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Quick Search     Adv Search 2020 Vol. 37, No. 11 Published: 2020-11-30   1608 Application of Growth Hormone Combined with Low-molecular Weight Heparin in Frozen Embryo Cycle of Patients with Recurrent Implantation Failure WEN Yi, MAO Zeng-hui, ZHOU Li-yuan, et al DOI: 10.3969/j.issn.1671-7171.2020.11.003 【Objective】To investigate the clinical efficacy of growth hormone combined with low-molecular-weight heparin in the frozen embryo cycle of patients with recurrent implantation failure. 【Methods】A retrospective analysis from Reproductive Center of Hunan Maternal and Child Health Hospital was studied on the clinical effect of 73 assisted-reproduction patients with recurrent implantation failures during 2017-2018. According to different treatment methods, patients were divided into the observation group (n=52) and the control group (n=21). Conventional hormone replacement program was used in the control group, while growth hormone combined with low molecular weight heparin was applied in the observation group. The endometrial condition and pregnancy outcome of the two groups were compared. 【Results】The comparison of the endometrial thickness of the corpus luteum transformation, percentage of normal endometrial morphology, and implant day endometrial thickness between the observation group and the control group were: 9.9±1.9 mm vs 9.3±0.8 mm、86.5% vs 80.9% and 10.3±1.9 mm vs 9.4±0.7 mm, respectively. The differences were statistically significant (P<0.05). The clinical pregnancy rate, embryo implantation rate, and live birth rate of the observation group were 38.5 %, 24.2%, and 26.9%, respectively, while those rates of the control group were 28.6%, 16.3% and 19.0%, respectively. There were no statistically significant differences (P>0.05). 【Conclusion】After the application of growth hormone combined with low molecular weight heparin in the frozen embryo cycle of patients with recurrent implantation failure, it can effectively improve the thickness and morphology of endometrium, which enhances endometrial receptivity. It provides a new idea for the strategy of assisted pregnancy for patients with recurrent implantation failure, though the embryo implantation rate, clinical pregnancy rate, and live birth rate of the study group were not really increased. 2020 Vol. 37 (11): 1608-1611 [Abstract] ( 63 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 1612 Birk Barel Syndrome Caused by KCNK9 Gene Mutation: A Case Report and Literature Review LI Jun-shuai, LIAO Zhen-yu, HUANG Rui-wen DOI: 10.3969/j.issn.1671-7171.2020.11.004 【Objective】To summarize the clinical manifestations of a case of Birk Barrel syndrome caused by KCNK9 gene mutation in our hospital, and to explore the characteristics and treatment of gene mutation of related diseases. 【Methods】The clinical datas of a case of Birk-Barel syndrome diagnosed and treated by the Department III of Neonatology in Hunan Children's Hospital in March 2019 were analyzed retrospectively. Using "KCNK9 gene", "KCNK9 imprinting syndrome" and "Birk-Barel syndrome" as key words to search databases at home and abroad, such as Wanfang database, CNKI and PubMed (from the establishment of database to May 2020), this paper summarizes the variation characteristics of KCNK9 gene and the clinical manifestations, treatment and prognosis of children with Birk-Barel syndrome. 【Results】This case is a boy. The main manifestations are: poor sucking, narrow and long craniofacial region, maxillary protrusion, mandibular retrusion, palmar penetration of both hands, contracture of index finger, middle finger and ring finger of both hands, inability to passively straighten, low muscle tension of limbs, incomplete original emission. High precision clinical exon sequencing showed that KCNK9 gene heterozygous mutation (NM-016601), the mutation site was c.706G > A (p.g236R). At present, there was no case report of Birk-Barel syndrome caused by KCNK9 gene mutation in China. A total of 20 cases of children with 3 articles abroad were retrieved, and 21 cases were added with this case. In 20 cases, the change of heterotopia was mainly c.770g > A, c.706g > C, c.706g > A, c.710c > A. In this case, the change of amino acid was p.a236n (1/21).【Conclusion】The main clinical manifestations of Birk-Barel syndrome are: congenital central hypotonia (manifested as hypokinesia, drowsiness, weak crying), severe eating difficulties caused by facial weakness and poor sucking, developmental retardation or mental retardation, and deformity. Treatment needs multidisciplinary intervention and regular follow-up and evaluation. 2020 Vol. 37 (11): 1612-1615 [Abstract] ( 87 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 1616 Ultrasonic Features of Fetal Biliary Dilatation LIANG Yan-ling, XIE LU-lu, DENG Ying, et al DOI: 10.3969/j.issn.1671-7171.2020.11.005 【Objective】To analyze the sonographic findings of fetal biliary dilatation to predict clinical prognosis.【Methods】We retrospectively studied the prenatal ultrasound screening of fetal biliary dilation (BD) from March 2018 to August 2020 in our hospital. The ultrasonic characteristics of BD and changes of cystic mass before and after birth were analyzed to track the prognosis.【Results】Pregnant women were 19 to 35 (27.7±4.2) years old and the average gestational age for prenatal cystic mass to be discovered at the first time was 18.1 to 33.6 (25.2±3.4) weeks. There were 22 fetal BD cases diagnosed prenatally, including 17 female fetuses (77.3%) and 5 male fetuses (22.7%). The coincidence rate of postpartum ultrasound was 81.8% (18/22) and the misdiagnosis rate was 18.2% (4/22), including 1 case of cystic biliary atresia, 2 cases of liver cyst, and 1 case of cyst regression. Cystic masses were mostly located in the first hepatic hilar area and the periphery of the gallbladder. There were 3 cases of gallbladder ultrasound imaging without obvious filling in the gallbladder area; while the other 19 cases had normal gallbladder morphology. There were 13 cases of cystic masses showing irregular shape and 9 cases were regular in shape. All the cases showed clear boundaries. There were 2 cases with floating bright spots in the mass, and the rest showed normal ultrasound internally. In the 22 cases, only 1 case of intrahepatic bile duct dilation was seen and 21 cases of cystic mass were linked to intrahepatic bile duct are visible. Except for the 4 misdiagnosed cases, the cystic masses in the remaining cases increased with the prolonged gestational age.【Conclusions】Prenatal ultrasound screening is a good way to make diagnosis for fetal bile duct dilatation, which can improve the prognosis. 2020 Vol. 37 (11): 1616-1618 [Abstract] ( 52 ) HTML (1 KB)  PDF  (0 KB)  ( 9 ) 1619 Distribution of Integrons and Drug Resistance of Carbapenem-resistant Escherichia Coli in Elderly Patients with Urinary Tract Infection XU Yan, CHEN Jian DOI: 10.3969/j.issn.1671-7171.2020.11.006 【Objective】To investigate the distribution of integron and drug resistance of carbapenem resistant Escherichia coli (CREco) in elderly patients with UTI.【Methods】E.coli was isolated from urine of UTI patients in our hospital from January 2016 to January 2020. Vitek-2 system was used to identify and detect drug sensitivity. The phenotype of the strains was confirmed by improved Hodge test, and the distribution of integrons was detected by PCR.【Results】A total of 610 strains of E.coli were isolated from urine samples of patients. The cases were mainly distributed in intensive care unit (22.63%), urology department (16.23%), rehabilitation department (13.93%), endocrinology department (13.13%), geriatrics department (11.64%); 68 strains of CREco were detected, accounting for 11.15% (68/610). The drug resistance of CREco strains was significantly higher than that of non CREco strains (P<0.05). Among 284 strains of E.coli with multiple drug resistance, 163 strains were positive for class Ⅰ integron, the detection rate was 57.39%, no class Ⅱ and Ⅲ integron were detected, among which 68 CREco strains were detected type Ⅰ integron. The distribution of class Ⅰ integron in CREco was significantly higher than that in non CREco group (P<0.01). 