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Quick Search     Adv Search 2019 Vol. 36, No. 11 Published: 2019-11-30   2081 Correlation between the Expression of CTNT-1 and CD90 Protein and the Recurrence of Primary Liver Cancer LI Kang, AN Xiao-cui, ZHU Rui-xue, et al DOI: 10.3969/j.issn.1671-7171.2019.11.001 【Objective】To investigate the relationship between the expression of ctnt-1, CD90 and the recurrence of primary liver cancer. 【Methods】From January 2016 to June 2018, 114 patients with primary liver cancer received surgical treatment in our hospital were divided into recurrence group (n=50) and non recurrence group (n=64) according to the recurrence situation in two years after operation. The positive rates of CTNT-1 protein and CD90 protein were compared between the two groups, and the risk factors of postoperative recurrence of liver cancer were studied by logistic regression analysis. 【Results】Ctnt-1 protein high expression rate and CD90 protein positive expression rate in relapse group were significantly higher than that in non relapse group (P<0.05). There were significant differences in TNM stage, AFP level and tumor differentiation between the recurrence group and the non recurrence group (P<0.05). Multivariate logistic regression analysis showed that increased TNM stage, increased AFP level, decreased tumor differentiation, high expression of CTNT-1 protein and positive expression of CD90 protein were independent risk factors for postoperative recurrence of primary liver cancer (P<0.05). 【Conclusion】The high expression of CTNT-1 protein and CD90 protein in primary liver cancer are the risk factors of postoperative recurrence. 2019 Vol. 36 (11): 2081-2083 [Abstract] ( 99 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 2084 Study on the Changes of Serum Inflammatory Factors and Pathogenesis in Patients with CHF of Different Degrees XIE Qi-hai, LI Hong-song, WANG Li-fang, et al DOI: 10.3969/j.issn.1671-7171.2019.11.002 【Objective】To explore the correlation between the activation of NOD-like-Receptor protein 3(NLRP3)inflammatory corpuscles and the classification of heart function in patients with chronic heart failure (CHF). 【Methods】From June 2017 to June 2018, 50 patients with CHF were enrolled in our hospital. NYHA heart function grading: 13 patients of grade Ⅱ, 23 patients of grade Ⅲ, 14 patients of grade Ⅳ; another 50 healthy people of our hospital at the same period were selected as the control group. The expression of NLRP3, IL-1 β (IL-1 β) and IL-18 (OD) in the two groups were measured by Western blot analysis, the levels of IL-1 β and IL-18 (PG/mL) were measured by enzyme-linked immunosorbent assay, and the left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDd) were evaluated by echocardiography. 【Results】The OD value of NLRP3, IL-1 β and IL-18 protein expression in CHF group was higher than that in the control group (P<0.05). With the aggravation of heart function damage (Ⅱ ~ Ⅳ), the OD value of NLRP3, IL-1 β and IL-18 protein expression gradually increased, and the serum IL-1 β and IL-18 levels also gradually increased in all levels of the heart function groups, while the LVEF gradually decreased, and the LVEDd gradually increased, the difference was statistically significant (P<0.05). The expression of NLRP3, IL-1 β and IL-18 was positively correlated with cardiac function grade Ⅳ. 【Conclusion】The activation of NLRP3 inflammatory corpuscles may be involved in the pathogenesis of CHF and is closely related to the classification of cardiac function. 2019 Vol. 36 (11): 2084-2087 [Abstract] ( 90 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 2088 Analysis of Status and Influencing Factors of Patients-identification with Correct Implementation before Pediatric Nursing Procedures XIONG Liang, ZHU Li-hui, XIE Jian-hui, et al DOI: 10.3969/j.issn.1671-7171.2019.11.003 【Objective】To investigate the status and influencing factors of patient-identification with correct implementation before pediatric nursing procedures in our hospital. 【Methods】A total of 300 nursing staff from emergency department, outpatient units and 32 wards in our hospital were selected by cluster sampling from September 2018 to December 2018. The survey covered 10 common nursing procedures (indwelling intravenous infusion, replacing liquid, blood collection/blood transfusion, intramuscular injection, intradermal injection, oral medication, aerosol inhalation, vital signs measurement, issuing checklists and instruments, and patients returning bed). The status of patient-identification before any of those operations by pediatric nurses was evaluated by wristband information viewing and patient's identity checking and asking. 【Results】Among the 300 nursing staff in our survey, patients' identification were correctly performed 232 times. The correct implementation rate was 77.33%. The total number of unqualified patient-identification before operations were 68 times (22.67%). Univariate analysis showed that the differences of correct implementation rate for patient-identification before operation among working years, job titles, investigation time period and department categories were statistically significant (P<0.05). Multivariate logistic analysis also showed that years of work, job title, investigation period, and department were independent risk factors that affected the correct identification of patients before operation (P<0.05). 【Conclusion】Pediatric nurses in our hospital still have room for further improvement in the identification of patients before any operations. The training of nursing staff at all levels should be emphasized, and the core system should be implemented. At the same time, the operational procedures should be standardized to strengthen the awareness of risk prevention of nursing staff. 2019 Vol. 36 (11): 2088-2091 [Abstract] ( 70 ) HTML (1 KB)  PDF  (0 KB)  ( 14 ) 2092 Effect of Biofilm Cleaning Agent on the Cleaning of the Hard-type Endoscope and the Effect on the Nosocomial Infection ZHANG Li-li, LANG Jing, WANG Fang DOI: 10.3969/j.issn.1671-7171.2019.11.004 【Objective】To explore the cleaning effect of biofilm cleaner on hard endoscopic instruments and its effect on hospital infection. 【Methods】Three hundred and eighty-nine rigid endoscopic instruments from January 2015 to December 2017 were randomly divided into observation group and control group with 199 instruments each. The observation group was cleaned with biofilm cleaner and the control group was cleaned with total enzyme cleaner. After cleaning, the two groups were compared in terms of equipment qualification, bacterial detection and equipment damage. 【Results】The qualified rate of special sterile cotton swabs: the qualified rate of the inner wall of the lumen and the occlusal teeth in the observation group was significantly higher than that in the control group (P<0.05), the qualified rate of the concave convex groove and the handle was slightly higher than that in the control group, but the difference was not statistically significant (P>0.05); the qualified rate of ATP bioluminescence detection: the qualified rate of the inner wall of the lumen, the occlusal teeth and the handle in the observation group was significantly higher than that in the control group (P<0.0 5) the qualified rate of concave convex groove was slightly higher than that of the control group, but the difference was not statistically significant (P>0.05). The content of pathogenic bacteria in the observation group was significantly lower than that in the control group (P<0.05), and the damage rate of instruments in the observation group after cleaning was significantly lower than that in the control group (P<0.05). 