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Quick Search     Adv Search 2021 Vol. 38, No. 2 Published: 2021-02-26   172 Expression and Clinical Significance of Stem Cell Markers CD44 and ALDH1 in Cervical Cancer CHEN Hong-xiang, LIU Xiao-wan, YU Hai-rong, et al DOI: 10.3969/j.issn.1671-7171.2021.02.004 【Objective】 To investigate the expression of stem cell markers CD44 and ALDH1 and their relationship with clinical pathological features in cervical cancer. 【Methods】 A total of 78 cases of cervical cancer specimens and 23 cases of adjacent cancer tissues were collected from the Department of Pathology in People's Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2019. The expression of CD44 protein and ALDH1 protein was detected by immunohistochemistry, and the relationship between them and clinicopathological characteristics were analyzed.【Results】 The positive sites of CD44 protein were mainly located in the cell membrane, while ALDH1 protein was mainly located in the cell membrane and cytoplasm,and they were yellow to brown.The positive expression rates of CD44 and ALDH1 protein in cervical cancer tissues were 51.3% (40/78) and 41.0% (32/78), respectively, which were significantly higher than those in adjacent tissues (21.7% (5/23) and 17.4% (4/23), and the differences were statistically significant (χ 2=6.276,P=0.012;χ 2=4.325,P=0.038). The positive expression rate of CD44 and ALDH1 protein in cervical cancer tissue was related to tumor diameter and differentiation degree (P<0.05); the positive expression rate of CD44 protein in cervical cancer tissue was related to clinical stage degree (P<0.05), but the positive expression rate of ALDH1 protein was not related to clinical stage (P>0.05).【Conclusion】 The positive expression of CD44 and ALDH1 is related to the malignant biological behavior of cervical cancer, which may affect the prognosis of cervical cancer patients. 2021 Vol. 38 (2): 172-174 [Abstract] ( 74 ) HTML (0 KB)  PDF (1160 KB)  ( 51 ) 175 Application of BIS-guided Administration in Anesthesia Induction Stage of Patients with Severe Traumatic Brain Injury DU Zhen-jie, LUO Hui-yu, XU Yang, et al DOI: 10.3969/j.issn.1671-7171.2021.02.005 【Objective】 To investigate the application value of bispectral index (BIS) in the anesthesia induction stage of patients with severe traumatic brain injury (STBI). 【Methods】 Fifty-two patients with severe traumatic brain injury (STBI) were randomly divided into the observation group (group N,n=26) and the control group (group C,n=26). In group N, propofol was slowly injected according to the BIS value. In brief, when the BIS value reached the predetermined value (40~60), sufentanil 0.4μg/kg and rocuronium 0.6mg/kg were injected immediately. Then tracheal intubation was performed when muscle relaxation was satisfactory. In group C, propofol was slowly injected according to the doctor's clinical experience and patient's weight. The other administrations and intubation methods were the same as those of group N. Mean arterial pressure (MAP), heart rate (HR) and BIS value were recorded before induction (T0), before tracheal intubation (T1), and 1 (T2), 5 (T3), 10 (T4) minutes afterwards. Venous blood samples were collected to determine the plasma cortisol (COR) level at T0, T1 and T3. Besides, the dosage of propofol used during induction was recorded. 【Results】 Compared to T0, the MAP, HR and BIS value in both groups were significantly decreased after induction and increased after tracheal intubation(P<0.05). Compared with Group N, MAP and BIS value had a significantly wider fluctuation range in Group C(P<0.05). At the point of T0, COR levels in both groups were higher than the normal level. After tracheal intubation, COR levels in both groups were increased, but there was no significant difference between the two groups(P>0.05). The dosage of propofol in group N was (1.1±0.3)mg/kg, which was significantly lower than that in group C (1.7±0.2)mg/kg; the difference was statistically significant (P<0.05). 【Conclusions】 In the anesthesia induction stage of patients with severe traumatic brain injury, administration under the guidance of BIS can not only ensure the depth of anesthesia, but also inhibit the stress reaction caused by endotracheal intubation. It can also reduce the dosage of propofol used, avoid the occurrence of low BIS value, and make the hemodynamics more stable, which is obviously better than the normal administration. 2021 Vol. 38 (2): 175-178 [Abstract] ( 61 ) HTML (1 KB)  PDF (1186 KB)  ( 40 ) 179 Evaluating Expression and Clinical Value of CALHM2 in Non-small Cell Lung Cancer Through Bioinformatics Data Analysis LIU Jie, HUANG Wei, WANG Lei DOI: 10.3969/j.issn.1671-7171.2021.02.006 【Objective】 Based on the high-throughput tumor data in TCGA and GEO, the expression and clinical value of CALHMs family genes such as CALHM2 in non-small cell lung cancer were analyzed. 【Methods】 Using online tools like Oncomine, GEPIA and UALCAN to analyze and verify the expression level of CALHMs (CALHM1-6) family genes in non-small cell lung cancer(NSCLC); Using Human protein Atlas (HPA) to analyze the protein level and location of CALHM2 in NSCLC tissues ; Using GEPIA and UALCAN to analyze the correlations between CALHM2 expression level and pathological stage, lymph node metastasis, p53 mutation and smoking history in patients with NSCLC; Using UALCAN to investigate promoter methylation of CALHM2 in NSCLC; Using Kaplan-Meier Plotter to analyze the relationship between CALHM2 expression level and prognosis of NSCLC including overall survival (OS), first-time progression survival (FP) and post-progression survival (PPS); Using LinkedOmics to analyze the genes that were significantly related to CALHM2 expression in NSCLC; Using Metascape to perform GO function enrichment with CALHM2 correlated genes. 【Results】 The expression of CALHM2 was significantly down-regulated in NSCLC tissue; CALHM2 protein was also significantly reduced in NSCLC tissue. The expression of CALHM2 showed no significant correlation with pathological stage, lymph node metastasis, p53 mutation and smoking history in NSCLC patients. Kaplan-Meier Plotter analysis showed that NSCLC patients with high CALHM2 expression had significantly better OS and FP than those with low CALHM2. LinckedOmics screened a total of 265 genes significantly related to CALHM2, and Metascape enrichment analysis showed that CALHM2 related genes were significantly enriched in lymphocyte activation and migration, immune activation-related processes, and cytokine release regulation. 【Conclusion】 CALHM2 is significantly downregulated in NSCLC and can be used as a prognostic marker for patients with NSCLC. 2021 Vol. 38 (2): 179-184 [Abstract] ( 54 ) HTML (1 KB)  PDF (3200 KB)  ( 79 ) 185 Application and Efficacy Analysis of MSCT and Endoscopy in the Diagnosis of Gastric Lipoma ZHANG Yin-xia, GUO Shan-shan, LI Nan-nan, et al DOI: 10.3969/j.issn.1671-7171.2021.02.007 【Objective】 To investigate the characteristics of gastric lipoma by multi-slice spiral CT (MSCT) and endoscopic examination in the diagnosis of gastric lipoma. 【Methods】 A total of 46 patients with suspected gastric lipoma admitted to our hospital were selected as subjects. Of which, 33 cases of gastric lipoma were confirmed by operation and pathology, and 13 cases were gastric lymphoma. All patients underwent endoscopic and MSCT examination before operation. The MSCT, endoscopic and pathological findings of gastric lipoma were observed. The receiver operating characteristic curve (ROC) was used to analyze the efficacy of endoscopy and MSCT in the diagnosis of gastric lipoma. 【Results】 (1) All patients with MSCT here showed single lesion with clear border and uniform density. Among them, 22 cases (66.67%) were located in the gastric antrum, 8 cases(24.24%) in gastric body, 3 cases(9.09%) in gastric fundus. Only 2 cases (6.06%) had lipoma in both gastric antrum and descending colon. Tumor morphology showed that a clear boundary, round or oval shape and uneven or uniform low density by plain scan; the enhancement by dynamic three-phase enhanced scan was not obvious. (2) Endoscopic examination showed that lesions were found in 23 cases (69.70%). Of which, 17 cases (73.92%) showed local submucosal local eminence in the local gastrointestinal tract, 3 cases (13.04%) intussusception showed intestinal lump like occupying, and 3 cases (13.04%) showed mucosal rupture bleeding on the surface of the lesion. (3) ROC curve analysis showed that the AUC of MSCT in diagnosing gastric lipoma was 0.887, which was higher than 0.774 in endoscopy. The combined examination of MSCT and endoscopy for diagnosis of gastric lipoma was more effective than any single index. 【Conclusion】 MSCT can make a clear judgement for gastric lipoma based on the image of shape, nature and size of the lesions. Endoscopy can clearly show the shape of the lesion and the local gastric mucosa, which has a certain diagnostic value for gastric lipoma. Combined both MSCT and endoscopy can improve the accuracy of diagnosis of gastric lipoma. 