【Conclusion】The drug resistance of CREco in elderly UTI patients is serious, which is related to the high distribution of class Ⅰ integrons in patients. It is necessary to strictly and rationally use drugs in clinic to avoid the spread and outbreak of CREco. 2020 Vol. 37 (11): 1619-1621 [Abstract] ( 51 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 1622 Analysis of the Causes of Short Stature in School-age Children in Panyu District, Guangzhou WENG Dian-zi DOI: 10.3969/j.issn.1671-7171.2020.11.007 【Objective】To evaluate the detailed etiology of school-age children with short stature in Panyu District, Guangzhou. 【Methods】The clinical data of 150 school-age (6-14-year-old) children with short stature were collected by mobile phone from July 1, 2018 to July 1, 2020 in the Pediatric Endocrinology Department of He Xian Memorial Hospital, Panyu District, Guangzhou city. The etiological factors of school-age children with short stature in this area were analyzed retrospectively, and the etiological distribution of children with different gender and age were analyzed retrospectively. 【Results】In Panyu District of Guangzhou, idiopathic dwarfism accounted for the highest proportion (55.33%), followed by growth hormone deficiency (30.67%), followed by familial dwarfism (4.00%), pituitary tumor (1.33%), hypophyseal dysplasia (3.33%), achondroplasia (0.67%), Turner syndrome (1.33%), small for gestational age (2.67%), and chronic renal insufficiency Tubular acidosis (0.67%). In children with short stature, male children were more common (69.33%), girls were less common (30.67%), idiopathic short stature and growth hormone deficiency were more common in male children (36.67% and 24.67%, respectively). Children aged 8-12 accounted for 59.33%, followed by children aged 6-8 and 12-14 (23.33% and 17.33%, respectively). Idiopathic short stature and growth hormone deficiency were mainly 8-12-year-old children (32.67% and 22.67%, respectively), while children aged 6-8 and 12-14 years accounted for 16.00%, 5.33% and 6.67% and 4.67% respectively.【Conclusion】There are many causes of school-age short stature in Panyu District of Guangzhou city. Idiopathic short stature and growth hormone deficiency are the main causes. Familial dwarfism, hypophysis hypoplasia and small for gestational age infants are also included. 2020 Vol. 37 (11): 1622-1624 [Abstract] ( 49 ) HTML (1 KB)  PDF  (0 KB)  ( 12 ) 1625 Clinical Efficacy of Ultrasound-guided PTCD in the Treatment of Hilar Cholangiocarcinoma JIANG Hua, WANG Xuan-jun, WANG Yue-hua, et al DOI: 10.3969/j.issn.1671-7171.2020.11.008 【Objective】To summarize the experience of PTCD treatment for hilar cholangiocarcinoma in Xuanwu Hospital of Capital Medical University in recent 5 years. 【Methods】 The clinical data of 86 patients with hilar cholangiocarcinoma treated with ultrasound-guided PTCD in Xuanwu Hospital of Capital Medical University from January 2015 to October 2019 were retrospectively analyzed. The operation related conditions and postoperative complications were recorded. The liver function indexes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), glutamyltransferase (GGT), total bilirubin (TBIL) and direct bilirubin (DBIL) were compared before and 2 weeks after operation.【Results】In this study, 86 patients underwent 108 times of puncture, including 76 cases of left lobe bile duct and 32 cases of right lobe bile duct,there were 22 cases of left and right bile ducts punctured at the same time. The first puncture success rate was 77.78% (84/108), the total technical success rate was 90.74% (98/108), and the clinical success rate was 86.05% (74/86). Postoperative bile duct bleeding occurred in 12 cases (13.95%), biliary tract infection and peritonitis in 32 cases (37.21%), and drainage tube shedding in 6 cases (6.98%). After operation, 22 patients with jaundice were treated with radical or palliative resection. 64 patients who could not be resected were discharged with catheter. The serum levels of alt, GGT, ALP, TBIL and DBIL were significantly lower than those before operation (P<0.05).【Conclusion】 Ultrasound guided PTCD is an important treatment for patients with hilar cholangiocarcinoma. Simple biliary drainage can improve the liver function, reduce jaundice and improve the quality of life of patients,which has the promotion significance in the basic level hospital. 2020 Vol. 37 (11): 1625-1627 [Abstract] ( 55 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 1628 Expression and Clinical Significance of GM-CSF in Colon Cancer SHAN Yong-feng, YU Hao, WU Xiao-xia, et al DOI: 10.3969/j.issn.1671-7171.2020.11.009 【Objective】To investigate the expression and clinical significance of granulocyte macrophage colony stimulating factor (GM-CSF) in colon cancer tissues. 【Methods】The expression of GM-CSF protein in colon cancer tissues and adjacent normal tissues collected from 68 patients with colon cancer in our hospital was detected by immunohistochemical staining, and its correlation with clinicopathological features was also determined. Then Kplan-Meier method was used to analyze the relationship between GM-CSF protein expression level and prognosis of colon cancer patients. 【Results】The expression level of GM-CSF protein in colon cancer tissues was significantly higher than that in adjacent normal tissues, and the difference was significant (P<0.05); there was no significant difference in the expression level of GM-CSF in the cancer tissues of patients with different gender, age, tumor location and histological grade (P>0.05); the expression of GM-CSF in the cancer tissues of patients with different tumor diameter, Dukes stage and lymph node metastasis was different The overall survival (OS) and progression free survival (PFS) of patients with positive expression of GM-CSF were significantly higher than those of patients with negative expression of GM-CSF (P<0.05).【Conclusion】GM-CSF is highly expressed in colon cancer, and its expression is correlated with lymph node metastasis and prognosis of patients with colon cancer. Detection of GM-CSF is helpful to understand the occurrence and progress of colon cancer, and provide reference for individualized treatment and prognosis judgment of colon cancer. 2020 Vol. 37 (11): 1628-1630 [Abstract] ( 86 ) HTML (1 KB)  PDF  (0 KB)  ( 13 ) 1631 Changes and Significance of Thyroid Function Indicators and Thyroid Autoantibodies in Patients with Hyperemesis Gravidarum LIU Yang, WANG Rui, FENG Cai-xia DOI: 10.3969/j.issn.1671-7171.2020.11.010 【Objective】To investigate the changes and significance of thyroid function parameters and thyroid autoantibodies in patients with hyperemesis gravidarum. 【Methods】A total of 60 patients with hyperemesis gravidarum (the observation group) and 60 cases of normal pregnant women (the control group) were selected from January 2015 to December 2018 in our hospital. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH), thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) were detected in the two groups. 【Results】The levels FT3 and FT4 in the observation group were (4.78 ±0.82) and (19.82±3.44) pmol/L, respectively, which were significantly higher than those of the control group (P<0.05), while the TSH was (0.69±0.21) mIU/L, which was significantly lower than that of the control group (P<0.05). There were no significant difference in the positive rates of TgAb and TPOAb between the observation group and the control group (P>0.05). In the observation group, FT3 and FT4 levels of parturients with hyperemesis gravidarum score ≥8 were (5.02±0.91) pmol/L and (21.15±2.81) pmol/L, respectively, which were significantly higher than those of parturients with score < 8 (P<0.05), while TSH level was (0.61±0.19) mIU/L, which was significantly lower than those of parturients with score < 8 (P<0.05). 【Conclusion】The serum levels of FT3 and FT4 in hyperemesis gravidarum patients are significantly increased and TSH is significantly decreased, which may be related to the condition of hyperemesis gravidarum , but the positive rate of thyroid autoantibody has no significant change. 2020 Vol. 37 (11): 1631-1633 [Abstract] ( 47 ) HTML (1 KB)  PDF  (0 KB)  ( 9 ) 1634 Predictive Value of Serum Bilirubin Level in Patients with Peritoneal Dialysis AN Ling DOI: 10.3969/j.issn.1671-7171.2020.11.011 【Objective】To investigate the correlation between serum bilirubin level and mortality in peritoneal dialysis(PD) patients and analyze its predictive value for prognosis of PD patients. 