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2019 Vol. 25, No. 6 Published: 2019-06-30 881 Effect of Low-dose Clarithromycin combined with Endoscopic Nasal Septum Correction and Sinus Opening for Chronic Rhinosinusitis Patients with ECP and TIgE Levels LI Dongbo, HAN Jinhua, GAO Wei DOI: 10.3969/j.issn.1006-6233.2019.06.001 Objective: To investigate the therapeutic effect of low-dose clarithromycin combined with endoscopic nasal septum correction and sinus open surgery on chronic rhinosinusitis (CRS) patients and serum eosinophil cationic protein (ECP) and total immunoglobulin E(TIgE) levels. Methods: From February 2016 to April 2018, 124 patients with CRS in our hospital were selected and divided into control group (n=62) and experimental group (n=62) according to simple randomization. The control group underwent endoscopic nasal septum correction and sinus open surgery. The test group was treated with low-dose clarithromycin combined with endoscopic nasal septum correction and sinus open surgery. The therapeutic effects of the two groups after surgery were compared with those of preoperative, postoperative, 1 month, and 3 months postoperative serum ECP, TIgE levels, and inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor- α(TNF-α)] level, quality of life score (SF-36). Results: The total effective rate of the test group was 93.55% at 3 months after operation, which was higher than that of the control group (P < 0.05). The serum ECP, TIgE, IL-6, The TNF-α level showed a decreasing trend, and the serum levels of the above test group decreased greatly. The two groups of serum ECP, TIgE, IL-6, TNF-α levels, different time points and interactions between groups and at different time points The difference was statistically significant (P<0.05). The SF-36 scores increased at 1 month and 3 months after operation, and the SF-36 score increased significantly in the experimental group. SF-36 There were significant differences in the interaction between the score groups, at different time points, and between groups at different time points (P<0.05). Conclusion: Low-dose clarithromycin combined with endoscopic nasal septum correction and sinus open surgery in patients with chronic rhinosinusitis can improve the therapeutic effect, reduce serum ECP and TIgE levels, reduce the body's inflammatory response and improve the quality of life of patients. 2019 Vol. 25 (6): 881-885 [Abstract] ( 101 ) HTML (1 KB)  PDF (1273 KB)  ( 290 ) 886 Effects of Microchannel and Standard Channel Percutaneous Nephrolithotomy on Hemodynamics and Blood Gas Analysis in Patients with Renal Calculus JIAO Changbao, WU Qi, XU Bing DOI: 10.3969/j.issn.1006-6233.2019.06.002 Objective: To analyze the effects of microchannel and standard channel percutaneous nephrolithotomy on hemodynamics and blood gas analysis in patients with renal calculus. Methods: 80 cases of renal calculus in our hospital from January 2016 to June 2018 were treated by percutaneous nephrolithotomy. They were divided into group A with microchannel and group B with standard channel, with 40 cases in each group. The perfusion volume, operation time, hemodynamics and arterial blood gas analysis indexes were compared between the two groups. Results: The perfusion volume in group B was significantly lower than that in group A, and the operative time was significantly shorter than that in group A (P<0.01). There was no significant difference in heart rate (HR) between the two groups at different time points (P> 0.05); central venous pressure (CVP) and mean arterial pressure (MAP) before perfusion (T2) were significantly lower than those before anesthesia (T1) (P< 0.05), and there was no significant difference in CVP and MAP between perfusion 10 minutes (T3) and pre-perfusion (T2) (P> 0.05); 30 minafter perfusion (T4), 60 minafter perfusion (T5) and postoperative (T6) CVP and MAP were significantly higher than those of T2 (P< 0.05); HR, CVP and MAP were not significantly different between the two groups at different time points (P> 0.05). The base excess (BE), pH and K+ of the two groupsafter operation (t3) were significantly lower than those before anesthesia (t1) (P<0.05); there was no significant difference in pH, K+, BE between the two groups at different time points (P> 0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: With the increase of operation time, the absorption of perfusate in patients with renal calculus treated by percutaneous nephrolithotomy has obvious influence on arterial blood gas analysis and hemodynamics, and because of the compensation of organ function, the difference of perfusion fluid absorption between standard channel and microchannel percutaneous nephrolithotomy does not cause significant difference in arterial blood gas analysis and hemodynamics. 2019 Vol. 25 (6): 886-889 [Abstract] ( 106 ) HTML (1 KB)  PDF (1274 KB)  ( 263 ) 890 Comparison on the Therapeutic Effect of Interventional Embolization of Intracranial Aneurysms at Different Times HUANG Yongwang, et al DOI: 10.3969/j.issn.1006-6233.2019.06.003 Objective: To compare the therapeutic effects of interventional embolization of intracranial aneurysms at different times. Methods: The clinical data of 102 patients with intracranial aneurysms treated by interventional embolization in our hospital from March 2015 to March 2018 were retrospectively analyzed. According to the timing of interventional therapy, group A (54 cases) had the onset time less than 72 hours, and group B (48 cases) had the onset time longer than 72 hours. The scores of embolism degree, modified Rankin scale, neurologic function impairment scale and MOS 36-items short form-health survey (SF-36) were compared between the two groups. Results: Compared with group B (58.33%), the complete embolization rate in group A (81.48%) was significantly increased (P< 0.05). Three months after operation, the scores of modified Rankin scale in both groups were significantly decreased compared with those before treatment, and the score in group A was significantly decreased compared with group B (P< 0.01). Compared with the preoperative scores, the scores of neurologic function impairment scale in both groups decreased significantly at 3 months after operation, and the score in group A was significantly decreased compared with those in group B (P< 0.01). Compared with pre-operation, the scores of SF-36 scale in two groups were significantly higher at 3 months after operation, and the scores in group A were significantly higher than those in group B (P< 0.05). Conclusion: Compared with the patients whose time between onset and treatment is more than 72 hours, interventional embolization within 72 hours can effectively improve the clinical efficacy of intracranial aneurysms, and play an important role in improving the prognosis, neurological function and quality of life of patients. Therefore, it should be popularized in clinic. 2019 Vol. 25 (6): 890-893 [Abstract] ( 109 ) HTML (1 KB)  PDF (1270 KB)  ( 182 ) 894 Effects of Three Kinds of Metal Repair Materials on the Levels of Inflammatory Factors in Periodontal Tissues and Gingival Crevicular Fluid of Patients with Oral Prosthetics ZHAO Hengyue, ZHOU Ying, CHEN Yijing, et al DOI: 10.3969/j.issn.1006-6233.2019.06.004 Objective: To explore the effects of three kinds of metal repair materials on the levels of inflammatory factors in periodontal tissues and gingival crevicular fluid of patients with oral prosthetics. Methods: A total of 213 patients with anterior porcelain fused to metal (PFM) full crown repair were selected. According to the three PFM repair materials, they were divided into nichrome PFM group (group A, n=71) and cobalt-chromium alloy PFM group (group B, n=71) and gold deposition PFM group (group C, n=71). And they were given 6 months of effective follow-up after oral prosthesis. The periodontal tissues, gingival crevicular fluid (GCF), gingival crevicular depth (GCD), gingival index (GI), gingival probing depth (GCD), gingival index (GI), receptor activator of NF-kB ligand (RANKL), osteoprotegerin (OPG) and RANKL/OPG ratio were detected in the three groups before repair and after 6 months of repair. Results: After 6 months of repair, the gingival crevicular fluid (GCF) in group A was significantly increased (P<0.05), and the gingival crevicular depth (GCD) was significantly prolonged (P<0.05), and the gingival index (GI) was increased (P<0.05), and there were no significant differences between group A and group B at different time points (P>0.05), and the above indexes in groups B and C were significantly lower than those in group A (P<0.05). After 6 months of repair, the levels of interleukin-1β (IL-1β), interleukin-6 (IL-6) and matrix metalloproteinase-2 (MMP-2) in periodontal tissues and gingival crevicular fluid were increased significantly in the three groups (P<0.05), and the receptor activator of NF-kB ligand (RANKL), osteoprotegerin (OPG) and RANKL/OPG ratio were significantly increased (P<0.05), and the changes in group A were significantly greater than those in group B and C (P<0.05), and there were no significant differences between the two groups (P>0.05). Conclusions: Cobalt-chromium alloy and gold precipitation PFM have less irritation to periodontal tissues than nickel-chromium alloy PFM. Inflammatory reaction in gingival crevicular fluid and bone absorption in alveolar bone of patients are lighter than nickel-chromium alloy PFM, which is suitable for clinical promotion. 2019 Vol. 25 (6): 894-897 [Abstract] ( 107 ) HTML (1 KB)  PDF (1274 KB)  ( 375 ) 898 Comparison on the Application Value of High-flexion Prosthesis and Rotating Platform Prosthesis in Total Knee Arthroplasty LING Xiaodong, LUO Zhengliang, HU Lintao DOI: 10.3969/j.issn.1006-6233.2019.06.005 Objective: To compare the application value of high-flexion prosthesis and rotating platform prosthesis in total knee arthroplasty (TKA). Methods: Patients with advanced knee joint pathological changes who underwent TKA in the hospital from January 2016 to May 2018 were enrolled in the study, including 50 patients treated with high-flexion prosthesis (group A) and 50 patients treated with rotating platform prosthesis (group B). The general surgical conditions (surgical time, intraoperative blood loss, loose rate of lateral joint capsule soft tissues, postoperative blood transfusion volume), clinical indicators [knee clinical score (KCS), knee function score (KFS), patellofemoral Feller score, pain visual analogue score (VAS), range of motion (ROM) of knee joint], imaging indexes (femoral angle, tibial angle, posterior slope, femoral flexion angle, Insall-Salvati value) and postoperative SF-36 quality of life scores were compared between the two groups. The incidence of complications was statistically analyzed. Results: There were no significant differences in the general surgical conditions, imaging parameters or incidence of complications between the two groups (P>0.05). KCS, KFS and Feller scores, knee ROM and SF-36 scores of both groups were significantly increased after surgery (P<0.05), while VAS scores were significantly decreased after surgery (P<0.05), There's no significant difference between the two groups (P>0.05). Conclusion: In TKA, the short-term efficacy of high-flexion prosthesis is similar to that of rotary platform prosthesis, but the clinical advantages of the latter need to be explored in a long-term follow-up. 2019 Vol. 25 (6): 898-901 [Abstract] ( 107 ) HTML (1 KB)  PDF (1271 KB)  ( 272 ) 902 Effect of Irbesartan Combined with Amiodarone on the Levels of Serum Inflammatory Factors Myocardial Enzymes