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Quick Search     Adv Search 2021 Vol. 38, No. 11 Published: 2021-11-26 Original Article          Original Article 1601 Diagnostic Value of Combined Detection of CRP, sCD14-ST and NAP in Children with Respiratory Tract Infectious Diseases LIU Ping-ding, YANG Fang-yi DOI: 10.3969/j.issn.1671-7171.2021.11.001 【Objective】To investigate the diagnostic value of combined detection of C-reactive protein (CRP), soluble cluster of differentiation 14 subtype (sCD14-ST) and neutrophil alkaline phosphatase (NAP) in children with respiratory tract infections. 【Methods】A total of 50 children with respiratory tract infections (as observation group) and 50 healthy children with health examination (as control group) in our hospital were selected for the study. Serum CRP, sCD14-ST levels and NAP scores were compared between the two groups, and the scores of CRP, sCD14-ST and NAP were also analyzed in sick children infected by different pathogens. The correlation among CRP,sCD14-ST and NAP was analyzed, and the diagnostic efficacy of CPR, sCD14-ST and NAP for respiratory infection was compared as well. 【Results】The serum CRP, sCD14-ST levels and NAP scores in the observation group were significantly higher than those in the control group (P<0.05). Serum CRP, sCD14-ST levels and NAP scores were significantly different in children with respiratory tract infection caused by different pathogens (P<0.05). The levels of serum CRP, sCD14-ST and NAP scores of children with bacterial respiratory infections were significantly higher than those of children with viral and mycoplasma respiratory tract infections, and the difference was significant (P<0.05). And serum CRP, sCD14-ST and NAP levels of children with viral respiratory tract infections were significantly higher than those of children with mycoplasma infection (P<0.05). The results showed that CRP was positively correlated with sCD14-ST and NAP (P<0.05), moreover, sCD14-ST was positively correlated with NAP (P<0.05). CRP, sCD14-ST and NAP were independent risk factors for respiratory infection (P<0.05); The diagnostic efficacy of combined detection of the three for respiratory tract infection was significantly better than that of individual detection (P<0.05). 【Conclusion】Serum CRP, sCD14-ST levels and NAP scores are significantly elevated in children with respiratory tract infections. The combined detection of the three can improve the diagnosis efficacy. 2021 Vol. 38 (11): 1601-1603 [Abstract] ( 87 ) HTML (0 KB)  PDF (1263 KB)  ( 36 ) 1604 Risk Assessment of Circulating Endothelial Progenitor Cells and Stromal Cell-Derived Factor-1α on Transient Ischemic Attack ZHAO Wang, LIAO Juan, YANG Zhao DOI: 10.3969/j.issn.1671-7171.2021.11.002 【Objective】 To investigate the relationship between circulating endothelial progenitor cells (EPCs) and plasma stromal cell-derived factor-1α(SDF-1α). 【Methods】 A total of 153 patients with TIA within 24 hours were collected and divided into high-risk TIA group (83 cases) and non high-risk TIA group (70 cases). The clinical data of patients were collected, the number of circulating EPCs was measured by flow cytometry, and the concentration of plasma SDF-1αand vascular endothelial growth factor (VEGF) was measured by enzyme-linked immunosorbent assay . 15 healthy volunteers were selected as normal control (NC). According to the time of admission, the circulating EPCs of the top 15 patients in the high-risk TIA group and the non high-risk TIA group were collected. The proliferation ability of circulating EPCs in the three groups was measured by MTT method, and the migration ability of EPCs was measured by Boyden chamber. 【Results】 Compared with the non high-risk group TIA, the high-risk group TIA had a higher age, and more patients with hypertension and diabetes, and three triglycerides, total cholesterol and low density lipoprotein in peripheral blood were also higher. There was no significant difference in smoking, body mass index and homocysteine between the two groups (P>0.05). Circulating EPCs, SDF-1α and VEGF in the non high risk TIA group was higher than that in the high-risk TIA group (P<0.01). Multivariate regression analysis showed that age, hypertension, diabetes, total cholesterol, SDF-1αand EPCs were high-risk TIA risk factors, and EPCs were high-risk TIA protective factors. Compared with the NC group, the proliferation and migration ability of EPCs isolated and cultured for 72 hours in the high-risk TIA group and the non high-risk TIA group decreased (P<0.05). Compared with the non high-risk TIA group, the proliferation and migration of cells in the high-risk TIA group decreased (P<0.01). 【Conclusion】 The level of circulating EPCs and plasma SDF-1αmay be used as an index to evaluate the severity of TIA. The decline of proliferation and migration ability of circulating EPCs may lead to high-risk TIA. 2021 Vol. 38 (11): 1604-1609 [Abstract] ( 67 ) HTML (1 KB)  PDF (1752 KB)  ( 51 ) 1610 Reversal of Cisplatin Resistance in Ovarian Cancer SKOV3/cDDP Cell Line by Mesothelin Silence ZHENG Fu-li, YANG Yong-kang, LIU Ya-hong, et al DOI: 10.3969/j.issn.1671-7171.2021.11.003 【Objective】To investigate the effects and mechanisms of mesothelin silencing (MSLN) on reversing the cisplatin resistance of ovarian cancer drug cisplatin-resistant SKOV3/DDP cell line. 【Methods】The expression level of MSLN mRNA and MSLN protein in SKOV3/cDDP cells and SKOV3 cells were detected by fluorescence quantitative PCR and Western blotting, respectively. SKOV3/cDDP cells were transfected with mesothelin RNAi lentivirus solution and empty vector lentivirus solution, respectively, to establish a stable cell line SKOV3/cDDP-LV-MSLN-RNAi (the experimental group), SKOV3/DDP-MSLN-neg (the negative control group). The sensitivity of the SKOV3/cDDP-LV-MSLN-RNAi cells to cDDP was detected by MTT assay. The apoptosis rate of SKOV3/cDDP-LV-MSLN-RNAi cells was examined by flow cytometry (FCM). 【Results】The expression level of MSLN mRNA and MSLN protein in SKOV3/cDDP cells were significantly higher than that in sensitive SKOV3 cells(P<0.01). The expression of MSLN protein in cells with transfected mesothelin RNAi lentivirus solution was significantly lower than that in cells with transfected empty vector lentivirus solution and cells without any transfection .The difference was statistically significant (P<0.01). The half inhibition concentration (IC50) of the cells in the experimental group was significantly lower than that in the negative control group and the blank group (P<0.01). The apoptotic rate of SKOV3/cDDP-LV-MSLN-RNAi cells in the experimental group was significantly higher than that in the negative control group and the blank group, and the difference was statistically significant. 【Conclusion】MSLN silence can enhance the sensitivity of ovarian cancer SKOV3/cDDP cells to cDDP, promote the apoptosis of drug-resistant ovarian cancer cells induced by cDDP, and to a certain degree reverse the cisplatin resistance of ovarian cancer SKOV3/cDDP cell lines. 2021 Vol. 38 (11): 1610-1613 [Abstract] ( 79 ) HTML (0 KB)  PDF (1248 KB)  ( 37 ) 1614 Distribution Characteristics of Allergens in Juvenile Allergic Rhinitis in Xiamen HE Jing-jing, GAO Jing, QIU Qian-hui DOI: 10.3969/j.issn.1671-7171.2021.11.004 【Objective】To understand the allergen characteristics, age, gender and season of high incidence of juvenile Allergic Rhinitis (AR) in Xiamen, as well as the general trend of its incidence in recent years, and to master AR overall characteristics and incidence situation. This study can provide accurate basis and guidance for health education, preventive medication and specific immunotherapy for AR patients in this area. 【Methods】The results of SPT (Skin Prick Test) of 2639 juvenile clinically suspected AR patients in Xiamen area from January 2016 to December 2019 were collected, and the allergen results were collated and analyzed. 【Results】The positive rates of allergens from high to low were dust mite (68.62%), house dust mite (68.09%), cockroach (19.78%), animal hair (1.89%), weed (0.42%), mold Ⅰ(0.38%), mold Ⅱ(0.19%) and mango (0.08%), respectively. There were 971 cases in 1 to 6 years old preschool group, 1344 cases in 7 to 13 years old school group, and 324 cases in 14 to 17 years old adolescent group. Males were significantly more than females in each group. The highest number of patients was in 2017, followed by 2016, and there were the fewest cases in 2018 and 2019. There were 1048 cases (39.71%) in summer, 533 cases (20.20%) in spring, 524 cases (19.86%) in autumn and 534 cases (20.23%) in winter, respectively. The positive rates of dust mites, house dust mites, cockroaches and animal hairs were statistically different among the three age groups, while the positive rates of weeds, mold Ⅰ, mold Ⅱ and mango were not statistically different among the three age groups. 