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Quick Search     Adv Search 2022 Vol. 39, No. 2 Published: 2022-02-26 Original Articles          Original Articles 161 Effect of Transcutaneous Electrical Acupoint Stimulation on Postoperative Hyperalgesia Induced by Remifentanil in Rat Incision Pain Model ZHANG Hang, ZHU Li, LI Na, et al DOI: 10.3969/j.issn.1671-7171.2022.02.001 【Objective】To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative hyperalgesia induced by remifentanil in rat incision pain model. 【Methods】 All rats were numbered and randomly divided into three groups: incision pain group, remifentanil group and TEAS treatment group, with 30 rats in each group. The rat incision pain model was established by Brennan method in each group. After successful modeling in remifentanil group, remifentanil was infused into caudal vein during operation. After anesthesia in TEAS treatment group, electroacupuncture stimulation at Zusanli and Sanyinjiao on the same side was for 30 minutes, and remifentanil was infused into caudal vein after electroacupuncture treatment. At 24 h (T0) before operation and 6 h (T1), 24 h (T2) and 48 h (T3) after operation, the thermal stimulation foot contraction reflex threshold (pwtl) and mechanical stimulation foot contraction reflex threshold (pmwt) of rats in each group were measured by intelligent hot plate instrument and filament pain meter. The spinal cord tissue of rats was stained by immunohistochemical method, the average number of nerve cells was calculated, and the number of c-fos positive nerve cells was obtained. 【Results】At T0, there was no significant difference in terms of pwtl and pmwt values among the three groups (P>0.05). Compared with T0, pwtl and pmwt in T1, T2 and T3 groups showed a downward trend, and the difference was statistically significant (P<0.05). At T1, T2 and T3, the pwtl and pmwt values of the remifentanil group and the TEAS treatment group were higher than those of the incision pain group, and those values in TEAS treatment group were higher than those in the remifentanil group (P<0.05). The c-fos positive neurons in rat spinal cord were located in the nucleus and they were stained in dark grayish brown, round and uniform granules. The negative neurons were dark gray in the middle and light gray at the edge. The difference in TEAS treatment group was significantly lower than that in the incision pain group and the remifentanil group (P<0.05). 【Conclusion】The c-fos may be involved in postoperative hyperalgesia in rats with incision pain induced by remifentanil. TEAS treatment can delay postoperative hyperalgesia in rats with incision pain. 2022 Vol. 39 (2): 161-164 [Abstract] ( 94 ) HTML (1 KB)  PDF (1729 KB)  ( 88 ) 165 Comparison of Transvaginal Posterior Fornix Puncture and Drainage and Laparoscopic Surgery in the Treatment of Ovarian Corpus Luteum Rupture YE Li-li, PAN Yue DOI: 10.3969/j.issn.1671-7171.2022.02.002 【Objective】To investigate the efficacy of transvaginal posterior fornix puncture and drainage and laparoscopic surgery in the treatment of ovarian corpus luteum rupture. 【Methods】A total of patients with ovarian corpus luteum rupture diagnosed and treated in the Third Hospital of Shandong Province from February 2018 to February 2020 was selected as the research objects. They were randomly divided into puncture and drainage group (n=30) and laparoscopy group (n=30). The patients in the puncture and drainage group were treated with transvaginal posterior fornix puncture and drainage, and the patients in the laparoscopic group were treated with laparoscopic surgery. The operation related indexes, postoperative pain, ovarian reserve function indexes (anti Mullerian hormone (AMH), inhibin B (INHB) and postoperative adverse reactions were compared between the two groups. 【Results】The amount of intraoperative bleeding, operation time, hospitalization days and hospitalization expenses in the puncture and drainage group were less than those in the laparoscopy group (P<0.05); The VAS scores at T1, T2 and T3 in the puncture and the drainage group were significantly lower than those in the laparoscopy group (P<0.05). After operation, the expression levels of serum AMH and INHB in the two groups were significantly lower than those before treatment (P<0.05), and the expression levels of serum AMH and INHB in the laparoscopic group were significantly lower than those in the puncture and drainage group (P<0.05). The incidence of postoperative lower abdominal pain, abnormal menstruation, abnormal basal body temperature and uterine bleeding in the puncture and drainage group were significantly lower than those in the laparoscopy group (P<0.05). 【Conclusion】 Compared with laparoscopic surgery, transvaginal posterior fornix puncture and drainage in the treatment of patients with ovarian corpus luteum rupture has less postoperative pain, less impact on ovarian reserve function, and high safety, which is worthy of clinical application. 2022 Vol. 39 (2): 165-167 [Abstract] ( 121 ) HTML (1 KB)  PDF (1135 KB)  ( 175 ) 168 Study on the Effect and Mechanism of Andrographolide Combined with Pirfenidone on the Activation of Hepatic Stellate Cells Induced by TGF-β1 XU Guang, MA Ti-dong, ZHAO Fan, et al DOI: 10.3969/j.issn.1671-7171.2022.02.003 【Objective】To investigate the effect of andrographolide (AG) combined with pirfenidone (PFD) on hepatic stellate cell activation induced by transforming growth factor-β1(TGF-β1) and its mechanism . 【Methods】 Hepatic stellate cells (LX-2) were used as the research object. After routine in vitro culture, they were divided into control group, TGF-β1 Group , AG group, PFD group and AG + PFD group. MTT assay was used to determine the cell viability of five groups, RT-PCR was used to detect the mRNA expression levels of fiber markers and inflammatory markers, and Western blot was used to detect the related protein expression level of TGF -β/ Smad signaling pathway cells in each group.【Results】 Compared with TGF- β1 group, fiber markers(α- SMA mRNA, Collagen-ⅠmRNA and CTGF mRNA) inflammatory marker (IL-1βmRNA, IL-6 mRNA and TNF- αmRNA) and TGF-β/ Smad signaling pathway related proteins (p-Smad2, p-smad3) of the AG group, the PFD group and the AG + PFD group were significantly down regulated (mean P<0.05); Compared with the PFD group, the expression levels of α- SMA mRNA and IL-6 mRNA in the AG + PFD group were significantly down regulated (mean P<0.05).【Conclusion】 Compared with monotherapy, AG combined with PFD therapy has significant effect on the activation of hepatic stellate cells induced by TGF-β1, and plays a better role in anti hepatic fibrosis, and its mechanism may be related to the regulation of TGF-β/ Smad signaling pathway. 2022 Vol. 39 (2): 168-172 [Abstract] ( 79 ) HTML (1 KB)  PDF (1591 KB)  ( 111 ) 173 Incidence and Influencing Factors of Urinary Incontinence after Transurethral Resection of Prostate in Patients with Benign Prostatic Hyperplasia Ren Hang, YANG Xin-xuan DOI: 10.3969/j.issn.1671-7171.2022.02.004 【Objective】To investigate the incidence and influencing factors of postoperative urinary incontinence in patients with benign prostatic hyperplasia treated by transurethral resection of the prostate. 【Methods】The clinical data of 150 patients with benign prostatic hyperplasia treated by transurethral resection of prostate from January 2017 to January 2020 were analyzed retrospectively. According to whether the patients had urinary incontinence after operation, they were divided into observation group (with urinary incontinence) and control group (without urinary incontinence). The incidence of postoperative urinary incontinence was recorded, the general data and perioperative indexes of the two groups were compared, and the influencing factors of postoperative urinary incontinence were analyzed by logistic regression. 【Results】 One month after operation, 29 patients had urinary incontinence. There were 1 case of true urinary incontinence, 13 cases of urgent urinary incontinence and 15 cases of stress urinary incontinence; There were 20 cases of mild urinary incontinence, 8 cases of moderate urinary incontinence and 1 case of severe urinary incontinence. The weight of prostatectomy/volume of prostate, volume of prostate, operation time, mass of prostatectomy tissue during operation, blockage rate of urinary catheter, proportion of postoperative constipation and water injection of urinary catheter balloon in the observation group were higher than those in the control group, and the training rate of pelvic floor muscle before operation was lower than that in the control group (all P<0.05). Multivariate logistic regression analysis showed that prostate volume, age, preoperative pelvic floor muscle training and the amount of water injected into urethral catheter balloon were the influencing factors of postoperative urinary incontinence in patients undergoing transurethral resection of prostate (P<0.05). 【Conclusion】 The incidence of postoperative urinary incontinence in patients with benign prostatic hyperplasia treated by transurethral resection of the prostate is high. Prostate volume, age, preoperative pelvic floor muscle training and the amount of water injected into the bladder of urinary catheter are the influencing factors of postoperative urinary incontinence. Preoperative pelvic floor muscle training can reduce the risk of urinary incontinence. 2022 Vol. 39 (2): 173-175 [Abstract] ( 58 ) HTML (1 KB)  PDF (1136 KB)  ( 38 ) 176 Relationship of Severity of COVID-19 Sickness with Blood Routine and Biochemical Indexes in 137 Patients LI Zeng, LI Jin-qiang, LIU Chang-ming, et al DOI: 10.3969/j.issn.1671-7171.2022.02.005 【Objective】To investigate the blood routine and biochemical indexes of 139 patients with coronavirus disease COVID-19, and explore the relationship between the indexes and the severity of COVID-19 disease. 