and NT-proBNP in Patients with Paroxysmal Atrial Fibrillation JI Ping, WANG Ping, WU Luling DOI: 10.3969/j.issn.1006-6233.2019.06.006 Objective: To analyze the effects of irbesartan combined with amiodarone on the levels of serum inflammatory factors, myocardial enzymes and amino terminal B-type N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with paroxysmal atrial fibrillation. Methods: 90 patients with paroxysmal atrial fibrillation were randomly divided into observation group and control group according to the simple random number table method after numbering with admission sequence, 45 cases in each group. The control group was given routine treatment and amiodarone, the observation group was given irbesartan combined with amiodarone treatment. The followed-up last for 12 months in both groups. The number of atrial fibrillation, maintenance rate of sinus rhythm, cardiac function [left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVDD), left ventricular posterior walldepth (LVPW), P wave dispersion (PD)], serum inflammatory factors, myocardial enzymes [Creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI)], NT-proBNP levels and incidence of adverse events in the two groups were recorded. Results: The number of atrial fibrillation in the observation group was less than that in the control group at 6 months and 12 months after treatment, while the maintenance rate of sinus rhythm was higher than that in the control group (P<0.05). At the end of treatment, the LVEF in the observation group was higher than that in the control group, while the LVDD, LVPW and PD were smaller than those in the control group (P<0.05). The levels of serum HSP27, hs-CRP, IL-6, CK-MB, cTnI and NT-proBNP in the observation group were lower than those in the control group after treatment (P<0.01). The incidence of adverse events in the observation group was 24.44%, slightly higher than that in the control group (17.78%) (P>0.05). Conclusion: The combination application of irbesartan combined with amiodarone for patients with paroxysmal atrial fibrillation can significantly reduce the number of atrial fibrillation, improve maintenance rate of sinus rhythm and cardiac function, reduce the levels of inflammatory factors and NT-proBNP, restore myocardial enzymes to normal. It is safe and reliable. 2019 Vol. 25 (6): 902-906 [Abstract] ( 106 ) HTML (1 KB)  PDF (1294 KB)  ( 307 ) 907 Observation on Effect of ACL Reconstruction combined with ALL Reconstruction on ACL Injury with High-grade Pivot-shift CHEN Peng, YU Defu, CHEN Tao DOI: 10.3969/j.issn.1006-6233.2019.06.007 Objective: To observe the curative effect of anterior cruciate ligament reconstruction combined with anterior lateral ligament reconstruction on ACL injury with high-grade pivot-shift. Methods: A total of 78 patients with ACL injury admitted to the hospital from October 2015 to January 2018 were enrolled in the study. They were divided into control group and combined group by hierarchical random number table method, 39 cases in each group. The control group was given ACL reconstruction. The combined group was given ACL reconstruction combined with ALL reconstruction.The stability grading, knee range of motion, recovery of muscle strength, change of Lysholm scoring and surgical safety were compared between the two groups. Results: There were no significant differences in stability grading, limited angle of knee flexion, limited angle of knee extension, atrophy index or Lysholm score between the two groups before the surgery (P>0.05). The negative rate in the stability grading of the combined group was significantly higher than that of the control group after the surgery (P<0.05). The limited angle of knee flexion, limited angle of knee extension and atrophy index were significantly decreased in both groups after the surgery, and the above indexes in the combined group was significantly lower than those in the control group (P<0.05). The Lysholm scores of the combined group at 1 month, 3 months and 5 months after surgery were significantly higher than those of control group (P<0.05). There was no significant difference in the total incidence of complications after the surgery between the two groups (P>0.05). Conclusion: ACL reconstruction combined with ALL reconstruction is effective in the treatment of patients with high axially displaced ACL injury. It plays an active role in improving joint stability, knee joint mobility and muscle strength recovery, and has a certain degree of safety. 2019 Vol. 25 (6): 907-910 [Abstract] ( 107 ) HTML (1 KB)  PDF (1249 KB)  ( 296 ) 911 Efficacy and Adverse Reactions of Prednisolone and ACTH in the treatment of Infantile Spasm and Effects on Eectroencephalogram HU Chongkang, JIANG Xun, ZHANG Wei DOI: 10.3969/j.issn.1006-6233.2019.06.008 Objective: To investigate the efficacy and adverse reactions of prednisolone and ACTH in the treatment of infantile spasm and effects on electroencephalogram. Methods: A retrospective analysis was made of 90 children with IS hospitalized in pediatrics department of our hospital from March 2010 to May 2017. They were divided into prednisolone group (treated with high dose prednisolone, n=42) and ACTH group (treated with ACTH, n=48) according to the treatment method. The curative effect, the improvement of EEG and the incidence of adverse reactions were compared between the two groups. One-year follow-up was performed and the recurrence rate was recorded. Results: The response rates of the prednisolone group and ACTH group were 90.48% and 95.83%, respectively (χ2=1.033, P>0.05). The effective rates of electroencephalogram improvement in prednisolone group and ACTH group were 95.83% and 97.92%, respectively (χ2=0.499, P>0.05). The incidence rates of adverse reactions in the prednisolone and ACTH group were 33.33% and 37.50. %, respectively (χ2=0.170, P>0.05). The recurrence rates of prednisolone group and ACTH group were 7.14% and 4.17%, respectively (χ2=0.378, P>0.05). Conclusion: The curative effect and adverse reactions of prednisolone and ACTH are equivalent in the treatment of IS. However, prednisolone is cheaper and simpler to operate. It can be used in clinical practice to replace ISTH with large-dose oral prednisolone. 2019 Vol. 25 (6): 911-913 [Abstract] ( 117 ) HTML (1 KB)  PDF (1233 KB)  ( 353 ) 914 Discussion on Safety and Effectiveness of Laparoscopic Pancreaticoduodenectomy combined with Accelerated Rehabilitation Surgery LI Xiaohui, et al DOI: 10.3969/j.issn.1006-6233.2019.06.009 Objective: To investigate the safety and efficacy of laparoscopic pancreaticoduodenectomy combined with accelerated rehabilitation surgery. Methods: 84 patients undergoing pancreaticoduodenectomy admitted to the hospital were enrolled according to the surgical procedure. 42 patients in the control group underwent open pancreaticoduodenectomy. 42 cases underwent laparoscopic pancreaticoduodenectomy. The safety and efficacy of the two groups of treatments were compared. Results: The operation time of the observation group was (543.8±59.2) min, which was higher than that of the control group. The intraoperative blood loss (191.5±56.2) mL in the observation group was 30.00% in the transfusion patients, which was lower than the control group (P<0.05). The VAS scores of the observation group at 2h, 6h and 12h after operation were lower than those of the control group (P<0.05). The delay of gastric emptying in the observation group was 6.0%, which was lower than that of the control group (26.0%) (P<0.05). The intensive care unit (2.4±0.8) days and the hospitalization time (14.6±1.3) days were shorter than the control group (P<0.05). The number of positive lymph nodes in the observation group was 1.0±0.4, the ratio of vascular invasion was 8.0%, the diameter of tumor was (2.7±0.6) cm, and the proportion of middle/middle-lower differentiated tumor was 42.0%, which was lower than that of the control group (P<0.05). Conclusion: Laparoscopic pancreaticoduodenectomy combined with accelerated rehabilitation surgery is safe and effective, which is worthy of promotion. 2019 Vol. 25 (6): 914-918 [Abstract] ( 97 ) HTML (1 KB)  PDF (1254 KB)  ( 225 ) 922 Effect of Low-dose Injection of Methylprednisolone Sodium Succinate combined with CRRT on Immune Function and Prognosis in Patients with Acute Sepsis WANG Na DOI: 10.3969/j.issn.1006-6233.2019.06.011 Objective: To investigate the clinical value of low-dose injection of methylprednisolone sodium succinate combined with continuous renal replacement therapy (CRRT) in the treatment of emergency sepsis. Methods: 70 patients with ICU sepsis in our hospital were enrolled. Patients treated with CRRT therapy + low-dose injection with methylprednisolone sodium succinate were divided into observation groups using simple CRRT. Therapists were divided into control groups, with 35 cases in each group. On the basis of routine and symptomatic treatment, the control group was given CRRT therapy, and the observation group was given CRRT therapy + low-dose injection with methylprednisolone sodium succinate. The treatment conditions were compared between the two groups (APACHE II score, vasoactive substances and antibiotic use after 7 days of treatment). Time, ICU check-in time, serum inflammatory factors [TNF-α, IL-1, procalcitonin (PCT)] levels before and 7 days after treatment Immune function [serum T lymphocyte subsets (CD4+, CD8+) levels], incidence of adverse reactions during treatment, 28-day mortality were counted. Results: (1) Treatment: The APACHE II score was lower in the observation group than in the control group after 7 days of treatment, and the vasoactive substances and antibiotic use time, ICU stay time was shorter than the control group (P<0.05); (2) inflammatory factor: treatment The levels of serum TNF-α, IL-1 and PCT in the post-observation group were lower than those in the control group (P<0.05). (3) Immune function: The levels of CD4+ and CD8+ in serum T lymphocytes were higher in the observation group than in the control group (P<0.05). (4) Safety: During the treatment period, the incidence of adverse reactions in the observation group was 17.14% (6/35) and the control group was 11.43% (4/35). There was no significant difference (P>0.05); (5) Prognosis: observation There was no significant difference between the group's 28-day mortality rate of 25.71% (9/35) and the control group of 37.14% (13/35) (P>0.05). Conclusion: CRRT therapy based on the treatment of patients with acute sepsis with low-dose injection of methylprednisolone sodium succinate is beneficial to delay the progression of the disease and promote early disease outcome, which may be related to its down-regulation of serum inflammatory factor expression and correction of immune disorders. And the safety of the program is guaranteed, but there is no direct data to confirm that it can significantly reduce the mortality rate of sepsis. 