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2019 Vol. 25, No. 1 Published: 2019-01-31 1 Curative Efficacy of Levonorgestrel Sustained Release System Combined with Triptorelin in Treatment of Adenomyosis of the Uterus and its Effect on Serum CA125 CA199 and HE4 FENG Huaping, ZHAO Shaojie, TANG Yan DOI: 10.3969/j.issn.1006-6233.2019.01.001 Objective: To investigate the efficacy of levonorgestrel sustained-release system combined with triptorelin in the treatment of adenomyosis and its effects on serum carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199) and human epididymal protein 4 (HE4). Methods: 88 patients with adenomyosis in our hospital were selected as the study subjects from April 2015 to April 2017, the randomized table method was used to divide the treatment group into the observation group (n=40) and the control group (n=48). The control group was treated with levonorgestrel sustained release system, and the observation group was treated with levonorgestrel sustained release system combined with triptorelin. The therapeutic effect and serum CA125, CA199 and HE4 levels, uterine volume, dysmenorrhea score, menstrual volume score and adverse reactions were compared between the two groups after treatment. Results: After treatment, the rate of annulus removal and irregular vaginal bleeding in the observation group were lower than those in the control group (P<0.05), and the relief of dysmenorrhea and the improvement of menstruation were higher than those in the control group (P<0.05). There was no significant difference in serum CA125, CA199 and HE4 levels between the two groups before treatment. After treatment, serum CA125, CA199 and HE4 levels of both groups decreased significantly, and serum CA125, CA199 and HE4 levels of the observation group were significantly lower than those of the control group (P<0.05). There was no significant difference in uterine volume, dysmenorrhea score and menstrual volume score between the two groups before treatment. After treatment, the uterine volume, dysmenorrhea score and menses score of the two groups decreased significantly, and the uterine volume, dysmenorrhea score and menses score of the observation group were significantly lower than those of the control group (P<0.05). The total incidence of adverse reactions in the observation group was 10.00%, significantly lower than the control group's 35.42% (P<0.05). Conclusion: In patients with adenomyosis, the use of levonorgestrel sustained release system combined with triptorelin has a significant effect, which can effectively improve the serum CA125, CA199 and HE4 levels of patients, and is worthy of promotion and application. 2019 Vol. 25 (1): 1-4 [Abstract] ( 142 ) HTML (1 KB)  PDF (1212 KB)  ( 323 ) 5 Two Kinds of Anesthesia Methods on the Postoperative Cognitive Function of Elderly Patients with Laparoscopy LI Guanjun DOI: 10.3969/j.issn.1006-6233.2019.01.002 Objectives: To study and analyze the effect of different anesthetic compatibility on cognitive function of elderly patients undergoing laparoscopic cholecystectomy. Methods: 60 elderly patients undergoing laparoscopic cholecystectomy from March 2015 to March 2017 in our hospital were selected as study objects. According to the random number method, the observation group was divided into observation group and control group, and the observation group was anesthetized with dexmetoimidine-remifentanil sevoflurane. The control group was anesthetized with midazolam-fentanyl-isoflurane. The recovery time of spontaneous respiration, the recovery of directional force, the time of eye opening and the time of tracheal extubation were compared between the two groups. MMSE through the Mini-Psychiatric scale cognitive function was evaluated and compared before and after anesthesia. Results: The observation group and the control group received MAP in different time after anesthesia, no significant differences in HR and BIS (P>0.05). The observation group orientation recovery time and recovery time of spontaneous breathing was significantly shorter than the control group. There was significant difference between the groups (t=4.977,3.377, P<0.05). The observation group patients in the postoperative 2h and MMSE were 12h total scores were (24.95 + 1.49)% and (26.95 + 2.49)%, significantly higher than those of control group (20.6 + 1.6)% and (22.45+1.45), group The difference was statistically significant (P<0.005). Conclusion: The clinical effect of dexmedetomidine-remifentanil-sevoflurane combined anesthesia in elderly patients undergoing laparoscopic cholecystectomy is obvious, and the cognitive function recovers well after operation. 