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Quick Search     Adv Search 2021 Vol. 38, No. 3 Published: 2021-03-30   331 Analysis of Parents' Mental Health Status and Influencing Factors Caused by Children with Biliary Atresia CHENG Zhen, WU Zhou-guang, WANG Bin, et al DOI: 10.3969/j.issn.1671-7171.2021.03.003 【Objective】 To evaluate the factors that affect the mental health of parents who have children with biliary atresia, reduce the psychological burden of diseases in families with biliary atresia, and improve the overall efficacy of children with biliary atresia. 【Methods】Using the convenience sampling method, a total of 100 parents with biliary atresia children, who were admitted to Shenzhen Children's Hospital from November 2017 to November 2019, were selected. The mental health status was assessed by the Symptom Self-Rating Scale (SCL-90). The evaluation data were compared with the national norm. Single factor analysis of variance and multiple linear regression were used to analyze the factors that affected the psychological status. 【Results】The total mean score and scores of somatization, anxiety, hostility, terror and psychosis obtained by the SCL-90 assessment of the parents with biliary atresia children were compared with the national norm. The difference was statistically significant ( P <0.05). The results showed that the mental health of the parents with biliary atresia children was not optimistic to a certain extent. A one-way analysis of variance was performed on the total scores of the parents, depression and anxiety. It showed that there were statistical differences in gender, family support, and birth history of the children ( P <0.05). At the same time, there were statistical differences in the total scores and depressive psychological status of the parents who had biliary atresia children in different age, education levels, occupations, nationalities, etc. ( P <0.05). Further multivariate linear regression results from meaningful factors showed that the status of parents' mental health total SCL-90 scores was negatively correlated with age and gender, and positively correlated with family support. The depression status was negatively correlated with gender, while it was positively correlated with age and family support. The anxiety status was positively correlated with family support. 【Conclusion】The mental health status of parents who have children with biliary atresia is generally not so good. There is a linear correlation of parents' mental health status with age, gender and family support. 2021 Vol. 38 (3): 331-335 [Abstract] ( 109 ) HTML (1 KB)  PDF (1205 KB)  ( 52 ) 336 Prenatal Ultrasound Imaging Features and Prognosis of Congenital Imperforate Hymen KONG Yi-fan, KUANG Hai-yan, LUO Ying-chun, et al DOI: 10.3969/j.issn.1671-7171.2021.03.004 【Objective】To explore the prenatal ultrasound characteristics and outcomes in the diagnosis of fetal imperforate hymen. 【Methods】 All data of 5 cases with fetuses diagnosed congenital imperforate hymen from January 2018 to July 2020 in our hospital were retrospectively analyzed for the characteristics of ultrasound and clinical outcomes. 【Results】The main echocardiographic features of congenital imperforate hymen were a thick-walled cystic mass behind the female fetus's bladder, with clear boundaries and irregular hyperechoic spots freely float in it. Color Doppler blood flow imaging showed no obvious blood flow signal. From this retrospective analysis, 5 congenital imperforate hymens were identified in the diagnosis of fetuses. Of which 3 cases combined with other abnormalities (1 case had left kidney polycystic renal dysplasia, 1 case had unilateral kidney absent, double inferior vena cava and single umbilical artery, 1 case had right kidney absent) and confirmed by autopsy. And 2 live births were confirmed by ultrasound, CT or MRI (Hydronephrosis and multiple kidney stones were found in 1 case after birth). Both cases underwent hymenotomy. After the milky white thick liquid was drained, the mass disappeared and the uterus moved down to the normal position. Both live-born infants had a good prognosis. 【Conclusion】Prenatal ultrasound can find congenital imperforate hymen in time and effectively, and provide important information for clinical treatment and follow-up. 2021 Vol. 38 (3): 336-338 [Abstract] ( 86 ) HTML (1 KB)  PDF (1915 KB)  ( 62 ) 339 Risk Factors for Vascular Dementia in Elderly Patients with Cerebral Infarction XUE Yan-hua, LI Jing, YU Qi-jin, et al DOI: 10.3969/j.issn.1671-7171.2021.03.005 【Objective】To explore the risk factors of vascular dementia (VD) in elderly patients with cerebral infarction. 【Methods】 A total of 193 elderly patients with cerebral infarction were selected for the study. According to the occurrence of VD, the patients were divided into the VD group (74 cases) and the non VD group (119 cases). General data of the two groups were compared. Risk factors for VD were evaluated by Logistic regression analysis, and the diagnostic efficacy of VD was analyzed using receiver operating characteristic curve (ROC). Pearson was used to explore the correlation among various factors and analyze the expression of risk factors in different degrees of dementia. 【Results】The multivariate analysis showed that age (OR=4.926, P <0.05), >6 years of Education ( OR =1.953, P <0.05), infarct area ( OR =5.147, P <0.05), severe vascular stenosis ( OR =3.031, P <0.05), hypertension ( OR =2.853, P <0.05), vascular endothelial growth factor (VEGF) level ( OR =5.452, P <0.05), and brain Neurotrophic factor (BDNF) ( OR =4.524, P <0.05) were independent influencing factors of VD after cerebral infarction. Particularly, age >60 years old, severe stenosis of blood vessels, hypertension, infarct area >7.18 cm2, VEGF<4.47ng/mL and BDNF<236.83 pg/mL patients need to be alert to the occurrence of VD. Correlation analysis showed that age was positively correlated with infarct size and negatively correlated with VEGF and BDNF. VEGF was positively correlated with BDNF. The levels of VEGF and BDNF increased with the severity of dementia, and the number of severe vascular stenosis and the number of hypertension increased with the severity of dementia as well. 【Conclusion】 Elderly patients with older age of primary cerebral infarction, large infarct area, high blood pressure (hypertension), high VEGF and BDNF level increase the probability of VD, while the elderly with more years of education may reduce the risk of VD. 2021 Vol. 38 (3): 339-342 [Abstract] ( 122 ) HTML (1 KB)  PDF (1368 KB)  ( 65 ) 343 Diagnostic Value of CAP in Children with Nonalcoholic Fatty Liver Disease LIU Min, ZHENG Xi, QIU Jun, et al DOI: 10.3969/j.issn.1671-7171.2021.03.006 【Objective】To evaluate the clinical diagnostic value of CAP in children with NAFLD fatty liver. 【Methods】From August 2016 to September 2020, 91 children with NAFLD were selected from the liver disease center of our hospital. All patients underwent liver biopsy and controlled attenuation parameter (CAP) examination. Another 30 children with other liver diseases were selected as the control group. No hepatic steatosis was confirmed by liver biopsy, and cap was also detected. NAFLD histological scoring system was used to grade hepatic steatosis, and correlation analysis was performed. 【Results】The BMI, AST, ALT, GGT, CAP, TC and TG of the observation group were higher than those of the control group ( P <0.05). The AUC of cap was 0.955, the best cut-off value was 222.5 dB/m, the 95%CI was 0.91-1.00, which was 94.5%, and the specificity was 86.7%. According to the best cut-off value, the accuracy of liver steatosis in the observation group was 94.51% (86/91). BMI was significantly correlated with CAP ( r=0.241, P =0.021<0.05).【Conclusion】 Cap has high clinical value in the diagnosis of NAFLD in children, which is worthy of clinical application. 2021 Vol. 38 (3): 343-345 [Abstract] ( 79 ) HTML (1 KB)  PDF (1251 KB)  ( 25 ) 346 Clinical Effect of Ibutilide in Treating patients with Pre-excitation Syndrome and Atrial Fibrillation SUN Shao-xi, TAN Wen-liang, LI Zhen-ci, et al DOI: 10.3969/j.issn.1671-7171.2021.03.007 【Objective】To investigate the clinical treatment and efficacy of ibutilide in patients with pre-excitation syndrome and atrial fibrillation. 