【Conclusion】The majority of juvenile AR patients in Xiamen area are perennial AR, mainly male patients with high incidence in summer. The onset age is the most common in school age, followed by the early school and the adolescence. The most common allergens are dust mites, house dust mites and cockroaches. The positive rate of dust mite, house dust mite, cockroach and animal hairs are increasing with age. However, in recent years, the incidence of juvenile AR patients in Xiamen has been decreasing. 2021 Vol. 38 (11): 1614-1617 [Abstract] ( 59 ) HTML (1 KB)  PDF (1185 KB)  ( 51 ) 1618 Expression and Clinical Significance of M-CSF and β-Catenin in the Serum of Patients with Severe Preeclampsia LIU Yan-yun, YAN Xiao-yan, LI Yun DOI: 10.3969/j.issn.1671-7171.2021.11.005 【Objective】To explore the relationship between the expression of macrophage colony stimulating factor (M-CSF) and β-catenin (β-Catenin) in the serum of patients with severe pre-eclampsia (PE) and its clinical significance. 【Methods】There were 51 patients with early-onset severe PE and 51 cases of late-onset severe PE were selected in each group. The serum M-CSF and β-Catenin cytokine expression levels, clinical biochemical indicators and pregnancy complications were compared between the two groups, and their interaction relationship was analyzed. 【Results】 The expression levels of serum M-CSF and β-Catenin factor in the early-onset severe PE group were higher than those in the late-onset severe PE group, the difference was statistically significant (P<0.05). Pearson correlation analysis showed that the relationship of M-CSF and β-Catenin expression in the serum of patients with severe PE was significantly positively correlated (r=0.75, P=0.00＜0.01). The quantitative levels of serum creatinine (SCr), blood urea nitrogen (BUN), blood uric acid (UA) and 24h urine protein (24hpro) in patients with early-onset severe PE were significantly higher than those in patients with late-onset severe PE, and the differences were statistically significant ( P<0.05). The incidence of complications in the early-onset severe PE group was 78.43% (40/51), which was significantly higher than 35.29% (18/51) in the late-onset severe PE group, and the difference was statistically significant (χ2=10.77,P=0.02).【Conclusion】 The expression of serum M-CSF and β-Catenin in patients with severe preeclampsia plays a synergistic role in the pathogenesis of PE, and is closely related to the severity of the disease and the incidence of complications. Clinical diagnosis of severe PE needs to be confirmed as soon as possible, so active treatment measures can be put properly to improve pregnancy outcome. 2021 Vol. 38 (11): 1618-1620 [Abstract] ( 67 ) HTML (0 KB)  PDF (1163 KB)  ( 73 ) 1621 Expression of miR-223 and miR-155-5p in Peripheral Blood of Patients with Urinary Sepsis after percutaneous Nephroscope with Holmium Laser Lithotripsy WANG Jia, DUAN Xiao-hui, HAO Chun-lin, et al DOI: 10.3969/j.issn.1671-7171.2021.11.006 【Objective】To investigate the significance of the expression miR-223 and miR-155-5p in peripheral blood of patients with urinary sepsis after percutaneous nephroscope with holmium laser lithotripsy. 【Methods】Patients who underwent percutaneous nephroscope combined with holmium laser lithotripsy in our hospital from May 2015 to June 2020 were selected as the research objects. Fifty-two patients with urinary sepsis after the operation were taken as the observation group, and 52 patients without urinary sepsis were considered as the control group. The levels of conventional infection markers procalcitonin (PCT), C-reactive protein (CRP) and the expression of miR-223 and miR-155-5p in the two groups were compared. The influencing factors of urinary sepsis after percutaneous nephroscoped with holmium laser lithotripsy were analyzed, and the value of peripheral blood miR-223 and miR-155-5p expression in the diagnosis of postoperative urinary sepsis was evaluated. 【Results】In the observation group, the proportion of male patients, preoperative urine routine positive, operation time ＞ 90 min, and levels of peripheral blood PCT, CRP, miR-223 and miR-155-5p expression were all higher than those in the control group (P<0.05). Logistic regression analysis showed that male, preoperative urine routine positive, operation time ＞ 90 min, peripheral blood PCT, CRP levels, miR-223 and miR-155-5p expressions were all influential factors of urinary sepsis after percutaneous nephroscope combined with holmium laser lithotripsy (P<0.05). The expression of miR-223 and miR-155-5p in peripheral blood of patients with urinary sepsis after percutaneous nephroscope combined with holmium laser lithotripsy was positively correlated with the levels of conventional infection markers PCT and CRP (P<0.05). The ROC curve was drawn and it was found that the combined diagnosis of miR-223 and miR-155-5p in peripheral blood had the highest AUC value for postoperative urinary sepsisafter percutaneous nephrolithotripsy combined with holmium laser lithotripsy, which had a good diagnostic efficacy. 【Conclusion】Percutaneous nephroscope combined with holmium laser lithotripsy has high expression of miR-223 and miR-155-5p in peripheral blood of patients with urinary sepsis. Monitoring their levels after surgery is helpful for the early diagnosis and prognosis prediction of urinary sepsis, and reduces the mortality rate. 2021 Vol. 38 (11): 1621-1624 [Abstract] ( 62 ) HTML (1 KB)  PDF (1310 KB)  ( 39 ) 1625 Effect of Sequential Calcium Dialysis on Maintenance Hemodialysis Patients with Hypertension QI Zhong-yi, PENG Xiang-he, YAN Lu, et al DOI: 10.3969/j.issn.1671-7171.2021.11.007 【Objective】To investigate the efficacy and safety of sequential calcium dialysis in patients with maintenance hemodialysis (HD) complicated with hypertension. 【Methods】Changes of blood pressure, serum calcium, blood phosphorus, parathyroid hormone (PTH) levels before and after sequential calcium dialysis treatment in 25 patients with maintenance HD with hypertension were compared. 【Results】Sequential calcium dialysis effectively reduced systolic blood pressure, diastolic blood pressure and mean arterial blood pressure during hemodialysis. The overall effective rate was 89.5% (17/25). The effective rate of hypotension was 73.3% (11/15) in male patients and 100% (10/10) in female patients; The difference was significant (P<0.05). The antihypertensive effective rate of patients under 60 years old was lower than that of patients over 60 years old, and the difference was significant (P<0.05). In patients with dialysis maintenance time of 1-3 years, the effective antihypertensive rate was 62.5% (5/8). The effective hypotensive rate of patients with 3-7 years maintenance was 91.67% (11/12 patients). The effective rate of hypotension was 100% (5/5) in patients with 8-9 years of maintenance dialysis. The longer the dialysis time was, the higher the effective hypotension rate was, and there was significant difference in between the two variables (P<0.05). There was no significant difference in serum calcium concentration and PTH level before and after sequential calcium dialysis treatment (P>0.05). 【Conclusion】 Sequential calcium dialysis can effectively reduce blood pressure during dialysis, and has a significant effect on female patients and elderly patients with longer dialysis maintenance time. It has no significant effect on serum calcium concentration and PTH level, which is safe in clinical application. 2021 Vol. 38 (11): 1625-1627 [Abstract] ( 66 ) HTML (0 KB)  PDF (1162 KB)  ( 47 ) 1628 Application of B-ultrasound Real-time Guided Arteriovenous Puncture in Surgical Treatment of Congenital Heart Disease in Infants CHEN Xiao-feng, LI Zhi-jian, DAI Ru-ping,et al DOI: 10.3969/j.issn.1671-7171.2021.11.008 【Objective】To evaluate the clinical effect of B-ultrasound real-time guided arteriovenous puncture in surgical treatment of congenital heart disease in infants. 【Methods】In this research, 70 cases of infants with congenital heart disease to receive catheterization for arteriovenous puncture with elective surgery are selected, including 36 boys and 34 girls aged 0~1, ASA classification Ⅱ~Ⅲ. Cases are divided by random number table into an ultrosound group and an anatomical group, each of 35 patients: the ultrasound group with ultrasonic short axis/out-of-plane location of radial artery and jugular vein; the anatomical group, using the traditional anatomical positioning method to locate radial artery and jugular vein for catheterization. 【Results】Radial artery puncture: the ultrasound group showed shorter total puncture time, fewer total puncture times and smaller number of puncture needles used than the anatomical group; the anatomical group showed more cases of arterial hematoma, hemorrhage and other complications than the ultrasound group; all the above differences were statistically significant. Internal jugular vein puncture: the overall success rate and first-time success rate of internal jugular vein catheterization on the right side of infants in the ultrasound group were higher than those of the anatomical group, with puncture time longer than the anatomical group but needle insertion times and puncturing points fewer than the anatomical group. The incidence of mis-operation into arteries in the ultrasound group was significantly lower than the anatomical group. All the above differences were statistically significant. 