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.

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.

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 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 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 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 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 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 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 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 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 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.

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 clinical nursing pathway combined with targeted sedation nursing on children with severe pneumonia undergoing bedside alveolar lavage. Method: A total of 94 children with severe pneumonia who underwent bedside alveolar lavage in Macheng People's Hospital from January 2019 to January 2022 were selected as the study subjects, they were divided into the observation group (n=47) and the control group (n=47) according to the coin toss method. The control group was given routine nursing, the observation group was given clinical nursing pathway combined with targeted sedation nursing. The sedation scores at different time during the operation, lung function, incidence of complications, mood and satisfaction of family members were compared between two groups. Result: There was no significant difference in Ramsay sedation score between two groups bedside alveolar lavage before sedation treatment (T1) (P>0.05); the Ramsay sedation scores of the observation group before bedside alveolar lavage (T2), fiberoptic bronchoscopy into the trachea (T3), sputum suction (T4), and end of lavage (T5) were higher than those of the control group, and the differences were statistically significant (P<0.05). The maximum mid-expiratory flow (MMF) and peak expiratory flow (PEF) at 24 h after operation in the observation group were higher than those in the control group, and the differences were statistically significant (P<0.05). The incidence of intraoperative complications in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). The positive emotion score of the family members in the observation group at 24 h after operation was higher than that in the control group, and the negative emotion score was lower than that in the control group, the Chinese version of the Critical Care Family Satisfaction Scale (C-CCFSS ) in the observation group at discharge was higher than that in the control group, and the differences were statistically significant (P<0.05). Conclusion: Clinical nursing pathway combined with targeted sedation nursing has a positive effect on children with severe pneumonia undergoing bedside alveolar lavage, which can effectively improve the intraoperative sedation score, reduce the occurrence of complications, improve lung function, relieve the negative emotions of family members, and improve the nursing satisfaction of family members.

Objective: To explore the effect of minimally invasive percutaneous plate osteosynthesis (MIPO) in the treatment of patients with elderly limb fractures and its impact on stress indicators. Method: A total of 128 elderly patients with limb fractures admitted to Beijing Chaoyang Integrative Medicine Rescue and First Aid Hospital from January 2020 to October 2021 were selected as the study objects. They were divided into control group and observation group, with 64 patients in each group by using the odd even sequence numbering method (participants were randomly assigned according to the order of admission and the parity of the numbering). The control group received open reduction and internal fixation (ORIF) treatment, while the observation group received MIPO treatment. The surgical related indicators, stress indicators, clinical efficacy, and incidence of complications between the two groups were compared. Result: The surgical time, incision length, and wound healing time of the observation group were shorter than those of the control group, and the intraoperative bleeding was less than that of the control group, the differences were statistically significant (P<0.05). Three days after surgery, the visual analogue scale (VAS) score and swelling degree score of the observation group were lower than those of the control group, the differences were statistically significant (P<0.05). Three days after surgery, the levels of epinephrine (E), Norepinephrine (NE) and renin (R) in the observation group were significantly lower than those in the control group, the differences were statistically significant (P<0.05). The excellent and good rate of surgical treatment in the observation group was significantly higher than that in the control group, and the incidence of postoperative complications was significantly lower than that in the control group, the differences were statistically significant (P<0.05). Conclusion: MIPO for elderly limb fractures can improve surgical outcomes, reduce perioperative stress reactions, and promote rehabilitation.

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.

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 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 investigate and compare the influence of different analgesia modes for hemorheology and platelet activation of elderly patients with hip replacement. Method: A total of 80 elderly patients with hip replacement in Shaowu Municipal Hospital from February 2020 to March 2022 were selected as the study objects and they were divided into group A of 40 cases and group B of 40 cases according to the random number table method. Group A was treated with patient-controlled intravenous analgesia, group B was treated with patient-controlled epidural analgesia. Then the pain degree [visual analog scale (VAS) score], hemorheology indexes (whole blood high shear viscosity, low shear viscosity, whole blood reduced viscosity, plasma viscosity and hematocrit) and platelet activation indexes (CD41, CD61 and CD63) of two groups before and after operation were compared. Result: There were no significant differences in the VAS score, hemorheology indexes and platelet activation indexes between two groups before operation (P>0.05); the VAS score, hemorheology indexes and platelet activation indexes of group B after 12 h, 24 h, 48 h of surgery were lower than those of group A, the differences were statistically significant (P<0.05). Conclusion: The control effect of patient-controlled epidural analgesia for the pain of elderly patients with hip replacement is better than that of patient-controlled intravenous analgesia, and it can more effectively control the hemorheology and platelet activation state, so its prevention and control effect for the postoperative thrombosis of elderly patients with hip replacement is better.