【Methods】The diagnostic criteria of ECG for pre-excitation syndrome with atrial fibrillation are: rapid ventricular rate, absolute RR interval, wide QRS complex with initial delta wave. A retrospective analysis of the clinical data and treatment measures of 7 patients with pre-excitation syndrome and atrial fibrillation in Guangzhou First People's Hospital from February 2017 to June 2019. All patients were treated with Ibutilide fumarate injection. After the medication, all patients received pre-excitation of the side channel and (or) radiofrequency ablation of atrial fibrillation. Patients' sinus rhythm cardioversion and surgery after medication were recorded. 【Results】All 7 patients had good curative effect after intravenous injection of ibutilide, which could effectively convert pre-excitation syndrome patients with atrial fibrillation to sinus rhythm and reduce ventricular rate. In brief, 5 cases were converted to sinus heart rate, 1 case had a lower ventricular rate than before treatment, 1 case had no significant change in ventricular rate after amiodarone treatment and electrical cardioversion failed. However, the ventricular rate decreased significantly after ibutilide treatment. All patients were successfully treated with pre-excited side channel and/or radiofrequency ablation of atrial fibrillation.【Conclusion】Ibutilide can effectively convert the heart rhythm of patients with pre-excitation combined with atrial fibrillation, and can effectively reduce the ventricular rate of patients with pre-excitation combined with atrial fibrillation, which is beneficial to subsequent radiofrequency ablation treatment. 2021 Vol. 38 (3): 346-348 [Abstract] ( 66 ) HTML (1 KB)  PDF (1174 KB)  ( 34 ) 349 Effects of Lp-PLA2, hs-CRP and D-dimer on the Occurrence and Development of Coronary Heart Disease YU Mao-wen DOI: 10.3969/j.issn.1671-7171.2021.03.008 【Objective】To investigate the correlation of serum lipoprotein associated phospholipase A2 (Lp-PLA2), high sensitivity C-reactive protein (hs CRP) and D-dimer levels with coronary heart disease.【Methods】A total of 100 patients with coronary heart disease admitted to our hospital from October 2018 to may 2019 were selected as the research objects, and they were divided into acute myocardial infarction group, stable angina pectoris group and unstable angina pectoris group according to the severity of the patient's condition. Meanwhile, healthy volunteers who had physical examination in our hospital during the same period were selected as the control group. The levels of serum Lp-PLA2, hs CRP, D-dimer, blood lipids and cardiac function indexes were compared between patients with coronary heart disease and control group, as well as patients with different severity of coronary heart disease. The correlation between the levels of Lp-PLA2, hs-CRP, D-dimer and blood lipids and cardiac function indexes in patients with coronary heart disease was analyzed.【Results】 The levels of serum Lp-PLA2, hs CRP, D-dimer, NT-proBNP, CTnI, TC, TG and LDL-C in myocardial infarction group, unstable myocardial infarction group and stable myocardial infarction group were significantly higher than those in the control group, while the levels of LVEF and HDL-C were lower than those in the control group, and the differences between coronary heart disease groups were statistically significant (all P <0.05). Serum Lp-PLA2, hs-CRP and D-dimer levels were positively correlated with NT-proBNP, CTnI, TC, TG and LDL-C levels ( P <0.05), and negatively correlated with LVEF and HDL-C levels ( P <0.05). 【Conclusion】The serum levels of Lp-PLA2, hs-CRP and D-dimer in patients with coronary heart disease are higher, which are closely related to the indexes of heart function and blood lipid level, and can reflect the condition of patients to a certain extent. 2021 Vol. 38 (3): 349-351 [Abstract] ( 98 ) HTML (1 KB)  PDF (1170 KB)  ( 46 ) 352 Clinical Study of Minimally Invasive Sacral Sinus Approach for Sanders Type Ⅱ Calcaneal Fracture ZHANG Hua, YANG Wang-li DOI: 10.3969/j.issn.1671-7171.2021.03.009 【Objective】To analyze the effectiveness of minimally invasive sacral sinus approach for Sanders type Ⅱ calcaneal fractures. 【Methods】 A total of 60 patients who were diagnosed as Sanders type Ⅱ calcaneal fractures patients in Shaanxi University of Traditional Chinese Medicine Hospital from March 2013 to June 2019 were selected as the research subjects. According to the stochastic indicator method, patients were divided into the observation group and the control group, with 30 cases in each group. The control group was treated with lateral calcaneus approach, while the observation group was treated with minimally invasive surgery through the tarsal sinus approach. Surgical conditions, Bohler Angle, Gissane Angle, ankle and posterior foot functional scores (AOFAS), postoperative complications were compared between the two groups. 【Results】The operation time and average hospitalization time in the observation group were significantly shorter than those in the control group, the incision length and intraoperative blood loss in the observation group were significantly less than those in the control group ( P <0.05). The postoperative Bohler Angle and Gissane Angle in the two groups were higher than those before the operation. The Bohler Angle in the observation group was larger than that in the control group ( P <0.05), but there was no significant difference in Gissane Angle between the two groups after operation ( P >0.05). The excellent and good rate of AOFAS in the observation group was higher than that in the control group (90.00% vs 66.66%) ( χ2 =4.812, P =0.028). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (13.34%vs36.66%) ( χ2 =4.356, P=0.037). 【Conclusion】Compared to the surgical treatment of lateral calcaneal approach, minimally invasive surgery of sacral sinus approach for Sanders type Ⅱ calcaneal fracture has achieved significant clinical efficacy, high safety, and can effectively reduce postoperative complications. 2021 Vol. 38 (3): 352-355 [Abstract] ( 80 ) HTML (1 KB)  PDF (1736 KB)  ( 118 ) 356 Clinical Analysis of Hepatitis C Virus Patients with Hepatocellular Carcinoma during Sustained Virological Response after Antiviral Intervention LIU Dong-yu, BAI Jie, ZHANG Wen-hua, et al DOI: 10.3969/j.issn.1671-7171.2021.03.010 【Objective】To investigate the clinical characteristics of hepatitis C virus (HCV) treated with direct-acting antivirals(DAA) patients with hepatocellular carcinoma (HCC) during the sustained virological response (SVR) after antiviral intervention. 【Methods】 A total of 130 patients with HCV infection in our hospital were recruited in the study. All patients were received HCV antiviral therapy and the SVR rate was recorded. The incidence of HCC were followed up after discharge. According to the occurrence of HCC, patients with SVR were further divided into the observation group (occurrence of HCC) and the control group (no occurrence of HCC).The basic data and clinicopathological characteristics were compared between the two groups. The Cox multivariate risk model was used to explore the high risk factors of HCC in patients with SVR after HCV antiviral intervention. 【Results】Among 130 patients with HCV,98 required SVR after HCV antiviral intervention. The SVR rate was 75.38%.There were 6 cases of HCC occurred during the follow-up period, which was 6.12% (6/98).There were significant differences in direct antiviral drugs (DAA) treatment, liver status, AST, ALT and AFP levels among patients with different prognosis, the difference were statistically significant ( P <0.05).The Cox multivariate risk analysis showed that the DAA treatment, liver status and AFP level were the risk factors for HCC after SVR ( P <0.05). 【Conclusion】 The DAA treatment, liver status and AFP level are the independent factors, which affect the occurrence of HCC for the patients with SVR after antiviral therapy. 2021 Vol. 38 (3): 356-358 [Abstract] ( 67 ) HTML (1 KB)  PDF (1196 KB)  ( 34 ) 359 Diagnostic Value of Immune-related Indicators and Nuclear Antigen Antibodies in Patients with Systemic Lupus Erythematosus YAN Xiao-qing, ZHOU Ying, ZHU Jin-wu DOI: 10.3969/j.issn.1671-7171.2021.03.011 【Objective】To investigate the diagnostic value of immune-related indicators and nuclear antigen (ENA) antibodies in patients with systemic lupus erythematosus (SLE). 【Methods】A total of 80 patients with SLE were selected and divided into the active group (35 cases) and the inactive group (45 cases) according to the disease activity condition. Forty healthy volunteers were selected as the control group. Peripheral blood immune related indicators (IgA, IgM, IgG, C3, C4) and ENA antibodies (anti-ds-DNA, anti-Sm, anti-SSA, anti-SSB, anti-nRNP) were examined and compared among the tree groups. The ROC curve was used to analyze the diagnostic value of relevant indicators for active SLE . 