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Quick Search     Adv Search 2024 Vol. 41, No. 3 Published: 2024-03-26 Review and lecture Original Articles          Review and Lecture 321 Research Progress of Hyperperfusion Syndrome in Patients with Severe Carotid Artery Stenosis after Intravascular Therapy YOU Chunmei, LU Yidan, ZHANG Feng, et al DOI: 10.3969/j.issn.1671-7171.2024.03.001 2024 Vol. 41 (3): 321-324 [Abstract] ( 62 ) HTML (1 KB)  PDF (1207 KB)  ( 62 )        Original Articles 325 Relationship of Serum TNC, Blood Pressure and Blood Glucose with Diabetic Peripheral Neuropathy and Proliferative Diabetic Retinopathy QIN Yanping, HE Jianming, HUANG Hongbo, et al DOI: 10.3969/j.issn.1671-7171.2024.03.002 【Objective】To investigate the relationship of serum tenascin-C(TNC), blood pressure and blood glucose with diabetic peripheral neuropathy(DPN) and Proliferative diabetic retinopathy(PDR). 【Methods】A total of 122 patients with type 2 diabetes(T2DM) admitted to Liuzhou Red Cross Hospital from June 2021 to June 2022 were selected and divided into group A(patients without DPN, n=75) and group B(patients with DPN, n=47) according to whether they had DPN or not. Group A and group B were further divided two sub-groups according to whether PDR was present. Group A was divided into group A1(patients without PDR, n=23) and group A2(patients with PDR, n=52), and group B was divided into group B1(patients without PDR, n=31) and group B2(patients with PDR, n=16). Serum TNC was detected by enzyme-linked immunoassay(ELISA), Fasting blood glucose(FPG) was measured by Roche biochemical analyzer, and blood pressure was measured in each group. 【Results】There were no significant differences in serum TNC, FPG and systolic pressure(SBP) between group A and group B(all P>0.05). There was significant difference in diastolic pressure(DBP) between group A and group B(P<0.05). There were no significant differences in serum TNC levels, SBP and DBP values between group A1 and group A2,as well as between group B1 and group B2(all P>0.05). There was no significant difference in serum FPG level between group A1 and group A2(P>0.05), but there was significant difference in serum FPG level between B1 and B2 groups(P<0.05). There was no correlation of DPN with TNC, SBP and DBP(P>0.05), but there was a positive correlation between DPN and FPG(P<0.05).【Conclusion】Serum TNC level is not associated with DPN, PDR or DPN with PDR. Patients with DPN had higher blood pressure than those without DPN, and patients with both DPN and PDR had higher FPG than those with DPN and PDR alone. Clinicians should control blood pressure and blood sugar levels in patients with T2DM to reduce the incidence of T2DM complications.Clinicians should pay attention to timely treatment and control of blood pressure and blood sugar in T2DM patients to reduce the occurrence of T2DM complications. 2024 Vol. 41 (3): 325-328 [Abstract] ( 98 ) HTML (1 KB)  PDF (1152 KB)  ( 274 ) 329 Clinical Application Value of Opportunistic Screening for Colorectal Cancer in Hospitalized Patients with Positive Stool Occult Blood Test ZHOU Hanshen, JIA Fenglan, WANG Tongling DOI: 10.3969/j.issn.1671-7171.2024.03.003 【Objective】 To explore the clinical application value of opportunistic screening for colorectal cancer in hospitalized patients with positive stool occult blood test. 【Methods】A retrospective analysis was conducted on the clinical data of 534 hospitalized patients with positive stool occult blood test who underwent opportunistic screening for colorectal cancer at the Fourth Affiliated Hospital of Zhejiang University School of Medicine from July 2021 to July 2022. According to the classification criteria for high-risk populations of colorectal cancer, patients were divided into high-risk group(n=99) and general population group(n=435). The stool occult blood test and colonoscopy were analyzed, and the colonoscopy results were compared among different groups. 【Results】 534 hospitalized patients underwent routine stool occult blood test, all of which were positive. Among them, 278 patients underwent colonoscopy, with a compliance rate of 52.1%(278/534). A total of 106 cases of colorectal cancer and precancerous lesions were detected by colonoscopy, with a detection rate of 38.1%(106/278). The compliance rate of colonoscopy in high-risk population group was 80.8%(80/99), which was significantly higher than that in general population group(45.5%), with significant difference(χ2=40.244, P<0.01). The positive rate of colonoscopy in high-risk population group was significantly higher than that in general population, with significant difference(χ2=8.196, P=0.04). 【Conclusion】Hospitalized patients with positive stool occult blood test have high compliance with colonoscopy screening. The compliance rate of high-risk population of colorectal cancer is significantly higher than that of general population. The recommendation of doctors is an important factor affecting screening compliance. Routine screening for colorectal cancer opportunity in hospitalized patients is one of the screening models suitable for China's national conditions. 2024 Vol. 41 (3): 329-331 [Abstract] ( 60 ) HTML (1 KB)  PDF (1178 KB)  ( 68 ) 332 The Application Value of Breast Cancer Ultrasonic Signs and Molecular Biological Indicators in the Prognosis Evaluation of Breast Cancer Patients 3 Years after Operation WANG Shu, YAN Jingru DOI: 10.3969/j.issn.1671-7171.2024.03.004 【Objective】 To explore the application value of breast cancer ultrasonic signs and molecular biological indicators in the prognosis evaluation of breast cancer patients 3 years after operation. 【Methods】The clinical data of 100 female breast cancer patients diagnosed and treated in our hospital from March 2017 to March 2020 were retrospectively analyzed. Cox risk regression model was used to analyze the predictive value of molecular biological indicators [estrogen receptor(ER), progesterone receptor(PR), proliferating cell nuclear antigen(Ki-67), human epidermal growth factor receptor 2(HER2), carbohydrate antigen 15-3(CA15-3), carbohydrate antigen 125(CA125)] and ultrasound signs(lymph node metastasis, tumor size, calcification, internal echo) for the prognosis of breast cancer patients after 3 years. 【Results】During the 3-year follow-up of 100 patients, 17(17.00%) patients developed local recurrence or metastasis, and 3(3.00%) patients died. Univariate COX regression analysis showed that tumor diameter, calcification, Ki-67 and pathological stage were the influencing factors of 3-year overall survival and recurrence free survival of breast cancer patients(P<0.05); Multivariate COX regression analysis showed that tumor diameter > 5.0 cm, calcification, Ki-67 ≥ 14% were the risk factors affecting the 3-year overall survival and recurrence free survival of breast cancer patients(P<0.05). 【Conclusion】Tumor diameter, calcification and Ki-67 are associated with poor prognosis in breast cancer patients. 2024 Vol. 41 (3): 332-335 [Abstract] ( 40 ) HTML (1 KB)  PDF (1331 KB)  ( 34 ) 336 Efficacy of Different Doses of Olanzapine in Treating Elderly Patients with Depressive Disorders Accompanied by Anxiety and Pain TAO Tao, ZHANG Boyu, ZHENG Shuang, et al DOI: 10.3969/j.issn.1671-7171.2024.03.005 【Objective】To investigate the efficacy of different doses of olanzapine in treating elderly depression patients with comorbid anxiety and pain, as well as its effects on somatic symptoms and sleep quality. 【Methods】 A total of 120 elderly patients with depression plus comorbid anxiety and pain from our hospital were randomly divided into a low-dose group and a high-dose group, with 60 patients in each group. Both groups were treated with paroxetine, while patients in the control group received a high dose of olanzapine(10 mg/dose) and in the observation group received a low dose of olanzapine(2.5 mg/dose), both for three months. The effectiveness and adverse reactions of the two groups were compared. The scores on the Hamilton Depression Scale(HAMD), Hamilton Anxiety Scale(HAMA), Patient Health Questionnaire-15(PHQ-15) for the severity of somatic symptoms, Pittsburgh Sleep Quality Index(PSQI), and levels of fasting blood glucose(FBG), total cholesterol(TC) and triglycerides(TG) were compared before and after treatment in both groups.【Results】 There was no significant statistical difference in the overall effectiveness rate between the two groups(P>0.05). There were no significant statistical differences in the HAMD, HAMA, and PHQ-15 scores between the two groups either before or after treatment(P>0.05), while there was a significant reduction in the scores after treatment if compared to before treatment in each group(P<0.05). There were no significant statistical differences in the individual and total PSQI scores between the two groups before and after treatment(P>0.05), however, the scores of both groups after treatment were significantly lower than those before treatment(P<0.05). There were no significant statistical differences in levels of FBG, TC and TG between the two groups before treatment(P>0.05). After treatment, the FBG, TC, and TG levels in the high-dose group were significantly higher than those before treatment, while the FBG,TC and TG levels of the high-dose group were significantly higher than those of the low-dose group(P<0.05). The total incidence of adverse reactions in the low-dose group was significantly lower than that in the high-dose group(P<0.05).【Conclusion】 Olanzapine can improve depression, anxiety, somatic symptoms, and sleep quality in elderly patients with depressive disorder plus comorbid anxiety and pain. Using a low dose of olanzapine can reduce the risk of hyperglycemia and hyperlipidemia, and it has fewer adverse reactions. 