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Quick Search     Adv Search 2023 Vol. 40, No. 10 Published: 2023-10-26 Original Articles          Original Articles 1441 Analysis of Pregnancy Outcomes in Pregnant Women with Structural Heart Disease LI Qiaorong, LONG Xiangdang, AO Kun, et al DOI: 10.3969/j.issn.1671-7171.2023.10.001 【Objective】To investigate the pregnancy outcomes of pregnant women with structural heart disease.【Method】The clinical data of 40 pregnant women diagnosed with structural heart disease (observation group) and 80 healthy pregnant women (control group) were retrospectively analyzed, and the pregnancy outcomes of the two groups were compared.【Results】Among the 40 pregnant women with structural heart disease, 10 cases (10/40,25.00%) were rheumatic heart disease and 30 cases (30/40,75.00%) were congenital heart disease.The incidences of stillbirth, premature birth, iatrogenic fetal loss,perinatal mortality,ICU admission,cesarean section,NICU admission in the case group were higher than those in the control group (P<0.05).The birth weight, Apgar score at 1 and 5 minutes and the gestational age of neonates in the case group were lower than those in the control group (P<0.05).The incidences of premature birth, perinatal death, cesarean section and NICU admission in the NYHA grade Ⅲ-Ⅳ group were higher than those in NYHA grade Ⅰ-Ⅱ group (P<0.05).The birth weight and the gestational age of neonates in the NYHA grade Ⅲ-Ⅳ group were lower than those in NYHA grade Ⅰ-Ⅱ group (P<0.05).【Conclusion】There is a high incidence of adverse pregnancy outcomes in pregnant women with structural heart disease, especially in those with NYHA grade Ⅲ-Ⅳ. 2023 Vol. 40 (10): 1441-1443,1447 [Abstract] ( 64 ) HTML (1 KB)  PDF (1220 KB)  ( 33 ) 1444 The Efficacy of Jisheng Shenqi Formula Combined with Xuefu Zhuyu Decoction in Treating Primary Nephrotic Syndrome LI Wenli, YANG Xuemei, YAN Jianfeng DOI: 10.3969/j.issn.1671-7171.2023.10.002 【Objective】To observe the efficacy of Jisheng Shenqi formula combined with Xuefu Zhuyu decoction in treating primary nephrotic syndrome (PNS) and its effects on renal function and lipid metabolism in patients. 【Methods】104 patients with PNS were randomly divided into an observation group and a control group, with 52 patients in each group. The control group received Western medicine treatment, while the observation group received Jisheng Shenqi formula combined with Xuefu Zhuyu decoction on top of the treatment given to the control group. The clinical efficacy, traditional Chinese medicine symptom scores, 24 hour urinary protein quantification (24hUPQ), renal function [serum creatinine (Scr), blood urea nitrogen (BUN), endogenous creatinine clearance rate (Ccr)], and lipid levels [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)] were compared between the two groups, as well as adverse reactions. 【Results】The overall efficacy in the observation group was higher than in the control group (P<0.05). After treatment, the traditional Chinese medicine symptom scores in both groups decreased, and the scores in the observation group were lower than in the control group (P<0.05). After treatment, 24hUPQ, Scr, and BUN levels in both groups decreased, and Ccr increased, with the observation group showing better improvements than the control group (P<0.05). After treatment, TC, TG, and LDL-C levels in both groups decreased, while HDL-C levels increased, with the observation group showing better improvements than the control group (P<0.05). The incidence of adverse reactions between the two groups showed no statistically significant difference (P>0.05). 【Conclusion】Jisheng Shenqi formula combined with Xuefu Zhuyu decoction has a good therapeutic effect on PNS, can significantly reduce traditional Chinese medicine symptom scores, and improve renal function and blood lipid metabolism levels in patients. 2023 Vol. 40 (10): 1444-1447 [Abstract] ( 39 ) HTML (1 KB)  PDF (1193 KB)  ( 72 ) 1448 The Value of NST Combined with Ultrasound Parameters in Evaluating the Adverse Pregnancy Outcomes of Singleton High-Risk Pregnant Women JIA Miao, LI Na, XIAO Ling, et al DOI: 10.3969/j.issn.1671-7171.2023.10.003 【Objective】To explore the value of non-stress fetal heart monitoring (NST) combined with ultrasound parameters in evaluating the adverse pregnancy outcomes of single high-risk pregnant women. 【Methods】A total of 150 singleton high-risk pregnant women admitted to Hanzhong Central Hospital of Shaanxi Province from December 2019 to December 2021 were selected as the observation group, and 150 normal pregnant women during the same period were selected as the control group. NST and ultrasound were performed before delivery. Taking the pregnancy outcomes of the two groups of pregnant women as the gold standard, the diagnostic coincidence of non-stress fetal heart rate monitoring and ultrasound examination for the adverse pregnancy outcomes of the two groups of pregnant women was analyzed. The consistency of non-stress fetal heart rate monitoring and ultrasound examination in the diagnosis of adverse pregnancy outcomes and final pregnancy outcomes in singleton high-risk pregnant women was analyzed. The diagnostic efficacy of non-stress fetal heart rate monitoring and ultrasound examination in the adverse pregnancy outcomes of singleton high-risk pregnant women was analyzed. 【Results】A total of 150 cases in the observation group were successfully delivered, including 43 cases of adverse pregnancy outcomes (28.67%), including 16 cases of oligohydramnios, 5 cases of fetal distress, 8 cases of amniotic fluid pollution, 3 cases of umbilical cord around the neck, 11 cases of cesarean section ; in the control group, 150 cases were successfully delivered, including 10 cases of adverse pregnancy outcomes (6.67%), including 2 cases of amniotic fluid, 5 cases of fetal distress, and 3 cases of cesarean section. Among 150 cases of singleton high-risk pregnant women in the observation group, 30 cases were abnormal in non-stress fetal heart monitoring, 32 cases were abnormal in ultrasound, and 40 cases were abnormal in the combination of the two. The coincidence rates were 69.77%, 74.42% and 93.02 %, respectively. Among the 150 normal pregnant women in the control group, 6 cases of non-stress fetal heart monitoring showed abnormalities, 7 cases of ultrasound showed abnormalities, and 9 cases of combined examination showed abnormalities. The coincidence rates were 60.00%, 70.00%, and 90.00%, respectively.The diagnostic results of non-stress fetal heart rate monitoring in single high-risk pregnant women were generally consistent with the final adverse pregnancy outcome (Kappa=0.587). The diagnostic results of ultrasound examination were generally consistent with the final adverse pregnancy outcome (Kappa=0.594). The diagnostic results of non-stress fetal heart rate monitoring combined with ultrasound examination were in good agreement with the final adverse pregnancy outcome (Kappa=0.802). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of non-stress fetal heart rate monitoring combined with ultrasound examination for adverse pregnancy outcomes of singleton high-risk pregnant women were higher than single non-stress fetal heart rate monitoring and ultrasound examination. The difference was statistically significant (P<0.05 ). 【Conclusion】The use of non-stress fetal heart rate monitoring and ultrasonography alone to evaluate the adverse pregnancy outcomes of single-fetal high-risk pregnant women has good value, and the combination of the two can further improve the diagnostic efficiency, which is worthy of clinical promotion. 2023 Vol. 40 (10): 1448-1451 [Abstract] ( 30 ) HTML (1 KB)  PDF (1187 KB)  ( 67 ) 1452 Differential Value of P16/Ki67 Double Staining Combined with HPV Genotyping in Cervical Precancerous Lesions in TCT-negative Patients HAN Shuang, ZHAI Huali, LEI Fang, et al DOI: 10.3969/j.issn.1671-7171.2023.10.004 【Objective】To explore the value of P16/proliferating nuclear antigen (Ki67) double staining combined with human papillomavirus (HPV) genotyping in the identification of cervical precancerous lesions in patients with negative liquid-based thin layer cytology test (TCT). 【Methods】A total of 104 TCT-negative patients who underwent cervical cancer screening in our hospital from May 2021 to July 2022 were selected, all patients underwent P16/Ki67 double staining, HPV genotyping and colposcopy biopsy. The colposcopy biopsy results as the gold standard, the consistency of P16/Ki67 double staining, HPV genotyping and colposcopy biopsy results was analyzed, and the value of P16/Ki67 double staining combined with HPV genotyping in the diagnosis of cervical precancerous lesions in TCT-negative patients was analyzed. 