Objective: To explore the significance of serum cytokeratin 18-M30 fragment (CK18-M30) and cytokeratin 18-M65 fragment (CK18-M65) levels in screening of fatty liver in physical examination population, and analysis of risk factors for fatty liver. Method: A total of 147 physical examiners from July 2020 to June 2022 in Taicang First People's Hospital were selected as the subjects of this study. The detection of fatty liver in physical examiners was recorded, and they were divided into fatty liver group (n=38) and non fatty liver group (n=109) according to whether they had fatty liver. The expression levels of CK18-M30 and CK18-M65 in serum of the two groups were compared, the factors influencing fatty liver were analyzed by univariate and multivariate logistic regression, and the application value of their expression levels in the diagnosis of fatty liver was analyzed with receiver operating characteristic (ROC). Result: Among 147 examiners, a total of 38 patients with fatty liver were detected, with a detection rate of 25.85% (38/147). The expression levels of CK18-M30 and CK18-M65 in the serum of the fatty liver group were higher than those of the non fatty liver group, the differences were statistically significant (P<0.05). The results of univariate analysis showed that there were no significant differences in gender, age, and the levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and aspartate aminotransferase (AST) between the two groups (P>0.05). The body mass index (BMI), waist circumference, the proportion of diabetes, hypertension, hyperlipidemia and alanine aminotransferase (ALT) levels in the fatty liver group were significantly higher than those in the non fatty liver group, the differences were statistically significant (P<0.05). Multivariate logistic regression analysis showed that high BMI (OR=1.874), high waist circumference (OR=2.114), combined diabetes (OR=2.257), high CK18-M30 (OR=2.577), and high CK18-M65 (OR=1.974) were independent risk factors for fatty liver (P<0.05). The results of ROC analysis showed that the area under the curve (AUC) of CK18-M30 and CK18-M65 in the diagnosis of fatty liver was 0.885 (95%CI: 0.822, 0.948), significantly higher than 0.735 (95%CI: 0.636, 0.834) of CK18-M30 alone and 0.778 (95%CI: 0.704, 0.853) of CK18-M65 alone. Conclusion: High BMI, High waist circumference, combined diabetes, high CK18-M30 and high CK18-M65 are independent risk factors for fatty liver. The levels of CK18-M30 and CK18-M65 show abnormally high expression in the serum of patients with fatty liver, which has good clinical diagnostic effect in fatty liver, and can be used as effective indicators for screening fatty liver in the physical examination population.

Objective: To analyze the influence of hospital to family seamless model nursing on the stigma and negative psychology of patients undergoing enterostomy. Method: A total of 80 patients undergoing enterostomy admitted to the Department of General Surgery of the First Affiliated Hospital of Xiamen University from January 2021 to June 2022 were selected as the study objects. They were divided into control group and observation group according to random number table method, with 40 cases in each group. The control group was given routine nursing, and the observation group was given hospital to family seamless model nursing on the basis of control group. Stigma, negative psychology before and after nursing and gastrointestinal function recovery time were compared between the two groups. Result: After nursing, the scores of social exclusion, intrinsic shame and social isolation in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). After nursing, depression score and anxiety score in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). The first feeding time, first ostomy defecation time and first ostomy exhaust time in the observation group were significantly earlier than those in the control group, and the differences were statistically significant (P<0.05). Conclusion: The hospital to family seamless model nursing can effectively reduce the sense of shame and negative psychological emotions of patients, and is more conducive to promoting the recovery of gastrointestinal function of patients.

　　Constipation is a common clinical symptom, which often leads to anorectal diseases, colorectal cancer, acute myocardial infarction, cerebrovascular accidents and other diseases. It affects the daily life of patients and causes economic and social burden. The unique "holistic concept" and "syndrome differentiation and treatment" theoretical system of traditional Chinese medicine has advantages in the treatment of constipation. In clinical practice, chronic constipation is common in the form of asthenia constipation, mainly in the form of Qi deficiency and Yin deficiency, and mostly mixed with each other. Therefore, this paper briefly describes the methods of treating constipation with deficiency of both Qi and Yin in recent years, with a view to providing inspiration or improving the deficiency of the treatment of constipation with deficiency of both Qi and Yin.

Objective: To explore the efficacy of mindfulness therapy in schizophrenia rehabilitation period patients. Method: A total of 100 schizophrenic rehabilitation period patients admitted to Qinzhou Psychiatric Hospital from January to October 2022 were selected as the research objects. They were randomly divided into observation group and control group, with 50 cases in each group. Both groups were treated with the same antipsychotic drugs. The control group was administered with routine health education, and the observation group was administered with mindfulness therapy. The medication adherence rate, and anxiety scores, depression scores, quality of life scores before and after the intervention were compared between the two groups. Result: The medication adherence rate of the observation group was 98.00%, which was higher than 80.00% of the control group, the difference was statistically significant (P<0.05). After intervention, the self rating anxiety scale (SAS) score and self rating depression scale (SDS) score of the observation group were (46.63±5.44) points and (47.69±5.56) points respectively, which were lower than (51.61±6.30) points and (53.17±5.72) points of the control group, the differences were statistically significant (P<0.05). The total score of the schizophrenia quality of life scale (SQLS) in the observation group was (20.71±5.21) points, which was significantly lower than (23.86±5.65) points of the control group, and the difference was statistically significant (P<0.05). Conclusion: Implementing mindfulness therapy in schizophrenic rehabilitation period patients can effectively improve the medication adherence, alleviate the anxiety and depression symptoms, improve the cognitive abilities such as attention and memory, enhance the emotional regulation ability, and improve the quality of life after prognosis.

In recent years, chromosome karyotype analysis combined with copy number variation sequencing (CNV-seq) technology is a common means of clinical prevention of birth defects in non-invasive prenatal testing (NIPT) high-risk pregnant women for prenatal diagnosis, detection of fetal serious genetic defects, and clinical intervention after informed consent. Due to its advantages of high sensitivity, specificity, accuracy, and non-invasive, noninvasive prenatal test (NIPT) technology has gradually become the mainstream technology for clinical prenatal screening in recent years. Chromosome karyotype analysis technology has always been considered as the "gold standard" for diagnosing chromosomal aberrations, and is also a first-line method for prenatal diagnosis of chromosomal diseases. The main limitation of chromosome karyotype analysis is that it can not effectively detect the small structural and genetic variations of chromosomes. CNV-seq technology can not only detect conventional chromosome number and structural abnormalities, but also provide more accurate detection information for chromosome fragments from unknown sources. Microdeletion and microduplication of chromosome fragments above 5 Mb can also be detected. However, CNV-seq technology has limitations such as inability to detect balanced translocation and inversion of chromosomes, so the advantages and disadvantages of the two prenatal diagnostic techniques can complement each other. Traditional karyotype analysis combined with CNV-seq technology for prenatal diagnosis will provide more accurate and reliable prenatal diagnosis results for NIPT high-risk pregnant women and reduce birth defects. This article will briefly review the clinical application of chromosome karyotype analysis combined with CNV-seq technology in prenatal diagnosis of NIPT high-risk pregnant women, providing reference for clinical work.