2024 Vol. 41 (3): 336-339 [Abstract] ( 44 ) HTML (1 KB)  PDF (1143 KB)  ( 42 ) 340 The Value of Echocardiographic Parameters, Peripheral Blood T Lymphocyte Subsets, NF-κB, and CD64 Levels in Predicting the Prognosis of Neonatal Sepsis WANG Fei DOI: 10.3969/j.issn.1671-7171.2024.03.006 【Objective】To explore the value of echocardiographic parameters, peripheral blood T lymphocyte subsets, nuclear factor-κB(NF-κB), and cluster differentiation antigen 64(CD64) levels in predicting the prognosis of neonatal sepsis. 【Methods】 A total of 95 neonatal sepsis patients admitted to our hospital from January 2020 to February 2023 were selected and divided into a survival group(n=80) and a death group(n=15) according to their prognosis. The echocardiographic parameters [left ventricular short axis shortening fraction(FS), ascending aorta diameter(AAO), left ventricular ejection fraction(LVEF)], myocardial injury markers [creatine kinase(CK), creatine kinase isoenzyme(CK-MB)], T lymphocyte subsets(CD3+, CD4+, CD8+), NF-κB, and CD64 levels were compared between the two groups. Logistic multivariable regression analysis was used to analyze the relevant factors affecting the poor prognosis of neonatal sepsis. The receiver operating characteristic(ROC) curve was used to analyze the clinical value of electrocardiogram and laboratory indicators in predicting the prognosis of neonatal sepsis. 【Results】 There was no significant difference in the levels of creatine kinase CK and CK-MB between the two groups(P>0.05). The FS, AAO, and LVEF in the survival group were higher than those in the death group, and the difference was statistically significant(P<0.05). There was no significant difference in the CD8+ level between the two groups(P>0.05). The CD3+ and CD4+ levels in the survival group were higher than those in the death group, while the NF-κB and CD64 levels were lower, and the difference was statistically significant(P<0.05). There was no significant difference in the NLR and CRP levels between the two groups(P>0.05). The WBC level in the survival group was lower than that in the death group, and the difference was statistically significant(P<0.05). Logistic multivariable regression analysis showed that FS, LVEF, and CD64 were related factors affecting the prognosis of neonatal sepsis(P<0.05). The area under the ROC curve for FS, LVEF, and CD64 combined to predict the prognosis of neonatal sepsis was 0.948, which was significantly higher than that of each individual indicator(0.827, 0.895, and 0.877, respectively)(P<0.05). 【Conclusion】The combined detection of FS, LVEF, and CD64 has good predictive value for the prognosis of neonatal sepsis. Clinicians can closely monitor these indicators to timely judge the prognosis of neonatal sepsis and take relevant intervention measures. 2024 Vol. 41 (3): 340-343 [Abstract] ( 40 ) HTML (1 KB)  PDF (1186 KB)  ( 40 ) 344 Early Diagnostic Value of Ultrasound E Imaging Combined with Serum Ferritin Level in Nonalcoholic Fatty Liver Disease GUO Fanglan, WANG Jun DOI: 10.3969/j.issn.1671-7171.2024.03.007 【Objective】To investigate the early diagnostic value of ultrasound E-imaging combined with serum ferritin(SF) level in nonalcoholic fatty liver disease(NAFLD). 【Methods】A retrospective analysis was performed on 85 NAFLD patients admitted to our hospital from February 2020 to June 2022 and 60 healthy volunteers who received physical examinations in our hospital during the same period. They were selected and recorded as the NAFLD group and the healthy group, respectively. According to the severity of hepatic steatosis, NAFLD patients were further divided into three subgroups: mild steatosis group(26 cases), moderate steatosis group(38 cases) and severe steatosis group(21 cases). Young's modulus values were determined by ultrasound E-imaging in all subjects, and SF levels were detected by radioimmunoassay. The clinical data, Young's modulus value and SF level of the two groups were compared. The values of Young's modulus and SF levels in patients with NAFLD with different degrees of hepatic steatosis were compared as well. The related factors affecting the incidence of NAFLD were analyzed to reveal the early diagnosis value of Young's modulus value, SF and the combination of the two in predicting NAFLD occurrence. 【Results】The levels of body mass index(BMI), fasting blood glucose(FPG), total cholesterol(TC), triglyceride(TG), Young's modulus and SF in the NAFLD group were higher than those in the healthy group(P<0.05). Young's modulus value and SF level in severe steatosis group were higher than those in mild steatosis group and moderate steatosis group(P<0.05). The Young's modulus value and SF level in the moderate steatosis group were higher than those in the mild steatosis group(P<0.05). The results of multivariate analysis showed that BMI, Young's modulus and SF were the influencing factors affecting the occurrence of NAFLD(P<0.05). The results of ROC curve analysis showed that the sensitivity of Young's modulus value, SF and their combination for early diagnosis of NAFLD was 76.47%,78.82% and 75.29%, respectively; The specificity was 71.67%,68.33% and 96.67%, respectively; And their AUC were 0.734, 0.714 and 0.901, respectively. 【Conclusion】The occurrence of NAFLD is related to BMI, Young's modulus value and SF level. Ultrasound E-imaging combined with SF level is of high value in the early diagnosis of NAFLD. 2024 Vol. 41 (3): 344-347 [Abstract] ( 43 ) HTML (1 KB)  PDF (1266 KB)  ( 35 ) 348 Relationship between Serum Inflammatory Factor Level and Cognitive Function in Patients with Obsessive-compulsive Disorder CHEN Min, SUN Xiaolan, JIANG Danma DOI: 10.3969/j.issn.1671-7171.2024.03.008 【Objective】To explore the relationship between serum inflammatory factor levels and cognitive function in patients with obsessive-compulsive disorder. 【Methods】A total of 252 patients with obsessive-compulsive disorder who were treated in our hospital were divided into the mild obsessive-compulsive disorder group(n=125) and the severe obsessive-compulsive disorder group(n=127) according to the Yale-Brown obsessive-compulsive scale(Y-BOCS). In the same period, 100 healthy people who came to our hospital for physical examination were recruited to the control group. The changes of serum levels of interleukin-2(IL-2), levels of interleukin-6(IL-6), tumor necrosis factor-alpha(TNF-α) and serotonin 5-hydroxytryptamine(5-HT) levels were compared among different groups. The cognitive function of each group using the Neurocognitive Battery test(MCCB) was evaluated and compared as well.Spearman correlation test was used to analyzed the relationship of cognitive function score with serum levels of IL-2, IL-6, IL-8 and TNF-α. 【Results】Information processing speed, visuospatial working memory, visual memory, reasoning and problem-solving scores, and 5-HT level in the obsessive-compulsive group were lower than those in the control group(P<0.05). The serum levels of IL-2, IL-6, IL-8 and TNF-α in pre-treated obsessive-compulsive group were higher than those post-treated obsessive-compulsive group, which was greater than the control group(P<0.05). The information processing speed, visuospatial working memory, visual memory, reasoning and problem-solving scores, and 5-HT level before and after treatment in the severe obsessive-compulsive group were lower than those in the mild obsessive-compulsive group(P<0.05), while the levels of IL-2, IL-6, IL-8 and TNF-α before and after treatment in the severe obsessive-compulsive group were significantly higher than those in the mild obsessive-compulsive group(P<0.05). Spearman test showed that serum levels of IL-2, IL-6, IL-8 and TNF-α were negatively correlated with information processing speed, visual spatial working memory, visual memory, reasoning and problem-solving scores in patients with obsessive-compulsive disorder(P<0.05). 【Conclusion】Serum levels of IL-2, IL-6, IL-8 and TNF-α are important inflammatory indicators that reflect the cognitive function of patients with obsessive-compulsive disorder. IL-2, IL-6, IL-8 and TNF-α levels are negative correlation with the cognitive function score of patients with obsessive-compulsive disorder. Thus they can be used as an auxiliary diagnostic index to detect the cognitive impairment of patients with obsessive-compulsive disorder. 2024 Vol. 41 (3): 348-351 [Abstract] ( 38 ) HTML (1 KB)  PDF (1152 KB)  ( 45 ) 352 Predictive Value of Systemic Immune-inflammatory Index for No-reflow after PCI in Patients with Acute ST Segment Elevation Myocardial Infarction ZHANG Lixia, DONG Jinli DOI: 10.3969/j.issn.1671-7171.2024.03.009 【Objective】To investigate the predictive value of systemic immune-inflammatory index(SII) for no-reflow after percutaneous coronary intervention(PCI) in patients with acute ST segment elevation myocardial infarction(STEMI). 【Methods】The clinical data of 208 STEMI patients who underwent PCI in our hospital from January 2016 to April 2020 were retrospectively analyzed. According to whether no-reflow occurred after PCI, they were divided into normal reflow group and no-reflow group. The general clinical data of the two groups were compared. Cox multivariate regression analysis was used to analyze the risk factors of no-reflow. Receiver operating characteristic(ROC) curve was used to evaluate the predictive value of reperfusion time, HbA1c and SII for no-reflow. According to the cut-off value of SII to predict no-reflow, the patients were divided into SII low-level group and SII high-level group. The 3-year survival rates between normal reflow group and no-reflow group, SII low-level group and SII high-level group were compared. 