医学临床研究
      Home  |  About Journal  |  Editorial Board  |  Instruction  |  Subscribe  |  Advertisement  |  Messages Board  |  Contact Us  |  中文
医学临床研究
   Forthcoming Articles
   Current Issue
   Archive
   Advanced Search
   Read Articles
   Download Articles
   Email Alert
   
Quick Search  
  Adv Search
2023 Vol. 40, No. 9
Published: 2023-09-26
Original Articles
 
 
       Original Articles
1281 Analysis of CT Imaging Features of Rhabdomyosarcoma in the Pelvic and Urogenital Tracts of Children
YIN Yiwei, CAI Qifang, TANG Jing
DOI: 10.3969/j.issn.1671-7171.2023.09.001
【Objective】To explore the CT imaging features of rhabdomyosarcoma in the pelvic and urogenital tracts of children.【Methods】A retrospective analysis was conducted on the imaging and clinical data of children admitted to our hospital from January 2017 to December 2022 who were pathologically confirmed as rhabdomyosarcoma after surgery. All patients underwent plain and enhanced CT scans to analyze the CT imaging features and pathological examination results of the tumor.【Results】All 15 cases of pediatric lesions in this group were located in the pelvic cavity and reproductive tract,with 5 cases occurring in the trigone of the bladder,2 cases in the testicles,3 cases in the pelvic cavity,5 cases in the perineum,and 2 cases with metastasis. The solid density of the tumor is lower than that of the muscle,and the enhanced scan shows uneven enhancement,delayed enhancement,and multiple new blood vessels around it,without any calcification,fat,or bleeding changes.【Conclusion】Rhabdomyosarcoma of the pelvic and urogenital tracts in children has certain CT imaging features and can be differentiated from other malignant tumors,but the final diagnosis requires pathological biopsy.
2023 Vol. 40 (9): 1281-1283 [Abstract] ( 70 ) HTML (1 KB)  PDF (1643 KB)  ( 77 )
1284 The Correlation between Preoperative Magnetic Resonance Signal Characteristics and Surgical Outcomes in Osteoporotic Lumbar Spine Fractures with PVP Surgery
QU Zhiqiang, LIU Tao
DOI: 10.3969/j.issn.1671-7171.2023.09.002
【Objective】To investigate the correlation between preoperative magnetic resonance signal characteristics and surgical outcomes of percutaneous vertebroplasty (PVP) for osteoporotic lumbar fractures.【Methods】A total of 92 patients with osteoporotic lumbar spine fractures admitted to the Hanzhong Central Hospital from April 2019 to February 2022 were selected and divided into complete bone marrow edema group (n=35),partial bone marrow edema group (n=33),and no bone marrow edema group (n=24) based on the preoperative MRI signal characteristics (bone marrow edema signal characteristics) of osteoporotic lumbar spine fracture patients. We compared the surgical conditions,pain,lumbar function,and lumbar anatomical parameters of three groups,and counted the incidence of recurrent fractures and complications during the follow-up period between the two groups.【Results】There was no statistically significant difference in the surgical time,amount of bone cement injection,and incidence of bone cement leakage among the three groups (P>0.05). The visual analog scale (VAS) of pain in the complete bone marrow edema group at 1 week,1 month,and 6 months after surgery was lower than that in the partial bone marrow edema group and the non bone marrow edema group (P<0.05). The VAS of the partial bone marrow edema group at 1 week,1 month,and 6 months after surgery was lower than that in the non bone marrow edema group (P<0.05). The difference in the Japanese Orthopedic Association (JOA) score and Oswestry Dysfunction Index (ODI) before and 6 months after surgery in the complete bone marrow edema group were higher than those in the partial bone marrow edema group and the non bone marrow edema group (P<0.05). There was no statistically significant difference in the difference in vertebral height ratio and Cobb angle between the three groups before and 6 months after surgery (P>0.05). There was no statistically significant difference in the incidence of recurrent fractures and total complications among the three groups (P>0.05).【Conclusion】The preoperative magnetic resonance signal characteristics of osteoporotic lumbar spine fracture with PVP are related to the surgical effect,and patients with bone marrow edema have better pain relief and lumbar function improvement after PVP treatment.
2023 Vol. 40 (9): 1284-1287 [Abstract] ( 36 ) HTML (1 KB)  PDF (1202 KB)  ( 28 )
1288 Application of Remimazolam Toluenesulfonate in Anesthesia for Small Intestinoscopy in Children
WEI Siwei, WU Lei, XIANG Zhen, et al
DOI: 10.3969/j.issn.1671-7171.2023.09.003
【Objective】To explore the clinical effect of remimazolam toluenesulfonate in anesthesia for small intestinal endoscopy in children.【Methods】A total of 98 children who underwent small intestinal endoscopy under general anesthesia and were admitted to our hospital from April 2022 to December 2022 were randomly divided into a propofol group (P group) and a remimazolam toluenesulfonate group (R group) using a random number table method,with 49 cases in each group. We compared the success rates of anesthesia induction,anesthesia maintenance,and the time of consciousness disappearance between the two groups; Compare the heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP),and blood oxygen saturation (SPO2) of two groups of children at rest (T0),1 minute after administration (T1),2 minutes after administration (T2),after tracheal intubation (T3),at the end of surgery (T4),and at PACU (T5); Two groups of perioperative related indicators,adverse reactions,and postoperative behavioral changes were also compared.【Results】The onset time of sedation in the Group R was significantly longer than that in the Group P,with a statistically significant difference (P<0.05). At T1,T2,T3,T4,and T5,the HR,SBP,and DBP of the two groups of children were significantly lower than those at T0 (P<0.05); At T1,T2,and T5,the SPO2 of the two groups of children was significantly lower than at T0 (P<0.05). At T1 and T2,the HR,SBP,DBP,and SPO2 levels in the Group R were higher than those in the Group P (P<0.05). The awakening time of the Group R was shorter than that of the Group P,and the difference was statistically significant (P<0.05). The incidence of perioperative hypotension,bradycardia,respiratory depression,and injection pain in the Group R was lower than that in the Group P,and the difference was statistically significant (P<0.05); There was no statistically significant difference in postoperative PHBQ-AS scores between the two groups (P>0.05).【Conclusion】Remimazolam toluenesulfonate is safe and effective in general anesthesia for small intestinal endoscopy in children,and the incidence of adverse reactions is low,which is worthy of clinical reference.
2023 Vol. 40 (9): 1288-1291 [Abstract] ( 41 ) HTML (1 KB)  PDF (1147 KB)  ( 28 )
1292 The Predictive Value of Serum CA125,CEA,and HE4 Levels for Clinical Outcomes in Ovarian Cancer Patients
CHANG Jiefang, LI Juan
DOI: 10.3969/j.issn.1671-7171.2023.09.004
【Objective】To explore the predictive value of serum levels of carbohydrate antigen 125 (CA125),carcinoembryonic antigen (CEA),and human epididymal protein 4 (HE4) in the clinical prognosis of ovarian cancer patients.【Methods】A total of 159 ovarian cancer patients (ovarian cancer group) admitted to the Hanzhong Central Hospital from May 2020 to July 2022 were selected,and 138 healthy volunteers (health group) who underwent physical examinations at Hanzhong Central Hospital during the same period were selected as controls. Compare the serum levels of CA125,CEA,and HE4 between the two groups,and analyze the clinical outcomes of the ovarian cancer group after three courses of chemotherapy. We compared the clinical data of patients in the improvement group and the adverse outcome group,analyzed the influencing factors of clinical outcome,and the predictive value of serum CA125,CEA,and HE4 levels for clinical improvement in ovarian cancer patients.【Results】The serum levels of CA125,CEA,and HE4 in the ovarian cancer group were higher than those in the healthy group (P<0.05); The serum levels of CA125,CEA,and HE4 in the improvement group were lower than those in the adverse outcome group (P<0.05); The difference in the proportion of refractory ascites and lymph node metastasis between the improvement group and the adverse outcome group was statistically significant (P<0.05); Serum levels of CA125,CEA,HE4,and refractory ascites are all related factors that affect clinical improvement (P<0.05); The analysis results of the receiver operating characteristic (ROC) curve showed that the optimal cutoff points for predicting clinical improvement in ovarian cancer patients with serum CA125,CEA,and HE4 levels were 541.39 U/mL,4.96 ng/mL,and 230.79 pmol/L,respectively,with specificity of 71.21%,75.76%,and 77.27%. The area under the curve (AUC) was 0.750,0.709,and 0.782,respectively. The specificity and AUC predicted by the combination of the three were 96.97% and 0.820,respectively.【Conclusion】Serum levels of CA125,CEA,and HE4 in patients with clinical improvement of ovarian cancer are lower than those in patients with poor prognosis. Serum levels of CA125,CEA,and HE4 are all related factors that affect clinical improvement of ovarian cancer patients. Serum levels of CA125,CEA,and HE4 can be used as sensitive indicators to predict clinical prognosis of ovarian cancer,and the combined predictive value is higher.