【Methods】A total of 140 patients with maintenance PD in our hospital from May 30, 2015 to May 30, 2017 were selected for the study. The blood bilirubin level was measured at 6 months of dialysis. The baseline clinical data and laboratory results were recorded. The termination time of follow-up was May 30, 2019, and the end point of follow-up was all-cause death. The ROC curve were used to determine the best cut-off point of blood bilirubin. The correlation between blood bilirubin and death were revealed and its predictive value for mortality were analyzed. 【Results】The follow-up time was 6-42 months and the median follow-up time was 34 months. A total of 33 patients died. The average level of blood bilirubin was (5.3 ± 1.4) μmol/L. The area under the ROC curve (AUC) of blood bilirubin predicted all-cause mortality was 0.69 (p=0.012), the best cut-off point of blood bilirubin was 3.3 μmol/L, the sensitivity was 67.5%, and the specificity was 69.1%. There were 32 patients with bilirubin low value (<3.3 μmol/L) and 108 patients with high bilirubin group (≥3.3 μmol/L). The albumin, serum calcium and hemoglobin levels in the low bilirubin group were lower than those in the high bilirubin group (P<0.05). The cumulative survival rate of low bilirubin group was lower than that of the high bilirubin group(P<0.05) . Uric acid, blood glucose, dialysis adequacy, age, and bilirubin were independent risk factors for all-cause mortality in maintenance PD patients (P<0.05). 【Conclusion】The mortality of maintenance PD with blood bilirubin <3.3 μmol/L is high. The blood bilirubin level is an effective biomarker for predicting all-cause death in patients with PD. 2020 Vol. 37 (11): 1634-1636 [Abstract] ( 52 ) HTML (1 KB)  PDF  (0 KB)  ( 12 ) 1637 Detection and Evaluation of CT, Uu, sIgA and IFN-γ in Cervical Secretions for Cervical Erosion Diagnosis and Treatment GUO Wei-juan, NI Yi DOI: 10.3969/j.issn.1671-7171.2020.11.012 【Objective】To investigate the levels and significance of chlamydia trachomatis (CT), ureaplasma urealyticum (Uu), secretory immunoglobulin (sIgA) and interferon-γ(IFN-γ) in cervical secretions of patients with cervical erosion. 【Methods】A total of 110 patients with cervical erosion treated in our hospital from February 2018 to March 2019 were selected as the observation group, and 60 healthy volunteers in the same time period were selected as the control group. Detection of CT and Uu infection, and levels of sIgA and IFN-γ in cervical secretions were detected. 【Results】 The infection rate of CT or Uu, and levels of sIgA and IFN-γ in cervical secretions of the observation group were significantly higher than those in the control group (P<0.05). However, there was no significant difference in the mixed infection rate of CT and Uu between the two groups (P>0.05). The infection rate of CT and Uu, and levels of sIgA and IFN-γ in cervical secretions of severe patients from the observation group were significantly higher than those from the mild and moderate patients (P<0.05); there was no difference in the mixed infection rate of CT and Uu between the mild to moderate patients and the severe patients (P>0.05). In the observation group, the levels of patients with sIgA and IFN-γ secretion and CT and Uu infection were significantly higher than those in non-pathogenic patients (P<0.05). 【Conclusion】The infection rate of CT and Uu in cervical secretions of patients with cervical erosion increases, while the levels of sIgA and IFN-γ enhance, which are related to the severity of the disease. 2020 Vol. 37 (11): 1637-1639 [Abstract] ( 45 ) HTML (1 KB)  PDF  (0 KB)  ( 9 ) 1640 Value of Phosphorylated tau Protein and Glial Fibrillary Acidic Protein in Early Diagnosis of Neonatal Hypoxic-ischemic encephalopathy Brain Damage REN Yan-lin, YU Tian-ying, WANG Lai-er DOI: 10.3969/j.issn.1671-7171.2020.11.013 【Objective】To investigate the value of phosphorylated tau protein (p-tau) and glial fibrillary acidic protein (GFAP) in the early diagnosis of neonatal hypoxic ischemic encephalopathy (HIE) brain damage. 【Methods】 Sixty-three neonates with hypoxic ischemic encephalopathy who were delivered in our hospital from June 2016 to August 1818 were selected as observation group. According to the severity of hypoxic ischemic encephalopathy, they were divided into the mild group (n=28), the moderate group (n=20) and the severe group (n=15). At the same time, 63 healthy newborns delivered in our hospital were selected as the control group. Levels of p-tau, GFAP, NSE and S100β within 24 hours after delivery were measured and compared between the observation group and the control group. Changes of p-tau, GFAP, NSE and S100β in the mild, moderate, and severe groups before treatment and at 7d, 14d, and 28d after treatment were recorded. Then we analyzed the correlation of p-tau and GFAP with brain injury markers NSE and S100β; ROC curves were used to assess the efficacy of p-tau and GFAP levels in the diagnosis of brain injury. 【Results】 (1) Compared to the control group, the levels of p-tau, GFAP, NSE and S100β in the observation group were significantly higher (P<0.05). (2)The differences of p-tau, GFAP, NSE and S100β among the three groups of different severity were statistically significant (P<0.05). The levels of p-tau, GFAP, NSE and S100β in the severe and moderate groups were higher than those in the mild group (P<0.05). The levels of p-tau, GFAP, NSE and S100β in the moderate group were higher than those in the mild group (P<0.05). (3) With the extension of treatment time, all the indicators in the three groups were improved. After 28 days of treatment, there was no significant difference in p-tau, GFAP, NSE, and S100β between the mild and moderate groups (P>0.05), though there were significant differences between the severe group and the control group (P<0.05). (4) Pearson correlation analysis showed that p-tau was positively correlated with NSE and S100β (P<0.05); and GFAP was positively correlated with NSE and S100β (P<0.05) as well. (5)The area under the curve (AUC) and 95%CI for diagnosing brain injury were 0.764 and (0.457-0.877), respectively. When the cut-off point was 79.47 ng/L, the sensitivity and specificity were 70.7% and 81.2%, respectively. The GFAP level was also used to diagnose the brain damage curve. The area under the area (AUC) and 95%CI for GFAP were 0.646 and (0.568-0.783), respectively. When the cut-off point was 0.71 μg/L, the sensitivity and specificity were 75.8% and 82.8%, respectively. 【Conclusion】The expression of p-tau and GFAP in neonates with hypoxic-ischemic encephalopathy is highly expressed and related to the severity of the disease, which is helpful for diagnosing the degree of brain injury and evaluating the prognosis of the child. 2020 Vol. 37 (11): 1640-1643 [Abstract] ( 59 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 1644 Analgesic Effect of Balanced Analgesia with Sufentanil and Flurbiprofen on Postoperative Pain in Patients Undergoing Cervical Cancer Surgery HAN Qi, LI Feng-ling, CHEN Hui-qun, et al DOI: 10.3969/j.issn.1671-7171.2020.11.014 【Objective】To explore the analgesic effect of balanced analgesia with sufentanil and flurbiprofen axetil on postoperative pain after cervical cancer surgery. 【Methods】A total of 130 patients with cervical cancer who underwent surgical treatment in our hospital were randomly divided into two groups with 65 cases in each group. The observation group was treated with sufentanil and flurbiprofen axetil, while patients in the control group received sufentanil only for postoperative analgesia. Pain scores (VAS) at different time points after surgery, postoperative intravenous analgesia pump (PCIA) compressions, serum prostaglandin E2 (PGE2), cortisol (Cor), beta endorphin (β-EP), and serotonin (5-HT) levels were compared between the two groups. 【Results】During 12-48h after operation, the VAS scores of the observation group were lower than those of the control group, and the differences between the two groups were significant (P<0.05). At 24 and 48 hours after surgery, the total number of PCIA compressions in the observation group was lower than that in the control group (P<0.05). There were no significant differences in serum PGE2, 5-HT, Cor and β-EP levels between the two groups before surgery (P>0.05). The levels of serum PGE2, 5-HT, Cor and β-EP in the observation group at 24 hours after operation were lower than those in the control group (P<0.05). 