2019 Vol. 25 (1): 5-8 [Abstract] ( 93 ) HTML (1 KB)  PDF (1208 KB)  ( 246 ) 9 Therapeutic Effect of three Surgical Schemes on Cholecystolithiasis with Choledocholithiasis and its Influence on Serum GGT and ALP HAO Yuqing, JIANG Xuwei, et al DOI: 10.3969/j.issn.1006-6233.2019.01.003 Objective: To analyze the curative effect of three surgical schemes for cholecystolithiasis with common bile duct stones and their effects on serum alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT). Methods: 115 cases of cholecystolithiasis and choledocholithiasis treated in our hospital from February 2015 to March 2017 were analyzed and divided into 3 groups according to different operative methods, among them, 31 patients were treated with laparoscopic cholecystectomy (LC) combined with choledochoscopy common bile duct exploration (LCBDE), named group A; 45 cases were treated with LC combined with endoscopic retrograde cholangiopancreatography (ERCP), named group B; 39 cases were treated with traditional open cholecystectomy choledochal exploration (CBDE), named group C. The operation index, postoperative complications, and the changes of serum GGT and ALT levels of patients in 3 groups before and after operation, and the effect of operation were observed. Results: The operative time, intraoperative blood loss, postoperative fasting time, postoperative exhaust time and length of stay in group A and group B were significantly lower than those in group C (P<0.05); the intraoperative blood loss and postoperative exhaust time in group A were approximately equal to those in group B (P>0.05). The incidence of complications in group C was significantly higher than that in group A and group B (P<0.05), and the difference between group A and group B was not statistically significant (P>0.05). There was no significant difference in GGT and ALP between the three groups of A, B and C before operation (P>0.05); the levels of GGT and ALP in group A and group B were significantly lower than those in group C (P<0.05), and GGT and ALP levels in group A were significantly lower than those in group B (P<0.05). The success rate of operation in group A and group B was significantly higher than that in group C (P<0.05), and the stones recurrence rate in group A and group B was significantly lower than that in group C (P>0.05); the success rate of operation in group A was significantly higher than that in group B (P>0.05), the stone recurrence rate in group A was significantly lower than that in group B (P>0.05), and group B and group C had one case of residual stones respectively , and recovered after repeated ERCP and choledochoscopy. Conclusion: Compared with traditional open surgery, minimally invasive combined operation has obvious advantages in treating cholecystolithiasis and choledocholithiasis, all the indexes of LC+LCBDE operation are better than that of LC+ERCP, the success rate of operation is high, the incidence rate of postoperative complications, the stones residual rate and the stones recurrence rate are relatively low, which can be considered as the main operation for the treatment of cholecystolithiasis and choledocholithiasis. 2019 Vol. 25 (1): 9-13 [Abstract] ( 105 ) HTML (1 KB)  PDF (1222 KB)  ( 257 ) 14 Effects of Callispheres Loadable Embolic Microspheres combined with Docetaxel TACE on bFGF VEGF and MVD in Patients with Primary Hepatocellular Carcinoma DUAN Bin, LUO Chengjing, LUO Haiyang DOI: 10.3969/j.issn.1006-6233.2019.01.004 Objective: To investigate the influences of callispheres drug carrying embolic microspheres combined with docetaxel transcatheter arterial chemoembolization (TACE) on basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and microvascular density (MVD) in patients with primary liver cancer. Methods: 84 cases of patients with primary liver cancer treated in our hospital from June 2013 to October 2017 were selected as the research subjects and were randomly divided into the observation group (n=42) and the control group (n=42). The control group was treated with Docetaxel Lipiodol Suspension TACE, and the observation group was treated with callispheres drug carrying embolic microspheres on the basis of the control group. The short-term curative effect, the change of liver function index, the occurrence of adverse reactions and the expressions of bFGF, VEGF and MVD were compared between the two groups. Results: The effective rate and disease control rate in the observation group were higher than those in the control group (P<0.05); The serum levels of aspartate aminotransferase (ASL), glutamate aminotransferase (ALT) and total bilirubin (TBIL) in the two groups were slightly higher than those