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Quick Search     Adv Search 2023 Vol. 40, No. 2 Published: 2023-02-26 Original Articles          Original Articles 161 Imaging Characteristics of the Middle Cerebral Artery Atherosclerotic Plaque and its Correlation with Acute Cerebral Infarction NIU Wen, QIU Xiao-hui, LIU Yi-chao DOI: 10.3969/j.issn.1671-7171.2023.02.001 【Objective】To investigate the relationship between the middle cerebral artery (MCA) atherosclerotic plaque and its correlation with acute cerebral infarction (ACI). 【Methods】A total of 56 patients with symptomatic middle cerebral artery stenosis were collected and divided into acute cerebral infarction group(ACI group) and non-acute cerebral infarction(NACI group) according to diffusion weighted imaging (DWI). First,Univariate analysis was used to analyze the differences in the differences the lumen stenosis rate,plaque location,shape,length and enhancement degree between the two groups of patients. Binary logistic regression and receiver operating characteristic (ROC) curve were constructed to evaluate the efficacy of selected variables in predicting cerebral infarction. 【Results】The plaque length and the proportion of plaque enhancement in the ACI group were higher than those in the NACI group,the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that plaque length and plaque enhancement were independent risk factors for ACI in patients with symptomatic MCA stenosis (P<0.05). The AUC of lumen stenosis rate,plaque length,plaque enhancement and their combination to predict the occurrence of ACI were 0.611,0.836,0.782 and 0.877,respectively. The predictive efficacy of plaque length and plaque enhancement degree on cerebral infarction was higher than lumen stenosis rate (P<0.05),and the combination of the three could significantly improve the predictive efficacy of cerebral infarction (P<0.05). 【Conclusion】The length and intensity of plaque are independent risk factors for ACI in patients with symptomatic MCA stenosis. Both of them are superior to lumen stenosis in predicting the occurrence of acute cerebral infarction. The combined detection of the three can improve the diagnostic efficacy of ACI. 2023 Vol. 40 (2): 161-164 [Abstract] ( 93 ) HTML (1 KB)  PDF (1256 KB)  ( 68 ) 165 Correlation Analysis between Blood Glucose Control Level before Delivery and Blood Glucose Level of Newborns after Cesarean Section in Pregnant Women with Diabetes HU Gai-qin, HUANG Xiao-li DOI: 10.3969/j.issn.1671-7171.2023.02.002 【Objective】 To explore the correlation between the blood glucose control level before delivery and the blood glucose level of newborns after cesarean section in patients with gestational diabetes mellitus (GDM). 【Methods】A total of 162 GDM patients who underwent cesarean section in the Affiliated Hospital of Yan'an University from April 2017 to April 2020 were selected. All patients underwent routine blood glucose control (diet control,exercise guidance) before delivery. According to the blood glucose monitoring results one day before delivery,they were divided into group A (twice FPG>6.16 mmol/L,n=72) and group B (twice FPG ≤ 6.16 mmol/L,n=90). FPG,2hPG and OGTT were measured before delivery after routine blood glucose control.FPG and 2hPG were detected at 6 h,12 h and 24 h after birth in both groups. The pregnancy outcome of the two groups of patients was counted,and the correlation between the blood glucose index of the two groups of patients and the blood glucose index of the newborn after birth was analyzed by Spearman coefficient. 【Results】The levels of FPG,2hPG and OGTT in the group A were significantly higher than those in the group B,and the difference was statistically significant(P<0.05);The serum FPG and 2hPG levels of newborns in the group A were significantly lower than those in the group B at 6 h,12 h and 24 h after birth (P<0.05). The incidence of postpartum hemorrhage,premature delivery,macrosomia,hypoglycemia and polyhydramnios in the group A was significantly higher than that in the group B,and the difference was statistically significant(P<0.05);The Apgar score of newborns in the group A was significantly lower than that in the group B (P<0.05). The correlation analysis showed that the FPG and 2hPG levels in the group A were negatively correlated with the blood glucose levels of FPG and 2hPG at 24 h of newborn (P<0.05). 【Conclusion】 The high blood glucose level of GDM patients can cause a series of maternal and infant complications and endanger the health of mothers and infants. At the same time,the correlation analysis confirms that the blood glucose level of GDM patients is closely related to the blood glucose level of newborns. 2023 Vol. 40 (2): 165-167 [Abstract] ( 50 ) HTML (1 KB)  PDF (1172 KB)  ( 78 ) 168 Efficacy of High Intensity Focused Ultrasound Combined with GnRH-a and LNG-IUS in the Treatment of Adenomyoma LI Xiao-xiao, ZHANG Yi-qun, CHEN Jin-yun,et al DOI: 10.3969/j.issn.1671-7171.2023.02.003 【Objective】To explore the clinical efficacy of high intensity focused ultrasound (HIFU) combined with Ganodotropin releasing hormone agonist (GnRH-a)and levonorgestrel releasing intrauterine system(LNG-IUS) in the treatment of uterine adenomyoma. 【Methods】In this study,201 patients with adenomyoma of uterus who were hospitalized in Taihe Hospital of Shiyan city from October 2019 to November 2021 were selected and divided into three groups:HIFU alone group (Group A,n=62),HIFU combined with LNG-IUS group (Group B,n=68) and HIFU combined with GnRH-a and LNG-IUS group (Group C,n=71).The ablation rates of lesions on MRI before treatment and on the first day after treatment were compared in the three groups. Levels of uterine volume,hemoglobin,visual analogue scale (VAS) and CA125 were compared before treatment and 1,3,6,12 months after treatment. 【Results】There were no significant differences in the ablation rates among the three groups (P>0.05). After 1,3,6 and 12 months of treatment,the uterine volume,dysmenorrhea VAS score,and CA125 level in all three groups were lower than those before treatment,while the hemoglobin value was higher than that before treatment. After 6 and 12 months of treatment,the uterine volume,dysmenorrhea VAS score and CA125 level in Group C were significantly lower than those in Group A and B (P<0.05),but there was no significant difference between Group A and group B (P>0.05). The hemoglobin value of Group C was higher than that of Group A and group B after treatment (P<0.05),however,there was no significant difference between Group A and group B (P >0.05). 【Conclusion】HIFU alone,HIFU combined with LNG-IUS and HIFU combined with GnRH-a and LNG-IUS are all safe and effective in the treatment of uterine adenomyoma. However,the therapeutic effect of HIFU combined with both GnRH-a and LNG-IUS is much better than that of HIFU alone and HIFU combined with LNG-IUS,while its recurrence rate was lower than that of HIFU alone and HIFU combined with LNG-IUS. 2023 Vol. 40 (2): 168-172 [Abstract] ( 47 ) HTML (1 KB)  PDF (1162 KB)  ( 76 ) 173 Relationship of Serum Hcy and HMGB1 with Prognosis of Patients with Multiple Myeloma GU Min, QIN Yun, BAI Sha-sha,et al DOI: 10.3969/j.issn.1671-7171.2023.02.004 【Objective】To investigate the relationship of serum homocysteine (Hcy) and high mobility group protein B1 (HMGB1) levels with the prognosis of patients with multiple myeloma (MM). 【Methods】A total of 72 MM patients treated in our hospital were divided into the good prognosis group (n=49) and the poor prognosis group (n=23) according to the survival of 3 years follow-up. The age,sex,body mass index (BMI),course of disease,smoking history,drinking history,hypertension history,anemia,light chain type,ISS staging data and the levels of bone marrow plasma cells,hemoglobin (Hb),blood calcium (Ca),blood creatinine (Scr),Hcy,and HMGB1 were compared between the two groups at admission. The predictive value of Hcy and HMGB1 levels on the poor prognosis of MM patients was analyzed with ROC curve,and the risk factors of the poor prognosis were identified with Logistic analysis. 【Results】The proportion of patients aged ≥ 60 years and the levels of Hcy and HMGB1 in the poor prognosis group were significantly higher than those in the good prognosis group (P<0.05). The area under the ROC curve predicted by Hcy and HMGB1 for the poor prognosis of MM patients was 0.815 and 0.777,respectively,(both P<0.05). Multivariate logistic regression analysis confirmed that age ≥ 60 years,Hcy ≥ 13.562 μmol/L and HMGB1 ≥ 216.919 pg/mL were risk factors for poor prognosis of MM patients (all P<0.05). 