【Methods】Clinical data of 137 patients with COVID-19 were collected from the Public Health Treatment Center of Changsha during January to March of 2020. The blood routine, liver and kidney function, myocardial enzymes, inflammation index (CRP), coagulation function and other data were compared between severe (n=25) and non-severe (n=112) COVID-19 patients. Logistic regression was used to analyze the early warning index of severe COVID-19.The value of predicting the progress of LDH, CRP and LYM to heavy COVID-19 was analyzed by using receiver operating characteristic curve (ROC curve). 【Results】 Severe patients had higher levels of age, neutrophil percentage (NEU%), C-reactive protein (CRP), creatine kinase (CK) and lactate dehydrogenase (LDH) than the non-severe patients(P<0.05). Lymphocyte count(LYM)was significantly lower in the severe group than that in the non-severe group(P<0.05).There were no significant differences in sex ratio, days of treatment, white blood cell count(WBC), platelet count(PLT), creatine kinase isoenzyme(CK-MB), total bilirubin(TBIL), alanine aminotransferase(ALB), aspartate aminotransferase (AST), albumin (ALB), creatinine (CREA), blood urea nitrogen (BUN), prothrombin time (PT) between the two groups(P>0.05). The spearman rank correlation test showed that age, NEU%, LYM count, CRP, CK and LDH were all significantly correlated with the severity of COVID-19;The correlation coefficients were 0.338, 0.516, -0.324, 0.477, 0.567 and 0.292, respectively, (P<0.05). ROC curve analysis shows that the optimal threshold for LDH was 262.60 U/L, the area under the curve (AUC) was 0.924, the sensitivity was 76.0%, and the specificity was 95.5%. The optimal threshold for CRP was 34.28 mg/L, the AUC was 0.856, the sensitivity was 76.0% , and the specificity was 86.6%. The optimal threshold of LYM was 0.925×109/L, the AUC was 0.742, the sensitivity was 76%, and the specificity was 63.4%. The AUC of the combined analysis of LDH, CRP and LYM was 0.944 (P<0.05), and the combined detection of the three had the highest diagnostic value.【Conclusion】LDH, CRP and LYM are valuable for early assessment of COVID-19, and their combined analysis can improve the effectiveness of early judgment of COVID-19 severity, which has certain significance for early clinical identification of severe COVID-19. 2022 Vol. 39 (2): 176-179 [Abstract] ( 80 ) HTML (1 KB)  PDF (1322 KB)  ( 46 ) 180 Correlation between Temperature of Hypothermia Treatment and Pulmonary Infection after Cardiopulmonary Resuscitation LIU Yan-ling, JU Fang-ping DOI: 10.3969/j.issn.1671-7171.2022.02.006 【Objective】To explore the correlation between mild hypothermia treatment at different temperatures and pulmonary infection in patients with cardiac arrest and recovery of cardiac rhythm through cardiopulmonary resuscitation. 【Methods】Seventy-two patients after cardiopulmonary resuscitation in our hospital were randomly divided into three groups: group A, group B and group C, with 24 cases in each group. Group A was treated with non-hypothermia, group B with 36 ℃ hypothermia and group C with 33 ℃ hypothermia. The survival rates at 2 weeks after treatment and at the time of hospital discharge in the three groups were compared, and the clinical pulmonary infection score (CPIS), sputum culture positive rate, sputum culture positive pathogenic bacteria spectrum, oxygen and index and infection indexes [Creactive protein (CRP) and procalcitonin (PCT)] on treatment 3 d and treatment 7 d were compared among the three groups. 【Results】There was no significant difference in the survival rate between the three groups after 14 days of treatment and at the time of discharge (P>0.05). The CPIS score of group C on 3 d and 7 d of treatment was lower than that of group A and group B (P<0.05). There was no significant difference in the positive rate of sputum culture among the three groups on 3 d of treatment (P>0.05). The positive rate of sputum culture on 7 d of treatment in group C was lower than that in group A and group B (P<0.05). There was no significant difference in sputum culture positive pathogenic bacteria spectrum between the three groups on treatment day 3 and treatment day 7 (P>0.05). On treatment 3 d and 7 d, the oxygen and index of group C were higher than those of group A and group B, and the levels of CRP and PCT were lower than those of group A and group B (P<0.05). 【Conclusion】The mild temperature control, which is at 33 ℃ hypothermia treatment after cardiopulmonary resuscitation, can reduce pulmonary infection, reduce the positive rate of sputum culture, increase oxygen and index, and improve the levels of CRP and PCT. 2022 Vol. 39 (2): 180-182 [Abstract] ( 49 ) HTML (1 KB)  PDF (1136 KB)  ( 37 ) 183 Value of Peripheral Blood Beclin1, LC3 and Th1/Th2 Balance in Predicting Liver Function Damage in Patients with Autoimmune Hepatitis HAO Yan-xia, BAI Hong-yan DOI: 10.3969/j.issn.1671-7171.2022.02.007 【Objective】To explore the value of Peripheral Blood Beclin1, LC3 and Th1/Th2 balance in predicting liver damage in patients with autoimmune hepatitis (AIH). 【Methods】A total of 91 AIH patients admitted to our hospital from April 2017 to June 2020 were selected as the research objects. According to whether liver damage occurred, they were divided into the liver function injured group (27 cases) and the liver function uninjured group (64 cases). The clinical characteristics of the two groups were compared and the levels of Beclin1, LC3, and Th1/Th2 balance in peripheral blood e that affected the occurrence of liver damage in AIH patients were analyzed. The area under the receiver operating characteristic (ROC) curve (AUC) value was used to evaluate the value of Beclin1,LC3 levels and Th1/Th2 balance in predicting liver function damage in AIH patients. 【Results】The levels of C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total bilirubin (TBIL), glutamyl transferase (GGT), alkaline phosphatase (ALP), immunoglobulin protein IgG, interferon-γ (INF-γ), Beclin1, LC3 and Th1/Th2 in the liver function injured group were all higher than those in the liver function uninjured group, while the level of interleukin-4 (IL-4) in the injured group was lower than that in the uninjured group (P<0.05). Logistic regression analysis showed that Beclin1, LC3 and Th1/Th2 were the influencing factors of liver damage in AIH patients (P<0.05). ROC curve analysis results showed that Beclin1, LC3, Th1/Th2 alone and the combined AUC of the three were 0.773, 0.844, 0.751 and 0.896, respectively. And the combined AUC of the three was the largest. 【Conclusion】 The levels of Beclin1 and LC3 in the peripheral blood of AIH patients are overexpressed, and the balance of Th1/Th2 tends to Th1. The combined detection of Beclin1, LC3 and Th1/Th2 has a better predictive value for AIH liver damage. 2022 Vol. 39 (2): 183-186 [Abstract] ( 48 ) HTML (1 KB)  PDF (1259 KB)  ( 36 ) 187 Application of Self-management Health Education Scheme Based on Schema Theory in Disease Cognition and Health Promotion Behavior of Stroke Patients SHENG Li-juan, YUAN Liang-yan, XIE Shan-shan, et al DOI: 10.3969/j.issn.1671-7171.2022.02.008 【Objective】To investigate the effects of self-management health education scheme based on schema theory in disease cognition and health promotion behavior of stroke patients.【Methods】Using convenience sampling method, we collected 80 stroke patients from March 2019 to January 2020 who met the inclusion and exclusion criteria and were hospitalized in the neurology department. Among them, 40 patients admitted from March to June 2019 were in the control group who received routine neurology care. While 40 patients admitted from July 2019 to January 2020 were included in the intervention group, who were given self-management health education scheme based on the control group. The cognitive status of disease knowledge and health promotion behavior of patients were evaluated by the Health-Promoting Lifestyle Profile Ⅱ (HPLPⅡ) before intervention during hospitalization and after intervention ( reexamination after 1 month of discharge).【Results】Before intervention, there were no statistically significant differences in stroke knowledge level and health promotion behavior between the two groups (P>0.05). After intervention, the stroke knowledge level and health promotion behavior score of patients in the intervention group were significantly higher than those in the control group. The difference was statistical significance (P<0.05).【Conclusion】The implementation of self-management health education scheme based on schema theory is beneficial to improve the cognitive level of disease-related knowledge in stroke patients, promote patients to adopt a healthy lifestyle and improve the level of self-management of patients, thereby improving the prognosis of disease and reducing the recurrence of stroke. 2022 Vol. 39 (2): 187-190 [Abstract] ( 66 ) HTML (1 KB)  PDF (1150 KB)  ( 91 ) 191 Influencing Factors of Repeated Implantation Failure in In-Vitro Fertilization-embryo Transfer and its Correlation with Endometrial Endothelial Nitric Oxide Synthase LI Na, Hu Meng-di, WANG Ying DOI: 10.3969/j.issn.1671-7171.2022.02.009 【Objective】To explore the influencing factors of repeated implantation failure in in-vitro fertilization-embryo transfer (IVF-ET) and its correlation with endometrial endothelial nitric oxide synthase (eNOS). 