2021 Vol. 38 (2): 185-188 [Abstract] ( 54 ) HTML (1 KB)  PDF (1813 KB)  ( 58 ) 189 Changes and Significance of Serum Neurofilament Protain-3 and Neurospecific Enolase in Patients with Acute Ischemic Stroke ZHANG Chen, SHEN Wen-juan DOI: 10.3969/j.issn.1671-7171.2021.02.008 【Objective】 To observe the changes and significance of serum neurospecific enolase (NSE) and neurofilament protein-3 (NFP-3) levels in patients with acute ischemic stroke (AIS). 【Methods】 A total of 65 patients with AIS were selected as the observation group, and another 40 healthy people in the same period were selected as the control group. Peripheral blood samples were collected in the observation group within 24 hours and on D3, D7 and D14, and peripheral blood samples were collected in the control group on the day of admission for detection of NSE and NFP-3 levels, and the differences between the two groups at different time points were compared; ROC curve was drawn to analyze the diagnostic value of NSE and NFP and their combination in patients with AIS.【Results】 The levels of NSE and NFP-3 in the observation group were significantly higher than those in the control group within 24 hours, 3 and 7 days after admission (P<0.05); there was no significant difference between the two groups on 14 days after admission (P>0.05); the levels of NSE and NFP-3 in the observation group increased first and then decreased with the change of admission time. The AUC of NSE, nfp-3 and their combination in predicting AIS were 0.874, 0.926 and 0.967, respectively. The sensitivity was 72.3%, 76.9% and 85.2%, and the specificity was 90.3%, 92.5% and 95.6%, respectively. The best cut-off values of NSE and NFP-3 were 17.25ng/mL and 15.55ng/mL, respectively.【Conclusion】 Serum NSE and NFP-3 levels in AIS patients were significantly increased, and with the improvement of the disease, their levels showed a downward trend. NSE and NFP-3 have higher diagnostic value for AIS, and the diagnostic value of nfp-3 is higher than that of NSE. The combination of NSE and nfp-3 can significantly improve the diagnostic value of AIS, suggesting that NFP-3 can be used for the diagnosis and assessment of AIS. 2021 Vol. 38 (2): 189-191 [Abstract] ( 47 ) HTML (0 KB)  PDF (1246 KB)  ( 38 ) 192 Risk Factors of Deep Venous Thrombosis in Patients with Gynecological Malignancies during Perioperative Period HU Zheng-zhong, ZHOU Yi-feng, PENG Jin, et al DOI: 10.3969/j.issn.1671-7171.2021.02.009 【Objective】 To investigate the risk factors of perioperative deep venous thrombosis (DVT) in patients with gynecological malignancies. 【Methods】 In this study, we selected the literatures of gynecological malignant tumor complicated with DVT published from January 2010 to December 2019 for META-analysis to explore the risk factors of gynecological tumor patients complicated with DVT during perioperative period.【Results】 A total of 12 articles were included, with 13 risk factors, including age, body mass index (BMI), operation, chemotherapy, tumor stage, hypertension, history of thrombosis, operation time, blood transfusion, PICC catheterization, hyperlipidemia, diabetes, D-dimer. The statistically significant risk factors were BMI (OR=2.65,95%CI:1.61~4.36, P=0.0001), surgery (OR=2.33, 95%CI:1.62~3.36, P<0.0001), chemotherapy (OR=2.08, 95%CI:1.50~2.90, P<0.0001), tumor stage (OR=2.42, 95%CI:1.54~3.8, P<0.0001), hypertension (OR=3.10,95%CI:2.13~4.50,P<0.0001), blood transfusion (OR=7.19, 95%CI: 2.55~20.30, P=0.0002), PICC catheterization (OR=2.07, 95%CI: 1.38~3.12, P=0.0005), diabetes (OR=3.66 , 95%CI:1.78~7.53,P=0.0004), operation time ≥3 h(OR=1.1, 95%CI: 1.01~1.20, P=0.03). 【Conclusion】 BMI, operation, chemotherapy, tumor stage, hypertension, blood transfusion, PICC catheterization, diabetes, operation time ≥3 h are the risk factors of DVT in the perioperative period of gynecological malignant tumor. It is possible that controlling the above factors can effectively reduce the incidence of DVT. 2021 Vol. 38 (2): 192-194 [Abstract] ( 51 ) HTML (1 KB)  PDF (1175 KB)  ( 34 ) 195 Correlation between Aquaporin 4, C3, C4 and Neurological Function in Patients with Craniocerebral Injury Hydrocephalus VPS and its Efficacy in Predicting Prognosis CHEN Yun-jiang DOI: 10.3969/j.issn.1671-7171.2021.02.010 【Objective】 To investigate the correlation between aquaporin 4 (AQP4), C3 and C4 complement levels and neurological function in patients with craniocerebral injury hydrocephalus undergoing ventriculoperitoneal shunt (VPS) and its efficacy of predicting prognosis. 【Methods】 From February 2017 to January 2020, 186 patients with hydrocephalus after craniocerebral injury treated by ventriculoperitoneal shunt were prospectively selected and divided into good prognosis group (n=146) and poor prognosis group (n=40) according to the prognosis of the patients. The levels of AQP4, C3 and C4, NIHSS and GCS were compared between the two groups before operation and 1, 3 and 7 days after operation. Pearson was used to analyze the correlation between serum AQP4, C3, C4 levels and NIHSS, GCS scores. Receiver operating characteristic curve (ROC) was used to analyze the efficacy of single and combined prediction of prognosis.【Results】 At 1 d and 3 d after surgery, the serum AQP4, C3, and C4 levels in both groups were higher than that before surgery, with a decreasing trend at 7 d after surgery in the good prognosis group but not in the poor prognosis group at 7 d after surgery (P<0.05); the levels of serum AQP4, C3, and C4 in the good prognosis group at 1 d, 3 d, and 7 d after surgery were lower than those in the poor prognosis group (P<0.05). At 3 d and 7 d after surgery, NIHSS scores in the good prognosis group showed a decreasing trend and GCS scores showed an increasing trend, and NIHSS scores at 3 D and 7 d after surgery in the good prognosis group were lower than those in the poor prognosis group, and GCS scores were higher than those in the poor prognosis group (P<0.05). Serum AQP4, C3 and C4 levels were significantly correlated with corresponding NIHSS and GCS scores at 1 d, 3 d and 7 d after surgery (P<0.05) , and the strongest correlation was observed for each index at 3 d after surgery. ROC curves showed that the AUC of the combined test for predicting prognostic efficacy was 0.895, 95%CI was (0.832-0.959), which was in turn superior to C3, C4 and AQP4, with a predictive sensitivity and specificity of 87.50% and 80.82%, respectively.【Conclusion】 The serum levels of AQP4, C3 and C4 were significantly increased in patients with ventriculoperitoneal shunt placement for craniocerebral injury hydrocephalus, and they were closely related to neurological function, and the combined detection of changes in their levels could help to improve the prognostic predictive value. 2021 Vol. 38 (2): 195-198 [Abstract] ( 54 ) HTML (0 KB)  PDF (1338 KB)  ( 72 ) 199 Efficacy of Eplerenone Combined with Enalapril in the Treatment of Type H Hypertension with Heart Failure and its Effects on NT-proBNP and Hcy LI Liu-wen, BAI Hong-yan, LI Gang-feng DOI: 10.3969/j.issn.1671-7171.2021.02.011 【Objective】 To investigate the efficacy of eplerenone combined with enalapril in the treatment of type H hypertension with heart failure and its effects on N-terminal B-type pro-brain natriuretic peptide (NT-proBNP) and homocysteine(Hcy). 【Methods】 From January 2016 to January 2019, 104 patients with H-type hypertension complicated with chronic heart failure in our hospital were selected as the research objects, and they were divided into observation group and control group according to the random number table method, with 52 cases in each group. The control group was treated with eplerenone, while the observation group was treated with enalapril maleate and folic acid tablets on the basis of the control group for 3 months. The clinical efficacy, serum Hcy and NT-proBNP levels before and after treatment, left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF), NYHA classification and incidence of adverse reactions were compared between the two groups. 【Results】 The clinical effective rate of the observation group was 92.31% (48/52), which was significantly higher than 76.92% (40/52) of the control group (χ 2=4.727,P=0.03<0.05). After treatment, SBP, DBP and serum Hcy, NT-proBNP levels of the two groups were lower than before treatment, and the observation group was significantly lower than the control group, the difference was statistically significant (P<0.05); LVESD and LVEDD of the two groups were lower than those before treatment, and the observation group was significantly lower than the control group; LVEF was higher than that before treatment, and the observation group was significantly higher than the control group; NYHA grade was significantly improved, the differences were statistically significant (P<0.05); no serious adverse reactions occurred in the two groups during the treatment.【Conclusion】 Eplerenone combined with enalapril folic acid has good clinical effect in the treatment of H-type hypertension with chronic heart failure. It can effectively control the blood pressure and reduce the serum NT-proBNP and Hcy levels. 