【Conclusion】Using biofilm cleaning agent to clean the hard endoscope, the qualified rate of instrument cleaning is higher, the residual pathogens are less, and the damage to the instrument is less, which is worthy of clinical application. 2019 Vol. 36 (11): 2092-2094 [Abstract] ( 65 ) HTML (1 KB)  PDF  (0 KB)  ( 15 ) 2095 Investigation on the Role and Mechanism of NR2D Subunit of NMDA Receptor in Hyperoxia-induced Lung Injury of Neonatal SD Rats ZHANG Xi, LI Lin-rui, DUAN Xiao-jun, et al DOI: 10.3969/j.issn.1671-7171.2019.11.005 【Objective】To investigate the role and mechanism of NR2D subunit of NMDA receptor in hyperoxia-induced lung injury of neonatal rats. 【Methods】Animal experiments were performed in a total of 40 newborn SD rats (within 12 hours of birth) . The rats were randomly divided into the control group (Con), 1 day after hyperoxia exposure group, 7 days after hyperoxia exposure group and 14 days after hyperoxia exposure group, with 10 rats in each group. Neonatal rats were exposed to hyperoxia (oxygen content ≥95%) for 3 days to establish lung injury model induced by hyperoxia. The neonatal rats in the hyperoxia group were sacrificed with the control group mice at 1, 7, 14 days after the establishment of lung injury model. Hematoxylin-eosin staining (HE) and Masson staining were used to observe the pathological changes of lung in rats of each group; then Holfbauer score was performed. The content of hydroxyproline (HYP) in lung tissue was measured by a hydroxyproline detection kit. The expression of NR2D subunit was detected by Western blot. In vitro experiments, rat alveolar epithelial cell line RLE-6TN was divided into six groups: the blank control group, the model group, NR2D overexpression plasmid group, NR2D empty plasmid group, NR2D siRNA group and NR2D siRNA negative control group. Cells in the model group and the transfected groups were exposed to hyperoxia to establish the lung cell injury status. After transfection of plasmid and siRNA, cell proliferation was detected by CKK-8 assay; levels of cytokines TNF-α, IL-6 and TGF-β secreted by cells were measured by enzyme-linked immunosorbent assay (ELISA); expressions of NR2D subunit, E-cadherin and Vimentin proteins were shown by Western blot. 【Results】Animal experiment results showed that, the Holfbauer score, HYP content and expression level of NR2D subunit of neonatal rats in the hyperoxia exposure group were higher than those in the control group and the trend of increase was in a time-dependent manner (P<0.05). Cell experiment results showed that, compared to the control group, cell proliferation and E-cadherin protein expression in the model group decreased (P<0.05), while the expressions of NR2D subunit, TNF-α , IL-6 , TGF-β and Vimentin increased (P<0.05). Compared to the model group, cell proliferation and E-cadherin protein expression in NR2D overexpression group decreased (P<0.05), while the NR2D subunit expression and protein expressions of TNF-α, IL-6, TGF-β and Vimentin increased (P<0.05). On the other hand, relative cell proliferation rate and E-cadherin protein expression in NR2D siRNA group were increased (P<0.05), while the NR2D subunit expression and protein expressions of TNF-α, IL-6, TGF-β and Vimentin were decreased (P<0.05). There were no significant changes of above indexes in both NR2D empty plasmid group and NR2D siRNA negative control group (P>0.05). 【Conclusion】NMDA receptor NR2D subunit plays an important role in the occurrence and development of lung injury induced by hyperoxia in neonatal rats. Downregulation of its expression protects alveolar epithelial cells from hyperoxia injury, possibly by reducing levels of cytokines TNF-α, IL-6 and TGF-β. 2019 Vol. 36 (11): 2095-2100 [Abstract] ( 63 ) HTML (1 KB)  PDF  (0 KB)  ( 13 ) 2101 Significance of MMP-9, TIMP-1 and VEGF Plasma Levels in Patients with Non-small Cell Lung Cancer LIANG Nai-chao, WANG Teng, CHE Jiu-ling, et al DOI: 10.3969/j.issn.1671-7171.2019.11.006 【Objective】To investigate the expression levels and significance of plasma matrix metalloproteinase (MMP-9), tissue matrix metalloproteinase inhibitor-1 (TIMP-1) and vascular endothelial growth factor (VEGF) in patients with non-small cell lung cancer (NSCLC). 【Methods】Plasma samples from 70 patients with non-small cell lung cancer were selected as the observation group. Plasma samples from 70 healthy volunteers were selected as the control group. The levels of MMP-9, TIMP-1 and VEGF in the plasma samples of the two groups were detected and compared; their correlation with pathological features and prognosis of NSCLC were analyzed. The survival of 70 patients with NSCLC was analyzed by Kaplan-Meier method. 【Results】The levels of plasma MMP-9, TIMP-1 and VEGF in the observation group were significantly higher than those in the control group (P<0.05). Spearman correlation analysis showed that MMP-9 was significantly correlated with TIMP-1 and VEGF (P<0.05), though TIMP-1 had no significant correlation with VEGF (P>0.05). The levels of MMP-9, TIMP-1 and VEGF in plasma of NSCLC patients were significantly correlated with tumor size, pathological differentiation, T stage, lymph node metastasis, distant metastasis, and TNM stage (P<0.05).The Kaplan-Meier curve was drawn by GraphPad Prims software for survival analysis. According to the Cut-off value, patients were divided into high expression group and low expression group. The results showed that the 5-year survival rate of MMP9 and VEGF low expression group was significantly longer than that of MMP9 and VEGF high expression group. The difference was statistically significant (P<0.05). However, there was no significant difference in the 5-year survival rate between the TIMP-1 low expression group and the TIMP-1 high expression group (P>0.05). 【Conclusion】The expression levels of MMP-9 and VEGF in plasma of NSCLC patients are significantly increased, which is of great significance for evaluating the condition and prognosis of patients with NSCLC. 2019 Vol. 36 (11): 2101-2103 [Abstract] ( 64 ) HTML (1 KB)  PDF  (0 KB)  ( 12 ) 2104 Study on Correlation of Serum Cytokines IL-12 and IL-6 with ET-1 and CEC Levels in Children with Bronchial Asthma Attack CHEN Lu, CHEN Yan-ping, HUANG Jian-bao, et al DOI: 10.3969/j.issn.1671-7171.2019.11.007 【Objective】To investigate the correlation of serum cytokines IL-12 and IL-6 with Endothelin-1( ET-1) and Circulating endothelial cells( CEC)in children with bronchial asthma attack. 【Methods】A total of 90 children with bronchial asthma were divided into the stable group (45 cases) and the attack group (45 cases) according to asthma attack status. The serum levels of IL-12 (the representative cytokine of helper T lymphocyte-1/Th1), IL-6 (the representative cytokine of helper T lymphocyte-1/Th2 ) and ET-1 were measured by ELISA, while the level of CEC was detected by flow cytometry. The levels of Th1/Th2 cytokines (IL-12 and IL-6), ET-1 and CEC were compared between in the two groups. The correlations between serum IL-12 and IL-6 cytokines with levels of ET-1 and CEC were analyzed. 【Results】Level of serum IL-12 in asthma attack group was lower than that in the stable group, while serum IL-6, ET-1 and CEC levels in the attack group were higher than those in the stable stage. The differences between the two groups were statistically significant (P<0.05). The partial correlation coefficient of IL-12 and IL-6 with ET-1 was 0.249, P=0.103, suggesting that IL-12 and IL-6 had a linear trend correlation with ET-1. The partial correlation coefficient of IL-12 and IL-6 with CEC was 0.340, P=0.024, suggesting that IL-12 and IL-6 had a linear correlation with CEC. 