【Methods】To retrospectively analyze the clinical data of 88 patients who underwent in-vitro fertilization-embryo transfer assisted conception at the Reproductive Medicine Center of our hospital from January 2018 to January 2021. According to the results of fertility, the first cycle of in-vitro fertilization-embryo transfer assisted pregnancy was set as the successful pregnancy group (n=56 cases), those who were still infertile after≥ 2 fresh cycles of assisted fertilization were set as the pregnancy failure group (n=32 cases). Logistic regression was used to analyze the related factors affecting pregnancy failure in patients with in vitro fertilization-embryo transfer implantation failures, the endometrium of all patients was sampled during the implantation window period of 1 cycle before embryo transfer, Reverse transcription-polymerase chain reaction was used to detect eNOS mRNA expression, the receiver operating curve (ROC) was used to analyze the value of eNOS mRNA expression level in predicting the pregnancy success of patients with in vitro fertilization-embryo transfer implantation failures. 【Results】Compared with patients in the pregnancy failure group, there were statistically significant differences in the composition ratio of miscarriage history, the length of infertility, estradiol level on HCG day, eNOS mRNA expression in the successful pregnancy group (P<0.05). Logistic multivariate regression analysis showed that the expression level of eNOS mRNA, the length of infertility, and the estradiol level on HCG day were all effect factors affecting pregnancy failure in patients with in vitro fertilization-embryo transfer implantation failures (P<0.05). ROC analysis showed that eNOS mRNA expression level predicts the best cut-off point for pregnancy success in patients with in vitro fertilization-embryo transfer implantation failure was 0.47, the sensitivity was 91.07%, the specificity was 87.50%, and the area under the curve (AUC) was 0.892. 【Conclusion】In vitro fertilization-embryo transfer implantation failures are related to eNOS mRNA expression levels, and eNOS mRNA expression levels, infertility years, and miscarriage history are all effect factors that affect pregnancy failure in patients with in vitro fertilization-embryo transfer implantation failures. Clinical detection of eNOS mRNA expression level can be used as a sensitive indicator for predicting pregnancy success in patients with in vitro fertilization-embryo transfer implantation failures. 2022 Vol. 39 (2): 191-193 [Abstract] ( 51 ) HTML (1 KB)  PDF (1142 KB)  ( 44 ) 194 Effect of Different Anesthesia Methods on Maintenance of Anesthesia and Endothelial Cell Function in Laparoscopic Cholecystectomy ZHANG Jing-yi, WEI Ning-hua DOI: 10.3969/j.issn.1671-7171.2022.02.010 【Objective】To observe the effect of different anesthesia methods on the maintenance of anesthesia and vascular endothelial function during laparoscopic cholecystectomy (LC).【Methods】A total of 78 patients who underwent LC in our hospital were divided into A Group (n=39) and B Group (n=39) by random number table. A group was anesthetized with propofol combined with remifentanil, and B group was anesthetized with sevoflurane. Anesthesia effects (induction time, extubation time, anesthesia recovery time) and vascular endothelial cell function such as peripheral blood P-selectin, intercellular adhesion molecule-1 (ICAM-1) and thrombomodulin (TM) were recorded and compared between the two groups. 【Results】The anesthesia induction time in A group were significantly higher than B group (P<0.01), while the extubation time, recovery time, and anesthesia recovery room stay time of A group were significantly lower than those of B group (P<0.01). The fluctuation range of blood pressure (MAP) and partial pressure of carbon dioxide (PaCO2) at 4 time points was smaller than B group (P>0.05). Levels of MAP and PaCO2 of patients in A group at 15 minutes of pneumoperitoneum were significantly lower than those in B group (P<0.01). After pneumoperitoneum, the PaCO2 of A group was significantly lower than B group (P<0.01). The plasma nitric oxide (NO) content of patients in A group was significantly lower than that in B group at 15 minutes of pneumoperitoneum (P<0.01), while at the same time plasma endothelin-1 (ET-1) content in group A was significantly higher than that in B group (P<0.01). P-selectin and TM in group A were significantly lower than those in B group at four times before pneumoperitoneum, at 15min of pneumoperitoneum and post-pneumoperitoneum, and the differences were statistically significant (P<0.01). There was no significant difference in ICAM-1 between two groups (P>0.05). 【Conclusion】The use of propofol combined with remifentanil for LC surgery will increase the induction time of anesthesia, while it had better intraoperative anesthesia effect to maintain the stability of hemodynamic indicators. At the same time, during the establishment of pneumoperitoneum, plasma NO concentration was increased, ET-1 level was decreased, and vascular endothelial cell function indicators P-selectin and blood ICAM-1 were decreased, which suggested LC had improved vascular endothelial cell function in patients. 2022 Vol. 39 (2): 194-197 [Abstract] ( 50 ) HTML (1 KB)  PDF (1162 KB)  ( 35 ) 198 Relationship of Proliferative Diabetic Retinopathy with Serum Magnesium and Glycosylated Albumin in Patients with Type 2 Diabetes Mellitus ZHAO Hui, SHAO Xiao-han DOI: 10.3969/j.issn.1671-7171.2022.02.011 【Objective】To investigate the relationship of proliferative diabetic retinopathy (PDR) with serum magnesium and glycosylated albumin in patients with type 2 diabetes mellitus (T2DM). 【Methods】A total of 90 patients with T2DM in our hospital from October 2017 to December 2018 were selected and divided into the proliferative diabetic retinopathy (PDR) group (n=42 cases) and non-proliferative diabetic retinopathy (NPDR) group (n=48 cases) according to the occurrence of PDR or not. The level of serum glycosylated albumin was detected by immunoturbidimetry and the level of serum magnesium was measured by enzyme-linked immunosorbent assay. The ROC curve was used to analyze the diagnostic efficacy of serum magnesium and glycosylated albumin in patients with T2DM complicated with PDR. In addition, logistic regression analysis was used to analyze the risk factors of PDR in patients with T2DM. 【Results】Compared with the NPDR group, the serum magnesium level in the group with PDR was lower (P<0.05), and the glycosylated albumin level was higher (P<0.05). The ROC curve showed that the area under curve (AUC) of serum magnesium and glycosylated albumin in the diagnosis of PDR in patients with T2DM were 0.699 and 0.768, their cut-off values were 0.79 mmol/L and 16.35%, respectively. The AUC of combined diagnosis of magnesium and glycosylated albumin was 0.857, which was significantly higher than that of serum magnesium and glycosylated albumin alone (P<0.05), the sensitivity and specificity were 71.4% and 87.5%, respectively. Serum magnesium, glycosylated albumin, triglyceride (TG), course of disease were the risk factors of PDR in patients with diabetes mellitus (P<0.05). 【Conclusion】The serum magnesium of patients with T2DM with PDR is significantly reduced, while glycosylated albumin is abnormally elevated, and both are risk factors for T2DM with PDR, which can be used as potential indicators for later disease diagnosis. 2022 Vol. 39 (2): 198-200 [Abstract] ( 53 ) HTML (1 KB)  PDF (1195 KB)  ( 136 ) 201 Predictive Value of Q-T Dispersion of Electrocardiogram for Occurrence of Cardiovascular Events in Patients with Maintenance Hemodialysis SHAO Shan-shan, WAN Tian-tian, LUO Ai-hong DOI: 10.3969/j.issn.1671-7171.2022.02.012 【Objective】To explore the predictive value of electrocardiogram Q-T dispersion (QTd) for cardiovascular events in maintenance hemodialysis (MHD) patients. 【Methods】A total of 182 patients with MHD who were treated in our hospital were selected as the research objects. During the 1-year follow-up, the cardiovascular events of MHD patients were counted and divided into the occurrence group and the non-occurring group according to whether a cardiovascular event occurred. Clinical data of patients in the occurrence group and the non-occurrence group were compared. Logistic multivariate regression was analyzed for related factors affecting cardiovascular events in MHD patients. The receiver operating characteristic curve (ROC) was drawn to analyze the predictive power of electrocardiogram QTd for cardiovascular events in MHD patients. 【Results】The incidence of cardiovascular events in this study was 23.63%(43/184). The dialysis age, blood creatinine, blood phosphorus, cystatin C and QTd of the occurrence group were significantly higher than those of the non-occurring group (P<0.05), and the residual kidney filtration rate of the occurrence group was significantly lower than that of the non-occurring group (P<0.05). Logistic regression analysis showed that residual kidney filtration rate, cystatin C and QTd were the influencing factors of cardiovascular events in MHD patients (OR=3.133, 2.776, 3.554, respectively, P<0.05). ROC analysis showed that the best cut-off points of ECG QTd for predicting cardiovascular events in MHD patients were 62.78 ms, and the sensitivity, specificity and area under the curve (AUC) were 62.79%, 75.54%, and 0.744, respectively. 【Conclusion】Electrocardiogram QTd has a high predictive power for cardiovascular events in MHD patients, and can be used as an important reference index for predicting cardiovascular events in MHD patients. 2022 Vol. 39 (2): 201-204 [Abstract] ( 51 ) HTML (1 KB)  PDF (1221 KB)  ( 49 ) 205 Efficacy of Pyrrotinib Combined with Chemotherapy in the Treatment of HER2 Positive Advanced Breast Cancer ZHAO Xiao-yu, SONG Zhong-hua, QU Xiang-hui DOI: 10.3969/j.issn.1671-7171.2022.02.013 【Objective】To explore the efficacy and survival status of pyrrotinib combined with chemotherapy in the treatment of human epidermal growth factor receptor 2 (HER2) positive advanced breast cancer. 【Methods】A total of 72 patients with HER2 positive advanced breast cancer admitted to our hospital was randomly divided into observation group and control group, 36 cases in each group. The control group was treated with routine chemotherapy, and the observation group was treated with pyrrotinib combined with chemotherapy. The use of chemotherapy drugs, short-term clinical efficacy, adverse reactions and survival of the two groups were compared.