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Quick Search     Adv Search 2021 Vol. 38, No. 9 Published: 2021-09-26   1285 Study on Optimized Pre-hospital Emergency Procedures on Patients with Severe Trauma DENG Sheng-lin, PENG Zhuo DOI: 10.3969/j.issn.1671-7171.2021.09.002 【Objective】To explore the optimization process and effects of pre-hospital first aid for patients with severe trauma. 【Methods】 A total of 60 patients with severe trauma received by the emergency department of our hospital from March 2019 to March 2021 were selected as the research objects (the observation group) and patients were treated with optimized first aid process. At the same time, 60 patients with severe trauma received from February 2017 to February 2019 were selected as the control group and received routine treatment procedure. The first aid receiving time, treatment success rate and complications of the two groups were compared . 【Results】The round-trip time from ambulance to pick-up, the staying time in the emergency room and the treatment time determined by the specialty in the observation group were less than those in the control group. There was significant difference between the two groups (P<0.05). The success rate of first aid in the observation group was higher than that in the control group, and the failure rate of first aid was lower than that in the control group. There was significant difference between the two groups (P<0.05). The incidence of complications in the observation group was lower than that in the control group, and there was significant difference between the two groups (P<0.05). 【Conclusion】The optimized process of pre-hospital first aid for patients with severe trauma can minimize the treatment time in the emergency room and the treatment time determined by the specialty, improve the efficiency and safety of emergency treatment, ensure patients to receive rapid and effective treatment, and reduce mortality. 2021 Vol. 38 (9): 1285-1287 [Abstract] ( 101 ) HTML (1 KB)  PDF (1119 KB)  ( 87 ) 1288 Effect of Shenqi Fuzheng Injection on Cardiac Toxicity Induced by Targeted Therapy for Her2-Positive Breast Cancer WANG Li, DUAN Wang-wang, WANG Song DOI: 10.3969/j.issn.1671-7171.2021.09.003 【Objective】To investigate the effect of Shenqi Fuzheng injection on prevention and treatment of cardiac toxicity induced by human epidermal growth factor receptor-2 (Her2) -positive breast cancer. 【Methods】A total of 80 cases of Her2-positive, estrogen and progesterone-negative breast cancer (ERBB2 + breast cancer) treated in our hospital were selected, and the patients were divided into two groups according to the random number table method. There were 40 cases in the observation group and 40 cases in the control group. Patients in the control group received trastuzumab combined with chemotherapy for injection, while patients in the observation group received Shenqi Fuzheng injection on the basis of the control group treatment. The Karnofsky score (KPS), myocardial enzymes [troponin I (cTnI) and creatine kinase isoenzyme (CK-MB)], left ventricular ejection fraction (LVEF) before and after chemotherapy, and the degree of side effects, ECG changes, and recurrence and metastasis were observed. 【Results】There were no significant differences in KPS, syndrome score, quality of life score, myocardial enzymes, and LVEF between the two groups before chemotherapy (all P> 0.05). At the end of chemotherapy, KPS, various quality of life scores, and LVEF in the observation group were higher than those of the control group and the syndrome score, cTnI, and CK-MB were lower than those of the control group; the differences were statistically significant (P<0.05). The proportion of grade 0 cardiac toxicity in the observation group (32 cases, 80.0%) was higher than that in the control group (21 cases, 52.5%, P<0.05). After chemotherapy, the rate of ECG change in the observation group (7.50%) was lower than that in the control group (27.50%) (P<0.05). There were no significant differences in the recurrence rate (12.50% vs. 12.50%), metastasis rate (5.00% vs. 7.50%), and mortality (10.00% vs. 7.50%) between the two groups after 2 years of follow-up (P>0.05). 【Conclusion】Shenqi Fuzheng Injection can reduce cardiac toxicity caused by targeted therapy of Her2-positive breast cancer and improve quality of life. 2021 Vol. 38 (9): 1288-1291 [Abstract] ( 61 ) HTML (1 KB)  PDF (1141 KB)  ( 136 ) 1292 Effects of Intravitreal Injection of Aflibercept Combined with Laser Photocoagulation on Visual Function and Prognosis of Patients with Diabetic Macular Edema LIU Zhen-tong, QIN Hong, TIAN Nan-nan DOI: 10.3969/j.issn.1671-7171.2021.09.004 【Objective】To explore the effects of intravitreal injection of aflibercept combined with laser photocoagulation on visual function and prognosis of patients with diabetic macular edema (DME). 【Methods】From June 2018 to December 2018, 86 patients with DME in our hospital were selected as the research objects and were divided into the control group and the observation group according to the random number table method, with 43 cases in each group. Control group was given intravitreal injection of ranibizumab while observation group was given intravitreal injection of aflibercept; and all patients in the two groups received laser photocoagulation after 1～2 weeks of intravitreal injection. The clinical efficacy and occurrence of adverse events were recorded in the two groups, and the central macular foveal thickness (CMT), intraocular pressure and visual acuity of different baseline vision [best corrected visual acuity (BCVA)] were compared between the two groups before treatment and after 4 weeks and 12 weeks of treatment. The quality of life [quality of life scale for patients with visual functional lesions (SQOL-DVI)] was evaluated before treatment and after 24 weeks of treatment. 【Results】The clinical efficacy in observation group was significantly higher than that in control group (P<0.05). There was no significant difference in the occurrence of adverse events between the two groups (P>0.05). The comparison of CMT before and after treatment in the two groups showed CMT before treatment> at 4 weeks of treatment> at 12 weeks of treatment (P<0.05). And at 4 and 12 weeks of treatment, the CMT in observation group was lower than that in control group (P<0.05). There was no statistically significant difference in the intraocular pressure between the two groups and within the groups at different time points before and after treatment (P>0.05). The comparison of BCVA before and after treatment in the two groups with better baseline vision showed BCVA before treatment> at 4 weeks of treatment> at 12 weeks of treatment (P<0.05). But there was no significant difference between the two groups (P>0.05). The comparison of BCVA before and after treatment in the two groups with poorer baseline vision showed BCVA before treatment> at 4 weeks of treatment> at 12 weeks of treatment (P<0.05). And at 4 weeks and 12 weeks of treatment, the BCVA in the observation group was lower than that in control group (P<0.05). After 24 weeks of treatment, the scores of dimensions of clinical symptoms and visual function, somatic function, social activity and psychophysiology of SQOL-DVI in the two groups were increased compared with those before treatment (P<0.05), and the scores in observation group were higher than those in control group (P<0.05) . 【Conclusion】Laser photocoagulation combined with intravitreal injection of aflibercept is more advantageous for the treatment of DME with poor baseline vision. It can effectively improve the visual function of patients and enhance the prognosis and quality of life, with few adverse reactions and high clinical application value. 2021 Vol. 38 (9): 1292-1295 [Abstract] ( 81 ) HTML (1 KB)  PDF (1150 KB)  ( 285 ) 1296 Meta-analysis of the Difference Between Invasive Blood Pressure and Non-invasive Blood Pressure Monitoring in Critically Children CHENG Ting, TIAN Xin-yi DOI: 10.3969/j.issn.1671-7171.2021.09.005 【Objective】To systematically evaluate the difference between invasive blood pressure and non-invasive blood pressure monitoring in critically ill children. 【Methods】We used online resources of PubMed, The Cochrane Library, EMbase, VlP, WanFang Data, CNKI database to search and collect clinical randomized controlled studies of invasive blood pressure and non-invasive blood pressure monitoring in critically ill children. The search time range was from January 1, 2000 to December 31, 2020. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies, and then used Revman5.3 software for Meta-analysis. 