2023 Vol. 40 (9): 1292-1295 [Abstract] ( 46 ) HTML (1 KB)  PDF (1262 KB)  ( 34 )
1296 Expression and Value of miRNA-17-3p in Prostate Cancer Tissues
DU Lingyun, WANG Shanlong, WANG Xiao
DOI: 10.3969/j.issn.1671-7171.2023.09.005
【Objective】To analyze the expression and value of microRNA-17-3p (miRNA-17-3p) in prostate cancer (PCa) tissues.【Methods】A total of 92 PCa patients in urology were collected randomly in this study between December 2017 and July 2019 as the PCa group,meanwhile 92 patients with benign prostatic hyperplasia were selected as the control group. All of them were accepted surgery after admission and the tissues were preserved during operation,then the level of miRNA-17-3p were detected from tissues and compared with the two groups. The receiver operating characteristic (ROC) curve was used to evaluate the clinical value of miRNA-17-3p in diagnosing PCa; Pearson correlation was used to analyze the correlation between miRNA-17-3p,Gleason score and PSA.【Results】The level of miRNA-17-3p in the PCa group was significantly higher than that of the control group. ROC curve analysis results showed that the area under the curve (AUC,95%CI) of the value of miRNA-17-3p in diagnosis of PCa was 0.84 (0.77-0.90),diagnostic cut-off value was 23.19,and sensitivity and specificity were 58% and 77%,respectively. The ratios of TNM stage (stage Ⅲ+Ⅳ),PSA,Gleason score and low differentiation of PCa in high-expression of miRNA-17-3p group were higher than those in low miRNA-17-3p expression group. Pearson correlation analysis results showed that there was a significant positive correlation of miRNA-17-3p expression with PSA (r=0.659,P=0.036) and with Gleason score (r=0.332,P=0.004).【Conclusion】The miRNA-17-3p was up-regulation in PCa,and it can be severed as a potential indicator in diagnosis and evaluation of PCa.
2023 Vol. 40 (9): 1296-1298 [Abstract] ( 48 ) HTML (1 KB)  PDF (1244 KB)  ( 32 )
1299 Effect of Tranexamic Acid Combined with Ergotrine Maleate on Puerperal Hemorrhage
WANG Di, XU Xiaoqin
DOI: 10.3969/j.issn.1671-7171.2023.09.006
【Objective】To investigate the effect of tranexamic acid combined with ergotrine maleate on puerperal hemorrhage.【Methods】A total of 197 primiparas with postpartum hemorrhage admitted to our hospital from February 2021 to October 2022 were selected as research subjects who were divided into the control group (n=98 cases) and the observation group (n=99 cases) by random number table method. The control group was given ergotrine maleate,while the observation group was given tranexamic acid in addition to the treatment of the control group. Hemostasis,coagulation function,hemorheology index,uterine arterial blood flow dynamics index,peripheral blood cytokine nitric oxide (NO) and nitric oxide synthase (NOS) were compared between the two groups. The adverse drug reactions were compared between the two groups as well.【Results】The blood loss and hemostatic time of the observation group at 2 h,6 h and 24 h after treatment were lower than those in the control group (P<0.05). The prothrombin time (PT),thrombin time (TT) and activated partial thrombin time (APTT) of the observation group after treatment were lower than those of the control group,while the fibrinogen protein (FIB) was higher than that in the control group (P<0.05). The whole blood viscosity,plasma viscosity and erythrocyte volume of the observation group after treatment were higher than those in the control group (P<0.05). The The peak systolic flow velocity (PSV) of the observation group after treatment was higher than that of the control group,while the pulsation index (PI) and resistance index (RI) in the observation group were lower than those in the control group (P<0.05). The levels of NO and NOS in the observation group after treatment were lower than those in the control group (P<0.05). There was no significant difference in the incidence of total adverse reactions between the two groups (P>0.05).【Conclusion】Tranexamic acid combined with ergotrine maleate in the treatment of puerperal hemorrhage can reduce the amount of blood loss,improve the coagulation function,hemorheology and uterine arterial blood flow dynamics of patients with good safety,and inhibit the synthesis of NO and NOS.
2023 Vol. 40 (9): 1299-1302 [Abstract] ( 64 ) HTML (1 KB)  PDF (1143 KB)  ( 47 )
1303 Efficacy of Different Dosages of Escitalopram in the Treatment of Generalized Anxiety Disorder Patients and its Impact on 5-HT and GABA Levels
CAO Jing, LI Juan
DOI: 10.3969/j.issn.1671-7171.2023.09.007
【Objective】To explore the efficacy of different dosages of escitalopram in the treatment of patients with generalized anxiety disorder (GAD) and its effect on plasma levels of 5-hydroxytryptamine (5-HT) and γ-aminobutyric acid (GABA).【Methods】A total of 86 patients with GAD admitted to our hospital were divided into the low,medium,and high dosage groups according to the different dosages of the treatment drug escitalopram,with initial dosages of 5 mg/d (low),10 mg/d (medium),and 20 mg/ d (high),respectively. The efficacy,Hamilton Anxiety Scale (HAMA) scores,Clinical Global Impression-Severity Scale (CGI-SI) scores,plasma levels of 5-HT and GABA,and the incidence of adverse reactions were compared among the three groups.【Results】The total effective rates in the medium-dosage group and high-dosage group were 93.10% (27/29) and 96.30% (26/27),respectively,which were significantly higher than 73.33% (22/30) in the low-dosage group (all P<0.05). There was no statistically significant difference in the total effective rate between the medium-dosage group and high-dosage group (P>0.05). HAMA and CGI-SI scores of the three groups after treatment were lower than those before treatment (P<0.05). The HAMA scores of the medium-dosage group and high-dosage group were significantly lower than that of the low-dosage group after treatment (P<0.05),but there was no statistically significant difference between the medium-dosage group and high-dosage group (P>0.05). The plasma levels of 5-HT and GABA in the three groups after treatment were higher than those before treatment (P<0.05). The plasma levels of 5-HT and GABA in the medium-dosage group and high-dosage group were significantly higher than those in the low-dosage group after treatment (P<0.05),but there was no statistically significant difference between the medium-dosage group and high-dosage group (P>0.05). The incidence of adverse reactions in the low-dosage group and medium-dosage group was 10.00% (3/30) and 17.24% (3/29),which were significantly lower than the 44.44% (12/27) in the high-dosage group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the low-dosage group and medium-dosage group (P>0.05).【Conclusion】Compared with low-dosage escitalopram treatment for patients with GAD,medium and high dosages can achieve better efficacy through effectively alleviating patients' clinical symptoms. And the medium-dosage group has a lower incidence of adverse reactions than the high-dosage group,with higher safety.
2023 Vol. 40 (9): 1303-1306 [Abstract] ( 43 ) HTML (1 KB)  PDF (1145 KB)  ( 30 )
1307 Correlation of Postoperative Prognosis in Patients with Esophageal Cancer with 18F-FDG PET-CT Metabolic Parameters and Serum Levels ALB and PA
WANG Hui, HU Haiping, YU Ling, et al
DOI: 10.3969/j.issn.1671-7171.2023.09.008
【Objective】To explore the correlation of postoperative prognosis in patients with esophageal cancer with fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)-CT metabolic parameters and levels of serum albumin (ALB) and prealbumin (PA).【Methods】Ninety patients with esophageal cancer were divided into two groups according to prognosis: 30 patients with good prognosis and 60 patients with poor prognosis. General information,18F-FDG PET-CT metabolic parameters,serum nutritional indicators (ALB and PA) of both groups were collected and compared. Receiver operating characteristic curve (ROC) analysis was used to evaluate the value of 18F-FDG PET-CT metabolic parameters,ALB,and PA in predicting postoperative prognosis in patients with esophageal cancer,and multiple logistic regression analysis was used to identify the risk factors for poor postoperative prognosis.【Results】There were no significant differences in age,sex,smoking history,drinking history,height,weight,and family history between the two groups (P>0.05). The maximum standard uptake value (SUVmax),metabolic volume (MTV),and total lesion glycolysis (TLG) in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The levels of ALB and PA in the poor prognosis group were lower than those in the good prognosis group (P<0.05). ROC analysis showed that SUVmax,MTV,TLG,ALB,PA could be used to predict poor postoperative prognosis in patients with esophageal cancer,with the areas under the curve being 0.985,0.913,0.963,0.726 and 0.731 respectively (all P<0.05). Multivariate logistic regression analysis confirmed that SUVmax ≥ 21.25,MTV ≥ 14.42 cm3,TLG ≥ 5.85,ALB < 52.795 g/L,and PA < 230.09 mg/L were risk factors for poor postoperative prognosis in patients with esophageal cancer (P<0.05).【Conclusion】The 18F-FDG PET-CT metabolic parameters and serum levels of ALB and PA can be used for predicting the prognosis of surgical patients with esophageal cancer. Clinicians can regularly monitor these indicators and promptly carry out postoperative follow-up chemotherapy to improve the prognosis.