【Results】The results of colposcopy pathological biopsy showed that among the 104 TCT-negative patients, there were 33 patients with cervical intraepithelial neoplasia grade 2 or higher, including 14 patients with CIN2, 18 patients with CIN3, and 1 patient with cervical adenocarcinoma, the remaining 71 cases were all negative lesions. P16/Ki67 double staining was used for the diagnosis of cervical precancerous lesions in TCT-negative patients, 28 positive patients were consistent with the diagnosis results of colposcopy pathological biopsy, and 64 negative patients were consistent with the diagnosis results of colposcopy pathological biopsy, after Kappa consistency test, Kappa=0.738, the agreement between the two diagnostic methods was general. HPV genotyping was used for the diagnosis of cervical precancerous lesions in TCT-negative patients, 25 positive patients were consistent with the diagnosis results of colposcopy biopsy, and 59 negative patients were consistent with the diagnosis results of colposcopy biopsy, after Kappa consistency test, Kappa=0.570. P16/Ki67 double staining combined with HPV genotyping was used for the diagnosis of cervical precancerous lesions in TCT-negative patients, 30 positive patients were consistent with the results of colposcopy biopsy, and 66 negative patients were consistent with colposcopy biopsy, after the Kappa consistency test, Kappa=0.825. The sensitivity, specificity, Youden index and accuracy of P16/Ki67 double staining combined with HPV genotyping were 90.91%, 92.96%, 0.839 and 92.31%, respectively, and the combined diagnosis was more accurate. 【Conclusion】P16/Ki67 double staining combined with HPV genotyping has high diagnostic accuracy for cervical precancerous lesions in TCT-negative patients, and it can be used for early screening of cervical precancerous lesions. 2023 Vol. 40 (10): 1452-1455 [Abstract] ( 33 ) HTML (1 KB)  PDF (1218 KB)  ( 42 ) 1456 The Clinical Efficacy of Ritodrine Hydrochloride Tablets Combined with Dydrogesterone in the Treatment of Recurrent Miscarriage Patients ZHAO Ziying, LUO Jing, YU Mengchun DOI: 10.3969/j.issn.1671-7171.2023.10.005 【Objective】 To explore the clinical efficacy of combination of ritodrine hydrochloride tablets and dexamethasone in the treatment of recurrent miscarriage patients.【Methods】A total of 88 patients with recurrent miscarriage admitted to Yan'an University Affiliated Hospital from January 2019 to December 2022 were randomly divided into a control group and an observation group, with 44 cases in each group. The control group was treated with ritodrine hydrochloride tablets, while the observation group was treated with dydrogesterone on the basis of the control group. Both groups received fetal protection treatment until the 70th day of pregnancy. We compared the clinical efficacy, incidence of adverse reactions during treatment, heart rate, blood pressure, progesterone (P), estradiol (E2), and soluble leukocyte antigen G (sHLA-G) levels before and after treatment between two groups.【Results】The total effective rate of the observation group was 93.18%, significantly higher than the control group's 72.73% (P<0.05). After treatment, the blood pressure and heart rate of both groups of patients decreased (P<0.05), and the heart rate and blood pressure of the observation group were lower than those of the control group (P<0.05). After treatment, the serum E2, P, and sHLA-G levels in both groups of patients decreased (P<0.05), and the serum E2, P, and sHLA-G levels in the observation group were on average lower than those in the control group (P<0.05). The total incidence of adverse reactions during treatment in the observation group was lower than that in the control group (P<0.05). 【Conclusion】 The combination of ritodrine hydrochloride tablets and dydrogesterone has a significant effect on the treatment of recurrent miscarriage patients, which can reduce E2 and P levels, reduce the incidence of adverse reactions, and is worthy of clinical promotion and application. 2023 Vol. 40 (10): 1456-1458 [Abstract] ( 29 ) HTML (1 KB)  PDF (1163 KB)  ( 27 ) 1459 Magnetic Resonance Diffusion Tensor Imaging Characteristics and Differentiation Value of Acute Cerebral Infarction Patients at Different Time Points GAO Qiang, HUANG Xiaoqi, MA Xiaowei DOI: 10.3969/j.issn.1671-7171.2023.10.006 【Objective】To explore the features and differences of magnetic resonance diffusion tensor imaging (DTI) in patients with acute cerebral infarction (ACI) at different time points. 【Methods】A total of 89 ACI patients treated in the two hospitals were selected and divided into the ultra-acute stage (onset ≤6 h) with 39 cases and the acute stage (6 h<onset≤3 d) with 50 cases based on the time of onset. The DTI parameters, including Fractional Anisotropy (FA), Mean Diffusion Coefficient (DCavg), and Isotropy (ISO) of lesion side and contralesional side were compared. Additionally, the values of lesion-side FA, DCavg, and ISO in diagnosing ultra-acute stage ACI were assessed. 【Results】 In the acute stage, the signal intensity on the FA image decreased and the brain white matter fibers were interrupted and destroyed, while no significant signal change was observed in the ultra-acute stage. In the ultra-acute stage, the signal on the DCavg image decreased and the brain white matter fibers were destroyed, whereas in the acute stage, brain white matter fibers were interrupted and reduced on the DCavg image. The FA value on the lesion side in the ultra-acute stage was higher than that in the acute stage, and the DCavg and ISO values were lower than in the acute stage (P<0.05). The DCavg value on the contralesional side in the ultra-acute stage was lower than in the acute stage, and the ISO value was higher (P<0.05). The DCavg values on the contralesional side in both the ultra-acute and acute stages were higher than on the lesion side, and the ISO values were lower (P<0.05). The FA value on the contralesional side in the acute stage was higher than on the lesion side (P<0.05). The Receiver Operating Characteristic (ROC) curve analysis showed that the Area Under the Curve (AUC) of the lesion-side FA value, DCavg value, ISO value alone and in combination for diagnosing ultra-acute stage ACI were 0.812, 0.842, 0.848, and 0.916 respectively. 【Conclusion】There are significant differences between the characteristics of DTI images in the acute stage and ultra-acute stage ACI patients. The DTI parameters, including FA, DCavg, and ISO values, can assist in diagnosing ACI staging, and their combined diagnostic efficacy is better. 2023 Vol. 40 (10): 1459-1462 [Abstract] ( 52 ) HTML (1 KB)  PDF (1263 KB)  ( 24 ) 1463 Observation on the Effect of Standardized Nutritional Therapy Intervention in the Elderly Patients with Colorectal Cancer LIU Haoyan, XU Fei DOI: 10.3969/j.issn.1671-7171.2023.10.007 【Objective】To explore postoperative standardized nutritional treatment intervention in elderly colorectal cancer patients to improve their sleep quality and reduce complications.【Methods】 A total of 120 patients with colorectal cancer were selected for the study. Surgery was received at our hospital between October 2019 and October 2021.Patients were divided into the control group (n=60) and the observation group (n=60). After surgery, patients in the control group received a routine care intervention, while patients in the observation group received a standardized nutritional treatment intervention. The pittsburgh sleep quality scale (Pittsburgh Sleep Quality Inder, PSQI), incidence of complications, nutritional indicators (prealbumin, fibronectin, and total serum protein), and clinical recovery indicators (bed stay time, exhaust time, and hospital stay) were compared between the two groups of patients before and after the intervention.【Results】 Before the intervention, the clinical index did not show any difference (P>0.05). After the intervention, the nutritional index and PSQI scores in the observation group were higher than those in the control group; And the differences were significant (P<0.05). The sleep time and sleep efficiency scores of the two groups of patients were all reduced. The observation group was lower than the control group, and the difference was statistically significant (P<0.05). After the intervention, the levels of prealbumin, fibronectin and total protein in both groups were higher than before the intervention, while the observation group was higher than the control group, and the difference was statistically significant (P<0.05). The observation group's bed rest time, exhaust time, and hospitalization time were all lower than those of the control group, and the differ (P<0.05).The incidence of complications and clinical recovery index in the control group were higher than those in the observed group, and the difference was significant (P<0.05).【Conclusion】 The implementation of standardized nutritional treatment intervention can greatly improve the sleep index of patients, reduce the occurrence of complications, and thus improve the value of nutritional index. It is worth of clinical promotion. 2023 Vol. 40 (10): 1463-1465,1470 [Abstract] ( 36 ) HTML (1 KB)  PDF (1224 KB)  ( 30 ) 1466 To Observe the Effect of 3D Orthotic Insole in Patients with Unequal Length of Lower Limbs and Lower Back Pain ZENG Zhen, LU Chunhua, WANG Kai, et al DOI: 10.3969/j.issn.1671-7171.2023.10.008 【Objective】To observe the effect of 3D orthotic insole in patients with unequal length of lower limbs and lower back pain.