Psoriasis is an inflammatory skin disease that occurs under the joint action of multiple factors such as genetics, environment, immunity etc. The interleukin-23 (IL-23) / T helper cell 17 (Th17) pathway is an important research achievement of the pathogenesis of psoriasis in clinical practice. Phosphodiesterase 4 (PDE4) inhibitors had a good blocking effect on cyclic adenosine monophosphate (cAMP) hydrolysis process, and effectively affected IL-23 secretion. This article briefly summarizes the pathogenesis of psoriasis, the mechanism of PDE4 inhibitors in the treatment of psoriasis and the progress of related PDE4 inhibitors drugs in the treatment of psoriasis.

Objective: To explore the effect of graded pain management based on numeric rating scales (NRS) in patients with subarachnoid hemorrhage (SAH) after surgery. Method: A total of 83 patients with SAH who underwent interventional embolization in Zhangzhou Hospital from January 2021 to January 2022 were enrolled in the study, the patients were divided into the control group (n=41) and the observation group (n=42) according to the random number table method. The control group was given routine pain management after SAH, and the observation group was given graded pain management based on NRS score. The pain score and self-efficacy score at different times, complications and satisfaction were compared between two groups. Result: There were no significant differences in NRS scores between two groups before and 10 d after intervention (P>0.05); the NRS scores of both groups decreased at 1 d, 3 d, 5 d and 10 d after intervention, the NRS scores in the two group at 1 d, 3 d and 5 d after intervention were significantly lower than those in the control group, the differences were statistically significant (P<0.05). There was no significant difference in the score of general self-efficacy scale (GSES) between two groups before intervention (P>0.05); the GSES scores in the observation group at 1 d, 3 d, 5 d and 10 d

Objective: To investigate the expression and significance of mutant P53 protein in the tissues of prophylactic salpingectomy. Method: A total of 929 patients who underwent laparoscopic total or subtotal hysterectomy and bilateral salpingectomy for benign uterine lesions in Xiamen Maternal and Child Health Care Hospital from May 2014 to September 2018 were collected, there were 827 cases of laparoscopic total hysterectomy+bilateral salpingectomy and 102 cases of laparoscopic subtotal hysterectomy+bilateral salpingectomy. The expression of mutant P53 protein in fallopian tube tissue was detected by immunohistochemistry. The factors affecting the expression of mutant P53 protein was analyzed, and followed up the occurrence of serous ovarian cancer after surgery. Result: There were no statistically significant differences in the expression of mutant P53 protein in different fallopian tube tissues among patients with benign uterine disease type, tubal ligation history, cesarean section history and age (P>0.05); however, there was significant difference in the expression of mutant P53 protein in different fallopian tube tissues among patients with the levels of carbohydrate antigen 125 (CA125) (P<0.05). logistic regression analysis showed that CA125 positive was a risk factor for mutant P53 positive protein expression (P<0.05). There was no serous ovarian cancer in the mutant P53 protein positive group after total uterus + bilateral salpingectomy and subtotal uterus + bilateral salpingectomy. Conclusion: The positive rate of mutant P53 protein expression in the tissues of prophylactic salpingectomy was 14.32%, and CA125 positive was a risk factor for mutant P53 positive protein expression, no serous ovarian cancer occurred in these patients after postoperative follow-up.

Objective: To compare the differences in clinical pharmacodynamic characteristics between Ciprofol and Propofol. Method: From July to October 2021, 80 patients underwent internal fixation of distal upper limb fractures in the Affiliated Hospital of Panzhihua University were randomly divided into Ciprofol group and Propofol group, 40 cases in each group. After the completion of ultrasound-guided brachial plexus block, two groups were intravenously pumped with 2 mg/kg Propofol and 0.4 mg/kg Ciprofol for 1 min. The mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO₂) and bispectral index (BIS) were recorded and compared between two groups before administration (T0) and 1 min (T1), 2 min (T2), 3 min (T3), 4 min (T4), 5 min (T5) after the start of pumping drugs; the induction time, consciousness recovery time and orientation recovery time of two groups were observed; in addition, the injection pain score and adverse reactions were compared between the two groups. Result: There were significant differences in MAP, HR, SpO₂ and BIS at different time points between two groups (P<0.05); MAP and SpO₂ at T1, T2, T3, T4, T5 in Propofol group were lower than those at T0, the differences were statistically significant (P<0.05); MAP at T1 and T2 in Ciprofol group were lower than those at T0, and SpO₂ at T1, T2, T3, T4 were lower than those at T0, the differences were statistically significant (P<0.05); MAP and SpO₂ at T1, T2, T3, T4, T5 of Ciprofol group were higher than those of Propofol group, the differences were statistically significant (P<0.05); HR at T1 and T2 of two groups were higher than those at T0, the differences were statistically significant (P<0.05); HR at T1 and T2 of Ciprofol group were lower than those of Propofol group, the differences were statistically significant (P<0.05); BIS at T1, T2, T3, T4 and T5 of two groups were lower than those at T0, the differences were statistically significant (P<0.05). The induction time, consciousness recovery time and orientation recovery time of Ciprofol group were significantly shorter than those of Propofol group, and the differences were statistically significant (P<0.05 ). The visual analogue scale (VAS) score and incidence of hypotension and hypoxemia in Ciprofol group were lower than those in Propofol group, and the differences were statistically significant (P<0.05). Conclusion: The anesthetic efficacy of 0.4mg/kg Ciprofol was equivalent to

Objective: To explore the application effect of new surgical film and optical cable storage tray for operation in operating room management. Method: Random number table method from January to December 2021 to the Second Affiliated Hospital of Nanhua University after treated 280 patients with urinary calculi surgery was divided into A, B, C, D four groups, each group of 70 cases. Group A was treated with a new surgical film, group B with surgical optical cable storage tray, group C with conventional intervention, group D with a new surgical film combined with surgical optical cable storage tray. The infection status of each group, the satisfaction of patients and medical staff were compared, and the cost was calculated. Result: There was significant difference in the incidence of infection among four groups (P<0.05); the incidence of infection in group D was lower than those in group A, group B and group C, the differences were statistically significant (P<0.05). There was significant difference in the nursing satisfaction of patients among four groups (P<0.05); the nursing satisfaction of patients in group D was higher than those of group A, group B and group C, the differences were statistically significant (P<0.05). There was significant difference in the satisfaction of surgical medical staff among four groups (P<0.05); the satisfaction of surgical medical staff in group D was higher than that in group C, the differences was statistically significant (P<0.05). There was significant difference in the cost accounting among four groups (P<0.001); the economic cost in group D was lower than that in group C, but which was higher than those in group A and group B, the differences were statistically significant (P<0.05). Conclusion: The new surgical film and optical cable storage tray in the operation process of patients with urinary calculi surgery can not only reduce the infection in the operating room, but also improve the satisfaction of patients and medical staff, and reduce the cost of medical consumables.

