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Quick Search     Adv Search 2023 Vol. 40, No. 4 Published: 2023-04-26 Original Articles Reviewand Lecture          Original Articles 481 Related Factors Affecting Hematoma Clearance after Minimally Invasive Catheterization and Drainage in Patients with Hypertensive Intracerebral Hemorrhage WEI Wen-yuan, BIE Xiao-hua, HAN Chao DOI: 10.3969/j.issn.1671-7171.2023.04.001 【Objective】 To explore the relevant factors affecting hematoma clearance after minimally invasive catheterization and drainage surgery in patients with hypertensive cerebral hemorrhage. 【Methods】 A retrospective analysis was conducted on the clinical data of 100 patients with hypertensive cerebral hemorrhage treated with minimally invasive catheterization and drainage in our hospital from January 2016 to January 2022. They were divided into a complete clearance group (n=38) and an incomplete clearance group (n=62) based on their postoperative hematoma clearance. We collected the gender,age,hematoma location,hematoma morphology,original blood volume,surgical puncture location,preoperative Glasgow Coma Scale (GCS) score,injury mechanism,admission to surgery time,blood pressure,platelet count (PLT),and coagulation function indicators of the enrolled patients. ROC analysis of coagulation indicators is used to predict the value of incomplete clearance of hematoma. Logistic multivariate regression analysis was used to identify the risk factors for incomplete clearance of hematoma. 【Results】 In the complete clearance group,the proportion of patients over 60 years old,with irregular hematoma morphology,and a hospital to surgery time of<6 hours were lower than those in the incomplete clearance group. The levels of TT,PT,and APTT were all higher than those in the incomplete clearance group,with statistically significant differences (P<0.05). ROC curve analysis showed that serum TT,PT,and APTT levels can be used for predicting incomplete clearance of hematoma,with areas under the curve of 0.738,0.699,and 0.652,respectively (P<0.05). Logistic multiple factor regression analysis showed that age>60 years old,irregular hematoma morphology,time from admission to surgery<6 hours,TT<15.881 s,PT<9.789 s,APTT<38.477 s were risk factors for hematoma failure (P<0.05). 【Conclusion】 Age,hematoma morphology,time from admission to surgery,and changes in TT,PT,and APTT levels are related to the clearance of hematoma after minimally invasive catheter drainage surgery in patients with hypertensive cerebral hemorrhage,and are risk factors for incomplete clearance of hematoma. 2023 Vol. 40 (4): 481-484 [Abstract] ( 84 ) HTML (1 KB)  PDF (1201 KB)  ( 54 ) 485 Relationship of Oxidative Stress,BDNF,and IGF-1 Levels with Severity of Epilepsy CHEN Xiao-ni, TAN Hui-hui, YIN Yan-ling, et al DOI: 10.3969/j.issn.1671-7171.2023.04.002 【Objective】 To explore the relationship of the severity of epileptic seizures with the levels of oxidative stress,brain derived neurotrophic factor (BDNF),and insulin like growth factor (IGF-1). 【Methods】 According to the severity of seizures,198 patients with epilepsy admitted to our hospital were divided into the mild group of 71 cases,the moderate group of 74 cases,and the severe group of 53 cases. Meanwhile,68 healthy individuals who underwent physical examination at the same time in our hospital were selected as the control group. The general data and serum oxidative stress indicators (MDA,CAT,SOD,T-AOC),as well as serum BDNF and IGF-1 levels were measured and compared among the four groups. We analyzed the correlation between the levels of various indicators and the severity of epilepsy in patients with different grades of epilepsy to show the relationship of severity of epilepsy with serum levels of MDA,CAT,SOD,T-AOC,BDNF,IGF-1. 【Results】 The levels of serum CAT,SOD and T-AOC in patients with epilepsy of different grades were significantly lower than those in the control group,while the level of MDA was significantly higher than that in the control group. As the severity of the disease increased,the levels of CAT,SOD,and T-AOC showed a downward trend,while the level of MDA showed a increase trend (all P<0.05). Serum BDNF level in patients with epilepsy of different severities was significantly lower than that in the control group,while IGF-1 level was significantly higher than that in the control group. As the severity of the disease increased,BDNF tended to decrease,while IGF-1 tended to increase (all P<0.05). Pearson correlation analysis showed that levels of serum CAT,SOD,T-AOC,and BDNF were negatively correlated with the severity of the disease (P<0.05),while MDA and IGF-1 levels were positively correlated with the severity of the disease (P<0.05). BDNF level was negatively correlated with MDA level,while it was positively correlated with CAT,SOD,and T-AOC levels. The level of IGF-1 was positively correlated with MDA level,and it was negatively correlated with CAT,SOD,and T-AOC levels (P<0.05). 【Conclusion】 There are significant differences in the levels of oxidative stress,BDNF,IGF-1,and BDNF,IGF-1 in epileptic patients with different severity of illness. The disease severity is significant correlation to the levels of oxidative stress,BDNF and IGF-1 in epileptic patients. 2023 Vol. 40 (4): 485-488 [Abstract] ( 68 ) HTML (1 KB)  PDF (1134 KB)  ( 22 ) 489 Application Effect of a New Type of Movable Double Arm Hanger in Orthopedic Lower Limb Surgery for Obese Patients LIN Cui-fang, LI Jie-bin, GUO Li-rong DOI: 10.3969/j.issn.1671-7171.2023.04.003 【Objective】 To explore the application effect of a new type of movable double arm suspension in orthopedic lower limb surgery for obese patients. 【Methods】 A total of 386 obese patients who underwent lower limb surgery in our hospital from September 2019 to October 2020 were selected and divided into a control group (ordinary orthopedic disinfection hanger,n=116) and an observation group (movable double arm hanger,n=270) based on the use of disinfection hangers. We compared the general information of two groups of patients during surgery,the perception of fatigue caused by surgical procedures by the chief surgeon and instrument nurses,as well as the degree of postoperative pain and comfort between the two groups of patients. 【Results】 The number of intraoperative posture adjustments,surgical time,intraoperative blood loss,and postoperative healing time in the observation group were lower than those in the control group,with statistically significant differences (P<0.05). The physical and psychological fatigue scores of the chief surgeon and instrument nurse in the observation group were lower than those of the control group,and the difference was statistically significant (P<0.05). The postoperative pain and comfort levels of the observation group patients were significantly better than those of the control group patients,with a statistically significant difference (P<0.05). 【Conclusion】 Compared to ordinary orthopedic disinfection hangers,the use of new movable double arm hangers is more effective for obese patients undergoing orthopedic lower limb surgery. Patients recover faster after surgery,and the chief surgeon and instrument nurse have relatively less fatigue caused by the surgical operation. Patients have relatively low postoperative pain and comfort. 2023 Vol. 40 (4): 489-491 [Abstract] ( 38 ) HTML (1 KB)  PDF (1496 KB)  ( 100 ) 492 Correlation between HCV Load and Glucose Metabolism in Chronic Hepatitis C Patients with Type 2 Diabetes WANG Min, TAN Xin-yan, XU Jiao DOI: 10.3969/j.issn.1671-7171.2023.04.004 【Objective】 To investigate the correlation between hepatitis C virus (HCV) load and glucose metabolism in patients with chronic hepatitis C (CHC) and type 2 diabetes (T2DM). 【Methods】 From March 2019 to February 2021,98 patients with CHC and T2DM (combined group) and 76 patients with simple CHC (CHC group) admitted to our hospital were selected. In addition,80 healthy volunteers who underwent physical examination in our hospital were selected as the control group,and the clinical data and glucose metabolism indicators of the three groups were compared. The patients with CHC and T2DM were divided into four subgroups according to the different HCV loads:virus negative group,low viral load group,medium viral load group,and high disease load group. The levels of glucose metabolism indicators in CHC and T2DM patients with different HCV loads were compared; Pearson correlation was used to analyze the relationship between HCV load and glucose metabolism indicators in patients with CHC and T2DM. 【Results】 There were significant differences in body mass index (BMI),total cholesterol (TC),and low density lipoprotein cholesterol (LDL-C) levels among the three groups (P<0.05); The levels of BMI,TC,LDL-C in the combined group were higher than those in the CHC group and the control group (P<0.05). The levels of fasting blood glucose (FPG),2-hour postprandial blood glucose (2hPG),glycosylated hemoglobin (HbA1c),and fasting insulin (FINS) in the three groups were significantly different (P<0.05); The levels of FPG,2hPG,HbA1c,and FINS in the combined group were higher than those in the CHC group and the control group (P<0.05). The levels of FPG,2hPG,HbA1c,and FINS in patients with CHC and T2DM with different HCV loads were significantly different (P<0.05); The levels of FPG,2HPG,HbA1c,and FINS in the low viral load group,the medium viral load group,and the high viral load group were higher than those in the virus negative group (P<0.05); The levels of FPG,2hPG,HbA1c,and FINS in the high viral load group were higher than those in the low viral load group and the medium viral load group (P<0.05). In patients with CHC and T2DM,HCV load was not correlated with 2hPG and FINS levels (P>0.05),but was positively correlated with FPG and HbA1c levels (P<0.05). 