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Quick Search     Adv Search 2022 Vol. 39, No. 9 Published: 2022-09-26 Review and lecture Original Articles          Original Articles 1288 Application of Uvulopalatopharyngoplasty and Continuous Positive Pressure Ventilation in the Treatment of OSAHS with Laryngopharyngeal Reflux ZHANG Xiao-ping, CHEN Gui, ZHANG Ming DOI: 10.3969/j.issn.1671-7171.2022.09.003 【Objective】To investigate the effect of uvulopalatopharyngoplasty (UPPP) and continuous positive airway pressure (CPAP) in the treatment of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and laryngopharyngeal reflux (LPR). 【Methods】A total of 79 patients with OSAHS and LPR were randomly divided into the UPPP group (n=42) and the CPAP group (n=37) according to the random number table method. Patients Aeration index (AHI), snoring index, upright Ryan index, supine Ryan index, reflux symptom index (RSI) score, the reflux symptom index (RSI) and the reflux fineling scores (RFS) before and mean oxygen saturation were recorded and compared between the two groups.【Results】OSAHS patients with LPR had severe daytime sleepiness, sleep efficiency reduction, moderate and severe sleep apnea, and obvious throat reflux symptoms before treatment. After treatment, AHI, snoring index, Ryan index, Ryan index in supine position, RSI and RFS in UPPP and CPAP group were significantly lower than those before treatment; And the mean blood oxygen saturation was significantly higher than that before treatment (P<0.05). Compared with CPAP group, the Ryan index in supine position, RSI and RFS in UPPP group were significantly lower than those in CPAP, and the difference was statistically significant (P<0.05). 【Conclusion】Both UPPP and CPAP are helpful in the treatment of OSAHS with laryngopharyngeal reflux. Compared to CPAP, UPPP alleviated the symptoms of LPR better. 2022 Vol. 39 (9): 1288-1290 [Abstract] ( 56 ) HTML (1 KB)  PDF (1174 KB)  ( 60 ) 1291 Value of Platelet Distribution Width Combined with Stress Hyperglycemia Ratio in Predicting Heart Failure in Patients with Acute Myocardial Infarction HUANG Jia-wen, ZHANG Mei-juan, ZHOU Yu DOI: 10.3969/j.issn.1671-7171.2022.09.004 【Objective】To explore the predictive power of platelet distribution width (PDW) combined with stress blood glucose increase ratio (SHR) for heart failure after acute myocardial infarction. 【Methods】Seventy six patients with acute myocardial infarction admitted to the hospital from January 2018 to January 2020 were selected, and 68 healthy patients who came to the hospital for physical examination during the same period were selected. The PDW and SHR of patients with acute myocardial infarction and healthy people were compared, follow-up for 1 year after treatment, the incidence of heart failure in patients with acute myocardial infarction was counted. The clinical characteristics of patients with acute myocardial infarction with heart failure and without heart failure, Logistic multiple regression analysis was used to determine the factors affecting heart failure in patients with acute myocardial infarction, the receiver operator characteristic (ROC) curve was used to analyze the efficacy of PDW combined with SHR in predicting heart failure in patients with acute myocardial infarction.【Results】The PDW and SHR of patients with acute myocardial infarction were higher than those of healthy people (P<0.05). After 1 year of follow-up, the incidence of heart failure in patients with acute myocardial infarction was 28.38%. Compared with patients without heart failure, the composition ratio of multivessel disease and left ventricular ejection fraction, PDW, SHR of patients with heart failure were significantly different (P<0.05). Logistic multivariate regression analysis showed that PDW, SHR, and left ventricular ejection fraction were all independent risk factors for heart failure in patients with acute myocardial infarction (P<0.05). ROC curve analysis showed that the best cutoff points for PDW and SHR to predict the occurrence of heart failure in patients with acute myocardial infarction were 20.086% and 1.250, respectively. The specificity and AUC of the combination of PDW and SHR were 98.11% and 0.889, respectively, which were higher than those predicted by PDW and SHR alone.【Conclusion】 PDW and SHR are abnormally elevated in patients with acute myocardial infarction. PDW and SHR are independent risk factors for heart failure in patients with acute myocardial infarction. The combination of PDW and SHR is of high value in predicting heart failure in patients with acute myocardial infarction. 2022 Vol. 39 (9): 1291-1294 [Abstract] ( 52 ) HTML (1 KB)  PDF (1232 KB)  ( 73 ) 1295 Effect of Atorvastatin on Pathological Changes of Aortic Valve in the Model of Hyperlipidemia Rabbits SHI Chuang, LI Ji-yong, WANG Po, et al DOI: 10.3969/j.issn.1671-7171.2022.09.005 【Objective】To investigate the effect of atorvastatin on the pathological changes of aortic valve induced by hyperlipidemia in rabbits. 【Methods】 A total of 39 healthy male New Zealand white rabbits were selected and divided into atorvastatin intervention diet high fat group (AI group), normal diet control group (N group) and simple high fat diet group (HC group) according to random number table. At 4, 8 and 12 weeks after the start of the experiment, venous blood was taken to measure the plasma lipid level, and aortic valve echocardiography was performed at 8 and 12 weeks after the start of the experiment. The morphological changes of valves in each group were analyzed, and the aortic valve markers were taken for histological examination. 【Results】 The levels of serum total cholesterol (TC), C-reactive protein (CRP), triacylglycerol (TG) and low-density lipoprotein cholesterol (LDL-C) in the group HC were significantly higher than those in the group AI and the group N (P<0.05); The levels of serum TC, TG, CRP and LDL-C in the group AI at 8 and 12 weeks were higher than those in the group N and lower than those in thegroup HC (P<0.05). At 12 weeks, the echocardiographic aortic valve in the group HC showed thickening and echo enhancement, and with the prolongation of high-fat diet, there was a tendency of valve calcification and decreased activity; Echocardiographic valve changes in the group AI were less severe than those in the group HC; There was no significant change in the group N before and after echocardiography. HE staining of aortic valve in the group HC showed endothelial injury, deposition of lipid calcium salt, growth of fibrous tissue and inflammatory reaction caused by macrophage infiltration; The pathological changes in the group AI were less severe than those in the group HC. 【Conclusion】 Atorvastatin can significantly delay the process of aortic valve disease induced by hyperlipidemia. 2022 Vol. 39 (9): 1295-1298 [Abstract] ( 42 ) HTML (1 KB)  PDF (1668 KB)  ( 52 ) 1299 Diagnostic Value of Superior Vena Cava Blood Flow Spectrum Parameters in Children with Pulmonary Hypertension YAO Tao-yue, LIU Qian-jun, HU Yuan, et al DOI: 10.3969/j.issn.1671-7171.2022.09.006 【Objective】To investigate the diagnostic value of superior vena cava (SVC) blood flow spectrum parameters in children with pulmonary hypertension (PAH).【Methods】From September 2019 to May 2022, 49 patients with PAH diagnosed by cardiac catheterization in our hospital (PAH group) were selected; In addition, 15 healthy children (control group) who were examined in our hospital at the same time were selected. All subjects were examined by transthoracic echocardiography, collected the SVC blood flow spectrum curve, and evaluated the diagnostic value of SVC blood flow spectrum parameters for PAH using the subject's work characteristic (ROC) curve. 【Results】 The SVC spectrum of the control group showed four phase wave [Systolic concentric wave (S wave), diastolic concentric wave (D wave), late systolic centrifugal wave (VR wave), and atrial late systolic centrifugal wave (AR wave)]; In the PAH group, 44 patients had four phase waves and 5 patients had non four phase waves. The peak velocity of AR wave, the peak velocity of VR wave, and AR/S in the PAH group were significantly higher than those in the control group (P<0.05). The peak velocity of S wave, the peak velocity of D wave, and AR/D, VR/S, VR/D in the two groups had no significant difference (P>0.05). The ROC curve analysis showed that the area under the AR/S curve was 0.812, which was the best for the diagnosis of PAH; When AR/S cut-off value was 0.43, the sensitivity of PAH diagnosis was 68.00%, and the sensitivity of moderate and severe PAH diagnosis was 74.00%. 【Conclusion】 The changes of SVC blood flow spectrum can reflect the changes of PAH. Among them, AR/S has certain diagnostic value for PAH, especially for moderate and severe PAH. When tricuspid regurgitation is not obvious or more ultrasonic support is needed, AR/S can become an effective reference index for clinical diagnosis of PAH in children. 2022 Vol. 39 (9): 1299-1302 [Abstract] ( 37 ) HTML (1 KB)  PDF (2067 KB)  ( 109 ) 1303 Effect of Zhenwu Decoction Combined with Xuefu Zhuyu Decoction on Cardiac Function and Ventricular Remodeling in Patients with Chronic Heart Failure XIANG Yue, FU Xiao-xing DOI: 10.3969/j.issn.1671-7171.2022.09.007 【Objective】To investigate the effect of Zhenwu decoction combined with Xuefu Zhuyu decoction on cardiac function and ventricular remodeling in patients with chronic heart failure. 