Objective: To analyze the effect of Bobath technology combined with multi frequency vibration in the treatment of stroke hemiplegia patients and its influence on lower limb muscle tone and function. Method: A total of 60 patients with stroke hemiplegia admitted to the Rehabilitation Department of Lianyungang Hospital of Traditional Chinese Medicine from January 2020 to September 2022 were selected as the research objects, and they were divided into observation group and control group by random number table method, with 30 cases in each group. The control group received routine treatment and exercise therapy, while the observation group received Bobath technology combined with multi frequency vibration on the basis of the control group. The efficacy and changes in lower limb muscle tone (Brunnstrom rating) and function [modified Ashworth spasm scale (MAS) score] before and after treatment were compared between the two groups. Result: The total effective rate of observation group was 93.33%, which was higher than 70.00% of the control group, and the difference was statistically significant (P<0.05). There were no significant differences in Brunnstrom rating between the two groups before treatment (P>0.05). After treatment, the cases of Brunnstrom grade Ⅴ, Ⅵ in the observation group was more than that in the control group, and the cases of Brunnstrom grade Ⅰ, Ⅱ was less than that in the control group, and the differences were statistically significant (P<0.05). There was no significant difference in MAS scores between the two groups before treatment (P>0.05). After treatment, the MAS score of observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: Bobath technology combined with multi frequency vibration can improve the efficacy of stroke hemiplegia patients, improve the lower limb muscle tone and function of patients.

Objective: To explore the effect of Yijing Decoction combined with Estradiol Tablets/Estradiol Dydrogesterone Tablets in the treatment of patients with premature ovarian failure. Method: A total of 80 patients with premature ovarian failure in Xiamen Tong’an District Hospital of Traditional Chinese Medicine from January 2021 to January 2022 were selected as study objects, and they were divided into control group and observation group by the random number table, with 40 cases in each group. The control group were treated with Estradiol Tablets/Estradiol Dydrogesterone Tablets, the observation group were treated with Yijing Decoction combined with Estradiol Tablets/Estradiol Dydrogesterone Tablets. Then the total effective rate, adverse reactions rate, and Kupperman scores, anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and ovarian color ultrasound results (ovarian diameter, sinus follicle number and endometrial thickness) before and after treatment were compared between the two groups. Result: The total 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). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Before treatment, there were no statistically significant differences in Kupperman score, AMH, FSH, LH, E2 and ovarian color ultrasound results between the two groups (P>0.05). After 2 months and 4 months of treatment, the Kupperman score and ovarian color ultrasound results of the observation group were significantly better than those in the control group, FSH and LH were significantly lower than those in the control group, AMH, E2 were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion: The effect of Yijing Decoction combined with Estradiol Tablets/Estradiol Dydrogesterone Tablets in the patients with premature ovarian failure is better, and can significantly improve the levels of AMH, FSH, LH, E2 and endometrial thickness.