【Methods】Research and Development of 3D printing orthotic insoles, We customized 3D printed orthotic insoles for each patient with LLD, who meet the research criteria. We requested the participants to wear it at any time when they are walking. General inquiries and functional preliminary evaluations were made prior to wearing the insole, including pain assessments, 3D gait analysis, health questionnaire, and functional final reviews after 12 weeks of wearing the 3D printed orthotic insoles.【Results】A total of 5 patients completed the study. Before treatment, patients complained about various degrees of pain at lower limb joint and lower back through their walks, as well as constrains of daily activities. After 12 weeks of wearing the customized 3D printed orthotic insoles, joint pain and lower back pain were in remission. All five participants have had improvement in their pace frequency, pace stride and the pace speed. Three of them, their support phases and swing phases of lower limbs became normal. The health statuses of all five participants have significantly improved. There were no any complaints, such as uncomfortable heel pain and abnormal feelings during the 12 week clinical study. All 3D printed orthotic insoles remain in good condition after 12 week clinical study.【Conclusion】The 3D printed orthotic insoles are made with clear procedures and practical execution. LLD patients have achieved a much better therapeutic effect on relieving muscle and joint pain as well as improving gait by wearing 3D printed orthotic insoles. With the development of 3D printing software and materials, the dropping price of printing equipment, and the advancing manufacturing process of 3D printing technology, the clinical applications of 3D printed orthotic insoles will be further promoted. 2023 Vol. 40 (10): 1466-1470 [Abstract] ( 35 ) HTML (1 KB)  PDF (1593 KB)  ( 54 ) 1471 The Value of Pelvic Floor Yoga Combined with TVT-O Surgery in the Treatment of Pelvic Organ Prolapse with Lower Urinary Tract Symptoms DONG Lijun, WEI Juan DOI: 10.3969/j.issn.1671-7171.2023.10.009 【Objective】To explore the value of pelvic floor yoga combined with tension-free vaginal tape-obturator (TVT-O) in the treatment of pelvic organ prolapse (POP) with lower urinary tract symptoms. 【Methods】A total of 83 patients with pelvic organ prolapse (POP) combined with lower urinary tract symptoms who were admitted to our hospital from January 2019 to January 2022 were selected as the subjects of the study. They were randomly divided into the observation group of 42 cases and the control group of 41 cases. Both groups underwent modified pelvic floor reconstruction surgery. The control group used TVT-O surgery during the operation. The observation group added pelvic floor muscle yoga for intervention after the same surgical method as the control group. The clinical efficacy, perioperative indicators [operation time, blood loss, postoperative residual urine volume, urinary catheter indwelling time, 24-hour postoperative body temperature, hospital stay], the improvement of lower urinary tract symptoms before and after the operation, pre- and postoperative pelvic floor function scores [pelvic floor impact questionnaire (PFIQ-7), pelvic floor distress inventory (PFDI-20), pelvic organ prolapse/urinary incontinence sexual function questionnaire (PISQ-12)], as well as postoperative complications and recurrence were compared between the two groups. 【Results】The overall effectiveness rate of the observation group was 97.62%, which was significantly higher than the 85.37% in the control group (P<0.05). There was no significant difference in the perioperative indicators between the two groups (P>0.05). The lower urinary tract symptoms in both groups got significantly improved after surgery compared to before surgery (P<0.05), and the improvement in the observation group was better than that in the control group (P<0.05). After surgery, the PFIQ-7 and PFDI-20 scores in both groups were lower than before surgery, and PISQ-12 scores were higher than before surgery (P<0.05). Furthermore, the PFIQ-7 and PFDI-20 scores in the observation group were lower than those in the control group, while PISQ-12 score in the observation group was higher than that in the control(P<0.05). The incidence of complications and recurrence in the observation group was lower than that in the control group (P<0.05) .【Conclusion】The clinical effect of combining pelvic floor muscle yoga with TVT-O surgery in the treatment of pelvic organ prolapse and lower urinary tract symptoms is significant. It can effectively improve patients' lower urinary tract symptoms and pelvic floor dysfunction, promote the recovery of pelvic floor function, effectively reduce complications, avoid recurrence, and is worth promoting in clinical practice. 2023 Vol. 40 (10): 1471-1474 [Abstract] ( 30 ) HTML (1 KB)  PDF (1185 KB)  ( 58 ) 1475 Application Value of Echocardiographic Parameters in the Diagnosis of Patent Foramen Ovale in Neonates WEI Yuxiu, LIU Mengmei, YANG Duo DOI: 10.3969/j.issn.1671-7171.2023.10.010 【Objective】To investigate the application value of echocardiographic parameters, including the foramen ovale valve length (FOV-L) and the ratio of foramen ovale diameter (FO-d) to atrial septal length (AS-L), in the diagnosis of patent foramen ovale in neonates. 【Methods】A retrospective analysis was conducted on clinical data from 90 pregnant women and their neonates who delivered in our hospital from June 2021 to June 2022. Based on the closure status of the foramen ovale three months after birth, neonates were divided into non-closure (n=54) and closure (n=36) groups. Prenatal echocardiographic measurements [fetal FOV-L, FO-d, AS-L, peak systolic velocity of the foramen ovale (FO-V)] were compared, and the ratios FOV-L/FO-d and FO-d/AS-L were calculated. Follow-up was conducted three months postpartum to observe the closure status of the neonatal foramen ovale. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of FOV-L and FO-d/AS-L for patent foramen ovale in neonates. Multifactorial logistic regression was used to analyze the risk factors for patent foramen ovale in neonates. The combined predictive value of FOV-L and FO-d/AS-L for patent foramen ovale in neonates was analyzed for consistency. 【Results】There was no statistically significant difference between the two groups in terms of FO-d, AS-L, FO-V, and FOV-L/FO-d (P>0.05). The non-closure group had significantly higher FOV-L and FO-d/AS-L than the closure group (P<0.05). ROC curve analysis showed that the areas under the curve for FOV-L and FO-d/AS-L in predicting patent foramen ovale in neonates were 0.847 and 0.827, respectively, with sensitivities of 0.759 for both and specificities of 0.833 and 0.778, respectively. Multifactorial logistic regression results indicated that FOV-L≥7.670 mm and FO-d/AS-L≥0.345 were risk factors for patent foramen ovale in neonates (P<0.05). Consistency analysis revealed that the combined prediction of FOV-L and FO-d/AS-L for patent foramen ovale in neonates had a sensitivity of 0.963, a specificity of 0.861, an accuracy of 0.922, and a Kappa value of 0.836. 【Conclusion】 Echocardiographic parameters are somewhat correlated with patent foramen ovale in neonates. Both FOV-L and FO-d/AS-L can be used to predict patent foramen ovale in neonates, with a higher predictive value when combined. 2023 Vol. 40 (10): 1475-1477,1481 [Abstract] ( 26 ) HTML (1 KB)  PDF (1280 KB)  ( 39 ) 1478 Study on the Selection of Needle Caliber for US-FNAB Examination of Hypervascular and Hypovascular Thyroid Nodules SONG Yani, YANG Zhijun DOI: 10.3969/j.issn.1671-7171.2023.10.011 【Objective】To investigate the selection of needle caliber for ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of hypervascular and hypovascular thyroid nodules. 【Methods】A total of 96 patients with thyroid nodules who underwent US-FNAB examinations in our hospital from December 2020 to December 2021 were included in the study, with a total of 107 nodules. Based on the pathological diagnosis results, specimens were divided into the satisfactory group (93 nodules) and unsatisfactory group (14 nodules). During the ultrasound examination, parameters such as nodule size, location, presence, and type of calcification, nodule margin morphology, nodule aspect ratio, nodule echogenicity, internal composition of the nodule, and surrounding tissue blood flow distribution were recorded. Clinical data between the two groups were compared, as well as the specimen satisfaction rate with different calibers of needles for different blood supply types. 【Results】There were no significant differences between the satisfactory and unsatisfactory groups in terms of gender, age, nodule size, location, type of calcification, nodule margins, aspect ratio, echogenicity, internal composition, and needle caliber (P>0.05). The number of hypervascular nodules in the satisfactory group was significantly less than that in the unsatisfactory group (P<0.05). Among the hypervascular nodules, 21 used a 23 G needle and 30 used a 25 G needle, with the 25 G needle showing a significantly higher specimen satisfaction rate than the 23 G needle (P<0.05). Among the hypovascular nodules, 31 used a 23 G needle and 25 used a 25 G needle, with the 23 G needle having a significantly higher specimen satisfaction rate than the 25 G needle (P<0.05). 