【Methods】A total of 120 patients with chronic heart failure admitted to our hospital from June 2018 to June 2021 were selected and randomly divided into observation group and control group with 60 patients in each group. The control group was treated with conventional western medicine, while the observation group was treated with Zhenwu decoction combined with Xuefu Zhuyu decoction on the basis of the control group. Compare the clinical efficacy of the two groups, record the TCM syndrome scores of the two groups, compare the left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular end diastolic thickness (PWD), left ventricular myocardial mass index (LVMI), left ventricular posterior wall thickness (LVPWT) of the two groups before and after treatment, and detect the serum aldosterone (ALD) Angiotensin Ⅱ (Ang Ⅱ) level and adverse reactions during treatment were recorded. 【Results】 The total clinical effective rate in the observation group was 88.33% (53/60), higher than that in the control group 75.00% (45/60), with a statistically significant difference (P<0.05). After treatment, the scores of main syndrome and secondary syndrome in the two groups were lower than those before treatment, and the scores in the observation group were lower than those in the control group, with a statistically significant difference (P<0.05); LVESD, LVEDD, PWD, LVMI, LVPWT of the two groups were lower than before treatment, LVEF was higher than before treatment, and the difference between the observation group and the control group was statistically significant (P<0.05); The levels of serum ALD and Ang Ⅱ in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group, the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 The Zhenwu decoction combined with the Xuefu Zhuyu decoction is effective in treating patients with chronic heart failure, which is beneficial to improve the clinical symptoms of patients with chest tightness, chest pain, palpitation, and better improve the cardiac function and ventricular remodeling of patients. It is safe and has popularization value. 2022 Vol. 39 (9): 1303-1306 [Abstract] ( 43 ) HTML (1 KB)  PDF (1135 KB)  ( 78 ) 1307 Correlation of MIC-1,CYFRA21-1 and TMB Levels with Efficacy of Targeted Therapy for Advanced Non-small Cell Lung Cancer LI Guo-xia, LIU Xiang-ling DOI: 10.3969/j.issn.1671-7171.2022.09.008 【Objective】To investigate the correlation of macrophage inhibitory factor 1 (MIC-1),cytokeratin19 soluble fragment (CYFRA21-1),tumor mutational burden (TMB) and related clinical characteristics with the efficacy of targeted therapy for advanced non-small cell lung cancer (NSCLC).【Methods】The clinical data of 118 patients with advanced NSCLC admitted to our hospital were collected and divided into the chemotherapy effective group (n=55) and the chemotherapy ineffective group (n=63) according to the short-term efficacy.The differences of general data and laboratory indicators (MIC-1,CYFRA21-1,TMB) between the two groups were compared.The value of MIC-1 and CYFRA21-1 in predicting the efficacy of advanced NSCLC was analyzed by ROC.The differences between the two groups were included in the multivariate Logistic regression analysis to identify the risk factors affecting the efficacy of advanced NSCLC.【Results】After treatment,10 patients had complete remission,45 patients had partial remission,41 patients had stable disease,and 22 patients had progressive disease.The total effective rate was 46.61% (55/118).There were no significant differences in gender,body mass index (BMI),tumor diameter and drinking history between the two groups (P>0.05).The proportion of patients with ≥60 years old,squamous cell carcinoma,poorly differentiated,TNM stage Ⅳ,smoking history,moderate or low TMB level in the chemotherapy ineffective group was significantly higher than that in the chemotherapy effective group (P<0.05).ROC analysis confirmed that MIC-1 and CYFRA21-1 could be used to predict the efficacy of advanced NSCLC,and the areas under the curve were 0.798 and 0.801,respectively (both P<0.05).Multivariate Logistic regression analysis confirmed that ≥60 years old,squamous cell carcinoma,low differentiation,TNM stage Ⅳ,smoking history,moderate to low TMB level,MIC-1≥1030.030 pg/mL,CYFRA21-1≥9.095 μg/mL were risk factors affecting the efficacy of targeted therapy for advanced NSCLC (P<0.05).【Conclusion】The level of TMB in tumor tissue and the efficacy of targeted therapy for advanced NSCLC are affected by many factors,such as age,pathological type,degree of differentiation,TMB level in tumor tissue,MIC-1,CYFRA21-1,etc.Clinicians should pay close attention to them when treating advanced NSCLC. 2022 Vol. 39 (9): 1307-1310 [Abstract] ( 46 ) HTML (1 KB)  PDF (1266 KB)  ( 62 ) 1311 Correlation Analysis of Risk of Intrahepatic Cholestasis of Pregnancy with Expression of Serum MMP-2, MMP-9 and IL-17 WEN Guan-liang, LA Mei, FANG De-chun DOI: 10.3969/j.issn.1671-7171.2022.09.009 【Objective】To study the relationship of intrahepatic cholestasis of pregnancy (ICP) with matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), interleukin-17 (IL-17). 【Methods】A total of 75 ICP patients who were hospitalized and delivered in Qian County Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were selected as the ICP group, and 75 normal pregnant women who were hospitalized and delivered without pregnancy complications in our hospital during the same period were selected as the control group. The levels of serum MMP-2, MMP-9, IL-17, total bilirubin (TBIL) and direct bilirubin (DBIL) were compared between the two groups. The value of ICP in pregnancy was evaluated by ROC analysis of serum MMP-2, MMP-9, IL-17, TBIL and DBIL. All 75 ICP patients were divided into the mild group (n=45) and the severe group (n=30) according to the severity of the disease. The levels of serum MMP-2, MMP-9, IL-17, TBIL, DBIL in patients with different severity of the disease were compared. The relationship of the severity of ICP patients with serum MMP-2, MMP-9, IL-17, TBIL and DBIL was analyzed by Spearman correlation coefficient. 【Results】Serum levels of MMP-2, MMP-9, IL-17, TBIL and DBIL in the ICP group were significantly higher than those in control group (P<0.05). ROC curve analysis showed that MMP-2 ≥ 176.277 ng/mL, MMP-9 ≥ 679.489 ng/mL, IL-17 ≥ 12.597 pg/mL, TBIL ≥ 13.208 μmol/L and DBIL≥3.998 μmol/L were the best cut-off value to evaluate ICP during pregnancy (all P<0.05). Serum levels of MMP-2, MMP-9, IL-17, TBIL and DBIL in the mild group were significantly lower than those in the severe group (P<0.05). Through correlation analysis, the severity of ICP patients was positively correlated with serum MMP-2, MMP-9, IL-17, TBIL and DBIL levels (P<0.05). 【Conclusion】Serum levels of MMP-2, MMP-9 and IL-17 are closely related to the occurrence of ICP, and they are positively related to the severity of ICP as well. 2022 Vol. 39 (9): 1311-1314 [Abstract] ( 37 ) HTML (1 KB)  PDF (1235 KB)  ( 49 ) 1315 Sequential Treatment of Adult APL Patients with All Trans Retinoic Acid Combined with Arsenic SHI Rui, WEN Jing, WU Wen, et al DOI: 10.3969/j.issn.1671-7171.2022.09.010 【Objective】To investigate the efficacy of all trans retinoic acid (ATRA) combined with arsenic in sequential treatment of acute promyelocytic leukemia (APL). 【Methods】 The clinical data of 94 APL patients admitted to our hospital were retrospectively analyzed. They were divided into observation group and control group according to different treatment methods, with 47 cases in each group. The control group was treated with ATRA, and the observation group was treated with arsenic based sequential therapy on the basis of the control group. Complete remission (CR) rate and 1-year cumulative survival rate were compared between the two groups. Time for CR patients to reach CR, PML-RARα. The negative conversion rate, recurrence rate, promyelocyte ratio, total leukocyte count and adverse reactions were compared. 【Results】The number of CR cases obtained and the number of CR cases not obtained in the observation group were 41 (87.23%) and 6 (12.77%) respectively, while the number of CR cases obtained and the number of CR cases not obtained in the control group were 40 (85.11%) and 7 (14.89%) respectively, and there was no significant difference between the two groups (P>0.05). The time for patients in the observation group to reach CR was significantly shorter than that in the control group.PML-RARα in the observation group. The negative conversion rate was higher than that of the control group, and the recurrence rate was significantly lower than that of the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the percentage of promyelocytes and total leukocytes between the two groups before treatment (P>0.05); After treatment, the percentage of promyelocytes and total leukocytes in the two groups were significantly lower than those before treatment (P<0.05), and the percentage of promyelocytes and total leukocytes in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in the 1-year cumulative survival rate between the two groups of CR patients (P>0.05), and there was no significant difference in the total adverse reaction rate between the two groups of CR patients (P>0.05). 【Conclusion】 The sequential treatment of APL patients with ATRA combined with arsenic is satisfactory. PML-RARα. The negative conversion rate is high, the recurrence rate is low, the long-term survival rate is high, and the drug safety of the two treatment methods is high. 2022 Vol. 39 (9): 1315-1317 [Abstract] ( 47 ) HTML (1 KB)  PDF (1238 KB)  ( 25 ) 1318 Value of Prostaglandin E1 in Preventing Renal Function Injury after PCI in Patients with Acute Myocardial Infarction CHEN Wei, ZHOU Jing DOI: 10.3969/j.issn.1671-7171.2022.09.011 【Objective】 To investigate the value of prostaglandin E1 (PGE1) in preventing renal function injury after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). 