2019 Vol. 25 (6): 922-926 [Abstract] ( 98 ) HTML (1 KB)  PDF (1282 KB)  ( 279 ) 927 Application Value of NLR Dynamic Monitoring in the Assessment of Early Neonatal Hypoxic Ischemic Encephalopathy WEN Xiaofang DOI: 10.3969/j.issn.1006-6233.2019.06.012 Objective: To investigate the value of dynamic monitoring of neutrophil/lymphocyte ratio (NLR) in the assessment of early neonatal hypoxic ischemic encephalopathy (HIE). Methods: 86 children with HIE in our hospital (November 2016-October 2018) were enrolled in the study group, and 86 normal newborns were selected as the control group. All the newborns were given 2 ml of blood samples on the 1st, 3rd and 7th day after delivery, and the neutrophil and lymphocyte values were detected by automatic blood cell analyzer, and NLR was calculated. Statistically analyze the neutrophil value, lymphocyte value, NLR, and statistical analysis of neutrophil values and lymphocytes on the 1st, 3rd and 7th day after delivery in the study group and the control group and the study group. Cell values, NLR and HIE severity were correlated. Results: The neutrophil value and NLR of the study group were higher than those of the control group on the 1st and 3rd day after delivery (P<0.05). There was no significant difference between the lymphocyte values and the control group and the 7th day after delivery (P>0.05). There were no significant differences in neutrophil value and lymphocyte value, NLR between the study group and control group (P>0.05). The neutrophil value and NLR were higher in children with severe HIE on the 1st and 3rd day after delivery. (P<0.05). There was no significant difference among lymphocyte values in children with mild HIE (P>0.05), neutrophil value and lymphocyte value, NLR in children with severe HIE on the 7th day after delivery. There was no significant difference among children with mild HIE (P>0.05). Spearman's test showed that there was a significant positive correlation between neutrophil value (r=0.801) and NLR (r=0.796) and HIE severity (P<0.05), there was no significant correlation between lymphocyte values (r=0.467) and HIE severity (P>0.05). Conclusion: The neutrophil value and NLR abnormality increase in the first 3 days after delivery of HIE children, and the increase rate increases with the severity of the disease. There is a significant positive correlation between the two, and the clinical manifestation of HIE can be assessed by dynamic monitoring of NLR, providing a reference for clinical development and adjustment of treatment plans. 2019 Vol. 25 (6): 927-930 [Abstract] ( 94 ) HTML (1 KB)  PDF (1266 KB)  ( 223 ) 931 The Value of Neuron Specific Enolase and Serum γ-GT in the Diagnosis of Neonatal Bilirubin Encephalopathy YUAN Ling, WANG Jun DOI: 10.3969/j.issn.1006-6233.2019.06.013 Objective: To investigate the clinical value of serum neuron specific enolase (NSE) and γ-glutamyltranspeptidase (γ-GT) in the diagnosis of neonatal bilirubin encephalopathy (NBE). Methods: A total of 340 children with neonatal hyperbilirubinemia admitted to our hospital from March 2014 to September 2018 were enrolled. Among them, 108 patients with NBE were in the study group and 232 patients with non-NBE were in the control group. The serum levels of total bilirubin (TBIL), indirect bilirubin (IBIL), NSE, and γ-GT were observed. To analyze the correlation between TBIL, IBIL and NSE, γ-GT; to evaluate the value of NSE, γ-GT and their combined diagnosis of NBE. Results: The serum levels of TBIL, IBIL, NSE and γ-GT in the study group were higher than those in the control group, and the difference was statistically significant (P<0.05). Correlation analysis showed that TBIL and IBIL were positively correlated with NSE and γ-GT levels (P<0.05); NSE was also positively correlated with γ-GT (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum NSE, γ-GT and the combined diagnosis of the two were 0.876, 0.825, 0.890; The sensitivity and specificity corresponding to the optimal threshold point were: NSE 72.2%, 93.1%, γ-GT 72.2%, 85.3%, and the combined diagnosis was 82.4% and 84.9%; The combined diagnostic efficacy of the two is higher than the single diagnosis. Conclusion: Serum NSE and γ-GT have diagnostic value for NBE, and NSE is superior to γ-GT, and the combination of the two has the highest diagnostic efficiency, which can provide an objective reference for early auxiliary evaluation of NBE. 2019 Vol. 25 (6): 931-934 [Abstract] ( 94 ) HTML (1 KB)  PDF (1394 KB)  ( 295 ) 935 Analysis of the Curative Effect of Laparoscopic Transrenal and Ureteroscopy in the Treatment of Upper Ureteral Stones of Incarcerated Ureter ZHANG Dongbang, et al DOI: 10.3969/j.issn.1006-6233.2019.06.014 Objective: To analyze and discuss the difference of curative effect of three methods of treatment (laparoscopic (RLU), transnephroscopic (mPCNL) and transureteroscopic (URL) adjuvant therapies) for patients with incarcerated upper ureteral calculi. Methods: 87 patients with incarcerated upper ureteral calculi admitted to our hospital from January 2012 to May 2018 were randomly divided into RLU group of 29 cases (using RLU surgical lithotripsy), mPCNL group of 29 cases (using mPCNL surgical lithotripsy) and URL group of 29 cases (using URL surgical lithotripsy). The operation time, intraoperative bleeding volume and post-operative pain score of the three groups were compared, and the complications of the three groups were recorded. Results: There were significant differences in blood loss, operation time, primary stone clearance rate, postoperative pain score, postoperative activity recovery time and hospitalization cost among the three groups (P < 0.01).The amount of intraoperative bleeding in RLU group was (187.8 ±45.9) ml. The operative time was (89.14 ±21.50) min,The postoperative pain score was (3.80 ±1.30), the recovery time of postoperative activity was (4.6 ±1.4) days, the hospitalization cost was (10.72 ±2.87) thousand yuan, and the intraoperative bleeding volume in mPCNL group was (225.5 ±42.0) ml,. The operative time was (87.31 ±19.62) min,The postoperative pain score was (4.25 ±1.60), the recovery time of postoperative activity was (2.3 ±1.2) days, the cost of hospitalization was (10.56 ±2.38) thousand yuan, the clearance rate of one stone was 96.55, the score of postoperative pain was (4.25 ±1.60), the recovery time of postoperative activity was (2.3 ±1.2) days.the hospitalization cost was (10.56 ±2.38) thousand yuan, which was significantly higher than that in the URL group [(162.6 ±38.1) ml, (42.68 ±14.36) min,82.76%, (3.20 ±1.15), (1.6 ±0.8) d, (4.21 ±1.23) thousand yuan].the difference was statistically significant (P < 0.05 ~0.01). The amount of intraoperative bleeding in mPCNL group was significantly higher than that in RLU group, but the recovery time of postoperative activity in mPCNL group was significantly shorter than that in RLU group (P<0. 01). Conclusions: RLU, mPCNL and URL can be used in the treatment of incarcerated upper ureteral calculi. Among them, RLU and mPCNL have higher stone clearance rate. Although compared with RLU, mPCNL has faster recovery time after operation and can be the first choice for the treatment of such calculi, it has a certain risk of bleeding. 2019 Vol. 25 (6): 935-938 [Abstract] ( 92 ) HTML (1 KB)  PDF (1280 KB)  ( 152 ) 939 Effects of Minocycline Lydrochloride Ointment combined with Metronidazole Film on Periodontal Index and Anti-inflammatory Factors in Patients with Periodontal Disease ZHU Yanyan, XIANG Yeping, et al DOI: 10.3969/j.issn.1006-6233.2019.06.015 Objective: To evaluate the efficacy of minocycline hydrochloride ointment combined with metronidazole film in the treatment of periodontal disease by studying anti-inflammatory factors and periodontal index. Methods: 84 patients with periodontal disease were randomly divided into control group and treatment group. The control group was given metronidazole film (containing 0.2560g metronidazole and 0.1024g chlorhexidine acetate) into periodontal pocket twice a week. The treatment group was given minocycline ointment (containing 10mg minocycline hydrochloride) twice a week on the basis of the control group. Both groups were treated for 4 weeks. The clinical indicators, total effective rate and adverse reactions were compared between the two groups. Results: There was no significant difference in plaque index (PLI), periodontal bag exploration depth (PD) and gingival sulcus bleeding index (SBI) between the two groups before treatment (P>0.05); compared with the control group, the plaque index, periodontal bag exploration depth and gingival sulcus bleeding index in the treatment group were significantly lower than those in the control group (P<0.05). Compared with the total efficiency of the control group, the treatment group was significantly higher (92.86% VS 71.43%, P<0.05). There were no obvious adverse reactions in both groups. Conclusion: Minocycline hydrochloride ointment combined with metronidazole film has a very obvious effect in the treatment of periodontal disease. It can not only effectively improve periodontal index and anti-inflammatory factors, but also ensure the safety and effectiveness. 2019 Vol. 25 (6): 939-941 [Abstract] ( 107 ) HTML (1 KB)  PDF (2395 KB)  ( 254 ) 942 Effect of Cetuximab combined with Different Chemotherapy Regimens on Survival and Adverse Reactions of Patients with Advanced Rectal Cancer ZHU Zhou, CHEN Rixin, QIN Jianing, et al DOI: 10.3969/j.issn.1006-6233.2019.06.016 Objective: To investigate the effect of cetuximab combined with different chemotherapy regimens in patients with advanced rectal cancer. Methods: 60 patients with advanced rectal cancer in our hospital were enrolled according to the random number table. 30 patients in FOLFIRI group received cetuximab plus FOLFIRI chemotherapy, and 30 patients in FOLFOX4 group received cetuximab plus FOLFOX4 chemotherapy Treatment. Observe and compare clinical treatment effects and serum epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1) levels, T lymphocyte subsets (CD3+) (CD4+) level changes before and after treatment, and statistical changes in the quality of life (independence, physiological function, psychological function, social relationship) scores before and after treatment, and the incidence and survival of adverse reactions. Results: The disease control rate was 66.67% (20/30) in FOLFOX4 group and 56.67% (17/30) in FOLFIRI group. There was no significant difference between the two groups (P > 0.05). The level of serum EGFR in two groups was significantly lower than that before treatment (P < 0.05), but there was no significant difference between the two groups (P > 0.05). The levels of serum VEGF and IGF-1 in FOLFOX4 group were lower than those in FOLFIRI group after 2 cycles of treatment (P < 0.05); there was no significant difference in the incidence of liver dysfunction between the two groups (P > 0.05); the incidence of leukopenia in FOLFOX4 group was 3.33% (1/30), and the incidence of nausea and vomiting was 3.33% (1/30). The incidence of diarrhea was 10.00% (3/30), the incidence of thrombocytopenia was 6.67% (2/30), which was lower than that of FOLFIRI group (P < 0.05); the median progression-free survival time of FOLFOX4 group was 11.2 months, and the median overall survival time was 28.90 months, which was higher than that of FOLFIRI group (7.03 months, 19.90 months) (P < 0.05). Conclusion: Cetuximab combined with oxaliplatin-based FOLFOX4 chemotherapy regimen for advanced rectal cancer patients is effective and safe. It can reduce serum levels of vascular endothelial growth factor and insulin-like growth factor-1 and prolong the survival time of patients. 2019 Vol. 25 (6): 942-946 [Abstract] ( 130 ) HTML (1 KB)  PDF (1591 KB)  ( 351 ) 947 Effect of Gemcitabine combined with DF Chemotherapy Regimen on 3D-CRT Therapy on Serum VEGF and MMP-9 Levels in Patients after Cervical Cancer Surgery YAN Jun, CAO Chun DOI: 10.3969/j.issn.1006-6233.2019.06.017 Objective: To investigate the effect of simultaneous three-dimensional conformal radiotherapy (3D-CRT) with gemcitabine combined with DF chemotherapy in patients with cervical cancer. Methods: A total of 90 patients with cervical cancer who underwent surgery from November 2013 to June 2015 were enrolled in our hospital. All patients were treated with synchronous 3D-CRT therapy, grouped according to random number table, 45 patients in the control group were treated with DF chemotherapy. 