【Conclusion】 Compared with CHC patients and healthy individuals,glucose metabolism in patients with CHC and T2DM is significantly abnormal,and there is a certain correlation between HCV load and FPG,HbA1c in patients with CHC and T2DM. 2023 Vol. 40 (4): 492-495 [Abstract] ( 32 ) HTML (1 KB)  PDF (1144 KB)  ( 57 ) 496 Effects of Jinhong Decoction on Intestinal Barrier Function in Rats Infected with Multidrug-resistant Pseudomonas Aeruginosa XIANG Lin, WANG Sheng-hui DOI: 10.3969/j.issn.1671-7171.2023.04.005 【objective】 To explore the effect of Jinhong Decoction on intestinal barrier function in rats infected with multidrug-resistant Pseudomonas aeruginosa (MDRPA). 【Method】 A total of 10 rats were randomly selected from 65 rats and given only 0.5 mL of physiological saline by gavage as the normal group; The remaining 55 rats were used to establish a model of intestinal MDRPA infection,and 50 rats were successfully modeled. They were randomly divided into model group,low dose group of Jinhong Decoction,medium dose group of Jinhong Decoction,high dose group of Jinhong Decoction,and piperacillin sodium tazobactam sodium (TZP) group,with 10 rats in each group. The low,medium,and high dose groups of Jinhong Decoction were gavaged with crude drug doses of 3.2 g/kg,6.3 g/kg,and 12.6 g/kg of Jinhong Decoction concentrated solution,while the TZP group was gavaged with TZP 70 mg/kg,with a dose volume of 10 mL/kg for each group,Continuously intervened for 2 weeks; The normal group and model group were given equal volume of physiological saline by gavage. The expression levels of intestinal barrier function,bacterial count of ileal contents,Toll like receptor 4 (TLR4) in colon tissue,myeloid differentiation factor 88 (MyD88),nuclear transcription factor κB p65(NF-κB p65)and p-NF-κB p65 protein of each group were compared. 【Results】 Compared with the normal group,the model group showed elevated levels of serum diamine oxidase (DAO),endotoxin (ET),and bacterial count in ileal contents (P<0.01); Compared with the model group,the levels of serum DAO and ET,as well as the bacterial count of ileal contents in the TZP group and each dose group of Jinhong Decoction decreased (P<0.05),and there was a dose-effect relationship between each dose group of Jinhong Decoction. Compared with the normal group,the expression levels of TLR4 and MyD88 proteins and p-NF-κB p65/NF-κB p65 in the model group increased (P<0.01); Compared with the model group,the expression levels of TLR4 and MyD88 proteins and p-NF-κB p65/NF-κB p65 in the TZP group and Jinhong Decoction at different doses decreased (P<0.05),and there was a dose-effect relationship between each dose group of Jinhong Decoction.【Conclusion】 Jinhong Decoction can improve the intestinal barrier function and reduce the bacterial count in the ileum of MDRPA infected rats,which may play a role by inhibiting the TLR4/MyD88 signaling pathway. 2023 Vol. 40 (4): 496-499 [Abstract] ( 27 ) HTML (1 KB)  PDF (1547 KB)  ( 33 ) 500 Clinical Efficacy of Terbutaline Aerosol Inhalation combined with Invasive-noninvasive Sequential Mechanical Ventilation in the Treatment of Severe Asthma Complicated with Respiratory Failure XIE Bo, LI Ning DOI: 10.3969/j.issn.1671-7171.2023.04.006 【Objective】 To investigate the clinical effect of terbutaline aerosol inhalation combined with invasive-noninvasive sequential mechanical ventilation (ENMV) in the treatment of severe asthma with respiratory failure. 【Methods】 A total of 106 patients with severe asthma complicated with respiratory failure admitted to the Department of Respiratory Medicine of our hospital from January 2019 to January 2022 were selected and divided into the observation group and the control group according to the random number table method,with 53 cases in each group. The control group was treated with ENMV,and the observation group was treated with terbutaline aerosol inhalation on the basis of the control group. We compared the clinical efficacy,length of stay in intensive care unit (ICU),tracheal intubation rate,incidence of ventilator-associated pneumonia (VAP),as well as lung function indicators,blood gas indicators,and inflammatory factor levels before and after treatment between two groups of patients. 【Results】 The total effective rate of the observation group was 88.68%,significantly higher than the control group's 73.58%,with a statistically significant difference (P<0.05). After treatment,the percentage of forced vital capacity in the first second (FEV1%),the ratio of forced expiratory volume in the first second (FEV1) to forced vital capacity (FEV1/FVC),and the maximum expiratory peak flow rate (PEF) in the observation group were significantly higher than those before treatment,and higher than those in the control group. After treatment,the arterial partial pressure of oxygen (PaO2) and oxygen saturation (SpO2) in the observation group were significantly higher than those before treatment,and higher than those in the control group; The level of arterial blood partial pressure of carbon dioxide (PaCO2) was significantly lower than that before treatment,and also lower than that of the control group. After treatment,the tumor necrosis factor (TNF-α),the levels of inflammatory factors such as interleukin-17 (IL-17),interleukin-18 (IL-18),and C-reactive protein (CRP) in the observation group were significantly lower than those before treatment,and even lower than those in the control group. The length of ICU hospitalization in the observation group was significantly shorter than that in the control group (P<0.05),and the tracheal intubation rate was significantly lower than that in the control group (P<0.05); There was no statistically significant difference in the incidence of VAP between the two groups of patients (P>0.05). 【Conclusion】 Terbutaline atomization inhalation combined with ENMV has a significant clinical effect in the treatment of severe asthma with respiratory failure,which can effectively improve the lung function and blood gas indicators of patients,reduce inflammatory reaction,and is worthy of clinical application. 2023 Vol. 40 (4): 500-503 [Abstract] ( 38 ) HTML (1 KB)  PDF (1198 KB)  ( 68 ) 504 Relationship between ciRs-126 and Acute Kidney Injury in Patients with Sepsis QI Heng, GAO Jing DOI: 10.3969/j.issn.1671-7171.2023.04.007 【Objective】 To investigate the correlation between ciRs-126 and acute kidney injury(AKI) in patients with sepsis. 【Methods】 Eighty patients with sepsis admitted to our hospital were divided into two groups according to the degree of renal injury:AKI group (30 cases) and non-AKI group (50 cases). General information,disease score and ciRs-126 levels of the two groups were compared. 【Results】 There were no differences in age,sex,body mass index (BMI),underlying complications,smoking history and drinking history between the two groups (P>0.05). There were no differences in tumor necrosis factor-α (TNF-α),hypersensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) levels between the two groups (P>0.05). Serum creatinine (Scr) and serum urea nitrogen (BUN) levels in the AKI group were higher than that in the non-AKI group,while the glomerular filtration rate (eGFR) level in the AKI group was lower than that in non-AKI group (P<0.05). The sequential organ failure score (SOFA) and acute physiological and chronic health score (APACHE Ⅱ) in the group with AKI were higher than those in the group without AKI (P<0.05). The level of ciRs-126 in the group with AKI was higher than that in the group without AKI (P<0.05). ROC analysis showed that Scr,eGFR,SOFA,APACHE Ⅱ and ciRs-126 could be used to predict occurrence of AKI after sepsis,and the areas under the curve were 0.725,0.800,0.687,0.751 and 0.785,respectively,(P<0.05). Multivariate Logistic regression analysis confirmed that Scr≥156.70 μmol/L,eGFR≤84.58 mL/min,SOFA≥13.24 scores,APACHE Ⅱ≥29.26 scores,ciRs-126≥3.76 were risk factors for AKI after sepsis(P<0.05).【Conclusion】 The increase of ciRs-126 level can predict the occurrence of AKI in patients with sepsis. It is necessary to strengthen the monitoring of this index. 2023 Vol. 40 (4): 504-507 [Abstract] ( 32 ) HTML (1 KB)  PDF (1229 KB)  ( 39 ) 508 Factors Affecting Myasthenia Gravis Crisis after Thymectomy in Children with Myasthenia Gravis ZHANG Si-si, WANG Jun, ZHANG Kun DOI: 10.3969/j.issn.1671-7171.2023.04.008 【Objective】 To explore the influencing factors of myasthenia gravis crisis (POMC) after thymectomy in children with myasthenia gravis (MG). 【Methods】 A total of 78 children with MG who underwent thymectomy were admitted to our hospital,of which 28 had POMC (POMC group) and 50 did not(the non POMC group). The influencing factors of POMC after thymectomy in MG patients were analyzed. 