【Results】A total of 16 original documents were included. In all studies, case selection, inspection methods, reference standards, case procedures and progress showed that the overall quality of the literature was high. The results of Meta-analysis were as follows: systolic blood pressure's WMD=-0.32 mmHg, 95%CI=-0.59~-0.06, the difference was statistically significant (P<0.05), which indicated that the invasive method for systolic blood pressure was higher than the noninvasive method for critically ill children. On the other hand, diastolic blood pressure's WMD=0mmHg, 95%CI= -0.25~0.26, the difference was not statistically significant (P>0.05).The mean arterial pressure WMD=-0.16 mmHg, 95%CI=-0.40~0.09. The difference is not statistically significant (P>0.05).【Conclusion】Invasive blood pressure can reflect the blood pressure of critically ill children in a timely manner, but it need more samples and studies to confirm the result. 2021 Vol. 38 (9): 1296-1299 [Abstract] ( 80 ) HTML (1 KB)  PDF (2404 KB)  ( 92 ) 1300 Effect of Laparoscopic Assisted Radical Gastrectomy on Gastric Cancer and Risk Factors of Postoperative Complications YU Zhi-hui, WEI Hao-ru DOI: 10.3969/j.issn.1671-7171.2021.09.006 【Objective】To analyze the efficacy of laparoscopic assisted radical gastrectomy for gastric cancer and the risk factors of postoperative complications. 【Methods】236 patients with gastric cancer who underwent laparoscopic radical gastrectomy in our hospital from January 2013 to January 2018 were selected. According to the classification standard of postoperative complications of gastric cancer formulated by the Japanese Clinical Oncology Group (JCOG), grade Ⅱ, the above complications were defined as complications, and grade II and below were defined as no complications. The related risk factors of complications after laparoscopic assisted radical gastrectomy were analyzed, and the survival, tumor recurrence or metastasis were followed up and recorded. 【Results】 236 patients with gastric cancer successfully completed laparoscopic assisted radical gastrectomy. A total of 65 cases (27.5%) had postoperative complications, including 14 cases of gastric emptying disorder, 12 cases of intestinal anastomotic leakage, 10 cases of intestinal obstruction, 7 cases of unexplained fever, 5 cases of duodenal stump fistula, 5 cases of pulmonary infection, 4 cases of pancreatic fistula and biliary fistula, 3 cases of anemia, 2 cases of abdominal bleeding and 2 cases of anastomotic leakage, Lower extremity venous thrombosis in 1 case. Univariate analysis showed that complications after laparoscopic assisted radical gastrectomy were associated with age, hypertension, diabetes, digestive tract reconstruction, operative time and intraoperative blood loss/body weight (P<0.05). Multivariate analysis showed that patients older than 60 years old, hypertension, diabetes, Billroth Ⅱ anastomosis, operation time longer than 180 min and intraoperative blood loss/body weight equal to 5 mL/kg were independent risk factors for postoperative complications. The follow-up results showed that 105 patients survived without tumor, 40 patients had tumor recurrence and/or metastasis, 36 patients died related to gastric cancer, 2 patients died of cardiovascular and cerebrovascular diseases and 1 died of accident. 【Conclusion】Laparoscopic assisted radical gastrectomy is effective in the treatment of gastric cancer. The age more than 60 years old, preoperative hypertension, diabetes underlying diseases, long operation time, bleeding during operation and Billroth Ⅱ anastomosis are independent risk factors for postoperative complications. 2021 Vol. 38 (9): 1300-1303 [Abstract] ( 75 ) HTML (1 KB)  PDF (1146 KB)  ( 59 ) 1304 Correlation between Serum Uric Acid and Mild Gastroenteritis Complicated with Benign Convulsion WANG Zhe, YOU Jie-yu DOI: 10.3969/j.issn.1671-7171.2021.09.007 【Objective】 To investigate the correlation between serum uric acid and mild gastroenteritis with benign convulsion【 Methods】A total of 320 children with acute gastroenteritis (age) treated in Hunan children's Hospital from March 2020 to March 2021 was divided into mild gastroenteritis with benign convulsion (bice group,n=60) and simple age group (n=260); In addition, children with simple febrile convulsion (FC) treated in our hospital in the same period (FC group,n=60) were selected. The serum uric acid (SUA) levels of children in the three groups before treatment were compared, and the serum uric acid levels of children in the age group and the BICE group before and after treatment were compared under different degrees of dehydration. 【Results】 Before treatment, the SUA level in the BICE group was significantly higher than that in the FC group and the age group, and that in the age group was significantly higher than that in the FC group. There was significant difference among the three groups (F=8.713, P<0.05). Before treatment, the SUA level of children with severe dehydration in the age group was significantly higher than that of children with mild dehydration, moderate dehydration and no dehydration, children with moderate dehydration were higher than those with mild dehydration and no dehydration, and children with mild dehydration were higher than those without dehydration (P<0.05); There was no significant difference in SUA levels between the BICE groups with different degrees of dehydration (P>0.05); There was no significant difference in SUA level between the BICE group and the pre-treatment group (P>0.05); The SUA level of children without dehydration and mild dehydration in the BICE group was significantly higher than that in the age group, and the SUA level of children with severe dehydration was significantly lower than that in the age group (P<0.05); There was no significant difference in SUA level between the BICE group and the age group (P>0.05). 【Conclusion】 The results of this study show that the level of serum uric acid in children with BICE is significantly higher than that in children with age alone, and is not affected by the degree of dehydration. This specificity suggests that there is a correlation between serum uric acid and the occurrence of BICE. 2021 Vol. 38 (9): 1304-1306 [Abstract] ( 66 ) HTML (1 KB)  PDF (1123 KB)  ( 89 ) 1307 To Compare and Analyze the Clinical Effects and Indications of 43-A Tibial Fracture (AO Type) Treatment by Different Methods: Percutaneous Minimally Invasive Osteosynthesis, External Fixation and Expert Intramedullary Nail YU Hong-jin, YIN Xin-zhe DOI: 10.3969/j.issn.1671-7171.2021.09.008 【Objective】To compare and analyze the clinical effects and indications of 43-A tibial fracture (AO type) treatment by MIPPO (minimally invasive percutaneous plate osteosynthesis), external fixation and ETN (expert intramedullary nail). 【Methods】From April 2017 to October 2019, 128 patients with tibial fracture who were treated by operation in our hospital were selected as the research objects. According to the different treatment methods, they were divided into three groups: percutaneous minimally invasive plate (42 cases in group A), external fixation frame (43 cases in group B) and expert intramedullary nail fixation (43 cases in group C). The operation time, intraoperative hemorrhage, fracture healing time and hospitalization time were compared among the three groups. X-ray examination was performed at 1, 3 and 6 months after operation. The AOFAS score, the rate of excellent scoring function and the incidence of postoperative complications were compared among the three groups. 【Results】The bleeding volume and fracture healing time in group B were higher than those in group A and group C (P<0.05), and the operation time in group B was significantly lower than that in group A and group C (P<0.05); The excellent rate of scoring ankle function and AOFAS score in group B were significantly lower than those in group A and C (P<0.05); there was no statistical significance in the total incidence of complications among the three groups (P>0.05). 【Conclusion】Three kinds of surgical methods have certain therapeutic effect on the patients with AO 43-A tibial fracture. The first choice is internal fixation. For the patients who are not suitable for internal fixation, the distal cross nail is used to avoid external fixation across the ankle joint. 2021 Vol. 38 (9): 1307-1310 [Abstract] ( 54 ) HTML (1 KB)  PDF (1136 KB)  ( 106 ) 1311 Comparative Study of Anterior and Posterior Decompression, Reduction and Fusion in the Treatment of Lower Cervical Fracture with Spinal Cord Injury ZHAO Long-zhen, BIAN Yan DOI: 10.3969/j.issn.1671-7171.2021.09.009 【Objective】To compare the clinical effects of anterior and posterior cervical decompression, reduction and fusion in the treatment of lower cervical fracture with spinal cord injury. 