45 patients in the study group were treated with gemcitabine on the basis of the control group. The therapeutic effects and serum vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9) levels, and tumor suppressor genes (Fas, p53), the level of change, and the incidence of adverse reactions and prognosis (1 year, 2 years, 3 years) survival rate were compared before and after treatment. Results: The clinical efficacy of the observation group was better than that of the control group, and the disease control rate was 82.22% (37/45) in the observation group, 57.78% (26/45) in the control group (P<0.05). The levels of VEGF and MMP-9 were significantly lower than those before treatment, and the levels of serum VEGF and MMP-9 in the observation group were lower than those in the control group (P<0.05). The levels of Fas and p53 in the two groups were significantly higher than those before treatment. The levels of Fas and p53 in the observation group were higher than those in the control group (P<0.05). The observation group had leukopenia (26.67%), diarrhea (31.11%), nausea and vomiting (37.78%), thrombocytopenia (44.44%), and hair loss. The incidence rate of 57.78% was not significantly different from that of the control group (P>0.05). The 1-year survival rate of the observation group was 93.33% (42/45), and the 2-year survival rate was 84.44% (38/45). The annual survival rate was 64.44% (29/45). The 1-year survival rate of the control group was 91.11% (41/45), the 2-year survival rate was 80.00% (36/45), and the 3-year survival rate was 57.78% (26/45) There was no significant difference between the groups (P>0.05). Conclusion: Synchronous 3D-CRT therapy with gemcitabine combined with DF chemotherapy can improve serum VEGF and MMP-9 levels, up-regulate tumor suppressor gene expression, increase disease control rate, and have fewer adverse reactions. 2019 Vol. 25 (6): 947-952 [Abstract] ( 108 ) HTML (1 KB)  PDF (1408 KB)  ( 266 ) 953 Correlation Analysis of Serum Levels of 25-hydroxyvitamin D and Dermatomyositis-associated Pulmonary Interstitial Diseases LIANG Zhiqiang, PEI Yinhui, et al DOI: 10.3969/j.issn.1006-6233.2019.06.018 Objectives: To investigate the correlation between serum levels of 25-hydroxyvitamin D (25OH-D) and dermatomyositis-associated pulmonary interstitial disease (DM-ILD). Methods: 81 cases of DM-ILD were selected from March 2016 to February 2017 in our hospital department of rheumatism in our hospital as the research object (research group), 82 DM patients and 80 healthy volunteers were selected as control group and healthy-control group in the same period. The serum levels of 25OH-D in each group were tested by the method of high performance liquid chromatography combined with tandem mass spectrometry.And the differences of 25OH-D levels among the groups were analyzed. Results: The serum levels of 25OH-D in research group was significantly lower than the control group and healthy-control group, and the difference were statistically significant (P<0.01). The serum level of 25OH-D in the control group was significantly lower than that in healthy control group, and the difference were statistically significant (P<0.05). The serum level of 25OH-D in research group was 97.53% which was significantly higher than that in the control group (43.90%)(P=0.035).The proportions of patients with ‘severely deficient’ or ‘lack’ of 25OH-D serum levels in research group were significantly higher than that in control group (P<0.05). Conclusions: The lower serum level of 25OH-D in patient with DM-ILD is closely related with DM-ILD, and it has a certain clinical value for the early diagnosis of DM-ILD. 2019 Vol. 25 (6): 953-954 [Abstract] ( 120 ) HTML (1 KB)  PDF (1239 KB)  ( 241 ) 955 The Relationship Between the Level of MiR-19a in Peripheral Blood with BNP and Heart Function of Patients with Ischemic Heart Failure LI Yongzheng, LIU Yang, WANG Jing , et al DOI: 10.3969/j.issn.1006-6233.2019.06.019 Objective: To investigate the relationships between the level of miR-19a in peripheral blood with brain natriuretic peptide (BNP) and heart function of patients with ischemic heart failure. Methods: According to the NYHA classification of heart function, 100 patients with ischemic heart failure were divided into 35 cases of grade II, 42 cases of grade III, 23 cases of grade IV, another 50 healthy persons in the same period were selected as control group. Left ventricular ejection fraction (LVEF), left ventricular anteroposterior diameter (LAD) and left ventricular end-diastolic diameter (LVEDD) were measured by echocardiogram, the serum BNP level was measured by electrochemiluminescence immunoassay, real time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression of miR-19a in peripheral blood, Pearson correlation analyzed the correlations between miR-19a, BNP with LVEF, LAD, LVEDD, receiver operating characteristic curve (ROC) was used to assess the predictive values of miR-19a and BNP for cardiac function classification in patients with ischemic heart failure. Results: Alanine aminotransferase, aspartate aminotransferase, creatinine, urea nitrogen, uric acid and blood glucose in the ischemic heart failure group were significantly higher than those in the control group, while hemoglobin and total cholesterol were significantly lower than those in the control group (P<0.05). With the increase of NYHA grade, LAD and LVEDD gradually increased, LVEF gradually decreased, BNP and miR-19a expressions gradually increased (P<0.05). BNP was positively correlated with LAD and LVEDD (r = 0.382, r = 0.358, P<0.000) and negatively correlated with LVEF (r = - 0.402, P<0.000). MiR-19a was positively correlated with LAD and LVEDD (r = 0.415, r = 0.336, P<0.000), and negatively correlated with LVEF (r = - 0.392, P<0.000). The AUC value of BNP for predicting grade III of heart function was 0.753, and the AUC value of BNP for predicting grade IV of heart function was 0.704. The AUC value of miR-19a for predicting grade III of heart function was 0.838, and the AUC value of miR-19a for predicting grade IV of heart function was 0.795. Conclusion: MiR-19a and BNP levels in peripheral blood of patients with ischemic heart failure are increased, which are positively correlated with cardiac function parameters and con be used as predictors of cardiac function classification. 2019 Vol. 25 (6): 955-960 [Abstract] ( 67 ) HTML (1 KB)  PDF (1729 KB)  ( 212 ) 961 Curative efficacy of Seretide combined with Standard Myrtle oil Enteric-coated Capsule in Treatment of Chronic Obstructive Pulmonary Disease and Effects on Serum SIRT1 sfrp5 and MRpro-ADM Levels ZHENG Li, CHEN Caiming, TANG Yuechan DOI: 10.3969/j.issn.1006-6233.2019.06.020 Objective: To investigate the efficacy of seretide combined with standard Myrtle oil enteric-coated capsule in the treatment of chronic obstructive pulmonary disease and its effects on serum SIRT1, Sfrp5 and MRpro-ADM. Methods: 100 patients of chronic obstructive pulmonary disease who received therapy from April 2016 to April 2018 in our hospital were selected as research objects, they were divided into observation group (55 cases) and control group (45 cases) by the simple random number table method, On the basis of routine treatment, the control group was treated with seretide while the observation group was treated with Standard Myrtle oil enteric-coated on the basis of the control group, they were treated for 8 weeks. The clinical efficacy, serum SIRT1, sfrp5, MRpro-ADM, lung function, respiratory questionnaire (mMRC) score and adverse reactions were compared between the two groups. Results: After treatment, the total effective rate of the observation group was significantly higher than those in the control group(P＜0.05); the serum SIRT1 and Sfrp5 levels in the observation group were significantly higher than those in the control group, and MRpro-ADM levels was significantly lower than those in the control group(P＜0.05); the first second forced expiratory volume (FEV1) and FEV1/forced vital capacity (FVC) in the observation group were significantly higher than those in the control group(P＜0.05); the mMRC score of the observation group was significantly lower than those in the control group(P＜0.05); there was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05). Conclusion: Seretide combined with standard Myrtle oil enteric-coated capsule has remarkable effect on chronic obstructive pulmonary disease. It can effectively regulate the expression of SIRT1, Sfrp5 and MRpro-ADM in serum, alleviate airway inflammation and improve lung function. It has high clinical value. 2019 Vol. 25 (6): 961-964 [Abstract] ( 124 ) HTML (1 KB)  PDF (1271 KB)  ( 320 ) 965 Effects of Mechanical Ventilation Combined with High-dose Ambroxol on Plasma PCT and CRP Levels in Elderly Patients with Severe Pulmonary Infection CAI Rong DOI: 10.3969/j.issn.1006-6233.2019.06.021 Objective: To explore the effects of mechanical ventilation combined with high-dose ambroxol on elderly patients with severe pulmonary infection. Methods: 84 cases of elderly patients with severe pulmonary infection who were admitted between January 2016 and June 2018 were divided into observation group and control group according to the simple random sampling, with 42 cases in each group. Control group was given mechanical ventilation combined with conventional-dose ambroxol, and observation group was given mechanical ventilation combined with high-dose ambroxol. The clinical efficacy, symptoms improvement times and mechanical ventilation time were compared between the two groups. The blood gas analysis indexes [arterial partial pressure of oxygen (PaO2), arterial oxygen saturation (SaO2), oxidation index (PaO2/FiO2)] were evaluated before treatment and after 1 w of treatment, and the inflammatory indexes [procalcitonin (PCT), C-reactive protein (CRP)] were evaluated before treatment and after 2 w of treatment. Results: After 2 w of intervention, the total effective rate of treatment in observation group was higher than that in control group (P<0.05). The symptoms improvement times of fever, cough, shortness of breath and lung wet rales and the mechanical ventilation time in observation group were shorter than those in control group (P<0.05). After 1 w of treatment, the PaO2, SaO2 and PaO2/FiO2 in the two groups were higher than those before treatment (P<0.05), and the increases in observation group were greater than those in control group (P<0.05). After 2 w of treatment, the levels of PCT and CRP in the two groups were lower than those before treatment (P<0.05), and the decreases in observation group were greater than those in control group (P<0.05). Conclusions: Mechanical ventilation combined with high-dose ambroxol has good effects in the treatment of elderly patients with severe pneumonia, and it is beneficial to control the levels of PCT and CRP. 2019 Vol. 25 (6): 965-968 [Abstract] ( 105 ) HTML (1 KB)  PDF (1269 KB)  ( 298 ) 969 Preventive Effect of Xuebijing Injection on Sepsis in Patients with Severe Burn and Its Effect on Inflammatory Factors SUN Tongzu DOI: 10.3969/j.issn.1006-6233.2019.06.022 Objective: To explore the preventive effect of Xuebijing injection on sepsis in severely burned patients and its effect on inflammatory factors. Methods: A total of 84 patients with severe burns admitted to our hospital from July 2015 to December 2017 were divided into observation group and control group by simple random grouping, with 42 cases in each group. After admission, both groups were treated with conventional burns, including: nutritional support, organ protection, fluid resuscitation, antibiotics, and conventional wound debridement and dressing change. On the basis of this, the observation group applied Xuebijing injection: 50 ml/time, twice/d for 1 week. The incidence of sepsis, serum levels of creatinine (Cr), urea nitrogen (BUN), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), acute physiology and chronic health (APACHE) score, sequential organ failure score (SOFA) at the time of admission and 1 week of treatmentwere compared between the two groups. Results: The incidence of sepsis in the observation group was 11.90% (5/42), and 30.95% (13/42) in the control group, the difference was statistically significant (P<0.05). There were no significant differences in serum levels of TNF-α, IL-6, Cr, BUN, APACHE scores, and SOFA scores between the two groups (P>0.05). After 1 week of treatment, the serum levels of TNF-α, IL-6, Cr, BUN, APACHE and SOFA were significantly lower than those at admission in both group (P<0.05). The serumlevels of TNF-α, IL-6, Cr, BUN, APACHEscore and SOFA scoreat 1 week of treatmentin the observation group were significantly lower than those in the control group(P<0.05). Conclusion: On the basis of routine treatment of western medicine, Xuebijing injection can treat severe burns, which can effectively improve the overall physiological condition of patients, inhibit inflammatory factors, block inflammatory damage induced by inflammatory transmitters, protect kidney function and prevent the occurrence of sepsis, the effect is significant, it is worth promoting. 