【Conclusion】 Compared with the traditional blind catheterization method, B-ultrasound guided arteriovenous puncture in surgical treatment of congenital heart disease in infants shows higher success rate and fewer complications and saves more time for rescue. Therefore, it is worth widespread application in clinical practice. 2021 Vol. 38 (11): 1628-1631 [Abstract] ( 56 ) HTML (1 KB)  PDF (1184 KB)  ( 123 ) 1632 Value of Combined Quantitative Diagnosis of Pet/Ct Metabolic Parameters in Predicting the Risk of Lymph Node Metastasis in Breast Cancer Patients QIAN Li-xin, QIN Dong-jie DOI: 10.3969/j.issn.1671-7171.2021.11.009 【Objective】To explore the value of positron emission tomography (PET/CT) combined with metabolic parameters in quantitative diagnosis and prediction of lymph node metastasis risk in breast cancer patients. 【Methods】A total of 78 patients with breast cancer admitted to our hospital were enrolled in the study. All patients underwent PET/CT examination and sentinel lymph node (SLN) biopsy before treatment. According to the results of SLN biopsy, 47 patients who showed SLN positive were divided into the metastatic group (n=42) and 6 patients were in the non-metastatic group .The differences of the maximum standard uptake of PET/CT metabolic parameters (SUVmax), tumor metabolic volume (MTV) and total glycolysis (TLG) between the two groups were compared, and the value of PET/CT metabolic parameters in predicting the risk of lymph node metastasis in breast cancer patients was analyzed by ROC. 【Results】SUVmax, MTV and TLG in the metastatic group were significantly higher than those in the non-metastatic group (P<0.05).ROC analysis confirmed that SUVmax, MTV and TLG could all be used to predict the risk of lymph node metastasis in adenocarcinoma patients, and the areas under the curve were 0.901, 0.678 and 0.871, respectively, with P<0.05.The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Kappa for the combined diagnosis of PET/CT metabolic parameters in predicting the risk of lymph node metastasis in breast cancer patients were 0.857, 0.944, 0.897, 0.897, 0.947 and 0.795 respectively. 【Conclusion】PET/CT metabolic parameters SUVmax≥5.475, MTV≥8.155 cm3, and TLG≥ 22.63 g can be used to predict the risk of lymph node metastasis in breast cancer patients, and furthermore the three parameters combined diagnosis has a higher sensitivity to predict the risk of lymph node metastasis, which is worthy of clinicians' attention. 2021 Vol. 38 (11): 1632-1634 [Abstract] ( 84 ) HTML (1 KB)  PDF (1200 KB)  ( 62 ) 1635 Influencing Factors of Clinical Outcome in Patients with Severe Pneumonia after Mechanical Ventilation ZHAN Yuan-chang, WANG Ping DOI: 10.3969/j.issn.1671-7171.2021.11.010 【Objective】To explore the influencing factors of clinical outcome in patients with severe pneumonia after mechanical ventilation. 【Methods】A total of 150 patients with severe pneumonia treated in our hospital from January 2018 to January 2020 was divided into good group (n=86) and bad group (n=64) according to the clinical outcome after mechanical ventilation. The data of gender, age, body mass index (BMI), course of disease, blood pressure level [systolic blood pressure (SBP), diastolic blood pressure (DBP)], serum plasminogen activator inhibitor-1 (PAI-1) and other data of the two groups were counted, and the coagulation function indexes [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), D-Dimer (D-D) and fibrinogen (FIB)] were compared between the two groups. Multivariate logistic regression was used to analyze the independent risk factors affecting the clinical outcome of patients with severe pneumonia after mechanical ventilation, and to analyze the correlation between serum PAI-1 and coagulation function indexes and the clinical outcome of patients with severe pneumonia after mechanical ventilation.【Results】There was no significant difference in gender, age, BMI, course of disease, proportion of combined diseases and blood pressure between the two groups (P>0.05); The levels of serum PAI-1, Pt, APTT, TT and D-D in the good group were lower than those in the bad group (P<0.05), and the level of FIB was higher than those in the bad group (P<0.05). Multivariate logistic regression analysis showed that PAI-1 (OR=9.795, 95% CI=1.819~20.256), APTT (OR = 3.256, 95% CI=1.316~8.447), TT (OR=1.896, 95% CI=1.245~9.847), PT (OR=3.958, 95% CI=1.421~14.429), D-D (OR=2.006, 95% CI=1.854~8.136), FIB (OR=4.008, 95% CI=1.923~11.125) were independent risk factors affecting the clinical outcome of patients with severe pneumonia after mechanical ventilation (P<0.05). Correlation analysis showed that PAI-1, APTT, TT, Pt and D-D were positively correlated with the clinical outcome of patients with severe pneumonia after mechanical ventilation (P<0.05), and negatively correlated with FIB (P<0.05). 【Conclusion】The clinical outcome of patients with severe pneumonia after mechanical ventilation is closely related to serum PAI-1 and coagulation function, which is helpful to judge the prognosis of patients. 2021 Vol. 38 (11): 1635-1638 [Abstract] ( 71 ) HTML (1 KB)  PDF (1189 KB)  ( 264 ) 1639 Predictive Value of Serum MCP-1 and HMGB1 in AECOPD Complicated with Ventilator-associated Pneumonia DING Ying-nan, YOU Qing-hai DOI: 10.3969/j.issn.1671-7171.2021.11.011 【Objective】To analyze the predictive value of serum monocyte chemoattractant protein-1 (MCP-1) and high mobility group protein 1 (HMGB1) in the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with ventilator-associated pneumonia. 【Methods】A total of 83 patients with AECOPD complicated with ventilator-associated pneumonia admitted to the first affiliated hospital of Anhui medical university from August 2018 to June 2021 were selected as the research objects. Basic data of all patients were collected and serological indexes [MCP-1 and HMGB1] of patients were detected within 24h. Patients were divided into the survival group and the death group according to the survival status within 1 month of follow-up. Logistic multivariate regression analysis was used to explore the relevant factors affecting the clinical prognosis of patients with AECOPD complicated with ventilator-associated pneumonia. The receiver operating characteristic curve (ROC) was used to determine the level of serum MCP-1 and HMGB1 for predicting clinical effects and prognosis of AECOPD with ventilator-associated pneumonia. 【Results】Among the 83 patients with AECOPD complicated with ventilator-associated pneumonia in this study, 19 patients died of ineffective treatment (he death group), accounting for 22.89% (19/83) and 64 surviving patients (the survival group), accounting for 77.11%. The acute physiological and chronic health status (APACHEⅡ) score> 20 points, the organ failure (SOFA) score> 6 points, the proportion of mechanical ventilation time ≥ 72 h and the serum MCP-1 and HMGB1 levels in patients of the death group were higher than those in the survival group. The difference was statistically significant (P<0.05). Logistic multivariate regression analysis showed that APACHEⅡ score>20 points, SOFA score>6 points, mechanical ventilation time ≥72 h, higher serum MCP-1 and HMGB1 expression levels were risk factors for death in patients with AECOPD complicated with ventilator-associated pneumonia (P<0.05). ROC analysis showed that the area under the curve (AUC) of single and combined serum MCP-1 and HMGB1 levels for clinical prognosis of patients with AECOPD complicated with ventilator-associated pneumonia were 0.774, 0.743 and 0.848 respectively. The efficacy of serum MCP-1 and HMGB1 levels alone in predicting the clinical prognosis of patients with AECOPD complicated with ventilator-associated pneumonia was lower than that of the combination of the two (P<0.05). 【Conclusion】Patients with AECOPD complicated with ventilator-associated pneumonia with high APACHEⅡ and SOFA scores plus longer mechanical ventilation are more likely to have a prognosis of death. Serum MCP-1 and HMGB1 have certain clinical predictive value for the prognosis of patients with AECOPD complicated with ventilator-associated pneumonia. 2021 Vol. 38 (11): 1639-1642 [Abstract] ( 64 ) HTML (1 KB)  PDF (1294 KB)  ( 24 ) 1643 Application of Different Surgical Methods in Tonsillectomy CHU Yu-min, WANG Jin-hui, LU Chuan, et al DOI: 10.3969/j.issn.1671-7171.2021.11.012 【Objective】To evaluate the advantages and disadvantages of conventional approach, monopolar electrocautery, ultrasonic knife,plasma knife in tonsillectomy. 【Methods】A total of 116 cases of tonsillectomy were collected and divided into 4 groups: the traditional tonsillectomy group ( group A,n=29), monopolar electrocautery group ( group B,n=29) ,ultrasound knife tonsillectomy group ( group C,n=29) and coblation tonsillectomy group ( group D,n=29) The operation time,intraoperative blood loss,postoperative sore throat situation,white film shedding time,postoperative bleeding and complications were recorded and compared among all groups.