【Conclusion】There are significant differences of serum IL-12, IL-6, ET-1 and blood CEC in children with bronchial asthma at different stages (stable vs attack). Serum cytokines IL-12 and IL-6 are closely related to ET-1 and CEC levels in children with bronchial asthma attack stage, which can effectively evaluate the condition of children and guide clinical diagnosis and treatment. 2019 Vol. 36 (11): 2104-2105 [Abstract] ( 70 ) HTML (1 KB)  PDF  (0 KB)  ( 12 ) 2106 Clinical Effect of Transcutaneous Nerve Electrical Stimulation on Fatigue Caused by Chemotherapy for Cervical Cancer XU Dong-mei, SHENG Jin-li, XU Fang, et al DOI: 10.3969/j.issn.1671-7171.2019.11.008 【Objective】To explore the clinical effect of transcutaneous nerve electrical stimulation in the treatment of fatigue caused by chemotherapy for cervical cancer. 【Methods】From February 2016 to December 2018, 82 patients who received postoperative chemotherapy for cervical cancer in our hospital were divided into observation group and control group, 41 cases in each group. The control group was given routine nursing, and the observation group was treated with transcutaneous nerve electrical stimulation twice a week for six weeks. The fatigue of the patients in the two groups was assessed by MFI and FQ, and the mood of the patients in the two groups was assessed by HADS. 【Results】Before treatment, there was no significant difference in MFI score, FQ score and hads score between the two groups (P>0.05); after 6 weeks of intervention, the MFI score, FQ score and hads score of the observation group were significantly lower than that before treatment (P<0.05), and the MFI score, FQ score and HADS score of the control group were no significant change compared with that before treatment (P>0.05); moreover, each index of the observation group was significantly lower than that of the control group The difference was statistically significant (P<0.05). 【Conclusion】Transcutaneous nerve electrical stimulation can improve the fatigue of patients with cervical cancer caused by chemotherapy, and relieve the anxiety and depression of patients, which is worthy of clinical application. 2019 Vol. 36 (11): 2106-2108 [Abstract] ( 55 ) HTML (1 KB)  PDF  (0 KB)  ( 9 ) 2109 Characteristics of Cerebral Hemodynamics in Early Neonatal Period LIU Xin-hui, Nur ima khan Maimait, GAO Xi-rong, et al DOI: 10.3969/j.issn.1671-7171.2019.11.009 【Objective】To investigate the characteristics of cerebral hemodynamic changes in the early neonatal period. 【Methods】A total of 142 neonates were detected by color Doppler ultrasound in our hospital. Systolic blood flow velocity (Vs), peak diastolic blood flow velocity (Vd) and resistance index (RI) of the middle cerebral artery were measured within 24 hours, 24-48 hours and 48-72 hours after birth. Statistical methods SPSS17.0 was used for statistical analysis. 【Results】Among the 142 newborns, there were 87 males and 55 females with gestational age of 28+4-44 weeks and birth weight of 950-4650 g. The comparison of Vs(cm/s), Vd (cm/s) and RI of the middle cerebral artery within 24 hours, 24-48 hours and 48-72 hours after birth were statistically significant (P<0.01). According to the birth weight, newborn babies were divided into three groups: <1500g,1500g-2500g and >2500g. The values of Vs, Vd and RI in the three groups were compared and the differences were statistically significant (P<0.01). Meanwhile the differences of Vs, Vd and RI in three gestational age groups (<37 weeks, 37+1-42 weeks and > 42 weeks) The Vs, Vd, and RI were statistically significant (P<0.01). Also, the differences in Vs, Vd and RI among no asphyxia, mild asphyxia, moderate asphyxia and severe asphyxia groups at birth were statistically significant (P<0.01). Lastly, hemodynamic characteristics of the intrauterine distress group and the non-intrauterine distress group were compared. The result showed that the differences were statistically significant (P<0.01). 【Conclusion】The hemodynamic changes of the middle cerebral artery in early neonatal period are different. The influencing factors include birth asphyxia, intrauterine distress, gestational age and birth weight. 2019 Vol. 36 (11): 2109-2111 [Abstract] ( 62 ) HTML (1 KB)  PDF  (0 KB)  ( 13 ) 2112 Application of Whole Course Medication Management Model in Day Cataract Surgery Patients LI Chun-yan, LIN Huan, DAI Min-hui DOI: 10.3969/j.issn.1671-7171.2019.11.010 【Objective】To investigate the impact of implementing the whole course medication management model for patients with day cataract surgery. 【Methods】A total of 100 patients with cataract in Xiangya Hospital Central South University from January to December in 2017 were randomly divided into the observation group (n=50) and the control group (n=50). The patients in the control group were given routine medication guidance, while patients in the experimental group received individualized whole course medication management. All patients were followed up for 1 month. The vision, eye drop instillation technique, local medication attainment, eye comfort, hand hygiene implementation rate and satisfaction were compared between the two groups of patients before intervention, 1 week and 1 month after the intervention. 【Results】Results showed that there was no difference in visual acuity between the two groups of patients before and after the intervention (P>0.05). However, eye drop technique, topical drug attainment, eye comfort, hand hygiene implementation rate and satisfaction of the observation group at 1 week and 1 month after the intervention were better than those of the control group (P<0.05). 【Conclusion】The whole course medication management model can effectively improve proficiency in eye drop instillation and medication attainment, reduce pain and irritation after day cataract surgery, and increase patient satisfaction and care quality. 2019 Vol. 36 (11): 2112-2114 [Abstract] ( 60 ) HTML (1 KB)  PDF  (0 KB)  ( 13 ) 2115 Significance of Preservation of Spleen No.10 and No.11 Lymph Node Dissection in Gastric Cancer Surgery WU Qi-ye, YI Guo-en, ZHANG Tian-zhu DOI: 10.3969/j.issn.1671-7171.2019.11.011 【Objective】To explore the clinical effect and value of splenomegaly lymph node (No.10) and paraarterial lymph node (No.11) preserved in D2 radical gastrectomy. 【Methods】Sixty-six patients with advanced gastric cancer were divided into observation group (30 cases,lymph node dissection with spleen No.10 and No.11 preserved in D2 radical gastrectomy) and control group (36 cases, D2 radical gastrectomy combined with splenectomy for gastric cancer) according to the operation method.The operation time, bleeding volume, hospitalization time, number of lymph nodes, positive lymph node detection rate, operation complication rate and 1-year and 3-year survival rate were compared between the two groups. 【Results】The operation time of the observation group was longer than that of the control group, and the bleeding volume and hospitalization time of the operation were lower than those of the control group (P<0.05). There was no significant difference between the two groups in the number of lymph nodes cleaned and the detection rate of positive lymph nodes (P>0.05). The incidence of surgical complications in the observation group was 13.33% (4 / 30) lower than that in the control group (30.56% 11/ 36). The difference was statistically significant (χ2= 4.44, P<0.05). There was no significant difference between the observation group and the control group (P>0.05); there was no significant difference between the observation group and the control group (P>0.05). The median 3-year survival time was 32.0 months in the observation group and 29.0 months in the control group, there was no significant difference (P>0.05). 