2021 Vol. 38 (2): 199-201 [Abstract] ( 47 ) HTML (1 KB)  PDF (1158 KB)  ( 24 ) 202 Effect of DEX on Serum S100B and NSE in Elderly Patients Undergoing Radical Gastrectomy and Inflammatory Index GAO Yuan-yuan, YAN Fei DOI: 10.3969/j.issn.1671-7171.2021.02.012 【Objective】 To explore the effect of the application of dexmedetomidine (Dex) on the serum S100B protein (S100B), neuron-specific enolase (NSE) and inflammatory indexes during radical resection of gastric cancer in the elderly under general anesthesia. 【Methods】 A total of 96 patients with gastric cancer undergoing laparoscopic radical gastrectomy under the management of the same group of medical staff in our hospital were randomly divided into DEX group and control group, 48 cases in each group. Both groups were given intravenous anesthesia under tracheal intubation,In the Dex group, 0.5 ml/kg DEX was pumped at the same time, and the same amount of normal saline was pumped after 15 minutes. The MMSE scores, serum S100B 24 hours preoperative and postoperative , NSE, tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), C-reactive protein (CRP) and the incidence of adverse reactions were compared between the two groups before operation, 1 and 3 days after operation. 【Results】 There was no significant difference in preoperative serum S100B, NSE, TNF-α, IL-1 βand CRP levels between the two groups (P>0.05). The difference of MMSE score between the two groups before and 3 days after operation was statistically significant (P<0.05), while the MMSE score of the control group was significantly lower on 1 day after operation. At 24 hours after operation, the serum levels of S100B, NSE, TNF-α, IL-1βand CRP in the Dex group were significantly lower than those in the control group (P<0.05). The incidence of adverse reactions in dex group was significantly lower than that in control group (8.33% vs 25.00%, χ 2=4.800, P<0.05). 【Conclusion】 Dex in elderly patients undergoing radical gastrectomy under general anesthesia can reduce the cognitive impairment and inflammatory stress reaction caused by surgery, and reduce the incidence of adverse reactions. 2021 Vol. 38 (2): 202-205 [Abstract] ( 53 ) HTML (0 KB)  PDF (1184 KB)  ( 28 ) 206 Effect of Electrical Stimulation Biofeedback Combined with Comprehensive Exercise Therapy on Stress Urinary Incontinence in Middle-aged and Elderly Women WU Fei, LUO Jun, LONG Ting, et al DOI: 10.3969/j.issn.1671-7171.2021.02.013 【Objective】 To explore the effect of electrical stimulate biofeedback combined with exercise therapy on stress urinary incontinence (SUI) in middle-aged and elderly women. 【Methods】 From June 2018 to June 2020, 80 cases of women who were diagnosed as "stress urinary incontinence" were selected as the subjects. Patients were randomly divided into the observation group (n=40 cases) and the control group (n=40 cases). Electrical stimulation biofeedback therapy combined with comprehensive exercise therapy (abdominal breathing, bridge exercise and Kegel exercise) in the observation group and electrical stimulation biofeedback therapy combined with Kegel exercise in the control group were applied for a course of treatment (2 months).The scores of urinary incontinence quality of life questionnaire (I-QOL), total effective rate, muscle strength of pelvic floor type Ⅰ and type Ⅱ muscle fibers and myoelectric potential were compared between the two groups. 【Results】 The total effective rate of patients in the observation group was 90% (36/40), which was significantly higher than 72.5% (29/40) in the control group, and the difference was statistically significant (χ 2=4.021,P=0.045). After one course of treatment, the scores of urinary Incontinencequality of life questionnaire (I-QOL) were improved in both groups. Compared to the control group, the improvement was more significant in the observation group (P<0.05). Before treatment, there was no significant difference in muscle strength distribution between the two groups of patients with type Ⅰ and type Ⅱ muscle fibers (P>0.05). After treatment, the pelvic floor Ⅰ and Ⅱ muscle fiber muscle strength were improved in both groups. However, the observation group was better than the control group, and the difference was statistical significance (P<0.05). There was no significant difference in pelvic floor myoelectric potential between the two groups before treatment (P>0.05); after treatment, the pelvic floor myoelectric potential of the observation group and the control group were significantly higher than before treatment, and the observation group was higher than the control group. The differences were statistically significant (P<0.05).【Conclusion】 Electric stimulation biofeedback combined with comprehensive exercise therapy (abdominal breathing, bridge exercise and Kegel exercise) can effectively improve the symptoms of stress urinary incontinence in middle-aged and elderly women and enhance pelvic floor muscle strength, which has more significant effect than electric stimulation feedback therapy combined with Kegel exercise. 2021 Vol. 38 (2): 206-208 [Abstract] ( 56 ) HTML (1 KB)  PDF (1161 KB)  ( 124 ) 209 Granulocyte Expression and its Correlation with Chlorpromazine Equivalent in First Episode Mental Illness and Schizophrenia YU Yan-hong, WANG Xin, ZHANG Jun, et al DOI: 10.3969/j.issn.1671-7171.2021.02.014 【Objective】 To investigate the correlation between the changes of granulocyte level and chlorpromazine equivalent in patients with first-episode mental illness and schizophrenia.【Methods】 Prospective selection of patients with first-episode psychosis and schizophrenia admitted to our hospital from May 2017 to February 2020 as the research object, and the same period of adult healthy volunteers as the control group (n=62).The levels of neutrophils at admitment (T0) and 6 weeks after therapy (T6) were recorded, and the positive and negative symptom scale (PANSS) was used to evaluate the mental symptoms. The cumulative chlorpromazine equivalent was calculated according to the dose conversion standard, and the correlation between granulocyte level and clinical symptoms, chlorpromazine equivalent was analyzed.【Results】 At T0 , compared with the control group, the levels of neutrophils and CRP in patients with mental illness (FEP group + SCHIZ group) were increased, while the levels of eosinophils were decreased, and the differences were statistically significant (P<0.05). At T6, BMI, neutrophils, eosinophils, monocytes and CRP levels in patients with mental illness (FEP + SCHIZ group) were higher than those in the control group (P<0.05). Compared with T0, at T6 , the BMI and eosinophil levels of the two groups were increased, and the PANSS score, neutrophil, monocyte and CRP levels were decreased, the differences were statistically significant (P<0.05). Pearson correlation analysis showed that PANSS score of patients with mental illness (FEP + schiz group) was positively correlated with neutrophil and serum CRP level (P<0.05), and negatively correlated with eosinophil level (P<0.05); serum CRP level of patients with FEP was positively correlated with PANSS score (P<0.05). Pearson correlation analysis also showed that chlorpromazine equivalent was negatively correlated with neutrophil level in FEP patients (r=-0.284,P=0.001), positively correlated with eosinophils (r=0.211, 0.011), and no other correlation (P>0.05).【Conclusion】 The occurrence of mental illness and schizophrenia may be related to the changes of innate immune system. A certain amount of chlorpromazine can improve the clinical symptoms of FEP and SCHIZ patients, and monitoring the levels of neutrophils, eosinophils and serum CRP can provide reference for judging the degree of the disease. 2021 Vol. 38 (2): 209-212 [Abstract] ( 54 ) HTML (0 KB)  PDF (1230 KB)  ( 49 ) 213 Analysis of Risk Factors for Primary Arteriovenous Fistula Dysfunction in Hemodialysis Patients TANG Wei, HUO Jie DOI: 10.3969/j.issn.1671-7171.2021.02.015 【Objective】 To explore the related factors of primary arteriovenous fistula (AVF) dysfunction in hemodialysis patients. 【Methods】 A total of 144 patients who underwent hemodialysis in our hospital were retrospectively analyzed. According to the functional status of primary AVF, 50 patients were in the dysfunction group and 94 patients were in the unobstructed group. The age, body mass index (BMI), internal fistula use time, puncture method and blood lipid index were compared between the two groups. Logistic regression analysis was used to analyze the related factors of primary AVF dysfunction in hemodialysis patients.