【Results】Compared to the group A, the operation time was shorter and the intraoperative blood loss was less in the group B, C and D. The white film shedding time was longer in group B,C and D than in group A. However, there were no statistically significant differences among group A, B and C (P>0.05). The degree of pharyngeal pain in the first three days after surgery in group C and in group D was significantly lower than that in group A and group B; while there was no difference among the four groups of patients with pharyngeal pain on the 4 to 6 days after operation (P>0.05). There was also no significant difference in postoperative bleeding among group A,B,C and D.【Conclusion】 electrocautery Monopolar electrocautery, ultrasonic knife and coblation tonsillectomy are the more safe and effective methods, which provides favorable clinical value. 2021 Vol. 38 (11): 1643-1646 [Abstract] ( 70 ) HTML (0 KB)  PDF (1184 KB)  ( 120 ) 1647 Comparison of Short-term Clinical Efficacy of PKEP and HoLEP in the Treatment of Senile Benign Prostatic Hyperplasia YU Xiao-long, HAN Hong-jia DOI: 10.3969/j.issn.1671-7171.2021.11.013 【Objective】To compare the short-term clinical effects of transurethral plasma enucleation of the prostate (PKEP) and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of senile benign prostatic hyperplasia (BPH). 【Methods】 A total of 68 patients with BPH treated in our hospital from March 2017 to may 2019 were selected as the research objects. They were randomly divided into HoLEP group and PKEP group, with 34 cases in each group. Patients in the PKEP group were treated with PKEP and patients in the HoLEP group were treated with HoLEP. The operation, clinical efficacy and incidence of adverse reactions were compared between the two groups. 【Results 】The amount of intraoperative bleeding in the HoLEP group was less than that in the PKEP group, and the operation time, urinary catheter retention time, hospital stay and bladder flushing time were significantly shorter than those in the PKEP group (P<0.05). At 1 and 6 months after operation, the prostate volume, RUV, QOL score and IPSS score of the two groups were lower than those before operation, and the Qmax was higher than that before operation. There was significant difference between the HoLEP group and the PKEP group (P<0.05). The total clinical effective rate in the HoLEP group was 91.18% (31/34), which was significantly higher than 70.59% (24/34) in the PKEP group(χ2 =4.660,P=0.031). The incidence of adverse reactions in the HoLEP group was 11.76% (4/34), which was significantly lower than 35.29% (12/34) in the PKEP group(χ2=5.231,P=0.022). 【Conclusion】 The clinical effect of HoLEP in the treatment of benign BPH in the elderly is better than PKEP. It can reduce the length of hospital stay, improve the quality of life and reduce postoperative complications. 2021 Vol. 38 (11): 1647-1649 [Abstract] ( 112 ) HTML (1 KB)  PDF (1162 KB)  ( 78 ) 1650 Value of Serum VEGF and SDF-l Levels Combined with Clinical Features in Predicting Short-term Prognosis of Moyamoya Disease Patients YE Nan, LI Yao-zeng, LIU Rui DOI: 10.3969/j.issn.1671-7171.2021.11.014 【Objective】 To explore the value of serum vascular endothelial growth factor (VEGF) and stromal cell-derived factor-1 (SDF-1) combined with clinical characteristics in predicting the short-term prognosis of patients with moyamoya disease. 【Methods】A total of 145 patients with moyamoya disease treated in our hospital from January 2018 to January 2020 were selected as the research object. All patients underwent vascular reconstruction. According to the prognosis one month after operation, the patients were divided into good prognosis group (107 cases) and poor prognosis group (38 cases). The clinical data of all patients were collected, including gender, age, body mass index (BMI), clinical manifestations (blood type, blood type), hypertension or diabetes, smoking or drinking, preoperative ischemia or bleeding, recurrence of stroke, and Suzuki staging. The levels of serum VEGF, SDF-l and the score of modified Rankin Scale (mRS) were recorded 7 days after operation. ROC curve was used to analyze the value of VEGF, SDF-1 and mRS score in predicting the short-term prognosis of patients with moyamoya disease. Unconditional logistic stepwise regression was used to analyze the risk factors of poor short-term prognosis of patients with moyamoya disease; The value of combining multiple risk factors in predicting poor short-term prognosis in patients with moyamoya disease was analyzed by consistency.【Results】Univariate analysis showed that the proportion of patients with hypertension, diabetes, alcohol consumption, preoperative ischemia or hemorrhage and recurrence of stroke was higher than those with good prognosis. The mRS score of poor prognosis group was higher, while the level of VEGF and SDF-1 was lower. The difference was statistically significant (P<0.05). ROC analysis showed that VEGF ≤ 188.065 pg/mL, SDF-1 ≤ 218.370 pg/mL and mRS score ≥3.130 were the best cutoff values for poor short-term prognosis in patients with moyamoya disease (P<0.05); Multivariate Logistic regression analysis showed that hypertension, diabetes, alcohol consumption, preoperative ischemia or hemorrhage, stroke relapse, VEGF < 188.065 pg/mL, SDF-1 < 218.370 pg/mL, mRS score greater than 3.130 were the risk factors for short-term prognosis of patients with moyamoya disease (P<0.05). By consistency analysis, the sensitivity of multiple risk factors combined to predict the poor short-term prognosis of moyamoya disease patients was 0.921, the specificity was 0.953, and the accuracy was 0.945 (κ=0.860). 【Conclusion】 VEGF ≤ 188.065 pg/mL, SDF-1≤218.370 pg/mL and mRS score ≥ 3.130 are the best cutoff values for poor short-term prognosis in patients with moyamoya disease. In addition, hypertension or diabetes mellitus, alcohol consumption, preoperative ischemia or hemorrhage, recurrence of stroke are risk factors for short-term prognosis. The levels of serum VEGF and SDF-1 combined with multiple risk factors have good predictive value for the short-term prognosis of patients with moyamoya disease. 2021 Vol. 38 (11): 1650-1654 [Abstract] ( 49 ) HTML (0 KB)  PDF (1294 KB)  ( 48 ) 1655 Relationship between Peripheral Blood Eosinophils and Th1/Th2 Cytokines in Elderly Patients with COPD Complicated with Asthma WU Xiao-hong, BAI Jin-e DOI: 10.3969/j.issn.1671-7171.2021.11.015 【Objective】Objective to investigate the relationship between the level of peripheral blood eosinophils (EOS) and Th1/Th2 cytokines in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with asthma. 【Methods】 Elderly COPD patients with asthma (combined group) diagnosed and treated in the geriatric Respiratory Department of the Affiliated Hospital of Yan'an University from August 2017 to August 2019 were selected. In addition, gender and age-matched patients with bronchial asthma and COPD diagnosed and treated in the same hospital in the same period were selected as asthma group (70 cases), COPD group (70 cases) and 70 healthy volunteers as the control group.The levels of EOS and Th1/Th2 cytokines [interferon -γ(INF- γ), Interleukin-6 (IL-6), IL-8, tumor necrosis factor-α(TNF-α)] in peripheral blood of each group were detected and compared. Pearson analyzed the correlation between EOS and Th1/Th2 cytokines. The patients in the combined group were followed up for 1 year. According to the acute attack of the patient's condition, they were divided into frequent acute attack group (acute exacerbation > 1 time) and non frequent acute attack group (acute exacerbation ≤ 1 time). The levels of EOS, Th1/Th2 cytokines and other data in the two groups were compared. The risk factors of COPD complicated with asthma were analyzed by multivariate logistic regression. 【Results】 The levels of EOS TNF -α,IL-6 and IL-8 in the combined group, asthma group, COPD group and control group decreased in turn, and IFN-γ levels increased in turn, and there was significant difference between the groups (P<0.05). Pearson correlation analysis showed that EOS level was negatively correlated with TNF-α(P<0.05) and were positively correlated with IFN-γ, IL-6 and IL-8 (P<0.05). Univariate analysis showed that the age, length of hospital stay, EOS, leukocyte count, lymphocyte count and IL-6 in the frequent acute attack group were significantly higher than those in the non frequent acute attack group (P<0.05). IFN-γ, the percentage of forced respiratory volume in the predicted value in the first second (FEV1%) and the ratio of forced respiratory volume to forced vital capacity in the first second (FEV1/FVC) were significantly lower than those in the non frequent acute attack group (P<0.05); Multivariate logistic regression analysis showed that age, length of hospital stay, EOS and IFN-γ,FEV1% was a risk factor for frequent acute attack of COPD complicated with asthma (P<0.05). 