【Methods】 A total of 62 patients with lower cervical fracture with spinal cord injury treated in our hospital from October 2013 to October 2018 was randomly divided into control group and observation group. The control group was treated with posterior decompression, reduction, fusion and internal fixation, and the observation group was treated with anterior decompression, reduction, fusion and internal fixation. The patients in both groups were followed up for one year. The operation time, intraoperative bleeding, wound diameter, hospital stay, vertebral reduction and neurological recovery were observed, and the incidence of complications during the follow-up were recorded. 【Results】 The patients in both groups were followed up for 1 year, and there was no loss of follow-up. The operation time, intraoperative bleeding, wound diameter and hospital stay in the observation group were less than those in the control group (P<0.05); At the last follow-up, the average Cobb angle and inter vertebral slip distance decreased and JOA score increased in the two groups. Compared with the control group, the average Cobb angle and inter vertebral slip distance decreased and JOA score increased more significantly in the observation group (P<0.05); The total incidence of complications in the observation group was lower than that in the control group (P<0.05). 【Conclusion】Anterior decompression, reduction, fusion and internal fixation in the treatment of lower cervical fracture with spinal cord injury can effectively improve the clinical effect and promote the recovery of cervical anatomical structure. 2021 Vol. 38 (9): 1311-1314 [Abstract] ( 58 ) HTML (1 KB)  PDF (1140 KB)  ( 96 ) 1315 Analysis of Phenylalanine Cut-off Value in Neonatal Phenylketonuria Screening in Shenzhen GUO Meng, WEN Wei, ZHAN Zi-jun, et al DOI: 10.3969/j.issn.1671-7171.2021.09.010 【Objective】To evaluate and adjust the cut-off value of phenylalanine (Phe) in neonatal phenylketonuria screening in Shenzhen by percentile method and ROC curve analysis.【Methods】A total of 559,496 newborns delivered in various hospitals in Shenzhen from January 2018 to December 2020 were selected. The Phe level was detected by fluorescence phenylalanine dehydrogenase method, the current Phe cut-off value was evaluated, and the best cut-off value of Phe level in Shenzhen was established. 【Results】 The Phe level of 559,496 newborns showed a skewed distribution, with a median of 1.06 mg/dL, a minimum of 0.01 mg/dL, a maximum of 24.55 mg/dL, a 95% quantile of 1.69 mg/dL, a 99% quantile of 1.96 mg/dL, a 99.5% quantile of 2.18 mg/dL and a 99.9% quantile of 2.73 mg/dL. 3,923 cases were reexamined with Phe level ≥2 mg/dL, including 3267 cases of screening positive recall. A total of 33 cases were finally diagnosed according to the diagnostic criteria. The sensitivity and specificity of 3,267 newborns at different cut-off values were finally adjusted from the current cut-off value of 2.0 mg/dL to 2.1 mg/dL; The area under ROC curve was 0.960, the standard error was 0.027, and the 95% confidence interval was 0.906~1.000, which was statistically significant (P<0.01). Finally, the current cut-off value of 2.0 mg/dL was adjusted to 2.1 mg/dL. 【Conclusion 】Combined with percentile method and ROC analysis, it is more appropriate to adjust the best cut-off value of Phe for neonatal PKU screening in Shenzhen to 2.1 mg/dL. 2021 Vol. 38 (9): 1315-1317 [Abstract] ( 46 ) HTML (1 KB)  PDF (1184 KB)  ( 70 ) 1318 Relationship of Plasma LPS Level with TNF-α, IL-6 and IL-8 in Patients undergoing Plasma Dialysis LEI Shui-juan, LIU YAN, LYU Jian-chun DOI: 10.3969/j.issn.1671-7171.2021.09.011 【Objective】To investigate the relationship of plasma bacterial lipopolysac-charide (LPS) level with tumor necrosis factor (TNF alpha), interleukin 6 (IL - 6) and interleukin 8 (IL - 8) in plasma dialysis patients. 【Methods】A total of 72 plasma dialysis patients admitted to our hospital from June 2018 to June 2020 were selected as blood dialysis group, in the same period, 42 healthy physical examination volunteers were selected as the control group. Levels of plasma LPS TNF-α, IL-6 and IL-8 were measured in patients of both groups. Pearson linear correlation analysis was used to analyze the relationship of LPS with TNF-α, IL-6 and IL-8 levels. 【Results】 Levels of LPS, TNF-alpha, IL-6 and IL-8 in the plasma dialysis group were significantly higher than those in the healthy control group (P<0.05). Pearson correlation analysis showed that LPS was positively correlated with TNF-α and IL-8 levels in plasma dialysis patients (P<0.05). There was no correlation between LPS and IL-6 in plasma dialysis patients (P>0.05). 【Conclusion】LPS, TNF-alpha and IL-8 levels in plasma dialysis patients were higher than those in normal subjects, and LPS level increases with levels of TNF-alpha and IL-8. 2021 Vol. 38 (9): 1318-1320 [Abstract] ( 62 ) HTML (1 KB)  PDF (1194 KB)  ( 21 ) 1321 Effect of Bushen Jianpi Antai Decoction Combined with Didroxyprogesterone Tablets on Maternal and Infant Outcome and Quality of Life in Elderly Threatened Abortion with Kidney Deficiency in Early Pregnancy ZHANG Yu-jie, QI Zhi-rong, ZHANG Xue-ying DOI: 10.3969/j.issn.1671-7171.2021.09.012 【Objective】To explore the effect of Bushen Jianpi Antai decoction combined with didroxyprogesterone tablets on maternal and infant outcome and quality of life in elderly threatened abortion with kidney deficiency in early pregnancy. 【Methods 】 A total of 114 elderly threatened abortion pregnant women with kidney deficiency diagnosed and treated in Beijing integrated traditional Chinese and Western medicine hospital from February 2018 to November 2019 was randomly divided into control group and observation group, with 57 cases in each group. The control group was treated with didroxyprogesterone tablets, and the observation group was treated with Bushen Jianpi Antai Decoction on the basis of the control group. The curative effects, hormone levels, maternal and infant outcomes and quality of life of the two groups were compared. 【Results】The total effective rate in the observation group was 89.47% (51/57), which was significantly higher than 70.18% (40/57) in the control group(χ2=6.591,P=0.01). Before treatment, there was no significant difference in E2, HCG and P levels between the two groups (P>0.05); After treatment, the levels of E2, HCG and P in the observation group were significantly higher than those in the control group (P<0.05). The full-term pregnancy rate in the observation group was significantly higher than that in the control group (P<0.05); However, there was no significant difference in preterm birth rate and abortion rate between the two groups (P>0.05). After treatment, the scores of mental health, emotional role, physical function, social function, health status, vitality, body pain and physical role in the observation group were significantly higher than those in the control group (P<0.05). 【Conclusion 】 Bushen Jianpi Antai decoction combined with didroxyprogesterone tablets can significantly alleviate the clinical symptoms of elderly threatened abortion pregnant women with kidney deficiency in early pregnancy, tonify the kidney and spleen, nourish blood and Qi, and improve the hormone level, full-term productivity and quality of life of patients. It is worthy of clinical application. 2021 Vol. 38 (9): 1321-1323 [Abstract] ( 41 ) HTML (1 KB)  PDF (1120 KB)  ( 67 ) 1324 Effect of p53 Expression on Prognosis in Triple Negative Breast Cancer YANG Xi-jia, LIU Qi DOI: 10.3969/j.issn.1671-7171.2021.09.013 【Objective】To explore the expression of p53 in triple-negative breast cancer and its relationship with prognosis. 【Methods】A total of 79 patients with operable triple-negative breast cancer treated in our hospital were selected. Fresh cancer tissues and adjacent tissues were collected during operation, and p53 expression was detected by immunohistochemistry. The patients were followed up to observe the recurrence, metastasis and overall survival (OS). The relationship of p53 expression with recurrence, metastasis and OS was analyzed. 