【Results】 There were significant differences in IgA, IgM, C3, C4, IgG, anti-ds-DNA, anti-Sm, anti-SSA, anti-SSB and anti-nRNP among the three groups ( P <0.05). The levels of IgA, IgM and IgG in the active group were higher than those in the control group and the inactive group; while levels of C3 and C4 were lower than those in the control group and the inactive group ( P <0.05). The IgA and IgG levels in the inactive group were higher than those in the control group, and C3 level in the inactive group was lower than that in the control group ( P <0.05). The positive rates of anti-ds-DNA, anti-Sm, anti-SSA, anti-SSB and anti-nRNP in the active and inactive groups were higher than those in the control group ( P <0.05). There was no significant difference in the positive rate of each individual ENA antibody between the inactive group and the active group ( P >0.05). The optimal critical point for IgA diagnosis of SLE 4.5g/L. When IgA was 4.5 g/L, the sensitivity of IgA in the diagnosis of SLE was 71.5%, the specificity was 80.1%, and the area under the AUC curve was 0.81. 【Conclusion】Immunologically relevant indicators and ENA antibodies have higher diagnostic value in patients with SLE, and IgA, IgG and C3 can better indicate the progress. 2021 Vol. 38 (3): 359-361 [Abstract] ( 65 ) HTML (1 KB)  PDF (1174 KB)  ( 37 ) 362 Relationship between ZEB2 Protein and Development and Prognosis of Colon Cancer JIN Hong-qi, ZHAO Lian-feng DOI: 10.3969/j.issn.1671-7171.2021.03.012 【Objective】To investigate the relationship between E-box binding zinc finger protein 2 (ZEB2) and the development and prognosis of colon cancer. 【Methods】The pathological specimens of 90 colon cancer patients collected from the pathology center of our hospital were selected, and 45 specimens of adjacent colon cancer tissues were selected as the control group. The intensity of ZEB2 protein expression in the two groups was detected by Western-blot technique. The differences of ZEB2 protein expression in colon cancer tissues with different age, gender, lesion diameter, tumor location, TNM stage, tumor differentiation, lymph node metastasis and colon cancer were analyzed by logistic regression. The relationship between ZEB2 protein and prognosis of colon cancer patients was analyzed by logistic regression. 【Results】The expression of ZEB2 protein in colon cancer tissues was higher than that in the control group, and the difference was statistically significant ( P <0.05). ZEB2 protein in colon cancer tissues with different ages, genders, different lesion diameters, different tissue differentiation degrees and different colon sites. There was no statistically significant difference between the expression intensity groups ( P >0.05). The differences in ZEB2 protein expression between the different TNM stages, lymph node metastasis, and 2-year follow-up of different outcomes were statistically significant. ( P <0.05); Logistic regression analysis showed that the higher the TNM stage, the lymph node metastasis and the increased ZEB2 protein expression were independent risk factors for poor prognosis in colon cancer patients ( P <0.05). 【Conclusion】ZEB2 protein expression is up-regulated in colon cancer tissues and is associated with tumor development and prognosis. 2021 Vol. 38 (3): 362-364 [Abstract] ( 78 ) HTML (1 KB)  PDF (1167 KB)  ( 52 ) 365 Analysis of the Effect of Single Hole Thoracoscopic Drainage Combined with Negative Pressure Drainage in the Treatment of Lung Cancer WANG Zhen-hua, ZHANG Li-guo, GUO Xi-xi DOI: 10.3969/j.issn.1671-7171.2021.03.013 【Objective】To investigate the drainage effect of single thoracic drainage tube combined with negative pressure drainage tube after single port thoracoscopic lung cancer radical operation. 【Methods】A total of 80 patients with non-small cell lung cancer who underwent SP-VATS radical resection from July 2015 to October 2019 were selected and randomly divided into observation group (single drainage combined with negative pressure drainage tube) and control group (conventional single drainage tube), 40 cases in each group. The postoperative drainage volume, hospital stay, catheter time and infection were recorded and compared between the two groups. The levels of serum C-reactive protein (CRP), tumor necrosis factor -α(TNF-α) and interleukin-8 (IL-8) were compared between the two groups.【Results】The postoperative drainage volume, hospital stay and tube time of the observation group were lower than those of the control group, and the postoperative wound infection rate of the observation group was lower than that of the control group, the differences were statistically significant ( P <0.05). The incidence of postoperative complications and the use rate of opioid analgesics in the observation group were lower than those in the control group ( P <0.05).The levels of serum CRP, TNF-α and IL-8 in the two groups 5d after operation were lower than those in the control group on postoperative 1day ( P <0.05).【Conclusion】The drainage effect of single thoracic drainage tube combined with negative pressure drainage after SP-VATS lung cancer radical operation is more significant than that of conventional use of thoracic drainage tube, which is conducive to reducing the inflammatory reaction, shortening the length of hospital stay, and has great significance for the prognosis of patients. 2021 Vol. 38 (3): 365-367 [Abstract] ( 63 ) HTML (1 KB)  PDF (1167 KB)  ( 67 ) 368 Study on Memory Impairment and Cognitive Impairment in Elderly Patients with Obstructive Sleep Apnea-Hypopnea Syndrome GU Liang, XU Dong-hui, DU Chun-ling DOI: 10.3969/j.issn.1671-7171.2021.03.014 【Objective】To observe the memory and cognitive impairment in elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). 【Methods】We selected 96 elderly OSAHS patients (OSAHS group) from January 2017 to December 2019 in our hospital, whose sleep apnea hypopnea index (AHI) times was more than 5 times/hour. In the same period, 40 elderly health checkups who participated this study were selected as the control group (SHIm: 0 times/h≤AHI≤5 times/h). Furthermore, the OSAHS Patients were divided into two groups according to the sleep apnea hypopnea index (AHI): the mild-moderate OSAHS group (56 patients, 5 times/h <AHI≤30 times/h) and the severe OSAHS group (40 patients, AHI> 30 times/h). The three groups of subjects received polysomnography (PSG), overall cognition, short-term memory, attention and executive ability tests'. Thus, the cognitive impairment and memory impairment were compared in the three groups. 【Results】The proportion of ODI (oxygen reduction index), AHI, RRMAI (respiratory related micro awakening index), NREM (non-rapid eye movement) sleep stage Ⅰ to Ⅱ ratio, severe cognitive dysfunction, TMT A use time, and TMT B use time in the severe OSAHS group were higher than those in the non-OSAHS group and mild-moderate OSAHS group ( P <0.05). LSaO2 (nocturnal pulse oxygen at night), NREM Ⅲ stage ratio, MMSE (simple mental state examination) scale score, MocA (Montreal cognitive assessment) scale score, DST (digital span test) forward, DST backward, CFT (complex graph test) redraw scores were lower than those in the mild to moderate OSAHS group and the non-OSAHS group ( P <0.05). The proportion of cognitive dysfunction, TMT A use time, and TMT B use time in the mild-to-moderate OSAHS group were higher than those in the non-OSAHS group ( P <0.05); and the MMSE, MoCA score, DST forward, DST reverse, and CFT redraw scores were lower than those in the non-OSAHS group ( P <0.05). Correlation analysis results showed that AHI was positively correlated with TMT A use time and TMT B use time ( P <0.05), and AHI was negatively correlated with DST forward, DST reverse, CFT redraw, MMSE, and MoCA ( P <0.05). 【Conclusion】OSAHS has memory impairment, cognitive impairment and decreased attention and execution ability. As the disease worsens, the degree of memory impairment and cognitive impairment plus the attention and execution ability decreases, which should draw important attention clinically. 2021 Vol. 38 (3): 368-371 [Abstract] ( 93 ) HTML (1 KB)  PDF (1195 KB)  ( 54 ) 372 Clinical Effect of Percutaneous Pedicle Screw Internal Fixation in Treatment of Single-vertebral Type A3 Thoracolumbar Fractures LIU Qing-hua, TONG Jie, CHEN Sheng-min, et al DOI: 10.3969/j.issn.1671-7171.2021.03.015 【Objective】To explore the clinical effect of the percutaneous pedicle screw internal fixation in the treatment of single-vertebral type A3 thoracolumbar fractures. 