Objective: Preclinical models often fail to capture the different heterogeneity of human malignant tumors, thus lacking clinical predictive ability. Patient derived tumor xenotransplantation (PDX) has become a powerful technique that preserves the molecular heterogeneity of its original samples. Among them, renal subcapsular xenotransplantation technology is a method of establishing a human cancer model in animals, which has received increasing attention in recent years. Based on this technology, medical researchers can study the biological characteristics, histological characteristics, and treatment responses of cancer by transplanting primary tumors obtained from patients into the renal capsule of mice, and then observing long-term reproduction and observation in mice. The article reviewed the progress and application of this technology in clinical and basic medical research in recent years, showcasing its advantages in the field of tumor treatment and research, providing reference for clinical and basic researchers in tumor prevention and treatment research.

Migraine is a common chronic neurovascular disease in clinical practice, with repeated attacks, stubborn and difficult to heal as the main characteristics, to the patient's physical and psychological caused significant distress, greatly affecting the quality of life of patients. In recent years, the in-depth study of intestinal microecology theory has found that intestinal flora can participate in the occurrence and development of migraine through various ways. Based on the theory of "microbial-gut-brain axis", this paper discusses the four aspects of meridians, Qi and blood, emotions, phlegm turbidity, so as to provide the basis for the treatment of migraine by spleen and stomach in traditional Chinese medicine.

Objective: To analyze the effect of Snake Antivenins and Agkistrodon Acutus Antivenin in the treatment of trimeresurus stejnegeri bite. Method: A total of 126 patients with trimeresurus stejnegeri bite who admitted to the First Affiliated Hospital of Longyan, Fujian Medical University from January 2019 to December 2022 were included as the study objects, and they were divided into the anti-pit viper group, the anti-five-step snake group and the combined group, with 42 cases in each group. The anti-pit viper group was treated with Snake Antivenins, the anti-five-step snake group was treated with Agkistrodon Acutus Antivenin, and the combined group was treated with Snake Antivenins combined Agkistrodon Acutus Antivenin. The rehabilitation and the blood routine, inflammatory indexes and coagulation function before and after treatment among three groups were compared. Result: The swelling disappearance time of affected limb, pain disappearance time and hospitalization time in the combined group were shorter than those in the anti-pit viper group and the anti-five-step snake group, the swelling disappearance time of affected limb, pain disappearance time and hospitalization time in the anti-five-step snake group were shorter than those in the anti-pit viper group, and the differences were statistically significant (P<0.05). After treatment, the erythrocyte, hemoglobin, white blood cell count, calcitonin, C-reactive protein, serum amyloid A, prothrombin time, thrombin time and fibrinogen in three groups were significantly improved compared with those before treatment, and the differences were statistically significant (P<0.05), the erythrocyte, hemoglobin and fibrinogen in the combined group were higher than those in the anti-pit viper group and the anti-five-step snake group, the white blood cell count, calcitonin, C-reactive protein and serum amyloid A were lower than those in the anti-pit viper group and the anti-five-step snake group, the prothrombin time and thrombin time were shorter than those in the anti-pit viper group and the anti-five-step snake group, and the erythrocyte, hemoglobin and fibrinogen in the anti-five-step snake group were higher than those in the anti-pit viper group, the white blood cell count, calcitonin, C-reactive protein and serum amyloid A in the anti-five-step snake group were lower than those in the anti-pit viper group, and the prothrombin time and thrombin time in the anti-five-step snake group were shorter than those in the anti-pit viper group, the differences were statistically significant (P<0.05). Conclusion: Both Snake Antivenins and Agkistrodon Acutus Antivenin can effectively improve the blood routine, inflammatory response and coagulation function of patients bitten by trimeresurus stejnegeri, the improvement effect of Agkistrodon Acutus Antivenin is better than that of Snake Antivenins, the combination of two can further enhance the clinical efficacy, accelerate the rehabilitation process, and shorten the time of symptom improvement and hospitalization.

Objective: To explore the application effect of early warning management intervention based on nurses' crisis awareness in stroke patients with hemiplegia. Method: A total of 116 patients with stroke hemiplegia who received treatment in Jiangsu Rongjun Hospital from January 2020 to June 2022 were selected as the study objects and randomly divided into two groups, with 58 patients in each group. The control group was given routine intervention, and the observation group was given early warning management intervention based on nurses' crisis awareness. The incidence of deep vein thrombosis (DVT) and lower limb swelling, limb motor function, negative emotion and quality of life were compared between the two groups. Result: After 1 week of intervention, the incidence of DVT and lower limb swelling in the observation group were significantly lower than those in the control group, the differences were statistically significant (P<0.05). After 1 week of intervention, the upper limb score, lower limb score and total score of the observation group were significantly higher than those of the control group, and the differences were statistically significant (P<0.05). After 1 week of intervention, self-rating anxiety scale (SAS) scores and self-rating depression scale (SDS) scores in the observation group were significantly lower than those in the control group, and the differences were statistically significant (P<0.05). The stroke specific quality of life scale (SS-QOL) score of the observation group was significantly higher than that of the control group after 1 week of intervention, and the difference was statistically significant (P<0.05). Conclusion: The application of early warning management intervention based on nurses' crisis awareness in stroke patients with hemiplegia can reduce the adverse events such as DVT and lower limb swelling, improve their limb motor function, and significantly relieve patients' negative emotions and promote the improvement of their quality of life.

The intestinal flora is large in number and variety, which is an important microorganism that determines the level of human health. Maintaining the diversity and abundance of intestinal flora can largely avoid the occurrence of a series of diseases such as intestinal inflammation. This article discusses the effects of phages on human intestinal flora and intestinal inflammation. Based on the relevant studies of many scholars, this article reviews the effects of intestinal phages on intestinal flora and intestinal inflammation, and proposes the use of phages to adjust the function of intestinal flora to treat intestinal inflammation, which provides a new direction for the regulation of intestinal flora and the treatment of intestinal inflammation in the future. We hope to provide some references for readers in the research and work in related fields.

Objective: To explore the status quo of postoperative autonomic perception in patients with endometrial cancer, and to analyze the related influencing factors. Method: A total of 72 patients with endometrial cancer admitted to Affiliated Hospital of Putian University from April 2020 to April 2022 were taken as the research object. The simplified Chinese version of the PEA scale (PEAS-SCV) was used to assess the level of patients' autonomic perception, a baseline data questionnaire was designed, and the clinical data of all patients were collected in detail. The differences of patients' relevant data were investigated and compared, and the possible factors were included, multivariate linear regression was used to analyze the influencing factors of postoperative autonomic perception in patients with endometrial cancer. Result: The PEAS-SCV score range of 72 patients with endometrial cancer was 50-71 points, with an average score of (60.50±5.29) points. There were statistically significant differences in endometrial cancer patients with different education level, social support, hope level and family care (P<0.05). The results of multiple linear regression analysis showed that education level, social support, hope level and family care were the influencing factors of the status of autonomic perception of endometrial cancer patients after surgery (P<0.05). Conclusion: The level of self perception of endometrial cancer patients after surgery is slightly low. Education, social support, hope level and family care are the influencing factors of the status of self perception of endometrial cancer patients after surgery.