【Conclusion】The poor prognosis of MM patients is closely related to age,Hcy level and HMGB1 level,which deserves clinical attention. 2023 Vol. 40 (2): 173-175 [Abstract] ( 72 ) HTML (1 KB)  PDF (1173 KB)  ( 242 ) 176 Study on Relationship of Peripheral Blood MIF with Severity of Sepsis for Predictive Value of ARDS BIAN Mao-cheng, ZHONG Fei, WAN Jian DOI: 10.3969/j.issn.1671-7171.2023.02.005 【Objective】To explore the relationship of peripheral blood macrophage migration inhibitory factor (MIF) with the severity of sepsis to predict complication of acute respiratory distress syndrome (ARDS). 【Methods】A total of 95 patients with sepsis admitted to the hospital were selected. The basic data of all patients and biochemical indicators before treatment were collected. Patients were followed up for 2 weeks after treatment. Peripheral blood MIF,acute physiology and chronic health score Ⅱ(APACHE Ⅱ),and sequential organ failure assessment (SOFA) scores of sepsis patients with different severity levels were analyzed. Factors affecting ARDS in patients with sepsis were analyzed. And the value of peripheral blood MIF in predicting ARDS in patients with sepsis was analyzed as well. 【Results】The scores of MIF,APACHE Ⅱ and SOFA in the septic shock group were higher than those in the sepsis group (P<0.05). Pearson correlation analysis showed that the level of MIF in patients with sepsis was positively correlated with APACHE Ⅱ score and SOFA score (P<0.05). Logistic multivariate regression analysis showed that APACHE Ⅱ score,MIF,and oxygenation index were independent factors that affected patients with sepsis complicated by ARDS (P<0.05). ROC curve analysis showed that the sensitivity,specificity,and area under AUC of peripheral blood MIF in predicting sepsis patients with ARDS were 71.43%,79.66%,and 0.778,respectively. 【Conclusion】The level of peripheral blood MIF in patients with sepsis is related to the severity of the disease and ARDS complication. MIF is effective in predicting ARDS in patients with sepsis. 2023 Vol. 40 (2): 176-179 [Abstract] ( 48 ) HTML (1 KB)  PDF (1165 KB)  ( 33 ) 180 Effects of Different Prone Position Combined with Reverse Trendelenburg Position on Pulmonary Ventilation Function and Respiratory Mechanics in Acute Respiratory Distress Syndrome Patients QI Yan-li, ZHANG Li DOI: 10.3969/j.issn.1671-7171.2023.02.006 【Objective】To observe the effects of different prone positions combined with reverse Trendelenburg position on pulmonary ventilation function and respiratory mechanics in acute respiratory distress syndrome (ARDS) patients. 【Methods】A total of 96 patients with acute respiratory distress syndrome who underwent mechanical ventilation in Shangluo Central Hospital from February 2018 to March 2020 were enrolled in the study. Patients were divided into four groups by random digital table method. The A group was ventilated by routine prone position for 2 hours followed by reverse Trendelenburg supine position ventilation for another 2 hours; The B group received prone position ventilation for 2 hours,then prone position combined with reverse Trendelenburg supine position for 2 hours; The C group was ventilated by conventional prone position ventilation combined with reverse Trendelenburg supine position for 2 hours,follow by prone ventilation alone for 2 h. The pulmonary ventilation function,static compliance of the total respiratory system (Ctot) and static compliance of the chest wall (Ccw) of the three groups were compared. 【Results】Before the intervention,there was no significant difference in PaO2/FiO2 and PaCO2 among the three groups (P>0.05). After 2 hours of intervention,PaO2/FiO2 in group C was higher than that in group A (P<0.05),and PaCO2 in group C was lower than that in group A and group B (P<0.05). After 4 h of intervention,PaO2/FiO2 among three groups were statistically different (P<0.05),however,PaCO2 was no statistically significant among the three groups (P>0.05). There were no significant differences in both Ctot and Ccw among the three groups before intervention (P>0.05). After 2 hours of intervention,the Ccw of group C was higher than that of group A and B (P<0.05); After 4 hours of intervention,the Ccw of group C was significantly higher than that of group A and B(P<0.05). 【Conclusion】Combined prone position with reverse Trendelenburg supine position can shorten the PaO2/FiO2 recovery time and increase Ccw. In the nursing process,the patients' airway and respiratory management needs should be considered comprehensively,therefore a reasonable posture should be selected. 2023 Vol. 40 (2): 180-182 [Abstract] ( 60 ) HTML (1 KB)  PDF (1170 KB)  ( 85 ) 183 Effect of Apatinib Combined with TACE on Advanced Hepatocellular Carcinoma WANG Hui, LING Qing-xia DOI: 10.3969/j.issn.1671-7171.2023.02.007 【Objective】To investigate the effects of Apatinib combined with transcatheter arterial chemoembolization (TACE) on serum alpha-fetoprotein (AFP),carbohydrate antigen 125 (CA125) and carbohydrate antigen 199 (CA199) in patients with advanced liver cancer. 【Methods】A total of 86 patients with advanced liver cancer who admitted to our hospital were divided into the observation group and the control group according to random number table method,with 43 cases in each group. Both groups received TACE treatment,while the observation group was additionally treated with Apatinib. After 3 months of treatment,the therapeutic effect,occurrence of adverse reactions and serum levels of AFP,CA125 and CA199 were compared between the two groups. The 1-year follow-up was performed to compare the 1-year survival rate between the two groups. 【Results】There was no significant difference in objective remission rate and disease control rate between the two groups after 3 months of treatment (P>0.05). Serum AFP,CA125 and CA199 levels in both groups after treatment were significantly lower than those before treatment (P<0.05); And AFP,CA125 and CA199 levels of post-treatment in the observation group was lower than those in the control group after treatment (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). The 1-year survival rate of observation group was 71.43%(30/42) which was higher than that of control group 51.16% (22/43),and the difference was statistically significant (P<0.05). 【Conclusion】Apatinib combined with TACE in the treatment of patients with advanced liver cancer has a good effect on tumor growth inhibition. It can reduce the levels of serum AFP,CA125 and CA199 without increasing adverse reactions. The 1-year survival rate of patients is higher. 2023 Vol. 40 (2): 183-186 [Abstract] ( 55 ) HTML (1 KB)  PDF (1204 KB)  ( 67 ) 187 CT Manifestation and Artificial Intelligence Quantitative Analysis of SARS-CoV-2 Omicron Variant LONG Ni-zhe, DING Ru, TANG Bin,et al DOI: 10.3969/j.issn.1671-7171.2023.02.008 【Objective】To explore the CT imaging features of patients infected with novel coronavirus Omicron variant,and to quantitatively score the total severity of lesions by artificial intelligence. 【Methods】The clinical data and chest CT imaging characteristics of 23 patients diagnosed with Omicron variant (B.1.1.529) of coronavirus in Huaihua First People's Hospital from March 17 to March 26,2022 were retrospectively analyzed. The volume and proportion of pneumonia were automatically identified and semi-quantitatively calculated by artificial intelligence software to evaluate the application in clinical classification/severity grading. 【Results】Of the 23 patients with Omicron variant of coronavirus,8 cases were positive on chest CT first,which included 6 cases of focal ground-glass opacities and 2 cases of nodular consolidation in the lung.Lesions were mainly distributed in the middle zone of the lung. Five patients had single lobe involvement,of which,4 cases had single lobe involvement in the left lung,1 in the right lung. There were 3 cases involoved in both lungs. No pleural effusion and lymph node enlargement were found in all 8 patients. After artificial intelligence analysis showed that all 8 patients with positive CT examination had the total CT severity score less than or equal to 5 points,including 4 cases with a score of 1 point,1 case with a score of 2 points,2 cases with 3 a score of points and 1 case with a score of 5 points. All patients had mild symptoms,and the CT value of some patients decreased significantly before and after treatment. 