【Conclusion】The balanced analgesia of sufentanil and flurbiprofen has a better analgesic effect after cervical cancer surgery, which can effectively reduce the secretion of postoperative pain related factors. 2020 Vol. 37 (11): 1644-1646 [Abstract] ( 48 ) HTML (1 KB)  PDF  (0 KB)  ( 9 ) 1647 Effects of Different Positions on Hemodynamics in Patients with Severe Pneumonias Undergoing Lung Recruitment Therapy YAN Xi-xiang, ZHENG Ai-dong, ZHANG Zhen-en, et al DOI: 10.3969/j.issn.1671-7171.2020.11.015 【Objective】To investigate the effects of different positions on hemodynamics in patients with severe pneumonias undergoing lung recruitment therapy. 【Methods】Ninety patients with severe pneumonia were divided into supine position group (group A) and prone position group (group B ) according to the body position selected in the treatment of lung recruitment. The changes of oxygen metabolism were observed before, 5 minutes and 1 hour after pulmonary reopening, including arterial partial pressure of oxygen (PaO2), mixed venous partial pressure of oxygen (PvO2), central venous oxygen saturation (ScvO2), oxygen supply (DO2) and oxygen uptake rate (ERO2).Hemodynamic changes were recorded before, immediately after and 1 hour after pulmonary recruitment, including central venous pressure (CVP), cardiac index (CI), global ejection fraction (GEF), peripheral vascular resistance index (SVRI), stroke volume variation (SVV), intrathoracic blood volume index (ITBVI). The incidence of complications in the two groups was also observed. 【Results】The levels of PAO2, PvO2, ScvO2 and DO2 of the two groups before lung recruitment were higher than those at 5min and 1h after recruitment (P<0.05). Those parameters in group B were significantly higher than those in the group A (P<0.05). The level of ERO2 at 5 minutes and 1 hour after lung recruitment was lower than that before lung recruitment (P<0.05), however, there was no statistically significant difference in between (P>0.05).The CVP, CI and GEF levels of the two groups immediately after recruitment were significantly lower than those before lung recruitment (P<0.05), and the SVV was significantly higher than that before lung recruitment (P<0.05).There were no significant differences in CVP, CI, GEF, SVRI, SVV and ITBVI between the two groups (P>0.05).There was no significant difference in the incidence of subcutaneous emphysema, pneumothorax and barotrauma between the two groups as well (P>0.05). 【Conclusion】Choosing supine position or prone position for lung recruitment in patients with severe pneumonia has less influence on hemodynamics and fewer complications. Prone position can further improve oxygen metabolism, and the effect is more remarkable. 2020 Vol. 37 (11): 1647-1649 [Abstract] ( 52 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 1650 Expression and Significance of TIPE-2 in Peripheral Blood of Patients with Rheumatoid Arthritis WANG Xue-yao, JING Cheng-bao, WANG Chan DOI: 10.3969/j.issn.1671-7171.2020.11.016 【Objective】To investigate expression and significance of tumor necrosis factor-alpha inducible protein-8-like molecule-2 (TIPE-2), p65 mRNA, tumor necrosis factor-α(TNF-α ) and interleukin-6 (IL-6) in peripheral blood of patients with rheumatoid arthritis (RA).【Methods】According to the disease activity score 28 (DAS28), 147 RA patients from our hospital from December 2015 to December 2018 were divided into RA remission group (DAS28≤3.2 score, n=65) and RA active group (DAS28＞3.2, n=82), while 45 healthy volunteers were selected as the control group. the levels of TIPE-2, p65 protein, TNF-α and IL-6 were detected and compared among the three groups. The relationship of TIPE-2 with p65 mRNA, TNF-α and IL-6 in peripheral blood of RA patients was analyzed by Sperman correlation analysis. 【Results】The levels of TIPE-2, DAS28, p65 mRNA, TNF-α and IL-6 in peripheral blood of RA group were higher than those of control group (P<0.05).P. Those indicators of RA active group were higher than those of RA remission group and control group; and the difference was statistically significant (P<0.05).Pearson correlation analysis showed that there was a positive correlation of TIPE-2 with DAS28 score, p65 mRNA, TNF-α and IL-6 in peripheral blood of RA patients, with r values of 0.322, 0.620, 0.705 and 0.632,respectively (P<0.001). 【Conclusion】The levels of TIPE-2, DAS28 score, p65 mRNA, TNF-α and IL-6 in peripheral blood of RA patients increased, where the level of TIPE-2 was positively correlated with DAS28 score, p65 mRNA, TNF-α and IL-6, which can provide certain value for the progress and prognosis evaluation of RA. 2020 Vol. 37 (11): 1650-1653 [Abstract] ( 48 ) HTML (1 KB)  PDF  (0 KB)  ( 9 ) 1654 Analysis of Complications and Maternal and Infant Outcomes of Very Early and Early Preterm Delivery in Elderly Women ZHU Li, ZENG Yue, XU Xi DOI: 10.3969/j.issn.1671-7171.2020.11.017 【Objective】To investigate the complications and maternal and infant outcomes of very early and early preterm delivery in elderly women.【Methods】A total of 78 elderly pregnant women who delivered at Jiangning Road community health service center in Jing'an District of Shanghai from March 2018 to June 2019 were selected as the research objects. According to the gestational weeks of delivery, they were divided into extremely early preterm delivery group (27 cases with gestational period of 24-28 weeks) and 51 cases of early premature delivery group (pregnancy period of 28-33+4 weeks),The maternal age, body mass index (BMI), past history, mode of delivery, birth weight, Apgar score, length of stay in NICU, pregnancy induced hypertension and diabetes mellitus were compared between the two groups.【Results】Among 78 cases of premature infants, 27 cases (34.62%) were very early preterm infants and 51 cases (65.38%) were early preterm infants. The birth weight, Apgar score and NICU of early preterm infants were significantly better than those of very early preterm infants (P<0.05). There was no significant difference between the two groups in the incidence of premature rupture of membranes, placental abnormalities, abnormal fetal position and other complications (P>0.05); however, the incidence of gestational diabetes mellitus in the early preterm birth group was significantly higher than that in the very early preterm birth group, and the rate of cervical dysfunction in the very early preterm birth group was significantly higher than that in the early preterm birth group (P<0.05); there were 4 cases of cesarean section in the two groups, accounting for 18.81%, and the cesarean section rate in the extremely early preterm birth group was significantly lower than that in the early preterm birth group (P<0.05); The cesarean section rate of pregnant women with abnormal placenta in early preterm delivery group was significantly increased (P<0.05).【Conclusion】 Premature rupture of membranes (PROM) is one of the most common complications of very early and early preterm delivery in elderly women. Therefore, we should attach great importance to the risk factors leading to premature rupture of membranes, treat pregnancy associated diseases, do a good job of pre pregnancy examination and relevant intervention measures, and consider cervical cerclage for cervical insufficiency, so as to prolong the gestational weeks as far as possible under the safety of mothers and infants, and improve the maternal and infant outcomes.age, and improve the outcome of mothers and infants. 2020 Vol. 37 (11): 1654-1656 [Abstract] ( 53 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 1657 Clinical Effect Observation of Trichosanthes Kirilowii (Gualou Guizhi) Decoction in the Treatment of Apoplectic Limb Spasm and its Influence on Cerebral Hemodynamic Indexes SHI Ke, FAN Xiu-feng, YUE Jing DOI: 10.3969/j.issn.1671-7171.2020.11.018 【Objective】To investigate the clinical effect of Trichosanthes kirilowii (Gualou Guizhi) decoction in the treatment of apoplectic limb spasm and its influence on cerebral hemodynamic indexes.