【Methods】From August 2016 to August 2018, a total of 40 patients with single-vertebral type A3 thoracolumbar fracture admitted in the First People's Hospital of Chenzhou were analyzed. They were divided into the observation group and the control group, with 20 cases in each group. Patients in the observation group received percutaneous pedicle screw internal fixation, while patients in the control group received posterior open surgery. The perioperative indexes, preoperative and postoperative VAS scores, Cobb's angle, and the percentage of the anterior edge of the vertebral body were compared between the two groups.【Results】Blood loss was (101.0±11.2) mL in the observation group and (360±29.3) mL in the control group ( P <0.01). Operation time was (96.0±9.8) min in the observation group and (133.6±9.5) min in the control group ( P <0.01). Incision length was (7.2±0.5) cm in the observation group and (14.3±1.3) cm in the control group ( P <0.01). Postoperative effusion was (15.0±3.28) mL in the observation group and (144.5±21.6)mL in the control group ( P <0.01). Postoperative hospital stay was (9.0±0.86) d in the observation group A and (16.3±1.0) d in the control group. The amount of blood loss, operation time, incision length, postoperative exudation, and hospital stay in the observation group were less than those in the control group, and the difference was statistically significant ( P <0.05). There was no significant difference in the preoperative VAS scores between the two groups (all P >0.05). VAS scores at 1 week, 1 month, 3 months, and 6 months after surgery in the observation group had significant lower than those in the control group; the difference was statistically significant ( P <0.05).There was no significant difference between the two groups in the preoperative Cobb angle and anterior height ratio of the injured vertebrae ( P >0.05). There were no significant differences in the Cobb angle and the anterior height of vertebral body at admitting to hospital, postoperative one month and one year after operation ( P >0.05). 【Conclusion】Minimally invasive percutaneous pedicle internal screw fixation without decompression pressure in the treatment of single-vertebral type A3 thoracolumbar fractures has better clinical curative effect than open surgery. It also provides less bleeding, shorter hospitalization time, a small incision, less postoperative pain and quicker recovery. 2021 Vol. 38 (3): 372-374 [Abstract] ( 65 ) HTML (1 KB)  PDF (1686 KB)  ( 48 ) 375 Clinical Characteristics of Pneumocystis Pneumonia Patients with Non-human Immunodeficiency Virus Infection CHEN Xue-ying, WANG Qi, XU Yong-jian, et al DOI: 10.3969/j.issn.1671-7171.2021.03.016 【Objective】To investigate clinical characteristics of pneumocystis pneumonia(PCP) in non-HIV-infected patients. 【Methods】 The clinical data of non HIV infected PCP patients diagnosed and treated in respiratory and critical care medicine department of our hospital from October 2018 to September 2019 were collected, and their clinical characteristics were analyzed.【Results】 Forty five patients were included in the study, and 19 (42.2%) died. The most common underlying diseases are autoimmune diseases, followed by malignant tumors, solid organ transplantation and kidney diseases; the main manifestations of PCP patients are nonspecific fever, cough and dyspnea, and the typical chest CT images are multiple or scattered ground glass shadows in both lungs. Compared with the patients who survived in hospital, the dead patients had lower albumin (33.9 ± 5.0 vs 27.7 ± 4.3), higher lactate dehydrogenase (390.7 ± 189.1 vs 524.1 ± 246.9), higher plasma urea nitrogen level [6.1 (5.2-8.0) vs 9.4 (5.0-15.5)] and worse oxygenation index [371.4 (316.2-423.8) vs 300.0 (257.1-354.8)], the differences were statistically significant (all P <0.05). After admission, 44 cases were treated with compound sulfamethoxazole anti PCP, 31 cases were treated with caspofungin; 41 cases (91.1%) were treated with glucocorticoid on the basis of anti infection.【Conclusion】The mortality of PCP patients without HIV infection is higher, and the prognosis of patients with low albumin, increased plasma lactate dehydrogenase and urea nitrogen and poor oxygenation index on admission is poor. 2021 Vol. 38 (3): 375-378 [Abstract] ( 109 ) HTML (1 KB)  PDF (1196 KB)  ( 90 ) 379 Value of Intravoxel Incoherent Motion Diffusion Weighted Imaging in Evaluating Efficacy of HIFU in the Treatment of Uterine Leiomyoma QUAN Xiao-hua, WANG Kang DOI: 10.3969/j.issn.1671-7171.2021.03.017 【Objective】To explore the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in evaluating the efficacy of high intensity focused ultrasound (HIFU) in the treatment of uterine leiomyoma. 【Methods】A total of 76 patients with uterine leiomyoma treated in Baoji Hospital Affiliated to Xi'an Medical College from January 2018 to March 2019 were selected and treated with HIFU. The IVIM-DWI was performed before and after treatment and its predictive value for HIFU treatment was evaluated. 【Results】After treatment, the true diffusion coefficient (D) value higher than that before treatment ( P <0.05), while the correlation diffusion coefficient (D*) value and perfusion fraction (F value) were significantly lower than those before treatment ( P <0.05). The changes of D* and F values in the group with leiomyoma ablation rate > 50% were significantly higher than those in the group with leiomyoma ablation rate ≤50% ( P <0.05). The area under ROC curve for predicting ablation rate of leiomyoma > 50% by the changes of D* value and F value was 0.681 and 0.901,respectively. Meanwhile, the cut-off values were 16.71×10-3 mm2/s and 15.70 mm2/s, the sensitivity was 58.60% and 82.80%, and the specificity was 77.80% and 88.90%.【Conclusion】IVIM-DWI parameters have certain application value in predicting the efficacy of HIFU in the treatment of uterine leiomyoma, which is worthy of clinical use. 2021 Vol. 38 (3): 379-381 [Abstract] ( 61 ) HTML (1 KB)  PDF (1228 KB)  ( 58 ) 382 Analysis of Influencing Factors of Acoustic Radiation Force Pulse in Detecting Liver Elasticity in Patients with Chronic Hepatitis B JIA Li-xia, CHEN Yue DOI: 10.3969/j.issn.1671-7171.2021.03.018 【Objective】To investigate the influencing factors of acoustic radiation force impulse (ARFI) in detecting liver elasticity in patients with chronic hepatitis B (CHB). 【Methods】The clinical data of 80 patients with CHB admitted to our hospital from August 2014 to August 2018 were retrospectively analyzed. All patients received ARFI examination on the day of admission to determine the liver elasticity. Patients were divided into success group and failure group according to whether the detection was successful. The clinical characteristics of the two groups were compared, including gender, age, body mass index (BMI), degree of inflammation (G), liver fibrosis grade (S), steatosis grade (F), and detection position. The relationship between detection quality and clinical characteristics was analyzed. Logistic regression model was used to analyze the influencing factors of liver elasticity in patients with CHB detected by ARFI. 【Results】Of the 80 patients, 64 (80.00%) were successful and 16 (20.00%) failed. BMI < 24 kg /m2, steatosis grade F1 and supine position detection accounted for 65.63%, 95.31%, 53.13% and 59.38% respectively in the success group, which were higher than 37.50%, 31.25%, 0.00% and 25.00% in the failure group ( P <0.05). Logistic regression model suggested that BMI (≥ 24 kg /m2), steatosis grade (F2-F3) and body position (lateral position) were the influencing factors of liver elasticity in patients with CHB detected by ARFI ( P <0.05).【Conclusion】The detection of liver elasticity in patients with CHB by ARFI is affected by BMI, steatosis grade and body position, which should be paid attention to. 2021 Vol. 38 (3): 382-384 [Abstract] ( 75 ) HTML (1 KB)  PDF (1446 KB)  ( 71 ) 385 Expression Characteristics and Clinical Value of p53 and COX-2 in Lung Cancer Patients with Different EGFR Gene Status BAI Guo-dong, WANG Kai-bin DOI: 10.3969/j.issn.1671-7171.2021.03.019 【Objective】To investigate the expression of P53 protein and cyclooxygenase-2 (COX-2) in lung cancer patients with different epidermal growth factor receptor (EGFR) gene status, and analyze their clinical value. 