【Results】The clinical control rate in the observation group was 69.44% (25/36), which was significantly higher than 47.22% (17/36) in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions such as nausea, vomiting, hair loss and fatigue between the observation group and the control group (P>0.05). After 6 months of follow-up, the survival rates of the control group and the observation group were 80.00% and 88.24% respectively. There was no significant difference in the survival curve between the two groups (P>0.05). 【Conclusion】Pyrrotinib combined with chemotherapy in the treatment of HER2 positive advanced breast cancer patients can improve the clinical control rate and is safe and reliable. However, the survival rate of patients with follow-up of 6 months after operation is not significantly improved. 2022 Vol. 39 (2): 205-207 [Abstract] ( 59 ) HTML (1 KB)  PDF (1166 KB)  ( 80 ) 208 Effects of Different Traction Methods Asisted by PFNA Internal Fixation on Operative Time and Early Postoperative Trauma Stress in Elderly Patients with Intertrochanteric Fracture of Femur GU Huan-min, LIANG Ting-ting, WANG Gui-ling DOI: 10.3969/j.issn.1671-7171.2022.02.014 【Objective】To explore the application value of different traction methods assisted by proximal femoral nail anti-rotation(PFNA) internal fixation in elderly patients with intertrochanteric fracture of femur (IFOF). 【Methods】A total of 80 elderly patients with IFOF in our hospital were randomly divided into brown frame traction group and traction bed traction group, with 40 cases in each group. Both groups were treated with PFNA internal fixation. The traction bed group was treated with supine traction bed traction, and the brown frame group was treated with half stone brown frame bone traction. The operation conditions, the time of getting out of bed after operation, the indexes of early postoperative trauma stress [norepinephrine (NE), cortisol (COR), angiotensin Ⅱ (Ang Ⅱ)] and hip function were compared between the two groups. 【Results】 The preoperative preparation time and operation time of the Brown's frame group were shorter than those of the traction bed group. The intraoperative blood loss, the number of intraoperative fluoroscopy and the number of X-ray exposures were less than that of the traction bed group. The postoperative time to get out of bed was shorter than that of the traction bed group (P<0.05); The comparison of serum NE, Cor, AngⅡ group, time point comparison and interaction difference were statistically significant (P<0.05); Intra-group comparison: Serum NE, Cor and AngⅡ at 1 and 3 days after operation were higher than those before operation, and serum NE, Cor and AngⅡ at 1 day after operation were higher than 3 days after operation (P<0.05); Comparison between groups: Serum NE, Cor and AngⅡ in the Brown's frame group were lower than those in the traction bed group at 1 and 3 days after surgery (P<0.05); Harris scores in the two groups were higher than before surgery at 6 months after surgery (P<0.05) , There is no significant difference between groups (P>0.05).【Conclusion】Brown's skeletal traction in the semi-lithotomy position and PFNA internal fixation in the supine position traction table are effective in the treatment of elderly patients with IFOF. However, the Brown's skeletal traction in the semi-lithotomy position can optimize the operation and reduce the early postoperative trauma stress and speed up the recovery process after surgery. 2022 Vol. 39 (2): 208-211 [Abstract] ( 46 ) HTML (1 KB)  PDF (1159 KB)  ( 68 ) 212 Efficacy Comparison of Involved Field and Prevention Field in Radical Radiotherapy for Elderly Esophageal Cancer ZHANG Shu-ze, HUAI Bao-hua, HONG Yue-yan, et al DOI: 10.3969/j.issn.1671-7171.2022.02.015 【Objective】To comparison the effects of the involved field and preventive field in radical radiotherapy for elderly esophageal cancer. 【Methods】A total of 80 elderly patients with esophageal cancer who underwent radical radiotherapy in our Hospital were randomly divided into the control group (indicating the involved field of radiation, 42 cases) and the observation group (Indicating the preventive field exposure, 38 cases). The short-term efficacy and the total incidence of side effects were compared between the two groups. Local control rate and survival rate were compared after 3 years of follow-up. 【Results】The total effective rates of radiotherapy in the control group and the observation group were 73.81% and 78.95%, respectively, with no statistically significant difference (P>0.05). The incidence of side effects in the observation group was 31.58%, which was significantly higher than that in the control group 11.90% (P<0.05). The local control rates of patients in the control group at year 1, 2 and 3 years were 76.19%, 61.90% and 50.00%, respectively, while the local control rates of patients in observation group at year 1, 2 and 3 were 92.11%, 76.32% and 65.79%, respectively. The differences between the two groups were not statistically significant (P>0.05). There was also no significant difference in 3-year survival curve between the control group and the observation group (P>0.05). 【Conclusion】The total effective rate, local control rate and 3 years survival rate of the two targeted area sketching methods in the radical radiotherapy for elderly patients with esophageal cancer were similar, but the total incidence of adverse reactions in the prevention field was higher than that in the involved field. 2022 Vol. 39 (2): 212-214 [Abstract] ( 63 ) HTML (1 KB)  PDF (1224 KB)  ( 52 ) 215 Application of High Flow Preglottic Oxygen Therapy in Painless Gastroscopy in Obese Patients WANG Qi-ming, DONG Li-lu, LUO Cheng DOI: 10.3969/j.issn.1671-7171.2022.02.016 【Objective】To investigate the safety and feasibility of preglottic high flow oxygen in painless gastroscopy in obese patients. 【Methods】Eighty obese patients undergoing painless gastroscopy were randomly divided into the observation group (group A) and the control group (group B), with 40 cases in each group. Group A was given preglottic high-flow oxygen (oxygen flow 8-10L/min), while group B was given traditional nasal catheter oxygen (oxygen flow 3L/min). The mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), and arterial oxygen saturation (SpO2) before anesthesia (T0), at the time of disappearance (T1), 2 minutes after the disappearance of eyelash reflexes (T2), and awake at the end of gastroscopy (T3) were compared between the two groups. Meanwhile the tongue base fall, jaw support or mask assisted ventilation , the dosage of propofol, the gastroscopy operation time and the awakening time were also compared. 【Results】 Levels of MAP, HR and RR at T0, T1, T2, and T3 between the two groups of patients were not statistically significant (P>0.05). The SpO2 levels of group A with high-flow preglottic oxygen at T1 and T2 were higher than those of group B with nasal cannula oxygen, the differences were statistically significant (P<0.05). The number of hypoxemia and jaw support in group A were 0, which were significantly lower than those in group B (6 cases of hypoxemia and 14 cases of mandibular support). The difference was statistically significant (P<0.05). There were no statistically significant differences in the total dosage of propofol, gastroscope operation time and anesthesia recovery time between the two groups (P>0.05). 【Conclusion】In the painless gastroscopy of obese patients, preglottic high-flow oxygen can significantly improve the SpO2 level and improve the safety of anesthesia, which is worthy of clinical promotion. 2022 Vol. 39 (2): 215-218 [Abstract] ( 72 ) HTML (1 KB)  PDF (1162 KB)  ( 61 ) 219 Evaluation of Serum 25-hydroxyvitamin D Level in Patients with Autoimmune Disease and Vitiligo LI Li-rong, DONG Gao-hong DOI: 10.3969/j.issn.1671-7171.2022.02.017 【Objective】To explore the serum 25-hydroxyvitamin D level and its significance in patients with autoimmune disease and vitiligo. 【Methods】A total of 67 patients with autoimmune disease and vitiligo who were admitted to the hospital (the observation group). While 54 healthy people without autoimmune disease and vitiligo who received physical examination at the same time period were selected as the control group. The basic data of the two groups were collected. Clinical characteristics and serum 25-hydroxyvitamin D levels of the two groups were compared and the factors affecting the occurrence of autoimmune disease and vitiligo were analyzed. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the value of serum 25-hydroxyvitamin D in diagnosing the occurrence of autoimmune disease and vitiligo. 【Results】There were no statistically significant differences in gender, age, body mass index, comorbidities, smoking history, drinking history and history of sun exposure between the groups (P>0.05). The proportion of blood group A, family history of vitiligo, CD14+ T lymphocytes, CD4+ T lymphocytes, CD8+ T lymphocytes, interleukin-6, interleukin-4, interleukin Su-21 level in the observation group was higher than control group, the difference was statistically significant (P<0.05). The level of 25-hydroxyvitamin D in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). Logistic multivariate analysis showed that 25-hydroxyvitamin D and CD8+ T lymphocytes were the influencing factors of vitiligo (P<0.05). The sensitivity, specificity and AUC of serum 25-hydroxyvitamin D in the diagnosis of vitiligo were 77.61%, 74.07%, and 0.786, respectively. 【Conclusion】The serum 25-hydroxyvitamin D level of patients with autoimmune disease and vitiligo is lower than healthy people. So the 25-hydroxyvitamin D may have a certain relationship with the occurrence of autoimmune disease vitiligo. 