. Due to the quantitative and qualitative limitations of the included trials, these results still need to be used with caution, and more and higher-quality studies need to be cited for further validation in the future.

Cognitive-behavioral therapy on the psychological state of patients with suicidal tendencies:a meta-analysis

Zhang Xuemei, Zhang Xian, Dong Xue, Guo Yanjie

2024, 39(12):  1073-1080.  doi:10.3969/j.issn.1004-583X.2024.12.002

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Objective To evaluate the effectiveness of cognitive behavioral therapy for suicidal tendencies by meta-analysis. Methods Randomized controlled trials reporting cognitive behavioral therapy for suicidal tendencies published until April 26,2023 were searched in the PubMed, Ovid, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and China Biology Medicine(CBM).Two investigators independently screened the literatures, extracted data and performed quality evaluation. Meta-analysis was conducted using RevMan 5.2 software. Results A total of 13 articles involving 1,660 patients with suicidal tendencies were included. The results of the meta-analysis showed that in contrast to the usual care and routine care, cognitive behavioral therapy more significantly reduced suicidal ideation (SMD=-0.35, 95%CI -0.51, -0.18,P<0.0001), and improved the depression (SMD=-0.34, 95%CI -0.46, -0.21,P<0.00001), anxiety (SMD=-0.22, 95%CI -0.38, -0.06,P=0.007), despair (SMD=-0.23, 95%CI -0.38, -0.08,P=0.003) and quality of life (SMD=0.32, 95%CI 0.07, 0.57,P=0.01). Conclusion Cognitive behavioral therapy can reduce suicidal ideation in suicidal tendency patients and significantly improve negative emotions such as depression, anxiety and despair, but the improvement of quality of life lacks sufficient evidence, and more studies should be conducted.

Application of vericiguat in elderly patients with heart failure with reduced ejection fraction

Wang Ting, Chai Chunyan

2024, 39(12):  1081-1084.  doi:10.3969/j.issn.1004-583X.2024.12.003

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Objective To evaluate the efficacy and safety of vericiguat in the treatment of heart failure with reduced ejection fraction (HFrEF) in elderly patients. Methods A total of 46 HFrEFpatients older than 75 years treated in our hospital from January 2023 to August 2024 were retrospectively recruited for analyses. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), serum potassium (K⁺), creatinine (Cr), N-terminal B-type natriuretic peptide precursor (NT-proBNP), six-minute walking test (6MWT) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) scores before and 3 months after treatment were compared. Results There were no significant differences in SBP, DBP, HR, K⁺ and Cr between the two groups after 3 months of treatment (P>0.05). NT-proBNP, 6MWT and KCCQ after 3 months of treatment were significantly improved by the treatment of vericiguat (P<0.05). Conclusion Vericiguat has little effects on SBP, DBP, HR, K⁺ and renal function in elderly patients with HFrEF, but improve cardiac function and quality of life.

Impact of stylistic training on the coping style and quality of life of schizophrenia patients during the rehabilitation period

Wu Zhouwen, He Xinyi

2024, 39(12):  1085-1088.  doi:10.3969/j.issn.1004-583X.2024.12.004

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Objective To explore the effects of stylistic training on the coping style and quality of life of schizophrenia patients during the rehabilitation period. Methods A total of 60 schizophrenia patients in the rehabilitation period re-visited in the Outpatient of Yunnan Psychiatric Hospital from March 2022 to March 2023 were included as the study subjects. They were randomly assigned into the stylistic training group ( n=30) and the control group ( n=30) according to the random number table method. All patients were given medication compliance + health education, and those in the stylistic training group were additionally stylistic training for 4 weeks. The effect of medical response style and quality of life were evaluated by the Medical Coping Modes Questionnaire (MCMQ) and the 36-item Short Form Health Survey (SF-36), respectively. Results After 4 weeks of intervention, 15 cases dropped out, including 8 cases in the stylistic training group and 7 cases in the control group. There were no differences in the subscales of MCMQ and SF-36 between the two groups at baseline. After 4 weeks, the yield dimension score of MCMQ (17.73±2.93 vs 19.78±3.69) and the avoidance dimension score (17.73±2.16 vs 19.43±2.06) in the stylistic training group were significantly lower than those of the control group, while the face dimension score (19.14±3.09 vs 16.78±3.74) was significantly higher than the control group (P<0.05). After 4 weeks, the scores of each dimension of SF-36 were as follows: somatic pain dimension (69.18±10.42 vs 61.91±12.91), overall health dimension (55.32±7.00 vs 47.09±11.14), life vitality dimension (55.77±7.14 vs 50.26±9.45), social function dimension (61.23±11.14 vs 54.09±9.25), emotional function dimension (53.36±10.30 vs 46.17±12.89), mental health dimension (48.50±5.23 vs 44.13±6.56) scores were significantly higher than those of the control group (P<0.05). Conclusion Stylistic training can improve coping style and quality of life of schizophrenia patients during the rehabilitation period.