【Methods】The clinical data of 96 patients with lung cancer admitted to our hospital from April 2017 to April 2018 were retrospectively analyzed. All patients were confirmed by pathological puncture. The mutation of EGFR gene was detected by Taqman-ARMS method. According to the results of EGFR mutation, patients were further divided into the mutant group and the wild type group. The expression of p53 and COX-2 in lung cancer tissues was determined by immunohistochemical method. Then the expression of p53 and COX-2 in the mutant group and the wild type group was compared. The patients were followed up for 12 months. Survival and death were analyzed. The survival and death of patients with different expression of p53 and COX-2 were compared as well. The risk factors of poor prognosis of lung cancer patients were analyzed by logistic regression model. 【Results】The mutation detection showed that there were 42 (43.75%) cases of the EGFR mutation and 54 (56.25%) cases of wild type EGFR. The positive expression rates of p53 and COX-2 in the EGFR mutant group were 33.33% and 40.48% respectively, which were significantly lower than those in wild type EGFR group (57.41% and 61.11%, respectively,)( P <0.05).During the follow-up period of all 96 patients, 29 (30.21%) died and 67 (69.79%)survived. Of which, the survival rate of p53 positive patients was 53.33%, significantly lower than that of p53 negative patients (84.31%); and the mortality rate of p53 positive patients was 46.67%, which was significantly higher than that of p53 negative patients (15.69%) ( P <0.05).The survival rate of COX-2 positive patients was 56.00%, which was significantly lower than that of COX-2 negative patients (84.78%). The death rate of COX-2 positive patients was 44.00%, which was significantly higher than that of COX-2 negative patients (15.22%) ( P <0.05). Logistic regression analysis showed that the degree of differentiation (moderate to low differentiation), stage of tumors (Ⅲ-Ⅳ), lymph node metastasis, diameter of tumors (> 3cm), p53 positive and COX-2 positive expression were risk factors for poor prognosis in patients with lung cancer ( P <0.05). 【Conclusion】The positive rates of p53 and COX-2 in lung cancer patients with EGFR gene mutation were lower, and the mortality risk of p53 and COX-2 positive patients was higher. Both of them were risk factors for poor prognosis of lung cancer. 2021 Vol. 38 (3): 385-388 [Abstract] ( 73 ) HTML (1 KB)  PDF (1197 KB)  ( 25 ) 389 Therapeutic Effect of Ankle Arthroscopic Reconstruction of Anterior Tibiofibular Ligament Combined with Internal Fixation for the Treatment of Posterior Orbital Ⅱ° Ankle Joint Injury WANG Xin-gang, HUANG Peng, LYU Tu DOI: 10.3969/j.issn.1671-7171.2021.03.020 【Objective】To investigate the clinical effect of ankle arthroscopic reconstruction of the anterior tibiofibular ligament combined with internal fixation for the treatment of posterior orbital Ⅱ grade ankle joint injury. 【Methods】From January 2014 to June 2018,102 patients with posterior orbital Ⅱ grade ankle injury were analyzed retrospectively. According to the treatment methods, patients were divided into the ankle arthroscopic reconstruction of anterior tibiofibular ligament combined with internal fixation of supporting plate (the observation group, n =51) and the open reduction combined with supporting plate internal fixation (the control group, n =51). After 1 year follow-up, the clinical efficacy and complication rate of the two groups were compared. 【Results】The operation time and intraoperative blood loss in the observation group were higher than those in the control group, however, the time of fracture healing and complete weight bearing after operation was smaller than that in the control group ( P <0.05).At the last follow-up, the Maryland scores of pain, function and alignment in the observation group were higher than those in the control group ( P <0.05). The excellent and good rate of the AOFAS score was higher than that in the control group ( P <0.05), and the incidence of complications was lower than that in the control group ( P <0.05). 【Conclusion】Ankle arthroscopic anterior tibiofibular ligament reconstruction combined with internal fixation in the treatment of posterior orbital Ⅱ grade ankle joint injury has less complications and can short recovery time. It is worthy of clinical application. 2021 Vol. 38 (3): 389-391 [Abstract] ( 77 ) HTML (1 KB)  PDF (1163 KB)  ( 69 ) 392 Hemostatic Effect of Cryoprecipitated Plasma Infusion on Acute Gastrointestinal Hemorrhage and Its Effect on T cell Subsets REN Jiao-xue, DENG Lei DOI: 10.3969/j.issn.1671-7171.2021.03.021 【Objective】To investigate the hemostatic effect of cryoprecipitated plasma infusion in the treatment of acute gastrointestinal hemorrhage and its influence on the level of T cell subsets.【Methods】A total of 140 patients with acute gastrointestinal hemorrhage admitted to our hospital from December 2015 to December 2018 were divided into the observation group ( n =70) and the control group ( n =70) according to random number table method. Both groups were given routine symptomatic treatment.The control group was infused with fresh frozen plasma, while the observation group was given cryoprecipitated plasma infusion. The clinical hemostatic effect of the two groups was compared, and the red blood cell volume and hospital stay of the two groups were recorded. Blood samples were collected before and after treatment. T cell subsets including CD3+, CD4+, CD8+, CD4+/CD8+, were measured by flow cytometry. The incidence of adverse reactions was recorded. 【Results】The total effective rate of the observation group (95.71%) was significantly higher than that of the control group (85.71%) ( P <0.05).The amount of erythrocyte transfusion in the observation group was significantly lower than that in the control group, and the time of hemostasis and hospitalization was significantly shorter than that in the control group ( P <0.05).After treatment, CD3+, CD4+, CD4+/CD8+ in both groups were significantly lower than those before treatment, and CD8+ was higher than that before treatment ( P <0.05).After treatment, CD3+, CD4+, CD4+/CD8+ in the observation group were still significantly higher than those in the control group, and CD8+ was significantly lower than those in the control group ( P <0.05).There was no significant difference in the incidence of non-hemolytic fever, allergy and hemosiderinosis between the two groups ( P >0.05). 【Conclusion】Cryoprecipitated plasma infusion can reduce the amount of red blood cells after transfusion, shorten the time of hemostasis and hospital stay, reduce post transfusion immunosuppression, without increasing the rate of adverse reactions, with high safety and significant overall efficacy. 2021 Vol. 38 (3): 392-395 [Abstract] ( 58 ) HTML (1 KB)  PDF (1194 KB)  ( 99 ) 396 Application of Single and Combined Detection of FER, AFP and AFP-L3 in Diagnosis and Therapeutic Evaluation of Hepatocellular Carcinoma SHAN Yong-feng, YU Hao, LIU Hui, et al DOI: 10.3969/j.issn.1671-7171.2021.03.022 【Objective】To explore the application value of ferritin (FER), alpha fetoprotein (AFP), alpha fetoprotein-L3 (AFP-L3) in the diagnosis and evaluation of curative effect of hepatocellular carcinoma (HCC). 【Methods】A total of 80 patients with HCC were selected as the HCC group. And 80 patients with benign liver disease were selected as benign liver disease group. The levels of FER,AFP,AFP-L3 were measured on the day of admission, and the diagnostic value of each index for HCC was analyzed. All patients with HCC received radiofrequency ablation. The therapeutic effect was analyzed one month after operation. The evaluation value of serum FER, AFP and AFP-L3 was analyzed. 【Results】The serum FER, AFP and AFP-L3 levels in HCC group were significantly higher than those in the benign liver disease group ( P <0.05).The sensitivity of FER, AFP and AFP-L3 alone in the diagnosis of HCC was 72.50%, 77.50% and 81.25% respectively. The specificity was 78.75%, 87.50% and 86.25%, respectively. The accuracy rates were 75.63%, 82.50% and 83.75%, respectively. The consistency of Kappa test with pathological diagnosis was 0.513, 0.650 and 0.675.The sensitivity, specificity, accuracy and consistency of FER, AFP and AFP-L3 in the diagnosis of hepatocellular carcinoma were 90.00%, 92.50%, 91.25% and 0.825.The sensitivity, specificity and accuracy of FER and AFP combined with AFP-L3 in the diagnosis of HCC were 90.00%, 92.50% and 91.25%, respectively. Its consistency with pathological diagnosis was 0.825. Among 80 cases of liver cancer patients, 65 cases were effective after treatment, and the overall response rate was 81.25%. The serum levels of FER, AFP and AFP-L3 in the effective treatment group were significantly lower than those in the ineffective treatment group ( P <0.05).The area under the curve of FER, AFP and AFP-L3 alone for evaluating the curative effect of HCC alone was 0.671, 0.688 and 0.716. The area under the curve of FER, AFP and AFP-L3 combined evaluation was 0.797. 