【Results】The proportion of patients with TIMI grade > 2 and the proportion of diabetes mellitus in the no-reflow group were higher than those in the normal reflow group, and the levels of STB, DTB, CK-MB peak, HDL, postprandial blood glucose, FPG and SII in the no-reflow group were higher than those in the normal reflow group, with statistically significant differences(P<0.05). Cox multivariate regression analysis showed that STB, DTB, HbA1c and SII were the relevant factors affecting no-reflow (P<0.05). ROC curve analysis showed that STB, DTB, HbA1c and SII had predictive value for no-reflow, but SII had higher predictive value for no-reflow than STB, DTB and HbA1c(Z= 3.965, 4.201, 4.062;P=0.018, 0.014, 0.021). The 3-year survival rate in the no-reflow group was 56.3%(27/48), which was lower than 80.6%(129/160) in the normal reflow group, and the difference was statistically significant(P<0.05). The 3-year survival rate in the SII high-level group was 30.8%(20/65), which was lower than 84.2%(80/95) in the SII low-level group, and the difference was statistically significant(P<0.05). 【Conclusion】 SII can predict the occurrence of no-reflow after PCI in patients with STEMI, and can affect the postoperative survival rate of patients. 2024 Vol. 41 (3): 352-355 [Abstract] ( 40 ) HTML (1 KB)  PDF (1199 KB)  ( 30 ) 356 Relationship between Fibrinogen to Prealbumin Ratio, Hemoglobin to Red Blood Cell Distribution Width Ratio and Prognosis of Colorectal Cancer Patients HE Jie DOI: 10.3969/j.issn.1671-7171.2024.03.010 【Objective】To investigate the relationship between fibrinogen to prealbumin ratio(FPR), hemoglobin to red blood cell distribution width ratio(HRR) and prognosis of colorectal cancer patients. 【Methods】A total of 92 patients with colorectal cancer who underwent surgery were followed up for 3 years. According to the prognosis, they were divided into good prognosis group(no recurrence, metastasis or death) and poor prognosis group(recurrence, metastasis or death). The clinical data, FPR and HRR levels of the two groups were compared, and the factors affecting the prognosis of the patients were analyzed; Receiver operating characteristic(ROC) curve was used to analyze the predictive efficacy of FPR and HRR levels on the prognosis of patients. 【Results】 The incidence of poor prognosis in colorectal cancer patients within 3 years after operation was 22.83%(21/92). The FPR level in the poor prognosis group was higher than that in the good prognosis group, and the HRR level was lower than that in the good prognosis group(P<0.05). ROC curve showed that the sensitivity of FPR, HRR and their combination to predict the prognosis of patients were 76.20%, 57.10% and 90.50%, respectively, and the specificity was 77.50%, 69.00% and 88.70%, respectively. The area under the curve(AUC) was 0.804, 0.722 and 0.899, respectively. The proportion of poorly differentiated and TNM stage Ⅲa in the poor prognosis group was higher than that in the good prognosis group(P<0.05); There was no significant difference in gender, age, maximum diameter of tumor, tumor location, pathological type between the two groups(P>0.05). Cox multivariate analysis showed that TNM stage Ⅲa and FPR were risk factors for the prognosis of patients, while HRR was a protective factor for the prognosis of patients(P<0.05). The survival curve of patients with high FPR level was significantly different from that of patients with low FPR level(P<0.05). The survival curve of patients with low HRR level was significantly different from that of patients with high HRR level(P<0.05). 【Conclusion】The detection of FPR and HRR levels in patients with colorectal cancer can be used to predict the prognosis of patients, and the combined predictive value of the two is better. 2024 Vol. 41 (3): 356-359 [Abstract] ( 39 ) HTML (1 KB)  PDF (1313 KB)  ( 37 ) 360 Correlation between Thyroid Hormone Level and Severity of Disease in Patients with Type 2 Diabetes Mellitus Complicated with Acute Cerebral Infarction WEI Lingyan, ZHANG Ying, SUN Fengjuan, et al DOI: 10.3969/j.issn.1671-7171.2024.03.011 【Objective】 To explore the correlation between thyroid hormone level and severity of type 2 diabetes mellitus(T2DM) complicated with acute cerebral infarction(ACI). 【Methods】 A total of 80 patients with T2DM complicated with ACI admitted to our hospital from January 2019 to January 2022 were selected as group A, and 80 patients with simple T2DM admitted to our hospital during the same period were selected as group B. After admission, blood glucose indexes [fasting blood glucose(FPG), mean daily blood glucose fluctuation(MAGE), standard deviation of blood glucose level(SDBG)] and thyroid hormone [triiodothyronine(T3), thyroxine(T4), thyroid stimulating hormone(TSH)] levels were detected and compared between the two groups. The National Institutes of Health Stroke Scale(NIHSS) was used to evaluate the degree of neurological deficit in group A patients. The patients were divided into mild group(n=27, NIHSS score ≤8), moderate group(n=32, NIHSS score 9-14), and severe group(n=21, NIHSS score ≥15). The differences of blood glucose and thyroid hormone in T2DM patients with ACI were compared, and the correlation between blood glucose, thyroid hormone and the severity of T2DM patients with ACI was analyzed. Three months after treatment, the improved Rankin scale was used to evaluate the neurological recovery of patients in group A, and they were divided into good prognosis group(n=50, grade 0-1 for good prognosis) and poor prognosis group(n=30, grade 2-6 for poor prognosis). The differences of blood glucose and thyroid stimulating hormone related indicators in patients with different prognosis in group A were compared, and the influence of the above indicators on the prognosis of T2DM patients with ACI was analyzed. 【Results】The levels of FPG, MAGE, SDBG and TSH in group A were significantly higher than those in group B(P<0.05), and the level of T3 in group A was significantly lower than that in group B(P<0.05). There was no significant difference in the level of T4 between the two groups(P>0.05). The levels of FPG, MAGE, SDBG and TSH in the mild group, the moderate group and the severe group increased in turn(P<0.05), and the level of T3 decreased in turn(P<0.05). There was no significant difference in T4 levels among the three groups(P>0.05). FPG, MAGE, SDBG, TSH were positively correlated with the severity of the disease(P<0.05), T3 was negatively correlated with the severity of the disease(P<0.05). The levels of FPG, MAGE, SDBG and TSH in the good prognosis group were significantly lower than those in the poor prognosis group, and the level of T3 in the good prognosis group was significantly higher than that in the poor prognosis group(P<0.05). There was no significant difference in the level of T4 between the two groups(P>0.05). 【Conclusion】The more severe the condition of T2DM patients with ACI, the higher the levels of FPG, MAGE, SDBG, TSH, and the lower the level of T3. 2024 Vol. 41 (3): 360-363 [Abstract] ( 45 ) HTML (1 KB)  PDF (1146 KB)  ( 57 ) 364 The Effect of Remimazolam on Surgical Stress Response, Quality of Postoperative Recovery, and Extubation in Elderly Patients Undergoing Radical Surgery for NSCLC JIA Zhijie, ZHANG Xiaoran, DUAN Wenjiao DOI: 10.3969/j.issn.1671-7171.2024.03.012 【Objective】To explore the effects of remimazolam on stress response, postoperative recovery quality, and extubation in elderly patients undergoing radical surgery for non-small cell lung cancer(NSCLC).【Methods】Eighty patients undergoing radical NSCLC surgery in The First Affiliated Hospital of Xinxiang Medical University were randomly divided into two groups, with 40 patients in each group. The control group received propofol, while the observation group was induced and maintained with remimazolam anesthesia. Levels of adrenocorticotropic hormone(ACTH) and nitric oxide(NO) were compared pre-surgery and post-surgery between the two groups. Additionally, heart rate(HR) and mean arterial pressure(MAP) were compared at different time points: before anesthesia induction(T1), within 1 minute of intubation(T2), 30 minutes after surgery started(T3), at the end of surgery(T4), and 10 minutes after extubation(T5). Postoperative recovery quality and the incidence of coughing were also compared between the groups. 【Results】 Compared to pre-surgery levels, both groups showed a significant increase in ACTH level and a decrease in NO level(P<0.05), but there was no significant difference between the groups(P>0.05). Both groups had significantly lower HR and MAP at T2 and T3 compared to T1(P<0.05). HR and MAP levels at T2 were higher in the observation group compared to the control group(P<0.05). There was no significant difference between the two groups in terms of postoperative recovery quality measured by bispectral index(BIS), postoperative visual analogue scale(VAS) scores, and agitation(P>0.05). The observation group had shorter eye-opening time, extubation time, and duration of stay in the post-anesthesia care unit(PACU) compared to the control group(P<0.05). The incidence of coughing was lower in the observation group(P<0.05). 【Conclusion】 The use of remimazolam for anesthesia induction in elderly patients undergoing radical NSCLC surgery can maintain hemodynamic stability, improve the quality of recovery period, and reduce the incidence of coughing during extubation. 2024 Vol. 41 (3): 364-367 [Abstract] ( 37 ) HTML (1 KB)  PDF (1141 KB)  ( 39 ) 368 Evaluation Value of FT3 and FT4 Levels in Patients with Hyperthyroidism Complicated with Hyperthyroid Heart Disease LI Dan, HUANG Feng DOI: 10.3969/j.issn.1671-7171.2024.03.013 【Objective】To explore the evaluation value of serum free triiodothyronine(FT3) and free thyroxine(FT4) in patients with hyperthyroidism complicated with hyperthyroid heart disease. 