【Conclusion】The main imaging manifestations of Omicron variant of coronavirus infection are focal ground-glass opacities and consolidation nodules,which are mainly distributed in the middle zone of the single lung lobe and segment. The prognosis is good,the rate of asymptomatic infection is high,and the degree of pneumonia is mild. The image analyzed by artificial intelligence quantitative characteristics of Omicron variant infection are of great significance for early identification and effective treatment. 2023 Vol. 40 (2): 187-190 [Abstract] ( 49 ) HTML (1 KB)  PDF (1918 KB)  ( 134 ) 191 Correlation between Severe Stenosis or Occlusion of Unilateral VA and Symptoms of Posterior Circulation Ischemia CHEN Li, LEI Bo, WU Jia-chuan,et al DOI: 10.3969/j.issn.1671-7171.2023.02.009 【Objective】To explore the correlation between the severe stenosis or occlusion of unilateral vertebral artery (VA) and the symptoms of posterior circulation ischemia. 【Methods】The clinical data of 177 patients with unilateral VA severe stenosis or occlusion admitted to our hospital were analyzed retrospectively. All patients underwent magnetic resonance imaging (MRI),digital subtraction angiography (DSA) and carotid artery ultrasound (CDU) after admission;The site of VA severe stenosis or occlusion,the condition of VA severe stenosis and occlusion,whether the patients with unilateral VA severe stenosis or occlusion had symptoms of posterior circulation ischemia,and hemodynamic parameters [peak systolic blood flow velocity (PSV),end-diastolic blood flow velocity (EDV),vascular resistance index (RI),and vertebral artery diameter (VAD)] were evaluated. The differences of hemodynamic parameters in patients with unilateral VA severe stenosis or occlusion in the initial segment,extracranial segment and intracranial segment were compared,and the occurrence of posterior circulation ischemia symptoms in patients with different VA severe stenosis or occlusion was observed. 【Results】All 177 patients completed MRI and DSA examination. The DSA examination showed that 62.71% of VA severe stenosis and 37.29% of VA mild stenosis; In MRI examination,54.24% of VA initial segment severe stenosis or occlusion,16.95% of extracranial segment severe stenosis or occlusion,28.81% of intracranial segment severe stenosis or occlusion,83.33% of initial segment severe stenosis or occlusion moderate and severe stenosis,16.67% of occlusion,46.67% of extracranial segment severe stenosis or occlusion moderate and severe stenosis,53.33% of occlusion,33.33% of intracranial segment severe stenosis or occlusion moderate and severe stenosis,66.67% of occlusion. In MRI examination,48.02% (85/177) had symptoms of posterior circulation ischemia,and 51.98% (92/177) had no symptoms of posterior circulation ischemia. PSV,EDV,RI and VAD of the affected side of patients with severe VA stenosis or occlusion at the initial segment were lower than those of the healthy side (P<0.05). The PSV and EDV of the patients with severe VA stenosis or occlusion in the extracranial segment were higher than those of the healthy side,and the VAD of the affected side was lower than that of the healthy side,the difference was statistically significant (both P<0.05); There was no significant difference in RI between the affected side and the healthy side of patients with severe VA stenosis or occlusion in extracranial segment (P>0.05). PSV,EDV and VAD of the patients with severe intracranial VA stenosis or occlusion were lower than those of the healthy side,and RI was higher than that of the healthy side (P<0.05). The incidence of posterior circulation ischemia symptoms (transient cerebral ischemia,cerebral infarction) in patients with severe VA stenosis or occlusion in extracranial segment and initial segment was higher than that in initial segment (P<0.05). 【Conclusion】 There is a certain relationship between the occurrence of posterior circulation ischemia symptoms and the location of severe VA stenosis or occlusion. Timely imaging examination of patients with unilateral VA severe stenosis or occlusion before treatment can provide help for the treatment and prognosis evaluation of the disease. 2023 Vol. 40 (2): 191-194 [Abstract] ( 64 ) HTML (1 KB)  PDF (1140 KB)  ( 72 ) 195 CT Imaging Characteristics of Peripheral Primitive Neuroectodermal Tumors in Children LI Chun-wang, TANG Jing DOI: 10.3969/j.issn.1671-7171.2023.02.010 【Objective】To investigate the CT imaging features of peripheral primitive neuroectodermal tumor (pPNET) in children. 【Methods】 The CT imaging data of 11 patients with pPNET confirmed by histopathological examination were retrospectively analyzed. All patients underwent plain and enhanced CT scanning,and the tumor location. CT imaging features and pathological examination results were analyzed. 【Results】Of the 11 children with pPNET,2 tumors occurred in the neck ,and it also occurred in shoulder and back,chest wall,adrenal gland,retroperitoneum,buttock,thigh,forearm,humerus and femur in 1 case respectively. The tumor occurred outside the bone and was characterized by large soft tissue mass with unclear boundary and uneven density,calcification (1 case) and hemorrhage (2 cases).The enhancement scan showed moderate and severe enhancement (7 cases),with small vessel shadow inside. Two children with pPNET occurred in the bones of limbs showed bone destruction and soft tissue mass,and no tumor bone was found; There was no periosteal reaction in 1 case,and the bone cortex was interrupted in 1 case with a small amount of periosteal reaction. The soft tissue mass showed obvious enhancement. 【Conclusion】 The CT imaging findings of children with pPNET are lack of specificity and difficult to differentiate from other malignant tumors of bone and soft tissue. The clinical diagnosis mainly depends on pathological examination. 2023 Vol. 40 (2): 195-197 [Abstract] ( 36 ) HTML (1 KB)  PDF (1832 KB)  ( 50 ) 198 Diagnostic Value of TIMD4 in the Prognosis of Patients with CNSCLC WANG Ru, ZHANG Min, LI Jun-she DOI: 10.3969/j.issn.1671-7171.2023.02.011 【Objective】To investigate the diagnostic value of T cell immunoglobulin and mucin domain 4 (TIMD4) in the prognosis of patients with central non-small cell lung cancer (CNSCLC).【Methods】A total of 139 patients with CNSCLC who received treatment in our hospital from April 2015 to June 2017 were selected as the research subjects. All patients were treated with transcatheter arterial chemoembolization (TACE) combined with percutaneous radiofrequency ablation (RFA). According to the 3-year prognosis,patients were divided into the survival group and the death group. Mononuclear cells were isolated by Ficoll density gradient centrifugation method. Western blotting was used to detect the expression level of TIMD4 in mononuclear cells,and the diagnostic value of TIMD4 in the prognosis of CNSCLC patients was analyzed. 【Results】The expression level of TIMD4 in the survival group and the death group showed a decreasing trend over time (P<0.05). The expression levels of TIMD4 at T1 and T2 in the survival group were lower than those in the death group,and the differences were statistically significant (P<0.05). The median survival time of the high TIMD4 group was lower than that of the low TIMD4 group; And the difference was statistically significant (P<0.05). COX regression analysis showed that TNM staging and T2-TIMD4 were independent risk factors for the prognosis of CNSCLC patients (P<0.05),while the differentiation degree and taking targeted drugs were independent protective factors for the prognosis of CNSCLC patients (P<0.05). The fitting curve of the nomogram regression model constructed by TNM staging,degree of differentiation,taking targeted drugs and T2-TIMD4 had a higher degree of coincidence with the ideal curve,whose consistency index C-index was 0.803. 【Conclusion】High TIMD4 expression in CNSCLC patients indicates a high risk of poor prognosis. The nomogram regression model based on TIMD4 has high accuracy and discrimination,which can evaluate the prognosis of CNSCLC patients. 2023 Vol. 40 (2): 198-201 [Abstract] ( 46 ) HTML (1 KB)  PDF (1268 KB)  ( 30 ) 202 Effect of Ureteroscopic Intraluminal Lithotripsy on Upper Urinary Tract Stones and Urinary Sepsis FENG Wei, LYU Zhong DOI: 10.3969/j.issn.1671-7171.2023.02.012 【Objective】To analyze the effect of ureteroscopic intraluminal lithotripsy on upper urinary calculi and prevention of sepsis. 【Methods】A total of 120 patients with upper urinary calculi were divided into the control group and the observation group,with 60 cases in each group. Patients in the control group received percutaneous nephrolithotripsy,while patients in thr observation group were treated with ureteroscopic intraluminal lithotripsy. Surgical conditions,clinical efficacy,infection-related indicators and incidence of urogenic sepsis were compared between the two groups. 