【Results】 There were no significant differences in age, gender, BMI, duration of internal fistula, Hb, TC, DD of the dysfunction group and the unobstructed group (P>0.05). and the patency group, the thrombosis method, The ratio of button puncture and thrombosis in the dysfunction group was higher than that in the unobstructed group. The time of compression in the dysfunction group was longer than that in the unobstructed group. Levels of PLT, TG, PTH, serum calcium, blood phosphorus and serum FER in the dysfunction group were higher than those in the unobstructed group. Levels of triacylglycerol (TG) and serum calcium were in the dysfunction group were lower than those in the unobstructed. All those differences were shown statistically significant (P<0.05). Multivariate logistic regression analysis showed that thrombosis, prolonged compression time, increased TG and blood phosphorus were independent risk factors for primary AVF dysfunction in hemodialysis patients (P<0.05). 【Conclusion】 There are many factors influencing the primary AVF dysfunction in hemodialysis patients. According to the results of this study, targeted intervention is helpful to prevent the occurrence of primary AVF dysfunction. 2021 Vol. 38 (2): 213-215 [Abstract] ( 73 ) HTML (0 KB)  PDF (1158 KB)  ( 41 ) 216 Correlation between Serum Prealbumin with Activity and Early Renal Injury in Patients with Systemic Lupus Erythematosus WANG Li-na, HUA Sha, LI Xiao-ming DOI: 10.3969/j.issn.1671-7171.2021.02.016 【Objective】 To investigate the correlation between serum prealbumin(PA) and systemic lupus erythematosus(SLE) activity and early renal injury. 【Methods】 According to SLEDAI score, 103 SLE patients were divided into mild activity group (42 cases), moderate activity group (25 cases) and severe activity group (36 cases); meanwhile, according to glomerular filtration rate (EGFR), the patients were divided into normal renal function group (49 cases) and abnormal renal function group (54 cases). Age, height, body mass, systolic blood pressure (SBP), diastolic blood pressure (DBP), platelet (PLT), hemoglobin (Hb), serum albumin (ALB), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), high sensitivity C-reactive protein (hs-CRP), serum creatinine (SCr), blood urea nitrogen (BUN), serum uric acid (UA), β2 microglobulin (β2MG),24 h urinary protein (UTP), erythrocyte sedimentation rate (ESR), complement C3 (C3), complement C4 (C4) and serum PA were collected .Binary logistic regression was used to analyze the risk factors of renal function injury, and the correlation between PA and the above risk factors was analyzed. ROC curve was used to evaluate the value of serum PA in predicting renal function injury.【Results】 (1) In different SLEDAI scores, PA level was the highest in mild activity group, followed by the moderate activity group, and the lowest in the severe activity group (P<0.05). (2) The level of PA in the normal renal function group was (212.34±60.92) mg/L, which was significantly higher than that in the abnormal renal function group (178.23±62.09) mg/L (P<0.05). (3) Age, UA and Hb were independent risk factors for renal dysfunction. Pearson correlation analysis showed that PA was positively correlated with age (P<0.05), and negatively correlated with UA and Hb (P<0.05). (4) The area under the curve (AUC) of ROC was 0.764, the sensitivity and specificity were 67.2% and 72.9% respectively.【Conclusion】 PA is correlated with SLE activity and renal injury, and can be used as one of the indexes to evaluate SLE activity and renal injury. 2021 Vol. 38 (2): 216-219 [Abstract] ( 60 ) HTML (1 KB)  PDF (1191 KB)  ( 48 ) 220 Study on Relationship between Serum miR-93 Level and Infertility in Patients with Endometriosis WU Jin-ping, HAN Qin-wei, LI Miao-ni DOI: 10.3969/j.issn.1671-7171.2021.02.017 【Objective】 To investigate the relationship between the level of serum miR-93 and infertility in patients with endometriosis (EMT). 【Methods】 From January 2017 to December 2018, 98 patients with endometriosis were selected as the observation group including infertility (n=59) and non-infertility (n=40), and 115 healthy women of childbearing age who had routine gynecological examination at the same time period were selected as the control group. According to the American Society for Reproductive Medicine (ASRM), EMT patients sub-divided into 55 cases in stage Ⅰ, 31 in stage Ⅱ, 8 in stage Ⅲ, and 4 cin stage Ⅳ. The expression of miR-93 in serum was detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). The receiver operating characteristic (ROC) was used to evaluate the value of miR-93 in the diagnosis of infertility in EMT. Logistic regression was used to analyze the risk factors of infertility. 【Results】 The expression level of miR-93 in the observation group (0.24 ± 0.09) was significantly lower than that in the control group (0.31 ± 0.12), and the difference was statistically significant (P<0.05). The serum miR-93 expression level of infertile EMT patients was 0.21±0.06, which was significantly lower than 0.28±0.11 of non-infertile patients, and the difference was statistically significant (t=-4.055, P=0.001). The relative expression of miR-93 in ASRM stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ in EMT patients was 0.21 ± 0.07 (phase Ⅰ), 0.25 ± 0.06 (phase Ⅱ), 0.34 ± 0.08 (phase Ⅲ) and 0.38 ± 0.04 (phase Ⅳ) , respectively. With the increase of ASRM stage, miR-93 expression level decreased; the difference was statistically significant in different stages (F=16.659, P< 0.001). ROC curve analysis showed that the best cut-off value for miR-93 to predict infertility in EMT was 0.28; the sensitivity was 93.24%, the specificity was 55.32%, and the area under AUC curve was 0.695. Multivariate logistic regression showed that miR-93 was an independent risk factor of infertility (OR:1.13;95%CI:1.07~1.20). 【Conclusion】 The level of serum miR-93 expression in patients with EMT decreased, and the degree of decline was consistent with the stage of the disease. The level of serum miR-93 expression in patients with infertility was significantly lower than that in patients with non-infertility EMT, suggesting that this index has a certain value for the evaluation of the disease progress of EMT. 2021 Vol. 38 (2): 220-222 [Abstract] ( 56 ) HTML (1 KB)  PDF (1259 KB)  ( 59 ) 223 Predictive Value of Endometriosis Fertility Index on Long-term Pregnancy Rate in Patients with Endometriosis Combined with Infertility GUO Yi-bu, HUANG Xiang-hong DOI: 10.3969/j.issn.1671-7171.2021.02.018 【Objective】 To investigate the predictive value of endometriosis fertility index (EFI) on the long-term pregnancy rate in patients with endometriosis combined with infertility. 【Methods】 A total of 200 patients with endometriosis and infertility who underwent laparoscopic surgery in our hospital from January 2017 to January 2020 were selected. The patients were followed up to observe the 3-year pregnancy rate after laparoscopic surgery. A total of 25 patients (12.5%) were lost to follow-up. According to the EFI before treatment, patients were divided into 3 groups: A group (85 cases, EFI ≥ 9 points), B group (48 cases, 5-8 points), C group (42 cases, ≤ 4 points). The pregnancy status in the 3 groups of patients were compared and the predictive value of EFI in patients' 3-year pregnancy rates were evaluated. 【Results】 There were statistically significant differences in age, infertility years, proportion of infertility, pregnancy rate, full-term delivery rate, and time of first pregnancy after operation in the three groups (P<0.05). The pregnancy rate and full-term delivery rate in the C group were lower than those in the A group and B group, and the differences were statistically significant (P<0.05). The first pregnancy time after surgery in the C group was longer than that in the A group and B group, and the difference was statistically significant (P<0.05). The first pregnancy time after surgery in the B group was longer than that in the A group , and the difference was statistically significant (P<0.05). The difference in pregnancy rates between 6, 13-24, and 25-36 months in the three groups was statistically significant (P<0.05). The pregnancy rate within 6 months after surgery in the A group was higher than that in the C group(P<0.05) , while the pregnancy rate in 13-24 and 25-36 months of the C group was higher than that of the A group(P<0.05). The ROC curve showed that the area under the curve for predicting the postoperative pregnancy rate by EFI was 0.76 (P<0.05), the specificity was 62.3%, and the sensitivity was 79.8%. 【Conclusion】 The 3-year pregnancy rate is higher in patients with endometriosis and infertility (EFI ≥9 points), and the first pregnancy time is shorter after surgery. EFI has certain value in predicting postoperative pregnancy. It can be used for early evaluation of patients' pregnancy. According to EFI, strict management and treatment plan can be adjusted to improve the long-term pregnancy rate 2021 Vol. 38 (2): 223-226 [Abstract] ( 52 ) HTML (1 KB)  PDF (1258 KB)  ( 57 ) 227 A Comparative Study on the Efficacy of Single Port VAST and single Utility Port VATS in the Treatment of Spontaneous Pneumothorax YU Zhi-qi, MENG Yong-sheng, SHAO Zhuang, et al DOI: 10.3969/j.issn.1671-7171.2021.02.019 【Objective】 To compare the clinical effect of single port video-assisted thoracoscopic surgery (SPVATS) and single utility port video-assisted thoracoscopic surgery (VATS) in the treatment of pulmonary bullectomy with pleurodesis. 