【Results】 Univariate analysis showed that the duration of MG in the POMC group and the non POMC group was (34.0 ± 4.8) months and (11.0 ± 1.4) months,respectively,with a statistically significant difference between the two groups (P<0.05); In the POMC group,there were 2 cases (7.1%),21 cases (75.0%),4 cases (14.3%),and 1 case (3.6%) of modified Osserman classification Ⅱa,Ⅱb,Ⅲ,and Ⅳ,respectively. In the non POMC group,there were 15 cases (30.0%),32 cases (64.0%),3 cases (6.0%),and 0 cases,respectively,with statistically significant differences (P<0.05); In the POMC group,18 cases (64.3%) underwent video-assisted thoracoscopic surgery and 10 cases (35.7%) underwent traditional open surgery,respectively. There was a statistically significant difference compared to 45 cases (90.0%) and 5 cases (10.0%) in the non POMC group (P<0.05); There were 13 cases (46.4%) and 0 cases of postoperative pneumonia in the POMC group and the non POMC group,respectively,with a statistically significant difference between the two groups (P<0.05). The statistically significant factors in univariate analysis were used as independent variables,and the occurrence of POMC in MG patients was included as the dependent variable in logistic regression analysis. The results suggest that the course of MG and postoperative pneumonia are independent risk factors for POMC in MG patients (P<0.05),while the surgical method (video-assisted thoracoscopic surgery) is a protective factor (P<0.05). 【Conclusion】 The occurrence of POMC in pediatric MG patients after thymectomy is closely related to the course of preoperative MG and postoperative pneumonia; Compared to traditional open surgery,video-assisted thoracoscopic surgery can significantly avoid the occurrence of POMC and is worthy of clinical promotion. 2023 Vol. 40 (4): 508-510 [Abstract] ( 30 ) HTML (1 KB)  PDF (1178 KB)  ( 31 ) 511 Correlation of Erythrocyte Sedimentation Rate,CRP and Fecal WBC with Small Intestinal Bacterial Overgrowth in Patients with Ulcerative Colitis DU Xin, YANG Yong-jun, WU Zhen-wei DOI: 10.3969/j.issn.1671-7171.2023.04.009 【Objective】 To investigate the relationship of erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) and fecal white blood cell count (WBC) with small intestinal bacterial overgrowth (SIBO) in patients with ulcerative colitis (UC) for evaluating the value of disease staging prediction. 【Methods】 A total of 154 patients with UC from June 2019 to August 2021 in our hospital were selected as the research subjects. Patients were divided into the remission group,the mild activity group,the moderate activity group,and the severe activity group according to the Southerland Disease Activity Index (DAI). The incidence of SIBO was determined by lactulose hydrogen breath test (LHBT). The erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),fecal white blood cell count (WBC) and intestinal mucosal barrier function indexes [diamine oxidase (DAO ) bacterial endotoxin (LPS),D-lactic acid] levels were measured. The correlation of ESR,CRP,fecal white blood cell count with DAI score,SIBO status and intestinal barrier function at admission was analyzed. 【Results】 The comparison of ESR,CRP,fecal white blood cell count,and DAI scores at admission among the four groups showed the order of the severe activity group>the moderate activity group > the light activity group > the remission group,which were statistically significant difference (P<0.05). The comparison of DAO and LPS among the four groups of patients at admission showed that the severe activity group>the moderate activity group>the mild activity group>the remission group,with a statistically significant difference (P<0.05). There was no statistically significant difference in D-lactate levels among the four groups of patients at admission (P>0.05). The levels of ESR,CRP,and fecal white blood cell count in the SIBO positive groups were higher than those in the SIBO negative groups at admission,with statistical significance (P<0.05). ESR,CRP,fecal white blood cell count at admission were positively correlated with SDAI score,LPS,DAO,and SIBO (P<0.05). 【Conclusion】 The levels of ESR,CRP,and fecal white blood cell count are significantly correlated with the stage of UC patients and the occurrence of SIBO,which can assist in early clinical diagnosis of SIBO and provide reference for evaluating disease stage. 2023 Vol. 40 (4): 511-514 [Abstract] ( 27 ) HTML (1 KB)  PDF (1138 KB)  ( 56 ) 515 Application of TESSYS Technique under Percutaneous Foraminal Endoscopy in the Treatment of Senile Lumbar Disc Herniation and its Effects on MRI Indexes and Life Quality LI Long, GUO Yi-fan DOI: 10.3969/j.issn.1671-7171.2023.04.010 【Objective】 To evaluate the clinical effect of percutaneous foraminal endoscopic transforaminal endoscopic spine system (TESSYS) in the treatment of senile lumbar intervertebral disc and its effect on MRI indexes and life quality. 【Methods】 A total of 98 elderly patients with lumbar disc herniation treated in our hospital from March 2018 to February 2021 were randomly divided into control group and the observation group,with 49 cases in each group. The patients in the control group were treated with traditional laminectomy,while the patients in the observation group were treated with TESSYS technique under percutaneous foraminal endoscopy. The operation indexes (operation time,incision length,intraoperative bleeding,postoperative bed rest and hospitalization time),postoperative complications,and levels of serum endothelin (ET),cortisol (Cor),angiotensin Ⅱ (Ang Ⅱ) and norepinephrine (NE) levels before and after operation were compared between the two groups. The lumbar function,pain and life quality were evaluated by Oswestry dysfunction index (ODI),VAS and WHOQOL-BREF before and 6 months after operation. The cross-sectional area of spinal canal,the area of intervertebral foramen and the midsagittal diameter of intervertebral foramen were measured by MRI. The clinical efficacy was evaluated by modified Mac Nab standard in 6 months after operation. 【Results】 The operation time,incision length,intraoperative bleeding,postoperative bed rest and hospital stay in the observation group were significantly shorter than or less than those in the control group (P<0.05). Six months after surgery,the VAS and ODI scores in the two groups were significantly lower than those before operation (P<0.05). The VAS and ODI scores of the observation group were significantly lower than those of the control group (P<0.05).The scores of WHOQOL-BREF in the observation group at 6 months after operation were significantly higher than that in the control group (P<0.05).There were no significant differences in the cross-sectional area of spinal canal,the area of intervertebral foramen and the sagittal diameter of the middle part of intervertebral foramen between the two groups before and after operation (P>0.05). The excellent and good rates of Mac Nab standard grading in the observation group and the control group were 93.88% and 91.84%,respectively; the difference was not statistically significant (P>0.05). There were no significant complications in both groups (P>0.05). 【Conclusion】 The effect of percutaneous foraminal endoscopic TESSYS in the treatment of senile lumbar disc herniation is positive. It can significantly improve MRI performance and quality of life. It has the advantages of less trauma and rapid postoperative recovery. 2023 Vol. 40 (4): 515-518 [Abstract] ( 38 ) HTML (1 KB)  PDF (1197 KB)  ( 73 ) 519 Quantitative Detection of Left Ventricular Function by Magnetic Resonance Imaging in Patients with Dilated Cardiomyopathy and its Correlation with NYHA Classification ZHANG Xue-ping, WANG Jun DOI: 10.3969/j.issn.1671-7171.2023.04.011 【Objective】 To investigate the correlation between quantitative detection of left ventricular function by magnetic resonance imaging (MRI) in patients with dilated cardiomyopathy and the New York Heart Association (NYHA) classification. 【Methods】 A total of 98 patients with dilated cardiomyopathy admitted to Xingyuan Hospital of Yulin from May 2018 to May 2020 (observation group) were selected and divided into Grade Ⅰ to Grade Ⅱ groups (n=22 cases),Grade Ⅲ group (n=42 cases),and Grade Ⅳ group (n=34 cases) according to NYHA classification. In addition,92 healthy individuals (control group) who came to Xingyuan Hospital of Yulin for physical examination during the same period were selected. Magnetic resonance imaging was used to quantitatively detect left ventricular function,including left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),and left ventricular ejection fraction (LVEF). The ventricular function indexes of patients with dilated cardiomyopathy and healthy subjects were compared,and the ventricular function indexes of patients with different NYHA grades of dilated cardiomyopathy were compared. Spearman correlation analysis was used to analyze LVEDV,LVESV The relationship between LVEF and NYHA grading. During a one-year follow-up period,the ventricular function indicators of patients with different prognosis were compared,and the value of LVEDV,LVESV,and LVEF in predicting death in patients with dilated cardiomyopathy was analyzed using subject working curve (ROC). 【Results】 LVEDV and LVESV in the observation group were higher than those in the control group (P<0.05),while LVEF was lower than that in the control group (P<0.05). The LVEDV and LVESV of patients in the Grade Ⅳ group were higher than those in the Grade Ⅰ~Ⅱ groups and the Grade Ⅲ group (P<0.05),while the LVEDV and LVESV of patients in the Grade Ⅲ group were higher than those in the Grade Ⅰ~Ⅱ groups (P<0.05); the LVEF of patients in grade Ⅳ group was lower than that in the Grade Ⅰ~Ⅱ groups and the Grade Ⅲ group (P<0.05),while the LVEF of patients in the Grade Ⅲ group was lower than that in the Grade Ⅰ~Ⅱ groups (P<0.05). Spearman correlation analysis showed that there was a positive correlation between LVEDV,LVESV,and NYHA grading in patients with dilated cardiomyopathy (P<0.05),while there was a negative correlation between LVEF and NYHA grading (P<0.05). The LVEDV and LVESV of the dead patients were higher than those of the surviving patients (P<0.05),and the LVEF was lower than those of the surviving patients (P<0.05). ROC curve analysis showed that the best cutoff points for predicting death in patients with dilated cardiomyopathy were 234.11 mL,179.15 mL,and 25.53% for LVEDV,LVESV,and LVEF,respectively. The area under the curve (AUC) was 0.803,0933,and 0.897,respectively. 