before treatment, the level of albumin (ALB) was slightly lower than before treatment,but there was no significant difference between the two groups (P>0.05); The incidence of adverse reactions such as fever, abdominal pain, nausea, vomiting and so on in the observation group were slightly lower than those in the control group,but there was no significant difference between the two groups (P>0.05); 1 month after treatment, the VEGF and MVD values in the control group did not change significantly compared with those before treatment (P>0.05), the bFGF levels of the two groups were lower than those before the treatment (P<0.05), there were statistically significant differences in bFGF, VEGF and MVD between groups (P<0.05). Conclusion: Callispheres drug carrying embolic microspheres combined with docetaxel TACE in the treatment of patients with primary liver cancer can obtain good short-term curative effect, the security is relatively high, and can inhibit the expressions of bFGF, VEGF and MVD to a certain extent. 2019 Vol. 25 (1): 14-17 [Abstract] ( 93 ) HTML (1 KB)  PDF (1217 KB)  ( 308 ) 18 Effects of Premixed Insulin Combined with Metformin on Islet function Recovery in Newly Diagnosed Type 2 Diabetes Mellitus LIU Jia, CUI Xuhong, WANG Liyan, et al DOI: 10.3969/j.issn.1006-6233.2019.01.005 Objective: To analyze the effect of premixed insulin combined with metformin on islet function recovery in newly diagnosed type 2 diabetes mellitus. Methods: 90 patients with newly diagnosed type 2 diabetes who according to simple random number table method were divided into 48 control group and 42 research group. The control group was treated with metformin, and the research group was treated with premixed insulin based on the control group. Then blood glucose compliance time, blood glucose metabolism indicators, islet function, liver and kidney function before and after treatment after 8 weeks and 12 weeks after treatment, and adverse reaction in both group were compared. Results: blood glucose compliance time of research group was higher than that in the control group (7.41±1.02) and (11.78±1.90) days (P<0.05). After 8 weeks and 12 weeks treatment, the blood glucose metabolism indexes in both groups was decreased, and the research group was lower than the control group (P<0.05). The fasting insulin (FINS), insulin resistance index (HOMA-IR) in research group were lower than the control group, while the islet beta cell function (HOMA-β) was higher than the control group, there was a statistically significant difference (P<0.05). liver and kidney function before and after treatment in both group was no statistically significant difference (P>0.05). Both groups had hypoglycemia and gastrointestinal reactions, the incidence of total adverse reactions in both groups was no statistically significant difference (P>0.05). Conclusion: Insulin pretreatment combined with metformin is effective and safe for the new diagnosis of type 2 diabetes, which can effectively control blood glucose and promote the recovery of insulin function. 2019 Vol. 25 (1): 18-21 [Abstract] ( 102 ) HTML (1 KB)  PDF (1211 KB)  ( 250 ) 22 Study on the Relationship between Serum IL-1β IL-6 IL-8 and the Pain of Patient with Acute Gouty Arthritis LIANG Hui, ZHANG Yitong, XIE Jihui, et al DOI: 10.3969/j.issn.1006-6233.2019.01.006 Objective: To study the relationship between the expression of serum IL-1β,IL-6 and IL-8 and pain in patients with acute gouty arthritis(AGA). Methods: 60 patients with AGA in Shijiazhuang Hospital of Traditional Chinese Medicine from March 2017 to June 2018 were selected as observation group, 30 healthy persons at the same time were selected as control group, then serum IL-1β,IL-6 and IL-8 of two groups were detected and compared, and the detection levels of observation group with different pain index were compared, then the relationship between serum IL-1β,IL-6 and IL-8 and the pain degree of patients were analyzed by Pearson correlation analysis. Results: The serum IL-1β,IL-6 and IL-8 of observation group were all significantly higher than those of control group, and there was a positive correlation between the degree of pain and the level of serum IL-1β,IL-6,IL-8 in observation group by Pearson correlation analysis, the difference was statistically significant(P<0.05). Conclusions: Serum IL-1β,IL-6 and IL-8 was positively correlated with pain in patients with acute gouty arthritis, and had high clinical value in acute gouty arthritis. 