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Quick Search     Adv Search 2022 Vol. 39, No. 5 Published: 2022-05-26 Original Articles          Original Articles 641 Efficacy and Safety of Dual Bronchodilators (LABA/LAMA) for Treating Symptomatic COPD YI Rong, XU Yu-zhu, FENG Ling, et al DOI: 10.3969/j.issn.1671-7171.2022.05.001 【Objective】 This study aimed to access the efficacy and safety of the medication use of long-acting β2-agonist combined with long-acting muscarinic antagonist (LABA/LAMA) for symptomatic COPD patients in the real world. 【Methods】 Patients were enrolled in the study cohort if they were diagnosed as COPD with CAT≥10 scores and new to LAMA/LABA treatment from the Second Xiangya Hospital of Central South University and Zhuzhou Central Hospital during December 2018 and January 2021.Patients enrolled in the study treated with LABA/LAMA 3 for months. According to whether other maintenance medication was used before enrollment, they were divided into 4 groups: the initial group, prior LAMA group,prior ICS/LABA group,prior ICS/LABA plus LAMA group. The effectiveness outcome was the change of CAT scores, the occurrence of moderate to severe acute exacerbations and clinical control during follow-up. Safety outcome was the appearance of adverse effects. 【Results】 Overall study population and patients from the initial group, prior LAMA group, prior ICS/LABA group ameliorated significantly in CAT scores (P<0.05), After 3 months, LABA/LAMA significantly reduced the rate of moderate or severe exacerbations(P<0.05). Study showed a significant improvement in clinical control (P<0.05). The overall incidence of adverse events is low. 【Conclusion】 Patients with COPD symptoms benefit from LABA/LAMA by improving their clinical symptoms, reducing the rate of moderate or severe exacerbations and improving clinical control rates. LABA/LAMA is safe and well tolerated. 2022 Vol. 39 (5): 641-643 [Abstract] ( 108 ) HTML (1 KB)  PDF (1191 KB)  ( 132 ) 644 Effects of Levocarnitine Combined with Alprostadil on Renal Function,Oxidative Stress and Inflammatory Response in Diabetic Nephropathy Patients JI Dong-lin, ZHANG Ya-qiong DOI: 10.3969/j.issn.1671-7171.2022.05.002 【Objective】 To investigate the effects of levocarnitine combined with alprostadil on renal function,oxidative stress and inflammation in patients with diabetic nephropathy (DN). 【Methods】 A total of 98 DN patients treated in Yulin Fifth Medical College from March 2019 to March 2021 were selected and divided into the observation group and the control group according to random number table method,with 49 cases in each group. The control group was treated with alprostadil,and the observation group was treated with L-carnitine on the basis of the control group,for consecutive 4 weeks. Clinical efficacy,renal function indexes [BUN,CYstatin C,24 h urinary protein,β2 microglobulin,24hUpro,β2-MG],oxidative stress indexes [MALondialdehyde (MDA),superoxide dismutase (SOD),reactive oxygen species (ROS)] and inflammatory factors [C-reactive protein (CRP), interleukin-1 β (IL-1β), interleukin-6 (IL-6), interleukin-17 (IL-17)] levels and the incidence of adverse reactions were compared between two groups. 【Results】 The total effective rate of observation group was 93.88%, which was significantly higher than that of control group (77.55%), and the difference was statistically significant (P<0.05). After treatment, the levels of BUN, CYS-C, 24hUpro, β2-MG, MDA, ROS, CRP, IL-1β and IL-6 in the observation group were significantly lower than those in the control group, while SOD was significantly higher than that in the observation group; The differences were statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 Levocarnitine combined with alprostadil in the treatment of DN can improve the clinical curative effect, reduce the damage to the kidney, reducing oxidative stress and inflammation index. 2022 Vol. 39 (5): 644-647 [Abstract] ( 52 ) HTML (1 KB)  PDF (1156 KB)  ( 32 ) 648 Effect of Otago Exercise Training Combined with Cytidine Diphosphate Choline on Limb Function of Stroke Patients with Hemiplegia BAN Yu-xia, BAI Li DOI: 10.3969/j.issn.1671-7171.2022.05.003 【Objective】 To investigate the effect of Otago exercise training combined with cytidine diphosphate choline on limb function of stroke patients with hemiplegia. 【Methods】 A total of 120 patients with stroke hemiplegia treated in our hospital from January 2020 to January 2022 were selected as the research object. They were randomly divided into observation group and control group. The control group was treated with Cytidine Diphosphate Choline. The observation group added Otago exercise intervention on the basis of the control group. The clinical efficacy, balance ability, upper and lower limb function, walking ability, activity ability and quality of life of the two groups were compared. 【Results】 After the intervention, the clinical effective rate of the observation group was significantly higher than that of the control group (P<0.05); After the intervention, the scores of Berg Balance Scale (BBS), modified fall response energy scale (MFEs), simple Fugl Meyer motor function scale (FMA), Holden walking function rating scale (FAC), Barthel index rating scale (BI) and stroke specialized quality of life scale (SSQOL) in the two groups increased significantly. The scores of BBS, MFEs, FMA, FAC, BI and SSQOL in the observation group were significantly higher than those in the control group (P<0.05). 【Conclusion】 Increasing Otago exercise can significantly enhance the therapeutic effect of stroke patients with hemiplegia, improve their balance ability, upper and lower limb function, walking ability and activity ability, and enable patients to have a better quality of life. 2022 Vol. 39 (5): 648-651 [Abstract] ( 56 ) HTML (1 KB)  PDF (1152 KB)  ( 124 ) 652 Effects of MiR-145-3p on Proliferation and Differentiation of Enteric Neural Stem Cells CHEN Qin-ming, YANG Liu-cheng, WANG Jian-jun, et al DOI: 10.3969/j.issn.1671-7171.2022.05.004 【Objective】 To establish the method for culturing and purifying enteric neural stem cells (ENSCs) derived from rat and to investigate the effect of miR-145-3p on proliferation and differentiation of ENSCs. 【Methods】 ENSCs which primarily extracted from 18-days SD rats embryos, were observed by cytological characteristics and identified by Nestin and GFAP immunofluorescence staining. The liposome transfection and lentivirus transfection were used to transfect the ENSCs. Overexpression of miR-145-3p in ENSCs was transfected through liposome and infected with lentivirus with miR-145-3p, which followed by fluorescence microscope and qRT-PCR measurement. Edu cell proliferation assay was used to analyze proliferating cells by recording the proportion of Edu/DAPI in each group. The neurospheres was differentiated by differentiation medium and the GFAP/DAPI ratio of differentiated cells was recorded. 【Results】 Primary culture of ENSCs showed the formation of a large number of neurosphere-like structures (undifferentiated neurospheres). The immunofluorescence showed that Nestin and GFAP were positive in these cells. The qRT-PCR showed that the relative expression level of miR-145-3p in overexpression group was 3.52±0.24 significantly higher than the negative control group 0.01±0.01, the difference was statistically significant (P<0.01). It indicated that lentivirus was successfully transfected into ENSCs. Edu cell infiltration showed that the positive rate of Edu in the miR-145-3p overexpression group was (15.23±1.17) %, while the negative control group was (22.38±1.52) % (P<0.05). After NESCs cells were exposed to the differentiation medium, the proportion of GFAP positive cells in the miR-145-3p overexpression group was (21.47±1.98)%, which was lower than that in the negative cell control group(33.86±2.52)% (P<0.05). 【Conclusions】 Lentivirus transfection is a high efficient transfection method in ENSCs. Overexpression of miR-145-3p inhibits the proliferation and differentiation of ENSCs, which may play an important role in the development of enteric nervous system. 2022 Vol. 39 (5): 652-655 [Abstract] ( 72 ) HTML (1 KB)  PDF (1811 KB)  ( 52 ) 656 Value of Multimodal Ultrasound Imaging Combined with MRI in the Diagnosis of Early Cesarean Scars Pregnancy LI Ling-ling, YUAN Hong-xia, WANG Ling, et al DOI: 10.3969/j.issn.1671-7171.2022.05.005 【Objective】 To explore the diagnostic value of multimodal ultrasound imaging combined with magnetic resonance imaging (MRI) in the early cesarean scars pregnancy (CSP). 【Methods】 A total of 106 patients with surgically and pathologically confirmed CSP from January 2017 to December 2020 were selected. All patients underwent multimodal ultrasound and MRI examination before surgery to compare the diagnostic efficacy of the two types of imaging indicators and their combined detection.