医学临床研究
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2016 Vol. 33, No. 3
Published: 2016-04-26
 
 
417 Effect of Mild Hypothermia on Hippocampal Expression of HIF1αand MMP2 After Cerebral Ischemia Reperfusion in Rats
ZHOU Zhiping,YU Dan,WANG Xueying,et al
【Objective】To observe the effects of mild hypothermia on cerebral ischemic rats and observe the expression of HIF1αand MMP2 in order to explore the neuroprotective mechanisms of mild hypothermia. 【Methods】Seventytwo adult SD rats were divided randomly into three groups: the sham group, ischemia/reperfusion model + normal body temperature group, and the ischemia/reperfusion model + hypothermia group. Every group was analyzed at four time points after ischemia/reperfusion: 1d, 3d, 7d and 14d. The expression of HIF1αand MMP2 was detected at each time point immunohistochemically. 【Results】There was a small fraction of HIF1αand MMP2 positive expression in the sham group. In the normal body temperature group and hypothermia group, we observed that the expression of HIF1αand MMP2 increased at 1d but decreased at 3d,there were significant differences between the two groups, which was shown the positivity in hypothermia group lower than that in normal temperature group at 1d,3d and 7d（P＜0.05). However, 14d after ischemic reperfusion, the differences became minimal to nonexistent（P>0.05）. 【Conclusion】Neuroprotection of mild hypothermia may contribute to the decrease in expression of HIF1α and MMP2 after cerebral ischemia reperfusion.
2016 Vol. 33 (3): 417-420 [Abstract] ( 122 ) HTML (1 KB)  PDF  (0 KB)  ( 37 )
420 Analysis of Risk Factors and Etiologic Patterns of Acute Multiple Brain Infarcts in the Posterior Circulation
ZHOU Yanwen，DAI Yahui，JIN Lingjing，et al
【Objective】To evaluate the risk factors and etiologic patterns of Acute Multiple Brain Infarcts in the Posterior Circulation. 【Methods】The 463 patients with acute cerebral infraction were enrolled. The patients were divided into acute multiple brain infarction(AMBI)group and acute single brain infarction (ASBI)group according to the lesion patterns on diffusion weighted imaging（DWI）. The classification of etiology of the brain infarction was down based on the Trail of Org 10172 in Acute Stroke Treatment(TOAST).The patients were divided into young and middleaged group, oldaged group and advancedaged group. Then single variable analysis and the logistic regression analysis were conducted. 【Results】There were significant statistical differences in drinking, hyperlipidemia and lower limb vascular patch between the AMBI group and ASBI group（P<0.05）. The logistic regression analysis showed that man（OR=2.833，95%CI：1.200～6.688）and hyperlipidemia（OR=2.332，95%CI：1.342～4.052）were independent risk factors for AMBI group. In the comparison of different ages in AMBI group, risk factors like drinking and smoking were more common in young and middleaged patients（P<0.05）. Heart disease was usual in oldaged patients(P=0.001). 【Conclusion】Male and hyperlipidemia were independent risk factors for AMBI group. Smoking and drinking behaviors were commonest in young and middleaged patients in AMBI group, and heart disease in old and advancedaged patients. 
2016 Vol. 33 (3): 420-423 [Abstract] ( 96 ) HTML (1 KB)  PDF  (0 KB)  ( 30 )
424 Correlation between Fetal Subcutaneous Soft Tissue Thickness and Liver Length
TIAN Aijun，TANG Qin，ZHANG Junhui
【Objective】To discuss the clinical evaluation on the correlation between the weight and fetal subcutaneous soft tissue thickness and liver length . 【Methods】1713 cases of normal fetuses with gestational age from13 to 40 weeks were divided into six groups according to gestational age: group A (13 ~ 16 weeks); group B (17 ~ 20 weeks); group C (21 ~ 24 weeks); group D (25 ~ 28 weeks); Group E (29 to 32 weeks); Group F (33 to 36 weeks); group G (37 ~ 40 weeks). 4D ultrasound was used to measure fetal biparietal diameter, head circumference, abdominal circumference, femur length, humerus length, and to estimate the EFW. Measurement of fetal neck skin thickness (NF), cheektocheek diameter (CCD), abdominal soft tissue thickness (ASTT), humeral soft tissue thickness (HSTT), femoral soft tissue thickness (FSTT) subcutaneous soft tissue thickness and liver length （LL）were simultaneously conducted, The correlation between the indicators and EFW were analyzed . 【Results】NF, CCD, ASTT, HSTT subcutaneous soft tissue thickness and LL and EFW showed significant positive correlation (r=0.53, 0.66, 0.60, 0.68, 0.71, 0.88,P<0.05) and NF, CCD, ASTT, HSTT and LL were positively related with gestational age（r=0.72, 0.71, 0.68,0.78, 0.81, 0.82，P<0.05）【Conclusion】 NF, CCD, ASTT, HSTT subcutaneous soft tissue thickness and LL and EFW show significant positive correlation. Fourdimensional color Doppler ultrasound measurement of NF, CCD,ASTT, HSTT, FSTT, LL and EFW are relatively accurate. The method is simple and convenient, and is worth to be popularized in clinical application.