【Conclusion】The specimen satisfaction rate is higher for hypervascular nodules using a 25 G needle, while hypovascular nodules achieve a higher specimen satisfaction rate with a 23 G needle. 2023 Vol. 40 (10): 1478-1481 [Abstract] ( 34 ) HTML (1 KB)  PDF (1186 KB)  ( 48 ) 1482 Clinical Efficacy of Nicergoline Combined with Donepezil in the Treatment of Elderly Hypertensive Patients with Dementia ZHANG Miao, CHEN Jing DOI: 10.3969/j.issn.1671-7171.2023.10.012 【Objective】To explore the efficacy of Nicergoline combined with Donepezil in the treatment of elderly patients with hypertension and dementia. 【Methods】A total of 80 elderly patients with hypertension and dementia admitted to our hospital were divided into two groups using odd even number lottery method, with 40 cases in each group. Both groups of patients received conventional antihypertensive therapy with amlodipine and donepezil, while the observation group was treated with combination therapy with Nicergoline for one month. The 24-hour mean systolic blood pressure (24hSBP) and 24-hour mean diastolic blood pressure (24hDBP), left ventricular ejection fraction (LVEF), nitric oxide (NO), endothelin (ET), acetylcholine (ACh) levels, as well as the scores of the Mini Mental State Scale (MMSE) and Clinical Idiotic Rating Scale (CDR) were compared between two groups of patients before and after treatment. 【Results】After treatment, the 24-hour SBP and 24-hour DBP of the observation group were lower than those of the control group (P<0.05); The LVEF, serum NO, and Ach levels in the observation group were higher than those in the control group (P<0.05), while the serum ET levels in the observation group were lower than those in the control group (P<0.05); After treatment, the MMSE score of the observation group was higher than that of the control group (P<0.05), while the CDR score was lower than that of the control group (P<0.05). 【Conclusion】The combination of Nicergoline and Donepezil in the treatment of elderly hypertensive patients with dementia helps to lower blood pressure, improve cardiac function indicators, and serum NO, ET, and ACh levels, effectively improving the patient's intelligence level, and achieving satisfactory clinical efficacy. 2023 Vol. 40 (10): 1482-1484,1488 [Abstract] ( 35 ) HTML (1 KB)  PDF (1219 KB)  ( 73 ) 1485 Relationship of Serum LP-PLA2 and MMP-9 Levels with the Vulnerability of Carotid Plaque in Patients with Type 2 Diabetes and Cerebral Infarction SHEN Jia, QIAN Duoduo, ZHANG Jue, et al DOI: 10.3969/j.issn.1671-7171.2023.10.013 【Objective】To explore the relationship of serum lipoprotein-related phospholipase A2 (LP-PLA2) and matrix metalloproteinase-9 (MMP-9) levels with the vulnerability of carotid plaque in patients with type 2 diabetes (T2DM) and cerebral infarction (CI) . 【Methods】Clinical data of 115 patients of T2DM combined with CI were collected. The occurrence of carotid artery plaques in patients with T2DM and CI were counted. Factors affecting the vulnerability of carotid plaque in patients with T2DM and CI were analyzed. The value of serum LP-PLA2 and MMP-9 in T2DM patients combined with CI in predicting vulnerable carotid plaque was analyzed as well. 【Results】Among 115 patients with T2DM and CI, 64 (55.65%) were vulnerable plaques, and the remaining 51 (44.35%) were stable plaques. Logistic multivariate regression analysis showed that levels of LP-PLA2(OR:4.600,95%CI:1.893~11.179),MMP-9(OR:3.931,95%CI:1.618~9.555) and low-density lipoprotein cholesterol (LDL-C,OR:4.067,95%CI:1.674~9.885)were independent factors affecting the stability of carotid plaque in patients with T2DM and CI (P<0.05). ROC curve analysis showed that serum LP-PLA2, MMP-9 and the combination of the two for predicting the AUC of vulnerable plaques in patients with T2DM and CI were 0.786, 0.721 and 0.884,respectively. 【Conclusion】T2DM patients with CI have a high risk of vulnerable plaque in the carotid artery, and LP-PLA2 combined with MMP-9 has a good predictive effect on the vulnerable plaque in the carotid artery. 2023 Vol. 40 (10): 1485-1488 [Abstract] ( 35 ) HTML (1 KB)  PDF (1262 KB)  ( 56 ) 1489 Correlation between Serum FPG, 2hPG, Blood Pressure and Hypothyroidism in People with Abnormal Lipid Metabolism QI Hongdu, WEI Jian, WANG Xiaoyan, et al DOI: 10.3969/j.issn.1671-7171.2023.10.014 【Objective】To analyze the correlation between serum fasting glucose (FPG), 2 h postprandial glucose (2hPG) and blood pressure levels and hypothyroidism in people with abnormal lipid metabolism. 【Methods】A total of 86 patients with abnormal lipid metabolism admitted to our hospital from March 2020 to March 2022 were selected. According to the Guidelines for the Diagnosis and Treatment of Adult Hypothyroidism, 86 patients were divided into subclinical hypothyroidism (SCH) group (TSH>4.5 mIU/L, n=38) and non hypothyroidism group (TSH ≤ 4.5 mIU/L, n=48). According to the diagnostic criteria of American Endocrine Association for SCH in 2004, the SCH group was divided into mild hypothyroidism group (n=25) and severe hypothyroidism group (n=13).Serum FPG, 2hPG, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), diastolic blood pressure (DBP) and systolic blood pressure (SBP) were measured in all subjects.The levels of FPG, 2hPG, DBP, SBP, TC, TG, LDL-C and HDL-C in patients with hypothyroidism of different degrees were compared between the two groups; The value of ROC analysis of serum FPG, 2hPG and blood pressure in predicting hypothyroidism in patients with abnormal lipid metabolism; The correlation between serum FPG, 2hPG, blood pressure and TSH level in patients with abnormal lipid metabolism was analyzed by Person coefficient. 【Results】The levels of FPG, 2hPG, DBP, SBP, TG, TC, LDL-C in the SCH group were higher than those in the non decreased group, and the HDL-C levels were lower than those in the non decreased group, with a statistically significant difference (P<0.05). The levels of FPG, 2hPG, DBP, SBP, TG, TC and LDL-C in mild hypothyroidism group were lower than those in severe hypothyroidism group, and the levels of HDL-C were higher than those in severe hypothyroidism group, with statistical significance (P<0.05). According to ROC analysis, the best cutoff values of serum FPG, 2hPG and DBP ,SBP levels for predicting hypothyroidism in patients with abnormal lipid metabolism were 5.243 mmol/L, 7.014 mmol/L, 80.050 mmHg , 128.450 mmHg. Through correlation analysis, the levels of FPG, 2hPG, DBP, SBP were positively correlated with the levels of TSH in patients with abnormal lipid metabolism (P<0.05). 【Conclusion】The levels of serum FPG, 2hPG, blood pressure and lipid metabolism indexes were significantly different between those with abnormal lipid metabolism who had hypothyroidism and those without hypothyroidism. The levels of FPG, 2hPG, DBP and SBP were significantly positively correlated with the levels of TSH in those with abnormal lipid metabolism. 2023 Vol. 40 (10): 1489-1492 [Abstract] ( 32 ) HTML (1 KB)  PDF (1211 KB)  ( 33 ) 1493 Clinical Observation of Treating Elderly Hepatitis B Cirrhosis with Insomnia with WuMei Pill Decoction NIU Jinhu, WANG Yizhen DOI: 10.3969/j.issn.1671-7171.2023.10.015 【Objective】To investigate the clinical efficacy of Wumei Pill decoction in treating elderly hepatitis B cirrhosis with insomnia. 【Methods】A total of 76 elderly patients with hepatitis B cirrhosis and insomnia who were admitted to Hanzhong Railway Central Hospital from February 2018 to October 2019 were selected. They were divided into observation group (n=38) and control group (n=38) according to the random number table method. The control group received conventional basic treatment, while the observation group received oral administration of Wumei Pill decoction on the basis of the treatment in the control group. Both groups were treated for 2 weeks. Sleep quality was evaluated before and after treatment in both groups. The levels of liver function indicators total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB) were analyzed before and after treatment in both groups. The prothrombin time (PT) and the occurrence of adverse reactions were compared between the two groups before and after treatment.【Results】 After treatment, the PSQI index in both groups was lower than before treatment, with that in the observation group being lower than in the control group (P<0.05). After treatment, TBIL, PT, ALT, and AST in both groups were lower than before treatment (P<0.05), while ALB was higher than before treatment (P<0.05). AST, TBIL, ALT, and PT in the observation group after treatment were lower than those in the control group (P<0.05), while ALB was significantly higher than that in the control group (P<0.05). The incidence of adverse reactions in the observation group was 15.79%, and that in the control group was 21.05%, without significant difference (χ2=0.35, P>0.05). 【Conclusion】Wumei Pill can effectively improve sleep quality and liver function in elderly patients with hepatitis B cirrhosis and insomnia without significant adverse reactions, with high safety and certain clinical promotion value. 