【Results】 Among 106 CSP patients, the accuracy rate of multimodal ultrasound diagnosis was 89.6% (95/106), and 11 cases were misdiagnosed. The accuracy rate of MRI was 91.5% (97/106), and 9 cases were misdiagnosed. The accuracy rate of both combination diagnosis was 97.2% (103/106), and only 3 cases were misdiagnosed. The χ2 test was used to compare the accuracy rate of the two imaging techniques and the combined diagnosis. The result showed there was no significant difference in the diagnostic accuracy of multimode ultrasound and MRI (P>0.05). However, there was a difference between single diagnosis and combined diagnosis of multimode ultrasound and MRI (P<0.05). 【Conclusion】 There is no significant difference in the accuracy rate of CSP diagnosis between multimode ultrasound and MRI. However, the diagnostic accuracy rate of CSP with MRI combined multimode ultrasound diagnosis is higher than the two alone, which improves the diagnostic value for CSP. 2022 Vol. 39 (5): 656-659 [Abstract] ( 44 ) HTML (1 KB)  PDF (1848 KB)  ( 115 ) 660 Analysis of Risk Factors for Secondary Osteoporosis in Elderly Stroke Patients with Hemiplegia WANG Li-xin, LI Qing-fen, GAO Jun, et al DOI: 10.3969/j.issn.1671-7171.2022.05.006 【Objective】 To investigate the influencing factors of secondary osteoporosis in elderly stroke patients with hemiplegia. 【Methods】 The clinical data of 60 elderly stroke patients with hemiplegia who were admitted to our hospital from January 2018 to January 2021 were retrospectively analyzed. According to whether there was secondary osteoporosis, they were divided into the occurrence group and the non-occurrence group. The age, course of disease, gender, body mass index (BMI), co-morbidities, involved circulatory part, homocysteine (Hcy), blood pressure [Systolic blood pressure (SBP), diastolic blood pressure (DBP)], blood lipids [high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triacylglycerol (TG), total cholesterol (TC)], coagulation indexes [prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), D-dimer (DD)] and other clinical related data of the two groups of patients were compared. Multivariate logistic regression was used to analyze the risk factors for secondary osteoporosis in patients. 【Results】 Among the 60 elderly stroke patients with hemiplegia, 26 (43.34%) patients had secondary osteoporosis, and they were classified as the occurrence group; the remaining 34 cases (56.66%) did not occur, and they were classified as the non-occurrence group. There were no significant differences in age, course of disease, BMI, blood pressure, blood lipids, and coagulation indexes between the two groups (P>0.05). The proportion of women, hypertension, multiple infarctions of unilateral anterior circulation, LDL-C and Hcy levels in the occurrence group were higher than those in the non-occurrence group (P<0.05). Multivariate Logistic regression analysis showed that gender (OR=3.421, 95%CI=2.011~6.087), involved circulation (OR=3.809, 95%CI=1.792~7.326), hypertension (OR=2.187, 95%CI=1.126～1.987), LDL-C(OR=0.968, 95%CI=0.621～3.874), Hcy (OR=4.932, 95%CI=2.154～6.514) were independent risk factors for secondary osteoporosis in elderly stroke patients with hemiplegia (P<0.05). 【Conclusion】 Gender, hypertension, involved circulatory fraction, LDL-C and Hcy are risk factors for secondary osteoporosis in elderly stroke patients with hemiplegia. 2022 Vol. 39 (5): 660-663 [Abstract] ( 57 ) HTML (1 KB)  PDF (1164 KB)  ( 41 ) 664 Effects of Sothibuvir Combined with PR Regimen on Markers of Liver Injury, Immune Factors and Indicators of Liver Fibrosis in Patients with Chronic Hepatitis C ZHUO Xin, PEI Yuan-yuan DOI: 10.3969/j.issn.1671-7171.2022.05.007 【Objective】 To investigate the effects of sothibuvir combined with PR regimen on liver injury markers, immune factors and liver fibrosis in patients with chronic hepatitis C (CHC). 【Methods】 A total of 134 patients with CHC admitted to the two hospitals were randomly divided into observation group and control group, with 67 cases in each group. The control group was treated with PR regimen, and the observation group was treated with PR regimen combined sothibuvir. The levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), Golgi protein 73 (GP73), ferritin (SF) and other markers of liver injury were observed before and after treatment; Serum CD4+, CD8+, CD4+/CD8+ and other immune factors; Changes of liver fibrosis indexes such as serum laminin (LN), hyaluronic acid (HA), type 3 procollagen (PCⅢ), type 4 collagen (C-Ⅳ) and occurrence of adverse reactions; 【Results】 After treatment, the levels of serum AST, ALT, GP73 and SF in the observation group were lower than those in the control group (P<0.05); The levels of serum CD4+, CD4+/CD8+ in the observation group were lower than those in the control group, and the level of CD8+ was higher than that in the control group (P<0.05); The levels of serum LN, HA, PCⅢ and C-Ⅳ in the observation group were lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 Sorfosbuvir PR regimen combined with CHC can effectively eliminate Hepatitis C virus, improve the level of immune factors, inhibit liver fibrosis, and reduce the level of liver injury markers and indicators of liver fibrosis. It is effective, safe and reliable. 2022 Vol. 39 (5): 664-666 [Abstract] ( 45 ) HTML (1 KB)  PDF (1199 KB)  ( 52 ) 667 Variations and Significance of Serum Syndecan-1 and N-terminal Pro-brain Natriuretic Peptide in Patients with Chronic Heart Failure LUO Han, OUYANG Ze-wei DOI: 10.3969/j.issn.1671-7171.2022.05.008 【Objective】 To investigate the serum levels and significance of N-terminal pro-brain natriuretic peptide (NT-proBNP) and Syndecan-1 (SDC1) in patients with chronic heart failure (CHF). 【Methods】 We selected 115 hospitalization patients with CHF in our hospital as the CHF group. The CHF group was further divided into 3 subgroups based on the 2021 ESC (European Society of Cardiology) guidelines for the diagnosis and treatment of acute and chronic heart failure: preserved ejection fraction (HFpEF, n=40), mildly reduced ejection fraction (HFmrEF, n=40) and reduced ejection fraction group (HFrEF, n=35).At the same time, 35 volunteers with normal cardiac function were selected as the control group. Statistical analysis was conducted on the differences of serum SDC1 and NT-proBNP levels among the three subgroups with CHF and the control group. Logistic regression was used to analyze the risk factors of CHF. ROC curve was used to analyze the diagnostic value of SDC1, NT-proBNP alone and combination for CHF. 【Results】 Compared to the control group, the CHF groups had significantly higher levels of both SDC1 and NT-proBNP. The difference was statistically significant (P<0.05). The serum levels of NT-proBNP in the HFrEF group, HFmrEF group and HFpEF group were decreased in turn, and the difference between the groups was statistically significant (P<0.05). Serum SDC1 level in HFpEF group was lower than that in HFmrEF group and HFrEF group (P<0.05), however, there was no significant difference in serum SDC1 level between HFmrEF and HFrEF group (P>0.05). Logistic regression analysis showed that high levels of SDC1, NT-proBNP and LAD and low LVEF were independent risk factors for CHF. The area under the curve (AUC) of NT-proBNP and SDC1 in the diagnosis of CHF were 0.855 and 0.808, respectively, whereas the area under the curve of combined application of the two indexes in the diagnosis was 0.896. 【Conclusion】 The serum levels of SDC1 and NT-proBNP in patients with CHF increased, and the combined application of both SDC1 and NT-proBNP can improve the diagnostic value for CHF. 2022 Vol. 39 (5): 667-670 [Abstract] ( 47 ) HTML (1 KB)  PDF (1247 KB)  ( 28 ) 671 Effects of miR-21-5p on Proliferation, Migration, Invasion and STAT3 Signaling Pathway of Multiple Myeloma Cells BAI Tao, LU Liang, GUO Xiao-ning, et al DOI: 10.3969/j.issn.1671-7171.2022.05.009 【Objective】 To investigate the effects of microRNA (miR)-21-5p on the proliferation, migration, invasion, signal transduction and activator of transcription 3 (STAT3) signal pathway of multiple myeloma (MM). 【Methods】 Human MM RPMI-8226 cells were cultured in vitro and divided into control group (without transfection), siRNA NC group (transfected with nonsense siRNA) and miR-21-5p siRNA group (transfected with miR-21-5p siRNA). The expressions of miR-21-5p and STAT3 in RPMI-8226 cells were detected by real-time fluorescence quantitative PCR (qRT-PCR); The proliferation of RPMI-8226 cells was detected by CCK-8 method; The migration and invasion of RPMI-8226 cells were detected by Transwell method; Western blot (WB) was used to detect the expression of p-STAT3, STAT3, Ki-67 and matrix metalloproteinase-9 (MMP-9) in RPMI-8226 cells.【Results】 Compared with the control group and the siRNA NC group, the expression levels of miR-21-5p, STAT3 mRNA, cell OD value, number of migrating cells, number of invasive cells, p-STAT3/STAT3, Ki-67 and MMP-9 protein in RPMI-8226 cells in the miR-21-5p siRNA group were significantly lower (P<0.05). 