【Conclusion】 LVEDV,LVESV,and LVEF in patients with dilated cardiomyopathy are abnormally elevated,while LVEF is abnormally decreased. LVEDV,LVESV,and LVEF are all related to NYHA classification in patients with dilated cardiomyopathy. Quantitative detection of left ventricular function using magnetic resonance imaging can be used as a sensitive indicator for evaluating the prognosis of patients. 2023 Vol. 40 (4): 519-522 [Abstract] ( 23 ) HTML (1 KB)  PDF (1163 KB)  ( 42 ) 523 Expression and Clinical Significance of MTA2 and FGFRL1 Protein in Patients with Cervical Squamous Cell Carcinoma LIU Ni, WANG Li-juan DOI: 10.3969/j.issn.1671-7171.2023.04.012 【Objective】 To explore the expression and clinical significance of metastasis-associated protein 2 (MTA2) and fibroblast growth factor receptor-like protein 1 (FGFRL1) in patients with cervical squamous cell carcinoma. 【Methods】 A total of 85 patients with cervical squamous cell carcinoma admitted to the hospital from February 2019 to February 2020 were selected and the cancer tissue and corresponding paracancerous tissue specimens from those cases were collected. The immunohistochemical method was used to detect the expression levels of MTA2 and FGFRL1,and their integrated optical density (IOD) was determined by computer image analysis technology. The expression levels of MTA2 and FGFRL1 in cancer tissues and adjacent tissues were compared. Deaths of patients with cervical squamous cell carcinoma were counted with 2-year follow-up,while the clinical characteristics of the dead and the surviving patients were compared. Logistic regression was used to analyze the factors affecting the death of patients with cervical squamous cell carcinoma,the receiver operating curve (ROC) was used to analyze the value of MTA2 and FGFRL1 expression levels in predicting the death of patients with cervical squamous cell carcinoma. 【Results】 The IOD values of both MTA2 and FGFRL1 in cancer tissues were higher than those in adjacent tissues (P<0.05). Comparing to the surviving patients,the composition ratio of lymph node metastasis,tumor differentiation degree,and both MTA2 IOD value and FGFRL1 IOD value of dead patients were significantly different (P<0.05). Logistic multivariate regression analysis showed that lymph node metastasis,MTA2 IOD value,FGFRL1 IOD value were independent risk factors affecting the death of cervical squamous cell carcinoma patients (P<0.05). ROC analysis showed that the best cut-off points for cancer tissue MTA2 and FGFRL1 IOD values to predict death of cervical squamous cell carcinoma patients were 0.63 and 9.88,respectively,whose the sensitivity were 78.12% and 75.00%,the specificity were 78.43% and 80.39%. The area under the curve (AUC) were 0.706 and 0.767,respectively,and the specificity and AUC of the combination of the two were 96.08% and 0.831,respectively. 【Conclusion】 The IOD values of both MTA2 and FGFRL1 in cervical squamous cell carcinoma are abnormally increased. MTA2 and FGFRL1 of cancer tissues are independent risk factors that affect the death of patients. Clinical detection of MTA2 and FGFRL1 IOD values in cancer tissues of patients with cervical squamous cell carcinoma can be used as sensitive indicators to predict patient death. 2023 Vol. 40 (4): 523-526 [Abstract] ( 31 ) HTML (1 KB)  PDF (1168 KB)  ( 19 ) 527 Effects of Traditional Chinese Medicine Acupuncture Combined with Western Medicine on Nerve Injury Factors in Patients with Post-stroke Complicated with Vascular Cognitive Impairment CHEN Bin, CHEN Si-wen DOI: 10.3969/j.issn.1671-7171.2023.04.013 【Objective】 To explore the effect of acupuncture and moxibustion combined with Western medicine on nerve damage factors in patients with vascular cognitive dysfunction (VCI) after stroke.【Methods】 A total of 96 patients with VCI were randomly divided into the control group and the observation group. Patients in the control group received cognitive function training and conventional drug therapy. While patients in the observation group was additionally treated with traditional Chinese medicine acupuncture. Traditional Chinese medicine syndrome score,Speech fluency test (VFT) score,clock drawing test (CDT) score,National Institute of Health Stroke Scale (NIHSS) score,Montreal Cognitive Assessment Scale (MoCA) score,and activities of daily living (ADL) score were compared between the two groups before and after treatment. The levels of β-amyloid protein 1-42 (Aβ1-42) matrix metalloproteinase-9 (MMP-9),homocysteine (Hcy),high-sensitivity C-reactive protein (hs-CRP),insulin-like growth factor-1 (IGF-1),and Tau protein were compared in the two groups as well. The total effective rate and adverse reactions were also compared between the two groups.【Results】 The total effective rate of the observation group was 95.83% (46/48),which was better than that of the control group [83.33% (40/48)]. The difference was statistically significant (P<0.05). After treatment,TCM syndrome score,NIHSS score,MMP-9,Hcy,hs-CRP and Tau protein decreased significantly in both groups,while the levels of Aβ1-42 and IGF-1,VFT score,CDT score,MoCA score and ADL score increased significantly if compared with before treatment. The improvement of above scores and cytokines in the observation group were better than those in the control group (P<0.05).【Conclusion】 Traditional Chinese acupuncture combined with Western medicine in the treatment of VCI after stroke can improve cognitive function,language ability and life ability by adjusting related factors. 2023 Vol. 40 (4): 527-530 [Abstract] ( 34 ) HTML (1 KB)  PDF (1195 KB)  ( 102 ) 531 Application Effect of Preoperative Dexmedetomidine Injection in Pediatric Inguinal Hernia Surgery XIANG Zhen, WEI Si-wei, YU Er-you, et al DOI: 10.3969/j.issn.1671-7171.2023.04.014 【Objective】 To explore the feasibility and safety of preoperative medication of dexmedetomidine in children undergoing high ligation of inguinal hernia sac. 【Methods】 A total of 90 children with indirect inguinal hernia who underwent high ligation of inguinal hernia sac in our hospital from July 2020 to August 2021 were selected and randomly divided into an observation group and a control group,with 45 cases in each group. Both groups were treated with intravenous inhalation combined with general anesthesia. The observation group was treated with dexmedetomidine before surgery,while the control group received intravenous infusion of physiological saline before anesthesia induction. The incidence of preoperative anxiety,intraoperative hemodynamic changes,postoperative pain,and postoperative adverse reactions in both groups of children were observed. 【Results】 The SBP and DBP of the observation group were lower than those of the control group at 5 minutes after entering the operating room (T1),5 minutes after inserting the laryngeal mask (T2),5 minutes after starting the surgery (T3),5 minutes after removing the laryngeal mask (T4),and 5 minutes after entering the anesthesia recovery room (T5),with statistically significant differences (P<0.05). The T1,T2,T3,T4,T5,and HR of the observation group were lower than those of the control group when leaving the recovery room,and the difference was statistically significant (P<0.05). The m-YPAS scores of patients in the observation group were lower than those in the control group during admission to the operating room,anesthesia induction,and 24 hours after surgery,with a statistically significant difference (P<0.05). The pain scores of the observation group at 1 day and 2 days after surgery were lower than those of the control group,and the difference was statistically significant (P<0.05); The Ramsay score of the observation group was lower than that of the control group,and the difference was statistically significant (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups of children (P>0.05). 【Conclusion】 Preinjection of dexmedetomidine before surgery should be used for high ligation of inguinal hernia sac,which can alleviate perioperative anxiety,alleviate postoperative pain,reduce the incidence of postoperative restlessness,and have no obvious adverse reactions. 2023 Vol. 40 (4): 531-534 [Abstract] ( 24 ) HTML (1 KB)  PDF (1141 KB)  ( 33 ) 535 Predictive Value of Cardiac Ultrasound Parameters and LUS on the Outcome of Mechanical Ventilation withdrawal in Patients with AECOPD and Respiratory Failure CHANG Kai-yue, LI Jun-she DOI: 10.3969/j.issn.1671-7171.2023.04.015 【Objective】 To explore the predictive value of cardiac ultrasound parameters and lung ultrasound score (LUS) on the outcome of mechanical ventilation withdrawal in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and respiratory failure. 【Methods】 A total of 125 patients with AECOPD and respiratory failure admitted to the Second Hospital of Yulin City from May 2018 to March 2021 were selected,and the outcome of mechanical ventilation withdrawal was statistically analyzed for all patients. Logistic multivariate regression analysis was used to analyze the influencing factors of mechanical ventilation withdrawal outcome for AECOPD and respiratory failure patients; The predictive value of cardiac ultrasound parameters and LUS on the outcome of mechanical ventilation withdrawal in AECOPD patients with respiratory failure was evaluated using the area under the subject operating characteristic (ROC) curve (AUC). 