2019 Vol. 25 (6): 969-971 [Abstract] ( 111 ) HTML (1 KB)  PDF (1257 KB)  ( 270 ) 972 A Efficacy Comparative Study of Bupivacaine Intraspinal Anesthesia and Fentanyl combined with Propofol General Anesthesia in Elderly Patients Undergoing Orthopaedic Surgery ZHAN Puyi, LIU Ming, LIAO Xi DOI: 10.3969/j.issn.1006-6233.2019.06.023 Objective: To efficacy compare bupivacaine intraspinal anesthesia with fentanyl combined with propofol general anesthesia in elderly patients undergoing orthopaedic surgery. Methods: A total of 60 elderly patients undergoing orthopaedic surgery in our hospital from January 2017 to December 2017 were studied, including 30 patients in the control group (fentanyl combined with propofol general anesthesia) and 30 patients in the observation group (bupivacaine intraspinal anesthesia). The physiological indexes of the two groups were compared. Results: Compared with the control group, the observation group had significantly shorter operation time and eye opening time, and the anesthetic dosage and language presentation time were also lower than the control group (P<0.05). Compared with the control group, the MMSE score of the observation group was significantly higher in the three time periods (1 hour, 3 hours and 6 hours after operation) (P<0.05). Compared with the control group, the incubation period of P 3 in the observation group was significantly shorter (P<0.05) in the three postoperative periods (1h, 3h and 6h), and the amplitude of P 3 in the observation group was significantly higher (P<0.05) in the three postoperative periods (1h, 3h and 6h). Conclusion: Intraspinal anesthesia has a better effect in the elderly orthopedic surgery. It can not only shorten the time of opening eyes, operation and language presentation, but also reduce the dosage of anesthetics effectively. It has less influence on the cognitive ability and mental state of the patients, and the patients can recover earlier. 2019 Vol. 25 (6): 972-975 [Abstract] ( 103 ) HTML (1 KB)  PDF (1267 KB)  ( 221 ) 976 Application Value of Real-time Three-dimensional Echocardiography in Diagnosis of Left Ventricular Function and Synchrony in Uremic Cardiomyopathy WEN Tong, ZHOU Wei, DANG Zhaohua DOI: 10.3969/j.issn.1006-6233.2019.06.024 Objective: To explore the mechanical synchrony of patients with urinary cardiomyopathy and the clinical value of left ventricular function by means of 3DE evaluation. Methods: 60 patients with uremia who had not received dialysis in August 2016 -2017 in our hospital in August were selected. A total of 40 outpatients were randomly collected. The latest Siemens Acuson SC2000 ultrasonic diagnostic apparatus was used for image analysis. The left ventricular ejection fraction (LVEF) and left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) were compared, and the synchrony and left ventricular short-axis tangential strain rates were compared. Results: HR, LVEDV and LVESV in uremia myocardial damage group (UMD) were higher than those in healthy group (P<0.05), and LVEF was lower than that in healthy group (P<0.05). There were significant differences in SDI-16, SDI-17, DDI-16 and DDI-17 between the two groups. The UMD group was higher than the control group (P<0.05). The basal, middle and apical strain rates in UMD group were lower than those in control group (P<0.05). Left ventricular systolic function was negatively correlated with contraction asynchrony index in UMD group (r=-0.751, P<0.01). Conclusion: For UMD patients, the synchrony of left ventricular contraction and the synchrony of diastole are relatively poor. Real-time three-dimensional echocardiography (RT-3DE) is a fast, simple and new method for evaluating left ventricular function and synchronization in UMD patients. 2019 Vol. 25 (6): 976-978 [Abstract] ( 94 ) HTML (1 KB)  PDF (1230 KB)  ( 261 ) 979 Analgesic Effect Assessment and Safety Analysis of Propofol for Painless Gastrointestinal Endoscopy LV Yali DOI: 10.3969/j.issn.1006-6233.2019.06.025 Objective: To analyze the clinical effect and safety of propofol for painless gastroscopy. Methods: 100 patients undergoing colonoscopy were selected and simple random divided into observation group and control group equally. The observation group was treated with painless gastrointestinal endoscopy. Before gastrointestinal endoscopy and treatment, propofol was given to patients for anesthesia and analgesia; the control group patients directly for gastrointestinal endoscopy examination and treatment. The vital signs, including blood oxygen saturation (SpO2) and heart rate (HR), were compared and analyzed, and the postoperative effects of the two groups were compared. Results: For the observation group, HR and SpO2 did not change significantly before and after diagnostic examination, and there was no difference between two groups (P>0.05); in control group, HR fluctuated significantly before and after enteroscopy, but the change of SpO2 was more stable, with significant difference between the two groups (P<0.05). The total effective rate in the observation group (98%) was higher than in the control group(76%);12% of the patients in the observation group were very nervous before gastrointestinal endoscopy treatment, which was significantly lower than that in the control group. Compared with the control group, the psychological state of the observation group was relatively better; compared with the control group, the patients in the observation group appeared bad after the examination. Compared with the control group, the observation group had a relatively low adverse reaction rate (P<0.05). Conclusion: Compared with conventional gastrointestinal endoscopy, painless gastrointestinal endoscopy has obvious advantages. It not only can effectively alleviate the pain of patients, but also has a better adaptability, and has the advantage of fewer adverse reactions. It has no significant impact on HR, SpO2 and other patients in the course of examination, and has high safety. The satisfaction degree of operation is high, which is worthy of wide application in clinic. But its price is high, and it has certain limitations in clinical popularization. 2019 Vol. 25 (6): 979-981 [Abstract] ( 106 ) HTML (1 KB)  PDF (1247 KB)  ( 546 ) 982 Comparative Study of CT 3D Reconstruction Two-dimensional CT and X-ray Diagnosis of Tile Classification of Pelvic Fractures SHEN Honglei, FENG Dehong, XU Hongjun, et al DOI: 10.3969/j.issn.1006-6233.2019.06.026 Objective: To compare the value of 64 slice spiral CT three dimensional reconstruction in Tile classification of pelvic fractures. Methods: From January 2017 to June 2018, 51 patients with pelvic fractures were selected as subjects. All patients were examined by X-ray, two-dimensional CT and CT three-dimensional reconstruction. The diagnostic results of the three methods were compared according to the gold standard of surgical diagnosis. Results: According to the gold standard, there were 9 cases of Tile A type, 30 cases of B type and 12 cases of C type in 51 patients. The diagnostic accuracy of three-dimensional CT reconstruction for Tile classification was 100.00%, significantly higher than that of X-ray scanning (74.51%) and two-dimensional CT (88.34%), the difference was statistically significant (P<0.05). Both X-ray scan and two-dimensional CT were in good agreement with the gold standard (к = 0.696, 0.859, P<0.001). CT three-dimensional reconstruction is fully consistent with the gold standard test results. Conclusion: CT three-dimensional reconstruction is superior to two-dimensional CT and X-ray scan in judging Tile classification of pelvic fracture. 2019 Vol. 25 (6): 982-985 [Abstract] ( 102 ) HTML (1 KB)  PDF (2161 KB)  ( 190 ) 986 The Influencing Factors of Febrile Convulsion and then Case-control Study WANG Jieying, ZHANG Xihuan, BAI Taomin, et al DOI: 10.3969/j.issn.1006-6233.2019.06.027 Objective: To explore the influencing factors of febrile convulsion. Methods: 110 cases of febrile convulsions whotreated from January 2016 to December 2017 in our hospital as the case group, and 86 cases of febrile children were selected as the control group in the same period. The single factor of febrile convulsion was analyzed, the clinical data in both groups were analyzed, the possible risk factors of febrile convulsion were observed, and the relationship between immunoglobulin, trace elements and its occurrence was analyzed. Results: There was no significant difference in sex, age and mode of delivery between the control group and the case group (P > 0.05). There were significant differences in body temperature, family history of convulsion, perinatal injury, poor living environment, creatine kinase MB isoenzyme (CK-MB), immunoglobulin and trace elements between the two groups (P < 0.05). Multivariate unconditional logistic regression analysis showed that body temperature, family history of convulsion, perinatal injury, poor living environment and CK-MB were independent risk factors for febrile convulsion. Immunoglobulin and trace elements were protective factors for febrile convulsion (P < 0.05). Conclusion: The occurrence of febrile convulsion is related to a variety of high-risk factors. Low levels of immunoglobulin and trace elements can participate in the occurrence of febrile convulsion. Clinical intervention may reduce the risk of febrile convulsion. 