2023 Vol. 40 (9): 1307-1310 [Abstract] ( 32 ) HTML (1 KB)  PDF (1202 KB)  ( 136 )
1311 Serum Levels and Significance of KIM-1,PCT and cys C in Patients with Acute Kidney Injury Caused by Ureteral Stone Obstruction
LI Qingying, REN Mengnan
DOI: 10.3969/j.issn.1671-7171.2023.09.009
【Objective】To investigate the changes and significance of Kidney Injury Molecule-1 (KIM-1),Procalcitonin (PCT),and Cystatin C (cys C) levels in the serum of patients with Acute Kidney Injury (AKI) caused by ureteral stone obstruction.【Methods】Ninety patients with ureteral stone obstruction admitted to our hospital were included in the study. Patients were divided into the AKI group (15 cases) and the non-AKI group (75 cases) based on whether AKI occurred during hospitalization. The differences in clinical data and levels of KIM-1,PCT,and cys C were compared between the two groups. Univariate and multivariate logistic regression analyses were used to evaluate the independent risk factors influencing the early occurrence of AKI in patients with ureteral stone obstruction. Receiver operating characteristic (ROC) curves were drawn to evaluate the predictive value of related indicators for the early occurrence of AKI in these patients.【Results】The levels of KIM-1,PCT,and cys C were higher in the AKI group than in the non-AKI group (P<0.05). The differences of clinical data between the two groups were not statistically significant (P>0.05). Multivariate logistic regression analysis showed that KIM-1,PCT,and cys C were independent risk factors affecting the early occurrence of AKI in patients with ureteral stone obstruction (P<0.05). ROC curves showed that KIM-1,PCT,and cys C all had certain predictive efficacy for the early occurrence of AKI in patients with ureteral stone obstruction,with areas under the curve (AUC) of 0.806,0.829,and 0.754,respectively. The combined prediction of the three indicators for the early occurrence of AKI in patients with ureteral stone obstruction had an AUC of 0.927.【Conclusion】The expressions of KIM-1,PCT,and cys C in the serum of patients with AKI caused by ureteral stone obstruction are significantly elevated. They are independent risk factors influencing the early occurrence of AKI,and the combined detection of these three indicators can be used as a screening index for the early occurrence of AKI.
2023 Vol. 40 (9): 1311-1314 [Abstract] ( 54 ) HTML (1 KB)  PDF (1230 KB)  ( 31 )
1315 Effects of Prone and Supine Mechanical Ventilation on Pulmonary Function and Inflammatory Cytokine Levels in Patients with Severe Pneumonia Complicated by Respiratory Failure
LIU Qiaoyan, WANG Juan, WANG Ping, et al
DOI: 10.3969/j.issn.1671-7171.2023.09.010
【Objective】To investigate the effects of prone and supine mechanical ventilation on pulmonary function and levels of inflammatory cytokines in patients with severe pneumonia complicated by respiratory failure.【Methods】Eighty patients with severe pneumonia complicated by respiratory failure treated in our hospital from January 2020 to January 2022 were selected. They were randomly divided into the observation group and the control group,with 40 cases in each group. Patients in the observation group received mechanical ventilation in the prone position,while the control group was ventilated in the standard supine position. Clinical efficacy,adverse event rates,and pulmonary function parameters [Forced Expiratory Volume in 1 second (FEV1),Peak Expiratory Flow (PEF),ratio of FEV1 to Forced Vital Capacity (FEV1/FVC),and Dynamic Lung Compliance (Cdyn)],levels of inflammatory cytokines [Soluble Triggering Receptor Expressed on Myeloid cells-1 (sTREM-1),High Sensitivity C-reactive Protein (hs-CRP),Interleukin-6 (IL-6)],and blood gas indicators [Oxygen Saturation (SpO2),Arterial Oxygen Partial Pressure (PaO2),and Carbon Dioxide Partial Pressure (PaCO2)] were compared between the two groups.【Results】The overall effectiveness in the observation group was significantly higher than that in the control group (P<0.05). Post-treatment FEV1,PEF,FEV1/FVC,and Cdyn in both groups were higher than those before treatment (P<0.05),with FEV1,PEF,FEV1/FVC,and Cdyn in the observation group being significantly higher than those the control group (P<0.05). Post-treatment sTREM-1,hs-CRP,and IL-6 in both groups were lower than those before treatment (P<0.05),and sTREM-1,hs-CRP,and IL-6 in the observation group were significantly lower than those in the control group (P<0.05). After treatment,PaO2 and SpO2 in both groups were higher than before treatment,and PaCO2 was lower than before treatment (P<0.05); And the PaO2 and SpO2 in the observation group showed higher than those in the control group,while PaCO2 showed lower than those in the control group (P<0.05). The incidence of adverse events between the two groups were not significantly different (P>0.05).【Conclusion】Prone position mechanical ventilation offers better treatment efficacy for patients with severe pneumonia and respiratory failure in comparison to the supine ventilation,through favorably improving pulmonary function,modulating inflammatory cytokine levels,and blood gas indicators. It also demonstrates good safety,thus recommended for clinical application.
2023 Vol. 40 (9): 1315-1318 [Abstract] ( 38 ) HTML (1 KB)  PDF (1203 KB)  ( 50 )
1319 Value of Blood Cell Parameters and Coagulation Function Indicators in Predicting Thrombolytic Prognosis of Acute Cerebral Infarction Patients
WANG Qianhui, YU Yonghui
DOI: 10.3969/j.issn.1671-7171.2023.09.011
【Objective】To explore the value of blood cell parameters and coagulation function indicators in predicting the thrombolytic prognosis of patients with acute cerebral infarction (ACI).【Methods】A total of 200 patients with ACI admitted to two hospitals were given rt-PA intravenous thrombolytic therapy. After one month of treatment,patients were divided into a good prognosis group (mRS score ≤2,114 cases) and a poor prognosis group (mRS score >2,86 cases) based on the modified Rankin Scale (mRS) score. The independent risk factors affecting the short-term prognosis of ACI patients treated with thrombolysis were analyzed,including blood cell parameters [red cell distribution width (RDW),platelet distribution width (PDW),platelet/lymphocyte ratio (PLR),and neutrophil/lymphocyte ratio (NLR)],and coagulation function indicators [thrombin time (TT),prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (FIB),D-dimer (D-D)]. The receiver operating characteristic curve (ROC) was used to evaluate the predictive efficacy of these parameters for the short-term prognosis.【Results】The proportion of atrial fibrillation,fasting blood glucose,and NIH Stroke Scale (NIHSS) score in the poor prognosis group were higher than those in the good prognosis group (P<0.05). RDW,PLR,NLR,FIB,and D-D in the poor prognosis group were higher than those in the good prognosis group (P<0.05),while TT in the poor prognosis group was lower than that in the good prognosis group (P<0.05). there was no statistically significant difference in PDW,PT,and APTT levels between the two groups (P>0.05). Multivariate Logistic regression analysis showed that,in addition to atrial fibrillation,fasting blood glucose,and NIHSS score,RDW,PLR,NLR,and D-D were independent risk factors affecting the short-term prognosis of ACI patients treated with thrombolysis (P<0.05). ROC curve analysis showed that RDW,PLR,NLR,and D-D had certain predictive efficacy for the short-term prognosis of ACI patients after thrombolysis,with areas under the curve (AUC) of 0.725,0.791,0.798,and 0.784,respectively; the combined AUC for predicting the short-term prognosis was 0.945.【Conclusion】RDW,PLR,NLR,and D-D are independent risk factors affecting the short-term prognosis of ACI patients after thrombolysis,and the combination of these four parameters can serve as sensitive predictive indicators for their short-term prognosis.
2023 Vol. 40 (9): 1319-1323 [Abstract] ( 46 ) HTML (1 KB)  PDF (1259 KB)  ( 214 )
1324 Effect of Cognitive Behavioral Therapy Combined with Medication Treatment on Non-Suicidal Self-Injury in Adolescents with Depression
MA Xuehong, YANG Zongru, HE Yanqin
DOI: 10.3969/j.issn.1671-7171.2023.09.012
【Objective】To explore the value of cognitive behavioral therapy (CBT) combined with medication treatment on non-suicidal self-injury (NSSI) in adolescents with depression.【Methods】Eighty non-NSSI adolescents with depression from our hospital were randomly divided into an observation group and a control group,with 40 cases in each group. The patients in the control group received medication treatment,while patients in the observation group received CBT combined with medication treatment. The therapeutic effects,occurrence of adverse reactions,Hamilton Depression Rating Scale (HAMD) scores,Self-Rating Depression Scale (SDS) scores,Self-Rating Anxiety Scale (SAS) scores,Coping Style Questionnaire (CSQ) scores,as well as levels of brain-derived neurotrophic factor (BDNF),neuropeptide Y (NPY),and serotonin (5-HT) were compared between the two groups before and after treatment.【Results】The total effective rate in the observation group was 87.50% (35/40),which was significantly higher than the control group's 67.50% (27/40),and the difference was statistically significant (P<0.05). The HAMD scores,SDS scores,and SAS scores in both groups after treatment were significantly lower than those before treatment,while these scores in the observation group were lower than those in the control group (P<0.05). There were no statistically significant differences in each factor score of the CSQ evaluation in the control group before and after treatment (P>0.05). After treatment,the scores of problem-solving and help-seeking factors in the observation group were significantly higher than those before treatment and the control group (P<0.05),the scores of avoidance and self-blame factors were significantly lower than those before treatment and the control group (P<0.05),There were no statistically significant differences in the scores of fantasy and rationalization factors in the observation group after treatment if compared to before treatment and the control group (P>0.05). The levels of BDNF,NPY,and 5-HT in both groups were significantly higher after treatment compared to before treatment (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).【Conclusion】CBT combined with medication treatment has good effects on improving depressive symptoms,coping skills,and autonomic nervous function in NSSI adolescents with depression. It is relatively safe as well.