【Methods】From January 2017 to July 2019, 108 cases of apoplectic limb spasm in our hospital were selected and divided into observation group and control group according to the treatment method, with 54 cases in each group. The control group was given routine medical treatment combined with rehabilitation training, and the observation group was given the Trichosanthes kirilowii decoction on the basis of the control group. The changes of cerebral hemodynamic indexes, myoelectric activity of affected side, simplified Fugl Meyer score, modified Ashworth spasticity scale (MAS), modified Barthel Index (BI) and serum levels of interleukin-1β(IL-1β), tumor necrosis factor-α(TNF -α), neuron specific alcoholase (NSE) and homocysteine (Hcy) were recorded before and after treatment, and the total effective rate of the two groups was statistically analyzed.【Results】The total effective rate of the observation group was 94.44% (51/54), which was significantly higher than that of the control group (81.48%) (χ2=4.285,P=0.038<0.05). After treatment, the average blood flow velocity of ACA, MCA and PCA in the two groups increased compared with that before treatment, and the observation group was significantly higher than the control group, the difference was statistically significant (P<0.05). The serum levels of IL-1β, TNF -α, NSE and Hcy in the two groups were lower than those before treatment, and those in the observation group were significantly lower than those in the control group (P<0.05).The RMS values of biceps brachii and quadriceps femoris in the two groups were lower than those before treatment. The RMS values of biceps brachii and quadriceps femoris in the observation group were lower than those in the control group (P<0.05). The simplified Fugl Meyer score and Bi score of the two groups were higher than those before treatment, while the MAS score was lower than that before treatment. The simplified Fugl Meyer score and Bi score of the observation group were higher than those of the control group, and the MAS score was lower than that of the control group (P<0.05).【Conclusion】The modified Trichosanthes kirilowii decoction can regulate the expression of related inflammatory factors, improve cerebral hemodynamics, and promote the affected limb. 2020 Vol. 37 (11): 1657-1660 [Abstract] ( 55 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 1661 Effect of Dezocine on Analgesia and Cytokines in Patients Undergoing Laparoscopic Radical Gastrectomy YANG Yan, CHEN Peng DOI: 10.3969/j.issn.1671-7171.2020.11.019 【Objective】To investigate the analgesic effect of dizosin on laparoscopic radical gastrectomy and the effects of inflammatory factors interleukin-6(IL-6), interleukin-10(IL-10) and tumor necrosis factor-α(TNF-α) in patients with gastric cancer.【Methods】A total of 90 patients undergoing laparoscopic radical gastrectomy were randomly divided into two groups. The control group was treated with remifentanil analgesia, while patients in the observation group received dezocine analgesia. The analgesic effect and inflammatory factors of the two groups were analyzed.【Results】There was no statistically significant difference in the levels of inflammatory factors between the two groups (P>0.05). At 12 h after operation, the level of IL-6 and TNF- α in observation group was lower than that in control group, while the level of IL-10 was higher than that in control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the observation group (13.33%) and the control group (22.22%) (P>0.05). There was no statistically significant difference between the two groups of preoperative visual simulation (VAS) scores and Mini Mental State Scale (MMSE) scores (P>0.05). At 12 h and 24 h after operation, the VAS score in the observation group was lower than that in the control group, while the MMSE score in the observation group was higher than that in the control group (P<0.05). 【Conclusion】Dezocine can enhance the analgesic effect of laparoscopic radical gastrectomy, regulate the level of postoperative inflammatory factors and improve the cognitive function of patients. 2020 Vol. 37 (11): 1661-1663 [Abstract] ( 73 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 1664 Analysis of miRNA-221-3p Expression and Clinical Diagnosis Value in Patients with Coronary Heart Disease XUE Han-bing, XUE Yi-nan, CAO Jian DOI: 10.3969/j.issn.1671-7171.2020.11.020 【Objective】To investigate the diagnostic value of the expression of microRNA221-3p in patients with coronary heart disease. 【Methods】 From May to November 2018, 400 suspected CHD patients were selected, 290 of whom were diagnosed as CHD by coronary angiography (observation group) and 110 as non CHD patients (control group). The expression of miRNA-221-3p in serum of the two groups was detected by real-time quantitative PCR, and the diagnostic value of miRNA-221-3p in diagnosing coronary heart disease was analyzed by working characteristic curve of the subjects.【Results】There was no significant difference in gender, age, leukocyte count, serum uric acid level, creatinine and fasting blood glucose between the two groups (P>0.05); the proportion of hypertension, diabetes, smoking and the expression level of BMI, TG, TC, LDL-C and miRNA-221-3p in the observation group were significantly higher than those in the control group, while HDL-C was significantly lower than that in the control group (P<0.05). ROC curve analysis showed that the best critical point of miRNA-221-3p for the diagnosis of CHD was 3.7. When miRNA-221-3p was 3.7, the sensitivity and specificity of miRNA-221-3p for the prediction of CHD were 66.9% and 70.9% respectively, and the area under AUC curve was 0.71. 【Conclusion】miRNA-221-3p can be used as a potential biomarker for the diagnosis of coronary heart disease. 2020 Vol. 37 (11): 1664-1666 [Abstract] ( 50 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 1667 Risk Factors Analysis of Pulmonary Complications after Thoracoscopic Radical Resection of Lung Cancer CHE Qiang, WANG Lin-bao, WANG Xiao-bin, et al DOI: 10.3969/j.issn.1671-7171.2020.11.021 【Objective】To investigate the risk factors of pulmonary complications after thoracoscopic radical resection of lung cancer.【Methods】A total of 55 patients with postoperative pulmonary complications who underwent thoracoscopic radical resection of lung cancer in our hospital from May 2014 to May 2017 were randomly selected as the complication group. A total of 60 patients without postoperative pulmonary complications after thoracoscopic radical resection of lung cancer at the same time were randomly selected as the control group. The relevant elements of general clinical data were set as observation variables to analyze the influencing factors of pulmonary complications after thoracoscopic radical resection of lung cancer.【Results】Age, smoking, chronic obstructive pulmonary disease (COPD), preoperative peak expiratory flow rate, and perioperative respiratory function exercise compliance were all independent factors influencing the occurrence of pulmonary complications after radical resection of thoracoscopic lung cancer (OR=1.153、1.252、1.358、0.593、1.923). 【Conclusion】Advanced age, smoking and combined COPD were independent risk factors for pulmonary complications after radical thoracoscopic lung cancer surgery, while preoperative peak expiratory flow rate and perioperative respiratory function exercise were protective factors to avoid pulmonary complications, which provided a reference for clinical individualization prediction of postoperative pulmonary complications. 2020 Vol. 37 (11): 1667-1670 [Abstract] ( 64 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 1671 Effect of Neoadjuvant Chemotherapy Cycle on Chemotherapy Effect of Triple Negative Breast Cancer ZHANG Lu, QIAO Jian, SUN Xiao-dong, et al DOI: 10.3969/j.issn.1671-7171.2020.11.022 【Objective】 To investigate the effect of neoadjuvant chemotherapy cycle on the chemotherapy effect of triple negative breast cancer.【Methods】The clinical data of 110 patients with triple negative breast cancer who received preoperative neoadjuvant chemotherapy in our hospital from June 2015 to June 2019 were retrospectively analyzed. All patients received epirubicin combined with docetaxel and cyclophosphamide neoadjuvant chemotherapy. They were divided into short cycle group (preoperative neoadjuvant chemotherapy 3-4 cycles, n=35) and long cycle group (preoperative neoadjuvant chemotherapy 6-8 cycles(n=75).The clinical and pathological efficacy, adverse reactions and disease-free survival (DFS) were compared between the two groups.