【Conclusion】 Down-regulating the expression of miR-21-5p can inhibit the proliferation, migration and invasion of MM RPMI-8226 cells, and block the activation of STAT3 signaling pathway. 2022 Vol. 39 (5): 671-674 [Abstract] ( 65 ) HTML (1 KB)  PDF (1711 KB)  ( 57 ) 675 Effect of Mirabilite Application on Recovery Time of Bowel Sounds and Degree of Abdominal Distension in Patients Undergoing Total Hysterectomy ZHENG Xin, WEI Shao-ben, HAN Bian-li DOI: 10.3969/j.issn.1671-7171.2022.05.010 【Objective】 To investigate the effect of mirabilite application on the recovery time of bowel sounds and the degree of abdominal distension in patients undergoing total hysterectomy. 【Methods】 A total of 166 patients who underwent total hysterectomy in our hospital from January 2018 to July 2020 were randomly divided into control group (routine nursing after operation) and observation group (mirabilite applied to the abdomen on the basis of the control group), with 83 cases in each group. The gastrointestinal related indexes, length of hospital stay, degree of abdominal distension, degree of pain and level of inflammatory mediators were compared between the two groups. 【Results】 The recovery of bowel sounds, first exhaust, first defecation and hospital stay in the observation group were shorter than those in the control group (P<0.05); The degree of abdominal distension in the observation group was lighter than that in the control group (P<0.05); The visual analogue scale (VAS) of the observation group was significantly lower than that of the control group at 6 hours and 3 days after operation (P<0.05); Three days after operation, the levels of serum PCT and CRP in the two groups were significantly lower than those before operation, and the levels in the observation group were lower, the difference was statistically significant (P<0.05). 【Conclusion】 Mirabilite application can promote the recovery of gastrointestinal function, shorten the recovery time of intestinal sounds, reduce the degree of abdominal distension and reduce inflammatory reaction in patients undergoing total hysterectomy. 2022 Vol. 39 (5): 675-677 [Abstract] ( 50 ) HTML (1 KB)  PDF (1189 KB)  ( 101 ) 678 Effects of Pioglitazone and Metformin on the Levels of Sex Hormones and Inflammatory Factors in the Treatment of Hormone Resistant PCOS Infertility HU Xiao-ying, XING Zhong-ying, CAO Ting-ting, et al DOI: 10.3969/j.issn.1671-7171.2022.05.011 【Objective】 To observe the effects of pioglitazone and metformin on the levels of sex hormones and inflammatory factors in the treatment of infertility with hormone resistant polycystic ovary syndrome (PCOS). 【Methods】 A total of 120 infertile patients with hormone resistant PCOS were randomly divided into the observation group (n=60) and the control group (n=60).The control group was treated with metformin alone and the observation group was treated with pioglitazone in addition to metformin. The clinical efficacy, adverse reactions, insulin resistance(IR) index before and after treatment [fasting plasma glucose(FPG),fasting insulin (FINS),insulin resistance index(HOMA-IR)],sex hormone [follicle-stimulating hormone (FSH),luteinizing hormone(LH),testosterone(T),estradiol(E2)] level and inflammation related index [interleukin 6(IL-6),interleukin-17(IL-17),tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs-CRP)] were compared between the two groups.【Results】 The total effective rate in the observation group was 95.00%,which was significantly higher than 80.00% in the control group (P<0.05).After treatment, FPG,FINS, HOMA-IR, FSH,LH,T,E2,IL-6,IL-17,TNF-αand hs-CRP were significantly decreased in the two groups compared with before treatment (P<0.05). Levels of FPG,FINS, HOMA-IR,FSH,LH,T,E2,IL-6,IL-7 TNF-αand hs-CRP in the observation group after treatment were significantly lower than those in the control group; And the differences were statistically significant (P<0.05). During the treatment period, there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 On the basis of metformin in the treatment of hormone resistant PCOS infertility, pioglitazone can effectively improve the clinical efficacy, which can have obvious blood glucose metabolism improvement, adjust the level of sex hormones, inhibit the inflammatory reaction. Safety of the drug is high, so it is worthy of clinical promotion. 2022 Vol. 39 (5): 678-681 [Abstract] ( 67 ) HTML (1 KB)  PDF (1157 KB)  ( 71 ) 682 Expression and Significance of Pyruvate Dehydrogenase Kinase 4 and Transcription Factor Homeobox A1 in Gastric Cancer and Adjacent Tissues MU Jin-ji, FAN Lei, YANG Jian DOI: 10.3969/j.issn.1671-7171.2022.05.012 【Objective】 To investigate the expression of pyruvate dehydrogenase kinase 4 (PDK4) and transcription factor homeobox A1 (HOXA1) in gastric cancer and adjacent tissues. 【Methods】 A total of 123 patients with gastric cancer who were diagnosed and treated surgically in our hospital from January 2019 to July 2021 were selected. The specimens were collected from the tissues of cancerous lesions in the stomach (gastric cancer group) and adjacent cancerous tissues (adjacent cancer group). The expression levels of PDK4 mRNA and HOXA1 mRNA in gastric cancer and its adjacent tissues were measured by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). The expressions of PDK4 and transcription factor Hoxa1 were detected by immunohistochemistry. The relationship between the expression levels of PDK4 and HOXA1 in gastric cancer and the related pathological parameters of gastric cancer patients was analyzed; The correlation between PDK4 and HOXA1 in gastric cancer was analyze. All patients were followed up for 3 years. Kaplan Meier method was used to analyze the relationship between the expression of PDK4 and HOXA1 and the poor prognosis of patients with gastric cancer. COX regression was used to analyze the risk factors affecting the poor prognosis of patients with gastric cancer. 【Results】 The expression levels of PDK4 mRNA and HOXA1 mRNA and the positive rate of protein in gastric cancer tissues were significantly higher than those in adjacent tissues (P<0.05); The expression of PDK4 was related to the depth of invasion, TNM stage, degree of differentiation and lymph node metastasis (P<0.05), and the expression of HOXA1 was related to the depth of invasion, tumor size, TNM stage, degree of differentiation and lymph node metastasis (P<0.05); There was a positive correlation between the expression of PDK4 and HOXA1 in gastric cancer (P<0.05). Kaplan Meier results showed that the survival rate of patients with positive expression of PDK4 and HOXA1 (26.0%, 23.6%) was lower than that of patients with negative expression (63.4%, 65.9%). Multivariate COX analysis showed that positive PDK4 and HOXA1 were risk factors for poor prognosis in patients with gastric cancer (P<0.05). 【Conclusion】 The expression of PDK4 and HOXA1 may be related to the occurrence and prognosis of gastric cancer. The expression of PDK4 and HOXA1 in gastric cancer is closely related, which is of great significance to evaluate the prognosis of gastric cancer. 2022 Vol. 39 (5): 682-685 [Abstract] ( 44 ) HTML (1 KB)  PDF (1218 KB)  ( 47 ) 686 Clinical Value of Transcatheter Angiographic Embolization Combined with External Fixation in the Treatment of Tile C Pelvic Fracture with Hemorrhagic Shock ZHANG Qiang, Ding Tao DOI: 10.3969/j.issn.1671-7171.2022.05.013 【Objective】 To investigate the clinical value of transcatheter angiographic embolization combined with external fixation in the treatment of Tile C pelvic fracture with hemorrhagic shock. 【Methods】 The clinical data of 102 patients with Tile C pelvic fracture with hemorrhagic shock treated in our hospital from March 2013 to August 2021 were retrospectively analyzed. According to different treatment schemes, they were divided into observation group (n=53) and control group (n=49). The observation group underwent external fixation after transcatheter angiographic embolization, and the control group underwent transcatheter angiographic embolization after external fixation. The mortality during treatment, the amount of norepinephrine used in anti shock treatment, the amount of blood transfusion and the time of shock correction, the level of blood lactic acid before and 4 hours after treatment, the level of serum inflammatory response and oxidative stress response, and the incidence of complications related to embolization and external fixator were compared between the two groups. 【Results】 The mortality of the observation group was lower than that of the control group, and the difference was statistically significant (χ2=4.274, P<0.05); The amount of norepinephrine used in the observation group was less than that in the control group (P<0.05); After treatment, the level of blood lactic acid in the two groups was lower than that before treatment, and the level of blood lactic acid in the observation group was lower than that in the control group (P<0.05); The levels of serum high-sensitivity C-reactive protein (hs-CRP) and superoxide dismutase (SOD) in the two groups were lower than those before treatment (P<0.05). 