【Conclusion】Serum level of FER, AFP and AFP-L3 alone has certain value in the diagnosis and evaluation of curative effect of HCC and the combined evaluation has the best effect. 2021 Vol. 38 (3): 396-398 [Abstract] ( 93 ) HTML (1 KB)  PDF (1413 KB)  ( 36 ) 399 Factors Influencing Early Death in Patients with Severe Heart Failure Treated by Continuous Renal Replacement Therapy JI Li-hua, LU Feng DOI: 10.3969/j.issn.1671-7171.2021.03.023 【Objective】To analyze the factors affecting early death in patients with severe heart failure with CRRT. 【Methods】A total of 100 patients with severe heart failure who underwent CRRT were enrolled. The mortality of patients treated for 28 days was observed. The patients were divided into death group and survival group according to whether they died. Patient clinical case data were collected and the influencing factors of death was analyzed. 【Results】 Among the 100 patients, 46 patients died, with a mortality rate of 46.0%, of which 34.0% (34/100) died within 14 days. Among the death group and the survival group, there were significant differences in the proportion of systemic inflammatory response syndrome (SIRS), sepsis, mean arterial pressure, base excess (BE), acute physiology and chronic health score (APACHE Ⅱ), sequential organ failure assessment score (SOFA), pH, N-terminal brain natriuretic peptide (NT-proBNP) level, time to start treatment and time to reach negative fluid balance after treatment ( P <0.05).Multivariate regression analysis showed that Sirs, Sepsis, mean arterial pressure, pH, start time of treatment, SOFA score were independent influencing factors of death ( P <0.05). CRRT patients of severe heart failure with SIRS, Sepsis, mean arterial pressure≤60mmHg, pH≤7.35, SOFA score > 10 had poor prognosis.【Conclusion】There are many influencing factors of death within 28 days in patients with severe heart failure receiving CRRT. Patients with SIRS, Sepsis, mean arterial pressure ≤ 60mmHg, pH ≤ 7.35, SOFA score > 10, and starting treatment time > 24h were risk factors for death within 28d. 2021 Vol. 38 (3): 399-402 [Abstract] ( 61 ) HTML (1 KB)  PDF (1188 KB)  ( 83 ) 403 Diagnostic Value of Serum miR-122 Level in the Degree of Liver Fibrosis in Patients with Chronic Hepatitis C JIA Xue-you, ZANG Xiao-qing DOI: 10.3969/j.issn.1671-7171.2021.03.024 【Objective】To explore the diagnostic value of serum microRNA-122 level in the degree of liver fibrosis in patients with chronic hepatitis C (CHC). 【Methods】One hundred and twenty patients with chronic hepatitis C in our hospital were enrolled. qRT-PCR was used to detect the expression of serum microRNA-122. The receiver operating characteristic (ROC) was used to evaluate the predictive value of microRNA-122 in the diagnosis of liver fibrosis in patients with chronic hepatitis C. 【Results】There were 62 males and 58 females with an average age of 46.91 ± 17.26 years.The levels of alanine aminotransferase(ALT)and aspartate aminotransferase (AST) were 72.85±21.34 U/L and 76.3±18.43 U/L, respectively.The expression level of miR-122 was 1.63±0.57, and the score of AST and platelet ratio index (APRI) was 1.42±0.52.Liver biopsy showed that there were 37/41/28/14 cases of liver fibrosis grade 1/2/3/4.According to the degree of liver fibrosis, the patients were divided into two groups: S1-2 group and S3-4 group. The levels of AST, alt, miR-122 and inflammatory activity in S3-4 group were significantly higher than those in S1-2 group ( P <0.05), but there was no significant difference in age, gender and APRI score between the two groups ( P >0.05).MiR-122 predicted that the best critical point of s3-4 fibrosis severity in CHC patients was 1.76.At this time, the predictive sensitivity of miR-122 was 78.91%, the specificity was 98.83%, and the area under the curve AUC was 0.940.【Conclusion】Serum microRNA-122 have diagnostic value for the severity of liver fibrosis in patients with CHC. 2021 Vol. 38 (3): 403-405 [Abstract] ( 82 ) HTML (1 KB)  PDF (1191 KB)  ( 37 ) 406 Predictive Model for Massive Blood Transfusion during Cesarean Section of Placenta Previa ZHOU Fen-he, PU Chi, BA Sang DOI: 10.3969/j.issn.1671-7171.2021.03.025 【Objective】To establish a predictive model for MT (massive transfusion) during cesarean section of placenta previa (PP). 【Methods】The medical records of PP patients who underwent cesarean section in our hospital from January 2016 to June 2020 were analyzed. According to the occurrence of massive intraoperative blood transfusion (MT), patients were divided into the MT group (infusion ≥ 5 units of packed red blood cells) and the non MT group (NMT, infusion <4 units of PRBC). Relationship between clinical factors and intraoperative massive blood transfusion was examined by univariate and multivariate logistic analysis. Single factor and multivariate logistic analysis were used to analyze the risk factors of intraoperative MT, the results of multivariate logistic analysis were used to draw up the intraoperative MT risk factor (MTR), and the receiver operating curve (ROC) was used to analyze the area under curve (AUC) that predicted MT with MTR and single risk factor. 【Results】There were significant differences between the MT group and the NMT group in preposition, history of miscarriage, placental lacuna, hypoechoic layer loss, and anterior placenta ( P <0.05).Binary multivariate logistic analysis showed that complete placenta previa, hypoechoic layer loss and anterior placenta were independent risk factors of NMT ( P <0.05). The MTR formula was MTR = 2.437 × (complete placenta previa) + 4.382 × (hypoechoic layer loss) + 1.167 × (anterior placenta). ROC curve showed that the AUC of MTR score predicting intraoperative MT was 0.918, which was higher than that of complete placenta previa (0.787), hypoechoic layer loss (0.718) and anterior placenta (0.717) ( Z =3.785, 5.266, 4.298, P <0.001). 【Conclusion】This study established the prediction model of MT during cesarean section in PP patients by multivariate logistic analysis. Clinicians can predict the risk of MT during cesarean section according to MT risk score, and prepare for massive blood transfusion in the early stage. 2021 Vol. 38 (3): 406-409 [Abstract] ( 63 ) HTML (1 KB)  PDF (1368 KB)  ( 42 ) 410 Effect of Transnasal Endoscopic Pituitary Tumor Resection on Stress Factors in Patients with Pituitary Tumor QIAO Zhi-qiang DOI: 10.3969/j.issn.1671-7171.2021.03.026 【Objective】To investigate the effect of endoscopic pituitary tumor resection on stress factors in patients with pituitary tumor.【Methods】 The clinical data of 62 patients with pituitary adenomas admitted to our hospital from August 2016 to June 2019 were retrospectively analyzed. According to different surgical methods, they were divided into observation group (single nostril transsphenoidal approach pituitary adenoma resection under nasal endoscope) and control group (transsphenoidal approach pituitary adenoma resection under microscope), 31 cases in each group. The curative effect, postoperative stress factors and complication rate of the two groups were analyzed. 【Results】The operation time and postoperative hospital stay of the observation group were shorter than those of the control group, the intraoperative blood loss and the proportion of total tumor resection of the observation group were lower than those of the control group, the difference was statistically significant ( P <0.05). Three days after operation, the levels of serum high sensitivity C-reactive protein (hs CRP), interleukin-8 (IL-8), growth hormone (GH), prolactin (PRL) and adrenocorticotropic hormone (ACTH) in the two groups were higher than those before operation, and those in the observation group were lower than those in the control group ( P <0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group ( χ2 =0.029, P =0.05).【Conclusion】Transnasal endoscopic pituitary adenoma resection has the advantages of less trauma, less blood loss and less stress response to the body, which is conducive to improving endocrine factors and has high safety. 