2019 Vol. 25 (6): 986-989 [Abstract] ( 107 ) HTML (1 KB)  PDF (1242 KB)  ( 229 ) 990 Observation on the Clinical Efficacy of Precise Light combined with Isotretinoin in the treatment of Rosacea WANG Xubing, WANG Liangfu DOI: 10.3969/j.issn.1006-6233.2019.06.028 Objective: To observe the clinical efficacy of precise light (DPL) combined with isotretinoin in the treatment of rosacea. Methods: 90 patients with rosacea in the outpatient clinic from October 2015 to March 2018 were enrolled, They were divided into observation group (n=45) and control group (n=45) by simple random method.The control group was treated with isotretinoin, the observation group was treated with DPL combined with isotretinoin. The clinical efficacy, lesion score and adverse reaction rate of the two groups were compared. Results: After treatment, the erythema score, papule score and pustule score of the observation group were significantly lower than the control group (P<0.05). The total effective rate of the observation group after treatment was 88.89%, significantly higher than that of the control group (66.67%) (P<0.05). The total adverse reaction rate in the observation group after treatment was 6.67%, significantly lower than that in the control group (22.22%, (P<0.05). Conclusion: The clinical efficacy of DPL combined with isotretinoin in the treatment of rosacea is significant, which can reduce the clinical symptoms of patients, and it is safer and worthy of further clinical promotion. 2019 Vol. 25 (6): 990-992 [Abstract] ( 156 ) HTML (1 KB)  PDF (1252 KB)  ( 337 ) 993 Relationship between Cervical Lymph Node Metastasis of Thyroid PapillaryCarcinoma and Serum Thyroid Stimulating Hormone ZHANGg Yan, LI Sanrong, TONG Shuhong DOI: 10.3969/j.issn.1006-6233.2019.06.029 Objective: To explore the relationship between serum thyroid stimulating hormone (TSH) and cervical lymph node metastasis of thyroid papillary carcinoma (PTC), in order to provide a theoretical basis for clinical diagnosis and treatment. Methods: The clinical data (observation group) of 80 patients with pathologically confirmed PTC admitted to our hospital from September 2013 to August 2018,In the same period, the clinical data (control group) of 62 patients who were diagnosed as benign thyroid nodules after treatment in our hospital were included.The general clinical data of the two groups were compared. Serum thyroid stimulating hormone (TSH) levels were compared between the two groups. The levels of TSH in different pathological data were compared. Results: A total of 80 patients in the observation group and 62 patients in the control group were included. There was no significant difference in the general clinical data between the two groups (P>0.05). Serum TSH (2.3±0.6 uIU/ml VS 1.1±0.4 uIU/ml; t=13.58, P<0.01) was significantly higher in the observation group than in the control group (P<0.05). There was no significant difference in serum TSH levels between the different pathological data in the observation group (P>0.05). There were significant differences in calcification, TNM stage, tumor diameter, and cervical lymph node metastasis. (P<0.05). Conclusion: Serum TSH has a certain correlation with PTC cervical lymph node metastasis, and it has certain clinical application value for the diagnosis and treatment of assisted PTC. 2019 Vol. 25 (6): 993-995 [Abstract] ( 105 ) HTML (1 KB)  PDF (1242 KB)  ( 189 ) 996 Study on the Correlation between Th1/Th2 Cytokines in Peripheral Blood of Patients with Different Types of Henoch Schonlein Purpura QI Haihua, HE Lei, HUANG Zhanqiang, et al DOI: 10.3969/j.issn.1006-6233.2019.06.030 Objective: To explore the correlation between Th1/Th2 immune imbalance and different types of Henoch-Schonlein purpura. Methods: A total of 90 patients with Henoch-Schonlein purpura who were treated in department of dermatology of the Affliated hospital of Chengde Medical College between December 2016 and December 2017 were collected. Thirty patients with allergic purpura who have renal injury and Thirty patients who have gastrointestinal injury were selected as the research object,which were named as purpura nephritis group and purpura abdominal type group. While 30 cases of simple purpura patients were used as the control group in the same period. IL-2, IL-4 were detected and the datas were compared. Results: The level of IL-2 in the purpura nephritis group and the purpura abdominal type group, was significantly lower than control group (P<0.05), the level of IL-4 was significantly higher than control group (P<0.05).The purpura nephritis group compared with the purpura abdominal type group,the difference both was not statistically significant(P＞0.05). Conclusion: The different types of Henoch Schonlein purpura is correlated with the imbalance of Th1/Th2, which can provide new evidence for the clinical treatment and prognosis of Henoch Schonlein purpura. 2019 Vol. 25 (6): 996-997 [Abstract] ( 95 ) HTML (1 KB)  PDF (1241 KB)  ( 461 ) 998 Comparison on the Therapeutic Effect of two Different Treatment for ACL Rupture CHEN Songliang, LIN Yongsheng, GUO Yangdan, et al DOI: 10.3969/j.issn.1006-6233.2019.06.031 Objective: To compare the efficacy of two different treatments for anterior cruciate ligament (ACL) rupture. Methods: The clinical data of 63 patients with ACL rupture in our hospital from September 2014 to August 2018 were collected. According to the different treatment methods, the patients were divided into non-tension-relieving group (41 cases) with routine anatomical reconstruction and post-operative rehabilitation, and without tension-relieving technique was used; the tension-relieving group (22 cases) with tension-relieving technique anatomical reconstruction and post-operative rapid rehabilitation treatment. The patients in both groups were followed up after operation. The knee flexion, Lysholm knee score and Hospital for Special Surgery (HSS) score before and after operation were compared between the two groups. The complications were recorded during the follow-up period. Results: All 63 patients were followed up for an average of (14.05±2.25) months. In the non-tension-relieving group, there were 2 cases of ligament relaxation and 1 case of joint stiffness. In the tension-relieving group, there was no complications and the ligament grew well. Compared with pre-operation, the knee flexion of the two groups increased significantly at 1 and 3 months after operation, and the knee flexion of the tension-relieving group was significantly higher than that of the non-tension-relieving group (P< 0.05). At 3, 6 and 12 months after operation, Lysholm knee score in both groups increased significantly compared with that before operation, and those scores in the tension-relieving group increased significantly compared with that in the non-tension-relieving group (P< 0.05). Compared with pre-operation, the HSS scores of the two groups increased significantly at 3, 6 and 12 months after operation, and the scores of the tension-relieving group increased significantly compared with those of the non-tension-relieving group (P< 0.05). Conclusion: Anatomical reconstruction with relaxation technique and rapid rehabilitation after operation can effectively improve the knee function of ACL rupture patients, promote the recovery of knee function, and reduce the occurrence of complications. It has a good safety. It is helpful to promote the recovery of patients'motor function, and its clinical effect is obviously better than that of those without tension-reducing technique. 2019 Vol. 25 (6): 998-1001 [Abstract] ( 94 ) HTML (1 KB)  PDF (1276 KB)  ( 278 ) 1002 The Significance of Two-dimensional Ultrasound in the Distal Ureteral Calculi and the Analysis of Related Factors Influencing the Ultrasonic Diagnosis Results JIN Minghua, et al DOI: 10.3969/j.issn.1006-6233.2019.06.032 Objective: To explore the significance of two-dimensional ultrasonic diagnosis of ureteral end-stone and the related factors influencing the ultrasonic diagnosis results. Methods: 120 patients with suspected distal ureteral calculi in our hospital from January 2017 to August 2018 were observed and studied. Two-dimensional ultrasound examination and spiral CT examination were performed on all patients. Then, the results of spiral CT examination were taken as the diagnostic criteria to analyze and summarize the image characteristics and diagnostic effects of two-dimensional ultrasound, and the data of all patients were analyzed. To summarize the influencing factors of misdiagnosis and missed diagnosis in the diagnosis of distal ureteral calculi by two-dimensional ultrasound. Results: The results of two-dimensional ultrasound examination were 9 cases of missed diagnosis and 2 cases of misdiagnosis.The sensitivity, specificity and accuracy of two-dimensional ultrasound in the diagnosis of distal ureteral calculi were 91.3% (95/104), 87.5% (14/16) and 90.8% (109/120). Two-dimensional ultrasound examination was used in patients of different genders and ages, and the results showed no significant difference in the effect of diagnosis of distal ureteral calculi (P>0.05). The incidence of misdiagnosis or missed diagnosis of distal ureteral calculi in obese patients was significantly higher than that in non-obese patients (P<0.05). The incidence of misdiagnosis or missed diagnosis of distal ureteral calculi in patients with bladder volume < 110 mL was significantly higher than that in patients with bladder volume > 110 mL (P<0.05). Conclusion: Two-dimensional ultrasonography is effective in the diagnosis of distal ureteral calculi, and the incidence of missed diagnosis or misdiagnosis is low.Obesity and bladder volume are the direct factors that influence the diagnosis effect, which needs targeted treatment to improve the diagnosis effect. 2019 Vol. 25 (6): 1002-1005 [Abstract] ( 93 ) HTML (1 KB)  PDF (1354 KB)  ( 263 ) 1006 Interventional Therapy for Deep Venous Thrombosis after Lower Extremity Surgery JING Yang, DING Meng, FU JiuYuan, at al DOI: 10.3969/j.issn.1006-6233.2019.06.033 Objective: To explore the effect and analysis of interventional technique in the treatment of deep venous thrombosis after lower extremity surgery. Methods: 136 patients with deep venous thrombosis of lower extremities who were treated in our hospital from January 2010 to December 2018 were divided into observation group and control group according to the digital table method, 68 cases in each group. The control group was treated with conventional anticoagulation therapy, while the observation group was treated with catheter thrombolytic interventional therapy on the basis of the control group. The perimeter of one healthy limb, popliteal vein blood flow velocity and intravascular diameter, plasma PAl-1 level and clinical biochemical indexes were compared and analyzed between the two groups. Results: After treatment, the effective rate of the observation group was 86.76%, significantly higher than that of the control group (67.65% (P > 0.05). Before treatment, there were no significant differences in the menstrual difference between the thighs and legs, popliteal vein internal diameter and blood flow velocity between the two groups (P > 0.05). After treatment, the menstrual changes of the legs of the two groups were significantly reduced. The comparison between the two groups showed that the experimental group was significantly smaller than that of the control group, with statistical significance. Significance (P < 0.05); experimental group and control group had significant differences in vascular diameter and blood flow velocity (P < 0.05). After treatment, PAI-1 in the experimental group was significantly higher than that in the control group, while t-PA was significantly lower than that in the control group, with statistical significance (P < 0.05). The levels of Lp (a), D-D, FIB, AT, PS and P C in the experimental group were lower than those in the control group, with significant difference (P < 0.05). The PLT index in the experimental group was significantly higher than that in the control group (P < 0.05). Although the MPV index in the experimental group was higher than that in the control group, there was no statistical significance (P > 0.05). Conclusion: Catheter thrombolysis interventional technique can effectively remove intraluminal thrombosis in the treatment of deep venous thrombosis after lower limb surgery, and its effect is better than anticoagulation therapy alone, which is worthy of clinical promotion. 