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Quick Search     Adv Search 2016 Vol. 33, No. 2 Published: 2016-02-26   209 Prognostic Value of Doppler Sonography for Ventricular Septal Defect in the 19~24 Weeks Gestation FAN Qiyun，YU Yimin，WU Yingheng，et al 【Objective】To investigate the prognostic value of Doppler sonography for the ventricular septal defect(VSD) in the 1924 weeks gestation. 【Methods】 A singlecentre prospective observational study was conducted．The pregnant women who underwent the prenatal examination in our hospital from December 2012 to January 2015 were enrolled and were divided into the VSD group(217 cases) and the control group (3535 cases) according to the prenatal ultrasound diagnosis examination at any time and followup within one year of diagnosis results. Fetal hemodynamics of the two groups of pregnant 19 to 24 weeks were recorded and compared : umbilical artery pulsatility index (UAPI) ; middle cerebral artery pulsatility index (MCAPI), middle cerebral artery resistance index( MCARI); splenic artery pulsatility index PI (SPAPI), splenic artery resistance index (SPA RI), splenic artery peak systolic velocity (SpAPSV); brain / umbilical pulsatility index ratio (MCA/UAPI )and brain / umbilical vascular resistance index ratio (MCA/UARI). 【Results】 Fetal UAPI (1.31 ± 0.54), UARI (0.77±0.33) of the VSD group were significantly higher than those the control group (1.09 ±0.33 and 0.68 ± 0.23) (P<0.05), MCAPI (1.48 ± 0.24), MCA/UAPI (1.12 ± 0.29), MCA/UARI (0.99 ±0.18) were significantly lower than those of the control group (1.61 ±0.33, 1.38 ± 0.33 and 1.11 ± 0.20) (P<0.05), but no statistically significant difference exist in MCARI, SpA, PI, SpA, RI, SpAPSV between the two groups (P>0.05). Logistic regression analysis showed that the increase of UAPI (OR=6.314, 95% CI: 240 ~ 24.803) and the decrease of MCAPI (OR=5.887, 95% CI: 1.078 to 13.637) and MCA/UAPI (OR=11.283, 95% CI: 1.597 ~ 106.442) were independent risk factors for prediction of VSD.【Conclusion】At 19 to 24 weeks, the increase of UAPI and the decrease MCAPI and MCA/UAPI are useful marker to predict the occurrence of fetal VSD. 2016 Vol. 33 (2): 209-212 [Abstract] ( 130 ) HTML (1 KB)  PDF  (0 KB)  ( 42 ) 212 Study of Molecular Markers to Predict the Effect of Neoadjuvant Chemotherapy on AdvancedStage Breast Cancer AI Xiuqing，JIA Zhiying，ZHANG Yinghua,et al 【Objective】To investigate the effects of Survivin, HER2, and p53 to predict the effect of neoadjuvant chemotherapy on advancedstage breast cancer. 【Methods】The 120 patients with advancedstage breast cancer and who had received neoadjuvant chemotherapy in our hospital from 2013 January to 2015 January were recruited as subjects. The expression changes and its relations to each factor were analyzed before and after chemotherapy. 【Results】 There were no differences in each factors expression before and after chemotherapy. The positive expression of Survivin and HER2 after chemotherapy were significantly lower than those of before chemotherapy (P<0.05), but the difference in p53 was not statistically significant（P>0.05). The Survivin and HER2 before chemotherapy showed positive correlation to each other but not to p53 before chemotherapy; the Survivin and HER2 showed positive correlation after chemotherapy. 【Conclusion】Survivin ,HER2, and p53 can not predict the effect of neoadjuvant chemotherapy on advancedstage breast cancer, but they can be the targets for evaluating the chemotherapy effect. 2016 Vol. 33 (2): 212-215 [Abstract] ( 93 ) HTML (1 KB)  PDF  (0 KB)  ( 34 ) 216 Research of the Mortality in Emergency Department Sepsis Score for Emergency Department Patients with Sepsis LIU Xu,LV Juan,LI Wenqiang 【Objective】To research the value of mortality in emergency department sepsis score (MEDS) in emergency department patients with sepsis. 