2023 Vol. 40 (10): 1493-1495,1499 [Abstract] ( 54 ) HTML (1 KB)  PDF (1216 KB)  ( 46 ) 1496 Effects of Different Doses of Atropine on Short-term Prognosis of Patients with Acute Organophosphorus Pesticide Poisoning YAN Wanshu, CHANG Yuxin, YAO Weiwei, et al DOI: 10.3969/j.issn.1671-7171.2023.10.016 【Objective】To investigate the effects of different doses of atropine on short-term prognosis of patients with acute organophosphorus pesticide poisoning (AOPP). 【Methods】A total of 120 patients with AOPP were randomly divided into high-dose group and low-dose group, with 60 patients in each group. The high-dose group received an initial dose of atropine of 5-10 mg, and intravenous injection of 2-5 mg every 10-30 min according to the patient's response, until the patient was atropinized. The low-dose group received an initial dose of atropine of 2-5 mg, and intravenous injection of 1-2 mg every 10-30 min according to the patient's response, until the patient was atropinized. The clinical efficacy, changes in blood cell parameters [white blood cell count (WBC), neutrophil count (NC), lymphocyte count (LC), and neutrophil/lymphocyte ratio (NLR)], changes in C-reactive protein (CRP), eosinophils (EOS), acetylcholinesterase (AchE), superoxide dismutase (SOD), malondialdehyde (MDA) levels, and drug safety were compared between the two groups.【Results】The cure rate in the high-dose group was 85.00% (51/60), which was significantly better than 68.33% (41/60) in the low-dose group (P<0.05). The amount of atropine used in the high-dose group was significantly higher than that in the low-dose group (P<0.05), but there was no significant difference in mechanical ventilation, ICU stay, and hospital stay between the two groups (P>0.05). After treatment, WBC, NC, and NLR in both groups were lower than before treatment, while LC was higher than before treatment (P<0.05); CRP and EOS were lower than before treatment (P<0.05); AchE and SOD were higher than before treatment, while MDA was lower than before treatment (P<0.05); and the above indexes in the high-dose group were better than those in the low-dose group (P<0.05). The incidence of adverse events in the high-dose group was slightly higher than that in the low-dose group, but there was no significant difference between the two groups (P>0.05). 【Conclusion】 High-dose atropine treatment for AOPP is significantly better than low-dose treatment, which can significantly improve blood cell parameters, regulate inflammatory factors and oxidative stress levels, and has good drug safety. 2023 Vol. 40 (10): 1496-1499 [Abstract] ( 36 ) HTML (1 KB)  PDF (1186 KB)  ( 37 ) 1500 Expression of TP53INP1 and RAI2 in Triple-Negative Breast Cancer and their Relationship with Patient Prognosis PANG Zongxin, SUN Xuan, LIANG Qingna, et al DOI: 10.3969/j.issn.1671-7171.2023.10.017 【Objective】To investigate the expression levels of TP53INP1 and RAI2 in triple-negative breast cancer (TNBC) tissues and their relationships with the clinical and pathological characteristics and prognosis of patients. 【Methods】The protein expression levels of TP53INP1 and RAI2 in 168 TNBC patients were detected and analyzed in relation to the patients' clinical and pathological characteristics and prognosis. 【Results】The positive rates of TP53INP1 and RAI2 in TNBC cancer tissues were 23.21% (39/168) and 32.74% (55/168) respectively, significantly lower than the 53.57% (90/168) and 58.93% (99/168) in adjacent non-tumor tissues (P<0.05). The expression level of TP53INP1 was correlated with lymph node metastasis, histological grade, and TNM staging (P<0.05), while the expression level of RAI2 was correlated with lymph node metastasis and histological grade (P<0.05). Univariate analysis showed that lymphatic metastasis, TNM stage, TP53INP1 expression, and RAI2 expression were risk factors affecting overall survival and disease-free survival rates. The 5-year disease-free survival rate and overall survival rate of groups without lymph node metastasis, TNM stages Ⅰ-Ⅱ,high TP53INP1 expression, and high RAI2 expression were significantly higher than their corresponding groups, with statistically significant differences (P<0.05). Cox hazard regression model analysis showed that the expressions of TP53INP1, RAI2, and lymph node metastasis were independent prognostic factors affecting disease-free survival. 【Conclusion】The expression levels of TP53INP1 and RAI2 are closely related to the occurrence, progression, and poor prognosis of TNBC. High expression of TP53INP1 and RAI2 may indicate a good prognosis. 2023 Vol. 40 (10): 1500-1503 [Abstract] ( 31 ) HTML (1 KB)  PDF (1181 KB)  ( 39 ) 1504 Effect of Leuprorelin Acetate Combined with Dydrogesterone on Ovarian Endometriosis Patients and its Influence on Postoperative Recurrence JIANG Li, FAN Yating, WANG Ying, et al DOI: 10.3969/j.issn.1671-7171.2023.10.018 【Objective】To investigate the effect of Leuprorelin acetate combined with Dydrogesterone on ovarian endometriosis patients and its influence on postoperative recurrence. 【Methods】A total of 110 patients with ovarian endometriosis admitted to Baoji High-tech Zone Hospital from August 2019 to June 2021 were selected and divided into observation group and control group according to the random number table method, with 55 cases in each group. Both groups received laparoscopic surgery. The control group received leuprorelin acetate treatment after surgery, while the observation group received dydrogesterone treatment on the basis of the control group. Both groups were treated for 3 months. The clinical efficacy, adverse reactions, postoperative recurrence, serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), visual analogue scale (VAS) scores for pelvic pain, dysmenorrhea, and dyspareunia before and after treatment were compared between the two groups. 【Results】One year after treatment, the total effective rate of the observation group was higher than that of the control group (P<0.05). After treatment, the serum FSH, LH, E2 levels of both groups were lower than those before treatment (P<0.05), and the serum FSH, LH, E2 levels of the observation group were lower than those of the control group (P<0.05). After treatment, the VAS scores for pelvic pain, dysmenorrhea, and dyspareunia in both groups were lower than those before treatment (P<0.05), and the VAS scores for pelvic pain, dysmenorrhea, and dyspareunia in the observation group were lower than those in the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). During the follow-up period of one year, one patient in the control group and two patients in the observation group were lost to follow-up, resulting in a follow-up rate of 97.27%(107/110). The postoperative recurrence rate in the observation group (3.77%) was lower than that in the control group (16.67%) (P<0.05). 【Conclusion 】 Leuprorelin acetate combined with Dydrogesterone is effective in treating ovarian endometriosis. It can improve serum hormone levels, reduce pelvic pain, dysmenorrhea, dyspareunia, and postoperative recurrence risk with good safety and reliability. 2023 Vol. 40 (10): 1504-1507 [Abstract] ( 44 ) HTML (1 KB)  PDF (1178 KB)  ( 34 ) 1508 Expression Levels of IFN-γ and IL-4 in Serum of Patients with Acute Traumatic Spinal Cord Injury Complicated with Infection and their Clinical Significance LI Wang, LI Jiaping DOI: 10.3969/j.issn.1671-7171.2023.10.019 【Objective】To investigate the expression levels and clinical significance of interferon-γ (IFN-γ) and interleukin-4 (IL-4) in the serum of patients with acute traumatic spinal cord injury complicated with infection. 【Methods】A retrospective analysis was conducted on 86 patients with acute traumatic spinal cord injury treated in our hospital from February 2017 to February 2022. The patients were divided into infection group (n=26) and non-infection group (n=60). The basic information and levels of IFN-γ and IL-4 were compared between the two groups. Multivariate Logistic regression was used to analyze the factors affecting post-injury infection in patients with acute traumatic spinal cord injury. The predictive value of IL-4 and IFN-γ for post-injury infection was analyzed using the receiver operating characteristic (ROC) curve. 【Results】The proportion of patients aged ≥60 years, ASIA (American Spinal Injury Association) score indicating complete injury, time from injury to admission ≥48 hours, and not using prophylactic antibiotics was higher in the infection group. IL-4 levels were higher and IFN-γ levels were lower in the infection group compared to the non-infection group (P<0.05). ROC curve analysis confirmed that IL-4 and IFN-γ can be used to predict post-injury infection in patients with acute traumatic spinal cord injury, with area under the curve (AUC) values of 0.875 and 0.906. Logistic regression analysis showed that age ≥60 years, ASIA score indicating complete injury, time from injury to admission ≥48 hours, not using prophylactic antibiotics, IFN-γ ≤14.084 pg/mL, and IL-4 ≥79.711 pg/mL were risk factors for post-injury infection in patients with acute traumatic spinal cord injury (P<0.05). 【Conclusion】The levels of IL-4 and IFN-γ are significantly correlated with the occurrence of post-injury infection in patients with acute traumatic spinal cord injury. Dynamic monitoring of IL-4 and IFN-γ levels can help assess the risk of post-injury infection complications. 