【Methods】A total of 84 patients with hyperthyroidism treated in Chang'an District Hospital from January 2021 to January 2023 were selected in the study. The incidence of hyperthyroidism patients complicated with hyperthyroidism heart disease was counted, and patients were divided into concurrent group(10 cases) and non-concurrent group(74 cases) according to whether hyperthyroidism heart disease occurred. The clinical data of patients in concurrent group and non-concurrent group were compared. Multivariate logistic regression analysis was used to analyze the risk factors of hyperthyroidism patients complicated with hyperthyroidism heart disease. The efficacy of FT3 and FT4 in the evaluation of hyperthyroidism patients complicated with hyperthyroidism heart disease was analyzed. 【Results】There were 10 cases of hyperthyroid patients complicated with hyperthyroid heart disease, which showed that the incidence of hyperthyroid heart disease was 11.90%. There were no significant differences in gender, age, diabetes mellitus, smoking history, hyperthyroidism drug use, uric acid, triglyceride, hemoglobin, albumin and infection between the concurrent group and the non-concurrent group(P>0.05). FT3 and FT4 in the concurrent group were higher than those in the non-concurrent group(P<0.05). The results of multivariate analysis showed that both FT3 and FT4 were independent risk factors for hyperthyroid patients complicated with hyperthyroid heart disease(OR=3.256, 3.368, P<0.05). The best cutoff points of FT3 and FT4 in predicting hyperthyroidism complicated with hyperthyroidism heart disease were 10.25 pmol/L and 36.52 pmol/L respectively, and the area under the curve(AUC) was 0.785 and 0.756. The specificity of the combination of FT3 and FT4 was 92.69%, which was higher than that of FT3 and FT4 alone(P<0.05). 【Conclusion】The incidence of hyperthyroid patients complicated with hyperthyroid heart disease is high. FT3 and FT4 have certain value in the evaluation of hyperthyroid patients complicated with hyperthyroid heart disease, but the value of their combined detection is even higher, which can be used as an important reference index for clinical evaluation. 2024 Vol. 41 (3): 368-370 [Abstract] ( 34 ) HTML (1 KB)  PDF (1186 KB)  ( 32 ) 371 Expression and Significance of miR-16-5p and FGF21 mRNA in Patients with Gestational Diabetes Mellitus SONG Xiaoyu, JIANG Qingying DOI: 10.3969/j.issn.1671-7171.2024.03.014 【Objective】To investigate the expression and significance of serum miR-16-5p and placental fibroblast growth factor 21(FGF21) mRNA in pregnant women with gestational diabetes mellitus(GDM).【Methods】A total of 102 GDM patients admitted to the Third Affiliated Hospital of Xinxiang Medical College from July 2021 to February 2023 were selected as the observation group, and 99 healthy pregnant women admitted to the Third Affiliated Hospital of Xinxiang Medical College during the same period were selected as the control group. The clinical data such as the expression of miR-16-5p in peripheral blood and the expression of FGF21 in placental tissue of the two groups were collected. The factors affecting the incidence of GDM were analyzed. The correlation between miR-16-5p and FGF21 expression in GDM patients in the study group was analyzed. The value of miR-16-5p in predicting the occurrence of GDM was analyzed. 【Results】The relative expression of miR-16-5p and FGF21 mRNA in the observation group were higher than those in the control group(P<0.05). Logistic multivariate regression analysis showed that age, pre-pregnancy body mass index, relative expression of miR-16-5p and the relative expression of FGF21 mRNA were independent factors affecting the incidence of GDM(P<0.05). Pearson correlation analysis showed that the relative expression of miR-16-5p in GDM patients was positively correlated with the relative expression of FGF21 mRNA in placental tissue(P<0.05). The results of ROC curve analysis showed that the sensitivity of the relative expression of miR-16-5p in peripheral blood to predict the onset of GDM was 78.43%, the specificity was 83.84%, and the AUC was 0.820. 【Conclusion】The expressions of miR-16-5p and FGF21 mRNA are related to the pathogenesis of GDM. The expression of miR-16-5p in peripheral blood of GDM patients is positively correlated with the expression of FGF21 in placental tissue. The expression of miR-16-5p has a good effect on predicting the pathogenesis of GDM. 2024 Vol. 41 (3): 371-374 [Abstract] ( 38 ) HTML (1 KB)  PDF (1194 KB)  ( 31 ) 375 Effect of SEPT9 Gene Methylation Level in Cancer Tissue on postoperative Progression-free Survival in Patients with Stage Ⅱ-Ⅲ Resectable Rectal Cancer LI Yueping, HAN Bo, ZHANG Rumeng, et al DOI: 10.3969/j.issn.1671-7171.2024.03.015 【Objective】To investigate the impact of SEPT9 gene methylation level in cancer tissues on progression-free survival after surgery in patients with stage Ⅱ-Ⅲ resectable rectal cancer. 【Methods】A total of 129 patients who underwent R0 total mesorectal excision for stage Ⅱ-Ⅲ resectable rectal cancer were followed up for 5 years postoperatively. The positive expression of SEPT9 gene methylation in cancer tissues and adjacent non-cancerous tissues was compared, and the relationship of SEPT9 gene methylation levels in cancer tissues with clinicopathological parameters was analyzed. Factors affecting postoperative recurrence or metastasis of rectal cancer were investigated, along with the relationship between positive expression of SEPT9 gene methylation in cancer tissues and progression-free survival after surgery. 【Results】The positive expression rate of SEPT9 gene methylation in cancer tissues was higher than that in adjacent non-cancerous tissues(P<0.05). Patients with poorly differentiated, N2 stage, stage Ⅲ, and tumor invasion into the vasculature had higher positive expression rates of SEPT9 gene methylation in cancer tissues than those with moderately to well-differentiated, N0-N1 stage, stage Ⅱ, and no tumor invasion into the vasculature(P<0.05). Cox regression analysis showed that preoperative carcinoembryonic antigen levels, pathological staging, differentiation degree, and positive SEPT9 gene methylation were independent factors affecting postoperative recurrence or metastasis(P<0.05). Patients with positive expression of SEPT9 gene methylation had lower progression-free survival rates than those with negative expression(P<0.05). 【Conclusion】The level of SEPT9 gene methylation in cancer tissues of patients with stage Ⅱ-Ⅲ resectable rectal cancer is related to clinicopathological parameters and prognosis. Patients with positive expression of SEPT9 gene methylation have a higher risk of postoperative recurrence and metastasis. 2024 Vol. 41 (3): 375-378 [Abstract] ( 42 ) HTML (1 KB)  PDF (1158 KB)  ( 33 ) 379 Correlation between Absolute Value of PTFV1 and Left Ventricular Diastolic Function in Patients with Coronary Heart Disease and Heart Failure HUANG Li, REN Meimei DOI: 10.3969/j.issn.1671-7171.2024.03.016 【Objective】To investigate the correlation between the absolute value of P-wave terminal force in lead V1(PTFV1) and left ventricular diastolic function in patients with coronary heart disease complicated with heart failure. 【Methods】A total of 100 patients with coronary heart disease complicated with heart failure admitted to our hospital from January 2021 to January 2022 were selected. According to the absolute value of PTFV1 on electrocardiogram, they were grouped into a positive group(n=67) with an absolute value of PTFV1 ≥0.04 mm?s and a negative group(n=33) with an absolute value of PTFV1 <0.04 mm?s. Echocardiography was used to detect cardiac function-related indicators, including left ventricular ejection fraction(LVEF), left ventricular end-diastolic volume(LVEDV), mitral valve early diastolic peak flow velocity(E), mitral valve late diastolic peak flow velocity(A), mitral annular lateral early diastolic motion velocity(E'), and E/A and E/E' values were recorded. Pearson correlation analysis was used to investigate the correlation between the absolute value of PTFV1 and left ventricular diastolic function. 【Results】The levels of LVEF, E, E', and E/A in the positive group were lower than those in the negative group, while the levels of A and E/E' in the positive group were higher than those in the negative group. The proportion of patients with E/E'>8 in the positive group was higher than that in the negative group(P<0.05). There was no significant difference in the level of LVEDV between the two groups(P>0.05). Pearson correlation analysis showed that the absolute value of PTFV1 was negatively correlated with LVEF, E, E', and E/A levels(P<0.05), and positively correlated with A and E/E'(P<0.05). 【Conclusion】 The absolute value of PTFV1 on electrocardiogram can be used to preliminarily assess the left ventricular diastolic function in patients with coronary heart disease and heart failure, which is helpful for clinicians to timely diagnose and treat such patients. 2024 Vol. 41 (3): 379-381 [Abstract] ( 34 ) HTML (1 KB)  PDF (1181 KB)  ( 47 ) 382 Diagnostic Value of HR-HPV DNA and LPT Detection in Patients with Cervical Squamous Cell Carcinoma HUI Min, CUI Jing DOI: 10.3969/j.issn.1671-7171.2024.03.017 【Objective】 To investigate the diagnostic value of high-risk human papillomavirus(HR-HPV) deoxyribonucleic acid(DNA) combined with liquid based thin-prep cytology(LPT) in cervical squamous cell carcinoma. 