2019 Vol. 25 (6): 1006-1009 [Abstract] ( 91 ) HTML (1 KB)  PDF (1267 KB)  ( 635 ) 1010 Study on the Correlation between Depression Occurrence Mechanism and Serum Thyroid Hormone and Adrenocortical Hormone Levels in Elderly Patients XU MoJu DOI: 10.3969/j.issn.1006-6233.2019.06.034 Objective: To explore the correlation between depression occurrence mechanism and serum thyroid hormone and adrenocortical hormone levels in elderly patients. Methods: 80 elderly patients suffering from depression of the study group were divided into the mild depression group(42) , moderate depression(26) and the severe depression group(12), according to the quantitative score points for by Zung depression score (ZDS)and Zung Anxiety score (ZAS). 80 people were selected for health examination during the same period, as control group. Thyroid hormone and adrenocortical hormone levels and serum potassium were detected by chemiluminescence, then, The correlation between depression and glucocorticoid and thyroxine levels was analyzed. Results: Compared with the control group, the quantitative scores of depression and anxiety in elderly patients increased significantly (P < 0.05), TSH increased, T3, FT3, FT4 decreased, and there were significant differences (P < 0.05). Compared with the control group, the levels of serum free COR, ACTH, blood potassium and 24-hour UFC in depressive patients at 8:00 and 16:00 were significantly lower than those in the control group (P < 0.01), and the levels of serum free COR were significantly lower than those at 16:00 (P < 0.01). Compared with mild and moderate depression group, the levels of thyroid hormone and adrenocortical hormone in severe depression group decreased significantly (P < 0.01). Conclusion: With the increase of the severity of depression, the levels of thyroid hormone and adrenocortical hormone will gradually decrease, which may be one of the mechanisms of depression in elderly patients. 2019 Vol. 25 (6): 1010-1012 [Abstract] ( 105 ) HTML (1 KB)  PDF (1255 KB)  ( 276 ) 1013 Clinical Application of Cocktail Intra-articular Injection in Analgesia after Knee Athroscopy SONG Rui DOI: 10.3969/j.issn.1006-6233.2019.06.035 Objective: To explore the clinical effect of "cocktail" intraarticular injection in the treatment of meniscus injury by knee arthroscope. Methods: 50 patients with meniscus injury admitted to the department of orthopedics of fuyang hospital of anhui medical university from July 2017 to July 2018 were randomly divided into two groups,25 patients in each group, Group A (experimental group) was given intraarticular injection of "cocktail" (sodium hyaluronate injection 6 ml, ropivacaine injection 3 ml, compound betamethasone injection 1 ml and normal saline 2 ml) and group B (control group)was given intraarticular injection of normal saline 10 ml. Compared of two groups with visual analog scale (VAS),hospital stays,usage amount of imrecoxib, Lysholm and adverse reactions. Results: All patients had no serious complications were found in 7 days postoperatively.Within 3 days after operation, the VAS score,hospital stays,consumption of analgeics and the Lysholm score were better in A group (P<0.05). Conclusion: The "cocktail" intra-articular injection is recommended for obvious analgesic effect after the treatment of meniscus injury with knee arthroscope. 2019 Vol. 25 (6): 1013-1016 [Abstract] ( 150 ) HTML (1 KB)  PDF (1255 KB)  ( 266 ) 1017 Risk Factors of Cardio-cerebrovascular Disease in MaintenanceHemodialysis Patients and its Impact on Short-term Prognosis XUE Yahui, WANG Yi DOI: 10.3969/j.issn.1006-6233.2019.06.036 Objective: To explore the risk factors of cardiovascular and cerebrovascular diseases in patients with maintenance hemodialysis (MHD) and its influence on short-term prognosis. Methods: 98 patients with MHD in our hospital from March 2013 to June 2018 were selected as the study subjects. According to whether they were complicated with cardiovascular and cerebrovascular diseases, they were divided into concurrent group and non-concurrent group. The clinical information of patients was analyzed to find out the risk factors of cardiovascular and cerebrovascular diseases. The patients were followed up for 2 years, and their survival and prognosis were recorded. Results: 35 cases were included in the concurrent group, and the incidence of cardiovascular and cerebrovascular diseases was 35.71% in MHD patients. Univariate analysis showed that hypertension (χ2= 10.671, P = 0001), dialysis age (t = 4.519, P<0.001), UA level (t=21.992, P<0.001) were related factors of cardiovascular and cerebrovascular diseases in MHD patients, but not with sex, diabetes history, serum albumin, Scr, BUN, TG, TC, LDL-C, HDL-C and Hb levels. The difference was not statistically significant(P>0.05).The results of binary logistic regression analysis showed that hypertension history, long dialysis age and high UA level were risk factors for cardiovascular and cerebrovascular diseases in MHD patients(P<0.05).The 2-year survival rate of the concurrent group was significantly lower than that of the non-concurrent group (P<0.05). Conclusion: The prognosis of MHD patients complicated with cardiovascular and cerebrovascular diseases is poor. Hypertension history, long dialysis age and high UA level are risk factors for the occurrence of cardiovascular and cerebrovascular diseases in MHD patients. 2019 Vol. 25 (6): 1017-1019 [Abstract] ( 109 ) HTML (1 KB)  PDF (1247 KB)  ( 291 ) 1020 Clinical Efficacy of Early Postpartum Pelvic Floor Rehabilitation WANG Xiaofen DOI: 10.3969/j.issn.1006-6233.2019.06.037 Objective: To study the effectiveness of pelvic floor electrical stimulation combined with biofeedback therapy in improving postpartum stress incontinence, uterine prolapse, vaginal wall protrusion and vaginal relaxation in women and to provide a theoretical basis for promoting pelvic floor rehabilitation treatment. Methods: 200 patients who came to pelvic floor muscle rehabilitation clinic from April 2015 to April 2018 were selected as the research objects. They were randomly divided into treatment group (100 cases) and control group (100 cases). The treatment group was treated with pelvic floor electromyographic stimulation combined with biofeedback therapy. The control group used Kegel exercise alone. Results: In the treatment group, symptoms were improved in 92 cases and 25 cases in the control group. Conclusion: The electromyographic activity of myofibrils I and II in the treatment group was higher than that in the control group, with statistical significance (p < 0.05), and the improvement rate of symptoms was significantly higher than that in the control group. It shows that pelvic floor electromyographic stimulation combined with biofeedback therapy is effective in improving pelvic floor muscle strength in postpartum women. It can relieve stress urinary incontinence, restore vaginal tightness, improve uterine prolapse and vaginal bulge. 2019 Vol. 25 (6): 1020-1022 [Abstract] ( 86 ) HTML (1 KB)  PDF (1250 KB)  ( 262 ) 1023 Synergistic Effect of Tegiol combined with Astragalus Polysaccharide Injection in Radiotherapy of Head and Neck Tumors WU Renrui, ZHONG Qiong, WANG Chen DOI: 10.3969/j.issn.1006-6233.2019.06.038 Objective: To observe the synergistic effect of tegiol combined with astragalus polysaccharide injection in radiotherapy of head and neck tumors. Methods: A total of 86 cases of head and neck cancer patients admitted to our hospital from July 2015 to July 2017 were randomly divided into observation group and control group, with 43 cases in each group. The control group received intensity modulated radiation therapy, the course of treatment lasted for 5 to 7 weeks. The observation group was given the tegafur, gimeracil and oteracil potassium capsules and astragalus polysaccharide injection on the basis of intensity modulated radiation therapy. The total remission rate, T-cell subsets (including CD4+, CD8+, CD4+/CD8+) and natural killer (NK) activity before and after treatment, the incidences of mucosal damage, dermatitis, dry mouth, feel sick and vomit, and diarrhea were compared between the two groups. Results: The total remission rate in the observation group was 83.72%, which was higher than 62.79% in the control group, the difference was statistically significant (P<0.05). There were no significant difference in CD4+, CD8+, CD4+/CD8+, and NK before and after treatment in the control group (P>0.05). The CD4+, CD4+/CD8+, and NK in the observation group increased after treatment and were higher than those in the control group, with a significant difference (P<0.05); While the CD8+ was lower than before treatment and was lower than the control group, with a significant difference (P<0.05). There were no significant difference in the severity grades of diarrhea and feel sick and vomit between the two groups (P>0.05). The severity of mucosal injury, dermatitis injury and dry mouth in the observation group were lower than those in the control group, with a significant difference (P<0.05). Conclusion: The combination of tegafur, gimeracil and oteracil potassium capsules and astragalus polysaccharide injection can effectively improve the radiotherapy efficacy of patients with head and neck cancer, enhance patient immunity and reduce toxic side effects, which worthy of promoting. 2019 Vol. 25 (6): 1023-1026 [Abstract] ( 86 ) HTML (1 KB)  PDF (1273 KB)  ( 254 ) 1027 The Role and Clinical Value of Th22 Cells in Peripheral in Rheumatoid Arthritis TANG Yan, et al DOI: 10.3969/j.issn.1006-6233.2019.06.039 Objective: To study the role and clinical value of Th22 cells levels in peripheral blood in rheumatoid arthritis (RA). Methods: According to the DAS28 score, 190 patients with RA were divided into DAS28≤3.2 (52 cases), 3.2<DAS28≤5.1 (63 cases), DAS28>5.1 (75 cases), 60 healthy subjects were selected as the control group. The levels of Th22 cells in peripheral blood of each group were detected by flow cytometry. The levels of related cytokines (IL-22, IL-17) were detected by enzyme-linked immunosorbent assay (ELISA). The differences of Th22 cells in peripheral blood were compared. The predictive value of Th22 cell in peripheral blood was evaluated in the degree of activity in RA. Results: Compared with healthy controls, the levels of Th22 cells and cytokine IL-22 in peripheral blood in patients with RA were significantly increased (P<0.05); The levels of Th22 cells, IL-22 and IL-17 in peripheral blood in different activity degrees of RA were statistically signifiant (P<0.05). Among them, the level of the above indicators in the DAS28>5.1 group was the highest, the 3.2<DAS28≤5.1 group was the second, and the DAS28≤3.2 group was the lowest. The level of Th22 cells in peripheral blood in patients with RA group was positively correlated with IL-22, IL-17 and DAS28 (r=0.831, P=0.000; r=0.575, P=0.025; r=0.673, P=0.014). ROC curves analysis showed that the area under curve of Th22 cells was 0.874 (95%CI 0.801~0.948), and optimal operating point (OOP) was 8.5%, which had 84.38% sensiticity and 81.48% specificity in predicting the activity degree of RA patients. Conclusions: The level of Th22 cells in peripheral blood is closely related to the occurrence of development of RA patients, and there is certain application