2016 Vol. 33 (3): 424-426 [Abstract] ( 106 ) HTML (1 KB)  PDF  (0 KB)  ( 37 )
427 Effect of Two Reverse Added Solutions on Sex Hormone and Bone Mineral Density upon GonadotropinReleasing Hormone (GnRH) Inhibitors in the Treatment of Pelvic Endometriosis (EM)
LI Bo,YANG Jing,HU Sainan,et al
【Objective】To compare the effect of two reverse added solutions on sex hormone and bone mineral density upon gonadotropinreleasing hormone (GnRH) inhibitors in the treatment of pelvic endometriosis (EM).【Methods】Eighty patients with requirement for fertility who were treated with conservative laparoscopic surgery for severe pelvic endometriosis were collected, and were randomly divided into control group and experimental group, 40 cases in each group. The control group were given with the GnRHa 3.6mg/28d ，seven times totally. On the basis of the control group, the experimental group was added with vitamin D3. At time before each treatment and on the fourth week, twelfth week, sixteenth week, twentieth week, twentyfourth week and menstrual cycle , the conventional ultrasound reexamination and follicle stimulating prime (FSH), luteinizing prime (LH) ,the change of E2 and bone density scan were detected; osteoporosis prevention and treatment effect of two groups of patients were compared.【Results】(1)In the two groups ,at 4th w, 12th w, 16th w, 20th w and 24th w after the treatment, the levels of serum E2, FSH, LH were significantly reduced , the difference was significant (P<0.05); at 4th w, the medication was reduced almost to the level of menopaus , FSH and LH were in a low level and serum E2, FSH and LH of the two groups had no significant difference (P>0.05). (2) Comparing with those before treatment, the difference of bone density of the two groups at 4th w, 8th w, 12th w after treatment were not statistically significant (P>0.05); 16 weeks, 20 weeks and 24 weeks after medication and the return of menses, the bone density in both groups was significantly decreased, the difference of the control had statistical significance comparing with those of the treatment group and that before treatment (P<0.05), compared to that before treatment, there were differences with the experimental group ,but no statistical significance (P>0.05).【Conclusion】 GnRH inhibitor, combined with a small dose of estrogen, calcium and vitamin D3 in patients with pelvic EM is able to prevent low estrogen level and osteoporosis, the effect sounds better.
2016 Vol. 33 (3): 427-429 [Abstract] ( 97 ) HTML (1 KB)  PDF  (0 KB)  ( 21 )
430 Impact of Warmed and Humidified Carbon Dioxide on Body Temperature and Blood Coagulation during Laparoscopic Gynecologic Surgery
DUAN Boqing,YI Lisheng,XIAO Wenjun
【Objective】To Investigate the Impact of Warmed and Humidified Carbon Dioxide on Patients Undergoing Laparoscopic Gynecologic Surgery. 【Methods】Sixty female patients undergoing laparoscopic gynecologic surgery were randomly divided into two groups (n=30): group A received standard gas (19℃, 0% RH) and group B received warmed (37° C) and humidified (98% RH) insufflation carbon dioxide. Body temperature was measured before anesthesia and postpneumoperitoneum 10 min, 30 min, 60 min, and 90 min and compared between the two groups. Blood coagulation value was observed before surgery and 60 min after pneumoperitoneum. 【Results】 Intraoperative body temperature change after pneumoperitoneum in group A were lower than before anesthesia (P<0.05). In group B, change 60min and 90 min after pneumoperitoneum were lower than before anesthesia (P<0.05), but change was not as significant in group B as in group A (P<0.05). The two groups of patients showed no significant difference in coagulation value (P>0.05). 【Conclusion】Heating and humidifying the carbon dioxide gas can better maintain the temperature of patients in the perioperative and reduce postoperative pain. It has no obvious effect on blood coagulation function in patients.