【Conclusion】 External fixation after transcatheter angiographic embolization in the treatment of Tile C pelvic fracture with hemorrhagic shock is helpful to reduce the mortality, reduce the amount of blood transfusion, shorten the shock correction time and reduce the risk of metabolic acidosis. 2022 Vol. 39 (5): 686-689 [Abstract] ( 48 ) HTML (1 KB)  PDF (1149 KB)  ( 39 ) 690 Clinical Efficacy of Supportive Expressive Group Psychological Intervention Combined with Paliperidone Palmitate in the Treatment of Acute First-Episode Schizophrenia ZHAO Wen-qing DOI: 10.3969/j.issn.1671-7171.2022.05.014 【Objective】 To explore the clinical effect of supportive expressive group psychological intervention combined with paliperidone palmitate in the treatment of acute first-episode schizophrenia. 【Methods】 The clinical data of 98 patients with acute first-episode schizophrenia treated in our hospital from January 2019 to February 2021 were analyzed retrospectively. According to different treatment methods, they were divided into observation group and control group, with 49 cases in each group. The control group was treated with paliperidone palmitate sustained-release tablets, and the observation group was given supportive expressive group psychological intervention on the basis of the control group. The scores of positive and negative emotional state scale (PANAS), social function deficiency screening scale (SDSS) and quality of life scale for patients with schizophrenia (SQLS) were compared between the two groups before and after treatment. 【Results】 After one month and three months of treatment, the positive emotion score of the two groups was higher than that before treatment, and the negative emotion score was lower than that before treatment. There was significant difference between the two groups after three months of treatment and one month of treatment, as well as between the two groups (all P<0.05); The social function defect score of the two groups was lower than that before treatment, and there was significant difference between the two groups after 3 months of treatment and 1 month of treatment, as well as between the two groups (all P<0.05); The scores of motivation and energy, psychosocial, symptoms and side effects of the two groups were lower than those before treatment, and there were significant differences between the two groups after 3 months of treatment and 1 month of treatment, as well as between the two groups (all P<0.05). 【Conclusion】 Supportive expressive group psychological intervention combined with paliperidone palmitate can better improve the emotional state, restore the social function and improve the quality of life of patients with acute first-episode schizophrenia. 2022 Vol. 39 (5): 690-692 [Abstract] ( 37 ) HTML (1 KB)  PDF (1190 KB)  ( 64 ) 693 Effects of Different Administration Strategies of Tirofiban Assisted PCI on Myocardial Perfusion Level, Electrocardiogram Performance and Inflammatory Factors in Patients with Acute Anterior Myocardial Infarction LIU Yan, BAI Guang-ming DOI: 10.3969/j.issn.1671-7171.2022.05.015 【Objective】 To explore effects of different administration strategies of tirofiban assisted PCI (percutaneous coronary intervention) on postoperative myocardial perfusion level, electrocardiogram performance, the incidence of major adverse cardiovascular events (MACE) and inflammatory factors such as soluble vascular cell adhesion molecule-1 (sVCAM-1) and platelet activating factor (PAF) in patients with of acute anterior myocardial infarction. 【Methods】 Clinical data of 96 patients with acute anterior myocardial infarction in Xi'an Gaoxin hospital were retrospectively analyzed and divided into the observation group and the control group by random number table, with 48 cases in each group. Both groups were given coronary thrombus aspiration and PCI. While the control group was given tirofiban intravenously and the observation group was given tirofiban catheter injection. Patients in the two groups were compared by myocardial perfusion level post-operation, ECG performance (ST-segment fall range and Tp-e/QT), adverse reactions and MACE incidence rates immediately after surgery, and myocardial injury indexes before and after surgery [creatine phosphokinase isoenzyme (CK-MB), troponin I (cTnI), brain natriuretic peptide (BNP), lactate dehydrogenase (LDH), creatine kinase (CK)], inflammatory injury indicators [sVCAM-1, soluble CD40L (sCD40L), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α)].【Results】 The improvement of immediate myocardial perfusion in the observation group was better than that of the control group (P<0.05).The good rate of ST segment fall in the observation group within 2 hours was higher than that of the control group (P<0.05). The Tp-e/QT values of the two groups after treatment were lower than those before treatment; And value of Tp-e/QT in the observation group was lower than that in the control group (P<0.05). After treatment, CK-MB, cTnI, BNP, LDH, CK, sVCAM-1, sCD40L, CRP and TNF-α in the observation group were lower than those before treatment. And the levels of the observation group were lower than those of the control group (P<0.05). The difference in the total incidence of adverse reactions and MACE at 3 months after treatment in the two groups was not statistically significant (P>0.05). 【Conclusion】 Compared with tirofiban intravenous infusion, catheter injection of tirofiban can significantly improve myocardial perfusion in patients with coronary thrombus aspiration + PCI, optimize ECG performance and adjust sVCAM-1 and PAF levels, which has certain safety. 2022 Vol. 39 (5): 693-696 [Abstract] ( 43 ) HTML (1 KB)  PDF (1157 KB)  ( 36 ) 697 Clinical Significance of CD177+ Neutrophils Proportion from Peripheral Blood in Patients with Myelodysplastic Syndrome DENG Lei, ZHAO Yue DOI: 10.3969/j.issn.1671-7171.2022.05.016 【Objective】 To detect the proportion of CD177+ neutrophils in patients with myelodysplastic syndrome (MDS) and explore its clinical significance. 【Methods】 A total of 100 MDS patients who were treated continuously in the Hematology Department of our hospital were selected. According to the MDS International Prognostic Scoring System (IPSS) risk, MDS patients were divided into the low-risk cases (n=63) and the high-risk cases (n=37).Furthermore, according to the severity of anemia, they were divided into normal hemoglobin (Hb) group (n=11), mild anemia group (n=23), moderate anemia group (n=42) and severe anemia group (n=24).In addition, 50 healthy vounteers who underwent physical examination during the same period were selected as the control group. The expression of CD177+ in neutrophils was detected by flow cytometry. Kaplan Meier method was used to analyze the relationship between the proportion of CD177+ neutrophils and the prognosis of MDS patients. Cox regression model was used to analyze the prognostic factors of MDS patients. 【Results】 The level of CD177+ neutrophils in the peripheral blood of MDS patients was significantly higher than that of the normal control group (P<0.05).Compared to those with normal hemoglobin, the levels of CD177+ neutrophils in MDS patients of moderate anemia group and severe anemia group were significantly increased (P<0.05), while there was no significant difference in the level of CD177+ neutrophils between MDS patients of mild anemia group and normal hemoglobin group (P>0.05). The levels of CD177+ neutrophils in MDS patients in mild anemia group, moderate anemia group and severe anemia group were increased in turn, and the differences were statistically significant (P<0.05). The level of CD177+ neutrophils was also related to the hemoglobin, platelet, chromosome and risk classification of IPSS (P<0.05). The 3 years cumulative survival rate of patients with myelodysplastic syndrome in the high CD177+ neutrophil level group was significantly lower than that in the low level group (35.11% vs 53.93%, P<0.05). Chromosomal abnormality and high level of CD177+ neutrophils were independent risk factors for poor prognosis of MDS (P<0.05). 【Conclusion】 The level of CD177+ neutrophils in the peripheral blood of MDS patients significantly increased, which is an independent risk factor for the prognosis of MDS patients 2022 Vol. 39 (5): 697-700 [Abstract] ( 47 ) HTML (1 KB)  PDF (1185 KB)  ( 29 ) 701 Application of Lung Ultrasound with PCT and CRP Combined Detection in Patients with Severe Pneumonia Complicated with ARDS LIU Xiao-hui, GAO Hong-liang, BAI Xue DOI: 10.3969/j.issn.1671-7171.2022.05.017 【Objective】 To explore the application value of lung ultrasound combined with procalcitonin (PCT) and C-reactive protein (CRP) detection in patients with severe pneumonia complicated by acute respiratory distress syndrome (ARDS). 