2023 Vol. 40 (10): 1508-1511 [Abstract] ( 30 ) HTML (1 KB)  PDF (1231 KB)  ( 38 ) 1512 Value of Balloon Dilatation Combined with Pneumatic Ballistic Ultrasound Lithotripsy in Percutaneous Nephrolithotomy for Renal Calculi WU Lifeng, WANG Suling DOI: 10.3969/j.issn.1671-7171.2023.10.020 【Objective】To investigate the value of balloon dilatation combined with pneumatic ballistic ultrasound lithotripsy in percutaneous nephrolithotomy (PCNL) for renal calculi. 【Methods】A retrospective analysis was conducted on the clinical data of 90 patients with renal calculi who underwent PCNL from March 2020 to March 2022 in Baoji City People's Hospital. The patients were divided into observation group and control group according to different treatment methods, with 45 patients in each group. The observation group received balloon dilatation combined with pneumatic ballistic ultrasound lithotripsy, while the control group received fascial dilatation combined with holmium laser lithotripsy. Perioperative indicators (operation time, intraoperative blood loss, stone clearance rate, hospital stay) were compared between the two groups. Serum levels of superoxide dismutase (SOD), malondialdehyde (MDA), hemoglobin (Hb), and white blood cell count (WBC) were compared between the two groups before and after surgery. Postoperative complications were compared between the two groups.【Results】The observation group had a shorter operation time than the control group (P<0.05). After surgery, serum SOD and Hb levels in both groups were lower than preoperative levels, while MDA and WBC levels were higher than preoperative levels. The observation group had higher SOD and Hb levels than the control group, and lower MDA and WBC levels than the control group (P<0.05). The observation group had a lower incidence of postoperative complications than the control group (P<0.05). 【Conclusion】 Balloon dilatation combined with pneumatic ballistic ultrasound lithotripsy in PCNL for renal calculi can shorten the operation time, reduce stress reactions, and decrease the incidence of postoperative complications. It is worth promoting. 2023 Vol. 40 (10): 1512-1514,1518 [Abstract] ( 29 ) HTML (1 KB)  PDF (1216 KB)  ( 93 ) 1515 Effect of Scalp Nerve Block-assisted General Anesthesia on Stress Response and Vital Signs in Patients Undergoing Intracranial Space-occupying Surgery HU Xia, ZHANG Zexin DOI: 10.3969/j.issn.1671-7171.2023.10.021 【Objective】To investigate the effect of scalp nerve block-assisted general anesthesia on stress response and vital signs in patients undergoing Intracranial space-occupying operation. 【Methods】 A total of 90 patients undergoing elective intracranial space-occupying operation in our hospital were randomly divided into two groups:the 45 patients in the control group underwent general anesthesia and the other 45 patients in the observation group underwent scalp nerve block-assisted general anesthesia. Vital signs such as diastolic blood pressure (DBP), systolic blood pressure (SBP), heart rate (HR) and serum dopamine (DA), adrenaline (A), noradrenaline (NE) were compared between the two groups at different time points:before anesthesia induction (T0), upper head frame placement (T1), skin incision (T2), periosteal separation (T3), bone flap/craniectomy (T4), intraoperative (T5), skin suture (T6), extubation (T7). and other body stress factor levels and the usage of drug doses in the two groups was recorded. 【Results】There were no significant differences in DBP,SBP and HR between the two groups at T0, T4, and T5 (P>0.05); While the DBP, SBP, HR at T1, T6, and T7 in the observation group were lower those in the control group; the DBP of the observation group at T2 was lower than that of the control group, and HR at T3 in the observation group was lower than that in the control group (P<0.05). There were no significant differences between the two groups in terms of SBP and HR at T2 plus SBP and DBP at T3 (P>0.05). There were no significant differences in serum DA, A and NE levels between the two groups at T0 (P>0.05). The serum DA, A and NE levels of the observation group were lower than those of the control group at T1, T2, T3, T4, T5, T6 and T7; And the differences were statistically significant (P<0.05). The remifentanil doses in the observation group and the control group were (2.24±1.60) mg and (4.72±1.52) mg, respectively, with statistically significant difference between the two groups (P<0.05). There was no significant difference of the propofol usage between the two groups (P>0.05). 【Conclusion】Scalp nerve block-assisted general anesthesia can better maintain the stability of vital signs during Intracranial space-occupying operation, relieve the relieve body stress and reduce the usage of general analgesics. 2023 Vol. 40 (10): 1515-1518 [Abstract] ( 34 ) HTML (1 KB)  PDF (1188 KB)  ( 26 ) 1519 Association between miR-27a Expression Level and Prognosis of Crohn's Disease Patients WU Shan, HE Miao, CHEN Jing DOI: 10.3969/j.issn.1671-7171.2023.10.022 【Objective】To investigate the correlation between the expression level of microRNA-27a (miR-27a) and the prognosis of Crohn's disease (CD). 【Methods】A retrospective analysis was conducted on the clinical data of 147 patients with CD admitted to our hospital from December 2019 to December 2021. The patients were divided into a good prognosis group (n=79) and a poor prognosis group (n=68) based on follow-up results. The receiver operating characteristic (ROC) curve was used to analyze the value of miR-27a in predicting poor prognosis in CD patients; unconditional logistic stepwise regression was used to analyze the risk factors for poor prognosis in CD patients. 【Results】The proportion of patients with age >40 years, disease type of stenosis and penetrating, and perianal lesions in the good prognosis group was lower than that in the poor prognosis group (P<0.05). The expression level of miR-27a after treatment in the good prognosis group was higher than that in the poor prognosis group (P<0.05). ROC curve analysis showed that the area under the curve for miR-27a expression level predicting poor prognosis in CD patients was 0.954 (95%CI 0.918-0.991), with an optimal cutoff value of 0.335, sensitivity of 0.911, and specificity of 0.941 (P<0.05). Multivariate logistic regression analysis showed that disease behavior of stenosis and penetrating, perianal lesions, and miR-27a ≤ 0.335 were risk factors for poor prognosis in CD patients (P<0.05). 【Conclusion】Stenosis and penetrating disease behavior, perianal lesions, and miR-27a ≤ 0.335 are risk factors for poor prognosis in CD patients. Close attention should be paid to such patients in clinical practice. 2023 Vol. 40 (10): 1519-1521,1525 [Abstract] ( 32 ) HTML (1 KB)  PDF (1265 KB)  ( 17 ) 1522 Study on Relationship of Coronary Artery Thrombus Burden with Levels of Cystatin C and D Dimer in Acute Myocardial Infarction LI Jinjin DOI: 10.3969/j.issn.1671-7171.2023.10.023 【Objective】To investigate the relationship of coronary artery thrombus burden with serum cystatin C (cys C) and D-dimer(D-D) levels in patients with acute myocardial infarction (AMI). 【Methods】Fifty patients who underwent coronary angiography (CAG) for AMI were selected as the observation group, and another 50 patients with chest pain symptoms but having completely normal CAG results were selected as the control group. The lipid profile, cys C, and D-D levels were compared between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of cys C and D-D for AMI. The observation group was further divided into a low thrombus burden group (n=21, thrombus grades 0-3) and a high thrombus burden group (n=29, thrombus grades 4-5) based on the coronary artery thrombus burden evaluation. The cys C and D-D levels were compared between the two groups, and their diagnostic value for high thrombus burden in AMI patients was analyzed. 【Results】The levels of triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) in the observation group were higher than those in the control group, while the level of high-density lipoprotein cholesterol (HDL-C) was lower (P<0.05). However, there was no significant difference in total cholesterol (TC) levels between the two groups (P>0.05). The levels of cys C and D-D in the observation group were significantly higher than those in the control group (P<0.05). The areas under the ROC curves for cys C and D-D in diagnosing AMI were 0.955 and 0.959, respectively. Compared to the low thrombus burden group, the high thrombus burden group had higher levels of cys C and D-D (P<0.05). The areas under the ROC curves for cys C and D-D in diagnosing high thrombus burden in AMI patients were 0.920 and 0.928, respectively. 【Conclusion】cys C and D-D levels are significantly elevated in patients with AMI, and their levels are higher in patients with high thrombus burden. Both cys C and D-D measurement have a high diagnostic value for both AMI and high thrombus burden. 2023 Vol. 40 (10): 1522-1525 [Abstract] ( 28 ) HTML (1 KB)  PDF (1297 KB)  ( 15 ) 1526 Diagnostic Value of Dynamic Electrocardiogram Long-Term Monitoring in Patients with Acute Myocardial Infarction and Coronary Heart Disease with Arrhythmia CUI Hailing, FENG Jing DOI: 10.3969/j.issn.1671-7171.2023.10.024 【Objective】To investigate the diagnostic value of dynamic electrocardiogram long-term monitoring in patients with acute myocardial infarction and coronary heart disease with arrhythmia. 