Causal relationship between reflux esophagitis and otitis media: a two-sample Mendelian randomization analysis in the European population

Hu Rongqiu, Yan Le

2024, 39(12):  1089-1094.  doi:10.3969/j.issn.1004-583X.2024.12.005

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Objective Observational studies have shown an association between otitis media (OM) and gastroesophageal reflux disease (GERD). However, traditional studies have biases that limit our understanding of the impact of GERD on OM. Methods A two-sample Mendelian randomization (MR) approach with the random-effects inverse variance weighted model was adopted to analyze genome-wide association study (GWAS) data in the European population from the available online database. The causal relationship between GERD and OM in the European population was analyzed. MR-Egger regression and weighted median were also used as supplements. Sensitivity analysis was performed by Cochran's Q test, MR Pleiotropy RESidual Sum and Outlier test (MR-PRESSO) and Mendelian randomization-Egger (MR-Egger) intercept tests, including horizontal pleiotropy and heterogeneity tests, to ensure the reliability of the study results. Results According to the IVW model, a causal relationship was found between GERD and acute suppurative otitis media (ASOM) ( O R=1.208; 95% C I: 1.030-1.416, P=2.00e-2). A causal relationship between GERD and chronic suppurative otitis media (CSOM) was strongly demonstrated ( O R=2.085, 95% C I: 1.329-3.270, P=1.38e-3). However, there was no causal relationship between GERD and non-suppurative otitis media (NSOM) ( O R=1.151, 95% C I: 0.970-1.366, P=2.50e-1), and a consistent correlation pattern was observed in some MR models. In addition, little evidence of bias was found in the sensitivity analyses. Conclusion The genetic susceptibility of GERD to ASOM and CSOM tends to increase, suggesting that GERD should be checked, and appropriate treatment should be selected when treating OM.

Clinical features and genetic variations of pseudohypertrophic muscular dystrophy in children

Li Jie, Cui Xinyi, Li Jianwei, Cui Qingyang, Tang Chenghe, Li Shujun

2024, 39(12):  1095-1100.  doi:10.3969/j.issn.1004-583X.2024.12.006

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Objective To analyze the clinical features and genetic variations of pseudohypertrophic muscular dystrophy (PMD) in children. Methods From August 2016 to May 2024, 107 children with PMD diagnosed by genetic testing in the Department of Pediatrics of the First Affiliated Hospital of Xinxiang Medical University and Dongguan Eighth People's Hospital / Dongguan Children's Hospital were included. The clinical manifestations, biochemical testing and genetic variation results were analyzed. Results All 107 patients were male, and the main clinical manifestations were muscle weakness, elevated transaminase and creatine kinase. Creatine kinase, alanine aminotransferase and aspartate aminotransferase increased significantly. Through high-throughput sequencing and multiplex ligation-dependent probe amplification, it was found that most of the anti-amyotrophic globulin genes had exon deletion mutations ( n=73), and exon duplication mutations, and minor mutations were detected in 12 and 22 cases, respectively. All mutations could occur anywhere in the gene, but dominantly in the exon 44-55 region ( n=60, 70.59%). Conclusion Muscle weakness, elevated transaminase and creatine kinase are the main clinical manifestations of children with PMD. Children with significant elevation of transaminase and creatine kinase need to be tested for anti-muscle atrophy globulin gene.

Effect of cinobufotalin combined therapy on cancer pain in patients with advanced non-squamous non-small cell lung cancer with Qi-Yin deficiency