【Results】There was no significant difference in the clinical total effective rate between the two groups (P>0.05); there was no significant difference in the Mille Payne pathological grade between the two groups (P>0.05). The PCR rate was 24.5%. The PCR rate of the long cycle group was 24.0% (18/75), which was not significantly different from that of the short cycle group (25.7%) (χ2=0.06,P=0.80). There was no significant difference in the incidence of arrhythmia, hematochezia, vomiting, diarrhea, thrombocytopenia, peripheral neuritis, menstrual disappearance and drowsiness between the two groups (P>0.05), but the incidence of abnormal liver enzymes and leukopenia in the long cycle group was higher than that in the short cycle group (P<0.05). The follow-up time was 12-36 months, with a median of 20.9 months. There were 24 cases of DFS, including 2 cases in the short-term group and 22 cases in the long-term group. Kaplan Meier method and Log rank test showed that there was no significant difference in DFS between the short cycle group and the long cycle group (log rank χ2=0.185,P=0.667).【Conclusion】Compared with 3-4 cycles of neoadjuvant chemotherapy, prolonging the neoadjuvant chemotherapy cycle (up to 6-8 cycles) may have little effect on the therapeutic effect and prognosis of triple negative breast cancer patients. 2020 Vol. 37 (11): 1671-1673 [Abstract] ( 57 ) HTML (1 KB)  PDF  (0 KB)  ( 9 ) 1674 Effect of Butylphthalide Combined with Ganglioside Intravenous Drip on Neurological Function and Quality of Life in Patients with Acute Cerebral Infarction ZHU Xiao-dun DOI: 10.3969/j.issn.1671-7171.2020.11.023 【Objective】To investigate the effect of Butylphthalide Combined with Ganglioside on preventing reperfusion injury and quality of life in patients with cerebral infarction. 【Methods】The clinical data of 126 patients with acute cerebral infarction admitted to the Department of Neurosurgery of our hospital from March 2014 to October 2018 were retrospectively analyzed. According to the different treatment drugs, they were divided into control group (n=63, receiving butylphthalide intravenous drip) and observation group (n=63, receiving butylphthalide combined with ganglioside intravenous drip). After 15 days of treatment, the NIHSS score of neurological function and Barthel score of activities of daily living of the two groups were compared to evaluate the therapeutic effect of the two groups. The serum levels of neuron specific enolase (NSE), S100 β protein, superoxide dismutase (SOD), malondialdehyde (MDA), tumor necrosis factor-α(TNF-α), C-reactive protein (CRP) were detected and compared between the two groups before and after treatment. 【Results】After 15 days of treatment, the NIHSS scores of the two groups were decreased compared with those before treatment, and the observation group was significantly lower than the control group, the differences were statistically significant (P<0.05); the Barthel scores of the two groups were improved, and the observation group was significantly higher than the control group, the differences were statistically significant (P<0.05). The levels of NSE, S100β, MDA, TNF-αand CRP in the two groups were lower than those before treatment, and the indexes in the observation group were significantly lower than those in the control group (P<0.05); the serum SOD levels in the two groups were higher than those before treatment, and the observation group was higher than the control group, the differences were statistically significant (P<0.05). After treatment, the total effective rate of the observation group was 93.7% (59/63), significantly higher than 76.2% (48/63) of the control group, the difference was statistically significant (P<0.05).【Conclusion】Butylphthalide combined with ganglioside intravenous drip can improve the neurological function of patients with acute cerebral infarction, promote the recovery of neurological function, improve the quality of life, and improve the therapeutic effect of cerebral infarction. The mechanism may be related to the reduction of oxidative stress and inflammatory injury. 2020 Vol. 37 (11): 1674-1677 [Abstract] ( 43 ) HTML (1 KB)  PDF  (0 KB)  ( 15 ) 1678 Relationship of MCL-1 and NIBP Expression in Colon Cancer Tissues with Tumor Progression FAN Yu-chen, MA Yue-zhen, LI Kai-nan DOI: 10.3969/j.issn.1671-7171.2020.11.024 【Objective】To investigate relationship of the expression of myeloid leukemia gene-1 (MCL-1) and NIK-IKK binding protein (NIBP) with tumor progression in colon cancer. 【Methods】Immunohistochemical staining was used to detect the expression of MCL-1 protein and NIBP protein in 82 cases of postoperative colon cancer tissues and corresponding adjacent tissues. The pathological parameters such as different TNM stage, tumor differentiation degree and lesion size were analyzed to reveal their relationship with positive expression rate of MCL-1 protein and NIBP protein. 【Results】The positive rates of MCL-1 protein and NIBP protein in colon cancer tissues were 68.29% and 60.98%, respectively, which were significantly higher than those in adjacent tissues (26.83% and 20.73%, respectively). The differences were statistically significant (P<0.05). The differential expression of MCL-1 protein and NIBP protein in colon cancer tissues with different tumor invasion depths, TNM stages, pathological differentiation, and lymph node metastasis were statistically significant (P<0.05). 【Conclusion】The expression of MCL-1 protein and NIBP protein in colon cancer tissues is significantly higher than that in adjacent tissues, which may be related to the progression of colon cancer. 2020 Vol. 37 (11): 1678-1680 [Abstract] ( 43 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 1681 Relationship of Peripheral Blood CTCs with Development and Prognosis of Colon Cancer HU Zuo-yu, CUI Zheng-lyu, FENG Wei DOI: 10.3969/j.issn.1671-7171.2020.11.025 【Objective】To investigate the relationship of circulating tumor cells (CTCs) in peripheral blood with the development and prognosis of colon cancer. 【Methods】A total of 87 patients who underwent surgical treatment of colon cancer in our hospital were selected in the observation (colon cancer) group, and 85 patients with colon polyps who were treated with intestinal polyps were selected as the control group. The levels of CTCs in the peripheral blood of the two groups were measured. The positive rate of peripheral blood CTCs in the group and different CTCs positive rates in colon cancer patients with different pathological features were analyzed. All patients were followed up for 3 years to evaluated the difference in 3-year survival rate and survival time between CTCs positive and negative colon cancer patients. 【Results】The detection rate of CTCs positive cells in peripheral blood of colon cancer group was 44.83%, which was significantly higher than that of control group (3.53%). The difference was statistically significant (P<0.05). The detection rate of CTCs positive cells in peripheral blood of colon cancer patients with different TNM stages, lymph node metastasis, and vascular invasion were compared between groups; and the difference was statistically significant (P<0.05). The positive cells of CTCs in peripheral blood of colon cancer patients with different degrees of differentiation and different tumor sites were detected. The difference between the two groups was not statistically significant (P>0.05). The survival rate analysis showed that the 3-year cumulative survival rate of patients with CTCs positive group was 19.10%, which was lower than that of the negative group (45.20%) (P<0.05). The median survival time was 28.0 months in the CTCs positive group and 35.0 months in the negative group (P<0.05). 【Conclusion】Detection of CTCs positive cells in peripheral blood of patients with colon cancer has certain guiding significance for disease assessment and prognosis. 