【Methods】 A retrospective analysis of 84 cases of spontaneous pneumothorax patients in our hospital from January 2016 to December 2019, according to the different surgical methods, they were divided into observation group (single port thoracoscopic surgery, n=43) and control group (single utility port thoracoscopic surgery, n=41). The length of incision, blood loss, operation time, postoperative catheter time, the proportion of analgesic methods, postoperative hospital stay and postoperative complications were recorded and compared between the two groups.【Results】 The incision length and bleeding volume of the observation group were significantly less than those of the control group (P<0.05); the operation time of the observation group was shorter than that of the control group, but the difference was not statistically significant (P>0.05). There was no significant difference between the two groups in pain relief, postoperative catheter time and postoperative hospital stay (P>0.05). One case of atelectasis accompanied with pleural effusion occurred in two groups respectively. The patients were given closed thoracic drainage under local anesthesia, anti infection and asked to strengthen respiratory exercise, and all recovered smoothly. There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05).【Conclusion】 On the premise of no longer operation and hospitalization time and no increase of surgical complications, single port thoracoscopy is more in line with the needs of patients for minimally invasive and beautiful. It is safe and reliable for the treatment of spontaneous pneumothorax, which is worthy of clinical application. 2021 Vol. 38 (2): 227-229 [Abstract] ( 73 ) HTML (0 KB)  PDF (1161 KB)  ( 60 ) 230 Comparative Study of Preoperative Systemic Intravenous Chemotherapy and Transcatheter Arterial Embolization Chemotherapy in Children with Nephroblastoma LIU Yu, HE Jun, He Tian-qu, et al DOI: 10.3969/j.issn.1671-7171.2021.02.020 【Objective】 To compare and analyze the effect of preoperative systemic venous chemotherapy and transcatheter arterial embolization chemotherapy on nephroblastoma in children. 【Methods】 Children with nephroblastoma admitted to our hospital from January 2010 to December 2019 were selected retrospectively as the study objects. Among them, 48 cases received preoperative chemotherapy by transcranial arterial embolization as the observation group, and 33 cases received systemic intravenous chemotherapy as the control group. The tumor volume reduction rate, tumor necrosis rate, capsule integrity rate, overall effective rate of preoperative chemotherapy, total tumor resection rate, 2-year tumor-free survival rate and adverse reactions were observed and compared in the two groups. 【Results】 Tumor volume reduction rate, tumor necrosis rate, capsule integrity rate, overall effective rate of preoperative chemotherapy and total tumor resection rate were all higher in the observation group than in the control group, and the incidence of adverse reactions was lower than that in the control group, with statistically significant differences (P<0.05).The 2-year tumor-free survival rate in the control group (94%) was higher than that in the observation group (88%), but the difference was not statistically significant (P<0.05). 【Conclusion】 Compared to systemic intravenous chemotherapy, preoperative transcranial arterial embolization is more beneficial to surgical resection, with higher efficacy and fewer adverse reactions in children with nephroblastoma. However, it does not show a better advantage in 2-year tumor-free survival rate, so it is necessary to further expand the sample size and follow up time for clinical study. 2021 Vol. 38 (2): 230-232 [Abstract] ( 61 ) HTML (1 KB)  PDF (1156 KB)  ( 45 ) 233 Effects of Breviscapine Injection Combined with Bivalrudin on the Electrocardiogram and serum H-FABP, IMA and TnT levels in patients with AMI after Intervention DONG Zhi-hua, ZHANG Chuan-hai, ZHAO He DOI: 10.3969/j.issn.1671-7171.2021.02.021 【Objective】 To investigate the effects of breviscapine injection combined with bivalrudin on the electrocardiogram and serum cardiac fatty acid binding protein (H-FABP), ischemia modifying albumin(IMA) and troponin T (TnT) levels in patients with acute myocardial infarction (AMI) after intervention. 【Methods】 A total of 116 AMI patients undergoing PCI surgery admitted to our hospital from February 2018 to April 2020 were selected as the research objects. They were divided into observation group (n=58) and control group (n=58) by simple randomization method. On the basis of conventional treatment, the control group was given bivalrudine, and the observation group was given breviscapine injection combined with bivalrudine. The TIMI blood flow classification, cardiac function indexes (LVEF, LVESD, LVEDD), serum indexes (IL-6, TNF-α, H-FABP, IMA, cTnT) and electrocardiogram (QT dispersion of surface electrocardiogram (QTd), ST segment depression) were compared between the two groups after treatment. The patients were followed up for 3 months after treatment, and the major adverse cardiovascular events (MACE) of the two groups were recorded. 【Results】 After treatment, TIMI blood flow classification of the two groups was improved, and the observation group was better than the control group, the difference was statistically significant (P<0.05); LVEF level of the two groups was higher than that before treatment, LVESD and LVEDD levels were lower than that before treatment, and there were differences between the observation group and the control group, the differences were statistically significant (all P<0.05). The serum levels of H-FABP, IMA, cTnT, IL-6 and TNF-αin the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P<0.05). QTd of the two groups were lower than before treatment, and the observation group was lower than the control group (P<0.05); the good rate of ST segment depression of the observation group was higher than that of the control group (P<0.05). After 3 months of follow-up, the observation group and the control group had 1 case of shedding. The incidence of MACE in the observation group was 7.02% (4/57), which was lower than 21.05% (12/57) in the control group, and the difference was statistically significant (χ 2=4.653,P=0.031<0.05).【Conclusion】 Breviscapine injection combined with bivalirudin can improve myocardial perfusion, electrocardiogram and cardiac function, reduce inflammatory reaction, serum H-FABP, IMA and TnT levels, reduce myocardial injury and reduce the incidence of MACE in patients with AMI after PCI, which is of great significance to improve the prognosis of patients. 2021 Vol. 38 (2): 233-236 [Abstract] ( 57 ) HTML (0 KB)  PDF (1188 KB)  ( 50 ) 237 Effect of GnRH-a Combined with Intrauterine Placement of LNG-IUS on Postoperative Recurrence, Reproductive Hormone, Dysmenorrhea and Serum CA125 in Patients with EMT ZHANG Juan, HAN Xiao-man, XIAO Min-su DOI: 10.3969/j.issn.1671-7171.2021.02.022 【Objective】 To investigate the effects of gonadotropin releasing agonist (GnRH-a) combined with levonorgestrel intrauterine sustained release system (LNG-IUS) on postoperative recurrence, reproductive hormone, dysmenorrhea, and serum glycoprotein 125 (CA125) in patients with endometriosis (EMT) postoperatively. 【Methods】 A total of 107 patients with EMT who underwent laparoscopic resection were enrolled in the study. Patients were randomly divided into the observation group (n=53) and the control group (n=54). The observation group received a gonadotropin-releasing agonist (GnRH-a) for 3 cycles after surgery, and then LNG-IUS was placed in the uterus; while the control group only received GnRH-a for 3 cycles of treatment after operation. The degree of dysmenorrhea (VAS score), serum CA125, Estrogen (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were compared between the two groups before and after surgery. The incidence of recurrence were followed up for 24 months. 【Results】 The dysmenorrhea degree (VAS) of the observation group was lower than that of the control group at 3 months, 12 months and 24 months after operation (P<0.05). There was no significant difference in the levels of E2,FSH, and LH between the two groups before and after operation (P>0.05). There was no significant difference in serum CA125 levels between the two groups before surgery (P>0.05);12 months after surgery, the serum CA125 level of the observation group was lower than that of the control group (P<0.05). After 24 months of follow-up, the recurrence rate of the observation group was 1.87% (1/53) , which was lower than that of the control group (12.96%,7/54). The difference was statistically significant (χ 2=4.744, P<0.05).【Conclusion】 Intrauterine placement of LNG-IUS after EMT patients plays an important role in preventing recurrence, lowering serum CA125 level, and further alleviating dysmenorrhea. 