【Results】The operation time in the observation group was shorter than that in the control group. The intraoperative blood loss in the observation group was less than that in the control group; And postoperative hospital time was shorter than that in the control group as well. The differences were statistically significant (P<0.05). The gravel success rate and stone clearance rate in the observation group were higher than those in the control group. Postoperative 2 h leukocyte count (WBC), neutrophil count (N) and serum Calcitonogen (PCT) in the observation group were lower than those in the control group (P<0.05). 【Conclusion】Uteroscopic endoscopic lithotripsy is used in patients with upper urinary calculi,which provides higher s gravel success rate and better stone removal rate,and reduce the risk of postoperative infection.It has certain clinical value for the prevention of urogenic sepsis. 2023 Vol. 40 (2): 202-204 [Abstract] ( 36 ) HTML (1 KB)  PDF (1169 KB)  ( 99 ) 205 Expression of EGP40 in Oral Squamous Cell Carcinoma and Its Relationship with Clinicopathological Features and Prognosis SUN Qin-qin, XIAO Jin-qing, ZHU Yu-juan DOI: 10.3969/j.issn.1671-7171.2023.02.013 【Objective】To investigate the expression of epithelial glycoprotein 40 (EGP40) in oral squamous cell carcinoma (OSCC) carcinoma and its relationship with clinicopathological features and prognosis. 【Methods】A total of 88 OSCC patients admitted to the hospital underwent radical surgery for OSCC and were followed up for 3 years. Immunohistochemistry was used to detect the expression of EGP40 protein in cancer and adjacent tissues. The relationship between EGP40 protein expression in cancer tissue and pathological parameters of patients was analyzed. The influence factors of postoperative recurrence and metastasis in OSCC patients were investigated; And the relationship of EGP40 expression with postoperative recurrence and metastasis were analyzed. 【Results】The positive expression rate of EGP40 in cancer tissues of OSCC patients was higher than that in adjacent tissues (P<0.05). The expression rate of EGP40 protein in cancer tissues of patients with stage Ⅲ-Ⅳ,invasion depth ≥5 mm,poorly differentiated,vascular involvement and lymph node metastasis was higher than that of stage Ⅰ-Ⅱ,invasion depth <5 mm,moderately and well differentiated,no vascular involvement and no lymph node metastasis (P<0.05). Cox regression analysis showed that stage,degree of differentiation,lymph node metastasis and EGP40 positive were independent factors affecting postoperative recurrence and metastasis in OSCC patients (P<0.05). The disease-free survival curve of patients with negative EGP40 expression was better than that of patients with positive EGP40 expression; And the difference was statistically significant (P<0.05). 【Conclusion】EGP40 is abnormally high in cancer tissue of OSCC patients. EGP40 expression is related to the pathological condition and prognosis of patients. Patients with positive EGP40 expression have a high risk of recurrence and metastasis after surgery. 2023 Vol. 40 (2): 205-208 [Abstract] ( 58 ) HTML (1 KB)  PDF (1220 KB)  ( 31 ) 209 Methylation Status of PCDH8 and TSLC1 Gene Promoters in Ovarian Cancer Tissue and Relationship with Prognosis WANG Rui, LIU Yang, DNEG Yun-jing DOI: 10.3969/j.issn.1671-7171.2023.02.014 【Objective】To investigate the methylation status of the promoter of PCDH8 and TSLC1 genes in ovarian cancer tissue and relationship with prognosis. 【Methods】The clinical data of 104 patients with ovarian cancer who underwent surgical treatment in our hospital from May 2017 to May 2018 were retrospectively analyzed. All patients were followed up for 36 months after surgery. The patients with metastasis,recurrence and death during the follow-up period were set as the poor prognosis group (n=60),and the rest were the good prognosis group (n=44). Methylation-specific polymerase chain reaction (MSP) was used to detect the methylation status of PCDH8 and TSLC1 gene promoters in ovarian cancer tissues of all patients. Univariate analysis and multivariate analysis were used to analyze the factors affecting the poor prognosis of ovarian cancer patients.【Results】The methylation rates of PCDH8 gene promoter and TSLC1 gene promoter in ovarian cancer tissue of patients with poor prognosis were 80.00% (48/60) and 58.33% (35/60),respectively,which were significantly higher than those of patients with good prognosis 36.36% (16/44) and 18.18% (8/44),respectively. The difference was statistically significant(χ2=20.422、16.875,P<0.05). There were statistically significant differences in FIGO stage,lymph node metastasis,degree of differentiation,PCDH8 gene promoter methylation status,and TSLC1 gene promoter methylation status between the poor prognosis group and the good prognosis group (P<0.05). FIGO stage Ⅲ~Ⅳ,lymph node metastasis,degree of differentiation G3,positive PCDH8 and TSLC1 gene promoter methylation status were all risk factors for the poor prognosis of ovarian cancer patients (P<0.05).【Conclusion】The positive rates of both PCDH8 and TSLC1 gene promoter methylation in the cancer tissue of patients with poor prognosis are significantly higher than those of patients with good prognosis. The methylation status of both PCDH8 and TSLC1 gene promoters is significantly correlated with the prognosis and can be used to evaluate the prognosis of patients with ovarian cancer. 2023 Vol. 40 (2): 209-212 [Abstract] ( 42 ) HTML (1 KB)  PDF (1135 KB)  ( 27 ) 213 Expression Level and Clinical Significance of Anti-mullerian Hormone in Serum of Patients with Polycystic Ovary Syndrome GONG Qin, GUO Wei DOI: 10.3969/j.issn.1671-7171.2023.02.015 【Objective】To investigate the expression level and clinical significance of anti-mullerian hormone (AMH) in serum of patients with polycystic ovary syndrome (PCOS). 【Methods】Ninety-one patients with PCOS were selected from January 2019 to January 2021 in our hospital as the observation group,and 90 healthy volunteers were selected as the control group. Serum AMH levels were detected by chemiluminescence (DXI800,Beckman) to compare the levels of serum AMH in patients with polycystic ovary syndrome and healthy women,which explored diagnostic value for polycystic ovary syndrome.【Results】 Serum level of AMH in patients with polycystic ovary syndrome was higher than that in the control group (P<0.05). Univariate analysis showed that age ≥35 years old,obesity,history of induced abortion,rare ovulation and serum AMH level ≥ 4.5 ng/mL was associated with polycystic ovary syndrome (P<0.05). Multivariate logistic regression analysis showed that age ≥ 35 years old,obesity,history of induced abortion,rare ovulation and serum ≥4.5 ng/mL was the risk factor of polycystic ovary syndrome (P<0.05). The sensitivity and specificity of serum AMH level in the diagnosis of polycystic ovary syndrome were 78.9% and 90.9%,respectively. The area under the working characteristic curve (AUC) was 0.855 and the 95%CI was 0.769~0.919. 【Conclusion】Serum AMH level in patients with polycystic ovary syndrome is abnormally high. Our results show that age≥ 35 years old ,obesity,history of induced abortion,infrequent ovulation,and serum AMH levels ≥ 4.5 ng/mL are all risk factors for the occurrence of PCOS. The level of serum AMH has a high value in the diagnosis of polycystic ovary syndrome. 2023 Vol. 40 (2): 213-215 [Abstract] ( 39 ) HTML (1 KB)  PDF (1286 KB)  ( 39 ) 216 Effect of Warfarin Gene Polymorphism Detection on INR and TTR in Patients with Atrial Fibrillation XING Xin, MAO Dian-bo DOI: 10.3969/j.issn.1671-7171.2023.02.016 Guide::null 【Objective】To investigate the effect of warfarin gene polymorphism detection on the initial international normalized ratio (INR) and the percentage of time to target (TTR) in patients with atrial fibrillation.【Methods】 A total of 112 patients with atrial fibrillation treated with warfarin were divided into the observation group (n=59,guided by warfarin gene polymorphism detection) and the control group (n=53,administered empirically) according to different administration methods. The distribution of different genotypes in the observation group was analyzed,and the predicted dose and steady-state dose of warfarin in patients with different genotypes in the observation group were compared. The occurrence of excessive anticoagulation events (INR>3.5 events) and insufficient anticoagulation events (INR<1.2 events) were compared between the observation group and the control group,and the difference in TTR and the incidence of adverse events of INR between the observation group and the control group at different times were compared. 