2016 Vol. 33 (3): 430-435 [Abstract] ( 90 ) HTML (1 KB)  PDF  (0 KB)  ( 32 )
432 Effect of Budesonide and Parecoxib Sodium Treatment on Relieving Postoperative Sore Throat after Tracheal Intubation of Thoracic Surgery Patients
CHEN Lihong,DONG Liang，HUANG Yidan,et al

【Objective】 To evaluate the effects of inhaling budesonide after extubation and parecoxib injection on the prevention and treatment of postoperative sore throat (POST) after tracheal intubation with a doublelumen endobronchial tube in thoracic surgery patients. 【Methods】One hundred and sixty patients aged 18~64  scheduled for elective thoracic surgery under general anesthesia were randomly divided into four groups equally with 40 patients each group. Patients in group C received no inhalation treatment. Patients in group B inhaled 1mg budesonide 30 minutes after extubation, patients in group P received a 40 mg parecoxib injection of sodium 30 minutes before postoperation, and patients in group BP inhaled 1mg budesonide and received a 40 mg parecoxib injection of sodium with a double_lumen endobronchial tube. The incidence and VAS score of POST at 1h，6h and 24h in the postoperative period after tracheal extubation were assessed. 【Results】 There was no statistical significance of patients' age, sex ratio, height, weight, time of operation, or intubation (P>0.05). The incidence and VAS scores of POST were significantly lower in group B，group P, and group BP than those of group C (P<0.05)，and lower in group BP than in group B and group P (P<0.05) after removal of endotracheal tube on a three point scale. No adverse reactions of inhalation of atomization and parecoxib sodium injection occured in any group. 【Conclusion】 The combination of budesonide and parecoxib sodium is safe and can reduce the incidence and VAS score of POST after tracheal intubation with a doublelumen endobronchial tube.
2016 Vol. 33 (3): 432-435 [Abstract] ( 96 ) HTML (1 KB)  PDF  (0 KB)  ( 42 )
436 Comparative Analysis of Sevoflurane and Ketamine on Pediatric Tonsillectomy Anesthesia Induction and Recovery Period
LUO Liu, MAO Xincheng
【Objective】Comparative analysis of the effects of sevoflurane and ketamine anesthesia on pediatric tonsillectomy patients' induction and restlessness. This will provide the basis for clinical anesthesia medication. 【Methods】120 cases of children who received treatment for tonsillectomy in our hospital were randomly divided into a sevoflurane group（n=60）and a ketamine group（n=60）. After induction of anesthesia by phenobarbital and atropine, children received sevoflurane and ketamine, respectively . Anesthesia induction and restlessness situation were compared between the two groups. 【Results】The patient groups were able to successfully carry out surgery, and anesthetic effects are good. There were no serious accidents. However, children in the sevoflurane group had shorter operative times, extubation times, and recovery times than children in the ketamine; the difference was statistically significant (P<0.05). The incidence of children with bronchospasm and SpO2 instability were significantly lower in the sevoflurane than in the ketamine group (P<0.05). Before extubation, MAP and HR of the two groups had no significant difference (P>0.05). 5min after extubation, the number of children with HR was significantly higher in the sevoflurane group than in the ketamine group (P<0.05). After extubation, MAP in the sevoflurane group was significantly higher than in the ketamine group (P<0.05), but showed no significant difference later (P>0.05). Agitation incidence was 15.00% in the sevoflurane group and 63.33% in the ketamine group; the difference was statistically significant (P<0.05). This shows that the agitation score of the sevoflurane group was significantly lower than that of the ketamine group. The difference was statistically significant (P<0.05). 【Conclusion】Sevoflurane in children can cause a rapid heart rate and an increase in mean arterial pressure, but also allows for a quicker recovery compared to ketamine. However, ketamine anesthesia is more stable than sevoflurane. It allows for rapid recovery after surgery, a short anesthesia time, smooth hemodynamics, low incidence of side effects, few cases of restlessness. Ketamine is more suitable for children.