【Methods】 A total of 198 patients with severe pneumonia admitted to our hospital from February 2018 to October 2020 were selected as the severe pneumonia group. During the same time period, 185 patients with common pneumonia in our hospital and 182 healthy volunteers were recruited as the common pneumonia group and the healthy control group. The lung ultrasound scores, PCT and CRP levels were compared among three groups. According to whether patients with severe pneumonia complicated with ARDS, they were divided into the concurrent group and non-complicated group. And the clinical data of the two groups were compared. Logistic multivariate regression was used to analyze the factors affecting severe pneumonia complicated with ARDS. A receiver operating characteristic curve (ROC) was made to analyze the diagnostic value of combined detection of lung ultrasound score, PCT and CRP levels for severe pneumonia complicated by ARDS. 【Results】 The lung ultrasound scores, PCT and CRP levels of the three groups were statistically different (P<0.05). The lung ultrasound scores, PCT and CRP levels of patients in the severe pneumonia group were significantly higher than those of the common pneumonia group and the healthy group (P<0.05). The lung ultrasound scores, PCT and CRP levels of the patients in the common pneumonia group were significantly higher than those of the healthy group (P<0.05). The incidence of severe pneumonia complicated by ARDS was 37.37%. The time of ICU stay, usage of mechanical ventilation, interleukin-6, white blood cell count (WBC), severity of pneumonia (PSI) score, acute physiology and chronic health score system Ⅱ(APACHE Ⅱ) score, lung ultrasound score, and levels of PCT and CRP in patients of the concurrent group were significantly higher than those of the non-complicated group (P<0.05). Logistic regression analysis and multivariate analysis showed that the length of admission to ICU, PSI score, lung ultrasound, and serum levels of PCT and CRP were all factors affecting severe pneumonia complicated by ARDS (OR=3.518, 3.900, 2.776, 4.415, 4.187, P< 0.05). ROC analysis showed that specificity the combination of the lung ultrasound, PCT level and CRP level was higher than the specificity of lung ultrasound, PCT level and CRP level separately evaluated. The area under the curve (AUC) for severe pneumonia complicated with ARDS detected by lung ultrasound combined with PCT and CRP level detection was 0.916, which was significantly higher than the AUC diagnosed by lung ultrasound, PCT and CRP alone (0.770, 0.812 and 0.767,respectively) (P<0.05). 【Conclusion】 Lung ultrasound combined with PCT and CRP have high diagnostic efficiency for severe pneumonia complicated by ARDS. It can be used as an important reference index for the diagnosis of severe pneumonia complicated by ARDS. 2022 Vol. 39 (5): 701-704 [Abstract] ( 43 ) HTML (1 KB)  PDF (1224 KB)  ( 46 ) 705 Effects of Interfering with PARP1 Gene Expression on Proliferation, Invasion and Migration of Gastric Cancer MGC-803 Cells CAO Qiu-xiang, NAN Hong, PAN Xiao-tao DOI: 10.3969/j.issn.1671-7171.2022.05.018 【Objective】 To investigate the effect of poly adenosine diphosphate ribose polymerase 1 (PARP1) gene on the proliferation, migration and invasion of gastric cancer cell line (MGC-803).【Methods】 Human gastric cancer cell line MGC-803 and human normal gastric mucosal epithelial cell GES-1 were cultured in vitro, and the expression of PARP1 mRNA was compared between the two cells; MGC-803 cells were randomly divided into control group, interference PARP1 expression group (si-PARP1 group) and negative control group (si-NC group); The expression of PARP1 mRNA in MGC-803 cells was detected by qRT-PCR; MTT assay, flow cytometry, scratch test and Transwell chamber method were used to detect cell proliferation, apoptosis, migration and invasion respectively. Western blot was used to detect the expression of PARP1, matrix metalloproteinase-2 (MMP-2), MMP-9, RhoA and Rock1 proteins. 【Results】 Compared with GES-1, the expression of PARP1 mRNA in MGC-803 cells increased significantly (P<0.05); Compared with the control group and the si-NC group, the apoptosis rate and proliferation inhibition rate of MGC-803 cells in the si-PARP1 group increased significantly (P<0.05), and the migration rate and invasion rate of cell scratch, the expression levels of PARP1 mRNA and PARP1 protein, MMP-2, MMP-9, RhoA and Rock1 protein decreased significantly (P<0.05). 【Conclusion】 Interfering with the expression of PARP1 can inhibit the proliferation, migration and invasion of human gastric cancer cells, which may be related to the inhibition of RhoA/Rock signaling pathway. 2022 Vol. 39 (5): 705-708 [Abstract] ( 49 ) HTML (1 KB)  PDF (1983 KB)  ( 72 ) 709 Clinical Study on Sedative Effect of Dexmedetomidine and Midazolam in Patients with Severe Tetanus FENG Yi-fan, LIU Kang DOI: 10.3969/j.issn.1671-7171.2022.05.019 【Objective】 To investigate the clinical effect of dexmedetomidine and midazolam on sedation in patients with severe tetanus. 【Methods】 A total of 64 patients with severe tetanus treated in Baoji People's Hospital from September 2018 to September 2020 were selected as the research object. According to the order of admission, they were divided into observation group and treatment group, with 32 cases in each group. The observation group was treated with human tetanus immunoglobulin combined with dexmedetomidine, and the control group was treated with human tetanus immunoglobulin combined with midazolam. The pulse oxygen saturation (SpO2), heart rate (HR), respiratory rate (RR) and mean arterial pressure (MAP) of the two groups were monitored before and 12 hours after treatment. The degree of sedation was evaluated by Ramsay score. The incidence of adverse reactions and mortality of the two groups were counted and compared. 【Results】 After 12 hours of treatment, SpO2 increased (P<0.05), HR, RR and MAP decreased (P<0.05), SpO2 in the observation group was higher than that in the control group (P<0.05), and HR, RR and MAP were lower than those in the control group (P<0.05).After 3 hours of treatment, the Ramsay score of the two groups was higher than that before treatment (P<0.05), but there was no significant difference between the two groups (P>0.05).The incidence of adverse reactions in the observation group was 6.25%, which was significantly lower than that in the observation group was 25.00%.The mortality of patients in the observation group was 3.13% (1/32), and there was no significant difference compared with 9.38% (3/32) in the group B (Fisher exact test,P=0.613). 【Conclusion】 For patients with severe tetanus, the application of human tetanus immunoglobulin combined with dexmedetomidine can achieve good sedative effect, improve SpO2, HR, RR and MAP, and have less adverse reactions. 2022 Vol. 39 (5): 709-712 [Abstract] ( 59 ) HTML (1 KB)  PDF (1153 KB)  ( 64 ) 713 Value of Coagulation Indexes and Thrombus Molecular Markers in Predicting Postoperative Deep Venous Thrombosis in Patients with Fracture WANG Yong, YU Hong-jing DOI: 10.3969/j.issn.1671-7171.2022.05.020 【Objective】 To investigate the value of coagulation indexes and thrombus molecular markers in predicting postoperative deep venous thrombosis (DVT) in patients with traumatic fracture. 【Methods】 The clinical data of 78 patients with traumatic fracture treated in the author's Hospital from October 2018 to October 2021 were analyzed retrospectively. According to whether DVT occurred after operation, they were divided into DVT group (n=32) and non DVT group (n=46). The gender, age, complications, fracture site, operation time, intraoperative bleeding, postoperative bleeding, use of postoperative hemostatic drugs, intraoperative blood transfusion, coagulation indexes [prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-Dimer (D-D)], thrombin antithrombin complex (TAT), plasmin were compared between the two groups ; the levels of DVT related factors such as anti plasmin complex (PIC)-α2, tissue plasminogen activator plasminogen activator inhibitor complex (t-PAIC), soluble thrombomodulin (sTM) were analyzed. The value of FIB, D-D, TAT, PIC, t-PAIC and sTM was predicted by ROC, and the risk factors of postoperative DVT were determined by multivariate logistic regression analysis. 【Results】 There was no significant difference in gender, age, complications, fracture site, operation time, intraoperative bleeding, postoperative bleeding, APTT, PT, use of postoperative hemostatic drugs and intraoperative blood transfusion between the two groups (P>0.05). FIB, D-D, TAT, PIC, t-PAIC and sTM in the DVT group were significantly higher than those in the non DVT group (P<0.05); By ROC analysis, FIB=4.766 g/L, D-D=4833.945 ng/mL, TAT=6.077 ng/mL, PIC=1.089 μ G/mL, t-PAIC=7.754 ng/mL and sTM=8.552 TU/mL were the best cutoff values for predicting postoperative DVT in patients with fracture; Logistic regression analysis showed that FIB≥4.766 g/L, D-D≥4833.945 ng/mL, TAT≥6.077 ng/mL and PIC≥1.089 μ G/mL, t-PAIC≥7.754 ng/mL and sTM≥8.552 TU/mL were the risk factors of postoperative DVT in patients with fracture (P<0.05). 