2020 Vol. 37 (11): 1681-1683 [Abstract] ( 55 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 1684 Influence of "Internet plus" Health Management Mode on FEV1, Acute Exacerbation and Quality of Life in Patients with Stable Chronic Obstructive Pulmonary Disease ZHONG Xiao-xia DOI: 10.3969/j.issn.1671-7171.2020.11.026 【Objective】To explore the influences of "Internet plus" health management mode on the forced expiratory volume in one second (FEV1), the frequency of acute exacerbation and the quality of life in patients with stable chronic obstructive pulmonary disease (COPD). 【Methods】A total of 106 patients with stable COPD in our hospital from January 2019 to April 2020 were selected and randomly divided into control group and study group. The former 53 cases were given routine management, the latter 53 cases implemented the health management mode based on the Internet plus in routine management. The self-management ability, pulmonary function index, times of acute exacerbation and quality of life were compared between the two groups. 【Results】 After 6 months of management, the scores of COPD Self-Management Scale (CSMS) and FEV1, FEV1 /forced vital capacity (FVC) of COPD patients in the two groups were higher than those before management (P<0.05), and those in the study group were higher than those in the control group (P<0.05); the St. George's Respiratory Questionnaire (SGRQ) score of the two groups was lower than before management (P<0.05), and that in the study group was lower than that in the control group (P<0.05); the number of acute exacerbations in the study group was less than that in the control group (P<0.05). 【Conclusion】The implementation of "Internet plus" health management mode in patients with stable COPD can significantly enhance the self-management ability of patients, significantly improve lung function and quality of life, and effectively reduce the number of acute exacerbations. 2020 Vol. 37 (11): 1684-1687 [Abstract] ( 83 ) HTML (1 KB)  PDF  (0 KB)  ( 12 ) 1688 Relationship of Treg, Th17 Cells and serum FGF23 with Carotid Atherosclerosis in Patients with MHD PAN Yan-zi, ZHANG Juan DOI: 10.3969/j.issn.1671-7171.2020.11.027 【Objective】To investigate the relationship of peripheral blood regulatory T cells (Treg), helper T cell (Th17) and serum fibroblast growth factor-23 (FGF23) with carotid atherosclerosis in patients with maintenance hemodialysis (MHD) treatment. 【Methods】A total of 120 patients who underwent MHD received color Doppler ultrasonography (CDFI) to measure the intima-media thickness (IMT) of carotid artery. There were 52 cases belonging to the sclerotic group with IMT≥1.0 mm and 68 cases were in the non-sclerotic group. The levels of Treg, Th17 cells and serum FGF23 in the peripheral blood were compared between the two groups. The correlation between the above indicators and IMT was analyzed. 【Results】There were no significant differences in age, gender, primary disease composition, hyperlipidemia, smoking, and alcohol consumption between the sclerotic group and the non-sclerosis group (P>0.05). compared to the non-sclerotic group, patients in the sclerosis group had longer dialysis treatment (P<0.05). Levels of Th17 cells, serum FGF23, and carotid IMT of the peripheral blood in the sclerotic group were higher than those in the non-sclerotic group (P<0.05). While the Treg level in the sclerotic group was significantly lower than that in the non-sclerotic group (P<0.05). Pearson linear correlation analysis showed that the peripheral blood levels of Th17 cells and serum FGF23 in MHD patients were positive correction with IMT (P<0.05); while Treg value showed a significant negative correlation with IMT (P<0.05). 【Conclusion】Immunity imbalance and elevated serum FGF23 level in patients with MHD may be associated with carotid atherosclerosis. 2020 Vol. 37 (11): 1688-1690 [Abstract] ( 46 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 1691 Levels and Significance of Serum PA, MMP-2, CYFRA21-1 in Patients with Decompensated Hepatitis B Cirrhosis XIA Xiao-xiao, SHI Dong-tao DOI: 10.3969/j.issn.1671-7171.2020.11.028 【Objective】To investigate the levels and significance of serum prealbumin (PA), matrix metalloproteinase-2 (MMP-2) and cytokeratin 19 fragment (CYFRA21-1) in patients with decompensated hepatitis B(HB) cirrhosis. 【Methods】Sixty-eight patients with chronic HB (chronic group), 50 patients with compensatory HB cirrhosis (compensatory group) and 42 patients with decompensated HB cirrhosis (decompensated group) were selected,and 60 healthy volunteers were selected as control group;serum PA, MMP-2 and CYFRA21-1 level were detected. 【Results】The levels of serum PA from low to high were the decompensated group, the bcompensatory group, the chronic group and the control group, and the differences were significant (P<0.05). MMP-2 and CYFRA21-1 from high to low were the decompensated group, the compensatory group, the chronic group and the control group, and there were significant differences among each group (P<0.05). In the decompensated group, serum PA was (37.22±9.94) mg/L, which was significantly lower than that of survival patients (P<0.05), while MMP-2 and CYFRA21-1 were (1.50±0.27) ng/L and (1.56±0.24) ng/mL, which were significantly higher than those of survival patients (P<0.05). The area under ROC curve for predicting death of patients with decompensated hepatitis B cirrhosis by serum PA, MMP-2 and CYFRA21-1 was 0.911, 0.736 and 0.686, respectively( All P<0.05). 【Conclusion】Serum PA is significantly decreased in patients with decompensated hepatitis B cirrhosis, while MMP-2 and CYFRA21-1 are significantly increased in patients with decompensated hepatitis B cirrhosis.The three methods have certain application value in predicting prognosis. 2020 Vol. 37 (11): 1691-1693 [Abstract] ( 46 ) HTML (1 KB)  PDF  (0 KB)  ( 8 ) 1694 KDM2B Expression Association with Gastric Cancer Recurrence YIN Jun, ZHAO Ye-jian DOI: 10.3969/j.issn.1671-7171.2020.11.029 【Objective】To investigate the relationship of Lysine (K)-specific demethylase 2B (KDM2B) expression with gastric cancer recurrence. 【Methods】Three hundred gastric cancer patients who received surgical treatment in our hospital were included in this study. The expression of KDM2B in gastric cancer tissues was detected and follow-up was conducted to determine the recurrence. Kaplan-Meier and log-rank test were used for univariate analysis, and significant factors in univariate analysis were introduced into Cox regression model. 【Results】According to TNM staging, among the 300 patients selected, 75 cases were categorized into stage Ⅰ, 63 cases were in stage Ⅱ, and 123 cases were in stage Ⅲ. Follow-up was completed in 278 patients, While 22 cases were lost to follow-up. The follow-up rate was 92.7%. KDM2B positive expression was shown in 123 patients (41%) . Recurrence and metastasis occurred in 142 patients. Univariate analysis showed that larger tumors, higher T stage, higher N stage, later TNM stage and positive KDM2B expression increased the risk of recurrence in patients with gastric cancer after surgery. Cox regression analysis showed that, compared to patients with negative KDM2B expression, patients with positive KDM2B expression increased risk of gastric cancer recurrence by 98% [HR:1.98;95%CI: 1.23-3.32]. 【Conclusion】Positive KDM2B expression increases the risk of postoperative recurrence in patients with gastric cancer and patients with positive KDM2B expression have a worse prognosis. 2020 Vol. 37 (11): 1694-1696 [Abstract] ( 40 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 1697 Clinicopathologic Features of 14 Primary Germ Cell Tumors from Central Nervous System LI Qiao-zhi, SHI Hai-yan, LI Xu-feng DOI: 10.3969/j.issn.1671-7171.2020.11.030 【Objective】To investigate the clinical characteristics of primary central nervous system (CNS) germline cell tumor (GCTs) and to investigate the diagnostic significance of immunohistochemical indexes (CD117, PLAP, CD30, CK and AFP). 【Methods】A retrospective analysis of 14 cases of central nervous system GCTs in Foshan First People's Hospital from May 2018 to June 2020 were studied. Clinical characteristics and immunohistochemical results were analyzed. 