2021 Vol. 38 (3): 410-412 [Abstract] ( 61 ) HTML (1 KB)  PDF (1168 KB)  ( 78 ) 413 Expression of PAX8, ASAH1 and Cullin7 in Tumor Tissues and Adjacent Tissues of Patients with Gliomatosis Cerebri and their Correlation with Survival Status ZHANG Guan-ping, LI Chang-sheng DOI: 10.3969/j.issn.1671-7171.2021.03.027 【Objective】To investigate the protein expression of paired box gene 8 (PAX8), acid ceramidase (ASAH1) and Cullin7 in the cancerous tissues and adjacent normal tissues of patients with gliomatosis cerebri (GC) and their correlation with survival. 【Methods】A total of patients with GC in our hospital from January 2014 to July 2017 were selected, all of them underwent surgical resection. The protein expressions of PAX8, ASAH1 and Cullin7 in cancer tissues and adjacent tissues were compared, and the correlation between the expression of PAX8, ASAH1 and Cullin7 was analyzed, as well as the correlation between the expression of PAX8, ASAH1 and Cullin7 and the clinicopathological features. The correlation between PAX8, ASAH1, Cullin7 protein expression and 3-year survival rate was analyzed.【Results】 The positive expression rates of Pax8, ASAH1 and cullin7 in cancer tissues were higher than those in adjacent tissues ( P <0.05); PAX8 protein was positively correlated with ASAH1 protein, ASAH1 protein was positively correlated with cullin7 protein, Cullin7 protein was positively correlated with Pax8 protein ( P <0.05); the expression of PAX8, ASAH1 and Cullin7 protein was significantly correlated with pathological type, pathological grade, differentiation degree, depth of invasion and peritumoral edema ( P <0.05); the positive expression of PAX8, ASAH1 and Cullin7 protein was negatively correlated with 3-year survival rate ( P <0.05).【Conclusion】 PAX8 protein, ASAH1 protein and Cullin7 protein are all positive in GC patients, and there is a negative correlation with survival status. 2021 Vol. 38 (3): 413-415 [Abstract] ( 99 ) HTML (1 KB)  PDF (1165 KB)  ( 39 ) 416 Diagnostic Efficacy and Significance of Coagulation Dysfunction ZHANG Lei, ZHANG Fu-ming, SUN Yan, et al DOI: 10.3969/j.issn.1671-7171.2021.03.028 【Objective】To investigate the diagnostic efficacy and significance of thromboelastography (TEG) and routine coagulation function indexes in the diagnosis of coagulation dysfunction in critically ill neonates. 【Methods】The clinical data of 160 cases of critical rebirth in Henan Provincial People's Hospital from August 2016 to April 2019 were retrospectively analyzed. According to the results of routine coagulation function examination, the patients were divided into abnormal coagulation function group (observation group, n =90) and normal coagulation function group (control group, n =70).TEG was performed in both groups.The results of routine coagulation function examination and TEG parameters were compared between the two groups. The changes of TEG parameters of children with different conditions in the observation group were analyzed. Pearson method was used to analyze the correlation of each index, and receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic value of each index for critically ill newborns.【Results】PT, APTT and TT in the observation group were significantly longer than those in the normal group ( P <0.05), R value and K value in TEG were significantly shorter than those in the control group; α angle, EPL and LY30 in the observation group were higher than those in the control group ( P <0.05), and there was no significant difference in FIB and MA between the two groups ( P >0.05). The PT and APTT of most critically ill children were significantly longer than those of critically ill children ( P <0.05), the R and K values were shorter than those of critically ill children, and the LY30 value was higher than that of critically ill children ( P <0.05).Pearson correlation analysis showed that R value was negatively correlated with PT and APTT, but not with TT. K value was negatively correlated with APTT ( P <0.05). EPL and LY30 were well correlated with PT and APTT ( P <0.05). ROC curve showed that APTT had the highest area under the curve in conventional coagulation indexes, and R value and LY30 had higher area under the curve in TEG parameters. Except K value, the area under the curve of other TEG parameters were higher than that of conventional coagulation function indexes. The overall diagnostic efficiency of TEG was higher than that of conventional coagulation function examination.【Conclusion】Compared with routine coagulation function test, TEG has higher value in the diagnosis of coagulation dysfunction in critically ill neonates, and the parameters of TEG are closely related, so it can be used as an auxiliary examination method. 2021 Vol. 38 (3): 416-420 [Abstract] ( 73 ) HTML (1 KB)  PDF (1379 KB)  ( 61 ) 421 Effect of Remifentanil Combined with Propofol Anesthesia on Immune Function and Postoperative Prognosis of Patients with Non-small Cell Lung Cancer Undergoing Radical Operation YANG Chong-yu DOI: 10.3969/j.issn.1671-7171.2021.03.029 【Objective】To investigate the effects of remifentanil combined with propofol anesthesia on peripheral blood T lymphocyte, cortisol (COR), blood glucose and postoperative prognosis in patients with non-small cell lung cancer (NSCLC) undergoing radical operation.【Methods】A total of 90 NSCLC patients planned to undergo radical surgery for lung cancer in our hospital were selected,and randomly divided to two group with 45 cases each . The experimental group was given propofol intravenous anesthesia combined with epidural anesthesia, and the control group was given propofol Intravenous anesthesia; the incidence of T lymphocyte subsets, Cor,blood glucose, and postoperative delusion of the two groups of patients before and 2 hours after the operation were compared. 【Results】There was no significant difference in operation time between the two groups ( P >0.05); the dosage of propofol in the observation group was significantly lower than that in the control group ( P <0.05). There was no significant difference in the levels of peripheral blood T lymphocytes, serum Cor and blood glucose between the observation group and the control group before operation ( P >0.05); the levels of CD3+, CD4+, CD4+/CD8+ in the observation group 2 hours after operation were higher than those in the control group ( P <0.05), and the measured value of CD8+ was lower than that in the control group ( P <0.05); the levels of serum cor and blood glucose in the observation group 2 hours after operation were lower than those in the control group ( P <0.05). The incidence of delusion within 48 hours in the observation group was 6.67% (3/45), which was significantly lower than 22.22% (10/45) in the control group ( P <0.05).【Conclusion】Remifentanil combined with propofol anesthesia has less influence on T lymphocyte, Cor and blood glucose levels of patients with NSCLC radical operation, and the incidence of postoperative delusion is less. 2021 Vol. 38 (3): 421-423 [Abstract] ( 61 ) HTML (1 KB)  PDF (1164 KB)  ( 47 ) 424 Application of Yanhuanglian Injection Assisted FOLFOXIRI Chemotherapy in Treatment of Patients with Advanced Colorectal Cancer FAN Lei, SONG Xiang-ni DOI: 10.3969/j.issn.1671-7171.2021.03.030 【Objective】To explore the effects of Yanhuanglian injection assisted FOLFOXIRI chemotherapy on the immune and clinical treatment in patients with advanced colorectal cancer. 【Methods】A retrospectively randomized control study was conducted in 102 patients with advanced colorectal cancer in our hospital from March 2017 to March 2020. They were divided into the observation group ( n =51) and the control group ( n =51) according to a random number table. Patients in the control group received FOLFOXIRI chemotherapy, and patients in the observation group received Yanhuanglian injection assisted FOLFOXIRI chemotherapy. Both groups were treated for 4 chemotherapy cycles. The efficacy and quality of life improvement rate, serum angiogenesis indicators [transforming growth factor-β1 (TGF-β1), hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF)], immune function index (CD3+, CD4+, CD4+/CD8+), tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125)] levels before and after treatment were compared between the two groups. 