【Conclusion】 The risk of postoperative DVT in patients with traumatic fracture is related to the levels of FIB, D-D, TAT, PIC, t-PAIC and sTM. The levels of coagulation indexes and thrombus molecular markers should be closely monitored to prevent the occurrence of postoperative DVT. 2022 Vol. 39 (5): 713-716 [Abstract] ( 66 ) HTML (1 KB)  PDF (1281 KB)  ( 403 ) 717 Effect of Nano Nnife Ablation Combined with PTCD on Prognosis and Liver Function in Elderly Patients with Unresectable Hilar Cholangiocarcinoma HU Pei-jun, XUE Ying DOI: 10.3969/j.issn.1671-7171.2022.05.021 【Objective】 To investigate the effect of nano knife ablation combined with percutaneous transhepatic biliary drainage (PTCD) on the prognosis and liver function of unresectable hilar cholangiocarcinoma in the elderly. 【Methods】 The clinical data of 72 elderly patients with unresectable hilar cholangiocarcinoma treated in the Ninth People's Hospital Affiliated to the Medical College of Shanghai Jiaotong University were analyzed retrospectively. According to different surgical treatment schemes, they were divided into control group (PTCD alone, n=40) and observation group (nano knife ablation combined with PTCD, n=32). The changes of glycogen (CEA), total bilirubin (CEA) and aminotransferase (ALT) before and after treatment were compared between the two groups. 【Results】 The tumor remission rate in the observation group was 87.50% (28/32), which was significantly higher than 65.00% (26/40) in the control group (P<0.05). After treatment, the levels of alt, AST and TBIL 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 levels of CA199, CA125 and CEA in the observation group were lower than those in the control group (P<0.05). The incidence of complications in the observation group was 21.87% (7/32), which was lower than 12.50% (5/40) in the control group. The difference was not statistically significant (χ2=1.13,P=0.29>0.05). The 2-year survival rate of the observation group was 38.70%, which was higher than 27.02% of the control group, but the difference was not statistically significant (Log Rank=1.473,P=0.225). 【Conclusion】 Nano knife ablation combined with PTCD in the treatment of elderly unresectable hilar cholangiocarcinoma has a good prognosis and can improve liver function, which is worthy of popularization. 2022 Vol. 39 (5): 717-720 [Abstract] ( 64 ) HTML (1 KB)  PDF (1214 KB)  ( 81 ) 721 Effects of Lactobacillus Reuteri and Lactobacillus Acidophilus on Gut Microbiota in Ovariectomized Osteoporosis Mice CHEN Jing-chen, LI Song-bo, LI Jian-wen, et al DOI: 10.3969/j.issn.1671-7171.2022.05.022 【Objective】 To investigate the changes of gut microbiota in ovariectomized osteoporosis mice fed with Lactobacillus reuteri and Lactobacillus acidophilus.【Methods】 C57BL/6J female mice (n=80) were randomly divided into eight different groups based on treatments: sham surgery (sham), sham with Lactobacillus reuteri feeding, sham with Lactobacillus acidophilus feeding, sham with both Lactobacillus reuteri and Lactobacillus acidophilus co-feeding, OVX surgery (OVX), OVX with Lactobacillus reuteri feeding, OVX with Lactobacillus acidophilus feeding, OVX and both Lactobacillus reuteri and Lactobacillus acidophilus co-feeding. There were 10 mice in each group. Data of 16rRNA high-throughput sequencing were used to analyze and compare the taxonomic composition, alpha diversity index and beta diversity index of gut microbiota in each group. 【Results】 Mice fed with probiotics had changes in the composition of their gut microbiota. Compared to the mice fed without probiotics, Firmicutes and Erysipelotrichia decreased in the OVX with probiotics fed groups. Proteobacteria, gamma proteobacteria and Enterobacterales increased in lactobacillus acidophilus fed groups. Verrucomicrobiota and Akkermansiaceae increased except for group of OVX with lactobacillus acidophilus fed. After the mice were fed with probiotics, the richness of gut microbiota was significantly increased (P<0.05). Ovariectomy made the richness and diversity of gut microbiota decreased significantly (P<0.05).The same surgery modeling and probiotic feeding patterns had similar and regular effects on gut microbiota. Mice fed with probiotics had a greater effect on their gut microbiota than the ovariectomized intervention.【Conclusion】 Lactobacillus reuteri and Lactobacillus acidophilus can change the composition of gut microbiota in ovariectomized mice with osteoporosis. There are certain rules to this change. This can provide experimental basis for studying the relationship of osteoporosis with probiotics and gut microbiota. 2022 Vol. 39 (5): 721-724 [Abstract] ( 44 ) HTML (1 KB)  PDF (2129 KB)  ( 75 ) 725 Prognostic Factors of Extracorporeal Membrane Oxygenation in Elderly Patients with Cardiogenic Shock LIU Jian-hong, YAN Hong-fang DOI: 10.3969/j.issn.1671-7171.2022.05.023 【Objective】 To investigate the prognostic factors of extracorporeal membrane oxygenation (ECMO) in elderly patients with cardiogenic shock (CGS). 【Methods】 A total of 124 elderly patients with CGS treated in Hancheng people's Hospital and Yanliang Hospital of Xi'an Honghui hospital from January 2018 to February 2021 were treated with ECMO. The prognosis of patients 90 days after ECMO treatment was recorded and divided into survival group and death group. The influencing factors of ECMO treatment prognosis, the effects of SOFA score, blood lactic acid and cTnT on the prognosis of elderly CGS patients were analyzed, and the value of SOFA score, blood lactic acid and cTnT alone and in combination in predicting the prognosis was evaluated. 【Results】 The 90 day survival rate of 124 elderly patients with CGS after ECMO treatment was 75.81%, and the mortality was 24.19%. Univariate analysis showed that the age of death group>75 years old, the time from ICU to ECMO≥5 hours, acute renal injury, SOFA score, blood lactic acid and cTnT before ECMO treatment were higher than those in survival group, and LVEF before ECMO treatment was lower than those in survival group (P<0.05). Multivariate analysis showed that age, time from ICU to ECMO, acute renal injury, LVEF, SOFA score, blood lactic acid and cTnT before ECMO treatment were the influencing factors of the prognosis of elderly patients with CGS after ECMO treatment (P<0.05). Before ECMO treatment, the area under the curve (AUC) of SOFA score, blood lactic acid and cTnT to predict the prognosis of elderly CGS patients after ECMO treatment was > 0.7. The AUC predicted by the combination of various indexes was the largest, which was 0.947. The best prediction sensitivity and specificity were 86.67% and 90.43% respectively. 【Conclusion】 ECMO is effective in the treatment of elderly patients with CGS. The combination of SOFA score, blood lactic acid and cTnT before treatment is of high value in predicting the prognosis of patients. 2022 Vol. 39 (5): 725-728 [Abstract] ( 56 ) HTML (1 KB)  PDF (1157 KB)  ( 62 ) 729 Efficacy and Safety of Everolimus Combined with Fulvestrant in the Treatment of Estrogen Receptor-positive Advanced Breast Cancer REN Xiao-hong, ZHAO Ni-xia DOI: 10.3969/j.issn.1671-7171.2022.05.024 【Objective】 To explore the efficacy and safety of everolimus combined with fulvestrant in the treatment of estrogen receptor-positive advanced breast cancer patients. 【Methods】 Seventy-three patients with estrogen receptor-positive advanced breast cancer admitted to our hospital were selected as the research objects, and they were randomly divided into the control group and the observation group. A total of 36 patients in the control group were treated with fulvestrant as a single agent. A total of 37 patients in the treatment group were treated with everolimus combined with fulvestrant. The treatment effect, progression-free survival (PFS) and the occurrence of adverse reactions of the two groups of patients were observed in the two groups. 【Results】 The objective response rate (ORR) was 18.92% (7/37) in the observation group and 11.11%(4/36) in the control group, which there was no significant difference between two groups (P>0.05). The disease control rate (DCR) of the treatment group was 81.08% (30/37), which was significantly higher than that of the control group 58.33% (21/36) (P<0.05). The median PFS of the control group was 5 months (95%CI:1.381~8.619) and the median PFS of the observation group was 10 months (95%CI:7.102~12.898). The PFS of the observation group was significantly longer than that of the control group (P<0.05). The incidence of abnormal liver function, bone marrow suppression, oral mucositis, skin rash and gastrointestinal reactions in the observation group was significantly higher than that in the control group (P<0.05). 