【Results】 There were 6 cases of GCTs in sellar region, of which 3 cases were germ cell tumors, 1 case was yolk sac tumor and 1 case was mature teratoma. Two cases occurred in the pineal gland, of which one was a germ cell tumor and the other was a mixed germ cell tumor with embryonic carcinoma component. One patient was a germ cell tumor in the third ventricle. Three cases occurred in the sacrococcyx, of which 2 cases were yolk sac tumor with mature teratoma and 1 case was yolk sac tumor. The last 2 cases occurred in the frontal lobe. The tumors were mainly intracranial hypertension and local compression symptoms. PLAP and CD117 were expressed in almost all germ cell tumors, AFP was expressed in yolk sac tumors, and CD30 and CK were characteristic in embryonic carcinoma. 【Conclusion】 Primary germ cell tumor of central nervous system is a rare type of tumors, which are prone to occur in sella region. According to the biological characteristics, the selection of landmark immunohistochemical indexes for accurate pathological diagnosis has important guiding significance for clinical treatment. 2020 Vol. 37 (11): 1697-1700 [Abstract] ( 42 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 1701 Influences of Postures on Curative Effect and Functional Recovery in Treatment of Lumbar Disc Herniation with Percutaneous Transforaminal Endoscopic Discectomy DANG Jing-dong, WANG Lei-jie, YE Lin-jiang, et al DOI: 10.3969/j.issn.1671-7171.2020.11.031 【Objective】To explore influences of different postures on the curative effect and functional recovery in treatment of lumbar disc herniation (LDH)with percutaneous transforaminal endoscopic discectomy (PTED) . 【Methods】A total of 80 LDH patients who were treated in Yulin Rehabilitation Hospital of Neck-Shoulder and Lumbocrural Pain from January 2017 to December 2018 were enrolled. They were divided into the control group and the observation group by random number table method, with 40 cases in each group. The control group underwent PTED in prone position, while the observation group underwent PTED in lateral position. The clinical curative effect after 1 year of surgery, intraoperative puncture time, times of fluoroscopy, number of cases with extreme discomfort, scores of visual analogue scale (VAS), Oswestry disability Index (ODI) and Japanese Orthopaedic Association (JOA) after 3 months and 1 year of surgery, and incidence of complications within 3 months after surgery were compared between the two groups. 【Results】After 12 months of surgery, there was no significant difference in good rate of treatment between the observation group and the control group (92.50% vs 87.50%) (P>0.05). During surgery, puncture time, times of fluoroscopy and number of cases with extreme discomfort in the observation group were lower than those in control group (P<0.05). There were no significant differences in scores of VAS of lumbar and leg pain, ODI and JOA before surgery between the two groups (P>0.05). At 3 months and 1 year after surgery, scores of lumbar and leg pain, and ODI in both groups were lower than those before surgery (P<0.05), while JOA scores were higher than those before surgery (P<0.05). Within 3 months after surgery, there was no significant difference in incidence of complications between the observation group and the control group (7.50% vs 10.00%) (P>0.05). 【Conclusion】The curative effect of PTED in both postures is good on LDH patients, which both can effectively improve lumbar function and alleviate lumbar and leg pain. The lateral position can reduce intraoperative puncture time and times of fluoroscopy, which showed more comfortable. 2020 Vol. 37 (11): 1701-1703 [Abstract] ( 45 ) HTML (1 KB)  PDF  (0 KB)  ( 10 ) 1704 Correlation of Vitamin D Binding Protein Level with cTnT, BNP and SYTNAX Score in Patients with ST-segment Elevation Myocardial Infarction CHENG Rong, ZHAO Jian-guo, LI Xiao-lin, et al DOI: 10.3969/j.issn.1671-7171.2020.11.032 【Objective】To detect the level of vitamin D binding protein (VDBP) in ST-segment elevation myocardial infarction (STEMI) patients, and further analyze the relationship of VDBP with SYTNAX score, cardiac troponin (cTnT) and B-type brain natriuretic peptide (BNP).【Methods】A total of 168 patients with acute ST-segment elevation myocardial infarction who were treated in our Department of Cardiology from January 2017 to January 2020 were selected in the observation group ; and 50 healthy volunteers were enrolled in the control group. According to the SYNTAX score, the observation group was further divided into the high-risk group, intermediate-risk group, and low-risk group. General clinical data were collected and various biochemical indicators were measured (Hexokinase activity assay kit for LDL-C level, BNP-Ⅱ assay kit for BNP, Roche Troponic-Ⅰ-HS kit for cTnT, enzyme-linked immunosorbent assay for measuring TC,TG and VDBP levels).Pearson correlation analysis examined the association of VDBP level with cTnT, BNP, and SYTNAX scores. 【Results】There were no significant differences in gender, age, BMI and biochemical markers (TC, TG and LDL-C) between the control group and the STEMI group (P>0.05). The number of smoking, hypertension and diabetes in the STEMI group was significantly higher than that in the control group. The levels of cTnT, BNP,LDL-C and VDBP in the STEMI group were higher than those in the control group (P<0.05).Patients were divided into three grades according to the SYNTAX score, 32 in the high-risk group, 84 in the intermediate-risk group, and 52 in the low-risk group. There was no difference in the proportion of smoking, hypertension and diabetes among the three groups (P>0.05). The differences of cTnT, BNP and VDBP levels among the high-risk group, the intermediate-risk group and the low-risk group were statistically significant (P<0.05).The Pearson correlation analysis showed that the expression level of VDBP was positively related to cTnT (r=0.599, P<0.001), BNP (r=0.699, P<0.001) and SYTNAX score (r=0.613, P<0.001). 【Conclusion】The expression level of VDBP in patients with STEMI is significantly increased, and it is positively correlated with cTnT, BNP and SYTNAX score. It can provide some help for the diagnosis of STEMI and the assessment of the degree of coronary artery disease. 2020 Vol. 37 (11): 1704-1707 [Abstract] ( 50 ) HTML (1 KB)  PDF  (0 KB)  ( 11 ) 1708 Clinical Analysis of Anterior Circulation Aneurysm Clipping Assisted by Fluorescein Angiography in the Treatment of Anterior Circulation Aneurysm ZENG Qun, JIANG Hui, XU Fan, et al DOI: 10.3969/j.issn.1671-7171.2020.11.033 【Objective】To investigate the value of indocyanine green angiography in the treatment of anterior circulation aneurysms by craniotomy. 【Methods】From March 2017 to March 2019, 90 cases of anterior circulation aneurysms were clipped by fluorescence-assisted microsurgery in neurosurgery department of Xiangtan Central Hospital. The clipping effect of aneurysms was evaluated by head CTA or DSA within 3 days after operation, and the prognosis was evaluated by GOS score three months after operation. 【Results】Six patients had parent artery stenosis after the first clipping. After changing the appropriate aneurysm clip or adjusting the position of the aneurysm clip, fluorescence angiography showed that the parent artery was unobstructed; 4 patients found residual aneurysm neck, 2 of these 4 patients added an aneurysm clip, and the other 2 timely adjusted the position of the aneurysm clip, and finally completely clipped the aneurysm. In 9 patients, the perforating vessels were mistakenly clipped. After angiography, the location of the aneurysm clip was adjusted to avoid the false clipping. The results of postoperative reexamination showed that there were no parent artery stenosis, residual tumor neck and perforating vessel injury in 90 patients. After 3 months of follow-up, all patients were evaluated by gos score. The GOS score was 4 points and 5 points in 68 cases, that is, mild disability but can live independently or return to normal life belongs to good recovery. The excellent and good rate of patients in this study was 75.6% (68/90). 【Conclusion】Indocyanine green fluorescence angiography assisted anterior circulation aneurysm clipping can effectively reduce the incidence of complications such as parent artery stenosis, residual aneurysm neck, perforating vessel injury, etc., and can improve the quality of life of patients, which has high clinical application value. 2020 Vol. 37 (11): 1708-1710 [Abstract] ( 44 ) HTML (1 KB)  PDF  (0 KB)  ( 12 )

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