2023 Vol. 40 (9): 1324-1327 [Abstract] ( 32 ) HTML (1 KB)  PDF (1145 KB)  ( 87 )
1328 Correlation Analysis of Levels of IL-10,IL-17,and ICAM-1 with the Severity of Bronchial Asthma in Children
CHEN Chunmei
DOI: 10.3969/j.issn.1671-7171.2023.09.013
【Objective】To investigate the correlation of levels of interleukin-10 (IL-10),interleukin-17 (IL-17),and intercellular adhesion molecule-1(ICAM-1) with the severity of children bronchial asthma.【Methods】A total of 120 children with bronchial asthma admitted to our hospital from December 2019 to December 2022 were selected as the observation group. According to the severity of bronchial asthma status,patients were further divided into the mild group,the moderate group,and the severe group. In the same time period,60 healthy children who underwent physical examination in our hospital were selected as the control group. The receiver operating characteristic (ROC) curve was used to analyze the value of analyzing the levels of IL-10,IL-17,and ICAM-1 using in predicting the occurrence of bronchial asthma. Spearman rank correlation analysis was applied to analyze the correlation between levels of IL-10,IL-17,ICAM-1 and the severity of the disease.【Results】The level of IL-10 in the observation group was lower than that in the control group (P<0.05),while the levels of IL-17 and ICAM-1 were higher than those in the control group (P<0.05). ROC curve analysis showed that the areas under the curve of IL-10,IL-17,and ICAM-1 in predicting the occurrence of bronchial asthma were 0.868,0.839,and 0.987,respectively (all P<0.05). The trend of IL-10 level was mild group>moderate group>severe group (P<0.05),while the trends of both IL-17 level and ICAM-1 level were in the order of mild group<moderate group<severe group (P<0.05). The level of IL-10 is negatively correlated with the severity of the disease condition (rs=-0.561,P<0.05),while the levels of IL-17 and ICAM-1 were positively correlated with the severity of the disease condition (rs=0.539,0.584,all P<0.05).【Conclusion】IL-10,IL-17,and ICAM-1 have a high predictive value for the occurrence of bronchial asthma in children,and the levels of IL-10,IL-17,and ICAM-1 in children with bronchial asthma are significantly correlated with the severity of the disease. The above indicators can be monitored clinically to predict the occurrence and progression of the disease.
2023 Vol. 40 (9): 1328-1330 [Abstract] ( 34 ) HTML (1 KB)  PDF (1247 KB)  ( 28 )
1331 Correlation of TIMP-4,FFA and EAT Thickness with Cervical Vascular Disease in Patients with Type 2 Diabetes Mellitus and Coronary Heart Disease
WANG Bo
DOI: 10.3969/j.issn.1671-7171.2023.09.014
【Objective】To investigate the relationship of tissue type metal Protease inhibitor 4(TIMP-4),Free Fatty Acid (FFA) and thickness of epicardial adipose tissue (EAT) with cervical vascular disease in patients with type 2 diabetes Mellitus (T2DM) and coronary heart disease (CHD).【Methods】From May 2019 to May 2022,158 patients with T2DM and CHD who underwent coronary angiography in our hospital were selected and divided into two groups: non-cervical vascular disease group (n=90) and cervical vascular disease group (n=68). The clinical data of the two groups of patients were collected and compared between the two groups. The Serum Levels of Timp-4 and FFA were measured by Elisa,and the thickness of EAT was measured by echocardiography. Multivariate Logistic regression was used to analyze the risk factors of cervical vascular disease in T2DM patients with CHD. The diagnostic value of serum levels of TIMP-4,FFA and EAT thickness in patients with T2DM complicated with CHD cervical vascular disease was evaluated by ROC.【Results】Compared with the non-cervical vascular disease group,the serum level of TIMP-4 decreased (P<0.05),while the FFA level and the thickness of EAT increased (P<0.05). Multiple Logistic regression analysis showed that the decreased level of TIMP-4,the increased level of FFA and the thickness of EAT were the risk factors of cervical vascular disease in T2DM patients with CHD (OR=3.968,2.587,and 4.125,respectively,P<0.05). The AUC of serum TIMP-4,FFA and EAT thickness alone and the combination of the three detections in the diagnosis of cervical vascular disease in T2DM patients with CHD were 0.753,0.506,0.856 and 0.915,respectively,the sensitivity were 83.1%,70.69%,83.1% and 85.77%,respectively,the specificity was 85.60%,62.87%,89.6% and 82.96% respectively.【Conclusion】The combined detection of TIMP-4,FFA and EAT thickness in serum is valuable in the diagnosis of cervical vascular disease in patients of T2DM with CHD,which can provide reference for early diagnosis,prevention and treatment of cervical vascular disease in T2DM patients with CHD.
2023 Vol. 40 (9): 1331-1334 [Abstract] ( 26 ) HTML (1 KB)  PDF (1169 KB)  ( 22 )
1335 Effect of Rehabilitation Training Based on Biomechanical Principles Combined with Visual Feedback Balance Training on Motor Function in Patients with Idiopathic Parkinson's Disease
WEN Jing, NING Hongxia
DOI: 10.3969/j.issn.1671-7171.2023.09.015
【Objective】To investigate the impact of rehabilitation training based on biomechanical principles combined with visual feedback balance training on motor function in patients with idiopathic Parkinson's disease (PD).【Methods】A total of 120 PD patients admitted to Yan'an Hospital of Xi'an Medical University were randomly divided into two groups,with 60 patients in each group. The control group received rehabilitation training based on biomechanical principles,while the observation group received additional visual feedback balance training on top of the basic rehabilitation training. The limb motor function,trunk control ability,and walking stability of the patients were compared between the two groups before and after 3 months of training.【Results】Before training,there were no statistically significant differences in limb motor function,trunk control ability,Berg Balance Scale (BBS) scores,and Dynamic Gait Index (DGI) scores between the two groups (P>0.05). After 3 months of training,the total scores of limb function in the observation group were higher than those in the control group (P<0.05). The trunk control ability scores in the observation group (in aspect of turning to the healthy side,turning to the affected side on the bed,sitting up from a lying position,and maintaining balance on an armless chair) were higher than those in the control group (P<0.05). The BBS and DGI scores in the observation group were also higher than those in the control group (P<0.05).【Conclusion】Biomechanical principles-based rehabilitation training combined with visual feedback balance training can effectively improve limb motor function,enhance trunk control ability,and maintain body balance and walking stability in patients with PD.
2023 Vol. 40 (9): 1335-1338 [Abstract] ( 31 ) HTML (1 KB)  PDF (1138 KB)  ( 153 )
1339 Changes in Serum Levels of sTREM-1,sCD14,and LBP in Elderly Patients with Liver Cirrhosis and Bacterial Peritonitis and their Impact on Patient Prognosis
WANG Ping, TIAN Pengfei, ZHOU Ming
DOI: 10.3969/j.issn.1671-7171.2023.09.016
【Objective】To investigate the changes in sTREM-1,sCD14,and lipopolysaccharide binding protein (LBP) in elderly patients with liver cirrhosis complicated with bacterial peritonitis (SBP).【Methods】A total of 108 elderly patients with liver cirrhosis and SBP admitted to our center and Xinxiang Central Hospital from August 2020 to March 2022 were selected as the observation group,while 108 elderly patients with liver cirrhosis without SBP were selected as the control group. According to the prognosis after 9-12 days of treatment,patients in the observation group were divided into a poor prognosis group (n=38) and a good prognosis group (n=70). The serum levels of sTREM-1,sCD14,and LBP were compared among different groups of patients before treatment,and logistic regression analysis was used to analyze the risk factors of elderly cirrhosis with SBP.【Results】Before treatment,the serum levels of sTREM-1,sCD14,and LBP in the observation group were higher than those in the control group,with statistically significant differences (P<0.05). Logistic regression analysis showed that serum sTREM-1>55.49 μg/mL,sCD14>24.94 mg/L,and LBP >90.79 μg/L before treatment were risk factors for elderly cirrhosis with SBP (P<0.05). After treatment,the serum levels of sTREM-1,sCD14,and LBP in the group with good prognosis were lower than before treatment (P<0.05),while those in the group with poor prognosis were higher than those in the group with good prognosis (P<0.05). The risk of poor prognosis in patients with high levels of serum sTREM-1,sCD14,and LBP in patients with cirrhosis and SBP was 2.116 times,2.992 times,and 2.088 times higher than that in patients with low levels (P<0.05).【Conclusion】Abnormal elevation of serum levels of sTREM-1,sCD14,and LBP can induce cirrhosis with SBP. Detecting their expression levels can provide a reference for clinical prediction of prognosis in patients with cirrhosis with SBP.