【Conclusion】The level of EOS in peripheral blood in Th1/Th2 cytokines in elderly COPD patients with asthma was negatively correlated with IFN -γand positively correlated with TNF-α, IL-6 and IL-8 . Moreover, peripheral blood EOS and IFN-γare all risk factors affecting patients with frequent acute attacks, which can provide reference for disease diagnosis, treatment and prognosis. 2021 Vol. 38 (11): 1655-1658 [Abstract] ( 52 ) HTML (1 KB)  PDF (1194 KB)  ( 49 ) 1659 Effects of Propofol on Proliferation and Androgen Transcriptional Activity of Prostate Cancer Cells and its Mechanism JIANG Yan-an, ZHANG Yu-ming, ZHANG Ru, et al DOI: 10.3969/j.issn.1671-7171.2021.11.016 【Objective】To investigate the effect of propofol on the proliferation of prostate cancer cell line (LNCaP) stimulated by dihydrotestosterone (DHT) and its mechanism. 【Methods】 LNCaP cells were divided into four groups according to the intervention mode: control group (normal saline), DHT group (10 nM DHT intervention), DHT + 10 μm propofol group (10 nM DHT + 10 μM propofol intervention) and DHT + 50 μM propofol group (10 nM DHT + 50 μM propofol intervention). Real time quantitative PCR was used to detect the levels of androgen dependent gene prostate specific antigen (PSA), FK506 binding protein 5 (FKBP5) and transmembrane protease serine 2 (TMPRSS2). MTT method was used to analyze the survival of cells in each group. Western blot was used to detect the expression of AR and hypoxia inducible factor (HIF) in cells in each group. 【Results】 Compared with the DHT group, the expression of PSA, FKBP5 and TMPRSS2 genes in the DHT+10 μM propofol group and the DHT+ 50 μM propofol group decreased significantly at 24 hours (P<0.05). Propofol exposure for 12 h and 24 h could significantly inhibit the proliferation of LNCaP cells (P<0.05), but exposure for 4 h had no significant effect. Compared with the DHT group, the expression of AR and HIF-1α protein in nucleus of the DHT + 10 μM propofol group and the DHT+50 μM propofol group were significantly lower (P<0.05). 【Conclusion】 Propofol inhibits the proliferation of LNCaP cells and AR transcriptional activity, so as to reduce the level of AR nucleoprotein. 2021 Vol. 38 (11): 1659-1662 [Abstract] ( 56 ) HTML (0 KB)  PDF (1217 KB)  ( 60 ) 1663 Effect of Early Enteral Nutrition Support with Probiotics on Intestinal Flora and Gastrointestinal Function of Patients with Severe Acute Pancreatitis LIU Zhen-zhen, HU Hui-ge, SHEN Gao-fei, et al DOI: 10.3969/j.issn.1671-7171.2021.11.017 【Objective】To investigate the effect of early enteral nutrition support containing probiotics on the intestinal flora and gastrointestinal function in patients with severe acute pancreatitis (SAP). 【Methods】A total of 106 SAP patients in our hospital from June 2018 to December 2020 were selected and divided into the observation group and the control group by random number table, with 53 cases in each group. The control group received routine early enteral nutrition support, and the observation group received early enteral nutrition support containing probiotics. Both were treated for 2 weeks. The gastrointestinal function scores, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) scores, nutritional parameters [prealbumin (PA), albumin (ALB), transferrin (TRF)], intestinal flora indicators (lactobacillus, escherichia coli, enterococcus, enterobacteria), serum humoral immune function [immunoglobulin M (IgM), immunoglobulin G (IgG), immunoglobulin A (IgA)] were compared between the two groups before treatment and 2 weeks after treatment. The recovery status of patients and the incidence of infection were counted. 【Results】After 2 weeks of treatment, the gastrointestinal function scores and APACHEⅡ scores of the two groups were lower than before treatment, however, the above parameters in the observation group were lower than the control group, the difference was statistically significant (P<0.05). The serum index (PA, ALB and TRF) levels in both groups after treatment were higher than before treatment; And these indexes in the observation group were higher than those in the control group after 2 weeks of treatment, the difference was statistically significant (P<0.05). The numbers of lactobacillus and escherichia coli in the observation group were higher than those in the control group after 2 weeks of treatment, and the numbers of enterococcus and enterobacter were lower than those in the control group. The differences were statistically significant (P<0.05). After 2 weeks of treatment, the serum IgM, IgG and IgA levels in the two groups were higher than those before treatment. And the IgM, IgG and IgA levels in the observation group were higher than those in the control group; the difference was statistically significant (P<0.05). In the observation group, the relief time of abdominal distension, relief time of abdominal pain, gastrointestinal function recovery time, and hospitalization time were shorter than those of the control group, and the infection rate was lower than that of the control group (P<0.05). 【Conclusion】Early enteral nutrition support with probiotics plays an important role in patients with SAP by regulating the intestinal flora, enhancing immunity, and improving nutritional status. At the same time, it can promote the recovery of intestinal barrier function, prevent intestinal infection, and improve the prognosis. 2021 Vol. 38 (11): 1663-1666 [Abstract] ( 52 ) HTML (1 KB)  PDF (1192 KB)  ( 159 ) 1667 Effects of Different Sedation Depth on Postoperative Inflammatory Factors and Cognitive Function in Elderly Patients with Fractures HE Hua-li, SHAN Zhao-ya, ZHAO Xiao, et al DOI: 10.3969/j.issn.1671-7171.2021.11.018 【Objective】To investigate the effects of different sedation depths on postoperative inflammatory factors and postoperative cognitive function in elderly patients with fractures. 【Methods】A total of 200 fracture patients in our hospital were randomly divided into A and B groups. Patients in both groups were given general anesthesia. Bispectral index(BIS )was maintained at 40-49 in the group A and 50-59 in the group B. The changes of awake time, extubation time, orientation recovery time, cognitive function recovery and serum inflammatory factors were compared between the two groups. 【Results】The awake time, extubation time and orientation recovery time of group A were shorter than those of group B (P<0.05).There was no significant difference in MMSE scores between the two groups before operation (P>0.05). The MMSE scores of the two groups were lower than those before operation (P<0.05). The MMSE scores of group A were higher than those of group B at each time point (P<0.05). The incidence of cognitive dysfunction in group A was lower than that in group B at 1d, 3d and 7d after operation(P<0.05).There were no significant differences in the levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α) and central nervous system specific protein (S100β) between the two groups before surgery (P>0.05). After operation, the levels of IL-6, TNF-α and S100β in the two groups were higher than those before operation. The levels of IL-6, TNF-α and S100β were lower than those in group B at each time point (P<0.05). 【Conclusion】In elderly patients, intraoperative BIS values of 40-49 can effectively reduce the impact on cognitive function, shorten postoperative waking time and recovery time, reduce immune stress response, and reduce the release of inflammatory factors. 2021 Vol. 38 (11): 1667-1669 [Abstract] ( 53 ) HTML (0 KB)  PDF (1163 KB)  ( 46 ) 1670 Comparison of MIPPO and ORIF in the Treatment of Type A Elderly Distal Tibial Fractures ZHENG Xiao-lin, GAO Qiang, LI Yuan-yuan DOI: 10.3969/j.issn.1671-7171.2021.11.019 【Objective】To compare the therapeutic effects of percutaneous minimally invasive plate internal fixation (MIPPO) and open reduction and internal fixation (ORIF) on type A elderly patients with distal tibial fractures. 【Methods】 A total of 84 elderly patients with type A distal tibial fracture treated in our hospital from June 2018 to March 2020 were selected as the research objects. According to the type of operation selected, the patients were divided into MIPPO group (MIPPO treatment, 42 cases) and ORIF group (ORIF treatment, 42 cases). The operation time, intraoperative bleeding, wound healing time, fracture healing time, serum inflammatory factor level before and 24 hours after operation and clinical curative effect 6 months after operation were compared between the two groups. The patients were followed up for 12 months. 【Results】The operation time, wound healing time and fracture healing time in the MIPPO group were shorter than those in the ORIF group (P<0.05), and the intraoperative blood output was lower than that in the ORIF group (P<0.05). At 24 hours after operation, the levels of C-reactive protein (CRP), interleukin-1 (IL-1) and interleukin-6 (IL-6) in the two groups were higher than those before operation (P<0.05). At 24 hours after operation, CRP, IL-1 and IL-6 in the MIPPO group were lower than those in the ORIF group (P<0.05). Six months after operation, the excellent and good rate in the MIPPO group was higher than that in the ORIF group (92.86% vs 76.19%,χ2=4.459, P<0.05). The total incidence of postoperative complications in the MIPPO group was lower than that in the ORIF group (4.76% vs 19.04%,χ2=4.086, P<0.05). 