【Methods】 A total of 84 AMI patients treated by PCI in Shangluo Central Hospital from May 2019 to May 2020 were selected and divided into the observation group and the control group according to the random number table, with 42 patients in each group. Both groups underwent PCI. The control group received routine intravenous rehydration before and after PCI. The observation group received intravenous drip of alprostadil on the basis of the control group. The contrast agent nephropathy (CIN) and the incidence of adverse events after operation were compared between the two groups. The renal function indexes [serum creatinine (Cr), cystatin C (cys C), blood urea nitrogen (BUN), creatinine clearance rate (Ccr)] and vascular endothelial function indexes [endothelin (ET-1), nitric oxide (NO), adiponectin (APN)] before and after operation were compared between the two groups. 【Results】There were 18 cases of CIN in 84 patients, including 2 cases (4.76%) in the observation group and 16 cases (38.10%) in the control group. The incidence of CIN in the observation group was significantly lower than that in the control group, with a statistically significant difference(χ2=13.859,P=0.000).On the 7th day after operation, the Cr, cys C, BUN of the two groups were higher than those before operation, and the Ccr was lower than that before operation. The difference between the observation group and the control group was statistically significant (P<0.05); ET-1 in the two groups was lower than that before operation, and NO and APN were higher than that before operation. The difference between the observation group and the control group was statistically significant (both P<0.05). The total incidence of adverse events in the observation group was 9.52% (4/42), lower than 14.29% (6/42) in the control group, but the difference was not statistically significant(χ2=0.45,P=0.50).【Conclusion】 PGE1 can effectively prevent the damage of renal function and endothelial function in AMI patients after PCI, which is worthy of clinical reference. 2022 Vol. 39 (9): 1318-1321 [Abstract] ( 54 ) HTML (1 KB)  PDF (1140 KB)  ( 43 ) 1322 Reference Range and Influencing Factors of Young's Modulus of Thyroid in Healthy Children Assessed by Real-time Shear Wave Elastography YANG Liu, XU Xiang-fen, YUAN Wen-fang, et al DOI: 10.3969/j.issn.1671-7171.2022.09.012 【Objective】 To explore the reference range and influencing factors of real-time shear wave ultrasonic elastography (SWE) in evaluating the maximum value (Emax), minimum value (Emin) and mean value (Emean) of Young's modulus of thyroid in healthy children. 【Methods】 A total of 314 healthy children in Hunan Children's Hospital who underwent SWE examination and recorded Emax, Emin, and Emean were selected to compare the differences of thyroid Young's modulus of elasticity Emax, Emin, and Emean among healthy children of different sexes, different ages, and left and right long axes. 【Results】 The thyroid Young's modulus Emax, Emin, and Emean of 314 healthy children were (13.630±3.520) KPa, (9.160 ± 2.927) KPa and (11.189 ± 3.127) KPa, respectively. There was no significant difference in young's modulus values Emax, Emin, and Emean of the left and right long axis thyroid of healthy children between different genders (P>0.05); The thyroid Young's modulus values Emax, Emin, and Emean of healthy children at different ages were statistically significant (P<0.05).【Conclusion】 As a quantitative and non-invasive examination method for thyroid hardness, SWE can calculate the reference range of Emax, Emin, and Emean in thyroid tissue of healthy children according to the collected data, but it is affected by age, which provides a reference basis for further formulating the reference value of normal modulus of elasticity of children's thyroid and diagnosing thyroid diseases. 2022 Vol. 39 (9): 1322-1324 [Abstract] ( 73 ) HTML (1 KB)  PDF (1421 KB)  ( 66 ) 1325 Effect of Low-dose Aspirin on Peripheral Nerve Regeneration around Titanium Alloy Implant in Rats QUAN Zhi-zen, CHEN Ying-zhe, YANG Xin-yu, et al DOI: 10.3969/j.issn.1671-7171.2022.09.013 【Objective】To investigate the effect of low-dose aspirin on peripheral nerve regeneration surrounding titanium alloy implant in rats.【Methods】A total of 40 male SPF and SD rats with 8-week-old were randomly divided into the control group and the observation (aspirin) group,with 20 rats in each group.A Ti-6Al-4V implant nail was implanted in the epiphysis of the right femoral shaft.After the rats woke up post-operation,the aspirin group was given amoxicillin 67 mg/(kg·d) (3 times/day for 3 consecutive days),and low-dose aspirin 1.786 mg/(kg·d) was given by gavage on the same day (for 8 weeks).The control group was given the same dose of amoxicillin and 0.9% sodium chloride injection by gavage at the same time.The femoral tissues of 10 rats with implants were taken from the two groups at 4 weeks and 8 weeks after drug intervention,respectively.Van Gieson staining was used to observe the bone histomorphology around the implant and calculate the trabecular volume ratio (TBV) and bone binding rate (BIC).The positive expressions of neurofilament protein (NFP) protein were measured by immunohistochemical method,and the positive rate of NFP protein was calculated.【Results】At 4 and 8 weeks after operation,new bone was formed on the implant surface in the control group and the observation group.The levels of TBV and BIC in the femoral tissue around the implant in the observation (aspirin) group were higher than those in the control group (P<0.05).The NFP positive nerve structures in the femoral tissue around the implant were distributed on the edge of the implant nest,the surrounding bone marrow cavity,the bone trabecular space and periosteum.At 4 weeks after administration,the NFP positive rates around the implant in the observation group and the control group were 90.00% and 60.00% respectively.The NFP positive rate in the observation group was higher than that in the control group (P<0.05); At 8 weeks after operation,the positive rates of NFP of two groups were 80.00%.There was no significant difference between the two groups (P>0.05).【Conclusion】Low dose aspirin may increase the number of nerve fibers around titanium alloy implants in rats,which can promote the regeneration of peripheral nerve function. 2022 Vol. 39 (9): 1325-1328 [Abstract] ( 30 ) HTML (1 KB)  PDF (3097 KB)  ( 107 ) 1329 Relationship between Coronary Plaque Stability and Platelet Chemokines in Patients with Coronary Heart Disease WANG Hai-qiang, WANG Lei DOI: 10.3969/j.issn.1671-7171.2022.09.014 【Objective】 To investigate the relationship between the stability of coronary plaque and the level of platelet chemokines in patients with coronary heart disease (CHD). 【Methods】 From June 2020 to February 2022, 60 CHD patients (observation group) admitted to the 986 Hospital of the Air Force of the People's Liberation Army of China were selected. At the same time, according to the stability of coronary plaque, they were further divided into stable group (n=35) and unstable group (n=25). In addition, 60 healthy volunteers who were healthy during the same period were selected as the study subjects (control group). Platelet chemokine 16 (CXCL16), platelet chemokine 4 (CXCL4), platelet lymphocyte ratio (PLR) and Fractalkine were compared between the observation group and the control group. CXCL16, CXCL4, PLR, Fractalkine indexes of patients with different plaque stability in the observation group were compared. The receiver operating characteristic curve (ROC curve) was used to evaluate the efficacy of CXCL16, CXCL4, PLR, Fractalkine in predicting plaque instability in CHD patients.【Results】 The levels of CXCL16, CXCL4, PLR and Fractalkine in the observation group were significantly higher than those in the control group (P<0.05). The levels of CXCL16, CXCL4, PLR and Fractalkine in the unstable group were higher than those in the stable group (P<0.05). ROC curve analysis shows that the best cut-off values of CXCL16, CXCL4, PLR and Fractalkine for predicting plaque instability were 2.766 μg/L, 0.956 ng/mL, 111.820, 61.064 ng/mL respectively. The area under the CXCL16 curve was 0.975, with high sensitivity and specificity, 0.920 and 0.943 respectively. 【Conclusion】 The levels of CXCL16, CXCL4, PLR and Fractalkine are closely related to the stability of coronary plaque in CHD patients, which is helpful for doctors and nurses to identify the stability of coronary plaque in CHD patients. 2022 Vol. 39 (9): 1329-1331 [Abstract] ( 53 ) HTML (1 KB)  PDF (1233 KB)  ( 59 ) 1332 Correlation of CER,GP73 and Liver Hardness with Hepatic Fibrosis Stage in Chronic Hepatitis B Patients with Slightly Elevated ATL LI Dan-jie, WEI Xiao-qiang DOI: 10.3969/j.issn.1671-7171.2022.09.015 【Objective】To investigate the correlation of serum golgi protein 73 (GP73),ceruloplasmin (CER) and liver stiffness/hardness (LSM) with liver fibrosis stage in chronic hepatitis B (CHB) patients with slightly elevated alanine aminotransferase (ATL).