2019 Vol. 25 (1): 22-24 [Abstract] ( 89 ) HTML (1 KB)  PDF (1204 KB)  ( 271 ) 25 Curative Efficacy of Nimodipine combined with Latanoprost in Treatment of Primary Open-angle Glaucoma and Effects on the Aqueous Humor EPO ET-1 sCD44 Level LIU Shuang, KONG Fanhong, et al DOI: 10.3969/j.issn.1006-6233.2019.01.007 Objective: To study the curative efficacy of nimodipine combined with latanoprost in treatment of primary open-angle glaucoma and effects on the aqueous humor erythropoietin(EPO), endothelin-1(ET-1), soluble CD44(sCD44) levels. Methods: 91 patients of primary open-angle glaucoma who received therapy from June 2015 to June 2017 in our hospital were selected as research objects, according to the random number table, those patients were divided into the 46 cases of observation group and the 45 cases of control group. The control group was treated with latanoprost, while the observation group was treated with nimodipine on the basis of the control group, they were continuous treatment for 6 months. The clinical efficacy, the changes of visual related index, optic disc sieve plate blood flow, aqueous humor EPO, ET-1, sCD44 levels and adverse reactions were compared between the two groups. Results: After treatment, the total effective rate of the observation group was 93.48% (43/46), which was significantly higher than that of the control group 77.78% (35/45) (P<0.05). The intraocular pressure and visual field defect in the observation group were significantly lower than that of the control group [(16.57±1.54)mmHg vs(18.72±1.85)mmHg,(9.21±1.10)dB vs(11.37±1.20)dB], the retinal light sensitivity and visual acuity were significantly higher than that of the control group[(18.74±2.30)dB vs(16.89±2.03)dB,(0.76±0.12)vs(0.71±0.09)](P<0.05). In the optic disc sieve plate blood flow, the blood flow velocity, blood flow and erythrocyte mobility in the observation group were significantly higher than that of the control group [(188.42±20.56)mm/s vs(167.34±17.57)mm/s,(15.68±1.62)L/min vs(12.73±1.50)L/min,(1.04±0.15)vs(0.83±0.10)](P<0.05); and the aqueous humor EPO, ET-1, sCD44 levels in the observation group were significantly lower than that of the control group [(7.05±1.17)mU/ml vs (8.49±1.45)mU/ml,(43.72±4.59)ng/L vs(51.04±5.64)ng/L,(13.40±1.39)ng/ml vs(18.15±1.70)ng/ml](P<0.05). During the treatment, the incidence of adverse reactions in the two groups was 10.87% (5/46) and 8.89% (4/45) respectively, and the difference was not statistically significant (P>0.05). Conclusion: The effect of nimodipine combined with latanoprostaglandin in patients with primary open angle glaucoma is remarkable. Its intrinsic mechanism may be related to the reduction of EPO, ET-1 and sCD44 expression in aqueous humor. Moreover, the safety of nimodipine combined with latanoprostaglandin is high, and it is worth popularizing. 2019 Vol. 25 (1): 25-29 [Abstract] ( 134 ) HTML (1 KB)  PDF (1220 KB)  ( 299 ) 30 Montelukast Sodium in the Treatment of Children with Acute Attack of Bronchial Asthma and the effect on the CD4+ CD8+ and CD4+/CD8+ Levels CHEN Liang, LIN Yuantao, ZHOU Hongyu DOI: 10.3969/j.issn.1006-6233.2019.01.008 Objective: To explore the clinical effect of montelukast sodium in children with acute attack of bronchial asthma and its influence on CD4+, CD8+ and CD4+/CD8+ levels. Methods: 76 children with acute attack of bronchial asthma in our hospital from June 2015 to June 2018 were selected and randomly divided into observation group and control group, 38 cases in each group. The control group was treated with routine oxygen inhalation and fluid replacement, while the observation group was treated with montelukast sodium. The levels of CD4+, CD8+, CD4+/CD8+, forced vital capacity (FVC), peak expiratory flow (PEF), forced expiratory volume (FEV1), changes of symptom score and improvement time of symptoms were compared between the two groups before and after treatment. Results:After treatment, the levels of CD4+, CD4+ /CD8+ in the immune function of the observation group were significantly higher than those of the control group [(39.25±7.15)% vs (32.87±6.38)%, (1.89±0.53) vs (1.37±0.54)] (P<0.05), and the level of CD8+ was significantly lower than that of the control group [(25.06±8.04)% vs (30.54±6.26)%] (P<0.05); The FVC, PEF and FEV1 in the observation group were higher than those in the control group [(79.24±7.11)% vs (68.48±5.26)%,(1.40±0.44)L/s vs (1.17±0.34)L/s, (76.55±3.55)% vs (65.85±3.46)%] (P<0.05); The symptom relief, time and signs disappeared in the observation group, all lower than those in the control group [(3.34±0.75)d vs (5.64±1.05)d, (5.22±1.17)d vs (7.62±1.55)d] (P<0.05); The daily symptom score and night symptom score of the observation group were lower than that of the control group [(1.12±0.45) score vs (1.63±0.58) score, (1.16±0.46) score vs (2.03±0.75) score] (P<0.05). Conclusion:On the basis of routine treatment for children with acute attack of bronchial asthma, montelukast sodium treatment can effectively improve the immune function and lung function of children, shorten the treatment time, and have a significant effect. 