2016 Vol. 33 (3): 436-438 [Abstract] ( 89 ) HTML (1 KB)  PDF  (0 KB)  ( 30 )
439 TSP1 Levels in Serum to the Diagnosis of Hepatic Carcinoma
YUE Yanghua，CAO Youde, LIAO Chushu,et al
【Objective】To explore the expression levels of Thrombospondin1(TSP1) in the serum of patients with hepatic carcinoma, and the application values of TSP1 combined with alphafetoprotein (AFP) in the diagnosis of hepatic carcinoma (HCC). 【Methods】Selected 48 cases of clinically diagnosed HCC patients, 43 cases of hepatic fibrosis, and 40 cases of normal healthy perple as the control group. Detection of TSP1 used the sandwich enzyme immunoassay technique, and detection of AFP used Chemiluminescence. A statistical analysis of TSP1 and AFP was performed to show the differences between groups, and both the sensitivity and the specificity of diagnosis to hepatic carcinoma. The best diagnostic value of TSP1 and AFP was defined by the ROC curve. An analysis of the diagnostic value of combined detection of TSP1 and AFP in hepatic carcinoma was performed. 【Result】1. TSP1 in group of hepatic carcinoma was significantly lower than group of hepatic fibrosis and normal control group. The group of hepatic fibrosis was lower than the group of normal control. AFP in the group of hepatic carcinoma was significantly higher than in the group of hepatic fibrosis and group of normal control. 2. To measure TSP1 respectively, the sensitivity of diagnosis to hepatic carcinoma was 79.17%（38/48) and the specificity was 78.31%（65/83）. 3.To measure AFP respectively, the sensitivity of diagnosis to hepatic carcinomas was 58.33%（28/48） and the specificity was 79.52%（66/83）. 4. The sensitivity of the serial test of TSP1 and AFP to the diagnosis of hepatic carcinoma was 43.75% (21/48) and the specificity was 95.18% (79/83). The sensitivity of the parallel test of TSP1 and AFP to the diagnosis of hepatic carcinoma was 93.75% (45/48) and the specificity was 62.65% (52/83).【Conclusions】The levels of TSP1 in serum can be used as a new marker for hepatic carcinoma and both the sensitivity and the specificity of measuring TSP1, respectively, were high in the diagnosis of hepatic carcinoma. It is very beneficial to the early diagnosis of hepatic carcinoma. Combined detection of TSP1 and AFP can improve the sensitivity and specificity in diagnosis of hepatic carcinoma.
2016 Vol. 33 (3): 439-441 [Abstract] ( 87 ) HTML (1 KB)  PDF  (0 KB)  ( 35 )
442 Sevoflurane Combined with Sufentanil Anesthesia in Pediatric Surgery Removal of Tracheal Foreign Bodies
ZHANG Wenjuan,GAO Hong
【Objective】To investigate the effects of sevoflurane combined with sufentanil anesthesia in the removal of tracheobronchial foreign bodies. 【Methods】 Selected 106 cases of tracheal foreign body removal in children patients in our hospital in July 2013 to 2015 July, and all cases were analyzed retrospectively and were randomly divided into experimental group and control group (n = 53). Sevoflurane combined with propofol intravenous anesthesia were used in the control group, the experimental group with sevoflurane combined with sufentanil intravenous anesthesia. Observed the two groups of patients with operation of HR, SBP, SpO2 and operation choking cough, breath holding, and vomiting. 【Results】The results of HR, SBP and SpO2 in the experimental group during the operation were higher than those in control group and the difference is statistical significance (P<0.05). The two groups of children showed no statistical significance in recovery time after surgery (P>0.05). Agitation (restlessness) in the experimental group (3.78% in severe level) waslower than that of the control group (22.64% in severe level), and the difference was statistically significant (P<0.05). In the experimental group, cough, breath holding and vomiting rate were significantly lower than that in the control group, with statistical significance (P<0.05). 【Conclusion】Sevoflurane combined with sufentanil anesthesia in children with tracheal foreign body removal surgery can reduce the occurrence of adverse circumstances and maintain stable vital signs.
2016 Vol. 33 (3): 442-446 [Abstract] ( 89 ) HTML (1 KB)  PDF  (0 KB)  ( 36 )
444 Correlation Between Platelet Parameters and hsCRP in Patients With Coronary Heart Disease Complicated by Impaired Glucose Tolerance
SUN Liping
【Objective】To investigate the correlation between platelet parameters and hypersensitive Creactive protein (hsCRP) in patients with coronary heart disease complicated by impaired glucose tolerance. 【Methods】Fortynine patients with coronary heart disease (CHD) complicated by impaired glucose tolerance (IGT) were selected as CHD with IGT group, 52 patients with CHD alone were selected as the CHD group, and 55 normal cases were selected as the control group. After admission, the levels of hsCRP and 5 platelet parameters (PLT,PCT,PDW,MPV and PLCR) were detected to analyze the correlation. 【Results】In the CHD with IGT group, hsCRP, PCT, PDW, MPV and PLCR were（7.94±0.51）mg/L,（0.24±0.04）%,（22.86±3.05）%,（16.04±3.97）fl and（59.68±8.24）%, respectively which were significantly higher than those in the CHD group and the control group. PLT（148.37±29.79）×109/L was significantly lower than in the CHD group and the control group, however, the differences between the CHD group and the control group were statistically significant (P<0.05); The correlation between platelet parameters and hsCRP was analyzed by Pearson correlation analysis. It was found that hsCRP was negatively correlated with PLT and positively correlated with PCT, PDW, MPV and PLCR. 【Conclusion】The platelet parameters of patients with CHD complicated by IGT are significantly correlated with hsCRP.