【Results】The positive expression rate of p53 (40.51%) in triple-negative breast cancer was higher than that in adjacent tissues (11.39%), and the difference was statistically significant(P<0.05).The proportion of N3 and grade Ⅲ in p53 high expression group was higher than that in p53 low expression group (both P<0.05). The follow-up time was 36-60 (49.6 ± 4.9) months. A total of 70 patients were followed up and 9 were lost to follow-up. A total of 17 patients relapsed. Of which, the recurrence rate in the p53 high expression group was significantly higher than that in the p53 low expression group, and the difference was statistically significant(P<0.05). A total of 11 patients had metastasis. The metastasis rate in the p53 high expression group (32.14%) was significantly higher than that in the p53 low expression group, and the difference was statistically significant(P<0.05). During the follow-up period, 17 patients died. Kaplan-Meier method and Log-rank test results showed that patients with triple-negative breast cancer plus high expression of p53 had shorter OS than those patients with triple-negative breast cancer plus low expression of p53 (P<0.05). Multivariate COX results showed that tumor size (T), lymph node stage (N), p53 expression, and histological grade were independent prognostic factors affecting the death of triple-negative breast cancer patients (P<0.05). 【Conclusion】The p53 expression is up-regulated in triple negative breast cancer, and patients with high p53 expression have a poor prognosis and high risk of recurrence, metastasis, and death. 2021 Vol. 38 (9): 1324-1327 [Abstract] ( 60 ) HTML (1 KB)  PDF (1423 KB)  ( 36 ) 1328 Study on the Relationship between Serum ZAG Level and Lipid Metabolism Indexes in Elderly Patients with Type 2 Diabetes LIAN Ping, FU Peng, ZHAO Xiu-min, et al DOI: 10.3969/j.issn.1671-7171.2021.09.014 【Objective】To study the relationship between serum zinc α2 glycoprotein (ZAG) level and lipid metabolism indexes in elderly patients with type 2 diabetes (T2DM). 【Methods】A total of 75 elderly patients with type 2 diabetes who were admitted to our hospital from January 2018 to January 2021 were selected as the observation group, and 80 volunteers in the healthy physical examination during the same period were selected as the control group. Statistics of age, gender, ZAG level, ambulatory blood pressure [24-hour average systolic blood pressure (24hSBP), 24-hour average diastolic blood pressure (24hDBP)] and other general data were collected between the two groups. After 2 hours of blood glucose (2hPG), glycosylated hemoglobin (HbA1C), fasting insulin (FINS)] levels and blood lipid indicators [total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), Low-density lipoprotein cholesterol (LDL-C)] levels were recorded to analyze the correlation between serum ZAG levels and lipid metabolism indicators in elderly patients with type 2 diabetes. 【Results】There was no significant difference in age, gender, BMI index, 24hSBP, and 24hDBP between the two groups (P>0.05). The ZAG level of the observation group was lower than that of the control group (P<0.05). The levels of FBG, 2hBG, HbA1C, FINS,TG and LDL-C in the observation group were higher than those in the control group (P<0.05), while the level of HDL-C was lower than that in the control group (P<0.05). There was no significant difference in TC levels between the two groups (P>0.05). According to Pearson's test, ZAG level in elderly patients with type 2 diabetes was negatively correlated with TG and LDL-C levels (P<0.05), and positively correlated with HDL-C level (P<0.05). 【Conclusion】ZAG levels in elderly diabetic patients are closely related to lipid metabolism disorders, indicating ZAG may participate in the regulation of lipid metabolism in type 2 diabetes. 2021 Vol. 38 (9): 1328-1330 [Abstract] ( 51 ) HTML (1 KB)  PDF (1123 KB)  ( 43 ) 1331 Comparative Study on the Influence of Postoperative Chronic Pain of Three Types of Adult Inguinal Hernia Surgery and their Effects on the Operation Area ZOU Yong-hong, TIAN Rui-xue DOI: 10.3969/j.issn.1671-7171.2021.09.015 【Objective】 To compare the efficacy of laparoscopic transperitoneal preperitoneal hernia repair (TAPP), laparoscopic total extraperitoneal patch repair (TEP) and Lichtenstein repair (LI) in the treatment of adult inguinal hernia and the effect of operation on postoperative chronic pain. 【Methods】 The clinical data of 297 patients with inguinal hernia who underwent surgery for the first time in our hospital from January 2015 to January 2019 were analyzed retrospectively, and the clinical effects of the three groups were compared. 【Results】 Among the 297 patients in this study, there were 110 in the LI group, 127 in the TAPP group and 60 in the TEP group. There was no significant difference in preoperative general conditions among the three groups. There was no significant difference in operation time, intraoperative bleeding and the first time out of bed after operation among the three groups. The postoperative hospital stay in the LI group was significantly longer than that in the TAPP group and the TEP group (P=0.032). The postoperative time of incision fat liquefaction (P=0.047) and the incidence of chronic pain in the operation area (P=0.045) were significantly higher than those in the TAPP group and the TEP group. 【Conclusion】Compared with the traditional open operation, TAPP and TEP hernia repair are effective methods for the treatment of adult inguinal hernia. They have fast postoperative recovery and less incidence of chronic pain in the postoperative area, which is worthy of clinical application. 2021 Vol. 38 (9): 1331-1333 [Abstract] ( 51 ) HTML (1 KB)  PDF (1115 KB)  ( 59 ) 1334 Study on Chinese Medicine Way of Hefa (Harmonic Herbs) in the Treatment of Menopausal Syndrome after Endocrine Therapy of Breast Cancer WU Xiao-mei, LUO He-ting, LIU Mi-hua, et al DOI: 10.3969/j.issn.1671-7171.2021.09.016 【Objective】To explore the clinical effects of treating postmenopausal syndrome after endocrine therapy of breast cancer with Chinese medicine way of Hefa (harmonic herbs). 【Methods】A total of 78 patients with menopausal syndrome after endocrine therapy of breast cancer from January 2018 to January 2020 in our hospital were selected for the study. All patients were divided into the observation group and the control group by random number table method, with 39 cases respectively. The control group was treated with endocrine drugs, oryzanol tablets and vitamin B1 at the same time. The observation group was treated with traditional Chinese medicine way of Hefa (harmonic herbs) on the basis of the control group. The clinical efficacy, TCM syndrome score, serum sex hormones [estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH)], tumor markers [carbohydrate antigen 15-3 (CA15-3), carbohydrate antigen 125 (CA125)] were compared between the two groups before and after treatment. 【Results】The total effective rate of the observation group was 92.31%, which was significantly higher than 74.36% of the control group (P<0.05).There was no significant difference in TCM syndrome score between the two groups before treatment (P>0.05). After treatment, the scores of menstrual disorder, hot flashes and sweating, emotional changes, dizziness and tinnitus, waist and knee soreness, palpitation and insomnia in the observation group were significantly lower than those before treatment and after treatment in the control group, and the difference was statistically significant (P<0.05).There were no significant differences in the levels of E2, LH, FSH, CA15-3 and CA125 between and within the two groups before and after treatment (P>0.05). 【Conclusion】After endocrine therapy of breast cancer, patients with menopausal like syndrome can be treated with traditional Chinese medicine way of Hefa (harmony) to significantly relieve the clinical symptoms of patients without significant impact on sex hormones and tumor markers. 2021 Vol. 38 (9): 1334-1337 [Abstract] ( 56 ) HTML (1 KB)  PDF (1143 KB)  ( 94 ) 1338 Expression Levels and Significance of GnSAF, LEP and APN in Peripheral Blood of Polycystic Ovarian Syndrome ZHANG Ping, WANG Kun DOI: 10.3969/j.issn.1671-7171.2021.09.017 【Objective】To explore the expression levels and significance of gonadotropin surge-attenuating factor (GnSAF), leptin (LEP) and adiponectin (APN) in the peripheral blood of polycystic ovarian syndrome (PCOS). 【Methods】A total of 121 patients with PCOS who were treated in our hospital from January 2017 to June 2019 (the observation group) and 60 female patients with non-PCOS infertility diagnosed due to fallopian tube factor, male factor or immune factor during the same time period (the control group) were selected as the study subjects. The clinical data were collected, and the levels of peripheral blood GnSAF, LEP and APN, ovulation induction and pregnancy outcomes were compared between the two groups. According to the pregnancy outcomes after follow-up, the patients in the observation group were divided into the pregnancy success subgroup and pregnancy failure subgroup. The levels of peripheral blood GnSAF, LEP and APN were compared between different pregnancy outcome subgroups. The receiver operating characteristic (ROC) curve was used to evaluate the differential diagnostic value (alone and combination) of peripheral blood GnSAF, LEP and APN for patients with PCOS and with non-PCOS infertility and predict the pregnancy outcomes of patients with PCOS. 