【Conclusion】Lymph node dissection with spleen No.10 and No.11 preserved in D2 radical gastrectomy have similar clinical effect and prognosis with splenectomy, and have lower complication rate and less trauma. 2019 Vol. 36 (11): 2115-2117 [Abstract] ( 68 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 2118 Expression of PPARγ and P16 in Cervical Intraepithelial Lesion and Cervical Cancer and Novel Relation with HPV Infection LI Fang, ZHANG Fei-yan, ZHANG Wei, et al DOI: 10.3969/j.issn.1671-7171.2019.11.012 【Objective】To investigate the expression of peroxisome proliferator activated receptor gamma (PPARγ) and P16 protein in cervical squamous cell carcinoma (SCC) and cervical intraepithelial lesion (SIL), and possible correlation with HPV infection. 【Methods】Expressions of PARγ and P16 in 17 cases of normal cervical epithelium (NCE),52 cases of SIL and 39 cases of SCC were measured by immunohistochemical MAXVisionTM method.HPV infection was detected by reverse dot blot hybridization method. The correlation between the expression of PPARγ and P16 with HPV infection was analyzed. 【Results】The positive expression rate of PPARγ and P16 from NCE to SIL and SCC showed a gradual increasing trend; the differences among groups were statistically significant (P<0.05). The infection rate of HPV in NCE,SIL and SCC was 29.41% (5/17),76.92% (40/52) and 97.44% (38/39), respectively, which also showed a gradual increasing trend. The difference between groups was statistically significant (P<0.05). The expressions of PPARγ and P16 were positively correlated with HPV infection (P<0.05). 【Conclusion】The expressions of PPARγ and P16 are highly expressed in cervical SCC tissues. PPARγ and P16 expressions are positively correlated with HPV infection, which play an important role in the development of cervical carcinoma. 2019 Vol. 36 (11): 2118-2120 [Abstract] ( 64 ) HTML (1 KB)  PDF  (0 KB)  ( 13 ) 2121 Effect of Early Hyperbaric Oxygen Combined with Rehabilitation Training on the Recovery of Neurological Function and Prognosis in Elderly Patients with Hypertensive Cerebral Hemorrhage after Drilling and Drainage SHAO Shi-rong, DENG Tian-fang, LIU Sha-sha, et al DOI: 10.3969/j.issn.1671-7171.2019.11.013 【Objective】To explore the effect of early hyperbaric oxygen combined with rehabilitation training on the recovery of neurological function and prognosis in elderly patients with hypertensive cerebral hemorrhage after drilling and drainage. 【Methods】The clinical data of 210 elderly patients with hypertensive intracerebral hemorrhage in our hospital were analyzed retrospectively. The patients in both groups were treated with drilling and drainage. According to the different rehabilitation treatment methods, they were divided into the observation group (early hyperbaric oxygen combined with rehabilitation training) and the control group (rehabilitation training), 105 cases in each group. Before and after treatment, the neurological function and limb movement were assessed by NIHSS, MMSE, ESS, FMA, GQOLI and Glasgow pre-treatment Post score (GOS) was used to evaluate the prognosis. 【Results】After treatment, NIHSS score and ESS score of the two groups were lower than those before treatment, MMSE score and FMA score were higher than those before treatment. After treatment, NIHSS score and ESS score of the observation group were lower than those of the control group, MMSE score and FMA score were higher than those of the control group, the difference was statistically significant (P<0.05). The physical function, psychological function, social function and total score of the observation group were higher than those of the control group, the difference was statistically significant (P<0.05). After 6 months follow-up, the good prognosis rate of the control group was 43.81% (46 / 105) higher than that of the observation group (78.10%) (82 / 105), the difference was statistically significant (P<0.05). 【Conclusion】Early rehabilitation training and hyperbaric oxygen therapy can promote the recovery of motor function of nerves and limbs, improve the quality of life and improve the prognosis of the elderly patients with hypertensive intracerebral hemorrhage. 2019 Vol. 36 (11): 2121-2123 [Abstract] ( 50 ) HTML (1 KB)  PDF  (0 KB)  ( 13 ) 2124 Diagnostic Value of Contrast-enhanced Ultrasound in Adrenal Mass-occupying Lesions ZHOU Shan, XU Chang-song, CHEN Jing, et al DOI: 10.3969/j.issn.1671-7171.2019.11.014 【Objective】To investigate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of adrenal mass-occupying lesions. 【Methods】A total of 27 patients with adrenal mass-occupying lesions who received both routine ultrasound and CEUS in our hospital were collected for the study.The ultrasound findings and angiographic features were observed and compared. 【Results】Among the 27 adrenal space-occupying lesions, 14 cases occurred on the left and 13 cases existed on the right. There were 11 cases of cortical adenoma, 1 case of hyperplasia, 4 cases of pheochromocytoma, 2 cases of myeloid lipoma, 6 cases of cysts, and 1 case of solitary fibroma, 1 case of cortical adenocarcinoma and 1 case of lymphoma. The difference of the size of adenoma and non-adenomas was statistically significant; the difference in size of benign and malignant lesions was statistically significant as well (P<0.05). According to time-intensity perfusion type and perfusion intensity characteristics, adrenal mass-occupying lesions were classified. Of the 11 adenomas, 9 cases belonged to type 2 and 2 cases belonged to type 3; in which 2 cases were rich in blood supply and 9 cases were poor in blood supply. Of the 16 non-adenomas, 2 cases were type 1, 5 cases of type 2, 3 cases of type 3 and 6 cases of type 4; in which 4 cases were rich in blood supply, 6 cases were lack of blood supply and 6 cases showed no blood supply. The difference between adenoma and non-adenomas was statistically significant (P<0.05). 【Conclusion】Contrast-enhanced ultrasound shows the blood supply of adrenal mass-occupying lesions that makes up for the deficiency of conventional ultrasound. 2019 Vol. 36 (11): 2124-2127 [Abstract] ( 56 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 2128 Expression level of ACC and LPL in Placenta and their Correlation with Gestational Diabetic Macrosomia GAO Yan, CHEN Bi-liang, LIU Duo-duo, et al DOI: 10.3969/j.issn.1671-7171.2019.11.015 【Objective】To investigate the expression of acetylcoa carboxylase (ACC) and lipoprotein lipase (LPL) in placenta and their relationship with gestational diabetes mellitus (GDM) macrosomia. 【Methods】From January 2015 to January 2018, 241 GDM patients were selected in our hospital, including 48 cases (group A) with birth weight > 4000 g (macrosomia), 193 cases (group B) with birth weight ≤ 4000 g (normal body weight). Before delivery, serum samples were collected to detect lipid metabolism, apolipoprotein and other indicators. After delivery, fetal placenta tissue was taken as test samples. The general data of two groups of newborn mothers were compared. The expression levels of ACC-mRNA and LPL mRNA were detected by RT-PCR. The correlation between the expression levels of acc-mrna and LPL mRNA and GDM macrosomia was analyzed. 【Results】There were no significant differences between the two groups in maternal age, BMI before delivery, body mass difference during pregnancy, TG, TC, HDL-C, LDL-C, ApoA Ⅱ, ApoC Ⅲ and HbA1c (P>0.05) The relative expression of acc-mrna in the group A was 2.01 ± 0.39, which was significantly higher than that in group B (1.07±0.12,t=28.615, P=0.000); the expression of LPL-mRNA was 0.49 ± 0.02, which was significantly lower than that in the group B (0.61 ± 0.04,t=20.144,P=0.000). According to Spearman's correlation analysis, the expression level of ACC mRNA in placenta was positively correlated with macrosomia (r=6.917, P<0.001), and the expression level of LPL mRNA was negatively correlated with macrosomia (r=6.017,P<0.001). 