Liu Yunfei, Chen Taoli, Wang Yanpeng, Sui Junzhao, Wang Qichuan

2024, 39(12):  1101-1105.  doi:10.3969/j.issn.1004-583X.2024.12.007

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Objective To investigate the effect of cinobufotalin combined therapy on the control of cancer pain in advanced non-squamous non-small cell lung cancer (NSCLC) with Qi-yin deficiency and its underlying mechanism. Methods A total of 76 NSCLC patients with Qi-Yin deficiency treated from May 2020 to October 2022 were recruited. They were assigned into the treatment group ( n=38) and control group( n=38) by random number table method. All patients were given conventional chemotherapy and analgesia treatment, and those in the treatment group were additionally given oral cinobufotalin capsules. After two months of treatment, the effect of cancer pain control, serum inflammatory factors (interleukin-6 [IL-6], interleukin-10 [IL-10], tumor necrosis factor-α [TNF-α], interferon-γ [INF-γ]), pain transmitters (5-hydroxytryptamine [5-HT), substance P [SP], neuropeptide Y [NPY], and β-endorphin [β-EP]) were compared between the two groups. Results During the experiment, 1 case dropped out the treatment group and 2 cases dropped out the control group. Finally, 73 cases were enrolled, involving 37 cases in the treatment group and 36 cases in the control group. The Numerical Rating Scale (NRS) score of the treatment group was significantly lower than that of the control group (P<0.05), and the effective rate was significantly higher (94.59% vs 77.78%, χ²=4.365, P<0.05). Serum IL-6, TNF-α and INF-γ contents in the treatment group were significantly lower than those of the control group, and IL-10 level was significantly higher (P<0.05). Serum 5-HT, SP and NPY in the treatment group were significantly lower than those of the control group, but β-EP was significantly higher (P<0.05). Conclusion Cinobufotalin combined therapy can alleviate cancer pain of advanced NSCLS with Qi-yin deficiency and improve the pain control effect via the antagonistic inflammatory response and regulation of pain neurotransmitters.

Effects of family-centered advance care planning on ACP readiness and quality of life in patients with advanced cancer

Wang Hongqian, Fang Xuewen

2024, 39(12):  1106-1110.  doi:10.3969/j.issn.1004-583X.2024.12.008

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Objective To analyze the effects of family-centered advance care planning (ACP) on ACP readiness and quality of life in advanced cancer patients. Methods A total of 82 patients with advanced cancer admitted to the oncology department of a top-three hospital in Yunnan Province were randomly divided into control group (n=42) and intervention group (n=40). The control group received routine clinical nursing measures for cancer patients, and the intervention group received family-centered ACP plus routine nursing care. ACP readiness and quality of life before and 1 week and 1 month after intervention between groups were analyzed. Results After intervention, there were significant differences in the ACP readiness and quality of life between the two groups (P<0.05). Conclusion Family-centered ACP can effectively improve the ACP readiness and improve the quality of life of advanced cancer patients.

Treatment experience of giant renal hamartoma rupture and hemorrhage in a patient with tuberous sclerosis complex and literature review

Jia Minnan, Liu Qiong, Xu Ruoyun, Niu Kai

2024, 39(12):  1111-1114.  doi:10.3969/j.issn.1004-583X.2024.12.009

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Objective To explore the causes and effective treatment of giant hamartomas. Methods The diagnosis and treatment of 1 case of nodular sclerosis with giant renal angiomyolipoma rupture and hemorrhage were retrospectively analyzed, and the relevant literatures at home and abroad were reviewed. Results The patient was treated with arterial embolization due to rupture and bleeding. After surgery, the patient developed fever and acute kidney injury, with a high risk of rebleeding that requires a renal resection. Conclusion Tuberous sclerosis combined with renal hamartoma is not likely to cause abnormal renal function. For patients with rupture and bleeding, conservative or interventional embolization is preferred. The disease is hereditary in families, and early diagnosis and monitoring are essential.

Treatment of hypokalemia and rhabdomyolysis caused by compound liquorice tablets: A case report and literature review

Liu Yingrou, Song Hui, Li Guanjiang, Zhang Xiugang

2024, 39(12):  1115-1118.  doi:10.3969/j.issn.1004-583X.2024.12.010

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Objective To explore the effective treatment of hypokalemia combined with rhabdomyolysis caused by compound liquorice tablets. Methods The clinical diagnosis and treatment of 1 case of hypokalemia combined with rhabdomyolysis caused by compound liquorice tablets for treating dry cough was retrospectively analyzed, and the relevant literature was reviewed. Results A 71-year male presented for 7 days of anorexia and numbness of limbs. After admission, the medical history was inquired and laboratory tests were performed. He was diagnosed as severe hypokalemia combined with rhabdomyolysis and metabolic alkalosis caused by compound liquorice tablets. After withdrawal of the compound licorice tablets, potassium infusion and fluid replacement, the hypokalemia was corrected, and the muscle enzyme level gradually returned to normal with a good prognosis. Conclusion Hypokalemia combined with rhabdomyolysis is an adverse event of using licorice preparations, leading to acute renal failure, multi-organ dysfunction syndrome or even death. Early detection and intervention generally result in a favorable prognosis.