2023 Vol. 40 (9): 1339-1341 [Abstract] ( 24 ) HTML (1 KB)  PDF (1185 KB)  ( 15 )
1342 Effect of Abdominal Electrical Stimulation on Pulmonary Infection and Airway Clearance in Patients with Severe Tracheostomy
WANG Xuan, ZHAO Xiumin, LI Yanmei, et al
DOI: 10.3969/j.issn.1671-7171.2023.09.017
【Objective】To explore the effect of abdominal electrical stimulation on the incidence of pulmonary infection and airway clearance ability in patients with severe tracheostomy.【Methods】Eighty patients who underwent tracheostomy for severe conditions were admitted to our hospital from February 2021 to February 2022. They were randomly divided into a control group and an observation group,each consisting of 40 patients. The control group received conventional treatment and early training,while the observation group additionally received abdominal electrical stimulation. Both groups were treated for two weeks. The incidence of pulmonary infection,average hospital stays,time of tracheal tube retention,and parameters like Forced Expiratory Volume in 1 second (FEV1),Forced Vital Capacity (FVC),FEV1/FVC ratio,diaphragmatic mobility,diaphragmatic thickening fraction,sputum production,abdominal muscle thickness,and peak cough flow were compared.【Results】The observation group showed lower rates of pulmonary infection,shorter average hospital stays,and shorter tracheal tube retention time compared to the control group (P<0.05). After treatment,the observation group had higher values of FEV1,FVC,FEV1/FVC ratio,diaphragmatic mobility,diaphragmatic thickening fraction,and sputum production than those before treatment. and the control group after treatment (P<0.05). No significant difference was observed in the thickness of external oblique and internal oblique abdominal muscles before and after treatment in both groups (P>0.05). The observation group showed a significant increase in peak cough flow after treatment compared to before treatment and the control group after treatment (P<0.05).【Conclusion】Abdominal electrical stimulation in patients with severe tracheostomy can increase diaphragmatic mobility,improve cough ability and sputum discharge,enhance airway clearance ability,thereby reducing the incidence of pulmonary infections and shortening the duration of tracheal tube retention and hospital stay.
2023 Vol. 40 (9): 1342-1345 [Abstract] ( 33 ) HTML (1 KB)  PDF (1141 KB)  ( 45 )
1346 Investigation on the Current Status of Protective Restraint in Psychiatric Patients and Related Influencing Factors
LI Xiang, YANG Xiaoli, YUAN Ming
DOI: 10.3969/j.issn.1671-7171.2023.09.018
【Objective】To investigate the current situation of protective restraint implementation in psychiatric patients and the factors influencing it.【Methods】A retrospective selection of clinical information from 120 psychiatric patients hospitalized in our institution was conducted. Based on whether protective restraint was applied,patients were divided into the protective restraint group and the non-restraint group. The patients' condition was surveyed,and the general information such as gender,age,type of illness,duration of the disease,occupation,cultural background,marital status,number of disease relapses,history of violence,physical characteristics,past restraint experiences,past aggressive behaviors,past runaway behaviors,and treatment compliance were statistically compared between the two groups. The independent risk factors affecting the protective restraint were analyzed using multifactorial logistic regression.【Results】Out of the 120 psychiatric patients,45 (37.50%) had protective restraints applied,while 75 (62.5%) did not receive protective restraints. The differences between the two groups in terms of age,duration of the disease,number of disease relapses,history of violence,past restraint experiences,past aggressive behaviors,past runaway behaviors,and treatment compliance were statistically significant (P<0.05). Multifactorial logistic regression analysis showed that duration of the disease (less than 5 years),past restraint experiences,past aggressive behaviors,past runaway behaviors,and poor treatment compliance were all independent risk factors affecting the protective restraint in psychiatric patients (P<0.05).【Conclusion】The duration of the disease,past restraint experiences,past aggressive behaviors,past runaway behaviors,and poor treatment compliance are independent risk factors influencing the protective restraint of psychiatric patients. Clinically,there should be increased attention to these factors in patients,timely preventive intervention measures should be taken,and the effectiveness of protective restraints should be enhanced.
2023 Vol. 40 (9): 1346-1349 [Abstract] ( 42 ) HTML (1 KB)  PDF (1133 KB)  ( 29 )
1350 Expression and Clinical Significance of IL-17 in Perianal Abscess,Anal Fistula Tissue and Peripheral Blood
QIAN Wenju, CHEN Jiemin, CHEN Guohai
DOI: 10.3969/j.issn.1671-7171.2023.09.019
【Objective】To investigate the expression and clinical significance of interleukin-17 (IL-17) in tissue and peripheral blood of perianal abscess,anal fistula.【Methods】Select 50 patients with primary perianal abscess admitted to our hospital from January 2022 to December (observation group),and divide them into rehabilitation group (no recurrence or occurrence of anal fistula) and anal fistula group (progression to anal fistula) based on the follow-up results of 6 months after surgery. Select 50 patients with mixed hemorrhoids who underwent surgical treatment in our hospital during the same period (control group). According to the positive expression of IL-17 protein in the observation group,patients were divided into a positive group and a negative group. Record the postoperative follow-up of patients in the observation group,and compare the expression levels of IL-17 protein and IL-17 mRNA in the anal and rectal tissues between different groups.【Results】The positive expression rate of IL-17 protein in the observation group was significantly higher than that in the control group,with a statistically significant difference (P<0.01). The proportion of abscess diameter ≥ 5 cm,wound surface healing time ≥ 4 weeks,and progression to anal fistula in the IL-17 protein positive expression group was higher than that in the IL-17 protein negative expression group; The difference was statistically significant (P<0.05). The expression level of IL-17 mRNA in the observation group was higher than that in the control group with a statistically significant difference (P<0.001). Patients in the observation group were followed up for 6 months after surgery; And the result showed that IL-17 mRNA expression level in the anal fistula group was higher than that in the rehabilitation group with a statistically significant difference (P=0.014).【Conclusion】The positive expression rate of IL-17 protein and the expression level of IL-17 mRNA are high in patients with perianal abscess and anal fistula. IL-17 plays an important role in the occurrence and development of perianal abscess and anal fistula.
2023 Vol. 40 (9): 1350-1352 [Abstract] ( 36 ) HTML (1 KB)  PDF (1343 KB)  ( 21 )
1353 Clinical Effecacy of Different Corneal Refractive Surgery in Treating Myopia
CAO Wenjuan, LIU Liming
DOI: 10.3969/j.issn.1671-7171.2023.09.020
【Objective】To investigate the effect and safety of different corneal refractive surgeries in the treatment of myopia patients.【Methods】A retrospective analysis was conducted among the 850 myopia patients who underwent surgical treatment in Xi 'an Huaxia Eye Hospital from January 2020 to January 2022. Patients were divided into group A,group B,and group C according to different surgical methods. Patients in group A received sub-bowman's membrane laser in situ keratomileusis (SBK),patients in group B were treated with femtosecond laser-assisted laser keratomileusis (FS-LASIK),and patients in group C were treated with femtosecond laser small incision matrix lens extraction (SMILE). The uncorrected visual acuity (UCVA),quality of life impact of refractive correction (QIRC) score and endothelial central cell density (ECD) were compared among the three groups at 1 month and 6 months after surgery.【Results】There was no statistically significant difference in UCVA among the three groups before surgery,1 month and 6 months after surgery (all P>0.05). Compared to before surgery,the UCVA of the three groups at 1 month and 6 months after surgery was obviously improved (all P<0.05). QIRC scores among the three groups had no significant differences before surgery,1 month after surgery,and 6 months after surgery (all P>0.05). ECD did not show significantly different among the three groups before surgery,1 month after surgery,and 6 months after surgery (all P>0.05).【Conclusion】SBK,FS-LASIK and SMILE have good effects in treating myopia patients,which can improve visual acuity and visual quality,and have good safety.