Objective: To explore the shunt value of gene methylation testing combined with high-risk HPV testing for cervical cancer screening. Method: The clinical data of 80 women who underwent opportunistic screening at the Cervical Disease Diagnosis and Treatment Center of Quanzhou First Hospital from October 2020 to October 2022 was collected, all of whom underwent gene methylation testing, high-risk HPV testing, and cervical pathological biopsy under colposcopy. Using the results of cervical pathological biopsy as the gold standard, and the consistency of gene methylation testing, high-risk HPV testing alone and in combination with the gold standard, and the diagnostic efficacy of cervical cancer, and the screening diversion of cervical cancer were compared. Result: Among the 80 cases of cervical cancer screening, a total 23 cases were positive in cervical pathological biopsy results, accounting for 28.75% (23/80), and 57 cases were negative, accounting for 71.25% (57/80). Among the 23 positive cases, cervical squamous cell carcinoma (SCC) accounted for 43.48% (10/23), low-grade squamous intraepithelial lesions (LSIL) accounted for 39.13% (9/23), and high grade squamous intraepithelial lesions (HSIL) accounted for 17.39% (4/23). There were 16 cases diagnosed with cervical cancer by gene methylation testing, and 15 cases diagnosed with cervical cancer by high-risk HPV testing, which showed poor consistency with the gold standard (Kappa=0.372, 0.357); there were 19 cases diagnosed with cervical cancer by combining the two tests, which showed good consistency with the gold standard (Kappa=0.784). The specificity, accuracy, and negative predictive value of gene methylation testing combined with high-risk HPV testing for screening cervical cancer were significantly higher than those of gene methylation testing and high-risk HPV testing alone, the differences were statistically significant (P<0.05). There were no statistically significant differences in the sensitivity and positive predictive value of the combined test compared to the two tests alone (P>0.05). The positive testing rate of SCC in combination testing was higher than that in individual testing, and the referral rate of colposcopy was lower than that in individual testing, the differences were statistically significant (P<0.05). There were no statistically significant differences in the positive testing rates of HSIL and LSIL detected by gene methylation testing, high-risk HPV testing and combination testing (P>0.05). Conclusion: The combination of gene methylation testing and high-risk HPV testing has high value in the diagnosis of cervical cancer. It can improve the positive diagnosis rate of cervical cancer and reduce the referral rate of colposcopy through shunt testing in cytological abnormalities.

Objective: To investigate the changes of electrocardiogram characteristic and heart rate variability (HRV) indexes in patients with pre-diabetes mellitus (DM) (pre-DM) and the predictive value for cardiovascular adverse events. Method: A total of 118 pre-DM patients admitted to Youxi County General Hospital from January 2019 to December 2020 were selected as the observation group, and 83 healthy physical examination personnel in our hospital during the same period were selected as the control group. HRV indexes of the two groups were detected, electrocardiogram characteristics of the two groups were analyzed, and 1-year follow-up investigation was carried out in the observation group. The HRV index and electrocardiogram characteristics of the two groups were compared. The occurence condition of cardiovascular adverse events in the observation group was analyzed, and the R-R interval standard deviation in all sinus beats (SDNN), standard deviation of R-R interval mean (SDANN), total spectrum, Q-T interval dispersion (QTd) and corrected QTd value (QTcd) were compared between patients with and without cardiovascular adverse events. The influencing factors of the occurence of cardiovascular adverse events in pre-DM patients was analyzed multifactorially. The predictive value of SDANN, QTd and QTcd for cardiovascular adverse events was analyzed. Result: The SDNN, SDANN and total spectrum in observation group were lower than those in control group, and QTd and QTcd were greater than those in control group, the differences were statistically significant (P<0.05). After 1-year follow-up, 21 patients in the observation group had cardiovascular adverse events, the incidence was 17.80% (21/118). In the observation group, the SDANN of patients with cardiovascular adverse events was lower than that of patients without cardiovascular adverse events, and the QTd and QTcd were greater than those of patients without cardiovascular adverse events, the difference was statistically significant (P<0.05). Prolonged QTd and QTcd were independent risk factors for cardiovascular adverse events in pre-DM patients, and increased SDANN was a protective factor (P<0.05). The AUC predicted by SDANN, QTd and QTcd for cardiovascular adverse events in pre-DM patients was 0.956, 0.679 and 0.714 respectively, and the AUC of joint prediction was 0.961. Conclusion: The SDANN decreased and QTd and QTcd prolonged in pre-DM patients, and the combination of the three predicted cardiovascular adverse events with the highest AUC, which is conducive to clinical monitoring and reducing the occurrence of cardiovascular adverse events in pre-DM patients.

Objective: To observe and analyze the effect of Sertraline combined with Tandospirone in the treatment of adolescent depression patients with non-suicide self-injury behavior (NSSI). Method: A total of 72 adolescent depression patients with NSSI who treated in Fujian Province Fuzhou Neuropsychiatric Hospital from October 2022 to January 2023 were selected as the research objects, the patients were divided into the control group and the observation group by random number table method according to the order of hospitalization, with 36 cases in each group. Both groups were treated with Sertraline Hydrochloride Tablets, and the observation group was treated with Tandospirone Citrate Capsules. The clinical efficacy, negative emotions [Hamilton depression scale-17 item (HAMD-17) score, Hamilton anxiety scale (HAMA) score], impulsive behavior [impulse scale (BIS-11)], NSSI behavior and adverse reactions were compared between two groups. Result: The total effective rate in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05). There were no statistically significant differences in HAMD-17 score and HAMA score between two groups before treatment (P>0.05); after treatment, the HAMD-17 score and HAMA score of two groups were lower than those before treatment, which in the observation group were lower than those in the control group, the differences were statistically significant (P<0.05). Before treatment, there were no significant difference in the attention, exercise, lack of planning and total scores between two groups (P>0.05); after treatment, the attention, exercise, lack of planning and total scores of two groups were lowere than those before treatment, and which in the observation group were lower than the control group, the differences were statistically significant (P<0.05). Before treatment, there were no significant difference in the frequency of occurrence of NSSI behavior between two groups (P>0.05); after 2 weeks and 4 weeks of treatment, the frequency of occurrence of NSSI behavior in two groups were less than those before treatment, and which in the observation group were less than those in the control group, the differences were statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between two groups (P>0.05). Conclusion: Sertraline combined with Tandospirone in the treatment of adolescent depression patients with NSSI can significantly improve anxiety and depression, improve impulsive behavior and NISSI behavior, and will not increase adverse reactions.