【Conclusion】 Compared with ORIF, MIPPO can shorten the operation time, wound healing and fracture healing time, reduce the amount of intraoperative bleeding, reduce the inflammatory reaction, improve the clinical treatment effect and reduce the incidence of postoperative complications. 2021 Vol. 38 (11): 1670-1673 [Abstract] ( 65 ) HTML (1 KB)  PDF (1193 KB)  ( 63 ) 1674 Effect Analysis of Working Pressure and Low Efficiency of Nurses in Operating Room MA Dong-fang, LIU Zi-han DOI: 10.3969/j.issn.1671-7171.2021.11.020 【Objective】To understand the current situation of nurses' work pressure and low work efficiency in operating room, and to analyze the relationship between nurses' work pressure and low work efficiency. 【Methods】A total of 150 nurses in the operating room of 5 municipal hospitals in Jinan was randomly selected by convenient sampling method. The nurses' job stressor scale and job restriction questionnaire were used to investigate, and the relevant results were analyzed. 【Results】145 valid questionnaires were collected. Among the 145 operating room nurses, the average total score of work pressure was (91.06±12.01), which belonged to the category of severe work pressure, including 12 (8.28%), 48 (33.10%), 70 (48.28%), 15 (10.34%) with severe work pressure, and the total score of work restriction was (49.30±6.24), Moderate work restriction; The total scores of mild, moderate, severe and super severe working operating room nurses with work restriction were (49.24±6.24), (35.24±5.45), (53.54±6.46) and (67.41±8.21) respectively (P<0.05); There is an inverted "V" relationship between work pressure and low work efficiency. 【Conclusion】 Operating room nurses are accompanied by work pressure. Clinically, work pressure should be controlled in the optimal bearing range acceptable to nurses in order to improve the work efficiency of operating room nurses. 2021 Vol. 38 (11): 1674-1676 [Abstract] ( 51 ) HTML (0 KB)  PDF (1235 KB)  ( 96 ) 1677 Effect of Danhong Injection Combined with Qingxin Huatan Decoction on the Treatment of Phlegm-heat and Heart-disturbing Atrial Fibrillation CHANG Lin, XUE Shan-na DOI: 10.3969/j.issn.1671-7171.2021.11.021 【Objective】To explore the clinical effect of Danhong injection combined with Qingxin Huatan Decoction in the treatment of phlegm heat disturbing heart atrial fibrillation. 【Methodsv】 A total of 85 patients with phlegm heat disturbing heart type atrial fibrillation treated in Xi'an Daxing hospital from March 2017 to March 2020 was randomly divided into observation group (n=42, routine treatment + Danhong injection + Qingxin Huatan Decoction) and control group (n=43, routine treatment + Danhong injection). The number of episodes of atrial fibrillation, the maximum time limit of ECG P wave (Pmax), P wave dispersion (PD), left atrial diameter, left ventricular ejection fraction (LVEF) and curative effect were recorded before and after treatment. 【Results】 After treatment, the cure rate, effective rate and effective rate of the observation group were higher than those of the control group (Z=15.897,P=0.001<0.05); The number of episodes of atrial fibrillation and left atrial diameter in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group; LVEF in both groups was higher than that before treatment, and that in the observation group was higher than that in the control group (P<0.05); Pmax and Pd in the two groups were lower than those before treatment (P<0.05); There was no significant difference between the observation group and the control group (P>0.05). 【Conclusion】 Danhong injection combined with Qingxin Huatan Decoction can significantly reduce the attack times of atrial fibrillation and improve ECG related indexes and cardiac function. 2021 Vol. 38 (11): 1677-1679 [Abstract] ( 57 ) HTML (0 KB)  PDF (1163 KB)  ( 61 ) 1680 Clinical Comparative Study of Percutaneous Anterior Screw Internal Fixation and Posterolateral Approach Screw Internal Fixation in the Treatment of Three Ankle Fractures LI You-ping, SHU Jun-feng DOI: 10.3969/j.issn.1671-7171.2021.11.022 【Objective】To compare the clinical effects of percutaneous anterior screw internal fixation and posterolateral approach screw internal fixation in the treatment of three ankle fractures. 【Methods】 A retrospective analysis of the clinical data of 92 patients with three ankle fractures admitted to our hospital from January 2017 to January 2020. According to the different treatment methods. Patients were divided into group A (45 cases) treated with percutaneous anterior screw internal fixation and group B (47 cases) treated with posterolateral screw internal fixation. The operation time, number of fluoroscopy, intraoperative blood loss, 1year postoperative ankle range of motion (ROM), imaging examination results, full weight bearing time, fracture healing time, and ankle-hindfoot function score at different moments evaluated by the American Association of Foot and Ankle Surgery (AOFAS) were compared between the two groups.. 【Results】There were no statistically significant differences between the two groups of patients in operation time, time to complete weight bearing, fracture healing time, AOFAS ankle-hindfoot function score, ankle dorsiflexion, plantar flexion, varus and valgus ROM at 1 year after surgery (P>0.05). Compared to the AOFAS score at 3 months after operation, the AOFAS ankle-hindfoot function scores increased in both groups at 6 months and 12 months after operation (P<0.05). The number of fluoroscopy in group A was more than that in group B (P<0.05), and the amount of intraoperative blood loss was lower than that in group B (P<0.05). The incidence of poor reduction/poor fixation in group A was higher than that in group B (P<0.05). One year after the operation, there was no loss of fracture reduction, loose internal fixation and narrow ankle joint space in both groups. 【Conclusion】Both percutaneous anterior screw internal fixation and posterolateral approach screw internal fixation can effectively treat three ankle fractures. The former has more fluoroscopy treatments than the latter and the intraoperative blood loss is lower than the latter, but the quality of internal fixation is superior to the latter. 2021 Vol. 38 (11): 1680-1682 [Abstract] ( 49 ) HTML (1 KB)  PDF (1164 KB)  ( 85 ) 1683 Expression and Clinical Significance of Plasma NPY and SP Levels in Patients with Postpartum Anxiety MAI Miao, JI Chao, DUAN Yuan-li DOI: 10.3969/j.issn.1671-7171.2021.11.023 【Objective】To observe the plasma levels of neuropeptide Y (NPY) and substance P (SP) in parturients and analyze the risk factors associated with postpartum anxiety. 【Methods】A total of 136 cases of puerpera delivered in our hospital from August 2018 to August 2020 were selected as the research objects. General data of puerpera were collected, including age, body mass index, whether primipara, education level, history of adverse pregnancy, stage of labor, gender of newborn, monthly family income, mode of delivery, Pittsburgh sleep quality index (PSQI), self-efficacy and NPY, SP. State Anxiety Scale (S-AI) was used to evaluate the anxiety of puerpera. According to the existence of anxiety, parturients were divided into the anxiety group and non-anxiety group. The independent influencing factors of postpartum anxiety were analyzed. 【Results】 Of the 136 parturients, 30 cases (22.06%) had anxiety after childbirth and 106 cases (77.94%) had no anxiety after childbirth. The proportion of patients with adverse pregnancy history, family monthly income < 3000 yuan, mode of delivery, PSQI score ≤ 7 and plasma SP level in the anxiety group were significantly higher than those in the non-anxiety group (P<0.05); and the plasma NPY level in the anxiety group was significantly lower than that in that in the non-anxiety group (P<0.05). ROC curve showed that plasma NPY and SP had certain predictive value for postpartum anxiety whose area under the curve was 0.810 and 0.758, respectively. The best cutoff value of plasma NPY level in predicting postpartum anxiety was 6.41 μ g/ml, with sensitivity of 0.821 and specificity of 0.798; The best cutoff value of plasma SP level in predicting postpartum anxiety was 6.72 μ g/ml, with sensitivity of 0.786 and specificity of 0.757. Multivariate logistic regression analysis showed that history of adverse pregnancy, monthly family income, mode of delivery, PSQI score, NPY and SP were the risk factors for postpartum distress (P<0.05). 【Conclusion】Plasma NPY and SP levels are related to the occurrence of postpartum anxiety, which can be used as auxiliary indicators to predict postpartum anxiety. 2021 Vol. 38 (11): 1683-1686 [Abstract] ( 64 ) HTML (0 KB)  PDF (1230 KB)  ( 66 ) 1687 Expressions and Significance of UHRF-1 and DNMT-1 in Tissues of Gastric Cancer XIAO Qin-rong, ZHU Wei-fang, DA Rong-feng, et al DOI: 10.3969/j.issn.1671-7171.2021.11.024 【Objective】 To investigate the expressions of UHRF-1 (ubiquitin-like PHD with ring finger domain-1) and DNMT-1 (DNA methyltransferase-1) in gastric cancer and its relationship with clinicopathological features. 