2019 Vol. 25 (1): 30-33 [Abstract] ( 116 ) HTML (1 KB)  PDF (1210 KB)  ( 219 ) 34 Prognostic Value of Lactic Acid in Patients with Malignant Tumors after Surgical Infection SHAO Lina, et al DOI: 10.3969/j.issn.1006-6233.2019.01.009 Objective: To evaluate the prognostic value of lactic acid in patients with malignant tumors after surgical infection. Methods: The clinical data of 83 patients with infection and septic shock after operation of malignant tumors admitted from January 2014 to December 2016 were retrospectively analyzed. According to the outcome of 28 days treatment, the patients were divided into survival group (47 cases) and death group (36 cases). The differences of initial lactate level, lactate clearance rate and acute physiology and chronic health score II (APACHE II) between the two groups were compared. The patients were divided into four groups according to the initial lactate level (initial lactate level < 2 mmoL/L, 2~4 mmoL/L, 4~10 mmoL/L and ≥10 mmoL/L). The prognosis of patients with different initial lactate levels was compared and the prognostic evaluation value of lactate in patients with malignant tumors after infection was evaluated. Results: The initial lactate level, the rechecked lactate level and the lactate clearance rate of survival group and death group were (2.54 ±1.69), 3.62±3.17), (1.78 ±1.43), 2.70±2.69), (24.02±32.79), 11.31±54.71), respectively. The P values of both groups were <0.05, with significant difference. The mortality rates were 35.48%, 43.33%, 50% and 100% when the lactate level was less than 2 mmoL/L, 2~4 mmoL/L, 4~10 mmoL/L and more than 10 mmoL/L, respectively. Conclusion: Initial serum lactate can be used to assess the severity of the postoperative - infection patients with tumor. The higher of the initial Serum lactate level,the more serious of the disease, and the worse prognosis of the patients. And the higher of the reviewal lactate clearance rate, the lower mortality of the patients. lactate monitoring can be used to evaluate the prognosis of postoperative - infection patients with tumor. 2019 Vol. 25 (1): 34-36 [Abstract] ( 121 ) HTML (1 KB)  PDF (1200 KB)  ( 208 ) 37 Effect of Butylphthalide on Serum MMP-9 IMA PPAR Gamma and Hemorrhagic Transformation in Patients with Acute Cerebral Infarction after Thrombolytic Therapy SUN Zhanfeng, YUAN Ying, ZHANG Jinlong, et al DOI: 10.3969/j.issn.1006-6233.2019.01.010 Objective: To investigate the effects of butylphthalide on serum matrix metalloproteinase-9 (MMP-9), ischemic modified albumin (IMA), peroxisome proliferator-activated receptor subtype-gamma (PPAR-gamma) and hemorrhagic transformation in patients with acute cerebral infarction after thrombolysis. Methods: 85 patients with acute cerebral infarction thrombolytic therapy in our hospital from June 2015 to June 2017 were selected as the study subjects. According to the random number table all the subjects were divided into observation group (n=45) and control group (n=40). The control group was treated with aitong thrombolytic therapy alone, and the observation group was treated with butylphthalide combined with aitong thrombolytic therapy. The clinical efficacy, serum mmp-9, IMA, PPAR renewal, haemorrhagic transformation, NIHSS score, modified Barthel index rating scale (MBI), neuron-specific enolase (NSE), S100B protein and glial fibrinolytic acid protein (GFAP) levels and complications of the two groups were compared. Results: After treatment, the total effective rate of the observation group was 93.33% higher than the control group's 75.00% (P<0.05). There was no significant difference in the levels of serum mp-9, IMA and PPAR prior to treatment between the two groups. After treatment, serum mmp-9 and IMA levels in both groups increased significantly, and serum PPAR tests in the observation group decreased significantly. Serum mp-9 and PPAR tests in the observation group were significantly lower than those in the control group, and IMA levels were significantly higher than those in the control group (P<0.05). The total incidence of hemorrhage transformation in the observation group was 8.89%, significantly lower than that in the control group (P<0.05). There was no significant difference in NIHSS and MBI scores between the two groups before treatment. After treatment, the NIHSS scores of the two groups decreased significantly, and the MBI scores increased significantly. Moreover, the NIHSS