【Results】The total effective rate and the improvement rate of quality of life after 4 cycles of chemotherapy in the observation group were 54.90% and 66.67%, respectively, which were higher than 35.29% and 41.18% in the control group ( P <0.05). Serum levels of TGF-β1, HIF-1α, VEGF, CEA, CA199, CA125, and miR-217 in the two groups after treatment for 4 cycles of chemotherapy were lower than those before treatment. And the levels in the observation group was lower than those in the control group. After treatment, serum levels of CD3+, CD4+, CD4+/CD8+ in the observation group were not statistically different from those before treatment ( P >0.05). The above indicators in the control group were lower than before treatment; and the difference was statistically significant ( P <0.05). Serum levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group after 4 cycles of chemotherapy ( P <0.05). 【Conclusion】The application of Yanhuanglian injection assisted FOLFOXIRI chemotherapy in the treatment of patients with advanced colorectal cancer can inhibit angiogenesis, reduce the expression of tumor markers, reduce immune function damage and improve efficacy and quality of life. 2021 Vol. 38 (3): 424-427 [Abstract] ( 74 ) HTML (1 KB)  PDF (1195 KB)  ( 41 ) 428 Risk factors of Endometrial Cancer in Patients Receiving Endocrine Therapy after Breast Cancer Surgery HAN Wen-he, WANG Xiao-tong, CHEN Yan-li DOI: 10.3969/j.issn.1671-7171.2021.03.031 【Objective】To analyze the risk factors of endometrial cancer in patients undergoing endocrine therapy after breast cancer surgery. 【Methods】The clinical data of 288 patients with endometrial lesions after endocrine therapy in our hospital from January 2015 to March 2020 were retrospectively analyzed. According to different types of lesions, they were divided into endometrial polyps group ( n =209), endometrial hyperplasia group ( n =47) and endometrial carcinoma group ( n =32). The risk factors of endometrial cancer were analyzed retrospectively. 【Results】There were significant differences in age, endometrial thickness, menopause and abnormal uterine bleeding among the three groups ( P <0.05); endometrial thickness, menopause and abnormal uterine bleeding were independent risk factors for endometrial cancer in patients receiving endocrine therapy after breast cancer surgery ( P <0.05); when endometrial thickness ≥ 7.760 mm, the sensitivity of predicting endometrial cancer was 59.4%,the specificity was 73.9%, the sensitivity of menopause and abnormal uterine bleeding in predicting endometrial cancer was 75.0% and 71.9% respectively.The specificity was 39.1% and 24.5% respectively.【Conclusion】Menopause, abnormal uterine bleeding and endometrial thickness ≥ 7.760 mm were independent risk factors for endometrial cancer in patients receiving endocrine therapy after breast cancer surgery. 2021 Vol. 38 (3): 428-430 [Abstract] ( 52 ) HTML (1 KB)  PDF (1255 KB)  ( 72 ) 431 Analysis of Curative Effect and Prognosis of Benign Thyroid Tumor Resection by Transthoracic and Mammary Approach RUAN Ying-jun, ZHANG Wen-jun DOI: 10.3969/j.issn.1671-7171.2021.03.032 【Objective】 To investigate the therapeutic effect and prognosis of patients with benign thyroid tumor resection via transthoracic approach. 【Methods】A total of 90 patients with benign thyroid tumor treated in our hospital from November 2015 to December 2017 were retrospectively analyzed. They were divided into observation group and control group according to the treatment method, 45 cases in each group. The patients in the observation group were treated with transthoracic and mammary surgery, while the patients in the control group were treated with traditional open surgery. The operation related indexes, serum interleukin-6 (IL-6), tumor necrosis factor -α(TNF -α), visual analogue scale (VAS) and postoperative complications were compared between the two groups【Results】The intraoperative blood loss and postoperative drainage of the observation group were lower than those of the control group, with significant difference between the two groups ( P <0.05). The operation time and postoperative hospital stay of the observation group were shorter than those of the control group, while the hospitalization expenses and beauty score of the observation group were higher than those of the control group, and the differences between the two groups were statistically significant ( P <0.05). The expression of IL-6 and TNF -αin the two groups after operation were improved, while the improvement in the observation group was higher than that in the control group, and the difference was statistically significant ( P <0.05); the incidence of incision pain, hoarseness, subcutaneous effusion, postoperative bleeding and other complications in the observation group was lower than that in the control group, and the difference was statistically significant (8.89% vs 82.2%, χ2 = 48.7855, P <0.05).【Conclusion】Transthoracic and mammary surgery for benign thyroid tumor can effectively improve the serum IL-6 and TNF -αlevels, shorten the hospital stay, and effectively reduce the incidence of postoperative complications, which is worthy of clinical application. 2021 Vol. 38 (3): 431-433 [Abstract] ( 45 ) HTML (1 KB)  PDF (1172 KB)  ( 36 ) 434 Expression Level and Significance of Decorin in Serum of Patients with Idiopathic Pulmonary Fibrosis (IPF) FANG Li-ying, WU Lin DOI: 10.3969/j.issn.1671-7171.2021.03.033 【Objective】To investigate the relationship between serum decorin (DCN) level and prognosis in patients with idiopathic pulmonary fibrosis (IPF). 【Methods】A prospective selection of 87 IPF patients (the IPF group), 82 IIP patients (idiopathic interstitial pneumonia or non-IPF group) and 100 healthy subjects (the control group), who were treated in Guangdong Women and Children Hospital and the Fifth Affiliated Hospital of Guangzhou Medical University from March 2016 to March 2018, were selected as subjects. Serum DCN levels were measured in all three groups by ELISA and the relationship between serum DCN levels and prognosis in patients with IPF was analyzed. 【Results】Serum DCN level in the IPF group was lower than that in the non-IPF group and the control group ( q =6.975, 18.962, both P <0.05). There was a negative correlation between serum DCN level and high resolution CT (HRCT) scores in patients with IPF ( r =-0.524, P <0.001). Serum DCN level in patients with acute exacerbation of IPF (AE-IFP) was lower than that in stable disease of IPF (SD-IPF) patients ( t =7.806, P <0.001). Eighty-seven patients with IPF were followed up for 1 to 12 months. The result showed that 18 patients (20.68%) died. The mean survival time of the DCN high-level group (DCN≥7.51 mg/L) was higher than that of the DCN low-level group (DCN<7.51 mg/L), the difference was statistically significant ( χ2 =11.423, P <0.001). Cox univariate and multivariate analysis showed that HRCT scores and DCN levels were closely related to the prognosis of patients with IPF. 【Conclusion】Serum DCN levels can reflect the severity of disease in IPF patients and are closely related to the prognosis of patients with IPF. 2021 Vol. 38 (3): 434-436 [Abstract] ( 66 ) HTML (1 KB)  PDF (1188 KB)  ( 55 ) 437 Clinical significance of Screening and Identification of Human Rh (D) Blood Group Antigen Mimotopes ZHANG Qin DOI: 10.3969/j.issn.1671-7171.2021.03.034 【Objective】To investigate the clinical significance of screening and identification of mimic epitopes of human Rh (d) blood group antigen.【Methods】Anti Rh (d) monoclonal antibodies were used as solid phase screening molecules, and 35 of them were randomly selected for cloning. The positive clones were identified by phage enzyme-linked immunosorbent assay (ELISA) and cross test. The antigenicity of phage was analyzed by Western blot. 【Results】The results of DNA sequencing and competitive inhibition test showed that four of the 11 phages displayed foreign polypeptides had no common characteristics, which might be non-specific binding. All of the seven cloned amino acid sequences contained the same structure (-WP-Q-) of proline (P), tryptophan (W) and glutamic acid (Q), with an inhibition rate of more than 40%. Western blot analysis showed that the selected phage could be specifically recognized by anti Rh (D) serum, and its antigenicity was similar to that of Rh (D) protein. 【Conclusion】Using anti-Rh (D) monoclonal antibody to screen the phage random peptide library, the Rh (D) antigen mimotope with (-WP-Q-) structure can be obtained. 2021 Vol. 38 (3): 437-440 [Abstract] ( 84 ) HTML (1 KB)  PDF (1588 KB)  ( 100 )

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