【Methods】A total of 84 patients with cervical squamous cell carcinoma(cervical squamous cell carcinoma group) and 60 patients with chronic cervicitis(chronic cervicitis group) who were diagnosed and treated in Xi'an High-tech Hospital from May 2019 to April 2021 were selected, and 50 healthy women who underwent physical examination in the Xi'an High-tech Hospital during the same period were selected as the control group. The positive rates of HR-HPV DNA and LPT were compared among the three groups; The positive rates of HR-HPV DNA and LPT in patients with cervical squamous cell carcinoma at different stages and different degrees of differentiation were compared. Taking the pathological examination results as the gold standard, the diagnostic efficacy of HR-HPV DNA combined with LPT detection for cervical squamous cell carcinoma was analyzed. 【Results】The positive rates of HR-HPV DNA and LPT in the cervical squamous cell carcinoma group and the chronic cervicitis group were higher than those in the control group(P<0.05); The positive rates of HR-HPV DNA and LPT in cervical squamous cell carcinoma group were higher than those in the chronic cervicitis group. There was no significant difference in the positive rates of HR-HPV DNA and LPT in patients with cervical squamous cell carcinoma at different stages(P>0.05); There was no significant difference in the positive rates of HR-HPV DNA and LPT in patients with cervical squamous cell carcinoma of different differentiation degrees(P>0.05). Receiver operating characteristic(ROC) curve analysis showed that the sensitivity of HR-HPV DNA combined with LPT in the diagnosis of cervical squamous cell carcinoma was significantly higher than that of HR-HPV DNA and LPT alone; The AUC of HR-HPV DNA combined with LPT in the diagnosis of cervical squamous cell carcinoma was higher than that of HR-HPV DNA and LPT alone(Z=3.940,P<0.001; Z=3.968, P<0.001). 【Conclusion】 HR-HPV DNA combined with LPT is highly effective in the diagnosis of cervical squamous cell carcinoma, and can be used as an important reference index for clinical diagnosis of cervical squamous cell carcinoma. 2024 Vol. 41 (3): 382-385 [Abstract] ( 42 ) HTML (1 KB)  PDF (1187 KB)  ( 32 ) 386 The Therapeutic Effect of Xingpi Yanger Granules Combined with Probiotics on Infantile Diarrhea and its Impact on Gastrointestinal Hormone Levels XIE Yufei, YANG Liping, TANG Lifang DOI: 10.3969/j.issn.1671-7171.2024.03.018 【Objective】 To investigate the therapeutic effect of Xingpi Yanger Granules combined with probiotics on infantile diarrhea.【Methods】A total of 120 cases of diarrhea in our hospital were randomly divided into two groups. The control group was treated with probiotics, and the observation group was treated with Xingpi Yanger Granules on the basis of the control group. The levels of gastrointestinal hormones, serum inflammatory factors, clinical indicators, electrolyte levels, clinical efficacy, and adverse reactions were compared between the two groups before and after treatment.【Results】There were no significant differences in the levels of all indicators between the two groups before treatment(P>0.05).After treatment, the levels of growth hormone in both groups were higher than before treatment(P<0.05), while the levels of motilin and gastrin in both groups were lower than before treatment(P<0.05), and the levels of all indicators in the observation group were better than those in the control group(P<0.05). The levels of interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), and high-sensitivity C-reactive protein(hs-CRP) in both groups were lower than before treatment(P<0.05), and the levels of all indicators in the observation group were lower than those in the control group(P<0.05). The time for diarrhea, dehydration, and appetite improvement in the observation group was shorter than that in the control group(P<0.05). After treatment, the levels of Na+ and Cl- in both groups were higher than before treatment(P<0.05), and the levels of all indicators in the observation group were higher than those in the control group(P<0.05). The total effective rate in the observation group was higher than that in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). 【Conclusion】Xingpi Yanger Granules combined with probiotics can effectively regulate gastrointestinal hormones, reduce serum inflammatory factors levels, improve clinical efficacy, and have higher safety in treating infantile diarrhea. 2024 Vol. 41 (3): 386-388 [Abstract] ( 47 ) HTML (1 KB)  PDF (1181 KB)  ( 92 ) 389 Clinical Efficacy of Low Molecular Weight Heparin Combined with Alprostadil in the Treatment of Patients with Hyperlipidemic SAP HAN Xiaohuan, LI Meixia, WU Nana DOI: 10.3969/j.issn.1671-7171.2024.03.019 【Objective】To investigate the clinical efficacy of low molecular weight heparin combined with alprostadil in the treatment of patients with hyperlipidemic severe acute pancreatitis(SAP). 【Methods】A total of 92 patients with hyperlipidemic SAP admitted to our hospital from July 2020 to July 2022 were selected and randomly divided into an observation group and a control group using a random number table method, with 46 cases in each group. The control group was treated with alprostadil on the basis of conventional treatment, while the observation group was treated with low molecular weight heparin on the basis of the control group's treatment. The conditions of recovery, Ranson score, Sequential Organ Failure Assessment(SOFA) score, hemorheological indexes [D-dimer(D-D), plasma viscosity, fibrinogen(FIB), platelet aggregation rate], blood lipid levels [low density lipoprotein cholesterol(LDL-C), triglyceride(TG), high density lipoprotein cholesterol(HDL-C)], inflammatory factors [white blood cell count(WBC), tumor necrosis factor-α(TNF-α), procalcitonin(PCT)], and prognosis were compared between the two groups. 【Results】After treatment, the mechanical ventilation time, abdominal pain subsidence time, ICU hospitalization time, and intestinal function recovery time in the observation group were shorter than those in the control group(P<0.05); the Ranson score and SOFA score in both groups were lower than those before treatment, and the observation group was lower than the control group, with significant differences(P<0.05); D-D, plasma viscosity, FIB, platelet aggregation rate in the observation group were lower than those before treatment, and those in the observation group were lower than those in the control group, with significant differences(P<0.05); LDL-C, TG in both groups were lower than those before treatment, HDL-C was higher than those before treatment, LDL-C, TG in the observation group were lower than those in the control group, HDL-C was higher than those in the control group, with significant differences(P<0.05); PCT, TNF-α, WBC in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group(P<0.05). The total incidence of complications and recurrence rate in the observation group were lower than those in the control group, with significant differences(P<0.05). 【Conclusion】 Low molecular weight heparin combined with alprostadil has better clinical efficacy in the treatment of hyperlipidemic SAP, which can promote patient recovery, improve microcirculation, reduce lipids and inflammation, and help improve patient prognosis. 2024 Vol. 41 (3): 389-392 [Abstract] ( 40 ) HTML (1 KB)  PDF (1148 KB)  ( 44 ) 393 Clinical Efficacy of Dicang Through Jiache Acupuncture Therapy in Treating Peripheral Facial Paralysis with Deviation of the Mouth ZHANG Yan, CHEN Min, ZHANG Hualin DOI: 10.3969/j.issn.1671-7171.2024.03.020 【Objective】To explore the therapeutic effect of Dicang through Jiache acupuncture therapy on patients with peripheral facial paralysis and deviation of the mouth.【Methods】Sixty patients with peripheral facial paralysis and mouth deviation treated in our hospital were randomly divided into two groups, with 30 patients in each. The observation group received Dicang through Jiache acupuncture, while the control group received conventional acupuncture. The therapeutic effects, Traditional Chinese Medicine(TCM) syndrome scores, and quality of life(SF-36) scores were compared between the groups before and after treatment. 【Results】The total effective rate of treatment in the observation group was 93.33%(28/30), which was significantly higher than the 73.33%(22/30) in the control group, with a statistically significant difference(P<0.05). There were no significant differences between the two groups in terms of TCM syndrome scores and SF-36 scores before treatment(P>0.05). After treatment, the TCM syndrome scores in both groups were lower than before treatment(P<0.05), and the scores in the observation group were significantly lower than those in the control group(P<0.05). After treatment, the SF-36 scores in both groups were higher than before treatment(P<0.05), and the scores in the observation group were significantly higher than those in the control group(P<0.05). 【Conclusion】Dicang through Jiache acupuncture therapy for peripheral facial paralysis is more effective than conventional acupuncture. It can promote rapid symptom disappearance, effectively improve the condition, and enhance the quality of life of patients. 2024 Vol. 41 (3): 393-395 [Abstract] ( 44 ) HTML (1 KB)  PDF (1114 KB)  ( 45 ) 396 Effects of Graded Baduanjin Rehabilitation Intervention on Pulmonary Function, Fatigue Status and Glucose and Lipid Metabolism in Patients with Stable COPD LI Yana DOI: 10.3969/j.issn.1671-7171.2024.03.021 【Objective】To explore the effect of graded Baduanjin rehabilitation intervention on lung function, fatigue status and glucose and lipid metabolism in patients with stable chronic obstructive pulmonary disease(COPD). 【Methods】A total of 98 patients with COPD admitted to our hospital from January 2018 to January 2021 were selected and randomly divided into observation group and control group, 49 cases in each group. The control group was given conventional drugs and rehabilitation intervention, while the observation group was intervened with graded Baduanjin rehabilitation exercises on the basis of the control group. Lung function [forced expiratory volume in the first second(FEV1),forced vital capacity(FVC) and their ratio(FEV1/FVC)], fatigue degree, glucose and lipid metabolism indexes [total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), triglycerides(TG), glycosylated hemoglobin(HbA1c)] were compared between the two groups. 