【Conclusion】 The efficacy of everolimus combined with fulvestrant in the treatment of estrogen receptor-positive advanced breast cancer patients is significantly better than that of fulvestrant monotherapy, however, it should be noted that the incidence of adverse reactions is also high. 2022 Vol. 39 (5): 729-731 [Abstract] ( 40 ) HTML (1 KB)  PDF (1241 KB)  ( 67 ) 732 Application Value of Mammography, MRI and Serum PCT in the Diagnosis of Benign and Malignant Breast Tumors MA Xiao-wei, LI Yao-feng DOI: 10.3969/j.issn.1671-7171.2022.05.025 【Objective】 To investigate the value of mammography and magnetic resonance imaging (MRI) combined with serum procalcitonin (PCT) in the differential diagnosis of benign and malignant breast tumors. 【Methods】 A total of 120 female patients with breast masses treated in the Yulin First Hospital were selected as the research object. According to the results of pathological examination, the patients were divided into benign breast tumor group (n=54) and malignant breast tumor group (n=66). All patients underwent mammography and MRI. At the same time, the level of serum PCT was detected by enzyme-linked immunosorbent assay (ELISA). The consistency between mammography, MRI, serum PCT and their combination in detecting breast malignant tumors and clinicopathological diagnosis was analyzed. The diagnostic value of mammography, MRI, serum PCT and their combination in breast malignant tumors was analyzed and compared. 【Results】 The level of serum PCT in breast malignant tumor group was significantly higher than that in breast benign tumor group (P<0.05). There were 54, 58 and 49 cases of breast malignant tumors detected by X-ray photography, MRI and serum PCT, respectively. The consistency with clinicopathological diagnosis was high, high and moderate respectively (Kappa=0.604, 0.734 and 0.493, all P<0.05). A total of 63 patients with breast cancer were detected by the combination of the three, which was in excellent agreement with the clinicopathological diagnosis ( Kappa=0.883, P<0.05). The sensitivity and accuracy of X-ray photography and serum PCT were lower than the combined detection, and the missed diagnosis rate was higher than the combined detection (P<0.05). 【Conclusion】 X-ray photography, MRI and serum PCT have certain diagnostic value for benign and malignant breast tumors. The detection rate of MRI is higher, and the combined diagnostic value of the three is higher than that of the three alone. 2022 Vol. 39 (5): 732-735 [Abstract] ( 54 ) HTML (1 KB)  PDF (1153 KB)  ( 59 ) 736 Efficacy of Longdan Xiegan Decoction Combined with Doxorubicin Injection in Treatment of Postherpetic Neuralgia CAO Yun-chao, MA Jian DOI: 10.3969/j.issn.1671-7171.2022.05.026 【Objective】 To observe the efficacy of Longdan Xiegan decoction combined with doxorubicin injection in the treatment of postherpetic neuralgia (PHN). 【Methods】 A total of 80 PHN patients admitted to Longxian Maternal and Child Health Hospital from December 2017 to December 2020 were collected in the study. They were randomly divided into two groups, with 40 cases in each group. Patients in the control group w received intraforaminal injection of doxorubicin under CT guidance, while patients in the observation group received Longdan Xiegan Decoction + doxorubicin for 1 month. The clinical efficacy, TCM syndrome score and visual analog scale (VAS) score were compared between the two groups. Blood was collected before and after treatment to detect serum inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), Interleukin-2 (IL-2)] and the expression of immune cells [CD4+, CD8+, CD4+/CD8+], and the incidence of adverse reactions between the two groups were compared. 【Results】 The total effective rate of the observation group was 90.00%, which was significantly higher than that of the control group (72.50%, P<0.05). Compared with before treatment, TCM syndrome score and VAS score of the two groups decreased significantly after treatment; And the observation group was significantly lower than the control group (P<0.05). After treatment, the contents of TNF-α and IL-1β in the two groups decreased (P<0.05), while the contents of IL-2 increased (P<0.05). Compared with the control group, TNF-α and IL-1β in the observation group decreased more, while IL-2 increased more; The differences were statistical significance (P<0.05). After treatment, CD4+ and CD4+/CD8+ increased (P<0.05) and CD8+ decreased (P<0.05) in the two groups, and the changes in the observation group were more obvious than those in the control group (P<0.05). The incidence of adverse reactions in observation group was 20.00%, which was not statistically significant compared with 17.50% in control group (P>0.05). 【Conclusion】 Longdan Xiegan Decoction combined with doxorubicin injection has obvious curative effect on PHN, which can promote pain relief, reduce inflammatory reaction and enhance immune function. It is safe for clinical application. 2022 Vol. 39 (5): 736-739 [Abstract] ( 53 ) HTML (1 KB)  PDF (1157 KB)  ( 144 ) 740 Correlation between the Expression Levels of Serum IL-1β and IL-6 and Pregnancy Outcome in Patients with Pregnancy Complicated with Schizophrenia ZHANG Rui, BAI Yu DOI: 10.3969/j.issn.1671-7171.2022.05.027 【Objective】 To investigate the correlation between the expression levels of serum interleukin-1β(IL-1β) and interleukin-6 (IL-6) and pregnancy outcome in patients with pregnancy complicated with schizophrenia. 【Methods】 A total of 37 pregnant women with schizophrenia (observation group) and 28 normal pregnant women (control group) who delivered in the obstetrics department of the Affiliated Hospital of Yan'an University from January 2020 to December 2020 were selected. The expression levels of serum IL-1β and IL-6 in all subjects were detected by enzyme-linked immunosorbent assay (ELISA); Pearson was used to analyze the correlation between the expression levels of IL-1β and IL-6 and the correlation between the expression levels of IL-1β and IL-6 and adverse pregnancy outcomes; ROC curve was used to analyze the predictive value of IL-1β and IL-6 expression levels on adverse pregnancy outcomes. 【Results】 Compared with the control group, the expression levels of serum IL-1βand IL-6 in the observation group increased (P<0.05); There was a positive correlation between the expression of serum IL-β1 and IL-6 (r=0.54, P<0.05); The incidence of premature delivery, premature rupture of membranes, placental abruption and postpartum hemorrhage in the observation group was significantly higher than that in the control group (P<0.05); The incidence of low fetal weight, fetal malformation, fetal distress, perinatal death and severe asphyxia in the control group were significantly higher than those in the control group (P<0.05); The expression of serum IL-1β and IL-6 was positively correlated with adverse pregnancy outcome (P<0.05); ROC curve analysis showed that the area under the curve (AUC) of serum IL-1β and IL-6 in predicting adverse pregnancy outcomes were 0.883 and 0.864 respectively, and the AUC of combined prediction of adverse pregnancy outcomes was 0.891. 【Conclusion】 Pregnancy complicated with schizophrenia can increase the incidence of adverse pregnancy outcomes. Serum IL-1β and IL-6 are highly expressed in the serum of patients with pregnancy complicated with schizophrenia, which are closely related to the adverse pregnancy outcomes of patients with pregnancy complicated with schizophrenia, which can provide a basis for the condition monitoring of pregnancy complicated with schizophrenia. 2022 Vol. 39 (5): 740-742 [Abstract] ( 36 ) HTML (1 KB)  PDF (1253 KB)  ( 47 ) 743 Study on the Relationship between the Expressions of Fibrinogen and Albumin and Unstable Angina Pectoris in the Elderly and its Prognosis WANG Lan, ZUO Bao-gong DOI: 10.3969/j.issn.1671-7171.2022.05.028 【Objective】 To investigate the correlation between the expression levels of fibrinogen (FIB) and albumin (ALB) and the prognosis of elderly patients with unstable angina pectoris. 【Methods】 A total of 120 elderly patients with unstable angina pectoris (observation group) treated in Xi'an first hospital from January 2018 to February 2019 were selected, and 120 healthy volunteers (control group) who underwent physical examination in our hospital at the same time were selected. The serum FIB and ALB levels of the two groups were detected respectively. The diagnostic value of FIB and ALB levels in patients with unstable angina pectoris was evaluated by the working characteristic curve (ROC). The related factors affecting the poor prognosis of patients with unstable angina pectoris were analyzed by multivariate Cox model. 