【Results】 Of the 125 patients with AECOPD and respiratory failure,24 failed to wean,while the remaining 101 were successfully weaned. Logistic multivariate analysis showed that shallow rapid respiratory index (RSBI),LUS,and early diastolic left atrioventricular valve flow velocity (V1)/early diastolic left atrioventricular annular motion velocity (V3) were independent factors affecting the outcome of mechanical ventilation withdrawal in AECOPD patients with respiratory failure (OR:3.673,4.450,3.442,95%CI:1.511-8.927,1.831-10.816,1.416-8.365,P<0.05). The results of ROC curve analysis showed that the AUC of LUS,V1/V3,and their combination in predicting the outcome of mechanical ventilation withdrawal in AECOPD patients with respiratory failure were 0.776,0.782,and 0.882,respectively. 【Conclusion】 Patients with AECOPD and respiratory failure have a higher risk of mechanical ventilation withdrawal failure. Cardiac ultrasound parameters V1/V3 and LUS are related to the outcome of mechanical ventilation withdrawal,and the combination of the two is more effective in predicting the outcome of mechanical ventilation withdrawal. 2023 Vol. 40 (4): 535-538 [Abstract] ( 31 ) HTML (1 KB)  PDF (1220 KB)  ( 51 ) 539 Analysis of Clinicopathological Characteristics of Adrenocortical Carcinoma and Prognostic Factors in Patients with Recurrence after Resection and Reoperation WANG Yan-jun, WU Li-feng DOI: 10.3969/j.issn.1671-7171.2023.04.016 【Objective】 To explore the clinicopathological characteristics of adrenocortical carcinoma (ACC) and factors affecting the prognosis of patients with recurrence after resection and reoperation. 【Methods】 A total of 61 patients who had recurrence after ACC resection and reoperation were followed up for 2 years. The pathological characteristics of ACC were recorded,the factors affecting the prognosis of patients with recurrence after ACC resection and reoperation were analyzed,and the Kaplan-Meier survival curve was used to calculate the survival status. 【Results】 Under the microscope,the cancer tissues were mostly arranged in nests,flakes,and strips. Pathological diagnosis showed that 2 cases had mucinous ACC,26 cases had high-grade nuclei,25 cases had pathological mitotic figures,30 cases had mitotic figures> 5,43 cases showed diffuse structure,39 cases had clear cells <25%,41 cases had vascular invasion,and 43 cases had envelope violation. Cox regression analysis showed pathological grade,ENSAT stage,lactate dehydrogenase(LDH) were independent factors affecting the overall survival rate of patients with recurrence and reoperation after ACC (P<0.05). By the end of follow-up,6 cases were lost to follow-up. Five of the 21 patients with poorly differentiated ACC who underwent recurrence and reoperation survived,20 of the 34 patients with moderately and well differentiated ACC who had recurrence and reoperation survived. The overall survival curve of patients with moderately and well differentiated ACC with recurrence and reoperation after operation was better than that of poorly differentiated patients (P<0.05). Of the 23 patients with stage Ⅲ ACC recurrence and reoperation,15 survived.Among the 32 cases patients with stage Ⅳ ACC recurrence and reoperation,10 cases survived.The overall survival curve of patients with stage Ⅲ ACC recurrence and reoperation was better than that of stage Ⅳ patients (P<0.05). Of the 26 patients with high LDH ACC recurrence and reoperation,8survived. Among the 29 patients with low LDH ACC recurrence reoperation after surgery,17 survived. The overall survival curve of patients with low LDH and recurrence after ACC reoperation was better than that of patients with high LDH (P<0.05). 【Conclusion】 The prognosis of patients with recurrence after ACC resection and reoperation is poor. The immunophenotype is helpful for pathological diagnosis. Patients with low degree of tumor differentiation,late stage,and high LDH have a high risk of poor prognosis. 2023 Vol. 40 (4): 539-542 [Abstract] ( 36 ) HTML (1 KB)  PDF (1250 KB)  ( 28 ) 543 Effect of Sanqi Tongshu Capsule Combined with rt-PA Intravenous Thrombolysis on IGF-1 and MMP-9 Levels in Patients with Acute Ischemic Stroke ZHAO Shu-ping, WANG Xue-ling, WANG Wen-hui DOI: 10.3969/j.issn.1671-7171.2023.04.017 【Objective】 To explore the effect of Sanqi Tongshu capsule combined with recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis on the levels of insulin-like growth factor-1 (IGF-1) and matrix metalloproteinase-9 (MMP-9) in patients with acute ischemic stroke (AIS). 【Methods】 A total of 240 patients with AIS admitted to our hospital were randomly divided into two groups,with 120 cases in each group. The control group was treated with rt-PA intravenous thrombolysis,while the observation group was treated with Sanqi Tongshu capsule combined with rt-PA intravenous thrombolysis. The treatment in the two groups lasted for 4 weeks. The curative effect,adverse reactions and the levels of Barthel index (BI),neurological function score (NIHSS),balance function score (BBS),TCM symptom score,IGF-1,MMP-9,calcitonin gene-related peptide (CGRP) of the two groups were compared before and after treatment. 【Results】 After treatment,the serum NIHSS of patients in the observation group was significantly lower than that before treatment in the observation group and after treatment in the control group,and the scores of BBS and BI were significantly higher than those before treatment of the observation group and after treatment in of the control group (P<0.05). The total effective rate of treatment in the observation group was 95.00%,which was significantly higher than 87.50% in the control group (P<0.05). After treatment,the scores of hemiplegia,mouth and eye deviation,and speech impairment in the observation group were lower than those before treatment in the observation group and after treatment in the control group (P<0.05). The levels of serum MMP-9 and CGRP of the observation group after treatment were significantly lower than those of the observation group before treatment and of the control group after treatment,while the level of IGF-1 was significantly higher than that of the observation group before treatment and of the control group after treatment(P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】 Sanqi Tongshu capsule combined with rt-PA intravenous thrombolytic therapy for AIS can increase the clinical efficacy,regulate the serum levels of MMP-9,IGF-1 and CGRP,improve the recovery of nerve function,enhance the ability of daily living and balance,while not increase adverse drug reactions. 2023 Vol. 40 (4): 543-546 [Abstract] ( 41 ) HTML (1 KB)  PDF (1141 KB)  ( 63 ) 547 Effects of Hyperthyroidism on Serum IGF-1 and Bone Metabolism Indexes in Type 2 Diabetes Mellitus SHI Yan-hong, LI Hai-ming DOI: 10.3969/j.issn.1671-7171.2023.04.018 【Objective】 To investigate the effects of hyperthyroidism on serum insulin-like growth factor-1 (IGF-1) and bone metabolism in patients with type 2 diabetes. 【Methods】 Seventy-seven patients with type 2 diabetes mellitus complicated with hyperthyroidism admitted to the Central Hospital of Tongchuan Mining Administration from February 2017 to February 2022 were enrolled in the observation group,and 70 patients with type 2 diabetes mellitus without hyperthyroidism admitted to Central Hospital of Tongchuan Mining Bureau during the same period were considered as the control group. Blood glucose [fasting blood glucose (FPG),glycosylated hemoglobin (HbA1c)] and thyroid function [free triiodothyronine (FT3),free thyroxin (FT4),thyroid stimulating hormone (TSH)] indexes of the two groups were detected and compared. The levels of insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-2 (IGF-2) were detected and compared between the two groups. Bone metabolism indexes of the two groups were detected and compared,including bone specific alkaline phosphatase (BAP),n-terminal osteocalcin (N-MID-OT),total type 1 collagen amino terminal prolongating peptide (T-P1NP),β-crosslaps (β-CTX),1,25 dihydroxyvitamin D3[1,25(OH)2D3]. Bone mineral density levels were measured in different parts of patients in the two groups:the 2nd-4th lumbar spine (L2-4),Ward's triangle,neck of femur,and greater trochanteric area. 【Results】 The levels of FPG,FT3,BAP,N-MID-OT,T-P1NP,β-CTX and FT4 in the observation group were significantly higher than those in the control group (P<0.05),while the levels of TSH,TSH,IGF-1,IGF-2 and 1,25(OH)2D3 in the observation group was significantly lower than those in the control group (P<0.05). There was no significant difference in HbA1c level between the two groups (P>0.05). The bone mineral densities of L2-4,Ward's triangle,neck of femur and greater trochanter in the observation group were significantly lower than those in control group (P<0.05). 【Conclusion】 The levels of blood glucose and thyroid in type 2 diabetes patients with hyperthyroidism are higher than those in patients without hyperthyroidism. Patients with T2DM have lower serum IGF-1,abnormal bone metabolism,and lower bone mineral density lower than those in patients without hyperthyroidism. Clinical monitoring of bone metabolism is necessary to prevent the occurrence of osteoporosis. 2023 Vol. 40 (4): 547-549 [Abstract] ( 34 ) HTML (1 KB)  PDF (1178 KB)  ( 94 ) 550 Effect of Traditional Chinese Medicine Tonic Optimization Combined with Behavioral Intervention on Nutritional Indicators and Immune Function of Patients after Colon Cancer Surgery WANG Xin, HAN Chong-lan DOI: 10.3969/j.issn.1671-7171.2023.04.019 【Objective】 To explore the effect of traditional Chinese medicine tonic optimization combined with behavioral intervention on the nutritional indicators and immune function of patients after colon cancer surgery. 