2022 Vol. 39 (2): 219-221 [Abstract] ( 51 ) HTML (1 KB)  PDF (1161 KB)  ( 127 ) 222 Effect of Probiotics Combined with Shuangzuotai Effervescent Tablets in the Treatment of Bacterial Vaginitis HE Jing, BAI Rui DOI: 10.3969/j.issn.1671-7171.2022.02.018 【Objective】To explore the application effect of probiotics combined with Shuangzuotai effervescent tablets in the treatment of bacterial vaginitis (BV). 【Methods】A total of 106 patients with BV in our hospital from February 2019 to December 2020 were selected and divided into two groups by random number table method. The control group was treated with Shuangzuotai effervescent tablets alone, while the observation group accepted Shuangzuotai effervescent tablets combined with probiotics. The clinical efficacy, symptom relief time, changes in the vaginal environment, adverse reactions and recurrence rates were compared between the two groups. 【Results】After treatment, the total effective rate of the observation group reached 94.34%, which was significantly higher than 81.13% of the control group (P<0.05). Clinical symptoms' relief time such as vaginal pain, itching, abnormal leucorrhea, and mucosal congestion in the observation group were all shorter than those in the control group (P<0.05). After treatment, the percentage of clue cells >20%, the percentage of positive amine test and the percentage of vaginal secretion (pH>4.5) in the observation group were lower than those in the single group (P<0.05); The recurrence rate of the observation group was 3.77%, which was lower than that of the control group 15.09% (P<0.05). 【Conclusion】Application of probiotics combined with Shuangzuotai effervescent tablets is effective in the treatment of bacterial vaginitis. It also has a certain value in reducing the recurrence rate and alleviating clinical symptoms. 2022 Vol. 39 (2): 222-224 [Abstract] ( 117 ) HTML (1 KB)  PDF (1133 KB)  ( 88 ) 225 Expression and Clinical Significance of PD-1 and PD-L1 in Laryngeal Carcinoma FAN Zhuang-zhuang, CUI Ying DOI: 10.3969/j.issn.1671-7171.2022.02.019 【Objective】 To investigate the expression and clinical significance of programmed death protein-1 (PD-1) and its ligand (PD-L1) in laryngeal carcinoma. 【Methods】Immunohistochemical SP method was used to detect the expression of PD-1 and PD-L1 in 60 cases of laryngeal squamous cell carcinoma and 33 cases of adjacent tissues, and the relationship between their expression and clinicopathological features and prognosis of laryngeal cancer patients was analyzed. 【Results】 PD-1 and The positive expression rate of PD-L1 was significantly higher than that of adjacent tissues (P<0.05). The positive expression of PD-1 and PD-L1 were related to regional lymph node metastasis, depth and scope of invasion and clinical stage (all P<0.05). The positive expression of PD-L1 was also related to the degree of tumor differentiation (P<0.05). Logrank test showed that there was no significant difference in the mean survival time between PD-1 negative and positive patients(χ2 = 3.065,P=0.089); There was significant difference in the mean survival time between patients with negative and positive expression of PD-L1(χ2=9.002,P=0.003). Cox multivariate analysis showed that PD-L1 was an independent factor affecting the poor prognosis of patients with laryngeal cancer (HR=0.135, 95%CI:0.024~0.756,P=0.023). 【Conclusion】 The positive expression rate of PD-1 and PD-L1 in laryngeal cancer is significantly increased, which is related to the occurrence and development of tumor, and the positive expression of PD-L1 is related to the poor prognosis of patients after operation. 2022 Vol. 39 (2): 225-228 [Abstract] ( 79 ) HTML (1 KB)  PDF (3188 KB)  ( 63 ) 229 Effect of Qishiyishen Recipe on Renal Function and Podocyte Markers in Patients with Chronic Glomerulonephritis ZHAO Wen-ge, FAN Xiong DOI: 10.3969/j.issn.1671-7171.2022.02.020 【Objective】To explore the effect of Qishiyishen Recipe on renal function and podocyte markers in patients with chronic glomerulonephritis. 【Methods】 A total of 130 patients with chronic glomerulonephritis treated in our hospital were divided into control group and observation group according to their admission number, with 65 cases in each group. The control group was treated with routine treatment, and the observation group was treated with Qishiyishen recipe. The indexes of renal function, cellular immune function and the levels of podocyte markers [podocyte marker protein (PCX) and transmembrane protein B7-1] were compared between the two groups before and after treatment. 【Results】 Before intervention, there was no significant difference in renal function, cellular immune function and podocyte markers between the two groups (P>0.05). After the intervention, the indexes of urinary nitrogen, 24h urinary protein and blood creatinine in the two groups were lower than those before the intervention (P<0.05), and those in the observation group were lower than those in the control group (P<0.05); The levels of CD4+, CD4+/CD8+ in the two groups were higher than those before the intervention (P<0.05), and that in the observation group was higher than that in the control group (P<0.05). The levels of CD8+ in the two groups were lower than those before the intervention (P<0.05), and that in the observation group was lower than that in the control group (P<0.05). The contents of urinary PCX and urinary B7-1 in the two groups were lower than those before intervention (P<0.05), and those in the observation group were lower than those in the control group (P<0.05). 【Conclusion】The application of Qishiyishen recipe in the treatment of chronic glomerulonephritis can improve the level of renal function, correct the imbalance of T lymphocyte subsets, improve cellular immune function and reduce the damage of immune inflammation to podocytes. 2022 Vol. 39 (2): 229-231 [Abstract] ( 55 ) HTML (1 KB)  PDF (1139 KB)  ( 68 ) 232 Relationship between Hypothyroidism and Spontaneous Abortion in Early Pregnancy LIU Juan-di, WANG Rui, HE Ju-xian DOI: 10.3969/j.issn.1671-7171.2022.02.021 【Objective】To investigate the relationship between hypothyroidism of pregnancy and spontaneous abortion in early pregnancy. 【Methods】 A total of 120 cases of hypothyroidism pregnant women in our hospital from March 2018 to March 2020 were selected as hypothyroidism group and 120 cases of subclinical hypothyroidism were selected as subclinical hypothyroidism group. In addition, 120 healthy pregnant women during the same time period were selected as the control group. The general data of all subjects were collected and compared, including age, body mass index (BMI), active and passive smoking, number of childbirth, and maternal status. The levels of serum thyroid stimulating hormone (TSH), free thyroid hormone (FT4) and the positive expression of thyroid peroxidase-Ab (TPO-Ab) were detected by immunofluorescence analysis. The pregnancy outcomes of the three groups were compared. The receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic value of serum TSH and FT4 levels in spontaneous abortion in early pregnancy. Multivariate Logistic regression analysis was used to analyze the risk factors of spontaneous abortion in early pregnancy. 【Results】Compared with those in the control group, the serum TSH level and TPO-Ab positive rate in hypothyroidism group and subclinical hypothyroidism group were significantly higher (P<0.05), and the FT4 level was significantly lower (P<0.05). Further compared with those in subclinical hypothyroidism group, serum TSH level and TPO-Ab positive rate in hypothyroidism group were significantly higher (P<0.05) and FT4 level was significantly lower (P<0.05). In the order of control group, subclinical hypothyroidism group and hypothyroidism group, the proportions of pregnant women with spontaneous abortion, premature delivery, premature rupture of membranes, and postpartum anemia increased sequentially (P<0.05). The AUC of serum TSH and FT4 levels in hypothyroidism patients for diagnosing spontaneous abortion in early pregnancy was 0.786 and 0.779, respectively, and the AUC of combined detection of TSH and FT4 was 0.898. TPO-Ab positivity, abnormal increase of serum TSH level and abnormal decrease of FT4 level were risk factors of spontaneous abortion in early pregnancy (P<0.05). 【Conclusion】Hypothyroidism in pregnancy may increase the risk of spontaneous abortion in early pregnancy. The detection of thyroid function related indicators is helpful to evaluate spontaneous abortion in early pregnancy. 2022 Vol. 39 (2): 232-235 [Abstract] ( 51 ) HTML (1 KB)  PDF (1182 KB)  ( 71 ) 236 Effect of Sodium Selenite on the Morphology of the Substantia Nigra and the Content of Glutamate in the Striatum of Rats with Parkinson's Disease FAN Kai DOI: 10.3969/j.issn.1671-7171.2022.02.022 【Objective】To observe the effect of sodium selenite on the morphology of the substantia nigra and the content of glutamate in the striatum of Parkinson's disease (PD) rats, and to explore the related mechanisms. 【Methods】A PD rat model was established by injecting 6-Hydroxydopamine (6-OHDA). Twenty successfully modeled rats were randomly divided into the model group and the experimental group, with 10 rats in each group. Ten rats were injected with saline only and set as the control group. Fifteen days after the injection, the experimental group were given sodium selenite 100 mg/kg, while the control group and model group were given an equal volume of normal saline, once a day for 30 consecutive days. The cognitive function was detected by T-maze experiment. The content of glutamate in the striatum were detected by high performance liquid chromatography (HPLC). The relative expression of substantia nigra c-Jun N-terminal kinase (JNK) and p-JNK protein were detected by Western blotting. 