【Results】The distribution of CYP2C9 * 3 genotype and VKORC1 genotype in the observation group conformed to Hardy Weinberg genetic balance law (P>0.05). In CYP2C9 * 3 genotype,there was no significant difference between the predicted dose and the steady-state dose of warfarin of AA,AC and CC genotype (P>0.05); There was no significant difference between the predicted dose and the steady dose of warfarin of AA type,GA type and GG type in VKORC1 genotype (P>0.05). The incidences of events with INR>3.5 and INR<1.2 in the observation group were lower than those in the control group (P<0.05). The TTR value of the observation group in the first 1 month and 3 months before INR was significantly higher than that of the control group (P<0.05),and there was no significant difference between the TTR value of the first 6 months and that of the control group (P>0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05). 【Conclusion】 Warfarin gene polymorphism detection can maintain the INR of patients with atrial fibrillation in a more stable range,and TTR can reach a higher level at the beginning of drug use,which can improve the safety of drug use and is worthy of clinical promotion. 2023 Vol. 40 (2): 216-219 [Abstract] ( 47 ) HTML (1 KB)  PDF (1144 KB)  ( 249 ) 220 Expression of miR-1181 in Nasopharyngeal Carcinoma and its Clinical Significance LUO Zhen-feng, YANG Hang, LI Heng DOI: 10.3969/j.issn.1671-7171.2023.02.017 【Objective】To investigate the expression and clinical significance of microRNA-1181 (miR-1181) in nasopharyngeal carcinoma (NPC). 【Methods】 A total of 71 NPC patients who received surgical treatment in the Ankang Central Hospital from October 2019 to May 2021 were randomly recruited. The relative expression of miR-1181 in NPC tissues and normal tissues adjacent to cancer was detected by real-time fluorescent quantitative PCR (RT-PCR),and the relative expression of miR-1181 in NPC tissues of patients with different degrees of differentiation,clinical stages,and distant metastasis was compared. All patients were followed up to analyze the correlation between miR-1181 and the prognosis of NPC. 【Results】Compared with normal tissues adjacent to cancer,miR-1181 was significantly down-regulated in NPC tissues; The relative expression of miR-1181 in clinical stage Ⅲ+Ⅳ NPC tissues was lower than that in stage Ⅰ+Ⅱ NPC tissues,the relative expression of miR-1181 in moderately and poorly differentiated NPC tissues was lower than that in highly differentiated NPC tissues,and the relative expression of miR-1181 in NPC tissues with distant metastasis was lower than that in non-metastatic NPC tissues,the difference was statistically significant (P<0.05). The relative expression of miR-1181 in patients with good prognosis was significantly higher than that in patients with poor prognosis (P<0.05); Logistic regression analysis showed that miR-1181<3.59 was associated with poor prognosis of NPC,and its odds ratio (OR)(95%CI) was 3.52 (1.65~5.28). 【Conclusion】 miR-1181 is low expression in NPC tissues,and high expression in NPC tissues with high differentiation,low clinical stage and distant metastasis,and miR-1181<3.59 is a risk factor for poor prognosis of NPC patients. 2023 Vol. 40 (2): 220-222 [Abstract] ( 47 ) HTML (1 KB)  PDF (1118 KB)  ( 62 ) 223 Study on the Current Situation and Influencing Factors of Cognitive Impairment in Painless Delivery LI Xia, LI Jun-liang, ZHAO Jing DOI: 10.3969/j.issn.1671-7171.2023.02.018 Guide::null 【Objective】To study the current situation and influencing factors of cognitive impairment in painless delivery. 【Methods】From July 2019 to March 2020,185 parturients who had painless delivery in Yan'an People's Hospital were included as the research subjects. A retrospective analysis was carried out. The incidence of cognitive impairment in painless delivery women was statistically analyzed. General data such as maternal education level,analgesia mode and labor process were collected. The independent risk factors of cognitive impairment in painless delivery women were analyzed by multivariate logistic regression analysis. 【Results】Among the 185 painless delivery,32 cases had postpartum cognitive impairment,accounting for 17.30%; 153 cases had no cognitive impairment,accounting for 82.70%. Multivariate logistic regression analysis showed that analgesia(OR=1.422,95%CI=1.857～1.978),neonatal transfer(OR=3.267,95%CI=1.473～1.588),prenatal Pittsburgh sleep quality index (PSQI)(OR=1.472,95%CI=1.176～1.385),visual analogue scale (VAS) score at uterine dilation 3 cm(OR=1.525,95%CI=1.252～1.402),and the VAS at uterine dilation 10 cm(OR=1.643,95%CI=1.511～1.671) were independent factor of cognitive impairment in painless delivery. 【Conclusion】Methods of analgesia,transfer of neonate,PSQI score before delivery,3 cm VAS scores and 10 cm VAS score of uterine dilation are the influencing factors of cognitive impairment in painless delivery,while effective analgesia can reduce the risk of cognitive impairment after delivery. 2023 Vol. 40 (2): 223-225 [Abstract] ( 50 ) HTML (1 KB)  PDF (1167 KB)  ( 138 ) 226 Application Value of Pulmonary Water B-line Score Combined with CA125 Level and VPW in Pulmonary Edema in Patients with Heart Failure ZHENG De-liang, LI Su-ling DOI: 10.3969/j.issn.1671-7171.2023.02.019 【Objective】 To explore the application value of pulmonary water B-line score combined with carbohydrate antigen 125 (CA125) level and vascular pedicle width (VPW) in pulmonary edema in patients with acute heart failure (HF). 【Methods】A total of 100 patients with acute heart failure admitted to our hospital from February 2021 to February 2022 were selected,and divided into pulmonary edema group (41 cases) and non-pulmonary edema group (59 cases) according to whether the patients were complicated with acute pulmonary edema. the lung water B-line score,CA125 level and VPW of the two groups were compared to draw the receiver operating characteristic curve (ROC) to evaluate the efficacy of the lung water B-line score,CA125 level and VPW alone and in combination to predict pulmonary edema in patients with acute heart failure. 【Results】The pulmonary water B-line score,CA125 level and VPW in the pulmonary edema group were significantly higher than those in the non-pulmonary edema group (P<0.05). The lung water B-line score,CA125 and VPW have certain predictive effect on pulmonary edema in patients with acute heart failure. The area under the curve was 0.902,0.663 and 0.690 respectively,the sensitivity was 0.927,0.659 and 0.683 respectively,and the specificity was 0.797,0.576 and 0.593 respectively; The area under the curve of the above three indicators combined to predict pulmonary edema in patients with acute heart failure was 0.967,the sensitivity was 0.951,and the specificity was 0.983. 【Conclusion】Pulmonary water B-line score,CA125 and VPW have certain predictive effect on pulmonary edema in patients with acute heart failure,while the combination of the above indicators has higher predictive effect on pulmonary edema in patients,which is worthy of clinical verification. 2023 Vol. 40 (2): 226-229 [Abstract] ( 45 ) HTML (1 KB)  PDF (1226 KB)  ( 72 ) 230 Predictive Value of the Expression of CD138 in the Endometrium on the Pregnancy Outcome of Patients with Chronic Endometritis and RIF ZHU Jing, LI Hai-xiang, JIANG Sai DOI: 10.3969/j.issn.1671-7171.2023.02.020 【Objective】To investigate the predictive value of membrane heparan sulfate proteoglycan ligand-1 (CD138) expression in the endometrium for pregnancy outcome in patients with chronic endometritis (CE) complicated with recurrent implantation failure (RIF). 【Methods】 A total of 126 patients with CE combined with RIF admitted to our hospital from August 2019 to October 2020 were selected as the research objects. Statistics of clinical pregnancy of all subjects were conducted. According to the clinical success of pregnancy,they were divided into success group (59 cases) and failure group (67 cases). The clinical data of patients in the failure and success groups were compared. Logistic multivariate regression analysis of risk factors affecting pregnancy outcomes in CE complicated with RIF patients was performed. Receiver operating characteristic (ROC) curve was prepared,and the area under the curve (AUC) was used to analyze the predictive power of CD138 expression in the endometrium on pregnancy outcomes in patients with CE complicated with RIF. 