【Conclusion】The abnormal expression of ACC and LPL in placenta is closely related to the development of GDM macrosomia. 2019 Vol. 36 (11): 2128-2130 [Abstract] ( 107 ) HTML (1 KB)  PDF  (0 KB)  ( 13 ) 2131 Effect of L-carnitine Combined with Furosemide on Heart Failure Treatment in Patients with Chronic Kidney Disease undergoing Hemodiafiltration JIANG Jia-wei DOI: 10.3969/j.issn.1671-7171.2019.11.016 【Objective】To investigate the efficacy of L-carnitine combined with furosemide in the treatment of heart failure patients with chronic kidney disease(CKD)undergoing hemodiafiltration (HDF). 【Methods】A total of 120 CKD patients with HDF, who complicated with heart failure, were randomly divided into two groups. The control group received proper HDF and conventional anti-heart failure treatment. While the observation group received intravenous injection of L-carnitine and furosemide on the basis of treatment in the control group. Patients in the two groups were treated continuously for 12 weeks . Cardiac function indicators, angiotensin (Ang Ⅱ), plasma renin (PRA), aldosterone (ALD) and N-terminal pro-brain natriuretic peptide (NT-proBNP), 6 min walking distance(6MWT) and incidence of adverse reactions were compared between two groups. 【Results】After treatment, the total effective rate of the observation group was 91.67% (55/60), which was significantly higher than that of the control group 75.00% (45/60); the difference was statistically significant (P<0.05). In both groups, the levels of AngⅡ, PRA, ALD, NT-proBNP, cardiac index (CI), LVEDD, LVPWT and IVST after treatment were significantly lower than those before treatment; While the levels of LVEF and 6MWT were significantly higher than those before treatment (P<0.05). The improvement level of the observation group was more obvious than that of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】The application of L-carnitine combined with furosemide in the treatment of heart failure patients with CKD undergoing HDF has good efficacy, which shows significant improvement of patients' cardiac function and 6MWT. It is safe and worthy of clinical application. 2019 Vol. 36 (11): 2131-2133 [Abstract] ( 61 ) HTML (1 KB)  PDF  (0 KB)  ( 12 ) 2134 Neuroendoscopic Third Ventriculostomy for Obstructive Hydrocephalus in Children MA Wei-ke, YANG Wei-guo, HE Yan-xia, et al DOI: 10.3969/j.issn.1671-7171.2019.11.017 【Objective】To explore the effect of endoscopic third ventriculostomy in the treatment of obstructive hydrocephalus in children. 【Methods】The clinical data of 64 children with obstructive hydrocephalus admitted to our hospital from January 2014 to June 2017 were analyzed retrospectively. According to different treatment methods, they were divided into observation group (n=33, endoscopic third ventriculostomy) and control group (n=31, ventriculoperitoneal shunt). The clinical effect, operation related indexes, developmental quotient scores before and after treatment were compared between the two groups, and the postoperative complications were analyzed. 【Results】The operation time and hospitalization time in the observation group were significantly lower than those in the control group (P<0.05). The clinical effective rate of the observation group was 93.94% (31 / 33), which was significantly higher than that of the control group (80.65%) (25 / 31). The difference was statistically significant (χ2=-2.097, P<0.05). The difference between the two groups was statistically significant (P<0.05). The incidence of postoperative complications in the observation group was 9.09%, lower than 32.26% in the control group. The difference was statistically significant (χ2=5.300,P=0.021<0.05). 【Conclusion】The application of endoscopic third ventriculostomy in the treatment of obstructive hydrocephalus in children has a good clinical effect, which is conducive to the recovery of children's neurological function. 2019 Vol. 36 (11): 2134-2136 [Abstract] ( 60 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 2137 miR-515-5p Targets SPHK1 to Regulate Erythroid Differentiation of K562 Cells LIAN Cheng, YAO Yuan, YANG Pei, et al DOI: 10.3969/j.issn.1671-7171.2019.11.018 【Objective】To investigate whether miR-515-5p targets SPHK1 to regulate erythroid differentiation in K562 cells. 【Methods】TargetScanHuman was used to analyze the match status between miR-515-5p and SPHK1. To detect miR-515-5p targeting SPHK1, the luciferase reporter system was applied. In the case of miR-515-5p mimics overexpression or miR-515-5p inhibitor knock-down of miR-7-5p, the expression levels of erythroid differentiation-related genes HBE, HBG1, HBB, GATA1, and KLF1 were measured by qPCR, and the expression levels of erythroid differentiation marker proteins CD71 and CD235a were detected by WB. 【Results】The luciferase reporter experiment showed that miR-515-5p targeted the 3'UTR of SPHK1. When miR-515-5p was overexpressed, the expression levels of erythroid differentiation-related genes HBE, HBG1, HBB, GATA1 and KLF1 in K562 cells decreased (P<0.05). The expression of SPHK1 decreased at both d0 and d4 (P<0.05).While the expression levels of the erythroid differentiation marker proteins CD71 and CD235a increased at d4 (P<0.05). Compared to the control group, the expression levels of CD71 and CD235a were lower (P<0.05). On the other hand, when knocking down miR-515-5p, the expression levels of erythroid differentiation related genes HBE, HBG1, HBB, GATA1 and KLF1 in K562 cells increased (P<0.05) and the expression of SPHK1 increased at d0 and d4 (P<0.05). The expression levels of the erythroid differentiation marker proteins CD71 and CD235a increased at d4 as well (P<0.05), however, on the 4th day the expression levels of CD71 and CD235a were higher compared to the control group (P<0.05). 【Conclusion】miR-515-5p inhibits the erythroid differentiation regulation of K562 cells after its targeting SPHK1. 2019 Vol. 36 (11): 2137-2140 [Abstract] ( 61 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 2141 Inhibitory Effect of miR-146a on Diabetic Retinal Pigment Epithelial Cell Injury by Regulating Expression of Interleukin-1 Receptor-related Kinase-1 XIAO Hong-xia, YANG Hai-rong DOI: 10.3969/j.issn.1671-7171.2019.11.019 【Objective】To investigate effects of miR-146a on human diabetic retinal pigment epithelial cell injury and novel mechanism. 【Methods】Diabetic retinal pigment epithelial cell injury model was established by culturing human retinal pigment epithelial cells (hRPE) in high glucose medium. When hRPE cells was transfected with miR-146a mimics and cultured with high glucose medium, the expression of miR-146a was detected by real-time PCR. The activity of SOD was measured by xanthine oxidation. The content of MDA was detected by thiobarbituric acid. Apoptosis was detected by flow cytometry. Gene prediction showed that interleukin-1 receptor related kinase-1 (IRAK1) was the possible target gene of miR-146a. So the luciferase reporter system was constructed to identify the targeting relationship. Western blot was further used to detect the effect of up-regulated miR-146a on IRAK1 expression. Finally, when both pcDNA3.1-IRAK1 and miR-146a mimics were co-transfected into hRPE cells, the effects of IRAK1 on MDA, SOD and cell apoptosis in hRPE cells regulated by microRNA-146 under high glucose condition were detected by the above methods. 