【Results】The levels of luteinizing hormone (LH), testosterone (T), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), body mass index (BMI), GnSAF and LEP in observation group were significantly higher than those in control group (P<0.05), while the APN level, ovulation rate and clinical pregnancy rate were significantly lower than those in control group (P<0.05). However, there were no statistically significant differences in the follicle stimulating hormone (FSH), fasting blood glucose (FPG), waist-hip ratio (WHR), miscarriage rate and multiple birth rate between the two groups (P>0.05). ROC curve showed that the single detection and combined detection of levels of peripheral blood GnSAF, LEP and APN could be used as differential efficacy indexes for patients with PCOS and patients with non-PCOS infertility, and could be used as efficacy indicators in predicting pregnancy outcomes in patients with PCOS (all P<0.05). The levels of peripheral blood GnSAF and LEP in pregnancy success subgroup were lower than those in pregnancy failure subgroup (P<0.05), while the APN level was higher than that in pregnancy failure subgroup (P<0.05). 【Conclusion】Peripheral blood GnSAF, LEP and APN may be involved in the pathogenesis of PCOS, and can be used as important indicators for the early clinical identification of causes for infertility and prediction of pregnancy outcomes with certain clinical significance. 2021 Vol. 38 (9): 1338-1341 [Abstract] ( 58 ) HTML (1 KB)  PDF (1145 KB)  ( 29 ) 1342 Correlation between Rotavirus Gastroenteritis and Atmospheric Environment in Children under 5 Years Old in Xi'an SHI Jian-fei, NING Yuan-zheng, LI Qiao, et al DOI: 10.3969/j.issn.1671-7171.2021.09.018 【Objective】 To explore the correlation between rotavirus (RV) infectious diarrhea and atmospheric environment in children under 5 years old in Xi'an. 【Methods】The clinical data of hospitalized children with positive stool routine RV and/or adenovirus (AV) in Xi'an children's Hospital from January 2017 to January 2019 were analyzed retrospectively, and the Stool RV and adenovirus detection of children in Xi'an from 2017 to 2019 were analyzed, The monthly air data were obtained from Xi'an ecological environment bureau to statistically analyze the correlation between air pollutant particles and RV and AV infection in children. 【Results】There were more males than females in children with positive RV test in Xi'an. The age was mainly under 3 years old, most of them were 1~3 years old. Neonatal RV infection showed an upward trend, as shown in Table 1. AV positive children aged 1~3 years were the most common, showing an upward trend. The monthly concentrations of NO2, PM10, SO2 and PM2.5 in Xi'an were significantly positively correlated with RV infection in hospitalized children every month (Mean P<0.05). 【Conclusion 】RV infection is mainly found in children under 3 years old in Xi'an. Air pollution particles may aggravate the occurrence of RV infectious diarrhea. 2021 Vol. 38 (9): 1342-1345 [Abstract] ( 55 ) HTML (1 KB)  PDF (2018 KB)  ( 63 ) 1346 Study on the Expression of Pregnancy-associated Protein-A and Vascular Endothelial Growth Factor in Decidual Tissues of Embryonic Cessation and Their Relationship with Ultrasound Blood Flow Parameters of Uterus WANG Xiao-mei DOI: 10.3969/j.issn.1671-7171.2021.09.019 【Objective】To investigate the expression of pregnancy-associated protein-A (PAPP-A) and vascular endothelial growth factor (VEGF) in the decidual tissues of embryonic cessation and explore their correlation with ultrasound blood flow parameters . 【Methods】A total of 195 embryos, who were discontinued from the family planning clinic from November 2017 to February 2021 in the hospital and treated with abortion, were selected as the observation group. During the same period, 180 normal pregnant women who had induced abortion due to personal reasons were selected as the control group. Obtain the stripped decidual tissues of the two groups of pregnant women and measure the expression levels of PAPP-A and VEGF in the stripped tissues. Simultaneously, the uterine ultrasound blood flow parameters in the two groups of pregnant women were measured, including the pulsation index (PI), resistance index (RI), and systole. Ratio of maximum blood flow velocity to end-diastolic blood flow velocity (S/D). The expression levels of PAPP-A and VEGF in the two groups of decidual tissues and the changes in the parameters of uterine ultrasound blood flow in the two groups were compared And the correlation in between were analyzed. 【Results】 The expression levels of PAPP-A and VEGF proteins in the decidual tissue of the observation group were significantly lower than those of the control group (P<0.05). The uterine ultrasound blood flow parameters RI, PI, and S/D on the dominant and non-dominant sides in the observation group were significantly higher than those in the control group (P<0.05). Pearson correlation analysis showed that PAPP-A was positively correlated with VEGF expression level in the decidual tissues of patients with embryonic termination (r=0.824, P<0.05). It also showed that both PAPP-A and VEGF were negatively correlated with uterine ultrasound blood flow parameters RI, PI, and S/D (P<0.05). 【Conclusion】PAPP-A and VEGF in the decidual tissues of embryonic cessation patients can change the uterine hemodynamics and control the development of uterine hemorrhage by controlling angiogenesis. 2021 Vol. 38 (9): 1346-1348 [Abstract] ( 41 ) HTML (1 KB)  PDF (1119 KB)  ( 29 ) 1349 Occurrence and Influencing Factors of Ulnar Nerve Dysfunction in Patients with Humeral Intercondylar Fracture Undergoing Open Reduction and Internal Fixation YAN Wei-jing, CAO Hui-chao DOI: 10.3969/j.issn.1671-7171.2021.09.020 【Objective】 To explore the influencing factors of ulnar nerve dysfunction after open reduction and internal fixation of intercondylar fracture of humerus. 【Methods】 The clinical data of 60 patients with humeral intercondylar fractures treated in our hospital from January 2017 to December 2019 were analyzed retrospectively. The age, gender, fracture classification, surgical approach, ulnar nerve treatment and other intraoperative related factors were recorded, and the patients were followed up. According to whether there was ulnar nerve dysfunction after operation, the patients were divided into asymptomatic group (control group) and symptomatic group (observation group). The risk factors of ulnar nerve dysfunction were analyzed by univariate analysis and multivariate logistic regression analysis. 【Results】 There were significant differences in surgical approach, ulnar nerve treatment and plate placement between the two groups (P<0.05); Multivariate logistic regression analysis showed that the bilateral approach of triceps brachii, anterior ulnar nerve and parallel plate were independent risk factors for postoperative neurological dysfunction (OR=1.992, 2.643, 2.282, P<0.05). 【Conclusion】 The incidence of ulnar nerve dysfunction after open reduction and internal fixation of intercondylar fracture of humerus is high. Bilateral approach of triceps brachii, anterior ulnar nerve and parallel placement of steel plate are independent risk factors of ulnar nerve dysfunction. Clinically, doctors should choose the appropriate surgical approach, plate placement and whether the ulnar nerve is in front according to the individual differences of patients, so as to minimize the occurrence of postoperative ulnar nerve dysfunction. 2021 Vol. 38 (9): 1349-1352 [Abstract] ( 35 ) HTML (1 KB)  PDF (1135 KB)  ( 56 ) 1353 Effect of Rilaluptide Combined with Calcium Dobesilate on Inflammation and Hemodynamics in Patients with Non-proliferative Type 2 Diabetic Retinopathy SHAO Jin-hua, QU Lai-qiang DOI: 10.3969/j.issn.1671-7171.2021.09.021 【Objective】To investigate the effect of rilaluptide combined with calcium dobesilate on inflammation and hemodynamics in patients with non-proliferative type 2 diabetic retinopathy. 