Diabetes mellitus (DM) has become one of the fastest growing public health problems in the world, and the incidence rate of its peripheral nerve complications has also increased, but the results are not satisfactory in terms of clinical diagnosis and treatment effect. With the in-depth study of diabetes peripheral neuropathy and the development of human metagenomics, more and more medical evidence shows that the intestinal microbiome or function of patients with diabetes peripheral neuropathy has changed. On this basis, the researchers proposed and confirmed the mechanism of some intestinal flora participating in the pathogenesis of diabetes peripheral neuropathy, and a new treatment method for diabetes peripheral neuropathy based on restoring the composition, structure and function of intestinal flora. This article will review the role of intestinal flora in the pathogenesis of diabetes peripheral neuropathy, and the research progress of relevant intervention measures based on intestinal flora theory.

Objective: To analyze the ABO difficult blood type identification and reasons for discrepancy between positive and negative typing. Method: From January 2021 to May 2023, 92 ABO difficult blood type samples were selected from Xinglin Branch, the First Affiliated Hospital of Xiamen University. All blood samples was determined by saline test tube method for blood type positive and negative typing, and the blood type was further determined by polybrene method and absorption and release test. The coincidence rate of blood type positive and negative typing measured by three methods was counted, and the reasons for non-conformity of positive and negative typing of saline test tube method were analyzed, and ABO blood type identification was completed. Result: The detection results of 92 blood samples showed that the coincidence rates of blood type positive and negative typing were 44.57% (41/92), 51.09% (47/92), 77.17% (71/92) respectively by saline test tube method, saline test tube method + polybrene method, saline test tube method + polybrene method + absorption and release test. The main reasons for non-conformity of positive and negative typing in saline test tube method were AB subtype, weak B antigen, weak A antigen, no anti-B antibody type A and no antibody type O. Among the 92 ABO difficult blood types, 29 cases were subtype A, 50 cases were subtype B, and 13 cases were subtype AB. Conclusion: The positive and negative typing of ABO difficult blood type by saline test tube method + polybrene method + absorption and release test can improve the accuracy of blood type identification in clinic.

Objective: To analyze the application effect of Alfentanil combined with Propofol in intravenous anesthesia of hysteroscopic surgery. Method: A total of 100 patients undergoing hysteroscopic surgery admitted to the Department of Anesthesiology in Changle District Maternal and Child Health Hospital of Fuzhou from November 2021 to October 2022 were selected as the study objects. According to the method of random number table, the patients were divided into group A and group B, with 50 cases in each group. Group A was given Sufentanil Citrate Injection combined with Propofol intravenous injection, group B was given Alfentanil Hydrochloride Injection combined with Propofol intravenous injection. The anesthetic effect, vital signs before anesthesia, after anesthesia, at cervical dilation, at the end of surgery, pain degree of 2 h, 6 h, 12 h, 24 h after surgery, atrial natriuretic peptide and stress response, neurotransmitter before and at 1 d after surgery and adverse reactions were compared between two groups. Result: The disappearance time of eyelash reflex, the recovery time and the orientation recovery time in group B were earlier than those in group A, and the dosage of Propofol was less than that in group A, the difference was statistically significant (P<0.05). The mean arterial pressure and heart rate of group B after anesthesia, at cervical dilation and at the end of surgery were higher than those of group A, and the differences were statistically significant (P<0.05). The numerical rating scale (NRS) scores of group B at 2 h, 6 h, 12 h and 24 h after surgery were lower than those of group A, and the differences were statistically significant (P<0.05). The levels of cortisol, atrial natriuretic peptide, epinephrine and norepinephrine in group B were lower than those in group A at 1 d after surgery, and the differences were statistically significant (P<0.05). The levels of acetylcholine and glutamate in group B at 1 d after were higher than those in group A, and the level of dopamine was lower than that in group A, the differences were statistically significant (P<0.05). The incidence of adverse reactions in group B was lower than that in group A, and the difference was statistically significant (P<0.05). Conclusion: The application of Alfentanil combined with Propofol in intravenous anesthesia for hysteroscopic surgery has a better effect, which can improve the anesthetic effect, stabilize the patients' vital signs during the surgery, reduce the stress reaction and postoperative pain, improve the level of neurotransmitters, and have fewer adverse reactions.

Objective: To explore the effect of cognitive behavioral therapy for insomnia (CBTI) on obstructive sleep apnea hypopnea syndrome (OSAHS). Method: A total of 80 OSAHS patients admitted to Sleep Medical Center of Xiamen Xianyue Hospital from May 2019 to May 2022 were selected as the study subjects, and they were divided into control group and observation group by random number table method, with 40 cases in each group. The control group was treated with Dexzopiclone Tablets, on this basis, the observation group was treated with CBTI, the course of treatment in both groups was 6 weeks. The clinical efficacy, scores of Montreal cognitive assessment (MoCA), mini mental state examination (MMSE), Pittsburgh sleep quality index (PSQI), sleep apnea-hypopnea index (AHI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) before and after treatment were compared between the two groups. Result: After treatment, the total clinical effective rate of the observation group was significantly higher than that of the control group, the difference was statistically significant (P<0.05). After treatment, the MoCA score and MMSE score of the observation group were significantly higher than those of the control group, while the PSQI score, AHI, SAS score, and SDS score were significantly lower than those of the control group, the differences were statistically significant (P<0.05). Conclusion: The application of CBTI in OSAHS patients has significant therapeutic effects, improving cognitive function and sleep quality, improving PSQI scores, and reducing the occurrence of negative emotions.

Objective: To explore the clinical efficacy of acupuncture combined with Flupentixol and Melitracen (Deanxit) and Estazolam in the treatment of patients with insomnia and depression and its influence on the quality of life. Method: A total of 80 patients with insomnia and depression admitted to Jingjiang Hospital of Traditional Chinese Medicine from January to December 2022 were selected, they were randomly divided into observation group and control group according to random number table, with 40 patients in each group. The control group was treated with Deanxit and Estazolam, and the observation group was treated with acupuncture on this basis. Both groups were treated for 6 weeks. The clinical efficacy, insomnia severity index scale (ISI), self-rating depression scale (SDS) and the MOS item short from health survey (SF-36) were compared between the two groups. Result: After treatment, the total effective rate of the observation group was higher than that of the control group, the difference was statistically significant (P<0.05). ISI scores and SDS scores in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group, the differences were statistically significant (P<0.05). The SF-36 scores in both groups were higher than those before treatment, and those in the observation group were higher than those in the control group, the differences were statistically significant (P<0.05). Conclusion: Acupuncture combined with Deanxit and Estazolam for patients with insomnia and depression can improve the clinical efficacy, improve the quality of sleep, relieve depression and improve the quality of life.