【Methods】A total of 75 gastric cancer patients treated in our hospital were selected as the research subjects. The lesion tissues and para-cancerous tissues were collected. The mRNA expressions of UHRF-1, DNMT-1 were detected by RT-PCR and immunohistochemistry, and the relationship between expression and the clinicopathological characteristics were analyzed. 【Results】The protein positive rates of UHRF-1, DNMT-1 in gastric cancer tissues were 84% (63/75) and 70.7% (53/75), respectively, which were significantly higher than those in the para-cancerous tissues 45% (34/75) and 20% (18/75), respectively (P<0.05). The mRNA expression levels of UHRF-1, DNMT-1 in gastric cancer tissues were significantly higher than those of para-cancerous tissues (P<0.05). The protein positive rates of UHRF-1 and DNMT-1 in gastric cancer tissues with tumor size (≥3 cm), moderately or poorly differentiated carcinomas, serosal invasion, stage Ⅲ+Ⅳ and lymphatic metastasis were higher than that of tumors <3 cm, well-differentiated carcinomas, none serosal infiltration, stage Ⅰ+Ⅱ, and no lymphatic metastasis. The difference was significant (P<0.05).【Conclusion】The expressions of UHRF-1and DNMT-1 in the lesion tissues of gastric cancer patients are significantly increased, and they are closely related to the clinicopathological features of patients with gastric cancer. 2021 Vol. 38 (11): 1687-1689 [Abstract] ( 45 ) HTML (0 KB)  PDF (1532 KB)  ( 38 ) 1690 Effects of Different Doses of Suixin Capsule on TrxR Activity and ATP and ADP Levels in Rats with Chronic Heart Failure GUO Dian-long, GONG Zhao-wei, NING Yi, et al DOI: 10.3969/j.issn.1671-7171.2021.11.025 【Objective】 To investigate the effects of different doses of Suixin Capsule on the activity of thioredoxin oxidoreductase (TrxR) and the levels of adenosine triphosphate (ATP) and adenosine diphosphate (ADP) in rats with chronic heart failure. 【Methods】 A total of 44 SPF and healthy male SD rats was randomly divided into control group, western medicine group, low-dose group and high-dose group, with 11 rats in each group. The rats in the control group were fed with animal feed under normal environment. The models of chronic heart failure were established by ligating the left anterior descending coronary artery in the western medicine group, low-dose group and high-dose group. After the successful establishment of the model, the rats were fed for 8 weeks. After the 8th week, the western medicine group was fed with captopril, the low-dose group was fed with Suixin capsule 20g/kg, the high-dose group was fed with Suixin capsule 40g/kg, and the three groups were fed once a day for 12 weeks. The left ventricular end diastolic diameter (LVDD), left ventricular end systolic diameter (LVSD), left ventricular posterior wall thickness (LVP-WT), ventricular septal thickness (IVST) and left ventricular ejection fraction (LVEF) were compared. The levels of adenosine triphosphate (ATP) and adenosine diphosphate (ADP) in myocardial tissue and thioredoxin reductase (TRx) and thioredoxin reductase (TrxR) in liver tissue were compared Level. 【Results】 LVED, LVEDS , LVP-WT and IVST in the control group and high-dose group were lower than those in the low-dose group and Western medicine group, and LVEF levels in the control group and the high-dose group were higher than those in the low-dose group and the Western medicine group (P<0.05). The contents of ATP and ADP in myocardial tissue and the levels of TRx and TrxR in liver in the control group and high-dose group were significantly higher than those in the low-dose group and the Western medicine group (P<0.05). 【Conclusion】 Suixin capsule can be used to treat rats with chronic heart failure, improve cardiac function, TRX system and cardiomyocyte energy. 2021 Vol. 38 (11): 1690-1692 [Abstract] ( 56 ) HTML (0 KB)  PDF (1160 KB)  ( 39 ) 1693 Application of Corrected Left Ventricular Ejection Time and Stroke Volume Variability in Perioperative Volume Management Guiding Off-pump Coronary Artery bypass Grafting WANG Wei-wei, REN Shao-yu, LIU Pan-pan DOI: 10.3969/j.issn.1671-7171.2021.11.026 【Objective】To explore the application value of corrected left ventricular ejection time (LVETc) and stroke volume variability (SVV) in perioperative volume management guidance of off-pump coronary artery bypass grafting (OPCABG). 【Methods】A total of 66 patients with OPCABG were randomly divided into the observer group and the control group, with 33 cases in each group. The volume management was guided by LVETc in the observation group , and it was guided by SVV in the control group. The basic indexes (operation time, total rehydration volume, intraoperative urine volume, intraoperative blood loss, extubation time) of the two groups during the perioperative period were recorded. The hemodynamic indexes at different time points (mean arterial pressure, stroke volume index, heart rate, cardiac index, systemic vascular resistance) and oxygen kinetic indexes at different time points (oxygen supply index, oxygen consumption index, oxygen uptake rate) were measured in the two groups. In addition, the adverse reactions of the two groups were compared as well. 【Results】The total rehydration volume in the observation group was significantly lower than that that in the control group (P<0.05).The heart rate of the observation group was significantly lower than that of the control group when the pericardium was opened (T0) (P<0.05).The cardiac index of the observation group at T0 and T1 (left anterior descending branch bypass), was significantly lower than that of the control group(P<0.05).The systemic vascular resistance of the observation group at T0,T1, T2 (blunt edge branch bypass) and T3 (posterior descending branch bypass) was significantly higher than that of the control group (P<0.05).The oxygen supply index of the observation group was significantly lower than that of the control group at T1,T2 and T3 (P<0.05).The oxygen uptake rate of the observation group was significantly higher than that of the control group at T1,T2 and T3(P<0.05).The difference was not statistically significant in comparison of postoperative cardiovascular adverse reactions between the two groups (P>0.05). 【Conclusion】Taking LVETc as the guidance of volume management can reduce the total rehydration volume, improve the hemodynamics and oxygen kinetic indexes of patients. It reduces the fluid load in tissue space which is worthy of clinical promotion. 2021 Vol. 38 (11): 1693-1696 [Abstract] ( 46 ) HTML (1 KB)  PDF (1191 KB)  ( 176 ) 1697 Effect of Ivabradine Combined with Fuling Wenshen Capsule on Chronic Heart Failure Treatment WANG Yi-lei, GAO Xin, LI Ya-feng, et al DOI: 10.3969/j.issn.1671-7171.2021.11.027 【Objective】To explore the effect of ivabradine and Fuling Wenshen capsule in the treatment of patients with chronic heart failure. 【Methods】A total of 116 patients with chronic heart failure in our hospital from December 2018 to January 2021 were selected. According to the random number table method, they were divided into the observation group and the control group, with 58 cases in each group. On the basis of conventional treatment, the control group was treated with ivabradine for 4 weeks, and the observation group was treated with ivabradine combined with Fuling Wenshen capsule for 4 weeks. The clinical efficacy, adverse reactions, and Lee's heart failure scores before treatment, 2 weeks, and 4 weeks after treatment, Minnesota living with heart failure questionnaire (MLHFQ) score, 6-min walking distance (6MWT), cardiac function indexes [left ventricular ejection fraction (LVEF), cardiac output (CO), stroke volume (SV)], Bax and Caspase-3 protein expression were compared between the two groups. 【Results】After 4 weeks of treatment, the total effective rate in the observation group was 93.10% (54/58), which was lower than 79.31% (46/58) in the control group. The difference was statistically significant (χ2=4.64, P<0.05). Compared to before treatment, Lee's heart failure score and MLHFQ score of the two groups were significantly reduced after 4 weeks of treatment, and 6MWT was significantly increased. The improvement in the observation group was better than the control group; and the difference was statistically significant (P<0.05). After 4 weeks of treatment, the levels of LVEF, CO and SV in the two groups were significantly higher than those before treatment; And the observation group increased better than the control group, the difference was statistically significant (P<0.05). The expression of Bax and Caspase-3 in the two groups showed a decreasing trend if comparing to before treatment, and the observation group was lower than the control group (P<0.05). 【Conclusion】The combination of ivabradine and Fuling Wenshen capsule in the treatment of chronic heart failure has a significant clinical effect and good safety. It can effectively control the symptoms of heart failure in patients, improve exercise endurance and quality of life, and at the same time alleviate myocardial cell damage, reduce apoptosis, and improve cardiac function. 