【Methods】A total of 122 CHB patients were selected as the observation group.In addition,100 healthy volunteers were selected as the control group.CER,GP73 and LSM levels were compared between the two groups.And levels of CER,GP73 and LSM were compared in CHB patients with different stages of liver fibrosis as well.The diagnostic value of CER,GP73 and LSM in CHB diagnosis and their relationship with liver fibrosis stage were determined by ROC and correlation analysis.【Results】The CER level in the observation group was significantly lower than that in the control group (P<0.05).The levels of GP73 and LSM in the observation group were significantly higher than those in the control group (P<0.05).ROC analysis confirmed that the areas under the curve of CER,GP73 and LSM for CHB diagnosis were 0.718,0.859 and 0.905,respectively (P<0.05).The value of CER in CHB patients with different stages of liver fibrosis was S1>S2>S3>S4,and the differences were statistically significant (P<0.05).While the levels of GP73 and LSM in CHB patients with different stages of liver fibrosis were S1<S2<S3<S4,and the differences were statistically significant (P<0.05).Correlation analysis confirmed that CER was negatively correlated with liver fiber staging in CHB patients,while GP73 and LSM were positively correlated with liver fiber staging in CHB patients (all P<0.05).【Conclusion】CER of CHB patients with ALT≤2× upper limit of normal value (ULN) decreased significantly,while GP73 and LSM increased significantly.Thus these changes can be used for disease diagnosis.They are closely related to the severity of liver fibrosis,which is worthy of clinical attention. 2022 Vol. 39 (9): 1332-1335 [Abstract] ( 61 ) HTML (1 KB)  PDF (1229 KB)  ( 164 ) 1336 Expression and Prognosis Predictive Value of IL-17A and ER Proteins in Endometrial Cancer WANG Li, HUI Hui DOI: 10.3969/j.issn.1671-7171.2022.09.016 【Objective】To investigate expression and prognostic significance of interleukin-17A (IL-17A) and Estrogen receptor (ER) proteins in endometrial carcinoma (EC). 【Methods】A prospective study was conducted in 89 EC patients admitted to Xi'an International Medical Center Hospital from May 2013 to August 2016. All patients underwent surgical resection and were followed up for 5 years after surgery. Immunohistochemistry was used to detect the expression of IL-17A and ER proteins. The expression of IL-17A and ER protein in cancer tissues and adjacent tissues were compared. The relationship of clinicopathological parameters with expression of IL-17A and ER proteins in EC patients was analyzed. Factors affecting the prognosis of EC patients were analyzed. The relationship between IL-17A and ER protein expression in cancer tissues and survival of EC patients was analyzed as well. 【Results】Eleven patients were lost to follow-up by the end of follow-up. The positive expression rate of IL-17A in cancer tissues was higher than adjacent tissues (P<0.05), and the positive expression rate of ER was lower than adjacent tissues (P<0.05). Positive expression rate of IL-17A in cancer tissues of patients with low differentiation, invasion depth ≥1/2, stage Ⅲ and vascular cancer thrombus was higher than that of patients with medium and high differentiation, invasion depth < 1/2, stage Ⅰ~Ⅱ and no vascular carcinoma thrombus (P<0.05). Positive expression rate of ER protein in cancer tissues of patients with low differentiation, invasion depth ≥1/2, stage Ⅲ and complicated with vascular tumor thrombus was lower than that of patients with medium and high differentiation, invasion depth <1/2, stage Ⅰ~Ⅱ and no complicated vascular tumor thrombus (P<0.05). Cox regression analysis showed that the degree of differentiation, surgical pathological stage, vascular tumor thrombus, positive IL-17A and positive ER expression were independent prognostic factors affecting EC recurrence (P<0.05). Tumor differentiation degree, surgical pathological stage, positive IL-17A and positive ER expression were independent prognostic factors affecting the overall survival rate (P<0.05). There were 37 disease-free patients with positive IL-17A and 25 disease-free patients with negative IL-17A; And the difference in disease-free survival curve between patients with positive IL-17A expression and patients with negative IL-17A expression was statistically significant (P<0.05).Forty-four patients with positive IL-17A survived, and 26 patients with negative IL-17A survived. There was no significant difference in the overall survival curve between patients with positive IL-17A expression and patients with negative IL-17A expression (P>0.05). There were 36 disease-free patients in ER positive patients and 26 disease-free patients in ER negative patients. The difference in disease-free survival curves between ER positive and negative patients was statistically significant (P<0.05). There were 39 ER positive patients survived and 31 ER negative patients survived; And the overall survival curve of ER positive and negative patients was statistically significant (P<0.05). 【Conclusion】Expression of IL-17A and ER protein in EC patients' cancer tissues is related to clinicopathological parameters and prognosis. Patients with IL-17A positive and ER negative have a high risk of poor prognosis. 2022 Vol. 39 (9): 1336-1340 [Abstract] ( 38 ) HTML (1 KB)  PDF (1727 KB)  ( 24 ) 1341 Clinical Effects of Erxian Decoction and Yougui Decoction Combined with Western Medicine in the Treatment of Patients with Premature Ovarian Failure LU Xi-yan, SHI Heng-jun, YAO Jia-jiu DOI: 10.3969/j.issn.1671-7171.2022.09.017 【Objective】To observe the clinical efficacy of Erxian Decoction and Yougui Decoction in combination with western medicine in the treatment of premature ovarian failure (POF). 【Methods】A total of 120 patients with kidney deficiency type POF in our hospital from September 2019 to September 2021 as the research subjects. Patients were divided into the observation group and the control group according to the random drawing method, with 60 cases in each group. The control group was treated with western medicine, while the observation group was additionally treated with Erxian Decoction and Yougui Decoction on the basis of the control group. Both groups continued to receive treatment for 3 months. The clinical efficacy of the two groups was evaluated after 3 months of treatment. The scores of TCM single syndromes before and after 3 months of treatment in the two groups were evaluated. Sex hormone levels [follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2)], ovarian function related indicators [serum anti mullerian hormone (AMH), inhibin B (INHB)] and phosphatidylinositol 3 kinase/serine threonine protein kinase (PI3K/AKT) signal pathway related indicators [B cell lymphoma gene 2 (bcl-2), bcl-2 related X protein (bax), PI3K, AKT] were measured before and after treatment in both groups. The incidence of adverse reactions in the two groups during the treatment period was counted. 【Results】The total effective rate of the observation group was 93.33%, which was significantly higher than that of the control group (78.33%) (P<0.05). After treatment, the scores of each TCM single syndrome in the observation group were significantly lower than those before treatment in the observation group and after treatment in the control group (P<0.05). The levels of FSH and LH after treatment in the observation group were significantly lower than those before treatment in the observation group and after treatment in the control group, while the level of E2 was significantly higher than those before treatment in the observation group and after treatment in the control group (P<0.05). After treatment, the levels of AMH and INHB in the observation group were significantly higher than those in the observation group before treatment and in the control group after treatment (P<0.05). The levels of bcl-2, bax, PI3K and AKT in the observation group after treatment were significantly lower than those before treatment in the observation group and after treatment 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】Erxian Decoction and Yougui Decoction in combination with western medicine have good curative effect in the treatment of POF, which can significantly improve the clinical symptoms, sex hormone indicators, ovarian function and PI3K/AKT signaling pathway-related indicators. It has high safety, which is worthy of clinical promotion. 2022 Vol. 39 (9): 1341-1344 [Abstract] ( 56 ) HTML (1 KB)  PDF (1194 KB)  ( 199 ) 1345 Predictive Value of HBP, sCD14-ST and IPS Scores for Urinary Sepsis after PCNL ZHANG Xiao-rong, LI Wei DOI: 10.3969/j.issn.1671-7171.2022.09.018 【Objective】 To investigate the predictive value of heparin binding protein (HBP), soluble CD14 subtype (sCD14-ST) and infection probability (IPS) scores on urinary sepsis after percutaneous nephrolithotomy (PCNL). 【Methods】 From January 2018 to January 2021, 44 patients with urinary sepsis after PCNL were selected as the observation group, and 44 patients without urinary sepsis after PCNL were selected as the control group. The clinical data, urinary HBP, serum sCD14-ST levels and IPS scores of the two groups were compared. The correlation between urinary HBP, serum sCD14-ST levels and IPS scores was analyzed. The influencing factors of urinary sepsis after PCNL were analyzed. The predictive value of each index for urinary sepsis after PCNL was evaluated. 