【Results】The accuracy rates of the T-maze experiment in the control group, the model group and the experimental group were (94.44±5.27)%, (50.00±6.39)% and (72.22±8.42)%, respectively. Of which, the content of glutamate in the striatum were (15.96±2.79)μg/mL, (31.87±4.21)μg/mL and (23.34±3.92)μg/mL. The substantia nigra p-JNK/JNK in the control group, the model group and the experimental group were 0.19±0.02,0.78±0.08 and 0.27±0.03, respectively. The differences of the correct rate of T-maze experiment, striatal glutamate content, substantia nigra p-JNK/JNK ratio between the model group and the control group were statistically significant (P<0.05). They were also significant differences between the model group and the experimental group(P<0.05). 【Conclusion】Sodium selenite can improve the cognitive function of PD rats in terms of the morphology of substantia nigra neurons, protect the function of substantia nigra dopaminergic neurons, and reduce the content of striatal glutamate, which may be achieved by inhibiting the JNK signaling pathway. 2022 Vol. 39 (2): 236-239 [Abstract] ( 45 ) HTML (1 KB)  PDF (2170 KB)  ( 65 ) 240 Analysis of Multiple Factors Affecting the Effect of Spinal Canal Decompression for Thoracolumbar Burst Fracture DENG Zhi-gang, TU Min, WANG Wen-zhi, et al DOI: 10.3969/j.issn.1671-7171.2022.02.023 【Objective】 To investigate the influencing factors of spinal canal decompression for thoracolumbar burst fractures. 【Methods】A total of 83 patients with thoracolumbar burst fractures treated in our hospital was selected as the research object. According to whether the ratio of the anterior posterior diameter of the spinal canal to the anterior posterior diameter of the adjacent spinal canal was ≥ 90%, they were divided into 57 cases in the good decompression group and 26 cases in the poor decompression group. The age, sex, body mass index (BMI), cause of injury, injury segment, AO classification, Asia classification (Grade A~E), time interval from injury to operation, bone turnover angle, bone displacement distance and surgical approach were compared between the two groups; Logistic regression analysis was used to explore the relationship between the displacement distance of posterior upper edge fracture block and the effect of spinal canal decompression. 【Results】The proportion of patients with Asia Grade A~B and anterior surgery in the good decompression group was higher than that in the poor decompression group (P<0.05); There was no significant difference in age, sex, body mass index (BMI), cause of injury, injury segment, AO classification and time interval from injury to operation between the two groups (P>0.05); The preoperative bone turnover angle and bone displacement distance of patients in the good decompression group were lower than those in the poor decompression group (P<0.05); Logistic regression analysis showed that the increase of preoperative bone mass displacement distance, the high preoperative Asia Grade (C~E Grade) and the use of posterior surgery were the independent risk factors for the poor effect of postoperative spinal canal decompression (P<0.05). 【Conclusion】Patients with thoracolumbar burst fractures have higher preoperative Asia grade, posterior surgery and increased displacement distance of the posterior upper edge of the vertebral body are independent risk factors for poor effect of postoperative spinal canal decompression. 2022 Vol. 39 (2): 240-243 [Abstract] ( 39 ) HTML (1 KB)  PDF (1416 KB)  ( 102 ) 244 Application of Comprehensive Intervention Based on Risk Nomogram Model in Patients with Urinary Retention after Vaginal Delivery CHEN Li-qin, YIN Sheng-xian DOI: 10.3969/j.issn.1671-7171.2022.02.024 【Objective】 To explore the value of comprehensive intervention based on risk nomogram model in patients with urinary retention after vaginal delivery. 【Methods】The clinical data of 856 cases of vaginal delivery in our hospital from January 2018 to March 2019 were retrospectively analyzed. According to whether urinary retention occurred or not,they were divided into urinary retention group (n=62) and normal group (n=794), logistics regression model was used to screen the risk factors of urinary retention after vaginal delivery. In a prospective study, 173 cases of vaginal delivery women who were diagnosed and treated in our hospital from May 2019 to October 2019 were randomly divided into observation group and control group. The observation group received comprehensive intervention based on risk line chart prediction model, while the control group received routine intervention. The time of self urination, incidence of urinary retention, postpartum hemorrhage of 2 h and residual urine volume of 6 h after delivery were compared between the two groups. 【Results】 A retrospective analysis showed that the incidence of postpartum urinary retention was 7.24% (62/856 ). Logistic regression analysis showed that labor analgesia, forceps delivery, hand to head transfer, first stage of labor and second stage of labor were independent risk factors for urinary retention after vaginal delivery (P< 0.05). According to the risk factors of urinary retention after vaginal delivery, a nomogram prediction model was constructed. The ROC curve was used to evaluate the nomogram of the nomogram , the area under the ROC curve was 0.790, the slope of the calibration curve was close to 1, and the discrimination and accuracy were good. In the prospective study, the time of self urination in the observation group was shorter than that in the control group, and the incidence of urinary retention was lower than that in the control group (P< 0.05). The amount of postpartum hemorrhage at 2 hours and residual urine at 6 hours in the observation group were less than those in the control group (P<0.05). 【Conclusion】 Comprehensive intervention based on risk nomogram prediction model can help prevent urinary retention after vaginal delivery, reduce postpartum hemorrhage and residual urine volume, and is worthy of clinical application. 2022 Vol. 39 (2): 244-247 [Abstract] ( 42 ) HTML (1 KB)  PDF (1239 KB)  ( 51 ) 248 Relationship between HBV Quantitation and HBV Intrauterine Infection in Patients with Chronic Hepatitis B Complicated with Pregnancy LI Cheng-mei, JIANG An-zhen DOI: 10.3969/j.issn.1671-7171.2022.02.025 【Objective】To investigate the relationship between hepatitis B virus (HBV) quantitation and HBV intrauterine infection in patients with chronic hepatitis B complicated with pregnancy. 【Methods】A total of 204 cases of chronic hepatitis B patients with pregnancy were selected and divided into 3 groups according to the serum hepatitis B markers of pregnant women: carrying group, group A (HBsAg, HBeAg and HBcAb test positive) and group B (HBsAg, HBeAb and HBcAb test positive). The HBV quantitation, HBV positive rates, HBV intrauterine infection rates, and the relationships between HBV quantitation and HBV intrauterine infection were compared among the 3 groups. 【Results】Among the 3 groups, HBV quantitation in serum and umbilical cord blood of pregnant patients in the group A was higher than that in the group B (P<0.05), and that in the group B was higher than that in the carrier group (P<0.05). The HBV positive rate and HBV intrauterine infection rate in the group A were higher than those in the group B (P<0.01), and the HBV positive rate in the group B was higher than that in the carrier group (P<0.01). The proportion of HBV intrauterine infection in patients with chronic hepatitis B complicated with pregnancy who were older than or equal to 35 years old, serum HBeAg positive, serum HBV quantitation greater than or equal to 1000 copies/mL and fetal distress were higher than those without infection (P<0.05), and antiviral therapy was lower than those without infection (P<0.05). Logistic regression analysis confirmed that age older than or equal to 35 years old, serum HBeAg positive, serum HBV quantitative greater than or equal to 1000 copies/mL and fetal distress were risk factors of HBV intrauterine infection (P<0.05), and antiviral therapy was its protective factor (P<0.05). 【Conclusion】 Among the patients with chronic hepatitis B complicated with pregnancy, the patients with positive HBsAg, HBeAg and HBcAb had the highest HBV infectivity. Age over 35 years old, serum HBeAg positive, serum HBV level ≥1000 copies/mL and fetal distress are risk factors for intrauterine HBV infection in neonates with chronic hepatitis B complicated with pregnancy. 2022 Vol. 39 (2): 248-251 [Abstract] ( 53 ) HTML (1 KB)  PDF (1158 KB)  ( 48 ) 252 Analysis of Leukemia-associated Immunophenotype and Clinical Features in AML patients with FLT3-ITD Positive Expression ZHOU Ying, LIU Ting, YAN Xiang-hong DOI: 10.3969/j.issn.1671-7171.2022.02.026 【Objective】To investigate the leukemia-associated immunophenotype (LAIP) and clinical features in acute myeloid leukemia (AML) with positive Fms-like tyrosine kinase 3-internal tandem repeat (FLT3-ITD) expression. 【Methods】A total of 206 patients with acute myeloid leukemia admitted to our hospital from March 2016 to March 2020 were selected as the study subjects. Patients were divided into the FLT3-ITD positive expression group (43 cases) and the FLT3-ITD negative expression control group (163 cases) according to the mutation status of FLT3-ITD gene. Clinical data and LAIP of the two groups were retrospectively analyzed. The survival of two groups and the outcome of one course of chemotherapy were compared between the two groups to evaluate the value of FLT3-ITD positive expression in AML patients. 