Objective: To analyze the effect of antenatal comprehensive nursing in patients with recurrent pregnancy and delivery with scarred uterus. Method: Clinical data of 80 patients with recurrent pregnancy and delivery with scarred uterus admitted to Xiamen Third Hospital from January 2021 to October 2022 were retrospectively analyzed. According to the patients' wishes, they were divided into observation group (40 cases) and control group (40 cases). The nursing method of patients with scarred uterus during recurrent pregnancy in the control group was routine nursing management. The nursing method during the recurrent pregnancy of the patients with scarred uterus in the observation group was antenatal comprehensive nursing. The rate of vaginal delivery, incidence of adverse pregancy outcomes, anxiety and depression were compared between the two groups, and the total satisfaction rate of the patients was assessed by the Newcastle nursing service satisfaction scale. Result: The vaginal delivery rate in the observation group (72.50%) was significantly higher than that in the control group (47.50%), and the incidence of adverse pregancy outcomes in the observation group (0) was significantly lower than that in the control group (10.00%), the differences were statistically significant (P<0.05). There were no significant differences in anxiety and depression scores between the two groups before nursing (P>0.05); after nursing, the scores of anxiety and depression in both groups were lower than those before nursing, those in the observation group were lower than those in the control group, the differences were statistically significant (P<0.05). The total satisfaction rate of observation group (97.50%) was significantly higher than that of control group (85.00%), the difference was statistically significant (P<0.05). Conclusion: The effect of applying antenatal comprehensive nursing to patients with recurrent pregnancy and delivery with scarred uterus is relatively significant, which can not only reduce the occurrence of adverse pregnancy outcomes, but also be very beneficial to promoting vaginal delivery, and reduce the adverse psychological effects of patients.

Objective: To evaluate the effect of transurethral plasma kinetic enucleation of prostate (TUKEP) transurethral plasma enucleation in patients with benign prostatic hyperplasia (BPH). Method: A total of 80 patients with BPH admitted to Wuzhou Workers' Hospital from March 2021 to October 2022 were selected and divided into control group [underwent transurethral bipolar plasma kinetic prostatectomy (TUPKP)] and observation group (underwent TUKEP) according to random number table method, 40 cases in each group. The perioperative indexes, urodynamics, quality of life scale (QOL), international prostate symptom scale (IPSS), international erectile function index scale (IIEF-5), intraoperative complications and recent complications of the two groups were evaluated. Result: The perioperative indexes of the observation group were better than those of the control group, and the differences were statistically significant (P<0.05). Before operation, there were no significant differences in urodynamics, QOL, IPSS and IIEF-5 between the two groups (P>0.05). After operation, the urodynamics indexes and IIEF-5 scores in the observation group were better than those in the control group, the differences were statistically significant (P<0.05). However, there were no statistically significant differences in QOL and IPSS scores between the two groups (P>0.05). There was no significant difference in the incidence of intraoperative complications between the two groups (P>0.05), but the incidence of recent complications in the observation group was lower than that in the control group, the difference was statistically significant (P<0.05). Conclusion: TUPKP and TUKEP can effectively treat BPH, alleviate symptoms and improve quality of life; while the TUKEP has more advantages in improving perioperative indicators and urodynamics, reducing complications, and is not easy to affect sexual function.

Objective: To investigate the effect of internal fixation with "F" shaped hollow nail on Pauwels type Ⅲ femoral neck fracture. Method: Retrospective analysis was made on the clinical data of 68 patients with Pauwels type Ⅲ femoral neck fracture who received internal fixation with hollow nails in Longyan Hospital of Traditional Chinese Medicine from September 2018 to September 2020. They were divided into "F" shape group (36 cases) and parallel group (32 cases) according to the different placement methods of hollow nails. The "F" shape group was treated with internal fixation with "F" shaped hollow nails, and the parallel group was treated with internal fixation with three inverted triangular parallel hollow nails. The patients in both groups were followed up for 12 months after surgery. The operation related indexes (length of stay, time of starting weight bearing after operation, time of fracture healing) and satisfaction with fracture reduction quality (Garden alignment index) of the two groups of patients were compared, and the hip joint conditions [extension-flexor range of motion (ROM), pain visual analogue scale (VAS) score, Harris hip function scale (Harris) score] before operation and at the last follow-up, as well as the occurrence of complications during the follow-up were recorded. Result: The length of stay in the "F" shape group was shorter than that in the parallel group, the time of starting weight bearing and fracture healing time of were earlier than those of the parallel group, the differences were statistically significant (P<0.05). The satisfaction of fracture reduction quality in the "F" shape group was 97.22%, which was higher than 81.25% in the parallel group, the difference was statistically significant (P<0.05). At the last follow-up, the ROM of the two groups was greater than before operation, the Harris score was higher than before operation, and the VAS score was lower than before operation, the differences were statistically significant (P<0.05); the ROM, Harris score and VAS score of the "F" shape group were better than those of the parallel group, the differences were statistically significant (P<0.05). The total incidence of postoperative complications in the "F" shape group was 19.44%, which was lower than 55.13% in the parallel group, the difference was statistically significant (P<0.05). Conclusion: Compared with the traditional internal fixation with three inverted triangular parallel hollow nails, the application of hollow nail "F" shaped internal fixation in Pauwels type Ⅲ femoral neck fracture has a more significant therapeutic effect, which can effectively improve the surgical related indicators, improve the satisfaction of reduction quality, restore hip joint function, and reduce the incidence of postoperative complications.