【Results】 The positive rate of urine culture before operation in the observation group was higher than that in the control group, the operation time was longer than that in the control group, and the urine HBP, serum sCD14-ST levels and IPS scores were higher than those in the control group(P<0.05). Pearson correlation analysis showed that urine HBP, serum sCD14-ST levels were positively correlated with IPS scores (r=0.608, 0.534, P<0.05). Logistic regression analysis showed that positive urine culture before operation, operation time, urine HBP, serum sCD14-ST, IPS score were the influencing factors of urinary sepsis caused by PCNL (P<0.05). The AUC of urine HBP, serum sCD14-ST and IPS scores for predicting urinary sepsis after PCNL was 0.909, 95%CI was 0.828～0.960, sensitivity was 95.45%, specificity was 75.00%, which was significantly higher than those predicted by the three alone.【Conclusion】Urine HBP, serum sCD14-ST and IPS scores are the influencing factors of urinary sepsis after PCNL. The combined detection can be used as an important method to predict the occurrence of urinary sepsis. 2022 Vol. 39 (9): 1345-1348 [Abstract] ( 42 ) HTML (1 KB)  PDF (1270 KB)  ( 72 ) 1349 Clinical Value of Retropuncture Combined with UN-CUT Anastomosis in Gastrointestinal Reconstruction after Laparoscopic Total Gastrectomy ZHANG Yin-ke, HAN Xin-ping DOI: 10.3969/j.issn.1671-7171.2022.09.019 【Objective】 To investigate the clinical value of retropuncture combined with UN-CUT anastomosis in gastrointestinal reconstruction after laparoscopic total gastrectomy for gastric cancer.【Methods】A total of 138 patients with laparoscopic total gastrectomy admitted to our hospital from September 2018 to January 2021 were selected and divided into reverse puncture group (reverse puncture combined with UN-CUT anastomosis) and Roux-en-Y group according to different ways of digestive tract reconstruction and anastomosis, with 69 patients in each group. The postoperative complications, nutritional changes and follow-up results were compared between the two groups.【Results】There was no significant difference between the two groups in operation time, digestive tract reconstruction time, number of lymph nodes cleared, first liquid diet time, drainage tube removal time, and hospital stay (P>0.05); The incision length, the time of the first anal exhaust, and the amount of bleeding in the reverse puncture group were lower than those in the Roux-en-Y group, with significant differences (P<0.05). There was no significant difference between the two groups in terms of weight loss 1 and 3 months after operation and the reduction of ALB and HGB 1 month after operation (P>0.05); The decrease of ALB and HGB in the reverse puncture group was less than that in the Roux-en-Y group 3 months after operation, and the difference was statistically significant (P<0.05). There were 1 case of food loop emptying disorder and intestinal obstruction in the reverse puncture group, and 5 cases and 3 cases in the Roux-en-Y group respectively,without significant difference between the two groups (P>0.05). All patients were followed up for 3 months. The incidence of reflux esophagitis and Roux syndrome in the reverse puncture group was lower than that in Roux-en-Y group (P<0.05). 【Conclusion】 Reverse puncture combined with UN-CUT anastomosis has the advantages of maintaining intestinal continuity, shortening the surgical incision, reducing the incidence of postoperative reflux esophagitis and Roux syndrome, and improving the nutritional status of patients, which can be applied in clinical practice. 2022 Vol. 39 (9): 1349-1352 [Abstract] ( 40 ) HTML (1 KB)  PDF (1131 KB)  ( 80 ) 1353 Effect of Immediate Implantation with Modified Shield Tunneling on the Bone Mass, Periodontal Tissue and Aesthetic Effect of the Upper Anterior Teeth ZOU Jing, DING Li DOI: 10.3969/j.issn.1671-7171.2022.09.020 【Objective】 To investigate the effect of modified shield tunneling (modified SST) immediate implantation on the bone mass, periodontal tissue and aesthetic effect of the labial maxillary anterior teeth. 【Methods】 From November 2016 to November 2021, 120 patients with immediate implant repair of a single tooth in the maxillary anterior tooth area who were treated in Ankang Hospital of Traditional Chinese Medicine were selected as the study objects, of which 60 patients were treated with traditional immediate implant as the control group, and 60 patients were treated with modified SST as the observation group. After 12 months of follow-up, the implant success rate, bone absorption at the lip side of the implant, and periodontal tissue around the implant were compared between the two groups [Including modified gingival sulcus bleeding index, periodontal probing depth, gingival papilla index, red aesthetic index (PES)].The incidence of adverse reactions of all patients was counted.【Results】The successful rate of implantation was 100% in both groups. The improved gingival sulcus bleeding index in the observation group was significantly lower than that in the control group (P<0.05). At 6 months and 12 months after repair, there was no significant difference in the improved gingival sulcus bleeding index between the two groups (P>0.05); The gingival papilla index of the observation group was higher than that of the control group at 6 months and 12 months after repair (P<0.05). Lip bone resorption in the observation group was significantly lower than that in the control group 6 months after repair and 12 months after repair (P<0.05). Lip bone absorption was higher in both groups 12 months after repair than in 6 months after repair. The bone resorption at the lip side of the patients in the observation group was lower than that in the control group 6 months and 12 months after the repair (P<0.05). The PES scores of the two groups increased 6 and 12 months after repair, and the scores of the observation group were higher than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reaction between the two groups (P>0.05). 【Conclusion】 The modified SST immediate implantation has a positive effect on maintaining the bone mass of the lip, and can obtain better soft tissue aesthetic effect with high safety. 2022 Vol. 39 (9): 1353-1355 [Abstract] ( 57 ) HTML (1 KB)  PDF (1172 KB)  ( 113 ) 1356 Effects of Wingspan Stent Implantation on Neurological Function Defect, Event Related Potential P300 and Prognosis in Patients with Severe Middle Cerebral Artery Stenosis TANG Yan, WU Xiao-gang DOI: 10.3969/j.issn.1671-7171.2022.09.021 【Objective】To analyze the effects of Wingspan stent implantation on neurological deficits, event-related potentials P300 and prognosis in patients with severe middle cerebral artery stenosis. 【Methods】 A total of 104 patients with severe stenosis of middle cerebral artery admitted to the Hospital of Northwestern Polytechnical University from May 2018 to May 2020 were selected and divided into the observation group (n=53) and the control group (n=51) according to different treatment schemes. The control group was treated with standardized drugs, and the observation group was treated with Wingspan stent implantation on the basis of the control group. The clinical efficacy, incidence of adverse events, NIHSS score, MMSE score, activity of daily living (BI) score and middle cerebral artery hemodynamics index [End diastolic velocity (Vd), peak systolic velocity (Vs), average blood flow velocity (Vm)],P300 index (amplitude and latency) level of event related potential were compared between the two groups.【Results】The total clinical effective rate of the observation group was higher than that of the control group, with a statistically significant difference (P<0.05). 12 months after treatment, NIHSS score and Vd, Vs, Vm levels of middle cerebral artery in the observation group were lower than those in the control group, while MMSE, BI scores were higher than those in the control group (P<0.05); The amplitude of event related potential P300 in the observation group was higher than that in the control group, and the latency was lower than that in the control group (P<0.05). The incidence of adverse events in the observation group was lower than that in the control group (P<0.05).【Conclusion】 Conclusion Wingspan stent implantation in the treatment of severe stenosis of middle cerebral artery can reduce the degree of neurological deficit, improve the hemodynamics of middle cerebral artery and the related indexes of event related potential P300, and help improve the cognitive function and daily living ability of patients. 2022 Vol. 39 (9): 1356-1359 [Abstract] ( 35 ) HTML (1 KB)  PDF (1137 KB)  ( 47 ) 1360 Relationship between Tripartite Motif Containing 13 and Prognosis of Non-small Cell Lung Cancer Treated with Percutaneous Radiofrequency Ablation YAO Hong-jun, HU Jing, YUAN Can-liang DOI: 10.3969/j.issn.1671-7171.2022.09.022 【Objective】To analyze the relationship of tripartite motif containing 13 (TRIM13) with the prognosis of percutaneous radiofrequency ablation (RFA) in non-small cell lung cancer (NSCLC) patients.【Methods】A total of 146 patients with NSCLC who were treated in our hospital were selected as the research objects.Ficoll density gradient separation method was used to separate mononuclear cells in peripheral blood; Western blotting was used to detect the expression level of TRIM13 in mononuclear cells.The relationship of TIRM13 expression level with the prognosis of NSCLC was analyzed.