Objective: To analyze the application effect of psychological nursing in puerpera with premature rupture of membranes (PROM). Method: A total of 240 puerpera with PROM who admitted to Quanzhou Guangqian Hospital from July 2019 to July 2021 were selected as the research subjects, they were divided into conventional nursing group and combined nursing group according to different nursing methods, with 120 cases in each group. The conventional nursing group adopted the basic obstetric nursing mode, while the combined nursing group adopted the psychological nursing on the basis of basic nursing mode. The delivery method, delivery time, pain level [visual analog scale (VAS)], psychological state [self rating anxiety scale (SAS), self rating depression scale (SDS)] and nursing satisfaction between the two groups were compared. Result: The natural delivery rate in the combined nursing group was 90.83%, which was higher than 70.83% in the conventional nursing group, the difference was statistically significant (P<0.05). After nursing, the three stages of labor in the combined nursing group were significantly shorter than those in the conventional nursing group, the differences were statistically significant (P<0.05). After nursing, the SAS score and SDS scores in the combined nursing group were lower than those in the conventional nursing group, and the differences were statistically significant (P<0.05). After nursing, the maternal VAS score in the combined nursing group was lower than that in the conventional nursing group, the differences were statistically significant (P<0.05). The nursing satisfaction rate in the combined nursing group was 95.83%, which was higher than 85.00% in the conventional nursing group, and the difference was statistically significant (P<0.05). Conclusion: Providing psychological nursing intervention on the basis of basic nursing can increase the natural delivery rate of PROM puerpera, shorten the delivery process, improve the negative emotions of puerpera, thereby reducing patient pain, improving the quality of obstetric delivery, and improving doctor-patient relationships and nursing satisfaction.

Objective: To explore the therapeutic effect and mechanism of Roxadustat on uremic maintenance hemodialysis patients with Renal Anemia. Method: A total of 64 uremic maintenance hemodialysis patients with renal anemia who treated in Suzhou Ninth People's Hospital from January 2019 to April 2022 were randomly divided into the experimental group and the control group, 32 cases in each group. The control group was treated with Exogenous Erythropoietin, and the experimental group was treated with Roxadustat, two groups were treated for 2 months. The serum hemoglobin (Hb), erythropoietin (EPO) anemia index, interleukin-6 (IL-6), ferritin metabolism level, C-reactive protein (CRP) and clinical efficacy of two groups were compared. Result: Before treatment, there were no significant differences in EPO and Hb between two groups (P>0.05); after treatment, EPO and Hb in two groups increased compared with those before treatment, and the experimental group were higher than those in the control group, the differences were statistically significant (P<0.05). Before treatment, there were no significant differences in the levels of IL-6 and ferritin between two groups (P>0.05); after treatment, the levels of ferritin and IL-6 in two groups decreased compared with those before treatment, and the experimental group were lower than those in the control group, the differences were statistically significant (P<0.05). Before treatment, there was no significant difference in CRP levels between two groups (P>0.05); after treatment, the CRP levels in two groups decreased compared with those before treatment, and the experimental group was lower than that in the control group, the differences were statistically significant (P<0.05). The total effective rate of the experimental group (93.75%) was higher than that of the control group (68.75%), the difference was statistically significant (P<0.05). Conclusion: Roxadustat in the treatment of uremic maintenance hemodialysis patients with renal anemia is conducive to improve anemia, promote IL-6 and ferritin metabolism, reduce inflammatory reaction, and improve the effect.

Objective: To investigate the effect of trans-urethral holmium laser enucleation of prostate (HoLEP) on elderly patients with benign prostatic hyperplasia (BPH). Method: A total of 92 elderly patients with BPH treated in Dafang County People's Hospital from June 2021 to June 2022 were selected as research objects. They were divided into group A and group B according to random number table method, with 46 cases in each group. Group A was given transurethral resection of prostate (TURP) and group B was given HoLEP. The relevant indexes, prostate symptoms, quality of life before and 1 month after surgery and complication grade were compared between the two groups. Result: One month after surgery, maximum urinary flow rate (Qmax) level of both groups increased, prostate volume and prostate specific antigen (PSA) level decreased, and Qmax level of group B was higher than that of group A, prostate volume and PSA level were lower than those of group A, the differences were statistically significant (P<0.05). One month after surgery, international prostate symptom score (IPSS) score decreased in both groups, quality of life instruments for chronic diseases-benign prostatic hyperplasia (QLICD-BPH) score increased, the IPSS score of group B was lower than that of group A, and the QLICD-BPH score of group B was higher than that of group A, the differences were statistically significant (P<0.05). The incidence of complication of grade Ⅱ and Ⅳ in group B was lower than that in group A, and the difference was statistically significant (P<0.05). Conclusion: HoLEP can increase Qmax of elderly patients with BPH, reduce prostate volume, relieve prostate symptoms and improve quality of life of patients, while helping to reduce postoperative complications.

Objective: To compare the effects of Enoxaparin Sodium and Dalteparin Sodium on coagulation function, dialysis adequacy and inflammatory indexes in hemodialysis patients. Method: A total of 160 patients who underwent hemodialysis in the 73rd Group Military Hospital of the Chinese People's Liberation Army from July 2019 to August 2021 were selected and randomly divided into observation group and control group, with 80 cases in each group. The observation group received dialysis treatment with Enoxaparin Sodium, and the control group received dialysis treatment with Dalteparin Sodium. The coagulation indexes [activated clotting time of whole blood (ACT), prothrombin time (PT), fibrinogen (FIB), activated partial thrombin time (APTT) and D-dimer], inflammation indexes [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP), neutrophil to lymphocyte ratio (NRL)] of the two groups were compared before dialysis and after a single dialysis; the levels of hemoglobin (Hb), platelet (PLT), albumin (ALB), calcium (Ca2+), phosphorus (P3+), urea clearance index (Kt/V), urea reduction ratio (URR), blood urea nitrogen (BUN) and serum creatinine (Scr) were compared between the two groups after a single dialysis and 3 months after dialysis; the clinical effects of the two groups were compared. Result: Before dialysis, there were no statistically significant differences between the two groups in coagulation indexes such as ACT, PT, FIB, APPT and D-dimer (P>0.05); after a single dialysis, the above coagulation indexes in the observation group were better than those in the control group, and the differences were statistically significant (P<0.05). After a single dialysis, there were no statistically significant differences in the Hb, PLT, ALB, Ca2+, P3+, BUN, Scr, Kt/V and URR indexes of the two groups (P>0.05). After 3 months of dialysis, the levels of Hb, ALB, Kt/V and URR in the observation group were higher than those in the control group, and the indicators of PLT, P3+, BUN and Scr in the observation group were lower than those in the control group, the differences were statistically significant (P<0.05). After a single dialysis, the levels of TNF-α, IL-6, PCT, CRP and NRL of observation group were significantly lower than those of the control group, the differences were statistically significant (P<0.05). The effective rate of treatment in the observation group was significantly higher than that in the control group, the difference was statistically significant (P<0.05). Conclusion: The use of Enoxaparin Sodium in hemodialysis patients with coagulation function, dialysis adequacy and inflammation has an obvious improvement effect.

Endometrial polyp is a common gynecological disease, with very few cases of malignant transformation. The etiology and pathogenesis are still unclear to this day. Clinical manifestations often include irregular menstruation, infertility, etc., leading to an increase in the patients' physical and economic burden. The author have studied and consulted academic papers on the treatment and clinical relevance of gynecological and obstetric diseases in recent years both domestically and internationally, summarized and analyzed the research process and conclusions of some experts and scholars at home and abroad, aiming to provide a reference basis for clinical treatment.