Objective: To explore the effect of low calcium dialysate combined with active Vitamin D on serum total parathyroid hormone (iPTH) and calcium and phosphorus metabolism in hemodialysis patients with secondary hyperparathyroidism (SHPT). Method: A total of hemodialysis 78 patients with SHPT admitted to Shanghang County Hospital from March 2021 to March 2022 were selected as the study objects, and they were divided into experimental group (n=39) and control group (n=39) according to random number table method. The control group was treated with active Vitamin D combined with conventional dialysate, and the experimental group was treated with active Vitamin D combined with low calcium dialysate. The serum iPTH, calcium and phosphorus metabolism indexes (calcium, blood phosphorus and calcium phosphorus product), renal function indexes [serum creatinine (Scr), urea nitrogen (BUN) and urea clearance index (KT/V)] between two groups were compared before and after treatment, and the occurrence of adverse reactions between two groups during 6 months of treatment were recorded. Result: After treatment, the iPTH, blood phosphorus and calcium phosphorus product levels in two groups were decreased compared with those before treatment, and at the same time those in the experimental group were lower than those in the control group, the differences were statistically significant (P<0.05); after treatment, the blood calcium levels in two groups were higher than those before treatment, and at the same time that in the experimental group was higher than that in the control group, the differences were statistically significant (P<0.05). There were no significant differences in the levels of Scr, BUN and KT/V between two groups before and after treatment (P>0.05). During 6 months of treatment, the incidence of adverse reactions in the experimental group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion: Low calcium dialysate combined with active Vitamin D can effectively reduce the secretion of iPTH in the treatment of hemodialysis patients with SHPT, and then improve the disorder of calcium and phosphorus metabolism, and has less adverse reactions.

Objective: To investigate the effect of combined spinal and epidural anesthesia on hemodynamics, pain degree, and cognitive function of orthopedic surgery patients. Method: The clinical data of 72 orthopedic surgery patients admitted to the People's Hospital of Ningxia Hui Autonomous Region from June 2021 to June 2022 were retrospectively analyzed. According to different anesthesia methods, they were divided into observation group and control group, 36 cases in each group. The control group was given general anesthesia, and the observation group was given combined spinal and epidural anesthesia. The hemodynamics before anesthesia (T0), before surgery (T1), 30 min of surgery (T2), at the end of surgery (T3), pain degree at 6 h, 12 h, 1 d and 2 d after surgery, cognitive function at 1 h, 6 h, 12 h and 1 d after surgery and adverse reactions were compared between the two groups. Result: At T1, T2 and T3, heart rate (HR) and mean arterial pressure (MAP) of the two groups were decreased compared with that at T0, but HR and MAP of the observation group were significantly higher than those of the control group, the differences were statistically significant (P<0.05). At 6 h,