2023 Vol. 40 (9): 1353-1356 [Abstract] ( 34 ) HTML (1 KB)  PDF (1141 KB)  ( 86 )
1357 Analysis of Factors Related to Acute Kidney Injury after Bee Sting Poisoning in Children
LUO Minghai, DUAN Wuqiong, LI Cong, et al
DOI: 10.3969/j.issn.1671-7171.2023.09.021
【Objective】To explore the influencing factors of acute kidney injury (AKI) in children after bee sting poisoning.【Methods】A retrospective analysis of clinical data from 120 children with bee sting poisoning was conducted. According to the presence or absence of AKI,they were divided into the AKI group (n=46) and non-AKI group (n=74). General information,such as the time from sting to admission and the blood tests at admission including red blood cells (RBC),white blood cells (WBC),hemoglobin (Hb),potassium ions (K+),calcium ions (Ca2+),carbon dioxide combining power (CO2CP),blood urea nitrogen (BUN),serum creatinine (Scr),creatine kinase isoenzyme (CK-MB),creatine kinase (CK),lactate dehydrogenase (LDH),alanine aminotransferase (ALT),aspartate aminotransferase (AST),prothrombin time (PT),activated partial thromboplastin time (APTT),were collected and compared between the two groups. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of these indicators for AKI after bee sting poisoning in children. The single factors with differences were incorporated into the logistic model to quantify and identify the risk factors for AKI after bee sting poisoning in children.【Results】The time from sting to admission and levels of WBC,K+,Scr,CK-MB,CK,LDH,ALT,and AST in the AKI group were significantly higher than those in the non-AKI group with statistical significance (P<0.05). ROC analysis showed that the areas under the curve of time from sting to admission,WBC、K+,Scr,CK-MB,CK,LDH,ALT,and AST for predicting AKI after bee sting poisoning in children were 0.943,0.876,0.845,0.947,0.875,0.920,0.906,0.919,and 0.956,respectively (all P<0.05). Multivariate logistic regression analysis confirmed that time from sting to admission ≥11.245 h,WBC≥14.095×109/L,K+≥5.5 mmol/L,Scr≥129.490 μmol/L,CK-MB≥50.130 U/L,CK≥371.410 U/L,LDH≥470.135 U/L,ALT≥83.745 U/L,AST≥96.195 U/L were risk factors for AKI after bee sting poisoning in children.【Conclusion】The occurrence of AKI in children after bee sting poisoning is closely related to the time from sting to admission,WBC,K+,Scr,CK-MB,CK,LDH,ALT,and AST. Those indicators should be paid attention to in clinical practice.
2023 Vol. 40 (9): 1357-1360 [Abstract] ( 26 ) HTML (1 KB)  PDF (1264 KB)  ( 30 )
1361 Clinical Efficacy of Hysteroscopic Surgery for Type Ⅰ Cesarean Scar Pregnancy
FANG Liping, LI Ni, REN Xiaoli
DOI: 10.3969/j.issn.1671-7171.2023.09.022
【Objective】To explore the clinical efficacy of hysteroscopic surgery for type Ⅰ cesarean scar pregnancy (CSP) patients.【Methods】A total of 80 patients with Type Ⅰ CSP admitted to our hospital from January 2015 to October 2019 were selected. Among them,30 patients underwent hysteroscopic resection of scar pregnancy lesions (hysteroscopic group),and 50 patients underwent uterine artery embolization intervention combined with negative pressure suction curettage (curettage group). We compared the intraoperative bleeding volume,surgical time,hospital stay,lump absorption time,and postoperative uterine function related indicators [Menstrual period,menstrual volume,menstrual recovery time,human chorionic gonadotropin (HCG) levels,HCG recovery time,vaginal bleeding time],Psychological changes of pregnant women before and after surgery [Self Rating Anxiety Scale (SAS) score,Self Rating Depression Scale (SDS) score],and the incidence of complications. between the two groups.【Results】The intraoperative bleeding volume,surgical time,hospitalization time,menstrual recovery time,HCG recovery time,and vaginal bleeding time in the hysteroscopy group were significantly lower than those in the curettage group,with statistical significance (P<0.05). The HCG level was significantly lower than that in the curettage group,with statistical significance (P<0.05); The postoperative SAS and SDS scores of the hysteroscopy group were significantly lower than those of the same group before and after the curettage group,and the difference was statistically significant (P<0.05); The incidence of complications in the hysteroscopy group was 10.00%,and there was no statistically significant difference compared to the 14.00% in the curettage group (P>0.05).【Conclusion】Compared with interventional embolization combined with curettage,hysteroscopic surgery has a better therapeutic effect on Type Ⅰ CSP,with fast recovery of uterine function and healthy psychological state,which is worthy of clinical promotion.
2023 Vol. 40 (9): 1361-1363 [Abstract] ( 46 ) HTML (1 KB)  PDF (1184 KB)  ( 29 )
1364 Correlation of Serum GFAP and S100B Levels with Brain Damage in Premature Infants
LIU Jie, ZHA Shanhui, GUO Mingyan
DOI: 10.3969/j.issn.1671-7171.2023.09.023
【Objective】To explore levels of serum glial fibrillary acidic protein (GFAP) and S100 protein B (S100B) and their correlation with brain damage in premature infants.【Methods】A total of 94 premature infants who were born in our hospital between March 2019 and March 2021 were selected and they were divided into the occurrence group (n=38 cases) and non-occurring group (n=56 cases) according to whether brain damage occurred. The levels of serum GFAP and S100B plus Apgar scores were compared in both groups. Then,the levels serum GFAP and S100B,and Apgar scores of premature infants with different severity of brain damage were compared. Pearson correlation was used to analyze the correlation of serum GFAP and S100B levels in brain injury children with their Apgar scores at 5 minutes after birth. The receiver operating characteristic (ROC) curve was used to analyze the value of serum GFAP and S100B levels at 12 hours after birth in assessing brain damage in premature infants.【Results】The serum levels of GFAP and S100B at 12 hours and 3 days after birth in the occurrence group were higher than those in the non-occurrence group at 12 hours and 3 days after birth (P<0.05). The serum levels of GFAP and S100B at 3 days after birth in the two groups were lower than that at 12 hours after birth (P<0.05). The Apgar score at 5 minutes after birth in the occurrence group was lower than that in the non-occurrence group (P<0.05). The levels of serum GFAP and S100B in the severe group were higher than those in the mild and moderate groups (P<0.05),while those in the moderate group were higher than those in the mild group (P<0.05); The Apgar score at 5 minutes after birth in the severe group was lower than that in the mild and moderate groups (P<0.05),while the Apgar score in the moderate group was lower than that in the mild group (P<0.05). Pearson correlation analysis showed that serum GFAP and S100B levels in children with brain injury at 12 hours and 3 days after birth were negatively correlated with Apgar score at 5 minutes after birth (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) for assessing brain injury in preterm infants with serum GFAP and S100B levels at 3 and 12 hours after birth were 0.848,0.866,0.908,and 0934,respectively (all P<0.05).【Conclusion】Serum GFAP and S100B levels are related to brain damage in premature infants,which can be used as sensitive indicators to assess brain damage in premature infants.
2023 Vol. 40 (9): 1364-1367 [Abstract] ( 40 ) HTML (1 KB)  PDF (1301 KB)  ( 21 )
1368 Predictive Value of Electrophysiological Parameters of Pelvic Floor Muscles for Postpartum Stress Urinary Incontinence
KE Shanying, GONG Qin
DOI: 10.3969/j.issn.1671-7171.2023.09.024
【Objective】To investigate the predictive value of electrophysiological parameters of pelvic floor muscles for postpartum stress urinary incontinence.【Methods】A total of 94 pregnant women who gave birth in the obstetrics department of Zhen'an Maternal and Child Health Care Hospital from February 2020 to June 2021 were selected,and the incidence of postpartum stress urinary incontinence was counted. Univariate analysis was used to analyze the factors affecting postpartum stress urinary incontinence,and logistic regression analysis was performed to analyze the factors affecting postpartum stress urinary incontinence,the receiver operating curve (ROC) was used to analyze the maximal muscle potential of pelvic floor muscle and the value of type Ⅱ muscle endurance at 1 month postpartum in predicting postpartum stress urinary incontinence.【Results】The composition ratio of multiparous women and neonatal weight in patients with postpartum stress urinary incontinence were higher than those in non-partum women (P<0.05),the maximum muscle potential and type Ⅱ muscle endurance at 1 month postpartum of patients with postpartum stress urinary incontinence were lower than those of non-partum women (P<0.05). Logistic multivariate regression analysis showed that maximum myopotential,type Ⅱ muscular endurance at 1 month postpartum and parity were independent risk factors for postpartum stress urinary incontinence (P<0.05). ROC analysis showed that the best cut-off points of pelvic floor muscle maximum muscle potential and type Ⅱ muscle endurance at 1 month postpartum in predicting postpartum stress urinary incontinence were 11.37 μV and 2.00 grade,respectively,and the specificity was 73.53% and 64.71%,the area under the curve (AUC) were 0.799 and 0.763,the specificity and AUC of the combination were 97.06% and 0.915,respectively.【Conclusion】Pelvic floor muscle maximum myoelectric potential and type Ⅱ muscular endurance can both be used as sensitive indicators for predicting postpartum stress urinary incontinence,and the combination of the two has higher predictive value.