【Methods】The 316 patients with sepsis were eligible for research and collected from March, 2013 to September, 2015. MEDS score, acute physiology, chronic health evaluation Ⅱ (APACHE Ⅱ) score, and arterial blood lactate were tested and the outcomes in 28 days were recorded. According to the sepsis score, all patients were divided into 5 mortality risk groups, namely very low risk group (0~4 points), low risk group (5~7 points), moderate risk group (8~12 points), high risk group (13~15points), and very high risk group (more than 15 points). The mortality rates were compared in five groups and then all patients were divided into survivors and nonsurvivors. MEDS score, APACHE Ⅱ score, and arterial blood lactate were compared. Receiver operating characteristic curve (ROC curve) was used to test the value of prediction between APACHE Ⅱ score, MEDS score, and arterial blood lactate. 【Results】Twentyfour patients were out of the followup and 292 patients were followed up completely among 316 patients. The actual mortality rates of very low risk group, low risk group, moderate risk group, high risk group and very high risk group were 0%, 11.4%, 19.2%, 47.1%, and 67.7%, respectively. Significant differences were observed in age, the level of arterial blood lactate, MEDS score, and APACHE Ⅱ score between survivors and nonsurvivors (P<0.05), but not in hospital time. MEDS score, APACHE Ⅱ score, and arterial blood lactate were valid and eligible for predicating the risk of mortality in patients with sepsis by using ROC curve. ROC squares of the three factors were 0.807, 0.713, and 0.730, respectively. 【Conclusion】 The sepsis score could be used to patients with sepsis and MEDS and was better for predicting 28 days mortality in Emergency department. 2016 Vol. 33 (2): 216-220 [Abstract] ( 63 ) HTML (1 KB)  PDF  (0 KB)  ( 40 ) 220 Effect of Stent Coating Material on Vascular Smooth Muscle Cells ZHAO Hongyan，SHI Bei，ZHAO Ranzun,et al 【Objective】To investigate the effect of stent coating material on vascular smooth muscle cells. 【Methods】Vascular smooth muscle cells of SD rats were used for testing. The effects of butylene styrene copolymer and polylactic acid coating material on production ability of vascular smooth muscle cells was observed. Flow cemetery method was used to determine cell cycle. 【Results】The number of vascular smooth muscle cells in both the butylene styrene copolymer and polylactic acid group increased with the culture time. The number of vascular smooth muscle cells in both the polylactic acid groups and butylene styrene copolymer group was significantly lower than in the control group (P<0.05). Compared with the control group, butylene styrene copolymer and polylactic acid cell cycle changes were in varying degrees, mainly for the G0/G1 phase cells increased, S phase, G2/M phase cells decreased（P<0.05）. There was no significant difference between the butylene copolymer of styrene and polylactic acid group (P＞0.05). 【Conclusion】Butylene styrene copolymer and polylactic acid, mainly through the regulating point (G1→S turning point), inhibited production of vascular smooth muscle cell. 2016 Vol. 33 (2): 220-222 [Abstract] ( 86 ) HTML (1 KB)  PDF  (0 KB)  ( 41 ) 223 Dexmedetomidine Can Stable Hemodynamics of Patients Undergoing Intracranial Aneurysm Embolism FENG Shunhua,HAN Chao,XU Lu,et al 【Objective】To evaluate the effects of dexmedetomidine on hemodynamics and recovery quality for patients undergoing intracranial aneurysms embolism under general anesthesia. 【Methods】40 adult patients with ASA class Ⅰ~Ⅱ for aneurysm embolization were divided randomly into two groups (n=20). All patients were anesthetized with the same scheme of induction and maintenance. The patients in group treated with dexmedetomidine received intravenously bolus dexmedetomidine 0.6 g/（kg•10min） 15 min prior to anesthesia followed by 0.4 g/（kg•h） during the operation. The patients in the saline group received the same dose of saline. HR and MAP were recorded preinfusion, 10 min after infusion, postintubation, end of the surgery, preextubation, immediately after extubation, 5 min after, and 10 min after. Waking time, extubation time, restless and cough score were observed and recorded. Sedation scores were evaluated and recorded with the Ramsay score after 10 min of extubation. 