Objective: To explore and analyze the situation of multidrug-resistant organisms (MDROs) in Neonatal Intensive Care Unit (NICU) of Laboratory Department of Suzhou Mundical and the risk factors of bloodstream infection with it. Method: A total of 618 strains of MDROs were isolated from 1 295 positive NICU samples collected from Suzhou Municipal Hospital from January 2017 to December 2021. The types and drug susceptibility of MDROs were analyzed. Univariate and multivariate logistic regression analysis were used to analyze the risk factors of multidrug-resistant bacteria of MDROs that caused bloodstream infection. Result: A total of 618 strains of MDROs were detected in 1 295 positive specimens submitted by NICU, and the detection rate was 47.72%. Blood samples had the highest detection rate, followed by catheter, throat swab, gastric juice, eye secretions, sputum samples, urine, abscess secretions, etc. Blood flow infection MDROs (n=243) was selected as the observation group, and non-MDROs infection (n=235) in the same ward was selected as the control group. Multivariate analysis showed that NICU stay time ≥14 d, invasive operation, antibacterial drug type ≥3, antibiotic drug use time ≥14 d, intravenous catheter time ≥14 d were the risk factors for MDROs infection (P<0.05). Conclusion: The most common MDRO in NICU is ultra-broad spectrum β-lactamase (ESBLs) bacteria, methicillin-resistant Staphylococcus epidermidis (MRSE), and Enterobacteriaceae bacteria (CRE), we can analyze the high risk factors causing bloodstream infection, and formulate targeted intervention strategies in order to reduce the risk of MDROs infection.

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.

Objective: To explore the effects of different doses of Dexamethasone and Methimazole on patients with autoimmune thyroiditis. Method: A total of 70 patients with autoimmune thyroiditis admitted to Tongcheng County People's Hospital from February 2019 to February 2022 were selected as the study objects, and the patients were divided into control group and study group by random number table method, with 35 cases in each group. Both groups were treated with Methimazole, on this basis, the control group was treated with high-dose Dexamethasone and the study group was treated with low-dose Dexamethasone. The efficacy, inflammatory factors, the level of antibodies related to thyroid function, immune function and incidence of adverse drug reactions were compared between the two groups. Result: There was no significant difference in the total effective rate between the two groups (P>0.05). Before treatment, there were no significant differences in the levels of inflammatory factors between the two groups (P>0.05). After treatment, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17) in the two groups were lower than those before treatment, and the differences were statistically significant (P<0.05), but there were no significant differences between the two groups (P>0.05). Before treatment, there were no significant differences in T lymphocyte subsets between the two groups (P>0.05). After treatment, CD4+ and CD4+/CD8+ were higher than those before treatment, and CD8+ were lower than those before treatment, the differences were statistically significant (P<0.05), but there were no significant differences between the two groups (P>0.05). Before treatment, there was no significant difference in thyroid function related antibody levels between the two groups (P>0.05). After treatment, the thyroid function related antibody levels in the two groups were lower than that before treatment, the differences were statistically significant (P<0.05), but there was no significant difference between the two groups (P>0.05). The total incidence of adverse reactions in the study group was lower than that in the control group, the difference was statistically significant (P<0.05). Conclusion: Low-dose Dexamethasone combined with Methimazole can effectively reduce the levels of inflammatory factors and thyroid function related antibodies in patients with autoimmune thyroiditis, and regulate the immune function of patients with higher safety.

Objective: To explore the application of comprehensive nursing in the treatment of bedside fiberoptic bronchoalveolar lavage in patients with severe pulmonary infection. Method: A total of 106 patients with severe pulmonary infection were collected from Wuxi People's Hospital from January 2017 to January 2019 as the objects. The patients were divided into two groups with 53 cases in a 1∶1 format. All included patients were treated with bedside fiberoptic bronchoalveolar alveolar lavage. The control group was treated with routine nursing measures, and the observation group was treated with comprehensive nursing on the basis of the former. The changes of oxygenation index, pulmonary infection score before and after treatment, and adverse reactions of the two groups were observed. Result: After nursing, the oxygenation indexes of the two groups were higher than those before nursing, and the observation group was higher than that of the control group, the differences were statistically significant (P<0.05). After nursing, the pulmonary infection scores of the two groups were lower than those before nursing, and the observation group was lower than that of the control group, the differences were statistically significant (P<0.05). The incidence of adverse reactions in control group was higher than that in observation group, and the difference was statistically significant (P<0.05). Conclusion: In patients with severe pulmonary infection, the oxygenation index and pulmonary infection score can be improved effectively and the incidence of adverse reactions can be reduced by adding comprehensive nursing measures in bedside fiberoptic bronchoalveolar lavage.