2023 Vol. 40 (9): 1368-1370 [Abstract] ( 29 ) HTML (1 KB)  PDF (1211 KB)  ( 50 )
1371 Effects of Different Doses of Mifepristone on Sex Hormone Levels in Patients with Uterine Fibroid and Anemia
DONG Lijun, WANG Wei
DOI: 10.3969/j.issn.1671-7171.2023.09.025
【Objective】To investigate the effect of different doses of mifepristone on sex hormone levels in patients with Uterine fibroid and anemia.【Methods】From March 2019 to March 2021,90 patients with Uterine fibroid and anemia in the Pucheng County Hospital were selected and divided into observation group and control group according to random number table,with 45 cases in each group. The control group received high-dose mifepristone (20 mg/dose) treatment before surgery,while the observation group received low-dose mifepristone (10 mg/dose) treatment before surgery. The operation time,intraoperative blood loss,hospital stay,hemoglobin content 24 hours after operation,adverse reactions after medication,levels of sex hormones [luteinizing hormone (LH),progesterone (P),Follicle-stimulating hormone (FSH),estradiol (E2)],diameter of Uterine fibroid,uterine volume,and quality of life scale (QOL) scores were compared between the two groups.【Results】There was no statistically significant difference (P>0.05) between the two groups in terms of surgical time,intraoperative bleeding volume,length of hospital stay,and postoperative 24 hour hemoglobin levels; The levels of LH,P,FSH,and E2 in the two groups of patients after treatment were lower than those in the same group before treatment,and the difference was statistically significant (P<0.05); After treatment,the diameter of fibroids and uterine volume of the two groups of patients were smaller than that before treatment,and the QOL scores was higher than that before treatment,with a statistically significant difference (P<0.05); The incidence of adverse reactions after medication in the observation group (15.56%) was significantly lower than that in the control group (35.56%),with a statistically significant difference (P<0.05).【Conclusion】Preoperative use of low-dose mifepristone in patients with Uterine fibroid and anemia can effectively reduce the level of sex hormones,reduce the volume of leiomyoma,and has high safety.
2023 Vol. 40 (9): 1371-1374 [Abstract] ( 33 ) HTML (1 KB)  PDF (1144 KB)  ( 15 )
1375 Efficacy of Transcranial Direct Current Stimulation Combined with Huperzine A in the Treatment of Senile Vascular Dementia Patients
LIANG Shanshan
DOI: 10.3969/j.issn.1671-7171.2023.09.026
【Objective】To investigate the effect of transcranial direct current stimulation (tDCS) combined with huperzine A in the treatment of senile vascular dementia (VD).【Methods】A total of 100 elderly patients with VD in our hospital from March 2021 to March 2022 were selected and divided into the observation group (n=50) and the control group (n=50) according to the random number table method. Patients in the control group B received tDCS therapy,while patients in the observation group received tDCS combined with huperzine A therapy. The total effective rate,Mini-Mental State Examination (MMSE),Montreal Cognitive Assessment (MoCA) score,P300 potential N2,N3 latency and P3 amplitude,anterior cerebral artery (ACA),posterior cerebral Arterial (PCA),middle cerebral artery (MCA) blood flow velocity,serum serotonin (5-HT),dopamine (DA),and norepinephrine (NE) levels 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 3 months of treatment,the MoCA and MMSE scores of the observation group were higher than those of the control group (P<0.05); And the observation group was higher than that of the control group,the difference was statistically significant (P<0.05). The N2 and N3 latency of P300 potential in the two groups were shorter than before treatment,and the P3 amplitude was higher than before treatment. After 3 months of treatment,the latencies of N2 and N3 of P300 potential in the observation group were shorter than those in the control group,while the amplitude of P3 was higher than that in the control group (P<0.05). The cerebral blood flow velocity of ACA,MCA,and PCA in the two groups was higher than before treatment,and the cerebral blood flow velocity of ACA,MCA,and PCA in the observation group was higher than that of the control group. The difference was statistically significant (P<0.05). The serum 5-HT,DA,and NE levels of the two groups were higher than before treatment. The levels of 5-HT,DA,and NE in the observation group was higher than those the control group,and the difference was statistically significant (P<0.05).【Conclusion】The tDCS combined with huperzine A in the treatment of elderly VD patients can further improve the curative effect,improve cognitive function and mental state,improve cerebral blood perfusion and facial nerve electrophysiological regulation effect,and regulate the level of nerve factors.
2023 Vol. 40 (9): 1375-1377 [Abstract] ( 33 ) HTML (1 KB)  PDF (1186 KB)  ( 42 )
1378 Effect of Internal Iliac Artery Balloon Intervention on Blood Loss during Cesarean Section in Patients with Placenta Previa
DU Yuxia, ZHANG Keke, WEI Fanyan
DOI: 10.3969/j.issn.1671-7171.2023.09.027
【Objective】To investigate the effects of internal iliac artery balloon occlusion on intraoperative blood loss in patients with placenta previa undergoing cesarean section.【Methods】A total of 86 patients with placenta previa treated in our department from December 2020 to June 2022 were chosen as research subjects and randomly divided into the observation and the control groups,each group comprising 43 cases. The observation group underwent internal iliac artery balloon occlusion,while the control group used localized suturing,intrauterine packing,and other hemostatic measures,and if necessary,bilateral internal iliac or uterine artery embolization,or hysterectomy. The perioperative indicators (operation time,intraoperative blood loss,transfusion volume,postoperative hemoglobin levels,and hospitalization duration),the incidence of complications during hospitalization,newborn conditions (1-min and 5-min Apgar scores,height,weight,and incidence of asphyxia),and pre-and postoperative serum inflammatory markers (IL-6,CRP,TNF-α) were compared between the two groups.【Results】There was no statistically significant difference in operation time between the two groups (P>0.05). The observation group had significantly lower intraoperative blood loss,transfusion volume,and length of hospital stay,but higher postoperative hemoglobin levels compared to the control group (P<0.05). No significant differences were observed in pre-and post-operative serum IL-6,CRP,and TNF-α levels between the two groups (P>0.05). However,both groups had significantly elevated levels of IL-6,CRP,and TNF-α postoperatively compared to preoperatively (P<0.05). The newborn conditions,including 1-min and 5-min Apgar scores,height,weight,and incidence of asphyxia,showed no significant differences between the two groups (P>0.05). The incidence of complications during hospitalization was significantly lower in the observation group (13.95%) than in the control group (39.53%) (P<0.05).【Conclusion】Internal iliac artery balloon occlusion effectively reduces intraoperative blood loss,transfusion volume,and postoperative complication rates in patients with placenta previa undergoing cesarean section,with a high level of safety.
2023 Vol. 40 (9): 1378-1381 [Abstract] ( 30 ) HTML (1 KB)  PDF (1147 KB)  ( 27 )
1382 Comparison of Efficacy and Safety of Dabigatran Ester,Rivaroxaban,and Warfarin in the Treatment of Atrial Fibrillation
LEI Xueting, WANG Ni
DOI: 10.3969/j.issn.1671-7171.2023.09.028
【Objective】To compare the efficacy and safety of dabigatran ester,rivaroxaban,and warfarin in the treatment of atrial fibrillation.【Methods】A retrospective study was conducted on 243 patients with atrial fibrillation admitted to our hospital from January 2020 to January 2022. Patients were divided into group A,group B,and group C by random number table method,with 81 patients in each group. All patients in the three groups received routine treatment for atrial fibrillation. On this basis,Group A patients were given dabigatran ester capsules,Group B patients were given rivaroxaban tablets,and Group C patients were given warfarin sodium tablets. The clinical efficacy and coagulation related indicators including thrombin time (TT),activated partial thromboplastin time (APTT),prothrombin time (PT),and fibrinogen (FIB) before and after treatment were compared among three groups. The incidence of adverse reactions during treatment among the three groups was compared as well.【Results】After 6 months of treatment,there were no statistically significant differences in the total effective rates among Group A,Group B,and Group C (P>0.05). After treatment,the TT,APTT,and PT of the three groups of patients were all higher than those before treatment (P<0.05). And there was no statistically significant difference in FIB among the three groups (P>0.05). There was no statistically significant difference in TT,APTT,PT,and FIB between Group A and Group B after treatment (P>0.05). However,after treatment,TT,APTT,and PT in Group A and Group B were significantly higher than those in Group C (P<0.05). The total incidence of adverse reactions in Group A and Group B was lower than that in Group C (P<0.05); And there was no statistically significant difference of adverse reactions between Group A and Group B (P>0.05).【Conclusion】There is no significant difference in the efficacy of dabigatran ester,rivaroxaban,and warfarin in anticoagulant therapy for patients with atrial fibrillation. However,compared to warfarin,dabigatran ester and rivaroxaban are safer and have a more significant improvement in coagulation indicators.