2021 Vol. 38 (2): 237-239 [Abstract] ( 48 ) HTML (0 KB)  PDF (1163 KB)  ( 62 ) 240 Effects of Fasudil on Serum Levels of MMP-10, ox-LDL and GSH-Px in Patients with Acute Cerebral Infarction SHEN Yu-hua, RUAN Qiong-yan, YANG Qi DOI: 10.3969/j.issn.1671-7171.2021.02.023 【Objective】 To investigate the effects of fasudil on MMP-10 (matrix metalloproteinase 10), ox-LDL (ox-LDL) and GSH-Px (glutathione peroxidase) in patients with acute cerebral infarction(ACI). 【Methods】 A total of 100 patients with ACI in our hospital were randomly divided into two groups, each group with 50 cases. Patients with conventional treatment were as the control group, while patients in the observation group received fasudil in addition to the conventional treatment. Serum index levels, neurologic impairment, life activity, clinical efficacy and safety of the two groups were compared. 【Results】 After treatment, the total effective rates for the observation group and the control group were 90% and 64%, respectively. The efficiency of the observation group was significantly higher than that of the control group; the difference was statistical significance (P<0.05). The NIHSS score in the two groups decreased significantly, and the ADL score increased significantly in the two groups as well. However, the NIHSS score in the observation group was lower than that in the control group, ADL score in the observation group was higher than that in the control group; the difference was statistical significance (P<0.05). After treatment, serum MMP-10, ox-LDL and GSH-Px levels were significantly reduced in the two groups, and the reduction level of the observation group was significantly lower than that of the control group (P<0.05). There was no adverse drug effects in the observation group showing good tolerance after treatment. 【Conclusion】 The use of fasudil on the basis of conventional treatment in the clinical treatment of ACI can reduce serum MMP-10, ox-LDL and GSH-Px levels and improve the ability of daily life. It has significant curative effect, no adverse reaction and high safety, which is worthy of clinical application. 2021 Vol. 38 (2): 240-242 [Abstract] ( 48 ) HTML (1 KB)  PDF (1160 KB)  ( 22 ) 243 Effects of Cilobatazole Combined with Amiodarone on Coagulation Function and Myocardial Remodeling in Patients with Coronary Heart Disease after PCI LIU Liang, LI Jun-peng DOI: 10.3969/j.issn.1671-7171.2021.02.024 【Objective】 To explore the effects of cilobatazole combined with amiodarone on coagulation function and myocardial remodeling in patients with coronary heart disease (CHD) after PCI. 【Methods】 A total of 80 patients with CHD who underwent PCI surgery in our hospital were randomly divided into two groups. The patients in the control group were treated with cilotazole, while the patients in the observation group were treated with cilotazole combined with amiodarone. Clotting function,The myocardial remodeling rate and platelet aggregation rate before and after treatment were compared between the two groups. The number of patients with adverse reactions and treatment efficiency was compared between the two groups. 【Results】 The coagulation function of the observation group was significantly better than that of the control group (P<0.05). The myocardial remodeling rate of the observation group was significantly higher and the platelet aggregation rate was lower than that of the control group (P<0.05). The number of patients with adverse reactions (such as nausea, dizziness and difficulty breathing) in the observation group was significantly lower than that in the control group (P<0.05). The overall treatment efficacy of the observation group was significantly higher than that of the control group (P<0.05). 【Conclusion】 The use of cilostazol combined with amiodarone for treatment of coronary heart disease patients who have undergone PCI can optimize the patients' coagulant function, increase the possibility of myocardial remodeling and platelet aggregation in patients and reduce the rate of patients with adverse reactions. It is worth popularizing in clinical practice. 2021 Vol. 38 (2): 243-245 [Abstract] ( 57 ) HTML (1 KB)  PDF (1159 KB)  ( 23 ) 246 Expression and Clinical Significance of Circulation microRNA-132 in Patients with Pulmonary Tuberculosis WANG Xin, GAO Yu, ZHANG Quan-wu DOI: 10.3969/j.issn.1671-7171.2021.02.025 【Objective】 To investigate the diagnostic value of microRNA-132 expression in patients with pulmonary tuberculosis (PTB). 【Methods】 During February 2017 and February 2019, 106 patients with PTB from our hospital were selected as the observation group, 40 patients with pneumonia were selected as pulmonary disease control group, and 40 healthy volunteers were selected as healthy control group. The real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to measure the expression of circulation microRNA-132. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of microRNA-132 for PTB. 【Results】 The expression of circulating microRNA-132 in PTB patients was significantly higher than those in healthy control group or pulmonary disease control group (P<0.05). According to ROC curve analysis, the optimal cut-off value of microRNA-132 for PTB diagnosis was 0.36. When MiR-132 was 0.36, the area under curve (AUC) of microRNA-132 was 0.72, 95%CI:0.65~0.78, the sensitivity was 68.9%, and the specificity was 76.2%. 【Conclusion】 MicroRNA-132 can be used as a potential diagnostic marker of PTB. 2021 Vol. 38 (2): 246-248 [Abstract] ( 55 ) HTML (1 KB)  PDF (1184 KB)  ( 36 ) 249 Effects of Sevoflurane Anesthesia on Inflammatory and Oxidative Stress Indexes in Patients with Lung Cancer Undergoing Radical Operation ZHANG Xiao-yong, HAN Jing-tian, HAN Yao-ming DOI: 10.3969/j.issn.1671-7171.2021.02.026 【Objective】 To investigate the effect of sevoflurane anesthesia on inflammatory and oxidative stress indexes in patients with lung cancer undergoing radical operation.【Methods】 A total of 90 patients with lung cancer were randomly divided into two groups, 45 cases in each group; the observation group was given sevoflurane and maintained anesthesia, and the control group was given propofol and maintained anesthesia. The operation time, recovery time, extubation time, spontaneous breathing recovery time, hospital stay, serum E-selectin, soluble interleukin-2 receptor (SIL-2), high mobility group box 1 (HMGB1), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), malondialdehyde (MDA) and superoxide dismutase (SOD) were recorded and compared between the two groups Matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9(MMP-9)levels were recorded and compared between the two groups.【Results】 The recovery time, extubation time and spontaneous breathing recovery time of the observation group were shorter than those of the control group (P<0.05), and there was no significant difference in the operation time and hospitalization time between the two groups (P>0.05); before operation, there was no significant difference in the serum E-selectin, sIL-2, HMGB1, TNF-α, IL-6 and MDA, SOD, MMP-2, MMP-9 levels between the two groups (P>0.05); 24 hours after operation, the observation group had no significant difference The levels of serum E-selectin, sIL-2, HMGB1, TNF-αand IL-6 in the observation group were lower than those in the control group (P<0.05); the levels of serum MMP-2, MMP-9 and MDA in the observation group were lower than those in the control group (P<0.05), and the level of SOD in the observation group was higher than that in the control group (P<0.05). 【Conclusion】 Sevoflurane anesthesia in radical operation of lung cancer can reduce the inflammatory reaction and oxidative stress reaction. 2021 Vol. 38 (2): 249-251 [Abstract] ( 54 ) HTML (0 KB)  PDF (1158 KB)  ( 29 ) 252 Value of TCD Combined with Serum D-D in Diagnosis of Intracranial Artery Stenosis in Acute Cerebral Infarction XU Ping, TANG Yan-yan, ZHANG Long DOI: 10.3969/j.issn.1671-7171.2021.02.027 【Objective】 To investigate the diagnostic value of transcranial Doppler sonography (TCD) combined with serum D-dimer (D-D) in the diagnosis of intracranial artery stenosis in acute cerebral infarction. 【Methods】 A total of 112 patients with acute cerebral infarction admitted to our hospital from July 2018 to July 2020 were selected as the research subjects. All patients received CT angiography (CTA) and TCD examination, and venous blood was drawn to detect the serum D-D level. The results of TCD and CTA in detecting intracranial artery stenosis were compared. Using CTA results as the gold standard, the diagnostic value of TCD on intracranial vascular stenosis was analyzed, and receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of serum D-D in the diagnosis of intracranial vascular stenosis, and the area under the curve (AUC) was recorded. The value of TCD combined with serum D-D in the diagnosis of intracranial vascular stenosis was compared with single detection. 