【Results】The expression of miR-146a was downregulated in hRPE cells after high glucose treatment. In the same condition, the content of MDA increased, SOD activity decreased and cell apoptosis rate increased in hRPE cells. Transfection of miR-146a mimics increased the expression level of miR-146a in hRPE cells under high glucose condition, therefore reduced cellular content of MDA, increased SOD activity and reversed cell apoptosis. The luciferase reporter system showed that miR-146a targeted IRAK1 gene, where the inhibitory IRAK1 protein expression was caused by miR-146a up-regulation. Co-transfection of pcDNA3.1-IRAK 1 and miR-146a mimics reversed the effects of miR-146a on MDA, SOD and cell apoptosis in retinal pigment epithelial cells under high glucose condition. 【Conclusion】miR-146a down-regulation of IRAK1 expression attenuates the damage of diabetic retinal pigment epithelial cells. 2019 Vol. 36 (11): 2141-2144 [Abstract] ( 56 ) HTML (1 KB)  PDF  (0 KB)  ( 12 ) 2145 Correlation between CT Imaging Features and Survival Status of Renal Clear Cell Carcinoma LIU Wei, XI Xin-long DOI: 10.3969/j.issn.1671-7171.2019.11.020 【Objective】To analyze the CT features and postoperative survival status of patients with renal clear cell carcinoma. 【Methods】From July 2015 to July 2017, 93 patients with renal clear cell carcinoma were selected. All patients underwent CT examination before operation and pathological examination after operation. According to the results of postoperative pathological examination, they were divided into observation group (high-grade renal clear cell carcinoma, n=37) and control group (low-grade renal clear cell carcinoma, n=56). The patients in both groups were scanned with GE Linght?speed 16 slice spiral CT. The results of CT examination were analyzed by two doctors with intermediate title or above in imaging department. The general data of the two groups were compared, mainly including: gender, age, tumor location, tumor stage. The tumor size, lobulation, hemorrhage, necrosis, capsule and CT value of the two groups were compared. The follow-up time was 1~5 years. The results of death, metastasis and survival were compared between the two groups. 【Results】There was no significant difference in sex, age, tumor location between the two groups (P>0.05). The proportion of patients above T2 in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05). There was no significant difference in maximum diameter, lobulation or none, CT value of enhanced scan in each periodand and bleeding necrosis , etc between the two groups (P>0.05).The CT value of the control group was lower than that of the observation group, and the integrity of the capsule was higher than that of the observation group (P<0.05). The survival rate of the control group was lower than that of the observation group (P<0.05). 【Conclusion】The capsule of high-grade clear renal cell carcinoma is often incomplete, and the CT value of plain scan is high, which indicates that the degree of tumor deterioration is high, which is closely related to the prognosis of patients. 2019 Vol. 36 (11): 2145-2147 [Abstract] ( 91 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 2148 Analysis of the Relationship between One-year Vaginal Microecological Treatment and HPV Outcome in Patients with High-grade Squamous Intraepithelial Lesions WANG Juan DOI: 10.3969/j.issn.1671-7171.2019.11.021 【Objective】To investigate the relationship between the vaginal microecological one-year therapy and the outcome of HPV in patients with high grade squamous intraepithelial lesions (HSIL). 【Methods】The clinical data of 96 cases of HSIL treated in our hospital from January 2013 to September 2017 were analyzed retrospectively. According to whether HPV turned negative in one year after treatment, they were divided into HPV persistent infection group (50 cases) and HPV turned negative group (46 cases). One year after treatment, the basic situation, the density of vaginal flora, the diversity of vaginal flora and the nature of vaginal flora were compared between the two groups. 【Results】There was no significant difference in age and chronic diseases between the two groups (P>0.05); the surface squamous cells and gynecological diseases in the HPV persistent infection group were significantly higher than those in the HPV transvaginal group (P<0.05); the abnormal rates of vaginal flora density, flora diversity and flora property in the HPV persistent infection group were significantly higher than those in the HPV transvaginal group (P<0.05). Multivariate logistic regression analysis showed that the diversity of vaginal flora and the nature of vaginal flora were independent risk factors for HPV outcome (P<0.05). 【Conclusion】The balance of vagina microecology is the key to the prognosis of HPV. In order to control the occurrence and development of HSIL and reduce the risk of cervical cancer, targeted treatment can be carried out according to the diversity of vagina flora and the number of dominant bacteria. 2019 Vol. 36 (11): 2148-2150 [Abstract] ( 81 ) HTML (1 KB)  PDF  (0 KB)  ( 12 ) 2151 Effect of Laparoscopic and Open Radical Surgery on the Level of Oxidative Stress in Patients with Bladder Cancer LI Ning, BAI Xiao-jing, ZHANG Ning DOI: 10.3969/j.issn.1671-7171.2019.11.022 【Objective】To compare the effects of laparoscopic and open radical surgery on oxidative stress in patients with bladder cancer. 【Methods】The clinical data of 100 cases of bladder cancer in our hospital were analyzed retrospectively. According to the operation methods, the patients were divided into two groups: the observation group (laparoscopic radical surgery) and the control group (open radical surgery), each group had 50 cases. The changes of serum cortisol(Cor), ROS, SOD and GSH PX were compared before and after operation. 【Results】The operation time of the observation group was longer than that of the control group, and the bleeding volume, exhaust time and hospitalization time were lower than those of the control group (P<0.05). 24 hours after operation, the levels of serum Cor and ROS in the two groups were higher than those before operation, the levels of serum SOD and GSH PX in the observation group were lower than those in the control group, and the levels of serum SOD and GSH PX in the observation group were higher than those in the control group (P<0.05). The incidence of postoperative complications in the observation group was 6% (3/50), lower than 22.00% (11/50) in the control group, and the difference was statistically significant (χ2 = 5.316, P<0.05). 【Conclusion】Compared with the open radical operation, laparoscopic radical operation has better clinical effect in the treatment of bladder cancer. It has less trauma to patients, faster postoperative recovery, and less oxidative stress response. It is worthy of clinical application. 2019 Vol. 36 (11): 2151-2153 [Abstract] ( 58 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 2154 Relationship of HRCT Manifestations of Pulmonary Ground Glass Nodules with New Pathological Classification and Nodular Invasiveness SHI Tai-gui, JI Hao-ming, SHEN Chun-lin, et al DOI: 10.3969/j.issn.1671-7171.2019.11.023 【Objective】To analyze the relationship of high-resolution computed tomography (HRCR) manifestations of pulmonary ground glass nodules with pathological new classification and nodular invasiveness. 【Methods】A total of 186 patients with pulmonary ground glass nodules were selected for the study. All patients received HRCT examination. The characteristics of HRCT manifestations were compared with pathological new classifications and nodular invasive status. 