【Results】The clinical pregnancy failure rate of 126 CE patients with RIF was 53.17%(67/126). The clinical pregnancy rate,continuous pregnancy rate and delivery rate of CD138 positive expression were lower than those of negative expression (P<0.05). The age,luteinizing hormone (LH),follicle-generating hormone (FSH),number of antral follicles,number of transferred embryos,and blastocyst rate in the failure group were lower than those in the successful group (P<0.05),while the proportion of CD138 positive and Histochemical score (H-SCORE) were higher in the successful group (P<0.05). Logistic multivariate analysis showed that the number of embryos transferred,CD138 positive expression,and H-SCORE were independent factors affecting the pregnancy outcome of patients with CE complicated with RIF (OR=2.807,3.089,3.367,P<0.05). The ROC analysis showed that the best cut-off point of the CD138 H-SCORE score in the endometrium for predicting the pregnancy outcome of patients with CE complicated with RIF was 107.43 points,and the AUC was 0.826.【Conclusion】The H-SCORE of CD138 in the endometrium has a high predictive value for the pregnancy outcome of patients with CE complicated with RIF,and can be used as an important reference index to predict the clinical outcome of such patients. 2023 Vol. 40 (2): 230-233 [Abstract] ( 38 ) HTML (1 KB)  PDF (1167 KB)  ( 82 ) 234 Relationship of HBsAg/HBV DNA Ratio with TGF-β1 and Tim-3 Levels in Patients with Hepatitis B YAO Bo-fang, GAO Fang-fang DOI: 10.3969/j.issn.1671-7171.2023.02.021 【Objective】To investigate the relationship of ratio of hepatitis B surface antigen (HBsAg)/hepatitis B virus (HBV) DNA with transforming growth factor-β1(TGF-β1) and T lymphocyte immunoglobulin mucin 3 (Tim-3) levels in patients with hepatitis B.【Methods】Seventy patients with hepatitis B admitted to our hospitals were divided into the mild HBV group (22 cases),the moderate HBV group (30 cases) and the severe HBV group (18 cases) according to the severity of the disease.Another 30 healthy people who were examined at the same time were selected as the control group.The clinical blood biochemical data of all subjects,liver function indexes,TGF-β1,Tim-3 level and the ratio of HBsAg/HBV DNA were analyzed by Pearson correlation.【Results】The levels of serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBIL) and platelet count (PLT) in patients with HBV of different severity and the control groups were in order of the control group<the mild HBV group the moderate HBV group the severe HBV group.The differences among the groups were significant (P<0.05).The comparison of HBsAg/HBV DNA ratios in each group showed the order of the mild HBV group>the moderate HBV group>the severe HBV group (P<0.05).The levels of TGF -β1 and Tim-3 in the control group were lower than those in all HBV groups (the mild HBV group the moderate HBV group the severe HBV group) (all P<0.05).HBsAg/HBV DNA ratio-was significantly negatively correlated to levels of TGF-β1 and Tim-3 in Patients with Hepatitis B (P<0.05).【Conclusion】The ratio of HBsAg/HBV DNA is negatively related to levels of both TGF-β1 and Tim-3 in patients with hepatitis B. 2023 Vol. 40 (2): 234-236 [Abstract] ( 42 ) HTML (1 KB)  PDF (1169 KB)  ( 53 ) 237 Perioperative Depression and Anxiety in Patients with Glioma and their Influencing Factors YAN Mei-lin, ZHAO Ru DOI: 10.3969/j.issn.1671-7171.2023.02.022 【Objective】To explore the status of depression and anxiety in patients with glioma during perioperative period and its influencing factors. 【Methods】 The clinical data of 104 patients with gliomas who received elective surgery from January 2016 to January 2018 were retrospectively analyzed,and the preoperative and postoperative related indicators were recorded. The preoperative indicators included tumor site,preoperative chemotherapy,level of serum vascular endothelial growth factor (VEGF) 3 days before surgery and the proposed surgical form. The postoperative indicators included pathological grade of gliomas,fatigue degree,and serum VEGF level the next day after surgery,Univariate analysis and multivariate regression were used to analyze the influencing factors of anxiety and depression in patients with glioma during perioperative period.【Results】 Single factor analysis showed that the scores of anxiety and depression of patients with different age,sex,course of disease,marital status,educational level,recurrence,tumor site,preoperative and postoperative serum VEGF level,surgical method,pathological grade of glioma,and postoperative fatigue were lower than those before surgery,and the differences were statistically significant (P<0.05). Multivariate regression analysis showed that the influencing factors of preoperative anxiety in patients with glioma were marriage and high grade of glioma(P<0.05). The influencing factors of preoperative depression were serum VEGF level ≥ 56 pg/mL and frontotemporal lobe (P<0.05). The influencing factors of postoperative anxiety were marriage and high grade of glioma(P<0.05). The influential factors of postoperative depression were women and high grade of glioma (P<0.05). 【Conclusion】 The influencing factors of anxiety and depression in patients with brain glioma during perioperative period are marriage,high grade of glioma,preoperative serum VEGF level ≥ 56 pg/mL,frontotemporal lobe and female. Clinical medical staff should pay attention to the patients with the above influencing factors. 2023 Vol. 40 (2): 237-240 [Abstract] ( 45 ) HTML (1 KB)  PDF (1141 KB)  ( 54 ) 241 Application of the Combination of Serum NT-proBNP and UA/Cr in Predicting the Incidence of AMI in UAP Patients WU Jing-jing, CHEN Run-xiang, LIAO Zhan-ling,et al DOI: 10.3969/j.issn.1671-7171.2023.02.023 【Objective】To investigate the relationship of serum amino-terminal precursor B-type brain natriuretic peptide (NT-proBNP) and uric acid (UA)/creatinine (Cr) with the severity of coronary heart disease in patients with unstable angina pectoris (UAP),and evaluate the predictive value of acute myocardial infarction (AMI) morbidity with NT-proBNP combined Cr measurement. 【Methods】A total of 127 UAP patients admitted to the hospital were selected as the research objects. The serum NT-proBNP and UA/Cr of patients with different severity of UAP were compared. Follow-up for 1 month,the occurrence of AMI in UAP patients was counted. Patients were divided into the occurrence group (23 cases) and the non-incident group (104 cases) according to whether AMI occurred or not. The clinical data of the patients in the occurrence group and the non-occurrence group were compared. Logistic multivariate regression was used to analyze the risk factors for AMI in UAP patients. The area under the curve (AUC) of receiver operating characteristic curve (ROC) was drawn to evaluate the predictive performance of serum NT-proBNP and UA/Cr on the occurrence of AMI in UAP patients. 【Results】Serum NT-proBNP and UA/Cr of UAP patients in the severe group were higher than those in the mild and moderate groups (P<0.05). The serum NT-proBNP and UA/Cr of UAP patients in the moderate group were higher than those in the mild group (P<0.05). The proportion of severe coronary heart disease,cardiac troponin I (cTnI),homocysteine,UA,serum NT-proBNP and UA/Cr in the AMI occurrence group were higher than those in the AMI non-occurrence group (P<0.05),while the left ventricular ejection fraction (LVEF) was lower in the non-occurrence group (P<0.05). Multivariate analysis showed that the disease was the disease severity,LVEF,cTnI ,NT-proBNP and UA/Cr were all risk factors for the occurrence of AMI in UAP patients (P<0.05). The results of ROC curve analysis showed that the sensitivity of serum NT-proBNP,UA/Cr alone and their combined detection to predict the occurrence of AMI in UAP patients was 69.57%,73.91% and 79.52%,respectively; And the specificity was 79.81%,74.04% and 98.08%,respectively. The AUC were 0.721,0.770 and 0.901,respectively. 【Conclusion】The serum NT-proBNP and UA/Cr of UAP patients are related to the severity of coronary heart disease and the incidence of AMI. The combination of NT-proBNP and UA/Cr of UAP detection has a higher predictive performance for the incidence of AMI in UAP patients. 