【Results】The expression level of TRIM13 in the survival group and the death group showed an increasing trend over time.The expression level of TRIM13 on the 7th and 14th day after operation in the survival group were higher than those in the death group (P<0.05).The diagnostic efficiency of TRIM13 on the 7th day after operation of NSCLC was higher than that before RFA and 14 days after operation(P<0.05).COX multivariate regression analysis showed that targeted therapy,degree of differentiation and 7-day postoperative TRIM13 were independent protective factors for the prognosis of NSCLC (P<0.05),and TNM staging was an independent risk factor for the prognosis of NSCLC (P<0.05).Restricted cubic spline fitting COX regression analysis showed that TRIM13 had a nonlinear relationship with the prognosis of NSCLC (P<0.05).【Conclusion】 TRIM13 is related to the prognosis of NSCLC patients with RFA treatment.The high level of TRIM13 expression indicates that the risk of poor prognosis for NSCLC is low. 2022 Vol. 39 (9): 1360-1363 [Abstract] ( 43 ) HTML (1 KB)  PDF (1395 KB)  ( 46 ) 1364 Clinical Effect of Intensive Insulin Injection on T2DM Patients with MSI YANG Xiao-ying, SUN Xi-juan DOI: 10.3969/j.issn.1671-7171.2022.09.023 【Objective】To explore the clinical effect of intensive insulin injection on type 2 diabetes mellitus (T2DM) complicated with maxillofacial multiple space infection (MSI).【Methods】 A total of 80 patients with T2DM combined with MSI who were admitted to Baoji High Tech Hospital and Fufeng County People's Hospital from February 2017 to February 2022 were selected and divided into control group and observation group according to random number table, with 40 patients in each group. The control group received oral hypoglycemic drugs, while the observation group received intensive insulin therapy. The following indexes were compared between the two groups before and after treatment:blood glucose level [FPG, 2hPG, HbA1c], Insulin function index [HOMA-IR and homeostasis model evaluation β Cell function index (HOMA-β)],inflammatory factor [tumor necrosis factor-α(TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6)], oxidative stress level [superoxide dismutase (SOD), malondialdehyde (MDA) and reduced glutathione (GSH)], periodontal index [sulcus bleeding index (SBI) score, periodontal probing depth (PD), attachment loss (AL)], the time of blood glucose reaching the standard and the time of incision and drainage wound healing.【Results】Compared with that before treatment, FPG, 2hPG, HbA1c, HOMA-IR, TNF-α, the scores of CRP, IL-6, MDA, SBI, PD and AL in the two groups after treatment decreased significantly (P<0.05); SOD、GSH、HOMA-β were significantly increased (P<0.05), and the change was more obvious in the observation group (P<0.05). The time of blood glucose reaching the standard and the healing time of incision and drainage wound in the observation group were significantly shorter than those in the control group (P<0.05).【Conclusion】 Intensive insulin therapy for T2DM with MSI has a good effect, which can effectively control the blood glucose level, shorten the time of reaching the blood glucose standard and the time of wound healing after incision and drainage, improve the function of pancreatic islets and periodontal index, and inhibit oxidative stress and inflammatory reaction. 2022 Vol. 39 (9): 1364-1367 [Abstract] ( 35 ) HTML (1 KB)  PDF (1193 KB)  ( 67 ) 1368 Analysis of Clinical Effect of Venlafaxine Combined with Namefene in the Treatment of Alcoholic Mental and Behavioral Disorders XU Juan, LI Xiao-xue DOI: 10.3969/j.issn.1671-7171.2022.09.024 【Objective】To investigate the clinical effect of venlafaxine combined with Namefene in the treatment of alcoholic mental and behavioral disorders.【Methods】A total of 72 patients with alcoholic mental and behavioral disorders admitted to Ankang Central Hospital from May 2019 to March 2020 were randomly divided into observation group and control group with 36 patients in each group. The control group was treated with routine therapy and Namefene, while the observation group was treated with venlafaxine on the basis of the control group. The therapeutic effect, adverse reaction rate, PANSS score, levels of neurocytokines [brain derived neurotrophic factor(BDNF), nerve growth factor (NGF), neurotrophin-3 (NT-3)], and the scores of Loewenstein Occupational Therapy Cognitive Assessment Scale (LOTCA) and Montreal Cognitive Assessment Scale (MoCA) before and after treatment were compared between the two groups. 【Results】 After 28 days of treatment, the total effective rate in the observation group was 94.44% (34/36), higher than that in the control group [77.78% (28/36)], with a statistically significant difference(χ2=4.18,P=0.04);The positive symptom score, negative symptom score, general psychopathology score and total score of the two groups were lower than those before treatment, and the observation group was lower than the control group, with a statistically significant difference (P<0.05); The levels of serum BDNF, NGF and NT-3 in the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group, with a statistically significant difference (P<0.05); The scores of LOTCA and MoCA in the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group, with a statistically significant difference (P<0.05). There was no significant difference between the two groups in the incidence of nausea, vomiting, dizziness, lethargy, dry mouth, diarrhea and skin itching (P>0.05). 【Conclusion】 Venlafaxine combined with Namefene is helpful to regulate the level of neurocytokines in patients with alcoholic mental and behavioral disorders, improve clinical treatment effect, improve mental symptoms, reduce cognitive dysfunction, and has good safety. 2022 Vol. 39 (9): 1368-1371 [Abstract] ( 34 ) HTML (1 KB)  PDF (1138 KB)  ( 133 ) 1372 Influential Factors of Carotid Plaque Instability in Patients with Large Atherosclerosis and Small Artery Occlusion in TOAST Classification of Acute Ischemic Stroke LIU Yun DOI: 10.3969/j.issn.1671-7171.2022.09.025 【Objective】 To investigate the influencing factors of carotid plaque instability in patients with acute ischemic stroke in TOAST classification. 【Methods】 Retrospective analysis was made on 127 patients with acute ischemic stroke admitted to our hospital from January 2019 to January 2022. According to TOAST classification, they were divided into two groups:large atherosclerosis group(n=48) and small artery occlusion group(n=69). The occurrence, stability and quantity of carotid plaque in the two groups were compared, and the related factors of plaque instability were analyzed by binomial logistic regression.【Results】Carotid plaque was found in 39 cases (81.25%) of the large atherosclerosis group and 59 cases (85.51%) of the small artery occlusion group. There was no significant difference between the two groups in the incidence of carotid plaque formation, the stability of carotid plaque, and the number of carotid plaque (P>0.05). The results of binomial logistic regression analysis showed that gender and plaque number were the influencing factors of carotid atherosclerotic plaque instability (P<0.05).【Conclusion】 Male and multiple plaques are the influencing factors of carotid plaque instability in patients with acute ischemic stroke. Clinical attention should be focused on such patients and intervention measures should be strengthened. 2022 Vol. 39 (9): 1372-1374 [Abstract] ( 55 ) HTML (1 KB)  PDF (1110 KB)  ( 72 ) 1375 Application of Blood Pressure Pulse Wave Index Monitoring in General Anesthesia of Elderly Patients Undergoing Laparoscopic Surgery LYU Ji-lu, GUAN Qing-lai DOI: 10.3969/j.issn.1671-7171.2022.09.026 【Objective】To explore the significance of blood pressure pulse wave index monitoring in the perioperative period of general anesthesia in elderly patients undergoing laparoscopic surgery.【Methods】The blood pressure and pulse wave index of 40 elderly patients undergoing general anesthesia and laparoscopic surgery were measured before anesthesia,at the end of operation and one week after operation.The blood pressure and pulse wave data and the changes of blood pressure and heart rate in different operation periods were observed,and the occurrence of postoperative complications was recorded. 【Results】 The brachial ankle pulse wave velocity (baPWV) and ankle brachial index (ABI) in the blood pressure pulse wave index of the patients at the end of the operation were higher than those before anesthesia (P<0.05),but the baPWV and ABI of the patients at the end of the operation had no significant change compared with those before anesthesia (P>0.05).The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower than those before endotracheal intubation (P<0.05); After skin cutting and immediately after drug withdrawal,SBP and DBP increased compared with that before endotracheal intubation (P<0.05),but there was no significant difference between them (P>0.05); The heart rate during endotracheal intubation was higher than that before operation (P<0.05),and the heart rate after skin incision and immediately after drug withdrawal was lower than that during endotracheal intubation (P<0.05); But there was no significant difference between them (P>0.05).Only 2 (5.00%) patients had ischemic heart disease,6 (15.00%) patients had hypooxia,4 (10.00%) patients had chills,and the complication rate was 30.00% (12/40). 【Conclusion】The blood pulse wave index,blood pressure and heart rate of the elderly patients during the peri operative period of general anesthesia and laparoscopic surgery have obvious changes,but there are no obvious changes after and before the operation; It indicates that this change can be reversed temporarily.In clinical practice,the blood pulse wave index can be used to monitor the arterial condition of the elderly patients,and intervention treatment can be carried out as soon as possible to alleviate the disease and reduce the occurrence of complications and improve the safety of the operation. 