【Results】 CTA examination results showed that among 112 patients, there were 81 cases of intracranial vascular stenosis and 31 cases of non-stenosis. Overall, 202 stenotic vessels were detected by CTA and 191 stenotic vessels were detected by TCD. TCD had a good consistency in the diagnosis of stenotic vessels, with Kappa value of 0.762. TCD had the highest diagnostic value on MCA vascular stenosis, with sensitivity of 91.76%, positive predictive value of 93.98% and the best consistency of Kappa value=0.852. ROC curve analysis results showed that the AUC value of serum D-D in the diagnosis of intracranial vascular stenosis was 0.714, and the diagnostic value was the highest when the cut-off point was>0.85mg/L, and the sensitivity and specificity were 48.15% and 87.10%, respectively. The sensitivity and accuracy of TCD combined with serum DD in the diagnosis of intracranial vascular stenosis were 93.83% and 95.54%, respectively, which were significantly higher than those of single detection of serum D-D (P<0.05), but there were no significant differences compared to single detection of TCD (P>0.05). 【Conclusion】 TCD has a high diagnostic value on intracranial artery stenosis in acute cerebral infarction, especially for MCA vascular stenosis. TCD combined with serum D-D can improve the diagnostic accuracy. 2021 Vol. 38 (2): 252-255 [Abstract] ( 56 ) HTML (0 KB)  PDF (1205 KB)  ( 51 ) 256 Clinical Outcomes of Modified Transumbilical Single Port Laparoscopy for Uterine Fibroids DENG Hua-juan, SHANG Ying-ying DOI: 10.3969/j.issn.1671-7171.2021.02.028 【Objective】 To investigate the clinical outcomes of modified transumbilical single hole laparoscopy for uterine fibroids.【Methods】 Eighty patients with uterine fibroids who were scheduled to undergo laparoscopic myomectomy at our institution from January 2017 to March 2018 were selected and divided into observation and control groups, 40 in each group, according to the random number table method.Modified transumbilical single hole laparoscopic myomectomy was used in the observation group, while traditional three hole laparoscopic myomectomy was used in the control group, and the perioperative indexes, postoperative pain levels, 2-year postoperative pregnancy rates and recurrence rates were compared between the two groups.【Results】 In the observation group, the operation time, postoperative hospital stay, drain removal time were shorter than those in the control group, and intraoperative blood loss was less than that in the control group, all of which were statistically significant (all P<0.05), but there was no significant difference between the two groups in the time to first ambulation and time to first flatus (all P>0.05). The visual analog scale (VAS) scores of the observation group were significantly lower than those of the control group at both 6 and 12 h postoperation (all P<0.05).There were no significant differences in the total incidence of complications, pregnancy and recurrence rates between the two groups (all P>0.05).【Conclusion】 The improved transumbilical Uniportal laparoscopic treatment of uterine fibroids is highly effective, leading to shorter operation time, less blood loss, less postoperative pain, and high safety, with little effect on recurrence and pregnancy rates, which merits clinical promotion. 2021 Vol. 38 (2): 256-258 [Abstract] ( 82 ) HTML (0 KB)  PDF (1157 KB)  ( 86 ) 259 Effect of Continuous Blood Purification Combined with Plasma Exchange on Patients with Non Biliary Severe Acute Pancreatitis FU Xin-ping, ZHAO Ying, SHANG Yan-ru DOI: 10.3969/j.issn.1671-7171.2021.02.029 【Objective】 To observe the effects of daytime continuous blood purification combined with plasma exchange on inflammatory factors and intestinal mucosal barrier dysfunction in patients with non-biliary severe acute pancreatitis(SAP). 【Methods】 A total of 80 patients with non-biliary SAP treated in our hospital were random divided into two group. The blood purification group (groupA) received continuous daytime blood purification treatment, and the combination group( groupB) received at least one plasma exchange treatment based on the blood purification group. The therapeutic effects, inflammation indicators, intestinal mucosal barrier function, complications and death were compared between the two groups. 【Results】 The total effective rate of combination group (87.5%) was higher than that of blood purification group (65.0%) (P<0.05). After treatment, the levels of serum amylase and lipase in the two groups were lower than those before treatment (all P<0.05), and those in the combined group were lower than those in the blood purification group (mean P<0.05). After treatment, CRP, TNF-αand procalcitonin in the two groups were lower than before treatment (all P<0.05), and the combined group was lower than the blood purification group (mean P<0.05). After treatment, endotoxin, diamine oxidase and D-lactate in the two groups were lower than before treatment (all P<0.05), and the combined group was lower than the blood purification group (mean P<0.05). The incidence of new complications in the combined group was lower than that in the blood purification group (20.0% vs 35.0%), but the difference was not significant (P>0.05), and the mortality of the two groups (5.0% vs 7.5%) was not significant (P>0.05). 【Conclusion】 Compared with daytime continuous blood purification alone, combined with plasma exchange can improve the curative effect of non biliary sap, improve gastrointestinal function and inflammatory level, and has high safety. 2021 Vol. 38 (2): 259-261 [Abstract] ( 51 ) HTML (1 KB)  PDF (1158 KB)  ( 30 ) 262 Effect of Ultrasound-guided Adductor Tube Block and Femoral Nerve Block for Postoperative Analgesia of Tibial Fractures CHEN Ya-li, WU Wei, WANG Xing-hua, et al DOI: 10.3969/j.issn.1671-7171.2021.02.030 【Objective】 To investigate the effect of ultrasound-guided adductor block and femoral nerve block for postoperative analgesia of tibial fracture. 【Methods】 A total of 80 patients with tibial fracture in our hospital were selected and divided into observation group (n=47) and control group (n=33) according to different analgesic schemes. The control group was given ultrasound-guided femoral nerve block analgesia, and the observation group was given ultrasound-guided adductor canal block. The analgesic and sedative effect, quadriceps muscle strength and adverse reaction rate of the two groups were compared.【Results】 At 12 h, 24 h and 48 h after operation, the VAS scores of the two groups when bending the knee and at rest were lower than those at 8 h and 4 h after operation (P<0.05).There was no significant difference in VAS score between the two groups at the same time when bending the knee and at rest (P>0.05). Ramsay scores at 8 h, 12 h and 24 h after operation in the two groups were lower than those at 4 h after operation (P<0.05). There was no significant difference in Ramsay scores between the two groups at the same time (P>0.05).The muscle strength of quadriceps femoris in the control group: preoperative > 24 h after operation > 48 h after operation (P<0.05), there was no significant change in the observation group (P>0.05); the muscle strength of the observation group 24 h and 48 h after operation were greater than those of the control group (P<0.05). The incidence of adverse reactions in the observation group was 19.15% (9/47), which was significantly lower than 42.42% (14/33) in the control group, and the difference was statistically significant (χ 2=5.127,P<0.05).【Conclusion】 Ultrasound guided adductor block has the same analgesic and sedative effects as femoral nerve block, but adductor block is more rapid in analgesia, has less effect on quadriceps muscle strength, and is more conducive to early postoperative rehabilitation treatment with higher safety. 2021 Vol. 38 (2): 262-265 [Abstract] ( 68 ) HTML (0 KB)  PDF (1178 KB)  ( 195 ) 266 Study on the Correlation between LncRNA AC007009.1 and Clinical Staging of Non-small Cell Lung Cancer REN Hong-min, QIN Wen-jing DOI: 10.3969/j.issn.1671-7171.2021.02.031 【Objective】 To study the correlation between LncRNA AC007009.1 and clinical stages of non-small cell lung cancer (NSCLC). 【Methods】 A total of 150 cases of NSCLC patients in our hospital from October 2015 to April 2019 were selected as the research objects. The cut-off value (5.23) of LncRNA AC007009.1 was taken from the median of LncRNA AC007009.1 level (5.24±2.05). The patients were divided into LncRNA AC007009.1 high expression group (n=93) and LncRNA AC007009.1 low expression group (n=57), The clinicopathological characteristics (age, gender, clinical stage, distant metastasis, smoking history, drinking history, tumor size) of the two groups were analyzed, and the difference information was included in the logistic regression analysis to analyze the risk factors of LncRNA AC007009.1 high expression, and to clarify the relationship between the pathological characteristics of NSCLC and LncRNA AC007009.1high expression, and to clarify the relationship between the pathological characteristics of NSCLC and lncRNA AC007009.1.