2016 Vol. 33 (3): 444-446 [Abstract] ( 85 ) HTML (1 KB)  PDF  (0 KB)  ( 31 )
447 Effect of Danshen Powder Injection on the Expression of Autophagyrelated Protein in the Peripheral Blood of Patients with Earlystage of Diabetic Nephropathy
XIE Jiayong,ZHU Qiang,GAO Jianming,et al
【Objective】To study the effect of Danshen powder injection on the expression of autophagyrelated protein in the peripheral blood of patients with earlystage of diabetic ephropathy. 【Methods】 Sixtyone patients with early diabetic nephropathy were divided into control group and treatment group according to the patients' willing. Both of the two groups were treated with glimepiride tablets 2 mg once a day, while the treatment group were given with Danshen powder injection 1200mg plus xylitol 250 mL intravenous drip once a day additionally. The treatment course covered 14 d, and two consecutive courses of treatment were conducted. The patients of two groups were detected before and after 24 h ,the urinary albumin excretion amount (UAER), 24 h urine total protein (Upro), serum creatinine (SCr) and blood urea nitrogen (BUN) and glomerular filtration rate (eGFR) and peripheral blood of autophagy associated protein p62 and LC3 expression levels were compared.【Results】The 24h UAER, 24 h Upro, BUN, SCr and eGFR in the control group had no statistical significance compared with those before treatment (P>0.05), but after treatment, the UAER,24hUpro、BUN、SCr and eGFR of the observation group was significantly decreased compared with those before treatment (P<0.05); The expression level of LC3, mRNA and p62 antibody positive rate of the control group had no significant difference before and after treatment (P>0.05); the expression level of LC3 mRNA of the treatment group was significantly increased compared to that before treatment (P<0.05), the p62 antibody positive rate was significantly decreased compared with that before treatment (P<0.05).【Conclusion】Danshen powder intravenous infusion has protective effect on kidney in early stage of DN, and its mechanism may be related to the intervention of autophagy. 
2016 Vol. 33 (3): 447-449 [Abstract] ( 90 ) HTML (1 KB)  PDF  (0 KB)  ( 32 )
450 Effects of Allicin on RhoA Activity and Axonal Growth in Neuronlike PC12 Cells
LV Runxiao，WU Jinhui，LU Chunwen，et al
【Objective】To observe the effects of allicin on RhoA activity and axonal growth in neuronlike PC12 cells and to explore the relationship between allicinpromoting PC12 cells axon growth and RhoA/ROCK signaling activity. 【Methods】 The effects of Allicin on the growth of PC12 cells were detected by MTT assay. The low, medium, and high concentrations of Allicin, which had no effect on the growth of PC12 cells, were selected. PC12 cells were cultured in medium with LPA to induce the activation of RhoA/ROCK signaling pathway and intervened with low, medium, and high concentrations of Allicin. Western blotting was used to detect the expression of ROCK1, ROCK2, RhoA, NF, synapsin and synaptophysin. 【Results】The three Allicin concentrations (10 ng/ml, 100 ng/ml and 1 μg/ml) had no effect on the growth of PC12 cells. The expression of RhoA, ROCK1 and ROCK2 were significantly increased and the expression of NF, synapsin and synaptophysin were dramatically reduced in PC12 cells treatment with LPA. Allicin could effectively reduced RhoA, ROCK1 and ROCK2 expression and recover the expression of NF, synapsin and synaptophysin. 【Conclusion】Allicin intervention can effectively alleviate RhoA activation and inhibitory effects for axon growth induced by LPA. Allicin can promote the growth of axons through inhibiting the activation of RhoA.
2016 Vol. 33 (3): 450-457 [Abstract] ( 73 ) HTML (1 KB)  PDF  (0 KB)  ( 37 )
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