【Methods】A retrospective analysis of the clinical data of 89 patients with acute myocardial infarction and coronary heart disease with arrhythmia who visited the hospital from February 2020 to March 2022 was studied. All patients first received 24-hour dynamic electrocardiogram monitoring and then adopted long-term dynamic electrocardiogram monitoring. The detection rate of arrhythmia, the detection of ventricular arrhythmia, the detection of atrial arrhythmia and the comfort status scale (GCQ) were compared between the two monitoring methods. The mean time between patients' first recorded asymptomatic and symptomatic arrhythmias was counted. 【Results】Intracardiac electrophysiological examination results showed that 79 of 89 patients with acute myocardial infarction and coronary heart disease had arrhythmia, including 18 cases of ventricular arrhythmia, 5 cases of atrial block, 38 cases of atrial arrhythmia, 10 cases of sinus arrhythmia, and 8 cases of junctional arrhythmia. The detection rate of arrhythmia in long-term monitoring of holter monitoring was higher than that of Holter monitoring within 24 hours (P<0.05). There was no difference in the detection rate of different types of premature ventricular contractions between the two monitoring methods (P>0.05). There was no difference in the detection rate of different types of atrial arrhythmias between the two monitoring methods (P>0.05). The detection rate of long-term monitoring of atrial arrhythmia was higher than that of 24-hour atrial arrhythmia monitoring (P<0.05). The mean time for patients to first record asymptomatic arrhythmias was 6.25 days, and the mean time for patients to first record symptomatic arrhythmias was 3.12 days. The GCQ score of long-term monitoring of Holter monitoring was higher than that of Holter monitoring of 24 hours (P<0.05). 【Conclusion】Dynamic electrocardiogram long-term monitoring in patients with acute myocardial infarction and coronary heart disease with arrhythmia has good diagnostic value and can improve the comfort of the patch. 2023 Vol. 40 (10): 1526-1528,1532 [Abstract] ( 29 ) HTML (1 KB)  PDF (1226 KB)  ( 41 ) 1529 The Relationship between Serum IGF-1, IL-1α Levels and the Efficacy of Neoadjuvant Chemotherapy in Patients with Non-small Cell Lung Cancer YAN Li, YAN Yajun DOI: 10.3969/j.issn.1671-7171.2023.10.025 【Objective】 To investigate the relationship between serum insulin-like growth factor-1 (IGF-1), interleukin-1α (IL-1α) levels and the efficacy of neoadjuvant chemotherapy (NCT) in patients with non-small cell lung cancer (NSCLC). 【Methods】 Eighty-seven NSCLC patients admitted to two hospitals received NCT for two cycles. Multivariate logistic regression analysis was used to evaluate whether serum IGF-1 and IL-1α were independent risk factors affecting the efficacy of NCT. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum IGF-1 and IL-1α for the efficacy of NCT. 【Results】After treatment, 7 patients achieved complete remission, 39 patients achieved partial remission, and they were included in the effective group; 37 patients had stable disease and 4 patients had progressive disease, and they were included in the ineffective group. The proportion of patients receiving targeted therapy in the effective group was higher than that in the ineffective group (P<0.05), and the levels of IGF-1 and IL-1α were lower than those in the ineffective group (P<0.05). Multivariate logistic regression analysis showed that IGF-1 and IL-1α were independent risk factors affecting the efficacy of NCT (P<0.05), and targeted therapy was an independent protective factor affecting the efficacy of NCT (P<0.05). ROC curve analysis showed that IGF-1 and IL-1α had certain predictive value for the efficacy of NCT, with area under the curve (AUC) of 0.756 and 0.734 respectively. When predicting efficacy of combined therapy for the two predictors, the AUC reached 0.917. 【Conclusion】Serum IGF-1 and IL-1α levels are independent factors influencing the efficacy of NCT in patients with NSCLC, and they have important predictive value for the efficacy of NCT. The predictive effect is higher when the two factors are combined. 2023 Vol. 40 (10): 1529-1532 [Abstract] ( 30 ) HTML (1 KB)  PDF (1283 KB)  ( 20 ) 1533 Effect of Butylphthalide Combined with Xueshuantong on Cerebral Blood Flow and Neurological Function in Patients with Acute Ischemic Stroke ZHENG Tingting, WANG Liang DOI: 10.3969/j.issn.1671-7171.2023.10.026 【Objective】To investigate the efficacy of nimodipine combined with urokinase in the treatment of acute ischemic stroke and its effects on cerebral blood flow and neurological function in patients. 【Methods】A total of 110 patients with acute ischemic stroke were randomly divided into observation and control groups, with 55 cases in each group. The control group was treated with urokinase, while the observation group was treated with urokinase combined nimodipine. After 2 weeks of treatment, the therapeutic effects, the national institutes of health stroke scale (NIHSS) scores, hemodynamic indices, and the incidence of adverse reactions in the two groups were compared. 【Results】The total effective rate in the observation group was 90.91% (50/55), which was significantly higher than that in the control group at 69.09% (38/55) (P<0.05). The post-treatment NIHSS scores and hemodynamic indices in both groups were lower than those before treatment (P<0.05), and the indices in the observation group were significantly lower than those in the control group after treatment (P<0.05). The total incidence of adverse reactions in the observation group was 10.91% (6/55), which was not statistically different from the 12.73% (7/55) in the control group (P>0.05). 【Conclusion】Nimodipine combined with urokinase in the treatment of acute ischemic stroke can effectively improve cerebral blood flow, promote neurological function recovery, significantly enhance therapeutic efficacy, and has high clinical application value. 2023 Vol. 40 (10): 1533-1535 [Abstract] ( 40 ) HTML (1 KB)  PDF (1161 KB)  ( 33 ) 1536 Correlation between QRS Wave Duration and QTc on Electrocardiogram and Clinical Outcomes in Acute Left Heart Failure Patients in Hospital GUO Yanli, LIU Ping DOI: 10.3969/j.issn.1671-7171.2023.10.027 【Objective】To explore the correlation between the QRS wave duration and corrected QT interval (QTc) on electrocardiogram and the hospital clinical outcomes of patients with acute left heart failure. 【Methods】 A total of 87 patients with acute left heart failure admitted to the Yulin Traditional Chinese Medicine Hospital from May 2019 to May 2022 were selected. They were divided into a poor prognosis group (n=30) and a good prognosis group (n=57) according to their in-hospital prognosis. The general information, N-terminal pro-B-type natriuretic peptide (NT-proBNP), soluble growth stimulation gene 2 protein (sST2), electrocardiogram parameters [QRS wave duration, corrected QT interval (QTc)], echocardiographic parameters [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD)], and multi-factor Logistic regression analysis were used to analyze the factors that affect the hospital clinical outcomes of patients with acute left heart failure. 【Results】The levels of NT-proBNP and sST2 in the poor prognosis group were higher than those in the good prognosis group, and the difference was statistically significant (P<0.05). The QRS wave duration and QTc in the poor prognosis group were longer than those in the good prognosis group (P<0.05), while the LVEF was lower than that in the good prognosis group (P<0.05), and there was no significant difference in LVEDD between the two groups (P>0.05). Logistic regression analysis showed that NT-proBNP, sST2, QRS wave duration, and QTc were factors that affected the hospital clinical outcomes of patients with acute left heart failure (P<0.05). 【Conclusion】 The QRS wave duration and QTc on electrocardiogram are significantly prolonged in patients with acute left heart failure, and they are related factors affecting the hospital clinical outcomes of these patients. 2023 Vol. 40 (10): 1536-1539 [Abstract] ( 39 ) HTML (1 KB)  PDF (1185 KB)  ( 29 ) 1540 Effects of LTSE and LCBDE on Levels of Serum Immunoglobulins and Inflammatory Factors in the Treatment of Choledocholithiasis Complicated with Cholecystolithiasis SUN Xuan, JIANG Xin, ZHOU Xin, et al DOI: 10.3969/j.issn.1671-7171.2023.10.028 【Objective】To observe the clinical effects of laparoscopic transcystic duct lithotripsy (LTSE) and laparoscopic common bile duct lithotomy (LCBDE) on the levels of serum immunoglobulin and inflammatory factors in the treatment of choledocholithiasis complicated with cholecystolithiasis. 