2023 Vol. 40 (9): 1382-1384 [Abstract] ( 33 ) HTML (1 KB)  PDF (1182 KB)  ( 30 )
1385 Therapeutic Effect of Enbipu Capsules on Transient Ischemic Attack Patients and its Impact on Related Factors
HUANG Liang, JIA Jun, QU Xinghan
DOI: 10.3969/j.issn.1671-7171.2023.09.029
【Objective】To explore the therapeutic effect of Enbipu capsules on transient ischemic attack (TIA) patients and its impact on related factors.【Methods】A total of 110 TIA patients were randomly divided into two groups,with 55 cases in each group. All patients received conventional treatment for TIA. The observation group was orally administered Enbipu capsules,while the control group was given enteric-coated aspirin tablets. Both groups were treated continuously for 14 days. The clinical efficacy,changes in inflammatory factors [serum hypersensitive C-reactive protein (hs-CRP),homocysteine (Hcy),interleukin-6 (IL-6),and matrix metalloproteinase-9 (MMP-9)],hemorheology indicators [whole blood viscosity at low shear rate (LS),whole blood viscosity at high shear rate (HS),and plasma viscosity (PV)],coagulation function indicators [fibrinogen (FIB),prothrombin time (PT),activated partial thromboplastin time (APTT)],and neurological function indicators [neurofunctional factor S-100B protein (S-100B) and neuron-specific enolase (NSE)] were compared between the two groups.【Results】The overall effective rate in the observation group was 92.73% (51/55),which was significantly higher than the 78.18% (43/55) in the control group with statistically significant difference (P<0.05). There were no significant differences of all indicators in both groups before treatment (P>0.05). Post-treatment levels of Hcy,hs-CRP,IL-6,and MMP-9 in both groups were significantly reduced compared to pre-treatment (P<0.05). And the post-treatment levels of Hcy,hs-CRP,IL-6,and MMP-9 in the observation group were significantly lower than those in the control group after treatment(P<0.05). Compared to before treatment,levels of LS,HS,and PV decreased significantly after treatment in both groups (P<0.05),while LS,HS and PV levels in the observation group were significantly lower than those in the control group (P<0.05). After treatment,FIB in both groups decreased significantly,while PT and APTT increased significantly (P<0.05); And FIB in the observation group after treatment was significantly lower than that in the control group after treatment,while both PT and APTT of the observation group after treatment were higher than those of the control group after treatment (P<0.05). S-100B and NSE levels after treatment in both groups decreased significantly if compared to pre-treatment (P<0.05); And levels of S-100B and NSE in the observation group were much lower than those in the control group (P<0.05).【Conclusion】Enbipu capsules have a significant therapeutic effect on TIA,which can effectively suppress inflammatory responses and significantly improve patients' hemorheology,coagulation function,and neurological function.
2023 Vol. 40 (9): 1385-1388 [Abstract] ( 31 ) HTML (1 KB)  PDF (1149 KB)  ( 38 )
1389 Efficacy of Letrozole Combined with Recombinant Human Growth Hormone in the Treatment of Adolescent Short Stature Boys and Drug Effects on Physical Development and Bone Metabolism
FU Chengli, NIU Wanke
DOI: 10.3969/j.issn.1671-7171.2023.09.030
【Objective】To study the efficacy of letrozole combined with recombinant human growth hormone in treating boys with pubertal short stature and drug effects on physical development and bone metabolism.【Methods】One hundred and fifty boys with adolescent short stature disorder admitted to the hospital from January 2021 to January 2022 were divided into a control group and a combination group with 75 cases each by the random number table method. The control group was treated with recombinant human growth hormone and the combination group was treated with letrozole combined with recombinant human growth hormone. The physical development indexes [height,weight,growth velocity (GV),height standard deviation score (HtSDS)],serum bone metabolism indexes [osteocalcin (OC),bone alkaline phosphatase (BALP),pre-collagen type Ⅰ amino-terminal peptide (PINP),β-collagen degradation product (β-CTX)],serum appetite stimulating hormone (Ghrelin),serum insulin-like growth factor binding protein-3 (IGFBP-3) levels,core generalized children's quality of life scale (PedsQL) scores,and incidence of adverse reactions were compared between the two groups.【Results】The physical development indexes in the combined group were higher than those in the control group after 6 and 12 months of treatment (P<0.05). After 6 and 12 months of treatment,the improvement of serum bone metabolism indexes and levels of both serum Ghrelin and IGFBP-3 in the combined group were greater than those in the control group (P<0.05). The PedsQL score in the combined group was higher than that in the control group after 6 and 12 months of treatment (P<0.05 ). The overall incidence of adverse reactions in the combined group was 9.33% and overall incidence of adverse reactions was 6.67% in the control group,which was not statistically significant (P>0.05).【Conclusion】The combination of letrozole and recombinant human growth hormone is effective in treating male children with adolescent short stature disorder,and it can regulate the level of bone metabolic indexes and promote the growth and development of children with high safety.
2023 Vol. 40 (9): 1389-1391 [Abstract] ( 35 ) HTML (1 KB)  PDF (1204 KB)  ( 110 )
1392 Diagnostic Value of Diffusion Weighted Imaging and Apparent Diffusion Coefficient Values in Delayed Encephalopathy Caused by Carbon Monoxide Poisoning
LI Xiaojuan, HAO Shao, ZHAN Xiaofei
DOI: 10.3969/j.issn.1671-7171.2023.09.031
【Objective】To explore the value of diffusion weighted imaging and apparent diffusion coefficient (DWI-ADC) in the diagnosis of delayed encephalopathy caused by carbon monoxide (CO) poisoning.【Methods】A total of 120 patients with acute CO poisoning admitted to our hospital from February 2020 to February 2022 were selected. Four different sequences of magnetic resonance imaging (MRI) were used to examine all patients and calculate the apparent diffusion coefficient value (ADC). The distribution of lesions in CO poisoning patients was analyzed,and the number of lesions detected in different lesion areas in different scanning sequences during MRI examination was compared. Spearman was used to analyze the correlation between the severity of CO poisoning patients and ADC values.【Results】Among the 120 patients with mild poisoning,35 had no abnormal MRI findings,accounting for 68.30% (35/52); 14 patients with moderate poisoning had no abnormal MRI findings,accounting for 25.45% (14/55); Two patients with severe poisoning had delayed encephalopathy,accounting for 15.38% (2/13). In different lesion areas and sequences of scans,the number of lesions detected by DWI was significantly higher than that on TSE-T2WI,SE-T1WI,and FLAIR-T2WI,with a statistically significant difference (P<0.05). There was no statistically significant difference in ADC values in the cerebral cortex of patients with different levels of CO poisoning (P>0.05); Compared with mild encephalopathy,the ADC values in the central half oval,paraventricular white matter,and globus pallidus of moderate,severe,and delayed onset encephalopathy were significantly reduced. Moreover,the ADC value of severe encephalopathy was lower than that of moderate,and the ADC value of delayed encephalopathy was lower than that of severe and moderate,with statistical significance (all P<0.05). Spearman correlation analysis showed that the severity of CO poisoning was negatively correlated with ADC values in the central oval,paraventricular white matter,and globus pallidus regions (all P<0.05).【Conclusion】DWI-ADC can predict the risk of delayed encephalopathy caused by CO poisoning in patients. The higher the DWI signal,the smaller the ADC value,indicating more severe white matter demyelination damage in patients,and the greater the risk of concurrent delayed encephalopathy.
2023 Vol. 40 (9): 1392-1395 [Abstract] ( 28 ) HTML (1 KB)  PDF (1142 KB)  ( 30 )
1396 The Application Value of Metallothionein-3 Combined with Tumor Markers in the Evaluation of Postoperative Efficacy of TACE for Primary Liver Cancer
ZHANG Lijing, WANG Pei
DOI: 10.3969/j.issn.1671-7171.2023.09.032
【Objective】To explore the application value of metallothionein-3 (MT-3) combined with tumor markers in evaluating the postoperative efficacy of transcatheter arterial chemoembolization (TACE) for primary liver cancer.【Methods】A retrospective analysis was conducted on the clinical data of 80 TACE treated primary liver cancer patients admitted to the Fourth People's Hospital of Shaanxi Province from January 2019 to January 2022. They were divided into a control group and an uncontrolled group based on their clinical efficacy. Clinical data such as Age,gender,body mass index (BMI),Child Pugh grading of liver function,tumor site,number of tumors,degree of tumor cell differentiation,tumor type,serum total bilirubin (TBIL),and serum tumor markers [CYFRA21-1,Squamous cell carcinoma antigen (SCC),carcinoembryonic antigen (CEA),alpha fetoprotein (AFP),carbohydrate antigen 19-9 (CA19-9)],and serum MT-3 of two groups of patients were collected; The evaluation value of serum MT-3 combined with tumor markers in the postoperative efficacy of TACE in patients with primary liver cancer were analyzed using the receiver operating characteristic (ROC) curve.【Results】Among the 80 cases,65 patients(81.25%) were effectively treated and included in the control group;15 patients (18.75%) were included in the uncontrolled group due to ineffective treatment. There was no statistically significant difference (P>0.05) between the two groups in terms of gender,tumor diameter,number of tumors,tumor location,degree of tumor cell differentiation,tumor type,liver cirrhosis,proportion of Child Pugh grading of liver function,age,BMI,TBIL,CA19-9,CEA; The levels of CYFRA21-1,SCC,and AFP in the uncontrolled group were higher than those in the control group (P<0.05),while the levels of MT-3 were lower than those in the control group (P<0.05). The ROC curve analysis results show that CYFRA21-1,SCC,AFP,and MT-3 all have certain predictive value for the postoperative efficacy of TACE in patients with primary liver cancer.【Conclusions】CYFRA21-1,SCC,AFP,and MT-3 have certain predictive value for the postoperative efficacy of TACE in patients with primary liver cancer,and the combined predictive value is higher. Clinicians should pay close attention to them.
2023 Vol. 40 (9): 1396-1399 [Abstract] ( 28 ) HTML (1 KB)  PDF (1167 KB)  ( 26 )
Copyright © Editorial Board of JOURNAL OF CLINICAL RESEARCH
Supported by:Beijing Magtech