【Methods】Seventy-six patients with non-proliferative type 2 diabetic retinopathy admitted to Xi'an Fifth Hospital from August 2017 to August 2019 were randomly divided into the observation group and the control group (with 38 cases each). The control group was treated with calcium dobesilate, while the observation group was treated with liraglutide combined with calcium dobesilate. The changes of macular retinal thickness, hemorheology index and blood lipids metabolism before and after treatment were compared between the two groups. 【Results】The total effective rate of the observation group was higher than that of the control group (92.11% vs 68.42%) (P<0.05). After treatment, the levels of hemorheology indexes were lower than before treatment. The whole blood low shear viscosity, whole blood high shear viscosity and plasma viscosity of the observation group were significantly lower than those of the control group (P<0.05).The retinal thickness of the macular area was significantly reduced after treatment. The retinal thickness of the macular area in the observation group was significantly lower than in the control group (P<0.05). 【Conclusion】The clinical effect of rilaluptide combined with calcium dobesilate in the treatment of non-proliferative type 2 diabetes has advantage, which can effectively alleviate the deterioration of the disease, reduce the damage of inflammatory factors and improve hemodynamics. 2021 Vol. 38 (9): 1353-1355 [Abstract] ( 54 ) HTML (1 KB)  PDF (1117 KB)  ( 43 ) 1356 Effect of Hyperbaric Oxygen on Neurological Function in Rats with Cerebral Ischemia-Reperfusion ZHANG Wei-jing, ZHAO Bin, LIU Xia, et al DOI: 10.3969/j.issn.1671-7171.2021.09.022 【Objective】To investigate the effect of hyperbaric oxygen on neural function in rats with cerebral ischemia-reperfusion. 【Methods】A total of 60 Wistar rats was randomly divided into 3 groups: sham operation group, model group and experimental group, with 20 rats in each group. The rats in the sham operation group were only operated without ischemia. The rats in the model group were directly subjected to middle cerebral artery ischemia-reperfusion. The rats in the experimental group were subjected to high-pressure preconditioning and then subjected to middle cerebral artery ischemia-reperfusion. The neurological deficit score, cerebral infarct volume and neuronal apoptosis index (AI) of ischemic lesions in the three groups were compared 24 hours after reperfusion, The activities of superoxide dismutase (SOD), lactate dehydrogenase (LDH), malondialdehyde (MDA) and nitric oxide (NO) in brain tissue changed. 【Results】 The brain tissue in the sham operation group was not damaged, and the neurological deficit score and the proportion of cerebral infarction volume were 0. The brain tissue in the model group and the experimental group was damaged, and the neurological deficit score, cerebral infarction volume and AI were increased, but the injury in the experimental group was mild, and the data were lower than those in the model group (P<0.05); There were significant differences in the activities of SOD and LDH and the contents of MDA and NO in the brain tissue of the three groups 24 hours after reperfusion (P<0.05). The activities of SOD and LDH in the model group were lower than those in the sham operation group (P<0.05), but the activities of SOD and LDH in the experimental group were higher than those in the model group (P<0.05). The activities of MDA and NO in the model group were higher than those in the sham operation group (P<0.05), but the activities of MDA and NO in the experimental group were lower than those in the model group (P<0.05). 【Conclusion】 Hyperbaric oxygen can inhibit cerebral ischemia-reperfusion injury in rats by improving oxidative stress injury in brain tissue. 2021 Vol. 38 (9): 1356-1360 [Abstract] ( 51 ) HTML (1 KB)  PDF (1413 KB)  ( 76 ) 1361 Evaluation on the Application of TEG in Blood Transfusion in Patients with Traumatic Hemorrhagic Shock DAI Si-yuan, GU Lan DOI: 10.3969/j.issn.1671-7171.2021.09.023 【Objective】To explore the significance of thromboelastography (TEG) in blood transfusion of patients with traumatic hemorrhagic shock.【Methods】A total of 104 Patients with traumatic hemorrhagic shock treated in our hospital from January 2018 to December 2020 were selected. Among them, 52 cases in the control group did not undergo TEG examination before receiving blood transfusion, while 52 cases in the observation group received blood transfusion under the guidance of TEG. The coagulation function tests such as activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen (FIB), the TEG test results ( R value, K value, α angle and MA value) before and after blood transfusion, the amount of blood component infusion and the prognosis of the two groups were compared.【Results】The levels of APTT, PT, TT after blood transfusion in the two groups were lower than that before blood transfusion (P<0.05), while the FIB level was higher (P<0.05). After blood transfusion, the levels of APTT, PT, and TT in the observation group were lower than those in the control group (P<0.05), and the FIB level in the observation group was higher than that in the control group (P<0.05). In the observation group, the R value and K value after blood transfusion were lower than before (P<0.05), and α angle and MA value were increased (P<0.05). The amount of RBCs and plasma in the observation group was lower than that of the control group, while the amount of cryoprecipitate and platelets was higher than that in the control group (P<0.05).【Conclusion】TEG can provide a reasonable strategy for blood transfusion in patients with traumatic hemorrhagic shock by improving blood coagulation function more effectively, which has great clinical value. 2021 Vol. 38 (9): 1361-1363 [Abstract] ( 49 ) HTML (1 KB)  PDF (1117 KB)  ( 23 ) 1364 Correlation between MPO Expression and Prognosis of Acute Myeloid Leukemia CHANG Yuan-yuan, YANG Ya-feng DOI: 10.3969/j.issn.1671-7171.2021.09.024 【Objective】To investigate the relationship of the level of myeloperoxidase (MPO) expression with the efficacy and prognosis of patients with acute myeloid leukemia.【Methods】A total of 60 patients with acute myeloid leukemia treated in our hospital were recruited in the study. The expression of MPO in the bone marrow of patients was determined. The patients were divided into MPO low expression group (the rate of antigen expression <70%, 35 cases) and the MPO high expression group (the rate of antigen expression ≥70%, 25 cases). Patients were followed up. The efficacy, overall survival (OS) and progression-free survival (PFS) of the two groups were compared, and the influencing factors of OS and PFS were analyzed. 【Results】The first CR induction rate in the MPO high expression group was 52.0% (13/25), which was significantly higher than the first CR induction rate in the MPO low expression group (25.71%, 9/35). The difference was statistically significant( P<0.05). The final CR rate in the MPO high expression group was significantly higher than that in the MPO low expression group, and the difference was statistically significant (P<0.05). The ROC results show that the area under the MPO prediction death and disease progression curves was 0.75 and 0.71. Kaplan-Meier method and Log-rank test showed that the cumulative OS and PFS rates of MPO low expression group were lower than those of MPO high expression group, the difference was statistically significant (P<0.05). COX multivariate analysis showed that NCCN risk stratification, MPO expression, first induction of CR were independent influencing factor of OS (P<0.05), and age, MPO expression, and first induction of CR were independent influencing factors of PFS (P<0.05). 【Conclusion】The acute CR rate and final CR rate of patients with acute myeloid leukemia with low expression of MPO are lower, OS and PFS are shortened. The expression level of MPO can effectively predict the efficacy and prognosis of acute myeloid leukemia. 2021 Vol. 38 (9): 1364-1367 [Abstract] ( 59 ) HTML (1 KB)  PDF (1347 KB)  ( 19 ) 1368 Correlation of Child-Pugh Classification in Patients with Hepatitis B Cirrhosis with Serum Levels of Costimulatory Molecules B7 Family 3 and Phosphotyrosine Adaptor Protein 1 ZHANG Tao, ZHANG Wen-rui DOI: 10.3969/j.issn.1671-7171.2021.09.025 【Objective】To investigate the relationship of Child-Pugh classification of patients with hepatitis B cirrhosis with serum levels of costimulatory molecules B7 family 3 (B7-H3) and phosphotyrosine adaptor protein 1 (APPL1) . 