【Methods】Fifty patients with choledocholithiasis and cholecystolithiasis who admitted to our hospital from January 2015 to January 2019 were randomly divided into the observation group (LTSE and LCBDE) and the control group (open choledocholithotomy combined with cholecystectomy), with 25 cases in each group. The operation time, incision length, intraoperative bleeding volume, gastrointestinal recovery time and hospitalization time of the two groups were compared. The levels of serum immunoglobulin G (IgG), immunoglobulin M (IgM) and immunoglobulin A (IgA) before and after operation were analyzed. The levels of inflammatory factors C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10) and tumor necrosis factors in the two groups were observed. The level of tumor necrosis factor-alpha(TNF-α) was measured and the incidence of postoperative complications in the two groups was analyzed. 【Results】The operation time, incision length, gastrointestinal recovery time and hospitalization time of the observation group were significantly shorter than those of the control group (P<0.05), and the intraoperative bleeding volume was significantly lower than that of the control group (P<0.05). After operation, there were no significant differences in the levels of IgG, IgM and IgA between the observation group and the control group (P>0.05). The levels of IgG, IgM and IgA after operation in the observation group were significantly lower than those before operation (P<0.05), while the levels of IgG, IgM and IgA in the observation group were significantly higher than those in the control group (P<0.05). After operation, the levels of CRP and IL-6 in the two groups were significantly higher than those before operation (P<0.05), while the levels of IL-10 and TNF-α were significantly lower than those before operation (P<0.05). There was no significant difference in the levels of TNF-α between the two groups after operation (P>0.05).However, the levels of CRP and IL-6 in the observation group were significantly lower than those in the control group, and the level of IL-10 was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). The incidence of complications in the observation group was 16.00%, which was significantly lower than 44.00% in the control group (P<0.05). 【Conclusion】Compared with traditional operation, both LTSE and LCBDE have good clinical safety in the treatment of common bile duct stones and cholecystolithiasis, have little impact on the body's immune function, and have mild inflammatory reactions in patients. It is worthy of clinical reference.. 2023 Vol. 40 (10): 1540-1543 [Abstract] ( 35 ) HTML (1 KB)  PDF (1185 KB)  ( 21 ) 1544 Low Frequency Transcranial Repetitive Stimulation Combined with Perceptual Reminder Therapy for Cognitive Function and Memory in Patients with Frontal Lobe Injury YU Haijing, WANG Yuan, YAO Huijuan, et al DOI: 10.3969/j.issn.1671-7171.2023.10.029 【Objective】To investigate the effect of low frequency transcranial repetitive stimulation combined with perceptual reminder therapy on cognitive function and memory recovery in patients with frontal lobe injury.【Methods】A retrospective analysis was conducted on the clinical data of 71 patients with frontal lobe injury admitted to our hospital from June 2018 to September 2021. They were divided into observation group (n=36) and control group (n=35) according to different treatment methods. The control group received perceptual reminder intervention therapy, while the observation group received low frequency transcranial repetitive stimulation intervention therapy on this basis. The montreal cognitive assessment (MoCA) was used to assess cognitive function in both groups after intervention, and RBMT-Ⅱ behavioral memory detection second edition was used to assess memory. Cognitive function and memory were compared between the two groups after intervention.【Results】Abstract ability, directional ability, attention, memory, language function, naming ability, visual space and executive space scores, as well as total scores in the observation group were higher than those in the control group, and the differences were statistically significant (P<0.05). The RBMT-Ⅱ score of the observation group after intervention was (21.03±1.16) scores, while that of the control group was (18.43±1.21) scores. The observation group was significantly higher than the control group, and the difference was statistically significant (t=9.24, P<0.05).【Conclusion】 In patients with frontal lobe injury, the application of low frequency transcranial repetitive stimulation intervention therapy on the basis of perceptual reminder therapy can effectively improve cognitive function and promote memory recovery, which has clinical promotion value. 2023 Vol. 40 (10): 1544-1546 [Abstract] ( 29 ) HTML (1 KB)  PDF (1160 KB)  ( 44 ) 1547 The Effect of Colostrum Oral Immunotherapy on Preventing Ventilator-associated Pneumonia in Premature Infants and its Influence on Serum Levels of NLR, CRP, and IL-6 LI Jing, GUO Xiaoxia, CAI Wei DOI: 10.3969/j.issn.1671-7171.2023.10.030 【Objective】To investigate the effect of colostrum oral immunotherapy in preventing ventilator-associated pneumonia (VAP) in premature infants and its influence on serum levels of neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and interleukin-6 (IL-6). 【Methods】A retrospective analysis was conducted on the clinical data of 98 premature infants who underwent mechanical ventilation from April 2021 to April 2022 in the Xidian Group Hospital. They were divided into an observation group and a control group according to different treatment methods, with 49 patients in each group. The control group received oral care with 2% sodium bicarbonate, while the observation group received colostrum oral immunotherapy in addition to the treatment for the control group. The mechanical ventilation time, hospitalization time, head circumference at discharge, and weight were compared between the two groups of children. The bacterial culture results were compared between the two groups of children. The incidences of oral infection and VAP were compared between the two groups of children. Serum levels of NLR, CRP, and IL-6 were compared between the two groups of children after treatment.【Results】 The mechanical ventilation time and hospitalization time in the observation group were significantly less than those in the control group (P<0.05). The positive rates of pharyngeal secretions and tracheal aspirate secretions in the observation group were significantly lower than those in the control group (P<0.05). The total incidence of oral infection and VAP in the observation group was significantly lower than that in the control group (P<0.05). Serum levels of NLR, CRP, and IL-6 after treatment in the observation group were significantly lower than those in the control group (P<0.05). 【Conclusion】 Colostrum oral immunotherapy can effectively prevent the occurrence of VAP in premature infants, reduce serum levels of NLR, CRP, and IL-6, and regulate immune function. 2023 Vol. 40 (10): 1547-1550 [Abstract] ( 32 ) HTML (1 KB)  PDF (1178 KB)  ( 118 ) 1551 Psychological, Social, and Iatrogenic Factors Associated with Premature Ovarian Failure in Reproductive-Age Women WANG Yan, WU Xiaohong, LIU Fenqin DOI: 10.3969/j.issn.1671-7171.2023.10.031 【Objective】To investigate the correlation between premature ovarian failure (POF) and psychological, social, and iatrogenic factors in reproductive-age women.【Methods】 A retrospective analysis was conducted on the clinical data of 80 POF patients admitted to the Xi'an Maternal and Child Health Hospital from January 2019 to January 2021 (observation group), and 127 healthy women who underwent health examination in the same period were selected as the control group. General information was compared between the two groups, and multiple factor logistic regression analysis was used to identify risk factors for POF in reproductive-age women. Pearson correlation analysis was used to analyze the correlation between POF and related factors. 【Results】The observation group had significantly higher scores on the Social Anxiety Scale (ASA) and Beck Depression Inventory (BDI), as well as a higher proportion of ovarian surgery history, pelvic surgery history, and use of contraceptives compared to the control group (P<0.05). Multivariate logistic regression analysis showed that social anxiety, depression, ovarian surgery history, pelvic surgery history, and use of contraceptives were risk factors for POF in reproductive-age women (P<0.05). Pearson correlation analysis showed a positive correlation between POF and social anxiety, depression, ovarian surgery history, pelvic surgery history, and use of contraceptives in reproductive-age women (P<0.05). Analysis of the receiver operating characteristic curve showed that social anxiety, depression, ovarian surgery history, pelvic surgery history, and use of contraceptives had high predictive efficiency, with area under the curve of 0.821, 0.871, 0.561, 0.634, and 0.613, respectively. 【Conclusion】The incidence of POF in reproductive-age women is related to factors such as social anxiety, depression, ovarian surgery history, pelvic surgery history, etc. Clinical medical workers need to start with the etiology to develop reasonable treatment plans and thereby improve the reproductive health and quality of life of POF patients in reproductive-age women. 2023 Vol. 40 (10): 1551-1554 [Abstract] ( 36 ) HTML (1 KB)  PDF (1279 KB)  ( 34 )

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