【Methods】 A total of 216 patients undergoing colon cancer surgery in Affiliated Hospital of Shaanxi University of Chinese Medicine from June 2018 to February 2021 were selected as the research objects. According to the randomized crossover control design,patients were randomly divided into two groups. Patients in the control group (n=110) received TCM tonic optimization intervention,while the observation group (n=106) received behavioral intervention in addition to TCM tonic optimization intervention. The nutritional status [Hemoglobin (HGB),albumin (ALB),prealbumin (PAB),transferrin (TRF) and peripheral blood lymphocytes (PBL)] and immune function [Immunoglobulin M (IgM),Immunoglobulin A (IgA) and Immunoglobulin G (IgG)] of the two groups of patients before and after the intervention were recorded and compared. 【Results】 After the intervention,levels of Hemoglobin (HGB),Albumin (ALB),Prealbumin (PAB),Transferrin (TRF) and Peripheral blood lymphocyte (PBL) in the two groups were higher than those before the intervention. And the changes in the observation group were higher than those in the control group. The difference was statistically significant (P<0.05). After the intervention,levels of IgM,IgA and IgG in the observation group were better than those in the control group. 【Conclusion】 Postoperative traditional Chinese medicine tonic optimization combined with behavioral intervention in patients with colon cancer can effectively improve nutritional status and immune function. Thus,it is of great significance to improve the prognosis and patient's quality of life. 2023 Vol. 40 (4): 550-553 [Abstract] ( 26 ) HTML (1 KB)  PDF (1134 KB)  ( 210 ) 554 Effects of Alprostadil on Continuous Renal Replacement Therapy and Oxidative Stress in Acute Renal Failure Patients with Diabetic Nephropathy HE Juan, ZHU Hui-rong, ZHAO Jin DOI: 10.3969/j.issn.1671-7171.2023.04.020 【Objective】 To investigate the effect of alprostadil on continuous renal replacement therapy(CRRT) and oxidative stress in acute renal failure patients with diabetic nephropathy(DN). 【Methods】 A total of 104 patients with acute renal failure with DN were randomly divided into the observation group and the control group The control group was treated with CRRT,while the observation group was additionally treated with alprostadil on the basis of the control group. The clinical efficacy,reactive oxygen species (ROS),superoxide dismutase (SOD),urinary albumin excretion rate (UAER),8-hydroxydeoxyguanine (8-OHdG),β2 microglobulin (β2-MG),endothelin-1 (ET-1),von Willebrand factor (vWF) levels and adverse reactions were compared between the two groups. 【Results】 The total effective rate of the observation group was higher than that of the control group (P<0.05). After treatment,the levels of ROS,SOD,8-OHdG,UAER,β2-MG and vWF in both groups were lower than those before treatment (P<0.05); And the parameters in the observation group were lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions in both groups (P>0.05). 【Conclusion】 The use of alprostadil with CRRT in acute renal failure patients with diabetic nephropathy can improve clinical efficacy,reduce oxidative stress,improve renal function,and have a certain protective effect on vascular endothelium. 2023 Vol. 40 (4): 554-556 [Abstract] ( 38 ) HTML (1 KB)  PDF (1183 KB)  ( 366 ) 557 Predictive Value of Serum Hcy and FGF-23 for Major Adverse Cardiovascular and Cerebrovascular Events in Patients with H-type Hypertension XU Guo-ping, REN Qian, XIAO Hong-fang DOI: 10.3969/j.issn.1671-7171.2023.04.021 【Objective】 To explore the predictive value of serum homocysteine (Hcy) and fibroblast growth factor 23 (FGF-23) on major adverse cardiovascular and cerebrovascular events in patients with type H hypertension. 【Methods】 A total of 86 patients with H-type hypertension admitted to our hospital (observation group) were selected,and 78 healthy volunteers who came to the hospital for physical examination during the same period (control group) were selected. We compared the serum levels of Hcy and FGF-23 between patients with H-type hypertension and healthy individuals. The observation group was followed up for 1 year and divided into two groups based on the occurrence of major adverse cardiovascular and cerebrovascular events:the occurrence group (n=22) and the non-occurrence group (n=64). Univariate analysis of factors affecting the occurrence of major adverse cardiovascular and cerebrovascular events in patients with type H hypertension. Logistic regression analysis was conducted on the factors influencing the occurrence of major adverse cardiovascular and cerebrovascular events in patients with H-type hypertension. The value of predicting the occurrence of major adverse cardiovascular and cerebrovascular events in patients with H-type hypertension was analyzed using the receiver operating characteristic curve (ROC curve) to analyze serum Hcy and FGF-23 levels. 【Results】 The serum FGF-23 and Hcy levels in the observation group were higher than those in the control group,with statistically significant differences (P<0.05). Univariate analysis showed that the mean arterial pressure (MAP),left ventricular mass index (LVMI),low-density lipoprotein (LDL-C),and serum Hcy and FGF-23 levels in the affected group were higher than those in the non affected group (P<0.05). Logistic multivariate regression analysis showed that LDL-C,Hcy,and FGF-23 were independent risk factors for the occurrence of major adverse cardiovascular and cerebrovascular events in patients with type H hypertension (P<0.05). 【Conclusion】 Serum Hcy and FGF-23 levels are associated with the occurrence of major adverse cardiovascular and cerebrovascular events in patients with H-type hypertension,and their combination can serve as sensitive indicators for predicting the occurrence of major adverse cardiovascular and cerebrovascular events. 2023 Vol. 40 (4): 557-560 [Abstract] ( 30 ) HTML (1 KB)  PDF (1170 KB)  ( 31 ) 561 Correlation Analysis between Serum MMP-3,HMGB-1 Levels and Severity of Chronic Periodontitis in 128 Patients with Pg Infection XIE Yi-Dun, WANG Sheng-dang DOI: 10.3969/j.issn.1671-7171.2023.04.022 【Objective】 To investigate the correlation between serum levels of matrix metalloproteinase-3 (MMP-3),high mobility group protein-1 (HMGB-1) and severity of chronic periodontitis in 128 patients with Porphyromonas gingivalis (Pg) infection. 【Methods】 A total of 128 patients with chronic periodontitis and Pg infection admitted to Xi'an Ninth Hospital from July 2019 to June 2021 were selected as the observation group,and 110 healthy volunteers who underwent physical examinations at Xi'an Ninth Hospital were selected as the control group. The clinical data and serum levels of MMP-3 and HMGB-1 were compared between the two groups of study subjects; 128 cases of chronic periodontitis were divided into mild,moderate,and severe groups based on the severity of Pg infection. The correlation between serum levels of MMP-3 and HMGB-1 and the severity of Pg infection in patients with chronic periodontitis was analyzed. 【Results】 The serum levels of MMP-3 and HMGB-1 in the observation group were higher than those in the control group (P<0.05); The levels of serum MMP-3 and HMGB-1 in the mild,moderate,and severe groups of patients increased sequentially,and there was a statistically significant difference between the groups (P<0.05). The periodontal pocket depth (PD),gingival sulcus bleeding index (BSI),simplified scale index (DI-S),procalcitonin (PCT),C-reactive protein (CRP),serum MMP-3 and HMGB-1 levels in severe group were higher than those in mild and moderate group (P<0.05). The results of logistic multivariate analysis showed that PD,PCT,MMP-3,and HMGB-1 were all influencing factors for the severity of chronic periodontitis Pg infection in patients (OR=3.059,2.732,3.404,3.010,P<0.05). 【Conclusion】 The serum levels of MMP-3 and HMGB-1 in patients with chronic periodontitis Pg infection are abnormally elevated,and there is a certain correlation between them and the severity of the condition in patients with chronic periodontitis Pg infection. 2023 Vol. 40 (4): 561-563 [Abstract] ( 25 ) HTML (1 KB)  PDF (1179 KB)  ( 48 ) 564 Relationship of Serum PCT,CRP,SAA and IL-6 Levels with Respiratory Tract Infection in Patients with AECOPD TAO Yun, WANG Xiao-xu DOI: 10.3969/j.issn.1671-7171.2023.04.023 【Objective】 To explore the relationship of serum procalcitonin (PCT),C-reactive protein (CRP),serum amyloid A (SAA),and interleukin-6 (IL-6) levels with respiratory tract infection in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). 【Methods】 The clinical data of 85 patients with AECOPD admitted to our hospital from April 2019 to April 2022 were retrospectively analyzed. According to whether the patients were complicated with respiratory tract infection,they were divided into two groups,namely,the infected group (n=30) and the uninfected group (n=55). The general data and serum levels of PCT,CRP,SAA and IL-6 were compared between the two groups. The value of PCT,CRP,SAA and IL-6 in predicting respiratory tract infection in AECOPD patients was analyzed by ROC analysis. The risk factors of AECOPD patients complicated with respiratory tract infection were determined by multivariate logistic regression analysis. 