【Results】After the intervention, there was no significant difference in lung function indexes between the two groups before and after the intervention(P>0.05); The body fatigue score, brain fatigue score and total score of the two groups were lower than those before the intervention, and the observation group was lower than that of the control group, the difference was statistically significant(P<0.05). After the intervention, the TC, TG and HbA1c of the two groups were lower than those before the intervention, and the observation group was lower than that of the control group, the difference was statistically significant(P<0.05); There was no significant difference in HDL-C between the two groups before and after intervention(P>0.05). 【Conclusion】The hierarchical Baduanjin rehabilitation intervention can improve the fatigue status and glucose and lipid metabolism level of COPD patients, and has an important role in improving the quality of life of patients. 2024 Vol. 41 (3): 396-398 [Abstract] ( 35 ) HTML (1 KB)  PDF (1178 KB)  ( 75 ) 399 Microbiological Disorder in Pregnant Women with Lower Reproductive Tract Infection and its Influence on Pregnancy Outcome ZHANG Jinhui, ZHANG Xi DOI: 10.3969/j.issn.1671-7171.2024.03.022 【Objective】To investigate microbiological disorder in pregnant women with lower reproductive tract infection and its impact on pregnancy outcomes. 【Methods】A total of 96 pregnant women in Xi'an Gaoxin Hospital from January 2019 to January 2022 were selected as research subjects, and patients were divided into the observation group and the control group according to the culture results of reproductive tract pathogens. There were 44 patients with pathogen positive culture in the observation group, and 52 cases with pathogen negative culture in the control group. The measurement of white blood cells, neutrophils and C-reactive protein, the occurrence of adverse pregnancy outcomes, and the total incidence of adverse neonatal complications were compared between the two groups. 【Results】Among the 96 pregnant women, there were 44 cases of lower genital tract infection showing the infection rate was 45.83%. Infectious pathogens included bacteria, fungi, chlamydia, mycoplasma, uplasma urealyticum, and trichomonas, The bacterial infection rate was 38.64%, the fungal infection rate was 13.64%, the chlamydia infection rate was 15.91%, the mycoplasma infection rate was 18.18%, the infection rate of urealyticum was 2.27%, and the trichomonas infection rate was 11.36%. Maternal leukocytes, neutrophils, and C-reactive protein in the observation group were significantly higher than those in the control group with statistically significant difference(P<0.05). The overall incidence of adverse pregnancy outcomes such as premature rupture of membranes,intrauterine infection and puerperium infection in the observation group was 22.73%, which was higher than the 3.85% in the control group with the statistically significant difference(P<0.05). The overall incidence of adverse complications such as neonatal sepsis, pathological jaundice, and neonatal pneumonia was 25.00% in the observation group, which was higher than that of 3.85% in the observation group. The difference was statistically significant(P<0.05). 【Conclusion】The pathogens of lower reproductive tract infection in pregnant women mainly include bacteria, fungi, chlamydia, mycoplasma, urealyplasma urealyticum and trichomonas. Lower reproductive tract infection in pregnant women will increase the total incidence of adverse pregnancy outcomes and adverse neonatal complications. Thus, infections should be treated timely and promptly once the infection are discovered. 2024 Vol. 41 (3): 399-402 [Abstract] ( 36 ) HTML (1 KB)  PDF (1140 KB)  ( 67 ) 403 Evaluation of Placental Blood Flow Parameters in Patients with Gestational Diabetes Mellitus in the Third Trimester by Three-dimensional Ultrasound LI Yan, QI Ming DOI: 10.3969/j.issn.1671-7171.2024.03.023 【Objective】To explore the value of three-dimensional ultrasound in evaluating placental blood flow parameters in patients with gestational diabetes mellitus(GDM) in the third trimester. 【Methods】 The clinical data of 100 pregnant women with GDM in the third trimester admitted to our hospital from January to December 2021 were retrospectively analyzed, and they were set as the observation group; In addition, 100 normal pregnant women who underwent regular prenatal examination in our hospital during the same period were selected as the control group. Three dimensional Doppler ultrasound was used to examine the placental vascular status and observe the fetal intrauterine development in both groups. The placental blood flow parameters [vascularization index(VI), blood flow index(FI), blood flow/vascular ratio(VFI)] were compared between the two groups; Spearman rank correlation was used to analyze the correlation between blood glucose and placental blood flow parameters in the third trimester of GDM patients; The neonatal condition and Apgar score were compared between the two groups; The pregnancy outcomes of the two groups were compared. 【Results】The levels of VI, FI and VFI in the observation group were lower than those in the control group(P<0.05); The correlation analysis showed that the blood glucose index in the third trimester of GDM patients was negatively correlated with VI, FI and VFI(P<0.05); The proportion of fetal distress, macrosomia and intrauterine growth restriction(FGR) in the observation group was higher than that in the control group(P<0.05), and the Apgar score was lower than that in the control group(P<0.05); The proportion of adverse pregnancy outcomes in the observation group was higher than that in the control group. 【Conclusion】 Three dimensional ultrasound can accurately reflect the placental blood flow parameters, and the placental blood flow parameters are closely related to GDM. It can be used to predict the pregnancy outcome and perinatal status in clinic, and provide the basis for clinical early development of countermeasures. 2024 Vol. 41 (3): 403-405 [Abstract] ( 35 ) HTML (1 KB)  PDF (1178 KB)  ( 60 ) 406 Clinical Efficacy of Argatroban Sequential Therapy Combined with rt-PA Thrombolysis in the Treatment of Acute Ischemic Stroke XU Xiaoge, LI Jingxue, WEI Mengli DOI: 10.3969/j.issn.1671-7171.2024.03.024 【Objective】To investigate the clinical efficacy of argatroban sequential therapy combined with alteplase(rt-PA) thrombolysis in the treatment of acute ischemic stroke(AIS). 【Methods】The clinical data of 96 patients with AIS treated in our hospital from May 2020 to December 2022 were retrospectively analyzed. According to the different treatment schemes, they were divided into observation group and control group, with 48 cases in each group. The control group was given rt-PA thrombolysis, while the observation group was given argatroban sequential therapy on the basis of thrombolysis. The efficacy, neurological injury factors [S100β protein, neuron specific enolase(NSE)], vascular endothelial injury indicators [serum calcitonin gene-related peptide(CGRP), endothelin-1(ET-1)], National Institutes of Health Stroke Scale(NIHSS), modified Rankin Scale(mRS), Barthel Index(BI) score and the incidence of complications were compared between the two groups. 【Results】 After 3 months of treatment, the total effective rate of the study group was higher than that of the control group(P<0.05); After 14 days and 3 months of treatment, S100β and NSE in the observation group were lower than those in the control group(P<0.05); After 14 days and 3 months of treatment, CGRP in the observation group was higher than that in the control group, and ET-1 was lower than that in the control group(P<0.05); After 3 months of treatment, the NIHSS and mRS scores of the observation group were lower than those of the control group, and the BI score of the observation group was higher than that of the control group(P<0.05); There was no significant difference in the total incidence of complications between the two groups(P>0.05). 【Conclusion】The effect of argatroban sequential therapy combined with alteplase in the treatment of AIS is significant, which can reduce vascular endothelial injury, improve neurological function and improve living ability. 2024 Vol. 41 (3): 406-409 [Abstract] ( 46 ) HTML (1 KB)  PDF (1142 KB)  ( 68 ) 410 Effect of Initiation Timing of Continuous Renal Replacement Therapy on 28-Day Cumulative Survival Rate of Patients with Sepsis-induced Acute Kidney Injury ZHANG Wenjing, LIU Juan DOI: 10.3969/j.issn.1671-7171.2024.03.025 【Objective】 To explore the impact of the initiation timing of Continuous Renal Replacement Therapy(CRRT) on the 28-day cumulative survival rate of patients with Sepsis-Induced Acute Kidney Injury(SI-AKI). 【Methods】A total of 144 SI-AKI patients admitted to the ICU of our hospital were randomly divided into an early CRRT group and a control group, with 72 patients in each group. Clinical data, treatment schemes, and the 28-day cumulative survival rates of the two groups were compared. The changes in inflammatory and renal function indicators before and after treatment in both groups were compared as well. The impact of early CRRT on the 28-day cumulative survival rate was analyzed. 