【Results】The patients in the FLT3-ITD positive group had higher CD56, CD11b, CD7 and CD33 expressions than those in the FLT3-ITD negative control group, while their CD34 and CD117 expression levels were lower than those in the control group (P<0.05). The disease-free survival rate and overall survival rate of the positive group were lower than those of the control group (P<0.05). The remission rate of the positive patients was lower than that of the control group (41.86% vs 80.37%, P<0.05). The cell antigen expression rate of the patients in the complete remission group was lower than that in the non-remission group (P<0.05). 【Conclusion】FLT3-ITD gene positive AML patients have antigen differentiation disorder on the surface of leukemia cells, low remission rate and poor prognosis. The expression of FLT3-ITD gene and LAIP in AML patients are of great significance for clinical guidance of treatment and prognosis judgment. 2022 Vol. 39 (2): 252-254 [Abstract] ( 63 ) HTML (1 KB)  PDF (1138 KB)  ( 46 ) 255 Effects of Forced Air Warming on perioperative Hypothermia, Complications, Body Stress and Inflammatory Response in Laparoscopic Surgery HAN Xin-ping, WANG Xiao-qi DOI: 10.3969/j.issn.1671-7171.2022.02.027 【Objective】To study the effect of forced air warming (FAW) in perioperative hypothermia, complications, body stress and inflammatory response in laparoscopic surgery. 【Methods】A total of 86 patients who underwent laparoscopic surgery in our hospital from June 2017 to May 2021 were selected and divided into the observation group (n=43) and the control group (n=43) according to random number table method. The control group received conventional insulation intervention, while the observation group received FAW intervention. Nasopharyngeal temperature before anesthesia (T0), after induction of anesthesia (T1), 30 min after skin incision (T2), 60 min after skin incision (T3), 10 min (T4) after PACU and 2d (T5) after surgery were measured in the two groups. Perioperative indexes, such as operation time, blood transfusion volume, intravenous fluid volume, abdominal flushing fluid volume, extubation time, recovery time, stay in PACU time, hypothermia and postoperative complications in the two groups were compared between the two groups. Levels of stress factors such as serum adrenalin (E) and norepinephrine (NE) and serum levels of c-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor -α (TNF-α) and other inflammatory factors before and 3 days after surgery were compared between the two groups as well. 【Results】There was no difference in nasopharyngeal temperature between the two groups at T0, T1 and T5 (P>0.05). At T2, T3 and T4, nasopharyngeal temperature in the observation group was higher than that in the control group (P<0.05). The operative time, the amount of intravenous blood transfusion, the amount of fluid infusion, the amount of abdominal flushing fluid, the time of recovery and the time of stay in PACU in the observation group were all lower and shorter than those in the control group (P<0.05). The incidence of hypothermia and postoperative complications in the observation group were lower than those in the control group (P<0.05). Serum E and NE levels at 3d after operation in the observation group were lower than those in the control group (P<0.05). On 3d after operation, serum CRP, IL-6 and TNF-α levels in the observation group were lower than those in the control group (P<0.05). 【Conclusion】Application of FAW can effectively maintain perioperative core body temperature of patients undergoing laparoscopic surgery, prevent perioperative hypothermia and complications, reduce body stress, avoid inflammatory reactions and contribute a lot to postoperative recovery of patients. 2022 Vol. 39 (2): 255-258 [Abstract] ( 41 ) HTML (1 KB)  PDF (1170 KB)  ( 111 ) 259 Expression and Significance of IL-35 and IL-17 in Serum and Aqueous Humor of Patients with Diabetic Retinopathy ZHOU Ai-ling, WANG Han-yu DOI: 10.3969/j.issn.1671-7171.2022.02.028 【Objective】To detect the levels of interleukin-35 (IL-35) and interleukin-17 (IL-17) in serum and aqueous humor of patients with diabetic retinopathy (DR), and to explore their clinical significance in the pathogenesis of DR. 【Methods】A total of 80 DR patients (80 eyes) who underwent cataract phacoemulsification in our hospital from March 2019 to March 2021 were selected as the study objects, while 65 elderly cataract patients (65 eyes) received cataract phacoemulsification in the same period were selected as the control group. The general clinical data of patients were collected and compared between the two groups. Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of IL-35 and IL-17 in serum and aqueous humor of subjects. Pearson correlation was used to analyze the correlation of IL-35 and IL-17 in serum and aqueous humor. The diagnostic values of IL-35 and IL-17 in serum and aqueous humor alone and their combination in DR were evaluated by receiver operating characteristic curve (ROC). 【Results】Compared with the control group, the levels of IL-35 in serum and aqueous humor of DR group were significantly lower (P<0.05), while the levels of IL-17 were significantly higher (P<0.05). Furthermore, the levels of IL-35 and IL-17 in serum of DR patients were lower than those in aqueous humor (P<0.05). Results showed that the levels of IL-35 and IL-17 in serum and aqueous humor of DR patients were negatively correlated (P<0.05). The area under curve (AUC) of IL-35, IL-17 and their combination in serum in the diagnosis of DR was 0.843, 0.863 and 0.957 respectively. The AUC of the combined detection of IL-35 and IL-17 in the diagnosis of DR was significantly higher than that of the single diagnosis of IL-35 and IL-17 in the serum (P<0.05). The AUC of IL-35 and IL-17 levels in aqueous humor and their combined detection for the diagnosis of DR was 0.830, 0.882 and 0.963 respectively. The AUC of the combined detection of both IL-35 and IL-17 in the diagnosis of DR was significantly higher than that of the independent diagnosis of IL-35 and IL-17 levels in aqueous humor (P<0.05). 【Conclusion】The expression levels of IL-35 in serum and aqueous humor of DR patients are low, and the expression levels of IL-17 are high in serum and aqueous humor of DR patients, which have certain diagnostic effects on DR. However, the method of serum sample collection is simple and more practical. 2022 Vol. 39 (2): 259-262 [Abstract] ( 47 ) HTML (1 KB)  PDF (1307 KB)  ( 48 ) 263 Effects of Different Delivery Methods on the Risk of Postpartum Female Stress Urinary Incontinence and the Electrical Signal Value of Pelvic Floor Muscle Surface XI Cui-ping, WANG Xi-mei DOI: 10.3969/j.issn.1671-7171.2022.02.029 【Objective】To investigate the effects of different delivery methods on the risk of postpartum female stress urinary incontinence (SUI) and the surface electrical signal value of pelvic floor muscle. 【Methods】A total of 115 primiparas who underwent 42 days postpartum outpatient review in the obstetrics department of the Affiliated Hospital of Yan'an University from June 2019 to June 2020 were selected. They were divided into vaginal delivery group (n=63) and cesarean section group (n=52) according to the mode of delivery. The clinical data, the incidence of SUI, the electrical signal value of pelvic floor muscle surface, the activity of bladder neck and the angle of urethral rotation were compared between the two groups.【Results】There was no significant difference in maternal age, number of pregnancies, number of births, weight gain during pregnancy, neonatal gender and neonatal birth weight between the two groups (P>0.05). The incidence of SUI in postpartum women in the vaginal delivery group was 26.98% (17/63), which was significantly higher than 11.54% (6/52) in the cesarean section group (χ2=4.248,P=0.039). The maximum value of fast muscle, 10s slow muscle, 60s slow muscle and post resting value in the vaginal delivery group were lower than those in the cesarean section group (P<0.05), and the pre-resting value and fast muscle contraction time were higher than those in the cesarean section group (P<0.05), but there was no significant difference in fast muscle relaxation time between the vaginal delivery group and the cesarean section group (P>0.05). The bladder neck mobility and urethral rotation angle in the vaginal delivery group were higher than those in the cesarean section group (P<0.05). 【Conclusion】 Compared with cesarean section, the risk of SUI in women after vaginal delivery is higher, which affects the electrical signal on the surface of pelvic floor muscle and significantly increases the activity of bladder neck and urethral rotation angle. However, cesarean section can not completely avoid the occurrence of SUI in postpartum women. Cesarean section without medical indications is not recommended to prevent the occurrence of postpartum SUI. 2022 Vol. 39 (2): 263-265 [Abstract] ( 48 ) HTML (1 KB)  PDF (1135 KB)  ( 37 ) 266 Effects of Different Loading Doses of Dexmedetomidine Combined with Ketorolac Tromethamine on Pain and Cognitive Function in Patients after Thoracoscopic Radical Resection of Lung Cancer XU Xi-tong, Meng Li DOI: 10.3969/j.issn.1671-7171.2022.02.030 【Objective】To investigate the effects of different loading doses of dexmedetomidine combined with ketorolac tromethamine on pain and cognitive function in patients after thoracoscopic radical resection of lung cancer.【Methods】A total of 81 patients who underwent thoracoscopic radical resection of lung cancer in our hospital from May 2019 to November 2021 were randomly divided into groups A, B and C, with 27 cases in each group. Group A was given ketorolac tromethamine 0.5 mg/kg intravenously before anesthesia induction, and group B was given dexmedetomidine 0.5 μg/kg on the basis of group A, group C added dexmedetomidine 1 μg/kg on the basis of group A. The anesthesia time, operation time, intraoperative blood loss, intraoperative rehydration, compression times of analgesic pump and postoperative sufentanil dosage were compared among the three groups; Immediately after operation (T1), 6 h(T2), 12 h(T3) and 24 h(T4), the patients' visual pain scale (VAS) and mini mental state examination scale (MMSE) scores were also compared. The incidence of adverse reactions during operation was counted. 