value for predicting the activity degree of RA. 2019 Vol. 25 (6): 1027-1029 [Abstract] ( 104 ) HTML (1 KB)  PDF (1486 KB)  ( 306 ) 1030 Influence on Enteral Nutrition for Adipokines in Patient with Early Acute Pancreatitis LI Guanghui, LV Feifei DOI: 10.3969/j.issn.1006-6233.2019.06.040 Objective: To study the effect of enteral nutrition for adipokines (adiponectin, leptin, omentin, visfatin) in patient with early acute pancreatitis. Methods: A total of 90 patients with AP from Jan. 2015 to Dec. 2017 were randomised to EN (n=45) and nil-by-mouth (NBM, n=45). Blood samples were taken on the first 4d of admission and adipokine concentrations was determined by ELISA assays. A linear mixed model analysis was used to determine differences in adipokine concentrations between the two study groups. Results: The infectious rate in patients with AP was lower than those with NBM. Omentin and leptin concentrations were significantly higher in patients with EN compared with NBM across the first 4 d of admission(63.5ng/ml vs 42.7ng/ml,6.3ng/ml vs 3.7ng/ml,P<0.05, respectively).No significant difference in adiponectin and visfatin concentrations were observed between the two groups. Conclusions: EN decreases the infectious rate in AP patients and it also increases omentin and leptin levels in AP. Further study is needed to understand whether these adipokines are responsible for the therapeutic benefits of EN. 2019 Vol. 25 (6): 1030-1033 [Abstract] ( 99 ) HTML (1 KB)  PDF (1345 KB)  ( 203 ) 1034 Characteristics and Clinical Value of Serum Free COR,ACTH Levels in Elderly Patients with Severe Nosocomial Infection LI Fucai DOI: 10.3969/j.issn.1006-6233.2019.06.041 Objective: To detect the levels of serum adrenocorticotropic hormone (ACTH) and free cortisol (COR) in elderly patients with severe nosocomial infection and to analyze the changes of the above factors and their clinical application value. Methods: From June 2015 to June 2018, 163 critically ill elderly patients in ICU ward of our hospital were selected. According to the criteria for the diagnosis of nosocomial infection, 76 patients were divided into infected patients (infection group), 87 cases without infection (control group)The levels of serum free COR,ACTH and serum potassium were measured in 8: 00 and 16: 00 in two groups. The changes of COR,ACTH and serum potassium levels in the two groups were analyzed and compared, Predictive value of serum free COR for infection by ROC curve analysis, the APACHE Ⅱ scores were recorded, the fatality rate of the two groups was observed at 28 days, and the changes of serum free COR,ACTH between survival and death patients were further observed. Results: The serum free COR at 8:00was (709.67 ±298.24) nmol/L, the level of serum free COR at 16:00 was (475.82 ±260.16) nmol/L, UFC was (185.94 ±161.29) g / 24 h and Apache Ⅱ score was (21.57 ±4.35)in the infected group. It was significantly higher than that of the control group [(364.03 ±152.78) nmol/L, (127.29 ±64.31) nmol/L, (71.31 ±16.44) μg / 24 h, (16.28 ±3.14), P<0. 01]. The fatality rate of 28 days in the infected group was significantly higher than that in the non-infected group (36.84% vs 3.45%, P<0.05). 8:00 the sensitivity of serum free COR to infection was 85.5, the specificity of serum free COR was 89.70.The sensitivity of serum free COR to infection was 97.4, and the specificity was 98.9;At 8:00, serum free COR was (1084.21 ±267.53) nmol/L,At16:00,serum free COR was (672.82 ±143.65) nmol/L, 8:00ACTH was (19.34 ±7.83) pmol/L,16:00ACTH was (17.58 ±5.63) pmol/L, UFC was (237.83 ±86.37) ?g/ 24 h in the death group. It was significantly higher than that in the survival group [(719.75 ±156.27) nmol/L, (268.29 ±78.37) nmol/L, (10.52 ±3.27) pmol/L, (9.74 ±3.96) pmol/L, (106.49 ±27.24)μg/24 h, P<0. 01]. Conclusions: The expression of serum free COR is higher in elderly patients with severe nosocomial infection. It can be used as an effective index for differentiating severe infection. At the same time, the high level of COR,ACTH may be related to the prognosis of the infected patients. The clinical monitoring of free COR and ACTH levels can be used to determine the prognosis of the patients. 2019 Vol. 25 (6): 1034-1037 [Abstract] ( 115 ) HTML (1 KB)  PDF (1353 KB)  ( 271 ) 1038 Effects of Sphincter-retaining Thread-drawing Therapy and Fistulectomy on Short-term Efficacy, Healing Time and Complications in Patients with Complex anal Fistula YIN Yudi, FANG Wenhui, NIU Zhongbao, et al DOI: 10.3969/j.issn.1006-6233.2019.06.042 Objective: To observe the effects of sphincter-retaining thread-drawing therapy and fistulectomy on the short-term efficacy, healing time and complications of patients with complex anal fistula. Methods: 90 patients with complex anal fistula were divided into sphincter-retaining thread-drawing therapy group (study group, n=45) and fistulectomy group (control group, n=45). The operation situation was observed, and the short-term efficacy was evaluated at 1 month after operation. The postoperative healing and anal function improvement 【anal incontinence score (Wexner)】 were compared between the two groups, and the incidence rate of complications was recorded. Results: The operation situation in study group was better than that in control group (P<0.05). There was no significant difference in the total effective rate between the two groups (P>0.05), and the good improvement rate in study group was higher than that in control group (P<0.05). The wound area, wound healing time and incidence rate of complications in study group were smaller than those in control group (P<0.05). There was no significant difference in the Wexner score between the two groups before operation (P>0.05), and the difference of Wexner score before and after operation in study group was greater than that in control group (P<0.05). Conclusions: Compared with fistulectomy, sphincter-retaining thread-drawing therapy for complex anal fistula can improve the operation situation, enhance the efficacy, and promote wound healing and anal function recovery, and it has good safety. 2019 Vol. 25 (6): 1038-1040 [Abstract] ( 91 ) HTML (1 KB)  PDF (1249 KB)  ( 290 ) 1041 Analysis on Accuracy and Influencing Factors of Intraoperative Frozen Section Pathological Diagnosis of Thyroid Papillary Micro Carcinoma FU Jinfeng, YIN Xia, JIANG Tao DOI: 10.3969/j.issn.1006-6233.2019.06.043 Objective: To analyze the accuracy of intraoperative frozen section pathological diagnosis of thyroid papillary micro carcinoma (PTMC), and to explore the influencing factors of frozen pathological diagnosis. Methods: 296 patients with thyroid diseases in our hospital from March 2015 to April 2018 were selected as the subjects, all the patients were diagnosed by pathological section of intraoperative frozen section and pathological diagnosis of postoperative paraffin section, the pathological diagnosis of postoperative paraffin section was the gold standard, the accuracy of pathological diagnosis of intraoperative frozen section was analyzed. Logistic regression analysis was used to explore the risk factors affecting the accuracy of intraoperative frozen pathological diagnosis. Results: 51 cases of PTMC patients were diagnosed with postoperative paraffin section, with a detection rate of 17.23%. 40 cases were diagnosed by intraoperative frozen section, the diagnostic rate was 78.43%, the misdiagnosis rate was 7.84%, the delayed diagnosis rate was 9.80%, the missed diagnosis rate was 3.92%, and there were no false positive cases. The diagnostic accuracy of intraoperative frozen section was significantly different in tumor size, capsular invasion and thyroid calcification (P<0.05). Logistic multivariate regression analysis showed that tumor size and capsular invasion were independent risk factors affecting the accuracy of intraoperative frozen section pathological diagnosis. Conclusion: Intraoperative frozen section is highly accurate in diagnosing PTMC, the accuracy of diagnosis is affected by tumor size and capsule invasion. 2019 Vol. 25 (6): 1041-1044 [Abstract] ( 177 ) HTML (1 KB)  PDF (1267 KB)  ( 355 ) 1045 Guiding Significance of Pharmacy Guidance based on Evidence-based Support for Prognosis of Patients with Type 2 Diabetes Mellitus LIANG Zhiguo, GOU Xin DOI: 10.3969/j.issn.1006-6233.2019.06.044 Objective: To explore the effect of pharmaceutical guidance based on evidence-based support for the prognosis of patients with type 2 diabetes mellitus. Methods: 140 patients with type 2 diabetes admitted to our hospital were randomly divided into two groups according to envelope method. 70 patients in the control group were given routine medication guidance, while 70 patients in the observation group were given pharmaceutical guidance based on evidence-based support. The interventions of the two groups were compared. Results: Compared with the control group, the fasting blood sugar, 2-hour postprandial blood sugar and glycosylated hemoglobin levels in the observation group were better than those in the control group (p < 0.05). Secondly, the incidence of adverse reactions and medication deviation in the observation group was lower than that in the control group (p < 0.05). Thirdly, the compliance analysis showed that the observation group was significantly higher than the control group (p < 0.05). Group (p<0.05). Conclusion: Pharmaceutical guidance based on evidence-based support is effective in improving drug safety, blood sugar control and drug compliance of patients with type 2 diabetes mellitus, and can be popularized. 2019 Vol. 25 (6): 1045-1047 [Abstract] ( 114 ) HTML (1 KB)  PDF (1246 KB)  ( 277 ) 1048 Clinical Observation on Treatment of Knee Osteoarthritis with Sea Mud Moxibustion and Electroacupuncture QIAO Ye, ZHANG Lide, DONG Jiazi, et al DOI: 10.3969/j.issn.1006-6233.2019.06.045 Objective: To explore the clinical efficacy of traditional Chinese medicine moxibustion combined with electroacupuncture in the treatment of KOA. Methods: 78 KOA patients who met the corresponding criteria were enrolled in the combined group and the basic group, 39 cases in each group. The patients in the basic group were treated with simple comprehensive conservative therapy of Western medicine, and the patients in the combined group were treated with sea mud moxibustion and electro-acupuncture besides the basic group. Both groups were treated for 10 days as a course of treatment, with three courses of treatment. Results: After treatment, the level of inflammatory factors in knee joint fluid of the two groups decreased only to a certain extent in the basic group (P < 0.05), while that in the combined group decreased significantly (P < 0.01), and the reduction in the combined group was more obvious than that in the basic group (P < 0.05). In terms of KOA severity score, both groups decreased after treatment (P < 0.05), and compared with the basic group, the combined group decreased more significantly (P < 0.01). The scores of knee joint motor function in both groups decreased after treatment (P < 0.05), and the reduction of joint group was more obvious than that of basic group (P < 0.05). The total effective rate of the combined group was higher than that of the basic group (P < 0.05), and the recovery rate of the combined group was higher than that of the basic group (P < 0.01). Conclusion: The clinical effect of traditional Chinese medicine moxibustion and external application combined with electro-acupuncture on KOA is remarkable. 2019 Vol. 25 (6): 1048-1052 [Abstract] ( 89 ) HTML (1 KB)  PDF (1272 KB)  ( 216 )

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