【Results】 The patients with age≥60 years, distant metastasis, clinical stage Ⅲ or Ⅳ, smoking in high expression group were significantly more than those in low expression group (P<0.05); there was no significant difference in gender, history of alcohol abuse, tumor size between the two groups (P>0.05). Logistic regression analysis showed that age ≥ 60 years old, no distant metastasis, clinical stage Ⅲ or Ⅳ, smoking history were risk factors for LncRNA AC007009.1overexpression. 【Conclusion】 LncRNA AC007009.1 is closely related to the age, clinical stage, distant metastasis and smoking history of NSCLC. It can be used as an important indicator for early evaluation of NSCLC and has high clinical application value. 2021 Vol. 38 (2): 266-268 [Abstract] ( 47 ) HTML (1 KB)  PDF (1161 KB)  ( 33 ) 269 Clinical Efficacy and Safety of Radiofrequency Ablation Combined with DC-CIK Immunotherapy for Advanced Primary Liver Cancer WU Wei DOI: 10.3969/j.issn.1671-7171.2021.02.032 【Objective】 To study the efficacy and safety of radiofrequency ablation of (RFA) combined with dendritic cells-cytokines-induced killer cells (DC-CIK) in the treatment of advanced primary liver cancer. 【Methods】 A total of 86 patients with advanced primary liver cancer in our hospital from January 2018 to June 2019 were selected and randomly divided into control group (treated with RFA) and observation group (treated with RFA combined with DC-CIK immunotherapy), 43 cases in each group. The serum indexes, immune function, liver function and survival of patients were observed before and after treatment, and the short-term efficacy and incidence of adverse reactions were compared between the two groups.【Results】 The disease control rate of the observation group was 79.07% (34/43), which was significantly higher than 41.86% (18/43) of the control group (P<0.05). After treatment, the levels of serum alpha fetoprotein (AFP), carcinoembryonic antigen (CEA) and vascular endothelial growth factor (VEGF) in the observation group were significantly decreased (P<0.05), and were lower than those in the control group (P<0.05); while the levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) in the observation group were higher than those before treatment, and were lower than those in the control group, the difference was statistically significant (P<0.05).The CD3+、CD4+、CD4+/CD8+ of peripheral blood T cell subsets in the observation group were significantly higher than those before treatment, and were significantly higher than those in the control group, the difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was 27.91% (12/43), which was higher than 23.26% (10/43) in the control group, and the difference was not statistically significant (P>0.05). The 1-year and 3-year survival rates of the observation group were significantly higher than those of the control group (all P<0.05).【Conclusion】 RFA combined with DC-CIK immunotherapy is effective in the treatment of patients with advanced primary liver cancer. It can reduce the level of serum tumor markers, improve the immune function, reduce the degree of liver function damage, prolong the survival rate, and has good safety, which is worthy of clinical application. 2021 Vol. 38 (2): 269-271 [Abstract] ( 60 ) HTML (0 KB)  PDF (1163 KB)  ( 45 ) 272 Value Analysis of Nursing Outcome Classification System in Health Education of Patients with Acute Pancreatitis DAI Bin, LI Xin DOI: 10.3969/j.issn.1671-7171.2021.02.033 【Objective】 To analyze the value of nursing outcome classification system in the evaluation of health education effect in patients with acute pancreatitis. 【Methods】 A total of 40 patients with acute pancreatitis in our hospital from January to December 2019 were selected as the research objects and randomly divided into observation group and control group, 20 cases in each group. The control group was given routine health education, and the observation group was given health education based on nursing outcome classification system on the basis of routine health education. The scores of health behavior, anxiety and depression were compared between the two groups. 【Results】 The scores of health responsibility, exercise, psychological status and nutritional status in the observation group were significantly higher than those in the control group (all P<0.05). After the intervention, the scores of anxiety and depression in the observation group were (10.73±2.59) and (10.86±2.62) respectively, which were significantly lower than (15.92±3.83) and (15.73±3.79) in the control group, and the differences were statistically significant (all P<0.05). 【Conclusion】 The application of nursing outcome classification system in the evaluation of health education effect of patients with acute pancreatitis can better regulate the health behavior of patients, improve their health behavior ability, and improve the negative emotions of patients, which is of great significance to improve the prognosis of patients, and is worthy of clinical application. 2021 Vol. 38 (2): 272-274 [Abstract] ( 52 ) HTML (1 KB)  PDF (1156 KB)  ( 44 ) 275 A Comparative Study of SREMB and Milligan-Morgan on Treatment of Mixed Hemorrhoids CHEN Fu-jun, LIU Chang-ping, LUO Chuan-yun, et al DOI: 10.3969/j.issn.1671-7171.2021.02.034 【Objective】 To investigate the clinical effect of SREMB(stapled the rectum mucosa except the back above hemorrhoidectomy ) in the treatment of mixed hemorrhoids. 【Methods】 The clinical data of 90 patients with mixed hemorrhoids treated from January 2017 to December 2017 were analyzed retrospectively,45 cases underwent SREMB(stapled the rectum mucosa except the back above hemorrhoidectomy group), and 45 underwent Milligan-Morgan hemorrhoidectomy (Milligan-Morgan hemorrhoidectomy group). The operation, clinical effect and postoperative recovery of the two groups were compared.【Results】 In the observation group, 42 cases were cured and 3 cases were effective. 41 cases were cured and 5 cases were effective in the control group. There was no significant difference between the two groups (χ2=0.14,P=0.71>0.05).No recurrent cases were found in 1-year follow-up. The operation time, intraoperative bleeding volume, postoperative hospitalization time and incision healing time in the observation group were lower than those in the control group, the difference was statistically significant (P<0.05). The pain score and anal border edema score of the observation group 24 h after operation were lower than those of the control group, and the incidence of postoperative urinary retention was lower than that of the control group (P<0.05).【Conclusion】 The effect of SREMB(stapled the rectum mucosa except the back above hemorrhoidectomy)is accurat, the recovery is fast and the complications are few. 2021 Vol. 38 (2): 275-277 [Abstract] ( 54 ) HTML (1 KB)  PDF (2077 KB)  ( 62 ) 278 Effect of Levodopa combined with Carbaratin on Cognitive Impairment, Motor Function and Balance Function in Parkinson's Disease MI Wan-jun, CHANG Lin DOI: 10.3969/j.issn.1671-7171.2021.02.035 【Objective】 To investigate the effect of levodopa combined with carbaratin on cognitive impairment, motor function and balance function in Parkinson's disease. 【Methods】 A total of 86 PD patients treated in our hospital from June 2016 to August 2018 were selected as the study subjects and randomly divided into control and observation groups by random number table method, with 43 patients in each group.Patients in the control group were treated with levodopa, and patients in the observation group were treated with levodopa combined with carbaratin continuously for 6 months.The time to clinical improvement, cognitive, motor, and balance function scores, tendon reflexes, muscle tone, and muscle spasms scores, and adverse effects were compared between the two groups. 【Results】 After treatment, patients in the observation group had significantly less time to improvement in clinical symptoms (myotonia, bradykinesia, resting tremor and postural walking disorders) than those in the control group (P<0.05); the Alzheimer's disease assessment scale cognitive subscale (ADAS COG) and Unified Parkinson's disease assessment scale Part Ⅲ(UPDRS Ⅲ) scores were reduced in both groups, and were significantly lower in the observation group than in the control group (P<0.05);Berg Balance Function Scale scores were significantly higher in both groups, and significantly higher in the observation group (P<0.05);Tendon reflexes, muscle tone, and muscle spasticity scores were reduced in both groups, and were significantly lower in the observation group than that in the control group (P<0.05);the incidence of adverse events in the observation group was 11.61%, which was significantly lower than that in the control group (32.54%)(P<0.05).【Conclusion】 The use of levodopa plus carbaratinin patients with Parkinson's disease has definite efficacy, can significantly improve patients' cognitive impairment, motor function, and balance function, and the safety profile is also high, which warrants clinical promotion. 2021 Vol. 38 (2): 278-280 [Abstract] ( 56 ) HTML (0 KB)  PDF (1160 KB)  ( 39 )

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