【Results】Patients in the early CRRT group had a longer non-mechanical ventilation time than those in the control group(P<0.05).Before treatment, there were no significant differences in any indicators between the two groups(P>0.05). After treatment, all inflammatory indicators including procalcitonin(PCT), C-reactive protein(CRP), WBC, tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), and renal function indicators such as serum creatinine(Scr), blood urea nitrogen(BUN), and Lactate, significantly decreased compared to before treatment(P<0.05), and the reductions in PCT, CRP, IL-6, Scr, BUN in the early CRRT group were significantly greater than those in the control group(P<0.05).Kaplan-Meier survival analysis indicated that the 28-day cumulative survival rate of patients in the early CRRT group was significantly higher than that of the control group (P<0.05). 【Conclusion】Early initiation of CRRT can improve the 28-day cumulative survival rate of SI-AKI patients and clinical outcomes. 2024 Vol. 41 (3): 410-412 [Abstract] ( 37 ) HTML (1 KB)  PDF (1200 KB)  ( 90 ) 413 Comparison of Diagnostic Efficacy of Different Electrocardiographic Criteria for Hypertensive Patients with Left Ventricular Hypertrophy ZHANG Xiaochen, YUAN Yiyan, JIAO Jingmei, et al DOI: 10.3969/j.issn.1671-7171.2024.03.026 【Objective】To explore the diagnostic efficacy of different electrocardiographic criteria for hypertensive patients with left ventricular hypertrophy. 【Methods】The clinical data of 180 patients with hypertension admitted to our hospital from May 2019 to May 2022 were retrospectively analyzed. All patients underwent echocardiography and electrocardiography, and the diagnosis of echocardiography was regarded as the gold standard. Kappa test was used to analyze the sensitivity, specificity, accuracy and consistency of Sokolow-Lyon voltage standard, Cornell voltage standard, Peguero-Lo Presti voltage standard and the combination of three ECG voltage standards in the diagnosis of left ventricular hypertrophy. 【Results】 Echocardiography was performed in 180 patients with hypertension. The results showed that 102 patients(56.67%) had left ventricular hypertrophy and 78 patients(43.33%) had non left ventricular hypertrophy. The consistency analysis showed that the sensitivity of Sokolow-Lyon voltage standard for the diagnosis of left ventricular hypertrophy was 0.373, the specificity was 0.821, and the accuracy was 0.567(Kappa=0.180,P=0.414); The sensitivity, specificity and accuracy of Cornell voltage standard in the diagnosis of left ventricular hypertrophy were 0.490, 0.872 and 0.656(Kappa=0.340,P=0.207); The sensitivity, specificity and accuracy of Peguero-Lo Presti voltage standard in the diagnosis of left ventricular hypertrophy were 0.863, 0.744 and 0.811(Kappa=0.612, P<0.001); The sensitivity, specificity and accuracy of three electrocardiographic voltage criteria in the diagnosis of left ventricular hypertrophy were 0.922, 0.923 and 0.922 respectively(Kappa=0.842, P<0.001). 【Conclusion】 The sensitivity, accuracy and kappa value of Peguero-Lo Presti voltage standard in the diagnosis of left ventricular hypertrophy are better than Sokolow-Lyon voltage standard and Cornell voltage standard. The combination of three ECG voltage standards can improve the sensitivity, specificity and accuracy in the diagnosis of left ventricular hypertrophy. 2024 Vol. 41 (3): 413-416 [Abstract] ( 32 ) HTML (1 KB)  PDF (1143 KB)  ( 28 ) 417 The Effect of Comfort and Detail Double-layer Infiltration Intervention on Immune Function in Patients with Acute Myocardial Infarction in CCU LI Minghui DOI: 10.3969/j.issn.1671-7171.2024.03.027 【Objective】To explore the effects of comfort and detail double-layer infiltration intervention on immune function in patients with acute myocardial infarction in CCU.【Methods】A total of 86 patients with acute myocardial infarction in CCU admitted to our hospital from March 2020 to March 2021 were selected. According to the wishes of the patients and their families, they were divided into an observation group and a control group, with 43 cases in each group. The control group received routine nursing measures, while the observation group received comfort and detail double-layer penetration intervention. We compared the comfort level, humoral immune indicators, and cellular immune indicators between two groups of patients before and after nursing care. 【Results】After intervention, the levels of CD3+, CD4+, and CD4+/CD8+ in both groups of patients were higher than before intervention, and CD8+ was lower than before intervention. In addition, the levels of CD3+, CD4+, and CD4+/CD8+ in the observation group were higher than those in the control group, and the levels of CD8+ in the observation group were lower than those in the control group, with statistical significance(P<0.05). After intervention, the levels of IgA, IgM, and IgG in both groups of patients were higher than before intervention, and the observation group was higher than the control group, with statistical significance(P<0.05). After intervention, the comfort scores of both groups were higher than before intervention, and the observation group was higher than the control group, with a statistically significant difference(P<0.05). 【Conclusion】The application of comfort and detail dual layer infiltration intervention in CCU acute myocardial infarction patients can improve patient comfort, improve immune function, and improve patient prognosis, which is worthy of clinical promotion and application. 2024 Vol. 41 (3): 417-419 [Abstract] ( 35 ) HTML (1 KB)  PDF (1180 KB)  ( 37 ) 420 Clinical Efficacy and Survival Analysis of Dacomitinib Combined with Cetuximab in the Treatment of Advanced Non-small Cell Lung Cancer LI Xuan, PAN Hua, ZHANG Xiaopeng, et al DOI: 10.3969/j.issn.1671-7171.2024.03.028 【Objective】To investigate the clinical efficacy and survival of dacomitinib combined with cetuximab in the treatment of advanced non-small cell lung cancer(NSCLC). 【Methods】A total of 204 patients with advanced NSCLC were randomly divided into the control group and the observation group, with 102 cases in each group. The control group was given cetuximab treatment, and the observation group was given dacomitinib orally in addition to cetuximab. In both groups, medication continued until disease progression or toxic intolerance. The anti-tumor efficacy, tumor marker changes, lung function and adverse drug reactions of the two groups were compared after 3 courses of continuous treatment, and the 1-year survival was also analyzed between the two groups. 【Results】In the observation group, 3 patients dropped off due to incomplete treatment, and 5 cases dropped off in the control group. Finally, 99 cases in the observation group and 97 cases in the control group were included, respectively. The clinical control rate of the observation group was higher than that of the control group(P< 0.05). The levels of tumor-specific growth factor(TSGF), cell proliferation antigen(PCNA), carcinoembryonic antigen(CEA) after treatment were lower than those before treatment. And the levels of TSGF, PCNA and CEA in the observation group after treatment were lower than those in the control group(P<0.05). The forced vital capacity(FVC) and forced expiratory volume in the first second(FEV1) /FVC in the two groups after treatment were higher than those before treatment(P<0.05), while those in the observation group were higher after treatment(P<0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05). By the end of follow-up, 2 cases in the control group and 1 case in the observation group were lost to follow-up. From the 1-year survival survey, 62 of 98 patients survived in the observation group and 47 of 95 patients survived in the control group. The 1-year overall survival curve of the observation group was better than that of the control group(P<0.05). 【Conclusion】Dacomitinib combined with Cetuximab in the treatment of advanced NSCLC can enhance anti-tumor efficacy, reduce tumor marker levels, and improve short-term survival. 2024 Vol. 41 (3): 420-423 [Abstract] ( 40 ) HTML (1 KB)  PDF (1193 KB)  ( 26 ) 424 The Effect of Escitalopram on the Level of Inflammatory Factors and Endothelial Function in Patients with Coronary Heart Disease Accompanied by Anxiety and Depression WANG Wenfeng, DING Shoukun DOI: 10.3969/j.issn.1671-7171.2024.03.029 【Objective】To investigate the effect of escitalopram on the levels of inflammatory factors and vascular endothelial function in patients with coronary heart disease accompanied by anxiety and depression. 【Methods】A total of 112 patients with coronary heart disease accompanied by anxiety and depression admitted to two hospitals from July 2021 to July 2022 were selected and randomly divided into an observation group and a control group according to a random number table method, with 56 cases in each group. The control group was given conventional drug treatment, while the observation group was treated with escitalopram on the basis of the control group. The vascular endothelial function [endothelin-1(ET-1), vascular endothelial growth factor(VEGF), nitric oxide(NO)], inflammatory factors [interleukin-2(IL-2), C-reactive protein(CRP), interleukin-8(IL-8), tumor necrosis factor-α(TNF-α)], neurotransmitters [brain-derived neurotrophic factor(BDNF), norepinephrine(NE), serotonin(5-HT)], cognitive function [Loewenstein Cognitive Assessment Rating Scale(LOTCA) score], Hamilton Depression Rating Scale(HAMD) score, and Hamilton Anxiety Rating Scale(HAMA) score were compared before and after treatment between the two groups. 【Results】After treatment, the levels of ET-1, TNF-α, IL-8, CRP, and IL-2 in the observation group were lower than those in the control group, while NO and VEGF were higher than those in the control group(P<0.05). After treatment, the levels of BDNF, NE, and 5-HT in the observation group were higher than those in the control group(P<0.05). After treatment, the LOTCA scores and total scores in the observation group were higher than those in the control group(P<0.05). After treatment, the HAMD and HAMA scores in the observation group were lower than those in the control group(P<0.05). 