2021 Vol. 38 (11): 1697-1699 [Abstract] ( 49 ) HTML (0 KB)  PDF (1163 KB)  ( 41 ) 1700 Effect of Laparoscopic High Ligation of Hernia in Children and its Effect on Inflammatory Factors and Intestinal Mucosal Barrier Function GUAN Min DOI: 10.3969/j.issn.1671-7171.2021.11.028 【Objective】 To investigate the clinical effect of laparoscopic high ligation of pediatric hernia and its effect on inflammatory factors and intestinal mucosal barrier function. 【 Methods 】 A total of 140 children with hernia treated in our hospital were randomly divided into control group (traditional surgical treatment) and observation group (laparoscopic high ligation of children's hernia), with 70 cases in each group. The operation time, incision length, intraoperative bleeding, first anal exhaust time and hospital stay were recorded. The pain scores 24 hours before operation and 8 and 24 hours after operation were compared between the two groups. The serum C-reactive protein (CRP), interleukin-10 (IL-10) and interleukin-1 were analyzed 24 hours before operation and 24 hours after operation β(IL-1β) And urinary lactulose/mannitol (L/M) ratio, urinary intestinal fatty acid binding protein (iFABP), and the levels of blood D-lactic acid (D-LA) 24 hours before and 24 hoursafter operation were observed.【Results】 The operation time, incision size, intraoperative bleeding, first anal exhaust time and hospital stay in the observation group were lower than those in the control group (P<0.05). At 8 h and 24 h after operation, the pain scores of the two groups were significantly lower than that of the control group, and the difference was statistically significant (P<0.05). 24 hours after operation, the levels of serum CRP, IL-10 and IL-1β in the two groups in the observation group were lower than those in the control group (P<0.05). At 24 hours after operation, the levels of serum D-LA, urinary L/M and IFABP in the control group were higher than those at 24 hours before operation (P<0.05), there was no significant difference in the observation group (P>0.05), and the levels in the observation group were lower than those in the control group (P<0.05). 【Conclusion】Compared with traditional surgery, laparoscopic high ligation of pediatric hernia has better clinical effect in the treatment of pediatric hernia. It can significantly reduce the amount of intraoperative bleeding, shorten the operation time, anal exhaust time and hospital stay, and has less inflammatory stress response and less impact on the function of intestinal mucosal barrier. 2021 Vol. 38 (11): 1700-1703 [Abstract] ( 56 ) HTML (1 KB)  PDF (1188 KB)  ( 69 ) 1704 Influencing Factors of Clinicopathological Characteristics and Recurrence Risk of Vocal Cord Leukoplakia BAI Feng-bo, CHE Na DOI: 10.3969/j.issn.1671-7171.2021.11.029 【Objective】 To explore the influencing factors of clinicopathological characteristics high clinical recurrence risk of vocal cord leukoplakia.【Methods】A retrospective analysis of 96 patients with vocal cord leukoplakia treated in our hospital was used as the observation group. The patients were divided into high-risk groups (n=15) and low-risk groups (n=81) according to their pathological types. According to the recurrence, patients were divided into recurrence group (n=17) and non-recurrence group (n=79). In the same time period, 89 volunteers who had a healthy physical examination in our hospital were selected as the control group. Clinical data were collected and analyzed. 【Results】 (1) There was no significant difference between the observation group and the control group in the proportion of males, age> 60 years old, general hospital depression scale (HADD) score> 1 point, and general hospital anxiety and depression scale (HADA) score> 1 point(P>0.05). However, the proportion of smoking, drinking, reflux symptom index (RSI)>10, reflux sign score (RFS)>6, and overuse of voice in the observation group was significantly higher than that of the control group (P<0.05). (2) The proportion of the high-risk group with age >60 years old and scattered leukoplakia was significantly higher than that of the low-risk group.( 3) The proportion of the recurrence group with age> 60 years old and scattered leukoplakia in the recurrence group was significantly higher than that in the non-recurrence group; the differences were statistically significant (all P<0.05). 【Conclusion】Smoking, drinking and overuse of voice are the influencing factors of vocal leukoplakia. The elderly patients with leukoplakia are at high risk of recurrence. 2021 Vol. 38 (11): 1704-1706 [Abstract] ( 65 ) HTML (0 KB)  PDF (1162 KB)  ( 24 ) 1707 Protective Effect of Lidocaine Combined with Lung Protective Ventilation on Tourniquet-induced Lower Limbs Ischemia-reperfusion Lung Injury MA Shi-cai, ZHANG Hai DOI: 10.3969/j.issn.1671-7171.2021.11.030 【Objective】To explore the protective effect of lidocaine combined with lung protective ventilation on tourniquet-induced lower limbs ischemia-reperfusion lung injury. 【Methods】A total of 108 patients undergoing unilateral lower extremity surgery admitted to the hospital from June 2019 to May 2020 were selected and divided into the control group and the observation group according to a random number table, with 54 cases in each group. Both groups were treated with combined spinal-epidural anesthesia, and lung-protective ventilation were given throughout the course. While the combined group received intravenous lidocaine and the control group received the same amount of normal saline instead. The blood pressure, heart rate, alveolar artery partial pressure of oxygen (A-aDO2), oxygenation index (OI), plasma malondialdehyde (MDA), interleukin-8 (IL-8), thromboxane B2 (TXB2) levels and adverse reactions of the two groups of patients at different time points were compared. 【Results】 The average arterial pressure at 5 minutes after loosening the tourniquet (T1) in the two groups were reduced. While the average arterial pressure at T1 and 30 minutes after loosening the tourniquet (T2) in the observation group were higher than that in the control group (P<0.05). The A-aDO2 increased at T1 and T2 in the two groups, and A-aDO2 at T1 and T2 in the observation group were lower than that in the control group (P<0.05). The OI at T1 and T2 of the two groups decreased, however, the OI at T1 and T2 of the observation group were higher than that of the control group (P<0.05). The MDA, IL-8 and TXB2 of the two groups increased at T1, and the MDA, IL-8 and TXB2 of the observation group were lower than those of the control group at T1 and T2 (P<0.05). There were no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】Lidocaine combined with lung protective ventilation can reduce the tourniquet-induced lower limbs ischemia-reperfusion lung injury, and it has a certain protective effect. 2021 Vol. 38 (11): 1707-1709 [Abstract] ( 55 ) HTML (1 KB)  PDF (1162 KB)  ( 42 ) 1710 Effect of Cardiac Function on Mortality in Elderly Patients with Hip Fracture XIN Yu-xi DOI: 10.3969/j.issn.1671-7171.2021.11.031 【Objective】To investigate the effect of cardiac function on the incidence of death in elderly patients with hip fracture. 【Methods】A total of 526 elderly patients with hip fracture treated in our hospital from August 2017 to December 2019 was selected as the research objects. Followed up for 1 year, the death of elderly patients with hip fracture was counted, and the patients were divided into death group and survival group according to whether death occurred. The clinical data of patients in death group and survival group were analyzed. The survival of patients with cardiac insufficiency group and good cardiac function group were compared. Logistic multivariate regression analysis was used to analyze the factors affecting the death of elderly patients with hip fracture. 【Results】 The mortality of elderly patients with hip fracture was 18.63%. The age, the proportion of coronary atherosclerotic heart disease, the proportion of renal insufficiency, the proportion of cardiac function grade Ⅱ~Ⅳ and the proportion of conservative treatment in the death group were significantly higher than those in the survival group (P<0.05). Logistic regression analysis showed that renal insufficiency, cardiac function grade Ⅱ~Ⅳ and conservative treatment were the risk factors of death in elderly patients with hip fracture (OR=4.141, 3.572, 2.866, P<0.05). The survival rates of cardiac insufficiency group and good cardiac function group were 59.57% and 86.11% respectively. There was significant difference between the two groups (P<0.05). 【Conclusion】 Renal insufficiency, cardiac insufficiency and conservative treatment are the risk factors of death in elderly patients with hip fracture, and the mortality of elderly patients with hip fracture and cardiac insufficiency is higher than that of patients with good cardiac function. 2021 Vol. 38 (11): 1710-1713 [Abstract] ( 62 ) HTML (0 KB)  PDF (1219 KB)  ( 18 )

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