Objective: To explore the clinical application value of cardiac color Doppler ultrasound combined with carotid artery ultrasound in the diagnosis of coronary heart disease (CHD). Method: A total of 117 suspected CHD patients who visited Ezhou Traditional Chinese Medicine Hospital from January 2021 to June 2022 were selected for the study objects. All enrolled patients underwent cardiac color Doppler ultrasound and carotid artery ultrasound examination, and the diagnostic efficacy in CHD was compared and analyzed. Using coronary angiography as the diagnostic gold standard, patients were divided into CHD group and non CHD group. The myocardial work index (Tei index), left ventricular ejection fraction (LVEF), plaque score, and carotid intima-media thickness (IMT) were compared between the two groups. And the clinical value of Tei index, LVEF, plaque score, and IMT in diagnosing CHD was analyzed by using receiver operating characteristic (ROC) curve. Result: The diagnostic sensitivity of cardiac ultrasound combined with carotid artery ultrasound for CHD was 95.18% (79/83), specificity was 100.00% (34/34), accuracy was 96.58% (113/117), negative predictive value was 89.47% (34/38), and positive predictive value was 100.00% (79/79). Compared with the non CHD group, Tei index, plaque score, IMT in the CHD group were higher, and LVEF was lower, the differences were statistically significant (P<0.05). Compared with the single vessel group, Tei index, plaque score, IMT in the double vessel group and multi vessel group were higher, and the LVEF was lower, the differences were statistically significant (P<0.05). Compared with the dual vessel group, Tei index, plaque score, IMT in the multi vessel group were higher, and the LVEF was lower, the differences were statistically significant (P<0.05). The Receiver operating characteristic was drawn with Tei index, LVEF, plaque integral and IMT as variables. The area under the curve of Tei index, LVEF, plaque integral and IMT combined diagnosis of CHD was 0.873 (95%CI: 0.811, 0.974, P<0.001), the diagnostic sensitivity was 86.49%, and the specificity was 82.73%. Conclusion: Cardiac ultrasound combined with carotid ultrasound has high application value in the screening and diagnosis of CHD, and can be used for the evaluation of clinical CHD patients.

Objective: To explore the correlation between homocysteine (Hcy), fibrinogen/albumin ratio (FAR), and the degree of coronary artery disease in patients with coronary heart disease (CHD). Method: A total of 107 patients with CHD admitted to the Chinese People's Liberation Army 92493 Army Hospital from March 2021 to June 2022 were selected as the study objects. All subjects underwent coronary angiography and the degree of lesion was evaluated using the Gensini score system. According to the Gensini score, patients were divided into severe lesion group (n=24) and moderate to mild lesion group (n=83). Analyzed the correlation between Hcy, FAR, and Gensini score using Pearson correlation coefficient, and determined the risk factors affecting the degree of coronary artery disease using multivariate logistic regression analysis. Result: The age, proportion of smoking history, proportion of 3 or more lesion branches, and levels of fibrinogen (FIB), Hcy, and FAR in the severe lesion group were higher than those in the moderate to mild lesion group; and the percentage of diseased branches in one and two branches, high-density lipoprotein cholesterol (HDL-C), left ventricular ejection fraction (LVEF), albumin (ALB) levels were lower than those in moderate to mild lesion group, and the differences were statistically significant (P<0.05). There were no significant differences between the two groups in gender, drinking history, hypertension, diabetes, medication history, white blood cells (WBC), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and serum creatinine (Scr) levels (P>0.05). Pearson correlation analysis showed that the levels of Hcy and FAR were positively correlated with the Gensini score (P<0.05). logistic regression analysis showed that low LVEF, high Hcy and high FAR were risk factors for severe coronary artery disease (P<0.05). Conclusion: Hcy and FAR are positively correlated with Gensini score, and low LVEF, high Hcy, and high FAR are risk factors for the degree of coronary artery disease.