【Results】The operation time, waking, and extubation time were no different between both groups (P>0.05). MAP and HR were significantly lower in patients of group dexmedetomidine than patients in group saline at the time of intubation and preextubation, extubation and 5 min after extubation (P< 0.05). Ramsay sedation scores were higher in patients of the dexmedetomidine group than in patients of group saline at the time of 10 min after extubation, and cough score, agitation score were significantly lower in patients of group dexmedetomidine than patients of group saline (P<0.05). 【Conclusion】It is helpful to stabilize hemodynamics and improve recovery quality when the patients undergoing intracranial aneurysms embolism are administered dexmeditomidine intravenously with bolus 0.6 g/（kg•10min） and followed by 0.4 g/（kg•h）.  2016 Vol. 33 (2): 223-225 [Abstract] ( 81 ) HTML (1 KB)  PDF  (0 KB)  ( 29 ) 226 Analysis of the Postoperative Hypopituitarism in Pituitary Adenomas after Endoscopic TransSphenoidal Microsurgery NI Shihui,BI ChangLong,YANG Yichun，et al 【Objective】 To investigate the change in the hormonal level of the pituitary adenomas resected by the endoscopic transsphenoidal microsurgery, to evaluate the postoperative damaging factors of pituitary function, and to guide hormonal replacement therapy. 【Methods】We retrospectively analyzed the clinical data and therapeutic methods of 82 cases of obtained pituitary adenomas. The determinations of the hormonal level preoperative and 3d postoperative were detected. These results suggested hypopituitarism and were statistically analyzed. 【Results】The pituitary hormone levels, including thyroid hormone, corticosteroid, and prolactin, were lower 3 days postoperatively in all patients (P<0.05). Hypopituitarism was found in 34 cases and accounted for 41.4% of the total 82 patients, including 2 cases of microadenomas (12 cases, 2.4%), 22 cases of macroadenomas and giant adenomas (70 cases, 16.7%), and 16 cases of nonfunctional adenomas (45 cases, 35.5%). Results showed that decreased function or hypopituitarism before operation was more commonly found in elder patients.【Conclusion】The surgical operation could effectively reduce the hormonal level for pituitary adenomas. The ratio of hypopituitarism postoperatively is wellrelated to tumor volume. Hypopituitarism postoperation is more likely to occur in elder patients or cases which had hypopituitarism before operation or nonfunctional adenomas. Reasonable hormone replacement therapy for patient's recovery is necessary. 2016 Vol. 33 (2): 226-228 [Abstract] ( 72 ) HTML (1 KB)  PDF  (0 KB)  ( 39 ) 229 Risk Factors Analysis of Poor Prognosis in Patients with Subarachnoid Hemorrhage caused by Ruptured Aneurysms Post Operation LIU Yongchang,LI Shaoquan,LI Liansheng, et al 【Objective】To explore the risk factors of poor prognosis in patients with subarachnoid hemorrhage caused by ruptured aneurysms post operation, so as to provide reference for early clinical evaluation and prevention. 【Methods】Retrospectively the clinical data of 120 SAH patients who underwent surgical treatment were collected and divided into poor prognosis group (32 cases) and good prognosis group (88 cases) according to the Glasgow outcome scale (GOS) score, the general data between the two groups were compared, the prognosis was set as the dependent variable, with various factors as independent variables and assignment, risk factors of poor prognosis were analyzed by Logistic regression . 【Results】 In poor prognosis group, the age was greater, the number of multiple aneurysm patients was larger, Fisher and grading Hunt  Hess classification were higher than those of the good prognosis group, the difference was statistically significant between the two groups (P<0.05); Logistic multivariate regression analysis results showed that age, multiple aneurysms, HuntHess classification were the risk factors of intracranial aneurysms after SAH poor prognosis, the OR values were respectively 3.259, 1.353, 1.656 , the difference was statistically significant (P<0.05). 【Conclusion】 Advanced age, multiple aneurysms and HuntHess classification of SAH patients had an increased risk of postoperative prognosis, thus more attention must be paid clinically and more relevant targeted prophylaxis needs to be taken. 