2023 Vol. 40 (2): 241-244 [Abstract] ( 34 ) HTML (1 KB)  PDF (1144 KB)  ( 39 ) 245 Effects of Streptomycin Combined with Different Doses of Simethicone Oil on Visual Field Clarity and Anesthetic Dosage in Electronic Gastroscopy WU Xiao-pei, YU ZHi-hui, FANG Xiao-wen DOI: 10.3969/j.issn.1671-7171.2023.02.024 【Objective】To investigate the effects of different doses of silicone oil and streptomycin on the visual field clarity and anesthetic dosage in electronic gastroscopy. 【Methods】A total of 231 patients who underwent electronic gastroscopy in our hospital from August 2020 to August 2021 were prospectively selected. They were randomly divided into low dose group (200 mg of silicone oil),medium dose group (400 mg of silicone oil) and high dose group (600 mg of silicone oil),with 77 patients in each group. The patients in the three groups were compared in terms of gastroscope visual field clarity,excellent and good rate,anesthetic dosage,total time of gastroscope examination and adverse reaction rate during gastroscope examination (decreased blood oxygen saturation,slow heart rate,choking,vomiting,dizziness). The hemodynamic indexes [heart rate (HR),mean arterial pressure (MAP)] of the three groups of patients before administration (T0),immediately after induction administration (T1),at the time of endoscopy (T2),at the beginning of examination (T3) and at the end of the examination (T4)were measured. 【Results】There were significant differences in the excellent and good rate of visual field definition among the three groups:the high-dose group>medium-dose group>low-dose group; And the differences were statistically significant (P<0.05). The anesthesia dosage and total time of gastroscopy in the three groups were high-dose group<medium-dose group<low-dose group. The differences were significantly different (P<0.05). There was no significant difference in HR and MAP between the three groups at different time points (P>0.05). The incidence of adverse reactions among the three groups was statistically significant as the middle-dose group<low-dose group<high-dose group. 【Conclusion】Streptomyces protease (pronase) combined with 400 mg of silicone oil is more suitable for use in electronic gastroscopy,which can not only improve the visual field of electronic gastroscopy,but also reduce the adverse reactions of patients,which is worthy of clinical reference. 2023 Vol. 40 (2): 245-247 [Abstract] ( 53 ) HTML (1 KB)  PDF (1172 KB)  ( 101 ) 248 Effects of CSEA and General Anesthesia on Hemodynamic Parameters,Pain and Cognition in Elderly Patients undergoing Prostatectomy HAO Zhen, DUAN Hao DOI: 10.3969/j.issn.1671-7171.2023.02.025 【Objective】To investigate the effect of combined spinal-epidural anesthesia (CSEA) and general anesthesia on hemodynamic parameters,pain and cognition in elderly patients undergoing prostatectomy. 【Methods】A total of 128 elderly patients who underwent prostatectomy in our hospital were divided into the observation group of 52 cases and the control group of 76 cases according to different anesthesia methods. Both groups were treated with transurethral plasma electrosurgical surgery of the prostate,while the observation group was treated with CSEA anesthesia and the control group was treated with general anesthesia. The anesthesia effects of the two groups of patients were compared before anesthesia induction (T0),immediately after tracheal intubation (T1),10 minutes after surgery (T2),and 10 minutes after extubation (T3). So did hemodynamics [mean arterial pressure (MAP),heart rate (HR),blood oxygen saturation (SpO2) level] at those time points. The Montreal Cognitive Assessment Scale (MOCA) was used to compare the two groups of patients before and 1,3 and 7 days after surgery. On the 1st day after the operation,the pain visual analog scale (VAS) was used to compare the pain sensation of the two groups of patients. The incidence of adverse reactions between the two groups of patients was compared as well. 【Results】There was no significant difference in anesthesia effect between the two groups (P>0.05). There was no significant difference in the levels of MAP,HR and SpO2 between the observation group and the control group at T0; And the levels of MAP,HR and SpO2 in the observation group at T1,T2 and T3 were higher than those in the control group. Levels of MAP and HR at T1 in both observation group and control group were higher than those at T0,T2,and T3,while the level of SpO2 was lower than those at T0,T2,and T3 (P<0.05). The anesthesia time of the observation group was longer than that of the control group. The rate of severe pain in the observation group were lower than that in the control group; And the rates of mild pain and no pain were higher than those in the control group. The MOCA scores of the observation group at 1 and 3 days after operation were higher than those of the control group. The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05). 【Conclusion】Compared to general anesthesia,CSEA anesthesia has a significant analgesic effect in elderly patients undergoing prostatectomy,which provides stable hemodynamics,less impact of postoperative cognitive function,and reduced adverse reactions. 2023 Vol. 40 (2): 248-251 [Abstract] ( 32 ) HTML (1 KB)  PDF (1146 KB)  ( 51 ) 252 Risk Factors of Perigastric Lymph Node Metastasis in Patients over 60 Years Old with Early Gastric Cancer LUO Xiao-ling, WANG Shao-chuang, LI Miao-miao,et al DOI: 10.3969/j.issn.1671-7171.2023.02.026 【Objective】To investigate the risk factors of perigastric lymph node metastasis in patients over 60 years old with early gastric cancer. 【Methods】 The clinical data of 256 patients with early gastric cancer over 60 years old who underwent radical D2 lymphadenectomy for gastric cancer in our hospital from January 2011 to January 2021 were retrospectively analyzed. According to the results of pathological examination,the patients were divided into non-metastatic group and lymph node metastasis group,and the related risk factors of perigastric lymph node metastasis in patients with early gastric cancer over 60 years old were analyzed. 【Results】 A total of 256 cases of early gastric cancer over 60 years old were successfully treated with D2 lymphadenectomy,and 35 cases (13.7%) had perigastric lymph node metastasis. Univariate analysis showed that the proportion of tumor invasion depth to submucosa,tumor diameter ≥ 20 mm,low differentiation and vascular invasion in the lymph metastasis group was significantly higher than that in the non-metastasis group (P<0.05). Multivariate logistic regression analysis showed that vascular invasion and poor differentiation were independent risk factors for perigastric lymph node metastasis in patients with early gastric cancer after operation (P<0.05). 【Conclusion】 Vascular invasion and low differentiation are independent risk factors for perigastric lymph node metastasis in early gastric cancer patients over 60 years old. For early gastric cancer patients with high risk,radical resection should be considered. 2023 Vol. 40 (2): 252-254 [Abstract] ( 49 ) HTML (1 KB)  PDF (1117 KB)  ( 79 ) 255 Effect of Early Enteral Immune Microbial Nutrition Support on Nutritional Status and Th17/Treg Balance in Elderly Patients with Acute Attack of Chronic Heart Failure HAN Dan-ning, LI Yun-yao DOI: 10.3969/j.issn.1671-7171.2023.02.027 【Objective】To study the effect of early enteral immune microbial nutrition support (EEN) on nutritional status and Th17/Treg balance in elderly patients with acute attack of chronic heart failure (CHF). 【Methods】A total of 106 elderly patients with acute attack of CHF admitted to our hospital from August 2019 to August 2021 were selected as the research subjects. The patients were randomly divided into two groups with 53 cases in each group. The control group was given routine treatment,and the observation group was given EEN in addition to routine treatment. The curative effect,myocardial function indexes [left ventricular end systolic diameter (LVESD),left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD)],nutritional indexes [albumin (ALB),transferrin (TF),prealbumin (PAB)] and Immune response balance indicators [regulatory T cells (Treg),T helper cell 17 (Th17),Th17/Treg ratio] were measured and compared between the two groups. 【Results】The total clinical effective rate in the observation group was 92.45% (49/53),which was higher than that in the control group 77.36% (41/53) (P=0.03). After treatment,TF,ALB,PAB and LVEF in the observation group were higher than those in the control group (P<0.05). LVEDD and LVESD in the observation group were lower than those in the control group (P< 0.05).After treatment,the levels of Th17 and Th17/Treg in the observation group were lower than those before treatment,while the level of Treg was higher than that before treatment. The differences were statistically significant (P<0.05). 