【Results】In general, HRCT is consistent with its pathological examination. Malignant nodules usually had irregular and paginated shape with border burrs, multiple vacuole lesions, pleural depression and vascular proliferation. Microinvasive and invasive nodules were generally irregular in shape and their boundaries were less smooth and less clear which had more vacuoles, pleural depression and vascular proliferation. 【Conclusion】More malignant and invasive nodules have more irregular shapes and unclear borders, where are associated with vacuoles and vascular hyperplasia. 2019 Vol. 36 (11): 2154-2156 [Abstract] ( 62 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 2157 Predictive Value of Monocyte/High-density Lipoprotein Ratio for Cardiovascular Events in Patients with Chronic Kidney Disease YANG Xi, HUA Xue-lian DOI: 10.3969/j.issn.1671-7171.2019.11.024 【Objective】To investigate the relationship of monocyte/high-density lipoprotein ratio (MHR) with chronic kidney disease (CKD) stage and predictive value of cardiovascular events in patients with CKD. 【Methods】A total of 180 patients with non-hemodialysis CKD (stage 3 to 5) in our hospital were collected for the study. According to the level of glomerular rate filtration (GFR), patients were divided into group A (CKD stage 3, n=65 cases), group B (CKD stage 4, n=55 cases) and group C (CKD stage 5, n=60 cases). They further were divided into the cardiovascular event group (n=75 cases) and non-cardiovascular event group (n=105 cases) depending on cardiovascular events occurred within 6 months of follow-up. There were 40 healthy volunteers enrolled in the control group. Blood routine, high-density lipoprotein (HDL), creatinine, urea nitrogen, NT-proBNP, GFR and MHR were recorded and compared among groups. The relationship of MHR with GFR and NT-proBNP was analyzed by Spearman correlation analysis. The predictive value of MHR and NT-proBNP on cardiovascular events in patients with CKD was analyzed by drawing the ROC curve. 【Results】The levels of MHR and NT-proBNP increased gradually with the increase of CKD stages, showing that the level of group C> group B> group A> the control group (P<0.05).The levels of MHR and NT-proBNP in patients with cardiovascular events were significantly higher than those in non-cardiovascular events (P<0.05). In patients with CKD, MHR was negatively correlated with GFR (P<0.01), while MHR was positively correlated with NT-proBNP (P<0.01).The area under the ROC curve for diagnosis of cardiovascular events by MHR and NT-proBNP in CDK patients were 0.958 and 0.932, respectively. The diagnostic sensitivities were 92% and 86.7%, respectively, and the specificity were 92.6% and 89.6%, respectively. 【Conclusion】There is a close relationship between the occurrence of cardiovascular events and inflammatory state in CKD patients. MHR is superior to traditional indicators in predicting the occurrence of cardiovascular events in CKD patients. 2019 Vol. 36 (11): 2157-2159 [Abstract] ( 54 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 2160 Predictive Value of Quick Sequential Organ Failure Assessment in Prognosis of Patients with ICU Infection DING Guo-yu, GE Lan DOI: 10.3969/j.issn.1671-7171.2019.11.025 【Objective】The predictive value of quick sequential organ failure assessment (qSOFA) in the prognosis of patients with ICU infection. 【Methods】The clinical data of 80 infected patients admitted to ICU of our hospital were retrospectively analyzed. The qSOFA, rapid emergency departmental (REMS) score and sequential organ failure assessment score (SOFA) were calculated. The prognosis of infected patients was recorded. The receiver operating characteristic curve (ROC) was used to analyze the predictive value of the three scoring methods for the prognosis of infected patients. 【Results】A total of 29 deaths that occurred within 28 days among 80 ICU admissions showed the mortality rate was 36.2% and the survival rate was 63.8% (51/80). As the scores of SOFA, qSOFA, and REMS increase, the patient mortality rate increased. The scores of SOFA, qSOFA and REMS in the death group were higher than those in the survival group,the different was statistically significant (P<0.05). The ROC curve showed that among the three scores, the SOFA score predicted the highest AUC (0.741) of the mortality rate, followed by the REMS and qSOFA scores. However, there were no significant differences in AUC among the three scores (P>0.05). The optimal cutoff value for the qSOFA score was 2 points, which the sensitivity was 69.4%, the specificity was 68.5%, and the AUC was 0.710. The death risk in the qSOFA ≥ 2 group was significantly higher than that in the qSOFA < 2 group (P<0.05). 【Conclusion】SOFA, qSOFA and REMS scores can predict the mortality of patients with ICU infection. We find that qSOFA is a simple and fast scoring system, which can quickly and effectively judge the severity and death of patients with ICU infection. 2019 Vol. 36 (11): 2160-2162 [Abstract] ( 64 ) HTML (1 KB)  PDF  (0 KB)  ( 15 ) 2163 Risk Factors of Hospital Death in Patients with Acute Myocardial Infarction MA En-hong, WANG Xin, ZHAO Wei, et al DOI: 10.3969/j.issn.1671-7171.2019.11.026 【Objective】To analyze the risk factors for in-hospital mortality in acute myocardial infarction patients. 【Methods】The clinical data of 235 AMI patients admitted to our hospital from May 2012 to December 2016 were analyzed retrospectively. According to the patients' in-hospital outcomes, they were divided into the observation group (n=51, in-hospital death patients) and the control group (n=184, in-hospital survival patients). The clinical characteristics, laboratory tests (CK-MB, cTnI, Cr) , LVEF and reperfusion treatment were collected by electronic case system. Binary logistic regression was used to analyze the risk factors of AMI patients' death in hospital. 【Results】The age, cTnI level and chest pain time of the patients in the observation group were higher than those in the control group, while the reperfusion treatment rate (PCI or selective PCI or thrombolysis after reperfusion for AMI patients) and LVEF were significantly lower than those in the control group (P<0.05). Logistic regression analysis showed that cTnI, age, LVEF and no reperfusion treatment were related to the death events of AMI patients in hospital (P<0.05). cTnI had the highest value in predicting the death events of AMI patients in hospital. The ROC area under curve (AUC) (95% CI) was as high as 0.89 (0.84~0.94), significantly higher than other risk factors (.0.05). 【Conclusions】The high level of cTnI, age, cardiac function and no reperfusion treatment are the risk factors of hospital death in AMI. 2019 Vol. 36 (11): 2163-2165 [Abstract] ( 87 ) HTML (1 KB)  PDF  (0 KB)  ( 30 ) 2166 DAP Scoring System in Evaluation of T1 Renal Tumor and Guidance to Surgical Procedures QI Ming-jun, WU Xiao-peng, ZHOU Zhong-xin, et al DOI: 10.3969/j.issn.1671-7171.2019.11.027 【Objective】To evaluate the DAP scoring system in T1 stage of renal tumor and selection of surgical methods. 【Methods】Data of 92 patients with T1 stage of renal tumor admitted to our hospital were randomly selected for retrospective analysis. According to the DAP scoring system, 92 patients were divided into 3 groups: the low score group (n=18), the medium score group (n=47) and the high score group (n=27). The correlation of surgical methods, surgical parameters and complications were compared among the three groups. 