【Conclusion】Escitalopram has significant effect on improving negative emotions in patients with coronary heart disease accompanied by anxiety and depression, which can reduce the inflammatory response and improve vascular endothelial function. 2024 Vol. 41 (3): 424-426 [Abstract] ( 35 ) HTML (1 KB)  PDF (1186 KB)  ( 35 ) 427 The Correlation between Disease Activity and Peripheral Blood Levels of IGF-2 and IGFBP-6 in Patients with Rheumatoid Arthritis LIN Hai, ZHANG Bin, WANG Yiyi DOI: 10.3969/j.issn.1671-7171.2024.03.030 【Objective】To investigate the correlation of disease activity with levels of insulin-like growth factor-2(IGF-2) and insulin-like growth factor binding protein-6(IGFBP-6) in the peripheral blood of patients with Rheumatoid Arthritis(RA). 【Methods】A total of 158 RA patients treated in our hospital were divided into high activity, moderate activity, and low activity groups based on the disease activity score of 28 joints. The levels of IGF-2 and IGFBP-6 in the peripheral blood of the three groups were compared. The relationship of different disease activities with the expression levels of IGF-2 and IGFBP-6 was evaluated; And the influencing factors of disease activity were analyzed as well.【Results】Among the 158 RA patients, 61(38.61%) were in the high activity group, 59(37.34%) in the moderate activity group, and 38(24.05%) in the low activity group. The IGF-2 level in the high activity group was higher than that in the moderate and low activity groups, while the IGFBP-6 level was lower than that in the moderate and low activity groups. The moderate activity group's IGF-2 level was higher than that of the low activity group, and the IGFBP-6 level was lower than that of the low activity group, with significant differences(P<0.05). There was a negative correlation of the disease activity with the expression level of IGF-2(P<0.001), and a positive correlation with the expression level of IGFBP-6(P<0.001). Multifactorial analysis showed that high white blood cell count, high expression level of IGF-2, and low expression level of IGFBP-6 were risk factors for high disease activity in RA patients(P<0.05).【Conclusion】In RA patients with high disease activity, the expression level of IGF-2 in peripheral blood is higher, which is negatively correlated with disease activity; And the expression level of IGFBP-6 in RA patients with high disease activity is lower, which is positively correlated with disease activity. 2024 Vol. 41 (3): 427-430 [Abstract] ( 32 ) HTML (1 KB)  PDF (1142 KB)  ( 29 ) 431 The Effect of Baduanjin Combined with Cardiac Rehabilitation Seven-step Intervention on the Living Ability and Psychological Status of Coronary Heart Disease Patients Undergoing Cardiac Surgery Treatment WANG Shengnan, WANG Yue, CHEN Shuhui DOI: 10.3969/j.issn.1671-7171.2024.03.031 【Objective】To explore the effects of the combination of Baduanjin and cardiac rehabilitation seven-steps intervention on the living ability and psychological status of coronary heart disease patients undergoing cardiac surgery. 【Methods】 Eighty patients with coronary heart disease treated with cardiac surgery admitted to our hospital from January 2020 to December 2021 were selected. They were randomly divided into a control group (receiving routine rehabilitation intervention) and an observation group (receiving eight segment brocade combined with seven step cardiac rehabilitation intervention on the basis of the control group) using a random number table method, with 40 patients in each group. We compared the daily living ability scale (ADL) scores, psychological state scores, and postoperative complication rates between two groups of patients. 【Results】After intervention, the ADL scores of the two groups of patients were higher than those before intervention, and the observation group was higher than the control group, with a statistically significant difference(P<0.05). After intervention, the scores of tension, depression, anger, and dullness in both groups of patients were lower than those before intervention, and the observation group was lower than the control group. The vitality scores of both groups of patients were higher than before intervention, and the observation group was higher than the control group, with statistical significance(P<0.05). The incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05).【Conclusion】The combination of Baduanjin and cardiac rehabilitation seven-steps method can effectively improve the daily living ability of coronary heart disease patients undergoing cardiac surgery, improve their psychological state, and reduce the incidence of complications. It is worthy of clinical promotion. 2024 Vol. 41 (3): 431-433 [Abstract] ( 38 ) HTML (1 KB)  PDF (1177 KB)  ( 101 ) 434 Efficacy Analysis of Dapagliflozin Combined with Metformin in the Treatment of Patients with Type 2 Diabetes CHEN Xianle, ZHANG Chunhua DOI: 10.3969/j.issn.1671-7171.2024.03.032 【Objective】To investigate the clinical efficacy of dapagliflozin combined with metformin hydrochloride in the treatment of type 2 diabetes(T2DM). 【Methods】A total of 87 patients with type 2 diabetes treated in our hospital from September 2020 to September 2023 were selected and divided into the observation group(treated with dapagliflozin combined with metformin hydrochloride, n=44) and the control group(treated with metformin hydrochloride, n=43) by random number table method. Fasting blood glucose(FPG), 2 h postprandial blood glucose(2hPG) and glycosylated hemoglobin(HbA1c), blood glucose standard deviation(sDBG), mean blood glucose fluctuation range(MAGE), inflammatory factors [C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), serum homocysteine(Hcy), cystatin C(cys C)], endocrine hormones [fasting insulin(Fins), pancreatic island β cell index(HOMA-β), insulin sensitivity index(HOMA-IR)], oxidative stress level [superoxide dismutase(SOD), catalase(CAT)] and incidence of adverse reactions were compared between the two groups before and after treatment. 【Results】Compared to before treatment, the levels of FPG, 2hPG, HbA1c, sDBG, MAGE, CRP, TNF-α, IL-6, Hcy and cys C in the two groups of T2DM patients decreased after treatment, while the above measurements in the observation group were significantly lower than those in the control group with statistical significance(P<0.05). Fins, SOD, CAT levels and HOMA-β of both groups increased after treatment if compared with before treatment, and their values in the observation group were significantly higher than those in the control group. The HOMA-IR of both groups decreased after treatment, and HOMA-IR level in the observation group was significantly lower than that in the control group. The difference was statistically significant(P<0.05). The incidence of adverse reactions in the observation group was 13.64%, compared with 23.26% in the control group, the difference was not statistically significant(χ2=1.341,P=0.247). 【Conclusion】Dapagliflozin combined with metformin hydrochloride can effectively reduce the levels of blood glucose and inflammatory factors, improve the function of islet cells in the treatment of type 2 diabetes patients, and it is safe and worthy of clinical application. 2024 Vol. 41 (3): 434-437 [Abstract] ( 41 ) HTML (1 KB)  PDF (1147 KB)  ( 32 ) 438 Application Value of Remote Management Combined with Family Participatory Intervention Mode in Home Management of Patients with Acute Coronary Syndrome after Discharge JIANG Meng, LI Tongtong DOI: 10.3969/j.issn.1671-7171.2024.03.033 【Objective】To explore the application value of remote management combined with family participatory intervention mode in home management of patients with acute coronary syndrome(ACS) after discharge. 【Methods】A total of 108 emergency ACS patients who underwent percutaneous coronary intervention(PCI) in our hospital from June 2020 to June 2022 were selected and divided into observation group and control group according to the random number table method, with 54 cases in each group. The control group implemented remote management combined with medical care led home management, while the observation group implemented remote management combined with family participatory home management. The knowledge mastery, self-management ability and quality of life of the two groups on the day of discharge and 8 weeks after discharge were compared. 【Results】 At 8 weeks after discharge, the scores of Perceived Knowledge Scale for the coronary heart disease(PKS-CHD) of the two groups were higher than those on the day of discharge, and the observation group was higher than that of the control group, the difference was statistically significant(P<0.05). At 8 weeks after discharge, the score and total score of coronary heart disease self-management scale(CSMs) of the two groups were higher than that of the day of discharge, and the observation group was higher than that of the control group, the difference was statistically significant(P<0.05). At 8 weeks after discharge, the Quality of Life Instruments for Chronic Diseases of the coronary heart disease scale(QLICD-CHD) of the two groups were higher than those on the day of discharge, and the observation group was higher than that of the control group, the difference was statistically significant(P<0.05). 【Conclusion】 The remote management combined with family participatory intervention mode is helpful to improve the knowledge mastery and self-management ability of emergency ACS patients, and to improve their quality of life. 2024 Vol. 41 (3): 438-441 [Abstract] ( 37 ) HTML (1 KB)  PDF (1139 KB)  ( 68 )

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