【Results】 The proportion of patients with respiratory failure and AECOPD attacks ≥ 3 times within one year in the infected group was significantly higher than that in the uninfected group (P<0.05),and the levels of PCT,CRP,SAA and IL-6 in the infected group were significantly higher than those in the uninfected group (P<0.05). By ROC and logistic analysis,the areas under the curve of PCT,CRP,SAA and IL-6 predicting AECOPD patients with respiratory tract infection were 0.778,0.809,0.865 and 0.816,respectively (P<0.05). Respiratory failure,AECOPD attacks ≥ 3 times within 1 year,PCT≥4.795 μg/L,CRP≥5.730 mg/L,SAA≥25.310 mg/L and IL-6≥10.535 ng/L were the risk factors of respiratory tract infection in AECOPD patients (P<0.05). 【Conclusion】 The levels of serum PCT,CRP,SAA and IL-6 are closely related to AECOPD patients with respiratory tract infection,and can be used as serum indicators to assist in the diagnosis of AECOPD patients with respiratory tract infection. 2023 Vol. 40 (4): 564-567 [Abstract] ( 28 ) HTML (1 KB)  PDF (1209 KB)  ( 91 ) 568 Expression of Peripheral Blood Toll-like Receptor 4 and its Correlation with Urinary Microalbumin Level in Chronic Glomerulonephritis WANG Xin-xian, GUO Xiao-xia, ZHU Wei-wei DOI: 10.3969/j.issn.1671-7171.2023.04.024 【Objective】 To investigate the expression of peripheral blood Toll-like receptor 4 (TLR4) in chronic glomerulonephritis (CGN) and its relationship with urinary microalbumin (UMA) level. 【Methods】 A total of 113 CGN patients admitted to Anyang Hospital of Traditional Chinese Medicine,including 77 patients with mild renal insufficiency,24 patients with moderate renal insufficiency and 12 patients with severe renal insufficiency,were enrolled in the observation group. Another 59 healthy volunteers who underwent physical examination in our hospital during the same time period were selected as the control group. The expression of renal function indexes such as TLR4 in peripheral blood and UMA in the observation group and the control group were detected,then the correlation between renal function index TLR4 and UMA in the observation group was analyzed. 【Results】 The levels of CD19+TLR4+ cells and CD3+TLR4+ cells in the severe renal insufficiency group were higher than those in the moderate renal insufficiency group and the mild renal insufficiency group (P<0.05). The levels of CD19+TLR4+ cells and CD3+TLR4+ in the moderate renal insufficiency group were higher than those in the wild renal insufficiency group (P<0.05). The levels of CD19+TLR4+ cells and CD3+TLR4+ cells in the observation group were higher than those in the control group (P<0.05). The levels of UMA,retinol binding protein (RBP) and transferrin (TRF), cystatin C,creatinine,blood urea nitrogen and uric acid in the observation group were higher than those in the control group (P<0.05). Pearson correlation analysis showed that the level of CD19+TLR4+ cells in the observation group was positively correlated with UMA,RBP,and cystatin C (P<0.05),and the level of CD3+TLR4+ cells was positively correlated with UMA (P<0.05). 【Conclusion】 The peripheral blood TLR4 expression of CGN patients is abnormally high,and the expression level of TLR4 is closely related to renal function indicators such as UMA. The higher the expression level of TLR4 is,the worse the renal function of CGN patients will be. 2023 Vol. 40 (4): 568-570 [Abstract] ( 27 ) HTML (1 KB)  PDF (1176 KB)  ( 44 ) 571 Investigation and Analysis of Clinical Characteristics and 25(OH)D3 Levels of Infants and Young Children with Rickets in Urban Area of Baoji City LIU Wen-jing, LYU Ju-hong, LI Dong-mei, et al DOI: 10.3969/j.issn.1671-7171.2023.04.025 【Objective】 To analyze the clinical characteristics and 25-hydroxyvitamin D3[25(OH)D3] levels of infants and young children with rickets in the urban area of Baoji City. 【Methods】 A total of 274 infants and young children who underwent routine health management at children's health clinics in various communities in the urban area of Baoji City from January 2020 to December 2020 were selected as the research objects. Basic information such as age,gender,height,weight,and dietary habits was recorded during the routine physical examination. The prevalence of rickets was analyzed based on imaging results. The clinical characteristics and levels of 25(OH)D3 and bone alkaline phosphatase (BALP) were compared between infants and young children with and without rickets. The value of 25(OH)D3 and BALP levels in predicting rickets in infants and young children was evaluated through ROC analysis. 【Results】 The incidence of rickets in infants aged 0 to 6 months was significantly higher than that in other age groups (P<0.05),while there was no significant difference in incidence among other age groups (P>0.05). Clinical characteristics such as increased sweating,diarrhea,abnormal or delayed bone development,motor dysfunction,and joint pain were more common in the rickets group than in the non-rickets group (P<0.05). The 25(OH)D3 level was lower and the BALP level was higher in the rickets group than in the non-rickets group (P<0.05). The ROC analysis confirmed that the 25(OH)D3 and BALP levels can be used to predict rickets in infants and young children with AUC values of 0.958 and 0.990,respectively,(both with P<0.05). 【Conclusion】 Infants aged 0 to 6 months are a high-risk age group for rickets,with clinical features mainly including increased sweating,diarrhea,abnormal or delayed bone development,motor dysfunction. In addition,the 25(OH)D3 level is lower in this group. Clinically,it is recommended to focus on screening children with the above risk factors and provide effective preventive and therapeutic measures as early as possible. 2023 Vol. 40 (4): 571-574 [Abstract] ( 32 ) HTML (1 KB)  PDF (1195 KB)  ( 39 ) 575 Relationship of miR-92a with Biochemical Recurrence after Radical Prostatectomy WANG Yuan-yuan, XU Min DOI: 10.3969/j.issn.1671-7171.2023.04.026 【Objective】 To analyze the relationship between miR-92a and biochemical recurrence after radical prostatectomy.【Methods】 A total of 123 prostate cancer (PCa) patients with radical prostatectomy in urology were enrolled and clinical data of all cases were collected. Meanwhile,the circulation level of miR-92a was detected. After hospital discharged,the biochemical recurrence of patients were followed-up with one year to analyze the correlation between miR-92a and biochemical recurrence. The ROC curve was used to evaluate miR-92a in diagnosis for biochemical recurrence. 【Results】 Compared to the control group,patients with biochemical recurrence had higher level of miR-92a,higher scores PSA and Gleason,and higher rates of lymph node metastasis and tumor differentiation (P<0.05).The miR-92a had a positive correlation with PSA (r=0.527,P=0.036) and Gleason score (r=0.341,P<0.01). The binary6 logistic regression analysis showed that miR-92a was an independent risk factor for biochemical recurrence,whose odds ratio was 2.18 (1.17-5.26).The value of miR-92a was useful in diagnosis of biochemical recurrence:the area under the curve (AUC) (95%CI) was 0.83 (0.75-0.91) and the best diagnostic cut-off was 22.68.Kaplan-Meier survival curve showed the biochemical recurrence-free time of patients with high miR-92a was significantly shorter than that of patients with low miR-92a.【Conclusion】 miR-92a was a potential predictor and independent risk factor for biochemical recurrence after radical prostatectomy. 2023 Vol. 40 (4): 575-577 [Abstract] ( 27 ) HTML (1 KB)  PDF (1332 KB)  ( 34 ) 578 Efficacy of Maintenance Therapy with Low Dose of Apatinib after TACE for Primary Liver Cancer GAO Meng-jia, WANG Yu, GUO Wen-wei, et al DOI: 10.3969/j.issn.1671-7171.2023.04.027 【Objective】 To investigate the clinical effect of maintenance therapy with low dose of apatinib after transcatheter arterial chemoembolization (TACE) for primary liver cancer. 【Methods】 A total of 90 patients with primary liver cancer in our hospital were randomly divided into the observation group and the control group with 45 cases each. Patients in both groups were treated with TACE,while the patients in the observation group received 250 mg of apatinib maintenance treatment after TACE. T lymphocyte subsets (CD3+,CD4+,CD8+,CD4+/CD8+) on 1 day before surgery and 4 weeks post-TACE,tumor objective response rate (ORR),progression-free survival,total survival and adverse reactions after 1,3,6 and 12 months of treatment were compared between the two groups. 【Results】 Four weeks after treatment,CD3+,CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group,and CD8+ was lower than that in the control group. The differences were statistically significant (all P<0.05). After 6 and 12 months of treatment,the ORR rate of the observation group was higher than that of the control group,and the difference was statistically significant (all P<0.05). The progression-free survival period was 6.6 months in the control group and 11.9 months in the observation group; The total survival period of the control group was 5.1 months,while the progression-free survival period of the observation group was 9.8 months; Kaplan-Meier method and Log-rank test showed that the progression-free survival and total survival of the observation group were longer than those of the control group,and the difference was statistically significant (both P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).【Conclusion】 The effect of maintenance therapy with low dose of apatinib after TACE for primary liver cancer is significant,which can improve the tumor remission rate and the immune function of patients,improve the progression-free survival and total survival,while the adverse reactions are controllable. 2023 Vol. 40 (4): 578-581 [Abstract] ( 32 ) HTML (1 KB)  PDF (1142 KB)  ( 28 ) 582 Factors Related to Poor Prognosis in Patients with Acute Myocardial Infarction Wrongly Activated by Intracardiac Catheterization XIONG Zhi-wei DOI: 10.3969/j.issn.1671-7171.2023.04.028 【Objective】 To analyze the related factors that affect the poor prognosis of intraventricular catheterization in patients with acute myocardial infarction (AMI). 