【Results】 The level of serum FIB in the observation group was higher than that in the control group, and the level of Alb was lower than that in the control group (P<0.05). ROC curve analysis showed that the AUC of FIB and ALB in the diagnosis of unstable angina pectoris were 0.886 and 0.781 respectively, and the cut-off values were 2.743 g/L and 40.98 g/L respectively. The AUC of combined detection of unstable angina pectoris was 0.927, and the sensitivity and specificity were 88.3% and 88.3% respectively. The incidence of poor prognosis in the high FIB group was higher than that in the low FIB group (P<0.05), and the incidence of poor prognosis in the low ALB group was higher than that in the high ALB group (P<0.05). Multivariate Cox model analysis showed that high FIB level and low ALB level were independent risk factors for the prognosis of patients with unstable angina pectoris (all P<0.05). 【Conclusion】 The level of serum FIB in patients with unstable angina pectoris is significantly increased and the level of serum ALB is significantly reduced. FIB and ALB have certain diagnostic value for unstable angina pectoris, and patients with high FIB and low ALB expression have a high risk of poor prognosis. 2022 Vol. 39 (5): 743-746 [Abstract] ( 56 ) HTML (1 KB)  PDF (1179 KB)  ( 41 ) 747 Expression and Significance of Serum miR-138 in Children with Acute Mycoplasma Pneumoniae Pneumonia TANG Lu, CUI Dong DOI: 10.3969/j.issn.1671-7171.2022.05.029 【Objective】 To investigate the expression of serum miR-138 in children with acute Mycoplasma pneumoniae pneumonia (MPP). 【Methods】 A total of 90 children with acute MPP (observation group) treated in pediatrics of our hospital from February 2019 to may 2020 were selected. According to the severity of the disease, they were divided into mild disease group (n=42) and severe disease group (n=48). Another 84 healthy children with physical examination were selected as the control group; The expression level of miR-138 in serum was detected by real-time fluorescence quantitative polymerase chain reaction; Levels of serum TNF-α, Interleukin-6 (IL-6), IL-1β and C-reactive protein (CRP) were detected by enzyme-linked immunosorbent assay. Pearson correlation was used to analyze the correlation between miR-138 level and inflammatory factor level.【Results】 The expression level of serum miR-138 in the observation group was significantly higher than that in the control group (P<0.05); The expression level of serum miR-138 in the severe group was significantly higher than that in mild group(P<0.05). The levels of serum TNF-α, IL-1β, IL-6 and CRP in the observation group were significantly higher than those in the control group (P<0.05). Pearson correlation analysis showed that the expression level of miR-138 in serum of children with acute MPP was positively correlated with the levels of serum TNF-α, IL-1β, IL-6 and CRP (all P<0.05).【Conclusion】 miR-138 is highly expressed in the serum of children with acute MPP, which is related to the severity of the disease and the level of inflammatory factors. 2022 Vol. 39 (5): 747-749 [Abstract] ( 56 ) HTML (1 KB)  PDF (1134 KB)  ( 36 ) 750 Expression and Significance of Plasma Presepsin and IL-6 in Patients with Acute Pyelonephritis JIANG Xiao-xiao, YE Li-li DOI: 10.3969/j.issn.1671-7171.2022.05.030 【Objective】 To investigate the expressions and significance of presepsin and interleukin (IL-6) in plasma of patients with acute pyelonephritis. 【Methods】 A total of 113 patients with acute pyelonephritis admitted to our hospital from October 2018 to May 2020 were selected as the observation group. According to the difference in clinical symptoms, they were divided into in the early group (91 cases) and in the late group (22 cases). Volunteers of 115 cases with health examination personnel were selected as the control group. The expression of presepsin and IL-6 was detected, the correlation between the levels of presepsin and IL-6 and glomerular filtration rate (GFR) was analyzed, and the predictive value of plasma presepsin and IL-6 in patients with early acute pyelonephritis was analyzed by ROC curve. 【Results】 Compared with those in the control group, the levels of WBC, C-reactive protein (CRP), Cystatin C (CysC), procalcitonin (PCT), serum creatinine (SCr), presepsin and IL-6 in the observation group were significantly higher (P<0.05), while the GFR was lower (P<0.05). compared to the early group, the expression levels of plasma presepsin and IL-6 in the late group were higher (P<0.05). The levels of plasma presepsin and IL-6 in patients with acute pyelonephritis were positively correlated with WBC, CRP and SCr (P<0.05), and negatively correlated with GFR (P<0.05). The area under the curve of plasma presepsin and IL-6 in patients with early acute pyelonephritis was 0.928, the sensitivity was 81.82% and the specificity was 90.11%.【Conclusion】 The high expressions of presepsin and IL-6 in plasma of patients with acute pyelonephritis are related to the levels of WBC, CRP, and SCr, which may be used as potential markers for early acute pyelonephritis. 2022 Vol. 39 (5): 750-752 [Abstract] ( 52 ) HTML (1 KB)  PDF (1214 KB)  ( 202 ) 753 Effects of Parathyroidectomy Combined with Forearm Autograft on Biochemical Indexes and Quality of Life in SHPT Patients Undergoing MHD ZHANG Wen-Rui, PANG Yi DOI: 10.3969/j.issn.1671-7171.2022.05.031 【Objective】 To investigate the effect of parathyroidectomy combined with forearm autotransplantation on biochemical indexes and quality of life in patients with maintenance hemodialysis (MHD) and secondary hyperparathyroidism (SHPT). 【Methods】 A total of 96 patients with MHD and SHPT were randomly divided into two groups with 48 cases in each group. The control group underwent simple total parathyroidectomy, and the observation group combined with forearm autograft on the basis of the control group. The levels of blood phosphorus (P3-), blood calcium ( Ca2+), parathyroid hormone (iPTH) and hemoglobin (Hb), quality of life and adverse reactions were compared between the two groups before and 3 months after operation.【Results 】 Three months after operation, the levels of P3-, Ca2+ and iPTH in the two groups were lower than those before operation, and the level of Hb was higher than that before operation (P<0.05); The levels of P3-, Ca2+ and iPTH in the observation group were lower than those in the control group, and the level of Hb was higher than those in the control group (P<0.05). Three months after operation, the scores of overall health, physical pain, social function and body vitality in the two groups were higher than those before operation (P<0.05), and those in the observation group were higher than those in the control group (P<0.05). Three months after operation, the incidence of hoarseness, muscle weakness and recurrent laryngeal nerve injury in the observation group were lower than those in the control group (P<0.05). 【Conclusion】 Parathyroidectomy combined with forearm autograft in the treatment of MHD patients with SHPT can more effectively improve the clinical symptoms, improve the quality of life with high safety. 2022 Vol. 39 (5): 753-755 [Abstract] ( 43 ) HTML (1 KB)  PDF (1129 KB)  ( 49 ) 756 Effect of Modified Shenqi Dihuang Decoction Combined with Alprostadil on Patients with Chronic Renal Failure MA Hao, WANG Chun-li, ZHANG Hui-min, et al DOI: 10.3969/j.issn.1671-7171.2022.05.032 【Objective】 To investigate the effects of modified Shenqi Dihuang Decoction combined with alprostadil on renal function, inflammatory indexes and the level of advanced protein oxidation products (AOPP) in patients with chronic renal failure. 【Methods】 A total of 100 patients with chronic renal failure treated in our hospital were randomly divided into traditional Chinese medicine group (50 cases) and Western medicine group (50 cases). The western medicine group was treated with alprostadil, and the traditional Chinese medicine group was treated with modified Shenqi Dihuang Decoction combined with alprostadil. The changes of renal function [serum creatinine (SCR), urea nitrogen (BUN), 24h urinary protein], AOPP level, inflammatory indexes [C-reactive protein (CRP), interleukin-17 (IL-17), interleukin-6 (IL-6)] and clinical efficacy and adverse reactions were compared between the two groups. 【Results】 Compared with before treatment, serum SCR, BUN, 24h urinary protein, AOPP, CRP, IL-17 and IL-6 decreased significantly in the two groups after treatment (P<0.05), and the decrease in the traditional Chinese medicine group was more obvious than that in the western medicine group (P<0.05); The total effective rate of traditional Chinese medicine group was 86.00% (43/50), which was significantly higher than that of Western medicine group [62.00% (31/50) (P<0.05)]; There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 The modified Shenqi Dihuang Decoction combined with alprostadil in the treatment of chronic renal failure can effectively regulate the inflammatory indexes, reduce the level of AOPP, improve renal function and oxidative stress, and is safe and effective. 2022 Vol. 39 (5): 756-758 [Abstract] ( 55 ) HTML (1 KB)  PDF (1128 KB)  ( 66 )

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