2022 Vol. 39 (9): 1375-1377 [Abstract] ( 65 ) HTML (1 KB)  PDF (1167 KB)  ( 82 ) 1378 Study on Effect and Safety of Intracavitary Electrocardiographic Positioning Technology in Catheter Tip Localization of Neonatal PICC YUAN Lei, ZHOU Xiao-yang, GONG Jie, et al DOI: 10.3969/j.issn.1671-7171.2022.09.027 【Objective】To explore the effect and safety of intracavitary electrocardiogram (ECG) positioning technology in positioning the tip of peripherally inserted central catheter (PICC) in newborns. 【Methods】From January 2020 to December 2021, 100 newborns who received PICC catheter in the neonatology department of our hospital were randomly divided into two groups according to the random number table method. There were 50 newborns in both observation group and control group. In the control group, X-ray was selected to locate the catheter tip during PICC catheter placement, while in the observation group, intracavitary electrocardiogram was selected to locate the catheter tip during PICC catheter placement. The one-time tip arrival rate, catheter placement times, catheter placement time, vital signs indicators, incidence of complications were compared between the two groups of newborns. The score of disease uncertainty, negative emotion score and parents' satisfaction of the two groups were compared as well. 【Results】Compared to the control group, the rate of one-time catheter tip placement in the observation group was higher (P<0.05), the times of catheterization of newborns in the observation group were significantly less (P<0.05), and the catheterization time in the observation group was significantly shorter (P<0.05). After catheterization, the systolic blood pressure, diastolic blood pressure and heart rate of newborns in the control group changed significantly compared with those before catheterization (P<0.05), while those in the observation group did not change significantly compared to before catheterization (P>0.05). The incidence of neonatal complications in observation group was lower than that in control group (P<0.05). Compared with before catheterization, the uncertainty score, anxiety score and depression score of neonatal parents in both groups after catheterization were significantly reduced (P<0.05). The scores of disease uncertainty, anxiety and depression of newborn's parents in the observation group after catheter placement were significantly lower than those in the control group(P<0.05). The total satisfaction rate of newborn's parents in the observation group was higher than that in the control group (P<0.05). 【Conclusion】Application of intracavitary ECG positioning technology to locate the catheter tip in the process of PICC catheter placement in newborns can improve the one-time tip delivery rate, reduce the number of catheterization times, shorten the catheterization time, maintain the stability of neonatal vital signs during catheterization, and reduce the incidence of complications. It also reduce the negative emotion and disease uncertainty of newborn's parents to make them more satisfied with PICC catheter placement service. 2022 Vol. 39 (9): 1378-1381 [Abstract] ( 40 ) HTML (1 KB)  PDF (1132 KB)  ( 87 ) 1382 Correlation between Severity of Chronic Atrophic Gastritis and miR-32, miR-181 and miR-129 ZHU Jie, TIAN Lin DOI: 10.3969/j.issn.1671-7171.2022.09.028 【Objective】To investigate the correlation between the severity of chronic atrophic gastritis (CAG) and miR-32, miR-181 and miR-129.【Methods】A total of 130 CAG patients (observation group) admitted to the Shangluo Central Hospital from August 2019 to August 2021 were selected, and 130 healthy volunteers (control group) who underwent physical examination at the same time were selected. The expression levels of miR-32, miR-181 and miR-129 were compared between the two groups. The ROC curve was used to analyze the expression levels of miR-32, miR-181, and miR-129 to predict the value of CAG and the expression levels of miR-32, miR-181, and miR-129 in CAG patients with different disease severity were compared at the same time. Spearman coefficient was used to analyze the correlation between the expression level of miR-32, miR-181, miR-129 and the severity of the disease in CAG patients.【Results】The expression levels of miR-32 and miR-181 in the observation group were significantly higher than those in the control group, and the expression levels of miR-129 were significantly lower than those in the control group (P<0.05). ROC curve analysis showed that the best cutoff values of miR-32, miR-181 and miR-129 for CAG prediction were 3.150, 0.813 and 3.288, and the areas under the curve were 0.931, 0.880 and 0.904 respectively (P<0.05). The expression levels of miR-32 and miR-181 gradually increased in mild, moderate and severe patients, and the expression levels of miR-129 gradually decreased, with a statistically significant difference (P<0.05). Spearman correlation analysis showed that the expression level of miR-32 and miR-181 in CAG patients was positively correlated with the severity of the disease (P<0.05), and the expression level of miR-129 was negatively correlated with the severity of the disease (P<0.05). 【Conclusion】 The expression levels of serum miR-32, miR-181 and miR-129 are related to the severity of the disease in patients with CAG, and can be used as a relevant indicator to predict the severity of the disease in patients with CAG. 2022 Vol. 39 (9): 1382-1384 [Abstract] ( 35 ) HTML (1 KB)  PDF (1251 KB)  ( 21 ) 1385 Efficacy of Captopril with different doses in Treatment of Adult Viral Myocarditis CHEN Yong-guo, WANG Dong-hong, SHANG Jiang DOI: 10.3969/j.issn.1671-7171.2022.09.029 【Objective】To explore the efficacy of Captopril with different doses in the treatment of adult viral myocarditis.【Methods】A total of 106 patients with viral myocarditis treated in our hospital were divided into the low-dose group (n= 50,25 mg) and the high-dose group (n= 56,50 mg) according to different doses of captopril on the basis of conventional treatment.The clinical efficacy and the levels of serum troponin T (cTnT),serum troponin I (cTnI),myocardial enzyme profile [α-hydroxybutyrate dehydrogenase (α-HBDH),lactate dehydrogenase (LDH),creatine kinase isoenzyme (CK-MB),aspartic aminotransferase (AST)] before and after treatment were compared between the two groups.The changes of cardiac function [left ventricular ejection fraction (LVEF),cardiac output per stroke (SV),ventricular short axis shortening rate (FS)] and the incidence of adverse reactions were compared between the two groups before and after treatment as well.【Results】The total effective rate in the high-dose captopril group was higher than that in the low-dose group (P<0.05).The levels of cTnT and cTnI in both groups were lower after treatment than before (P<0.05).The cTnT level in the high-dose group was lower than that in the low-dose group (P<0.05),while there was no significant difference in the cTnI level between the high-dose group and the low-dose group (P>0.05).After treatment,the levels of α-HBDH,LDH,CK-MB and AST in both groups were decreased compared to those before treatment (P<0.05).After treatment,the levels of α-HBDH,LDH,CK-MB and AST in the high-dose group were lower than those in the low-dose group (P<0.05).After treatment,the levels of LVEF,SV and FS in both groups were higher than those before treatment (P<0.05).The levels of LVEF,SV and FS in the high-dose group were higher than those in the low-dose group (P<0.05).The incidence of adverse reactions in the high-dose group was higher than that in the low-dose group (P<0.05).【Conclusion】Compared to captopril low-dose medication,high-dose captopril is more effective in the treatment of adult viral myocarditis,however,it increases the risk of adverse reactions. 2022 Vol. 39 (9): 1385-1388 [Abstract] ( 37 ) HTML (1 KB)  PDF (1134 KB)  ( 36 ) 1389 Pregnancy Outcome and its Influencing Factors in Patients after Laparoscopic Myomectomy LIU Li-ying, QU Shu-yun, REN Xiao-hong DOI: 10.3969/j.issn.1671-7171.2022.09.030 【Objective】To investigate the pregnancy outcome and its influencing factors of patients after laparoscopic myomectomy. 【Methods】 A total of 216 patients with fertility requirements who underwent laparoscopic myomectomy in our hospital from August 2018 to August 2020 were selected, and were divided into the observation group (single leiomyoma, n=142) and the control group (multiple leiomyomas, n=74) according to the number of leiomyomas. The pregnancy, delivery and abortion of the two groups were compared, and the independent risk factors of adverse pregnancy outcomes were analyzed by multivariate logistic regression. 【Results】 There was no significant difference in pregnancy rate, live birth rate, ectopic pregnancy rate and abortion rate between the two groups (P>0.05). 33 of 216 patients (15.28%) had adverse pregnancy outcomes. Multivariate logistic regression analysis showed that age, large number of myomas, and preoperative intrauterine adhesions were independent risk factors for adverse pregnancy outcomes after laparoscopic myomectomy. 【Conclusion】 Age, the number of myomas and intrauterine adhesions before operation are all important factors that affect the pregnancy outcome of patients after laparoscopic myomectomy. Clinical attention should be paid to these factors, and preventive treatment should be carried out to improve the pregnancy outcome. 