【Methods】A total of 78 patients with hepatitis B cirrhosis in our hospital from December 2019 to November 2020 were selected as the observation group, and 70 healthy volunteers were selected as the control group. The serum levels of B7-H3, APPL1, CHE, TG, and total cholesterol (TCHO) in the two groups were detected, and the related influencing factors of hepatitis B cirrhosis were analyzed. The serum levels of B7-H3 and APPL1 in the observation group with different Child-Pugh grades were compared, and the correlation of Child-Pugh grades with serum levels of B7-H3 and APPL1was analyzed. 【Results】The incidence of drinking history, malnutrition, and cholestasis in the observation group was significantly higher than that of the control group. The serum levels of B7-H3 and APPL1 in the observation group were higher than those in the control group, while the levels of CHE, TG and TCHO in the observation group were lower than those in the control group (P<0.05). Logistic regression analysis showed that drinking history, malnutrition, cholestasis, CHE, TG, TCHO, APPL1 and B7-H3 were influencing factors of hepatitis B-induced cirrhosis (P<0.05). In the observation group, serum APPL1 and B7-H3 levels of Child-Pugh grade A patients were lower than those of grade B patients, while grade B patients were lower than grade C patients; and the differences were statistically significant (P<0.05). Spearman correlation analysis showed that Child-Pugh classification was significantly positively correlated with serum levels of B7-H3 and APPL1 (r=0.573, 0.690, both P<0.05).【Conclusion】Serum levels of B7-H3 and APPL1 are positively correlated with Child-Pugh grade in patients with hepatitis B cirrhosis. Dynamic monitoring of B7-H3 and APPL1 levels has a positive effect on clinical evaluation of patients' disease progress and development of targeted treatment plan, which is worthy of clinical application. 2021 Vol. 38 (9): 1368-1370 [Abstract] ( 31 ) HTML (1 KB)  PDF (1124 KB)  ( 26 ) 1371 Correlation between Serum Galectin 3 Level and Recurrence after Radiofrequency Ablation in Patients with Atrial Fibrillation ZHOU Na, CHEN Jun-min DOI: 10.3969/j.issn.1671-7171.2021.09.026 【Objective】 To investigate the correlation between galectin-3 (Gal-3) and recurrence after radiofrequency ablation in patients with atrial fibrillation.【Methods】The clinical data of 90 patients with atrial fibrillation treated by radiofrequency ablation in the Department of Cardiology of our hospital from June 2016 to June 2018 were selected. They were divided into recurrence group (n=27) and non recurrence group (n=63) according to whether they relapsed after operation. The concentration of serum Gal-3 was detected by sandwich enzyme-linked immunosorbent fluorescence method, and the effect of serum Gal-3 level on the recurrence of atrial fibrillation after ablation was analyzed by Cox regression model.【Results】Among the 90 patients with atrial fibrillation, 48 patients (53.3%) had persistent atrial fibrillation, and 24.4% had CHA2DS2 -VASC score>2. Warfarin was the main anticoagulant (60.0%). There were significant differences in age, type of atrial fibrillation, CHA2DS2-VASC score, left atrial diameter (LAD), serum amino terminal B-type pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP) and Gal-3 between recurrent group and non recurrent group (P<0.05). Univariate Cox regression analysis showed that age, LAD, persistent atrial fibrillation and the levels of serum Gal-3 and hs-CRP were the risk factors for postoperative recurrence of atrial fibrillation (P<0.05). Multivariate Cox regression analysis showed that persistent atrial fibrillation, LAD and serum Gal-3 and hs-CRP levels were independent risk factors for recurrence after RFCA in patients with atrial fibrillation (P<0.05).【Conclusion】The level of serum Gal-3 is an independent risk factor for recurrence after RFCA in patients with atrial fibrillation. 2021 Vol. 38 (9): 1371-1374 [Abstract] ( 43 ) HTML (1 KB)  PDF (1145 KB)  ( 38 ) 1375 Clinical Value of Thromboelastography in Acute Cerebrovascular Disease Patients WEI Xiao-qiang, LI Dan-jie DOI: 10.3969/j.issn.1671-7171.2021.09.027 【Objective】To explore the changes and clinical value of thromboelastography in acute cerebrovascular disease patients. 【Methods】A total of 146 patients with acute cerebrovascular disease (73 patients with acute cerebral hemorrhage and 73 patients with acute cerebral infarction) treated in our hospital were collected in this study. All of them received CT scanning after admission to evaluate the volume of cerebral hemorrhage and area of cerebral infarction. Venous bloods were collected to detect level of TEG [coagulation reaction time (R), blood formation time (K), angle, maximum amplitude (MA) and coagulation index (CI)] to compare the difference between two groups and analyze the relationship of TEG indexes with the amount of cerebral hemorrhage and area of cerebral infarction. Meanwhile, the value of TEG to distinguish the two types of acute cerebrovascular disease was identified by using receiver operating characteristic (ROC) curve. 【Results】 (1) the K time and R time of the cerebral hemorrhage group were higher than those of the cerebral infarction group, while angle and CI levels were lower than those in the cerebral infarction group (P<0.01). (2) Compared to cerebral hemorrhage 30 mL, patients with cerebral hemorrhage 30 mL had shorter K time, while they had higher value of MA and angle; Compared to patients with small and medium-sized cerebral infarction, patients with large-area cerebral infarction had lower R time and higher value of MA and angle (P<0.01). (3) The ROC curve found that the value of K-time, R-time, angle and CI for diagnosis of cerebral hemorrhage were 0.73(0.64-0.81), 0.82(0.75-0.89), 0.76(0.68-0.84) and 0.65 (0.60-0.74),respectively; and all p values were less than 0.05. 【Conclusion】The level of TEG in acute cerebral hemorrhage and acute cerebral infarction was significantly different. It can be used as an index to identify acute cerebral hemorrhage and infarction, which had a relationship with the status of acute cerebrovascular disease. 2021 Vol. 38 (9): 1375-1377 [Abstract] ( 54 ) HTML (1 KB)  PDF (1267 KB)  ( 51 ) 1378 Short and Long Term Effects of Transcatheter Arterial Chemoembolization Combined with Portal Vein 125 Iodine Seed Implantation in the Treatment of Liver Cancer Complicated with Portal Vein Tumor Thrombus ZHAO Yong-hua, BAI Xue-mei, LIU Ya-min, et al DOI: 10.3969/j.issn.1671-7171.2021.09.028 【Objective】To investigate the short-term and long-term effect and safety of transcatheter arterial chemoembolization (TACE) combined with portal vein 125 iodine (125I) seed implantation in the treatment of liver cancer complicated with portal vein tumor thrombus (PVTT). 【Methods】 A total of 90 patients with liver cancer complicated with PVTT was randomly divided into control group and observation group. The control group was treated with TACE, and the observation group was treated with TACE combined with portal vein 125I seed implantation. The serological indexes, recurrence rate, survival rate, progression free survival time (PFS) and overall survival time (OS) were compared between the two groups before and after treatment. The short-term efficacy of primary liver tumor and PVTT and the incidence of adverse reactions during treatment were compared between the two groups. 【Results】(1) the remission rate of primary tumor and PVTT in the observation group were significantly higher than those in the control group (P<0.05). (2) After treatment, the serum levels of alpha fetoprotein (AFP) and carcinoembryonic antigen (CEA) in the observation group were lower than those in the control group, and the levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) in the observation group were higher than those in the control group (P<0.05). (3) The 1-year recurrence rate in the observation group was lower than that in the control group (22.2% vs 28.9%, P<0.05), and the 1, 2 and 3-year cumulative survival rates were higher than those in the control group (73.3% vs 57.8%, 44.4% vs 24.4%, 33.3% vs 15.6%, respectively) (P<0.05). The average PFS and OS in the observation group were longer than those in the control group (all P<0.05). (4) There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). 【Conclusion 】 TACE combined with 125I seed implantation in portal vein is effective in the treatment of liver cancer complicated with PVTT. It can effectively control the progression of primary tumor and PVTT, prolong the survival time and improve the survival rate, and has good safety. 2021 Vol. 38 (9): 1378-1381 [Abstract] ( 34 ) HTML (1 KB)  PDF (1147 KB)  ( 62 ) 1382 Effect of Hyponatremia on Periventricular Intraventricular Hemorrhage and Hydrocephalus in Preterm Infants SUN Hui, FAN Qiao-ling DOI: 10.3969/j.issn.1671-7171.2021.09.029 【Objective】 To investigate the effect of hyponatremia on hydrocephalus in preterm infants with periventricular intraventricular hemorrhage (PVH-IVH).