2016 Vol. 33 (2): 229-231 [Abstract] ( 83 ) HTML (1 KB)  PDF  (0 KB)  ( 36 ) 232 Change of Connective Tissue Growth Factor in Gastric Mucosa during Healing of Gastric Ulcers PAN Qizhong, LU Rijian, BI Weiwen,et al 【Objective】To explore the role of secretary leukocyte protease inhibitor（SLPI）in the mechanism of peptic ulcer via investigating its expression and distribution in gastric mucosa during gastric ulcer healing. 【Methods】Expression of SLPI in gastric mucosa of 30 patients with gastric ulcer before and after treatment was examined by ABC immunohistochemistry stain and reverse transcription polymerase chain reaction (RTPCR). 【Results】The expressions of SLPI stain were found mainly in the cytoplasm of epithelial cells in gastric mucosa. Absorbance of SPLI in gastric mucosa before treatment (A=0.7083±0.0593) was significantly higher than in the healing mucosa after treatment （A=0.2641±0.0236,P<0.05）. Meanwhile, mRNA level change of SLPI by PTPCR demonstrated very similar findings compared to that of SLPI protein expression change（P<0.05）. 【Conclusion】The overexpression of SLPI may be involved in gastric ulcer healing by regulating connective tissue formatting and angiogenesis. 2016 Vol. 33 (2): 232-234 [Abstract] ( 99 ) HTML (1 KB)  PDF  (0 KB)  ( 34 ) 235 Risk Analysis for Deep Vein Thrombosis After Total Hip Arthroplasty ZHANG Desheng， LIU Shuping， LIU Yuehong，et al 【Objective】To investigate the risk factors of deep vein thrombosis after total hip arthroplasty. 【Methods】Ninety patients with total hip arthroplasty in our hospital from 2011 June to 2013 June were collected. Eight targets (sex, age, BMI, primary disease, complications, operation time, bleeding volume, use of operation) were studied of the relationship between the targets, and deep vein thrombosis were analyzed by multivariate Logistic regression primary disease contained osteoarthritis, necrosis of femoral head, femoral neck fracture, bone tumor, complication contained hypertension and diabetes. 【Results】Twentynine cases with deep vein thrombosis were found in 90 patients, the occurrence rate was 32.22%. The regression coefficient of complication with hypertension and diabetes was r=4.184，P=0.041, the results were statistically significant. Complications with hypertension and diabetes were the independent risk factor of deep vein thrombosis. 【Conclusion】Complications with hypertension and diabetes are the independent risk factor of deep vein thrombosis. 2016 Vol. 33 (2): 235-237 [Abstract] ( 87 ) HTML (1 KB)  PDF  (0 KB)  ( 38 ) 238 GnRHa Combined with Laparoscopic Conservative Surgery in the Treatment of Ⅲ~Ⅳ Phase of EMS ZHAN Runfang 【Objective】 To analyze the surgical effects of GnRHa in the treatment of endometriosis (EMS) in Ⅲ~Ⅳ phase EMS after laparoscopic conservative surgery, and to analyze the related factors of recurrence after treatment. 【Methods】 The 240 patients with EMS were randomly divided into control group and trial group. The control group was treated with laparoscopic conservative surgery (n=120) and trial group treated with same surgery add to GnRHa. According to the treatment time, the trial and control groups was redivided into A Group (treated 3 months) and B Group (6 months). All patients were followed up after 12 months to compare the effect of the treatment (improvement rate and recurrence rate), the rate of pregnancy, the level of the hormone levels before and after treatment, and analyze the factors related to recurrence. 【Results】 After operation, remission rates in the A group and B group were 46.3% and 59.1%, respectively. The improvement rates were 35.2% and 43.9%, and were better than rates in the control group, and better in the A group than in B group, P<0.05. In the A group and B group, the relapse rates were 12.9% and 7.6%, all of which are lower than in the control group, A group better than that in B group, P<0.05. The pregnancy rate of A group and B group were 25% and 26.9%, and there was no statistical difference with the control group 28.3% (P>0.05). After treatment, the hormone levels were lower in the observation group, hormone levels decreased significantly by a significant margin, P<0.05. Using logistic regression analysis, the relationship between the recurrence of endometriosis operation history, intrauterine operation history and postoperative close, as risk factorsanti EMS drugs and postoperative pregnancy are a protective factor. 