【Conclusion】Early enteral immune microbial nutrition support is effective in the treatment of acute attack of CHF in the elderly. It can improve malnutrition,repair cardiac function and correct immune imbalance. 2023 Vol. 40 (2): 255-257 [Abstract] ( 36 ) HTML (1 KB)  PDF (1170 KB)  ( 52 ) 258 To Analyze the Relationship between Neutrophil-lymphocyte Ratio and Urinary Albumin Excretion Rate in Diabetic Nephropathy Patients REN Li, WANG Xiao-yan DOI: 10.3969/j.issn.1671-7171.2023.02.028 【Objective】To investigate the relationship between neutrophil-lymphocyte ratio (NLR) and urinary albumin excretion rate (UAER) in diabetic nephropathy (DN) patients. 【Methods】The clinical data of 150 DN patients diagnosed in Department of Nephrology in two hospitals were retrospectively analyzed. Patients were divided into the high UAER group (UAER≥582.07 μg/min,n=76) and the low UAER group (UAER<582.07 μg/min,n=74) according to the level of UAER,thus the differences of NLR in two groups were analyzed. 【Results】Compared to the low UAER group,the level of NLR was significantly increased in the high UAER group [(2.51±0.84) % vs (1.76±0.65) %,P<0.01]. In addition,the levels of Cr,BUN in the high UAER group significantly increased,however,eGFR decreased significantly. UAER had a positive correlation with NLR (r=0.724,P<0.01),Scr (r=0.428,P=0.024) and BUN (r=0.502,P=0.037) ,while it was negatively correlated with eGFR (r=-0.364,P<0.01).Binary logistic regression analysis showed that high NLR was associated with high UAER in DN patients,whose odds ratio (OR)(95%CI) was 2.06 (1.93~4.59) (P<0.01). 【Conclusion】NLR was closely related to UAER in DN patients,and this might be used as an indicator to predict urinary albumin in patients with DN. 2023 Vol. 40 (2): 258-260 [Abstract] ( 39 ) HTML (1 KB)  PDF (1116 KB)  ( 38 ) 261 Summary of the Best Evidence for the Prevention of Hypoglycemia by Parenteral Nutrition after Gastrointestinal Malignancy ZHU Fei, ZHANG Can-zhi, DING Qiong,et al DOI: 10.3969/j.issn.1671-7171.2023.02.029 【Objective】To search and screen the relevant evidence-based methods for preventing hypoglycemia in patients with gastrointestinal malignant tumor undergoing parenteral nutrition after operation. 【Methods】 The US National Guide Library,Scottish Intercollegiate Guide Network,Joanna Briggs Institute (JBI) website,Cochrane Library,PubMed,Web of Science,International diabetes Alliance website,VIP,CNKI,Wanfang database,Yimaitong and Chinese biomedical literature database were searched in order to explore the relevant methods to prevent hypoglycemia during parenteral nutrition treatment after operation of gastrointestinal malignant tumor. These data include guidelines,clinical decision-making,evidence summary,systematic evaluation and expert consensus.The retrieval period was from August 2021 to December 2021. Two researchers independently evaluated the quality of the literature,and extracted and summarized relevant evidence at the same time.【Results】 A total of 11 documents were included,including 2 guidelines,6 expert consensus,1 evidence summary,and 2 RCT papers. A total of 16 evidences were summarized,including 8 aspects,including preoperative evaluation,insulin addition method,recommended dose,blood glucose control,establishment of blood glucose management team,blood glucose monitoring program,parenteral nutrition solution configuration,and perioperative diet guidance.【Conclusion】It is comprehensive to summarize the best method to prevent hypoglycemia in patients with gastrointestinal malignant tumor after operation by parenteral nutrition,which can provide evidence basis for reducing the incidence of hypoglycemia in patients with gastrointestinal malignant tumor after operation by parenteral nutrition. 2023 Vol. 40 (2): 261-264 [Abstract] ( 44 ) HTML (1 KB)  PDF (1137 KB)  ( 122 ) 265 Study of Cardiac Magnetic Resonance Tissue tracking Technology in Evaluating Left Ventricular Strain and its Diagnostic Value in Patients with Cardiac Amyloidosis RAN Chun-jie, ZHANG Chun DOI: 10.3969/j.issn.1671-7171.2023.02.030 【Objective】To evaluate the left ventricular strain in patients with cardiac amyloidosis (CA) by cardiac magnetic resonance tissue tracking (CMR-TT) and its diagnostic value. 【Methods】A total of 99 CA patients (observation group) admitted to our hospital from March 2017 to May 2020 were selected, and 68 healthy volunteers who underwent physical examination in the same period were selected as the control group. The cardiac function parameters [left ventricular end-diastolic volume index (LVEDVI), ventricular output index (SVI), myocardial mass index (MMI), left ventricular ejection fraction (LVEF)], and the left ventricular global strain parameters [radial strain (RS), longitudinal strain (LS), and circumferential strain (CS)] of the control group and the observation group were measured by CMR-TT, Pearson was used to analyze the correlation between left ventricular global strain parameters and left ventricular ejection fraction (LVEF). According to the size of LVEF measured by CMR-TT, patients in the observation group were divided into group A ( LVEF≥50%,n=57) and group B (LVEF<50%, n=42). The cardiac function parameters and left ventricular global strain parameters of CMR-TT were compared between group A and group B, and the working characteristic curve (ROC curve) of the subjects was drawn. The overall RS, CS The diagnostic value of LS to CA. 【Results】LVEDVI,SVI and MMI in the observation group were higher than those in the control group, and LVEF was lower than that in the control group, the difference was statistically significant (P<0.05). The overall RS, CS and LS of the left ventricle in the observation group were lower than those in the control group (P<0.05). Pearson analysis showed that the overall CS, LS, RS and LVEF were positively correlated (r=0.641, 0.685, 0.415, all P<0.05). The overall RS, CS and LS of patients in Group B were lower than those in Group A, while LVEDVI and MMI of patients in Group B were higher than those in Group A (P<0.05). The ROC curve analysis showed that the overall RS, CS and LS had certain diagnostic value for CA. The area under the curve (AUC) was 0.787, 0.778 and 0.746 respectively (P<0.05). 【Conclusion】 CMR-TT can evaluate the left ventricular strain characteristics of patients with CA, and the overall strain parameters RS, CS, LS have certain diagnostic value for CA. 2023 Vol. 40 (2): 265-267 [Abstract] ( 31 ) HTML (1 KB)  PDF (1200 KB)  ( 45 ) 268 Evaluation of the Difference of Abdominal Fat between Patients with Cirrhosis and Cirrhosis Complicated with HIV by CT Histogram Texture Parameters YANG Ning-jing, XIONG Ya-wei, LIAO Jia-jia,et al DOI: 10.3969/j.issn.1671-7171.2023.02.031 Guide::null 【Objective】 To explore the difference of CT histogram texture parameters in evaluating abdominal fat in patients with cirrhosis and cirrhosis complicated with HIV. 【Methods】From January 2010 to January 2012,patients with simple cirrhosis (cirrhosis group,n=44) and patients with cirrhosis complicated with HIV (combination group,n=33) confirmed by the First People's Hospital of Liangshan Yi Autonomous Prefecture,Sichuan Province were retrospectively analyzed. Both groups of patients underwent L3 plane abdominal CT examination. The abdominal fat area (TAA) of the CT image was measured with ImageJ software. At the same time,the texture parameters were analyzed by histogram,including Kurt,Skew,Feret diameter or fixed direction wire diameter (Feret),perimeter (Peri),mean pixel value (Mean),integral gray level (IntDen),area percentage (AF),and the differences between the two groups were compared. 【Results】 Peri,Kurt and AF in the cirrhosis group were higher than those in the combined group,while Feret,IntDen and TAA in the cirrhosis group were lower than those in the combined group,with a statistically significant difference (P<0.05). There was no significant difference between Skew and Mean in the two groups (P>0.05). 【Conclusion】 There is a difference in the distribution of abdominal fat between patients with simple cirrhosis and patients with cirrhosis complicated with HIV. The texture parameters of Image J can reflect this difference,and can be used as an auxiliary index for nutritional metabolism analysis of patients with cirrhosis and cirrhosis complicated with HIV. 2023 Vol. 40 (2): 268-271 [Abstract] ( 39 ) HTML (1 KB)  PDF (1664 KB)  ( 50 )

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