【Results】There was no significant difference in anesthesia time, operation time, intraoperative blood loss and intraoperative rehydration among the three groups (P>0.05). The pressing times of analgesic pump and the dosage of sufentanil after operation in the group C were less than those in the group A and the group B, and the group B was less than that in the group A, the difference was statistically significant (P<0.05). At each time point of T1,T2,T3 and T4, the VAS scores of the three groups increased first and then decreased, and the VAS scores of the group C were lower than those of the group A and the group B, and that of the group B was lower than that of the group A (P<0.05). The MMSE scores of the three groups at each time point showed a gradual upward trend. The MMSE scores of the group C were lower than those of the group A and the group B, and the MMSE scores of the group B at T1 and T2 time points were lower than those of the group A (P<0.05), but there was no significant difference between the group A and the group B at T3 and T4 time points (P>0.05). There was no significant difference in the incidence of adverse reactions between the group A and the group B (P>0.05), but the incidence of adverse reactions in the group C was higher than that in the group A and the group B (P<0.05). 【Conclusion】Dexmedetomidine combined with ketorolac tromethamine in thoracoscopic radical resection of lung cancer can reduce the degree of pain and the dosage of other anesthetics; when the loading dose of dexmedetomidine is at 1 μg/kg, the degree of pain was lighter, but the loading dose of 0.5 μg/kg is conducive to the recovery of cognitive function and less adverse reactions. It should be selected according to the actual needs. 2022 Vol. 39 (2): 266-270 [Abstract] ( 46 ) HTML (1 KB)  PDF (1189 KB)  ( 81 ) 271 Risk Factors of Postoperative Ureteral Stricture in Patients with Ureteral Calculi Treated by Retroperitoneal Laparoscopic Ureterolithotomy WANG Yi, DOU Hai-feng DOI: 10.3969/j.issn.1671-7171.2022.02.031 【Objective】To investigate the risk factors of ureteral stricture after retroperitoneal laparoscopic ureterolithotomy (RLU) in the treatment of ureteral calculi. 【Methods】The clinical data of 501 patients with ureteral calculi who were treated with RLU from February 2016 to August 2019 were analyzed retrospectively. According to whether there was ureteral stenosis after operation, they were divided into observation group (postoperative ureteral stenosis,n=26) and control group (no postoperative ureteral stenosis,n=475). The patients were followed up for 1 year. The situation of ureteral stenosis after RLU was counted, and the factors affecting ureteral stenosis after RLU were analyzed by logistic regression. 【Results】 Total of 26 cases (5.19%) of 501 patients with ureteral calculi treated by RLU were complicated with ureteral stenosis, including 21 patients with proximal ureteral stenosis, 5 patients with distal ureteral stenosis, and the remaining 475 patients had no ureteral stenosis. Univariate analysis showed that the course of stone incarceration, stone diameter and degree of hydronephrosis were the influencing factors of ureteral stenosis after RLU (P<0.05). Logistic multivariate analysis showed that the course of stone, stone diameter and degree of hydronephrosis were the influencing factors of ureteral stenosis after RLU (P<0.05). 【Conclusion】 The risk of ureteral stricture after RLU is high in patients with ureteral calculi. The course of stone, stone diameter and degree of hydronephrosis are the risk factors of ureteral stricture after RLU. 2022 Vol. 39 (2): 271-273 [Abstract] ( 51 ) HTML (1 KB)  PDF (1138 KB)  ( 40 ) 274 Correlation Analysis of Cognitive Impairment with Serum IGF-1 and IGFBP-3 Expression in Patients with Vascular Dementia SU Hang, JIANG Xing-wen DOI: 10.3969/j.issn.1671-7171.2022.02.032 【Objective】To investigate the expression levels of IGF-1 and IGFBP-3 in serum of patients with vascular dementia (VD) and their relationship with cognitive impairment. 【Methods】From January 2018 to January 2020, 63 patients with VD admitted to our hospital were selected as VD group, and they were further divided into the mild VD group (15 cases), moderate VD group (26 cases) and severe VD group (22 cases) according to Mini-mental state examination (MMSE) score. Another 60 cases of healthy volunteers without VD in our hospital during the same period were selected as normal control group. The expression levels of IGF-1 and IGFBP-3 were detected by ELISA; Pearson method was used to analyze the correlation of serum IGF-1 and IGFBP-3 expression levels with the Montreal cognitive assessment scale (MoCA) score. Logistic regression model was used to analyze the influencing factors of VD. 【Results】The expression levels of serum IGF-1 and IGFBP-3, and scores of MOCA and MMSE in the VD group were lower than those in the control group (P<0.05). The levels of serum IGF-1 and IGFBP-3 in patients with VD mild group, moderate group and severe group were significantly decreased in turn (P<0.05). The expression levels of IGF-1 and IGFBP-3 were positively correlated with MoCA score (P<0.05). Low MMSE score, low MoCA score, low level of IGF-1 and low level of IGFBP-3 were risk factors for VD(P<0.05). 【Conclusion】The levels of serum IGF-1 and IGFBP-3 in VD patients are significantly decreased, and they are closely related to the degree of cognitive impairment, which could be used as serum indicators to evaluate the occurrence of VD. 2022 Vol. 39 (2): 274-277 [Abstract] ( 55 ) HTML (1 KB)  PDF (1189 KB)  ( 33 ) 278 Effect of Soluble Growth Stimulating Factor 2 on Prognosis of AMI Patients after PCI WANG Rui, ZENG Xin-chun DOI: 10.3969/j.issn.1671-7171.2022.02.033 【Objective】 To investigate the effect of soluble growth stimulating factor 2 (sST2) on the prognosis of patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). 【Methods】A total of 132 patients with AMI treated in our hospital from January 2019 to December 2020 was selected. According to the prognosis after PCI, they were divided into poor prognosis group (n=29) and good prognosis group (n=103). The clinical data of the two groups were compared, the levels of ST2 in patients with different Killip cardiac function grades were compared, the diagnostic value of ST2 in the diagnosis of poor prognosis after PCI in patients with AMI was analyzed, and the clinical factors affecting the poor prognosis were analyzed by COX risk regression model. 【Results】The time of chest pain and the levels of cTnI, ST2 and LDL-C in the poor prognosis group were higher than those in the good prognosis group, and LVEF was lower than those in the good prognosis group (P<0.05). The level of ST2 in Killip grade Ⅲ and Ⅳ patients was (28.04±7.52) ng/mL, which was significantly higher than that in Killip grade Ⅰ and Ⅱ (19.37±4.14) ng/mL(t=8.147, P<0.01). ROC curve evaluation of the value of ST2 in the diagnosis of poor prognosis in patients with AMI showed that the area under the diagnostic value curve (AUC) (95%CI) was 0.78 (0.67~0.88). COX risk regression model analysis showed that cTnI and ST2 were independent risk factors for poor prognosis in patients with AMI (P<0.05), and LVEF was a protective factor for poor prognosis in patients with AMI (P<0.05). 【Conclusion】ST2 is a potential clinical index to affect and evaluate the poor prognosis of AMI patients after PCI. 2022 Vol. 39 (2): 278-280 [Abstract] ( 48 ) HTML (1 KB)  PDF (1168 KB)  ( 20 ) 281 Clinical Efficacy of Ulinastatin Combined with Meglumine Cyclic Adenosine Monophosphate in the Treatment of Viral Myocarditis and its Effect on Related Apoptotic Molecules GAO Min, XIAO Ming, ZHOU Guo DOI: 10.3969/j.issn.1671-7171.2022.02.034 【Objective】To investigate the clinical efficacy of ulinastatin combined with meglumine cyclic adenosine monophosphate in the treatment of viral myocarditis (VMC) and its effect on related apoptotic molecules. 【Methods】A total of 106 patients with VMC treated in our hospital were randomly divided into observation group (ulinastatin combined with meglumine cyclophosphate) and control group (meglumine cyclophosphate), with 53 cases in each group. The two groups were treated for 2 weeks. The clinical efficacy, myocardial injury indexes (cardiac troponin I (cTnI), creatine kinase (CK), creatine kinase isoenzyme (CK-MB)), the levels of apoptosis molecules (soluble apoptosis factor (sFas), soluble apoptosis related factor ligand (sFasL)) and the incidence of adverse reactions were compared between the two groups. 【Results】 Tow weeks after treatment, the total effective rate of clinical efficacy in the observation group was 92.45% (49/53), which was significantly higher than 75.47% (40/53) in the control group(χ2=5.68,P=0.017＜0.05).After 2 weeks of treatment, the levels of serum cTnI, CK, CK-MB, sFas and sFasL in the two groups were lower than those before treatment, and the levels in the observation group were lower than those in the control group (P<0.05). The incidence of adverse reactions in the observation group was 11.32% (6/53), which was higher than 5.66% (3/53) in the control group, but the difference was not statistically significant(χ2=0.49,P=0.48＞0.05).【Conclusion】 Ulinastatin combined with meglumine cyclic adenosine monophosphate is effective in the treatment of VMC patients, which can effectively reduce the myocardial injury of patients, which may be related to the inhibition of apoptotic molecules, and the addition of ulinastatin does not significantly increase the adverse drug reactions, which is worthy of clinical reference. 2022 Vol. 39 (2): 281-283 [Abstract] ( 63 ) HTML (1 KB)  PDF (1140 KB)  ( 32 )

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