2022 Vol. 39 (9): 1389-1391 [Abstract] ( 40 ) HTML (1 KB)  PDF (1100 KB)  ( 101 ) 1392 Relationship between Ovarian Reserve Function and Thyroid Function in Women with Perimenopausal Syndrome SI Mei-li, SHI Fan DOI: 10.3969/j.issn.1671-7171.2022.09.031 【Objective】To explore the relationship between ovarian reserve function and thyroid function in women with perimenopausal syndrome. 【Methods】A total of 80 patients with perimenopausal syndrome treated in our hospital from January 2020 to January 2022 were selected. According to whether the patients had ovarian reserve function decline, the observation group (with ovarian function decline, n=50) and the control group (without ovarian function decline, n=30) were selected. Age at admission, body mass index (BMI), blood type, smoking history, age at menarche, age at first sex, age at first pregnancy, history of dysmenorrhea, menstrual period, menstrual cycle, number of abortions, pregnancy times, pelvic inflammatory disease and sleep quality were collected. The levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were detected in both groups at admission. The differences of basic data and laboratory indicators between the two groups were compared. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of TSH, FT3 and FT4 levels for ovarian reserve function decline in women with perimenopausal syndrome. Unconditional logistic regression was used to analyze the risk factors for ovarian reserve decline in women with perimenopausal syndrome. 【Results】The levels of TSH, FT3 and FT4 in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). The areas under the ROC curve of TSH, FT3 and FT4 levels in predicting ovarian reserve decline in women with perimenopausal syndrome were 0.879, 0.987 and 0.924, respectively. Multivariate Logistic regression analysis confirmed that TSH≥2.516 mIU/L, FT3≥4.669 pmol/L, FT4≥15.577 pmol/L were risk factors for ovarian reserve decline in women with perimenopausal syndrome (all P<0.05). 【Conclusion】TSH, FT3 and FT4 can be used as blood indicators to predict the decline of ovarian reserve function in female patients with menopausal syndrome. Thus, these parameters provide reference for the prevention and treatment of such patients, which is worthy of clinicians' attention. 2022 Vol. 39 (9): 1392-1394 [Abstract] ( 37 ) HTML (1 KB)  PDF (1255 KB)  ( 47 ) 1395 Level Changes and Clinical Significance of Serum Five Tumor Markers and Procalcitonin before and after Chemotherapy in Lung Adenocarcinoma XU Li-hong, WANG Yu, YUE Hong DOI: 10.3969/j.issn.1671-7171.2022.09.032 【Objective】To explore the changes and clinical significance of serum five tumor markers and procalcitonin (PCT) levels before and after chemotherapy for lung adenocarcinoma.【Methods】A total of 124 patients with lung adenocarcinoma two were treated with paclitaxel (or docetaxel) chemotherapy on the basis of routine treatment.Five tumor cell markers in serum [carcinoembryonic antigen (CEA),alpha fetoprotein (AFP),glycoprotein antigen 19-9 (CA19-9),glycoprotein antigen 125 (CA-125),glycoprotein antigen 15-3 (CA15-3)] and PCT were detected. Changes of the above indicators before and after chemotherapy were compared between the chemotherapy effective group and the ineffective group,the two-year survival group and the death group.【Results】The overall analysis of patients with lung adenocarcinoma showed that the levels of serum CEA,CA-125 and PCT after treatment were lower than those before treatment (P<0.05).Among 124 patients with lung adenocarcinoma,74 patients (59.68%) were effective in treatment,and 50 patients (40.32%) were ineffective in chemotherapy.The serum CEA and CA-125 levels in the two groups after treatment were lower than those before treatment,and the serum PCT levels in the chemotherapy effective group after treatment were lower than those before treatment (P<0.05).After treatment,serum CEA,CA-125 and PCT levels in the effective group were lower than those in the ineffective group (P<0.05).Among 124 patients with lung adenocarcinoma,28 patients (22.58%) had a survival period of ≥ 2 years,and 96 patients (77.42%) died within 2 years.The levels of serum CEA,CA-125 and PCT in the two groups after treatment were lower than those before treatment,and those in the survival group were lower than in the death group (P<0.05).The rates of serum CEA,CA-125 and PCT level decrease in the survival group after chemotherapy were higher than those in the death group (P<0.05).【Conclusion】The changes of serum CEA,CA-125 and PCT levels are closely related to the curative effect and prognosis of patients with lung adenocarcinoma,which can be used to assist in evaluating the disease progression and prognosis of patients with lung adenocarcinoma. 2022 Vol. 39 (9): 1395-1398 [Abstract] ( 51 ) HTML (1 KB)  PDF (1135 KB)  ( 44 ) 1399 Correlation between Nutritional Status and Disease Severity in Elderly Patients with Diabetes Foot TIAN Tian, CAO Yun-chao DOI: 10.3969/j.issn.1671-7171.2022.09.033 【Objective】To explore the correlation between nutritional status and disease severity in elderly patients with diabetes foot. 【Methods】A total of 102 elderly patients with diabetic foot (DF) in our hospital from September 2019 to September 2020 were selected as the observation group; And patients were divided into grade Ⅰ~Ⅱ (n=38) and grade Ⅲ~Ⅴ (n=64) according to Wagner diagnostic grading standard of the disease severity. A total of 102 elderly patients with diabetes treated in our hospital during the same period were selected as the control group. Blood lipid indexes [triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C)] and nutritional indexes [serum total protein (TP), prealbumin (PA), hemoglobin (Hb), albumin (ALB)] were detected at admission. The predictive value of TC, PA, Hb and ALB levels on DF was analyzed by ROC. The relationship of disease severity with serum TC, PA, Hb and ALB levels was analyzed by Spearman coefficient. 【Results】There were no significant differences in TG, HDL-C, LDL-C and TP between the two groups (P>0.05). The levels of TC, PA, Hb and ALB in the observation group were significantly lower than those in the control group. The differences were statistically significant (P<0.05). According to the ROC curve analysis, TC≤4.510 mmol/L, PA≤221.004 mg/L, Hb≤131.640 g/L and ALB≤36.693 g/L were the best cut-off values for predicting DF. The areas under the curve of TC, PA, Hb and ALB for predicting DF were 0.641, 0.802, 0.936 and 0.781, respectively (P<0.05). There were no significant differences in TG, HDL-C, LDL-C and TP between Wagner grade Ⅰ~Ⅱ patients and Ⅲ~Ⅴ patients (P>0.05). The levels of TC, PA, Hb and ALB in Ⅲ~Ⅴ patients were significantly lower than those in Ⅰ~Ⅱ patients; And the differences were statistically significant (P<0.05). The serum levels of TC, PA, Hb and ALB in DF patients were negatively correlated with the severity of the disease (all P<0.05). 【Conclusion】The nutritional status of diabetic patients is closely related to the occurrence of DF. TC, PA, Hb and ALB of diabetic patients should be monitored and personalized intervention measures should be taken in time. 2022 Vol. 39 (9): 1399-1401 [Abstract] ( 45 ) HTML (1 KB)  PDF (1269 KB)  ( 133 ) 1402 Curative Effect of Lugua Polypeptide Injection on Knee Osteoarthritis LI Sheng, LIU Xue-mei, LYU Wen-hao DOI: 10.3969/j.issn.1671-7171.2022.09.034 【Objective】To explore the efficacy of Lugua polypeptide injection in the treatment of knee osteoarthritis (KOA).【Methods】A total of 110 patients with KOA in our hospital were randomly divided into the observation group and the control group,with 55 cases in each group.The control group was treated with routine therapy,while the observation group was treated with intra-articular injection of Lugua polypeptide on the basis of the control group.The total effective rate,Lequesne score,laboratory related indexes (ESR,CRP,COX-2,IL-6),the level of interleukin-18 (IL-18),and matrix metalloproteinase-13 (MMP-13) in synovial fluid were compared between the two groups after treatment.【Results】The total effective rate of the observation group was significantly higher than that of the control group (P<0.05).The scores of pain or discomfort,morning stiffness or pain after getting up,discomfort during walking,maximum walking distance and daily activity score in the two groups after treatment were significantly lower than those before treatment (P<0.05),and the above scores in the observation group after treatment were significantly lower than those in the control group (P<0.05).The levels of serum ESR,CRP,COX-2 and IL-6 in the two groups after treatment were significantly lower than those before treatment (P<0.05),and the levels of the above indicators in the observation group after treatment were significantly lower than those in the control group (P<0.05).After treatment,the levels of IL-18 and MMP-13 in synovial fluid of the two groups were significantly lower than those before treatment (P<0.05),and their levels in the observation group were significantly 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】Lugua polypeptide injection has a significant effect in the treatment of KOA,which can improve relevant symptoms and laboratory indicators,reduce the levels of IL-18 and MMP-13 in synovial fluid.The incidence of adverse reactions has not increased significantly. 2022 Vol. 39 (9): 1402-1405 [Abstract] ( 55 ) HTML (1 KB)  PDF (1136 KB)  ( 90 )

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