【Methods】 A prospective study was conducted on 107 AMI patients admitted to our hospital from May 2019 to February 2022 who were mistakenly activated by intracardiac catheterization. Based on the patient's prognosis,they were divided into an observation group (those with poor prognosis,n=31) and a control group (those with good prognosis,n=76). Clinical data of patients were collected and logistic multiple factor regression analysis was used to analyze the related factors that affect the poor prognosis of cardiac catheterization in AMI patients.【Results】 The incidence of poor prognosis in 107 AMI patients with intracardiac catheter misactivation was 28.97% (31/107). There was a statistically significant difference (P<0.05) between the two groups of patients in terms of cardiovascular risk factors,history of coronary heart disease,previous PCI history,time of first medical contact with the device,left bundle branch block,time of infarcted artery reconstruction,and chest pain symptoms. Logistic regression analysis showed that the time of infarcted artery reconstruction,history of coronary heart disease,previous PCI history,time of first medical contact with the device,left bundle branch block,and chest pain symptoms were the influencing factors for poor prognosis in patients with intracardiac catheter room activation (P<0.05). 【Conclusion】 The poor prognosis of AMI patients with intracardiac catheterization room misactivation is influenced by factors such as infarct artery reconstruction time,history of coronary heart disease,previous PCI history,time of first medical contact with the device,left bundle branch block,chest pain symptoms,etc. Clinical scholars can develop intervention measures based on these factors to reduce the occurrence of adverse cardiovascular events and improve patient prognosis. 2023 Vol. 40 (4): 582-584 [Abstract] ( 25 ) HTML (1 KB)  PDF (1174 KB)  ( 26 ) 585 Application of Serum miR-146a Level Combined with CT Examination in the Early Diagnosis of Lung Cancer in High-risk Population DAI Feng-xia, JIN Qiang DOI: 10.3969/j.issn.1671-7171.2023.04.029 【Objective】 To explore the value of serum microribonucleic acid-146a (miR-146a) level combined with computerized tomography (CT) in the early diagnosis of lung cancer in elderly high-risk populations. 【Methods】 A total of 124 elderly patients at high risk of lung cancer,who were admitted to Shangluo International Medical Center Hospital from October 2019 to December 2020,were selected as the research subjects. Serum miR-146a measurement and CT examinations were performed. According to the diagnosis of clinical pathological results,patients were divided into the positive group (diagnosed as lung cancer patients) and negative group (no lung cancer patients). The serum miR-146a levels were compared between the positive group and the negative group. The CT examination results were compared with the pathological diagnosis results. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was used to evaluate the diagnostic efficacy of serum miR-146a combined with CT in the elderly high-risk population of lung cancer. 【Results】 Among the 124 elderly patients with high risk of lung cancer,78 were positive and 46 were negative. The level of serum miR-146a in the positive group was higher than that in the negative group (t=21.512,P<0.001). A total of 72 positive patients were detected by CT examination:the positive coincidence rate,negative coincidence rate and total coincidence rate were 84.62%,86.96%,and 85.48%,respectively. ROC analysis showed that the best cut-off of serum miR-146a for the diagnosis of elderly high-risk patients with lung cancer was 1.42,and the AUC of serum miR-146a combined with CT examination in the diagnosis of elderly high-risk patients with lung cancer was 0.906,which was higher than that of serum miR-146a and CT examination alone (Z=3.021,P=0.003; Z=2.289,P=0.022). 【Conclusion】 The diagnostic efficacy of serum miR-146a combined with CT scans is relatively high in elderly high-risk populations of lung cancer. It can be used as an important reference index for clinical evaluation. 2023 Vol. 40 (4): 585-588 [Abstract] ( 29 ) HTML (1 KB)  PDF (1178 KB)  ( 41 ) 589 Correlation Analysis of Serum Immunoglobulin,C3 and C4 Levels with Prognosis of Patients with Hypertensive Intracerebral Hemorrhage CHEN Hong-nan, XI Feng-yu, ZHANG Yun, et al DOI: 10.3969/j.issn.1671-7171.2023.04.030 【Objective】 To investigate the relationship of serum immunoglobulin,C3 and C4 levels with the prognosis of patients with hypertensive intracerebral hemorrhage (HICH). 【Methods】 A total of 114 patients with HICH in our hospital from January 2018 to May 2021 were selected as the control group. In the same period,67 hypertensive patients with good blood pressure were enrolled in the control group. The levels of serum immunoglobulin (IgG,IgA),C3,and C4 were compared between the control group on the day of admission and the observation group before operation and after operation. According to the prognosis of the observation group,patients were divided into the good prognosis group and the poor prognosis group. The levels of serum immunoglobulin,C3,and C4 in patients with different prognosis were compared 7 days after operation. Spearman rank correlation model and COX stepwise regression model were used to analyze the correlation between levels of serum immunoglobulin,C3,C4 with the prognosis of patients. 【Results】 Serum IgG,IgA levels and preoperative C3,C4 levels in the observation group were lower than those in the control group on 1 day,3 days,7 days,and 14 days after operation (P<0.05); The level of C3 and C4 showed a decreasing trend,and the levels of C3 and C4 showed a rising trend,and the difference was statistically significant (P<0.05). The serum IgG and IgA levels of patients in the good prognosis group were higher than those of patients in the poor prognosis group,while the levels of C3 and C4 in the good prognosis group were lower than those of patients in the poor prognosis group (P<0.05). Spearman rank correlation analysis showed that serum IgG and IgA levels 7 days after surgery were positively correlated with prognosis,and C3 and C4 levels were negatively correlated with prognosis. COX stepwise regression model analysis showed that serum IgG,IgA,C3,and C4 levels 7 days after operation were the relevant factors affecting prognosis (P<0.05).【Conclusion】 The levels of serum immunoglobulin,C3 and C4 are significantly correlated with the prognosis of patients with HICH. Dynamic monitoring of the changes of serum immunoglobulin,C3 and C4 levels is helpful to guide the clinical treatment. 2023 Vol. 40 (4): 589-591 [Abstract] ( 24 ) HTML (1 KB)  PDF (1175 KB)  ( 35 ) 592 Guiding Value of Perioperative Intracranial Pressure Monitoring in Minimally Invasive Intracranial Hematoma Aspiration Surgery for Hypertensive Intracerebral Hemorrhage LI Hu, CAO Ning DOI: 10.3969/j.issn.1671-7171.2023.04.031 【Objective】 To explore the guiding value of perioperative intracranial pressure (ICP) monitoring in minimally invasive intracranial hematoma aspiration surgery for hypertensive intracerebral hemorrhage (HICH). 【Methods】 The clinical data of 138 cases HICH patients treated by minimally invasive intracranial hematoma aspiration from April 2017 to April 2019 in Baoji High-Tech Hospital neurosurgery were retrospectively analyzed. According to the different treatment methods,they were divided into an observation group and a control group,with 69 cases in each group. The control group was treated with minimally invasive intracranial hematoma aspiration surgery,while the observation group added ICP monitoring to the control treatment. The ICP threshold was set at 15 mmHg,and aspiration was immediately stopped when the threshold was achieved. The volume of intraoperative blood suction,the percentage of blood suction volume to the initial hematoma volume,the evacuation time of postoperative hematoma,and the rate of rebleeding were recorded for both groups. In addition,the neurological deficits before and after treatment (4 weeks after onset) were evaluated for both groups. Postoperative follow-up was conducted for 3-12 months to evaluate the postoperative outcomes of both groups of patients,and the good rate was statistically analyzed. 【Results】 The observation group had significantly lower intraoperative hematoma volume,percentage of hematoma volume to initial hematoma volume,postoperative hematoma evacuation time,and rebleeding rate compared to the control group (P<0.05). After treatment,the SSS scores of both groups of patients were lower than before treatment,and the observation group was lower than the control group,with a statistically significant difference (P<0.05). Following up for 3~12 months,there were no deaths in either group. The good postoperative outcome rate in the observation group was 65.2% (44/69),higher than 46.4% (32/69) in the control group,with a statistically significant difference (χ2=4.965,P<0.05). 【Conclusion】 Continuous ICP monitoring during the perioperative period of HICH minimally invasive treatment can effectively reduce the risk of rebleeding caused by excessive suction during surgery,guide postoperative stepwise treatment,improve prognosis,and have high clinical application value. 2023 Vol. 40 (4): 592-595 [Abstract] ( 24 ) HTML (1 KB)  PDF (1136 KB)  ( 104 )

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