Objective: To investigate the effects of Dapagliflozin in the treatment of patients with diabetes mellitus type 2 (T2DM) complicated with coronary heart disease (CHD). Method: A total of 119 patients with T2DM complicated with CHD who were treated in Xiamen Fifth Hospital from January 2020 to March 2021 were selected. According to random number table method, they were divided into conventional group (59 cases) and Dapagliflozin group (60 cases). Both groups were given conventional CHD medication. The conventional group was given Metformin Hydrochloride Sustained-release Tablets, and the Dapagliflozin group was given Dapagliflozin. Blood glucose index, blood lipid index, inflammatory factors before treatment (T0) and after 24 weeks of treatment (T1) and adverse cardiovascular events were compared between the two groups. Result: At T1, fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 h PBG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) levels in both groups were lower than those at T0, the levels of FPG, 2 h PBG, HbA1c, TC, TG and LDL-C in Dapagliflozin group were lower than those in conventional group, the differences were statistically significant (P<0.05). At T1, the levels of interleukin-6 (IL-6) and C-reactive protein (CRP) in both groups were decreased compared with those at T0, and the levels of IL-6 and CRP in Dapagliflozin group were lower than those in conventional group, the differences were statistically significant (P<0.05). The incidence of adverse cardiovascular events in Dapagliflozin group was lower than that in the conventional group, and the difference was statistically significant (P<0.05). Conclusion: Dapagliflozin can regulate blood glucose, blood lipid and inflammatory factors in patients with T2DM complicated with and CHD, which is helpful to reduce the risk of adverse cardiovascular events.

Objective: To explore the effect of pre-control and early-warning risk management on minimally invasive hematoma puncture and drainage for hypertensive intracerebral hemorrhage. Method: A total of 86 patients with hypertensive intracerebral hemorrhage who underwent minimally invasive hematoma puncture and drainage in the First Affiliated Hospital of Xiamen University from January 2019 to June 2021 were selected as research objects. Patients who received infection prevention interventions from January 2019 to April 2020 were included in the control group (n=43). Patients who received pre-control and early-warning risk management from May 2020 to June 2021 were included in the observation group (n=43). Compared the intervention effects, incidence of complications (digestive bleeding, infection, cerebral hernia, high fever), blood pressure indicators, Fugl-Meyer motor function assessment scale scores, and activity of daily living assessment (ADL) scale scores between the two groups. Result: After 3 months of intervention, there was no statistically significant difference in treatment effectiveness between the two groups (P>0.05). After 3 months of intervention, blood pressure indicators in both groups were better than those before intervention, and the observation group were better than those in the control group, the differences were statistically significant (P<0.05). After 3 months of intervention, the Fugl-Meyer motor function assessment scale scores and ADL scale scores of the two groups were higher than those before intervention, and the observation group were higher than those in the control group, the differences were statistically significant (P<0.05). The total 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: Pre-control and early-warning risk management can reduce the incidence of complications in hypertensive intracerebral hemorrhage patients undergoing minimally invasive hematoma puncture and drainage, improve the prognosis, and has little influence on the therapeutic effect.

Objective: To investigate the effect of hematoma removal through lateral fissure approach on coma degree and prognosis of patients with hypertensive basal ganglia intracerebral hemorrhage. Method: A total of 128 patients with hypertensive basal ganglia intracerebral hemorrhage who treated in Longyan People's Hospital from August 2020 to August 2022 were selected as subjects and randomly divided into the lateral fissure group and the temporal cortex group, 64 cases in each group. Two groups were treated with hematoma removal, the temporal cortex group was operated through the temporal cortex approach, and the lateral fissure group was operated through the lateral fissure approach. The perioperative indexes (operation time, operation bleeding, hospitalization time, hematoma clearance rate) between two groups were compared, the scores of coma degree [Glasgow coma scale (GCS)] between two groups before operation, 3 d after operation and 1 week after operation were compared, the incidence of complications (pulmonary infection, cerebral hernia, intracranial rebleeding, epilepsy) in two groups within 1 month after operation were observed, the prognosis of two groups at 3 months after operation [Glasgow outcome scale (GOS)] were compared. Result: The operation time and hospital stay in the lateral fissure group were significantly shorter than those in the temporal cortex group, and the hematoma clearance rate was significantly higher than that in the temporal cortex group, operation bleeding time was less than that in the temporal cortex group, the differences were statistically significant (P<0.05). At 3 d and 1 week after operation, the GCS scores in two groups were significantly higher than those before operation, and the scores in the lateral fissure group were higher than those in the temporal cortex group, the differences were statistically significant (P<0.05). Within 1 month after operation, the incidence of complications in the lateral fissure group were significantly lower than those in the temporal cortex group, the differences were statistically significant (P<0.05). The GOS score in the lateral fissure group at 3 months after operation was significantly better than that in the temporal cortex group, the difference was statistically significant (P<0.05). Conclusion: The treatment of hypertensive basal ganglia intracerebral hemorrhage by hematoma removal through lateral fissure approach has a significant effect, which can improve the coma of patients and reduce postoperative complications.

Objective: To investigate the effects of Fulvestrant combined with Abemaciclib in the treatment of hormone receptor (HR) positive advanced breast cancer. Method: A total of 80 HR positive patients with advanced breast cancer admitted to Taixing People's Hospital from May 2021 to May 2022 were selected. They were divided into observation group and control group according to random number table method, with 40 cases in each group. The control group was given Fulvestrant treatment, and the observation group was given Abemaciclib on the basis of the control group. The short term efficacy, follow up time, immune function before and after treatment, adverse reactions were compared between the two groups. Result: The objective response rate (ORR) and disease control rate (DCR) of observation group were higher than those of control group, and the differences were statistically significant (P<0.05). The follow up time in the observation group was longer than that in the control group. After treatment, CD3+, CD4+ and CD4+/CD8+were significantly increased in both groups, CD3+, CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group, and the differences were statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Fulvestrant combined with Abemaciclib in the treatment of HR positive advanced breast cancer can improve the short term effect, improve the immune function of patients, and does not increase the adverse effects, which is safe and effective.

Objective: To analyze the clinical efficacy and safety of Aripiprazole and Risperidone in the treatment of patients with schizophrenia. Method: A total of 208 patients with schizophrenia diagnosed and treated in Fuzhou Psychiatric Sanatorium from January 2019 to August 2022 were selected as research objects. According to random single blind method, the patients were divided into observation group and control group, 104 cases in each group. The control group was given Risperidone Orally Disintegrating Tablets, and the observation group was given Aripiprazole Orally Disintegrating Tablets. Both groups were given routine treatment during treatment. The clinical symptoms, memory function before treatment and after 8 weeks of treatment, clinical efficacy and adverse reactions of the two groups were compared. Result: After 8 weeks of treatment, the scores of positive symptoms, negative symptoms and general psychopathological symptoms in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). The incidence of adverse reactions in observation group was lower than that in control group, and the difference was statistically significant (P<0.05). After 8 weeks of treatment, the scores of recognition, association, picture memory and number memorization memory in the observation group were higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion: Aripiprazole and Risperidone are commonly used in the treatment of schizophrenia. Aripiprazole has more obvious therapeutic advantages, good efficacy, high safety, and can effectively improve the disease symptoms and memory function of patients.