【Results】Data showed that 3 cases in the low score group, 27 cases in the medium score group and 8 cases in the high score group received open surgery; 13 cases in the low score group, 6 cases in the medium score group and 1 case in the high score group had laparoscopic surgery; 1 case in the low score group, 15 cases in the medium score group and 18 cases in the high score group had radical nephrectomy. There were differences between surgical selections and DAP scores (P<0.05). The DAP scoring system was correlated with surgical approach, duration of operation, duration of warm ischemia and estimated blood loss (P<0.05). It was not correlated with the length of hospital stay or glomerular filtration rate (P>0.05). The incidence of complications was not related to age, body mass index, location of onset and duration of warm ischemia (P>0.05). It was correlated with operation mode, operation duration, blood loss and DAP system score (P<0.05). 【Conclusion】The clinical application of DAP scoring system in patients with T1 renal tumor is helpful for the selection of clinical treatment methods and valuable for clinical prediction of perioperative outcomes. 2019 Vol. 36 (11): 2166-2168 [Abstract] ( 72 ) HTML (1 KB)  PDF  (0 KB)  ( 12 ) 2169 Effect of Low Dose Ketamine on Postoperative Pain in Patients Undergoing Laparoscopic Appendectomy ZHANG Hui, DING Hai-lei DOI: 10.3969/j.issn.1671-7171.2019.11.028 【Objective】To investigate the effect of low dose ketamine on postoperative pain in patients undergoing laparoscopic appendectomy (LA). 【Methods】Sixty patients with acute appendicitis treated with LA were randomly divided into two groups, 30 in each group. In the group K, 10ml ketamine (0.3mg / kg) was given intravenously 10 minutes before suturing, while in the group C, normal saline (10ml) was given. The pain, sedation, inflammatory factors and adverse reactions were compared between the two groups. 【Results】The visual analogue score (VAS) of 30 minutes (T0), 6 hours (T1), 12 hours (T2), 24 hours (T3) and 48 hours (T4) after extubation in Group K was significantly lower than that in group C (P<0.05).The Ramsay Sedation scores of T1 and T2 in the group K were significantly higher than those of the group C (P<0.05); the serum C-reactive protein (CRP) levels of T1, T2 and T3 were significantly lower than those of the group C (P<0.05); the total incidence of adverse reactions in the group K was 6.67% (2 / 30), significantly lower than that of the group C 20.00% (6 /30) (P<0.05). 【Conclusion】Low dose ketamine can relieve the pain of La patients before suturing. The effect of sedation is good, the level of serum CRP is stable, and the incidence of adverse reactions is reduced. 2019 Vol. 36 (11): 2169-2171 [Abstract] ( 75 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 2172 A Comparative Study of Three Excimer Laser Refractive Surgical Methods for Myopia and Astigmatism ZOU Guang-cheng, YE Jing-juan DOI: 10.3969/j.issn.1671-7171.2019.11.029 【Objective】To compare clinical efficacy (the visual quality, dry eye symptom and biomechanical stability) of patients with myopia and astigmatism treated by femtosecond laser small incision keratomileusis (Smile), femtosecond laser flap excimer laser in situ keratomileusis (Fs-lasik) and excimer laser in situ keratomileusis (Lasik). 【Methods】The clinical data of 698 cases of myopia and astigmatism treated in our hospital from January 2015 to October 2018 were analyzed retrospectively. According to the surgical methods, they were divided into the Smile group (with Smile operation, n=302 cases for 508 eyes), the Fs-lasik group (with Fs-lasik operation, n=189 cases for 321 eyes) and the Lasik group (with Lasik operation, n=207 cases for 356 eyes). The postoperative visual quality, dry eye condition and postoperative biomechanical stability of the patients were compared in three groups. 【Results】①There were no significant differences in diopter, UCVA, BCVA and high order shadow aberrations between the Fs-lasik group and the Lasik group before and after operation (P>0.05). In the Smile group, there was no significant difference in diopter, UCVA and BCVA before and after operation (P>0.05), however, there was significant difference in high-order shadow aberrations between pre- and post-operation (P<0.05). One month after operation, the differences among the Smile group, the Fs-lasik group and the Lasik group were statistically significant (P<0.05). The number of eyes in the range of ±0.50D was also significantly different among the three groups at 1 month after operation (P<0.05); and there was significant difference between Fs-lasik group and Lasik group (t=3.319, P=0.003). However, there was no significant difference in the other indicators among the three groups at the same time point(P>0.05).②After surgery, the values of NIBUTf and NIBUTa among the three groups were lower than those before surgery (P<0.05), however, there was no significant changes in LTMH (P＞0.05). There were no significant differences of NIBUTf and LTMH in the three groups of patients at the same time point before and after surgery (all P> 0.05). At 3 months after operation, the NIBUTa in the Smile group was significantly lower than that in the Fs-lasik group and the Lasik group (χ2=8.573,P=0.004;χ2=9.047,P=0.003). There were no significant differences at other time points (all P> 0.05).③The levels of postoperative corneal lag (CH) and corneal resistance factor (CRF) in the three groups were significantly lower than those before operation (P<0.05).However, among the three groups there were no significant differences in the CH and CRF values at the same time point before and after operation (all P＞0.05). 【Conclusion】Laser surgeries of Smile, Fs-lasik and Lasik have effectiveness and stability in the correction of myopia and astigmatism at 3 months after operation. Effects of Smile on UCVA and NIBUTa are relatively better than those of Fs-lasik and Lasik, which is worthy of clinical application. 2019 Vol. 36 (11): 2172-2175 [Abstract] ( 63 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 2176 Anesthetic and Coagulation Effects of Fentanyl Combined with Dexmedetomidine on Percutaneous Vertebroplasty in Patients with Vertebral Compression Fracture XUE Na, WU Li, WU Xian-wei, et al DOI: 10.3969/j.issn.1671-7171.2019.11.030 【Objective】To investigate the anesthetic and coagulation effects of fentanyl combined with dexmedetomidine(Dex)on percutaneous vertebroplasty( PVP) in patients with vertebral compression fractures. 【Methods】A total of 94 patients with vertebral compression fractures underwent PVP were divided into the control group (n=47) and the observation group. (n=47) with random number table method. The control group was given remifentanil combined with propofol anesthesia. While the observation group was anesthetized with fentanyl and Dex . The anesthetic effect, coagulation function and safety were compared between the two groups. 【Results】The anesthesia recovery time and extubation time of the observation group were all shorter than those of the control group (P<0.05). The VAS score of the observation group was lower than that of the control group (P<0.05). The Ramsay sedation score of the observation group was higher than that of the control group (P<0.05). The time of PT and APTT in the observation group was longer than those in the control group, while the fibrinogen (FIB) and platelet (PLT) levels in the observation group were lower than those in the control group (P<0.05). There was no significant difference in safety between the two groups after operation (P>0.05). 【Conclusion】Fentanyl combined with dexmedetomidine achieves good anesthetic effect on percutaneous vertebroplasty in patients with vertebral compression fractures. It can improve coagulation function with safe clinical application. 2019 Vol. 36 (11): 2176-2178 [Abstract] ( 63 ) HTML (1 KB)  PDF  (0 KB)  ( 11 )

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