【Conclusion】 Laparoscopic conservative surgery combined with GnRHa in Ⅲ~Ⅳ EMS is effective, the efficacy of 6 months is the most ideal, effective improve the pregnancy rate, and postoperative pregnancy is the protective factor of EMS, and can help to improve the prognosis of patients. 2016 Vol. 33 (2): 238-241 [Abstract] ( 93 ) HTML (1 KB)  PDF  (0 KB)  ( 34 ) 241 Effects of Noninvasive Mechanical Ventilation Combined with IntraAortic Balloon Pump (IABP) on Cardiac Pulmonary Edema yI Xiaoping, XU Daomiao 【Objective】To study and analyze the treatment effects of IABP on the cardiac pulmonary edema by noninvasive mechanical ventilation.【Methods】A total of 74 patients with cardiac pulmonary edema were treated with noninvasive mechanical ventilation combined with IABP. The indexes of the patients were observed and compared before and after treatment. 【Results】 66 cases of the 74 patients (89.20%) completed treatment. Two to ten hours after treatment with noninvasive mechanical ventilation combined with IABP treatment, the indexes of the patients were compared to the indexes before treatment. The indicators of the 66 patients showed that respiratory rate and heart rate decreased significantly (P<0.001), urine volume increased (P<0.001), SpO2 increased significantly (P<0.001), and B type natriuretic peptide (BNP) decreased (P<0.01). 【Conclusion】A combination of noninvasive mechanical ventilation and IABP treatment can significantly increase the oxygenation of patients with pulmonary edema, and improve cardiac function. 2016 Vol. 33 (2): 241-243 [Abstract] ( 88 ) HTML (1 KB)  PDF  (0 KB)  ( 42 ) 244 Correlation Studies of the Lower Back Pain and Lumbar Lordosis Angle after Lumbar Interbody Fusion Surgery GUI Shuguang, LI debin, LIU Anping,et al 【Objective】To explore the correlation between lower back pain and lumbar lordosis angle after lumbar interbody fusion surgery. 【Methods】The clinical data of the 124 cases of the patients who received lumbar interbody fusion surgery from February 2011  February 2011 were respectively analyzed, with 32 cases of patients with low back pain considered the observation group and 92 cases of patients without low back pain considered the control group. The lumbar lordosis angle, lower back pain VAS score, and lumbar dysfunction ODI score of the two groups at the time of the preoperative and postoperative 6 weeks, 3 months, 6 months ,12 months ，24 months and the time of the last followup were observed. The correlation was tested using the Pearson correlation analysis. 【Results】The preoperative lumbar lordosis Cobb Angle, low back pain VAS scores and lumbar dysfunction ODI score of the two groups had no statistical significance differences (P>0.05). The postoperative lumbar lordosis Cobb Angle, low back pain VAS scores and lumbar dysfunction ODI score of the two groups were obviously improved than the preoperative, had statistically significant difference (P<0.05); The postoperative lumbar lordosis Cobb Angle of the control group at the each time node were significantly greater than the observation group,had statistically significant difference (P<0.05); With longer duration of the followup,the lumbar lordosis Cobb Angle of the observation group showed a trend of gradually reducing , the low back pain VAS scores and lumbar dysfunction ODI score showed a trend of gradually rising; The three indicators of the observation group after 1 year, 2 years and at the last followup had statistically significant differences with the 6 weeks after surgery (P<0.05);Pearson correlation analysis results show that : the low back pain VAS scores, lumbar dysfunction ODI score of observation group had linear correlation with lumbar lordosis Cobb Angle,show a negative correlation (r=0.702, 0.682,P< 0.05). 【Conclusion】The postoperative low back pain and lumbar dysfunction of the patients with degenerative diseases who received interbody fusion surgery was associated with the lumbar lordosis angle lost, should try to rectify lumbar lordosis Angle. 2016 Vol. 33 (2): 244-247 [Abstract] ( 97 ) HTML (1 KB)  PDF  (0 KB)  ( 39 )

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