Objective: To investigate the effect of Esketamine combined with Remifentanil and Propofol anaesthesia on pain levels and postoperative awakening in patients undergoing ureteral stent removal. Method: A total of 95 patients who underwent ureteral stent removal in Hai’an Hospital of Traditional Chinese Medicine from June 2022 to June 2023 were selected. Random number table method was used to divide the control group (n=47) and the study group (n=48). The control group was given Remifentanil+Propofol anesthesia, and the study group was given Remifentanil+Propofol+Esketamine anesthesia. Anesthesia effect, pain degree, quality of recovery, cognitive function and incidence of adverse reactions were analyzed and compared between the two groups. Result: The total excellent and good rate of anesthesia in the study group was 95.83%, which was significantly higher than 80.85% in the control group, and the difference was statistically significant (P<0.05). The visual analogue scale (VAS) score of the study group was significantly lower than that of the control group, and the recovery time was earlier than that of the control group, the differences were statistically significant (P<0.05). At 1 h and 3 h after operation, the score of mini-mental state examination (MMSE) in the study group was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). The total incidence of adverse reactions in the study group was 8.33%, which lower than 14.89% in the control group, but there was no significant difference between the two groups (P>0.05). Conclusion: Esketamine combined with Remifentanil and Propofol can significantly reduce the pain of patients undergoing ureteral stent removal, reduce cognitive impairment, shorten postoperative recovery time, and have a high safety.

Objective: To explore the clinical effect of Dupilumab combined with Desonide Cream in the treatment of severe atopic dermatitis in children. Method: A total of 78 children with severe atopic dermatitis who treated in Quanzhou First Hospital from February 2020 to February 2022 were selected as the study subjects, they were divided into the control group and the experimental group according to the random number table method, 39 cases in each group. Both groups were treated with Desonide Cream, and the experimental group was treated with Dupilumab on the basis. The treatment effect, treatment safety, clinical symptom relief time, eosinophil level and children's skin lesion symptom score were compared between two groups. Result: The total effective rate of the experimental group was higher than that of the control group, the remission times of eczema-like rash, dry skin and pruritus were earlier than those of the control group, the eosinophil level and eczema area and severity index (EASI) score after treatment were lower than those of the control group, the differences were statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The treatment of children with severe atopic dermatitis treated with Dupilumab combined with Desonide Cream has achieved better clinical results, which can reduce eosinophil level and EASI score, significantly shorten the remission time of clinical symptoms. Moreover, adverse reactions are not significantly increased during the process.

Acute pulmonary embolism (APE) is a common and potentially fatal thrombotic disease, while atrial fibrillation (AF) is a common arrhythmia, whose coexistence with pulmonary embolism (PE) has received increasing attention in recent years. Both APE and AF are associated with significant morbidity and mortality, respectively, and patients with APE with AF have poorer clinical outcomes and higher hospitalization and long-term mortality. Its mechanism is relatively complex, which is related to a variety of factors, and both of them interact to increase the risk of hospitalization. Therefore, it is particularly important to understand the relationship between APE and AF. On the one hand, AF may increase the risk of APE and affect the short-term and long-term survival rate of patients; on the other hand, APE may cause cardiac dysfunction and thus induce AF. This article described the research progress of the correlation between APE and AF.

Pulmonary fibrosis is a chronic progressive respiratory disease with a high prevalence in the elderly population. At present, it is still an intractable interstitial lung disease. Recent studies have shown that pulmonary endothelial cells can participate in the formation and development of pulmonary interstitial fibrosis through endothelium-mesenchymal transformation (EndMT), leading to fibrosis. Notch signal pathway is widely involved not only in the process of EndMT but also in the fibrosis of lung and other organs, which affects the prognosis of patients with pulmonary fibrosis. Therefore, this article mainly reviews the relationship between Notch signal pathway, EndMT and pulmonary fibrosis.

Objective: To analyse the diagnostic value of combining tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), carbohydrate antigen 242 (CA242) and carbohydrate antigen 724 (CA724) in early gastric cancer. Method: From June 2021 to June 2023, 56 suspected early gastric cancer patients admitted to Clinical Oncology School of Fujian Medical University were selected as the observation group. In addition, 40 patients with benign stomach diseases admitted to in the same period were selected as the control group. The levels of the tumor markers CEA, CA199, CA242 and CA724 were compared between the two groups, and the diagnostic value of the above four tumor markers were tested alone and in combination was analyzed. Result: The levels of CEA, CA199, CA242 and CA724 in observation group were significantly higher than those in control group, the differences were statistically significant (P<0.05). Among the 56 suspected early gastric cancer patients in the observation group, there were 48 positive cases (25 papillary adenocarcinoma cases, 23 tubular adenocarcinoma cases) and 8 negative cases (5 gastric ulcers cases, 3 chronic gastritis cases). The results showed that the sensitivity and accuracy of the combined detection of CEA, CA199, CA242 and CA724 were 93.75% and 92.86%, which were higher than the sensitivity and accuracy of the four separate tests, and the differences were statistically significant (P<0.05). There was no significant difference between the specificity of the combined test and that of the four separate tests (P>0.05). Conclusion: The combined detection of tumor markers CEA, CA199, CA242 and CA724 has high diagnostic value, which is significantly superior to each single detection, and can provide an important theoretical reference for the rapid screening and diagnosis of early gastric cancer.

Objective: To explore and analyze the occurrence of postpartum negative emotions and related risk factors in second birth parturient. Method: The clinical data of 275 second birth parturient who were admitted and gave birth in Jian’ou Maternal and Child Health Hospital from June 2020 to June 2022 were retrospectively analyzed as research samples, and they were divided into the control group (n=223) and the observation group (n=52) according to whether the parturient had postpartum negative emotions. Summarized the clinical baseline data of all parturient, conducted univariate analysis, and perform multivariate logistic regression analysis on statistically significant indicators in univariate analysis to screen out independent risk factors that affect the occurrence of postpartum negative emotions in second birth parturient. Result: The results of multivariate logistic regression analysis showed that non occupation, weight gain during pregnancy>20 kg, pregnancy comorbidities, absence of delivery companionship, monthly family income of 5 000-9 999 yuan, poor mother-in-law and daughter-in-law relationship, low objective support, and low support utilization were all risk factors for postpartum negative emotions in second birth parturient (P<0.05). Conclusion: No occupation, pregnancy weight gain>20 kg, pregnancy complications, no childbirth companion, monthly family income 5 000-9 999 yuan, poor relationship between mother-in-law and daughter-in-law, low objective support and low support utilization are all risk factors for postpartum negative emotions in second birth parturient. Clinical intervention measures can be taken according to the above results, reduce the risk of postpartum negative emotions in second birth parturient.