Objective: To investigate the efficacy and safety of Drospirenone Ethinylestradiol Tablets combined with Levonorgestrel-Releasing Intrauterine System (LNG-IUS) in the treatment of endometrial hyperplasia (EH). Method: Sixty EH patients admitted to the Changle District Maternal and Child Health Hospital of Fuzhou City from January 2020 to January 2022 were selected as the study objects, and they were divided into two groups according to random number table method, with 30 cases in each group. The control group was treated with LNG-IUS, and the observation group was treated with Drospirenone Ethinylestradiol Tablets combined with LNG-IUS. The clinical efficacy, sex hormone levels, endometrial thickness, menstrual volume and safety of the two groups were compared. Result: The total effective rate of the observation group was 93.33%, which was higher than 70.00% of the control group, the difference was statistically significant (P<0.05). After 3 months of treatment, the relative expression levels of progesterone receptor mRNA and estrogen receptor mRNA in both groups were down-regulated compared with those before treatment, and the indexes in the observation group were lower those the control group, the differences were statistically significant (P<0.05). After 3 months of treatment, endometrial thickness and menstrual volume in both groups were lower than those before treatment, and the indexes in the observation group were lower than the control group, the differences were statistically significant (P<0.05). The incidence of adverse reactions in the observation group was 3.33%, lower than 20.00% in the control group, and the difference was statistically significant (P<0.05). Conclusion: Drospirenone Ethinylestradiol Tablets combined with LNG-IUS can achieve significant effects in the treatment of EH, which can not only improve clinical efficacy, improve sex hormone levels, reduce endometrial thickness and menstrual volume, but also promote the further improvement of treatment safety for patients.

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 explore the application effect of Ezetimibe combined with Simvastatin in elderly patients with coronary atherosclerotic heart disease (coronary heart disease), and to provide evidence for the treatment of the disease. Method: A total of 91 elderly patients with coronary heart disease who admitted to Nanjing Lishui People's Hospital from January 2021 to January 2023 were selected as the study objects, and they were divided into the control group (n=45) and the observation group (n=46) according to random number table method. The control group was given Simvastatin, and the observation group was given Ezetimibe on the basis of the control group. The therapeutic effects and the changes of cardiac function, carotid plaque and oxidative stress before and after treatment of two groups were compared. 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). After treatment, the left ventricular ejection fraction (LVEF) of two groups were higher than those before treatment, and that in the observation group was higher than that in the control group, the left ventricular end-systolic dimension (LVESD) and left ventricular end diastolic dimension (LVEDD) 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); after treatment, the number of carotid plaques and carotid intima-media thickness in two groups were better than those before treatment, and which in the observation group were better than the control group, the carotid artery diameter of two groups were larger than those before treatment, which in the observation group was larger than that in the control group, the differences were statistically significant (P<0.05); after treatment, the levels of superoxide dismutase (SOD) in two groups were higher than those before treatment, and that in the observation group was higher than that in the control group, the levels of maleic dialdehyde (MDA) and myeloperoxidase (MPO) in two groups were lower than those before treatment, and which in the observation group were lower than the control group, the differences were statistically significant (P<0.05). Conclusion: Ezetimibe combined with Simvastatin has a significant effect in the treatment of elderly patients with coronary heart disease, which can significantly improve cardiac function, stabilize carotid atherosclerotic plaques, and reduce oxidative stress.