【Methods】 A total of 155 premature infants with pvh-ivh born and treated in our hospital from January 30, 2018 to May 30, 2019 was divided into control group (children with PVH-IVH, n=115) and observation group (children with PVH-IVH complicated with hydrocephalus, n=40) according to whether hydrocephalus occurred within 14 days after birth. The biochemical indexes within 24 hours of birth and the clinical data of children were detected, and the correlation between hyponatremia and PVH-IVH complicated with hydrocephalus, and the influencing factors of PVH-IVH complicated with hydrocephalus were analyzed. 【Results】 Hydrocephalus occurred in 40 of 155 premature infants with PVH-IVH, with an incidence of 25.8%. The mortality of the observation group (25.0%, 10/40) was higher than that of the control group (11.3%, 13/115)(χ2=4.405,P=0.036). The gestational age and birth weight of the observation group were lower than those of the control group, and the proportions of male, severe asphyxia, Grade Ⅲ-Ⅳ PVH-IVH, metabolic acidosis, hyponatremia and hypoglycemia were higher than those of the control group (P<0.05). Logistic multivariate analysis showed that severe asphyxia,PVH-IVH grade, hyponatremia and gestational age were independent influencing factors of PVH-IVH hydrocephalus (P<0.05). 【Conclusion】 The prognosis of premature infants with PVH-IVH complicated with hydrocephalus is poor. Hyponatremia is an independent risk factor for hydrocephalus in PVH-IVH. Early correction of hyponatremia is of great significance to prevent PVH-IVH complicated with hydrocephalus. 2021 Vol. 38 (9): 1382-1384 [Abstract] ( 48 ) HTML (1 KB)  PDF (1117 KB)  ( 29 ) 1385 Complications and Influencing Factors of TEP、TAPP and Open Tension-free Hernia Repair for Adult Inguinal Hernia TIAN Rui-xue, ZOU Yong-hong DOI: 10.3969/j.issn.1671-7171.2021.09.030 【Objective】To investigate the complications and influencing factors of three hernia repair methods: total extraperitoneal laparoscopic (TEP), laparoscopic transabdominal preperitoneal (TAPP) and open tension-free hernia repair for the treatment of adult inguinal hernia.【Methods】From March 2015 to March 2019, 150 cases of adult inguinal hernia admitted to our general surgery department were analyzed retrospectively. According to different surgical methods, they were divided into three groups: A, B and C. There were 50 cases in each group. Among them, group A was treated with TEP (56 sides), group B was treated with TAPP (58 sides), and group C was treated with open tension-free hernia repair (54 sides). The incidence of postoperative complications was compared among the three groups, and the influencing factors of possible complications were observed and analyzed. 【Results】The incidence of complications was 8.00% (4 cases) in group A, 10.00% (5 cases) in group B, and 26.00%(13 cases) in group C; The difference between the groups was statistically significant (P<0.05).The results of univariate analysis showed that the occurrence of postoperative complications of inguinal hernia was related to the operation mode, BMI and the degree of hernia ring adhesion (P<0.05),while it was not related to gender, age, size of hernia sac, location of hernia, type of hernia and internal diseases (P>0.05) . Multivariate analysis showed that operation mode, BMI and degree of hernial ring adhesion were independent factors of postoperative complications of inguinal hernia (OR=2.16, 1.89, 2.14, P<0.05). 【Conclusion】The operative method, BMI and the degree of hernial ring adhesion were independent risk factors of postoperative complications in patients with inguinal hernia. Therefore, in order to reduce the incidence of postoperative complications, we should select the appropriate operation mode according to the patients' own situation, strengthen the control of BMI and the use of hernia bag more standardized. 2021 Vol. 38 (9): 1385-1388 [Abstract] ( 58 ) HTML (1 KB)  PDF (1143 KB)  ( 216 ) 1389 Relationship between the Efficacy of Risperidone in the Treatment of Schizophrenia and Dopamine D2 Receptor Gene Polymorphism YU Xiang-man, LI Zhi-hua DOI: 10.3969/j.issn.1671-7171.2021.09.031 【Objective】To investigate the relationship between the efficacy of risperidone in the treatment of schizophrenia and the polymorphism of dopamine D2 receptor gene (DRD2). 【Methods】A total of 68 schizophrenic patients treated in our hospital from October 2018 to October 2019 was selected as the research objects. They were treated with risperidone for 8 weeks. The efficacy of risperidone was evaluated by positive and negative symptom scale (PANSS). According to PANSS, they were divided into total effective group and ineffective group, negative symptom effective group and ineffective group, positive symptom effective group and ineffective group. The genotypes and allele frequencies of rs6275 and rs6277 in DRD2 receptor gene of 68 patients were detected by single nucleotide polymorphism (SNP). 【Results】The total score, positive symptom score, negative symptom score and general psychopathology of 68 patients after treatment were significantly lower than those before treatment (P<0.05). Risperidone was effective in 52 cases and ineffective in 16 cases; Positive symptoms were effective in 54 cases and ineffective in 14 cases; Negative symptoms were effective in 53 cases and ineffective in 15 cases. There was no significant difference in gender, age and course of disease among different treatment groups (P>0.05).There were significant differences in the total efficacy of different genotypes of rs6275 between the effective group and the ineffective group, as well as the distribution of CC, CT, TT and alleles C and T (P<0.05).There were significant differences in the total efficacy of different genotypes of rs6277 between the effective group and the ineffective group, and the distribution of CC, CT, TT and allele C and T positive symptoms between the effective group and the ineffective group (P<0.05).【Conclusion】DRD2 gene polymorphism is related to the clinical efficacy of risperidone in the treatment of schizophrenia. Individualized drug regimens can be given to schizophrenic patients according to different DRD2 gene polymorphisms. 2021 Vol. 38 (9): 1389-1391 [Abstract] ( 46 ) HTML (1 KB)  PDF (1121 KB)  ( 30 ) 1392 Predictive Value of FGFR4 Arg388 Genotype for Pathological Complete Remission in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy CAO Qin, HU Xiao-ling, XU Zhi-jiang, et al DOI: 10.3969/j.issn.1671-7171.2021.09.032 【Objective】To explore the correlation between Arg388 monocyte nucleotide polymorphism of fibroblast growth factor receptor 4 (FGFR4) gene and pathological complete remission (pCR) in breast cancer patients treated with neoadjuvant chemotherapy.【Methods】A total of 80 patients with locally advanced breast cancer who received preoperative neoadjuvant chemotherapy in the children's Hospital Affiliated to Zhejiang University Medical College and its Second Affiliated Hospital of DNA were selected. Peripheral blood samples were collected before chemotherapy and blood was extracted. The FGFR4 gene Arg388 genotype was detected by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). The pCR status of patients after treatment was observed. The relationship between Arg388 polymorphism and PCR was analyzed.【Results】There were 15 cases of GG genotype, 25 cases of GA genotype and 40 cases of AA genotype in 80 patients. Arg388 genotype was correlated with lymph node metastasis (P<0.05). The lymph node metastasis rate of patients with GG genotype was higher than that of patients with AA genotype, and the difference was significant (P<0.05). There were 19 cases (23.75%) with postoperative pathological PCR. The PCR rate of Arg388 GG type was lower than that of AA type (P<0.05), but there was no significant difference between GA type and AA type (P>0.05). Univariate analysis showed that TNM stage, molecular typing and lymph node status were the influencing factors of PCR. Logistic analysis showed that TNM stage, molecular typing, lymph node status and Arg388 genotype were independent influencing factors of PCR (P<0.05).【Conclusion】The Arg388 genotype of FGFR4 gene is associated with pCR in patients with breast cancer. Compared with patients with type AA, the rate of lymph node metastasis in GG patients is high and pCR is low. Arg388 genotype has a certain predictive effect on pCR of breast cancer. 2021 Vol. 38 (9): 1392-1395 [Abstract] ( 41 ) HTML (1 KB)  PDF (1148 KB)  ( 40 )

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