Objective: To explore the effect of physical factor therapy on medication compliance and psychological state of elderly schizophrenic patients with shoulder, neck, waist and leg pain. Method: A total of 111 elderly schizophrenic patients with shoulder, neck, waist and leg pain who were hospitalized in Shanghai Jiading Mental Health Center from March to July 2021 were selected as the study objects. They were randomly divided into intervention group (n=55) and control group (n=56). The control group received conventional psychiatric treatment and nursing, and the intervention group received physical factor therapy on this basis. After continuous intervention for 4 weeks, the medication compliance and psychological state of the two groups were compared. Result: Before intervention, there were no significant differences between the proportion of patients with medication compliance and the proportion of patients with normal psychological state between the two groups (P>0.05). After 4 weeks of intervention, the proportion of patients with medication compliance and normal psychological state in the intervention group were higher than those in the control group, and the differences were statistically significant (P<0.05). Before intervention, there were no significant differences between the two groups in taking medication attitude score, Hamilton anxiety scale (HAMA) score and Hamilton depression scale (HAMD) score (P>0.05). After 4 weeks of intervention, the treatment attitude score of the intervention group was higher than that of the control group and before intervention, and the HAMA score and HAMD score were significantly lower than those of the control group and before intervention, the differences were statistically significant (P<0.05). Conclusion: Physical factor therapy can improve the medication compliance of elderly schizophrenic patients with shoulder, neck, waist and leg pain in hospital for a long time, and can improve their psychological state.

Objective: To explore the effect of nursing intervention based on Maslow's hierarchy of needs theory combined with CICARE communication on elderly cataract patients after surgery. Method: A total of 84 elderly cataract patients after surgery who admitted to the 910th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from August 2020 to October 2022 were selected as the research objects and were divided into the control group (n=42) and the intervention group (n=42) according to the method of random number table. The control group was given CICARE communication nursing, and the intervention group was given nursing intervention based on Maslow's hierarchy of needs theory combined with CICARE communication. The treatment compliance and quality of life of two groups were compared. Result: The scores of compliance with medicine, reasonable rest, prevention of recurrence, cooperative treatment, scientific diet and psychological control in the intervention group were significantly higher than those in the control group, the differences were statistically significant (P<0.05). Before intervention, there were no statistically significant differences in the scores of the Chinese version of the low vision quality of life questionnaire (CLVQOL) between the two groups (P>0.05); after intervention, the scores of reading and fine movement, regulation ability, daily living ability and distant vision in two groups increased compared with those before intervention, and which in the intervention group were higher than those in the control group, the differences were statistically significant (P<0.05). Conclusion: Nursing intervention based on Maslow's hierarchy of needs theory combined with CICARE communication for elderly cataract patients after surgery can help improve treatment compliance and improve quality of life.

Objective: To study the effect of spiritual care combined with death education on the cognitive attitude towards death and quality of life of patients with advanced cancer. Method: A total of 152 advanced cancer patients admitted to New Kunhua Hospital of Yunnan First People's Hospital from January to September 2020 were selected and divided into two groups based on random number table method, with 76 patients in each group. The control group received routine health education, while the observation group received spiritual care combined with death education. Compared the brief fatigue inventory (BFI) scores, profile of mood states (POMS) scores, European Organization for Reasearch and Treatment of Cancer quality of life (EORTC QLQ-C30) scores, and cognitive attitude towards death before and after intervention between two groups. Result: Before intervention, there was no statistically significant difference in BFI scores between the two groups (P>0.05). After 2 weeks of intervention, the BFI scores in both groups were lower than those before intervention, and the BFI scores in the observation group was lower than that in the control group, the differences were statistically significant (P<0.05). Before intervention, there were no statistically significant differences in the scores of each sub scale of POMS between the two groups (P>0.05). After 2 weeks of intervention, the scores of 5 negative emotion scales and the total scores in the two groups were lower than those before intervention, while the scores of 2 positive emotion scales were higher than those before intervention, moreover, the scores of 5 negative emotion scales and the total scores in the observation group were lower than those in the control group, and the scores of 2 positive emotion scales were higher than those in the control group, the differences were statistically significant (P<0.05). After 2 weeks of intervention, the cognitive attitude towards death in the observation group was better than that in the control group, the difference was statistically significant (P<0.05). Before intervention, there was no statistically significant difference in the EORTC QLQ-C30 scores between the two groups (P>0.05). After 2 weeks of intervention, the EORTC QLQ-C30 scores in both groups were higher than those before intervention, and the observation group was higher than that in the control group, the differences were statistically significant (P<0.05). Conclusion: The implementation of spiritual care combined with death education for patients with advanced cancer can help alleviate the symptoms of cancer-related fatigue, improve the emotional state and death cognitive attitude of patients, and promote the improvement of quality of life.