scores of the observation group were significantly lower than those of the control group, and the MBI scores were significantly higher than those of the control group (P<0.05). There was no significant difference in NSE, S100B and GFAP levels between the two groups before treatment. After treatment, the levels of NSE, S100B and GFAP in both groups decreased significantly, and the levels of NSE, S100B and GFAP in the observation group were significantly lower than those in the control group (P<0.05). The total complications in the observation group were 4.44%, significantly lower than the control group's 32.50% (P<0.05). Conclusion: The use of butylphthalide in patients with acute cerebral infarction with thrombolytic therapy has significant effects, and can improve the serum mmp-9, IMA, PPAR, and hemorrhagic transformation of patients. Therefore, it is worthy of clinical promotion. 2019 Vol. 25 (1): 37-41 [Abstract] ( 90 ) HTML (1 KB)  PDF (1234 KB)  ( 193 ) 42 Preventive Effect of Double Staining of P16/Ki67 on Cervical Lesions in Patients with HPV16 and HPV18 Positive and TCT Negative TIAN Qiaoxian, XIA Shuhua, WU Yahua DOI: 10.3969/j.issn.1006-6233.2019.01.011 Objective: To explore the feasibility of p16/ cell proliferating nuclear antigen (Ki67) double staining test for cervical disease screening in TCT negative combined HPV16 and HPV18 positive patients. Methods: A total of 100 patients with negative TCT results but positive HPV16 and HPV18 tests were collected from March 2016 to January 2018. Both p16/Ki67 double staining and colposcopic pathological biopsy were performed within 6 weeks after TCT. The sensitivity and specificity of p16/Ki67 double staining for screening cervical lesions were analyzed based on the gold standard of biopsy results. Results: Pathological biopsy showed cervical intraepithelial neoplasia over grade 2 (CIN2+) were 39 cases (39.00%), including 1 case of cervical adenocarcinoma (1.00%), 21 cases of CIN3 (21.00%), 17 cases of CIN2 (17.00%). The result of pathological biopsy was as the gold standard, the sensitivity of p16/Ki67 double staining test for screening CIN2+ cervical lesions was 89.74%, the specificity was 96.72%, the positive predictive value was 94.59%, the negative predictive value was 93.65%. Conclusion: P16/Ki67 double staining test has high sensitivity and specificity for screening CIN2+ cervical lesions, it can be used for early screening of cervical lesions, and has a certain early warning effect. 2019 Vol. 25 (1): 42-44 [Abstract] ( 232 ) HTML (1 KB)  PDF (1379 KB)  ( 841 ) 45 Effect of Dexmedetomidine combined with Lornoxicam on Restlessness and Stress Response after Total Hip Arthroplasty WANG Yeqing DOI: 10.3969/j.issn.1006-6233.2019.01.012 Objective: To study Effect of dexmedetomidine combined with lornoxicam on restlessness and stress response after total hip arthroplasty. Methods: 100 patients undergoing total hip arthroplasty who received therapy from June 2017 to May 2018 in our hospital were selected as research objects. According to simple random number table, those patients were divided into the observation group (n=48) and the control group (n=52). The control group was treated with dexmedetomidine, while the observation group was treated with dexmedetomidine combined with lornoxicam. Then the VAS score, Harris hip score, stress response level (Cor, E, NE) and incidence of adverse reactions of two groups before and after treatment were compared. Results: The postoperative 12h, postoperative 24h, postoperative 36h and postoperative 72hVAS scores in the observation group were significantly lower than those in the control group(P<0.05). Postoperative 7d and postoperative 14d harris hip score were significantly higher than those of the control group(P<0.05). Postoperative 12h, postoperative 24h, postoperative 36h, postoperative 72hCor, E and NE levels were significantly lower than those in the control group(P<0.05). Incidence of adverse reactions were significantly lower than those in the control group [12.50%(6/48)vs 30.76%(16/52)](P<0.05). Conclusion: The sedative and analgesic effects of dexmedetomidine combined with lornoxicam in adjuvant patients undergoing total hip artroplasty are remarkable. It can stabilize hemodynamics, reduce stress response, reduce the incidence of post-restlessness, relieve the pain of patients, and is conducive to postoperative recovery. 2019 Vol. 25 (1): 45-49 [Abstract] ( 124 ) HTML (1 KB)  PDF (1214 KB)  ( 296 ) 50 Clinical Efficacy of Menorrine combined with Small Dose Mifepristone in treatment of Adenomyosis Patients and its Influences on Nerve Growth Factor Soluble CD147 Vascular Endothelial Growth Factor WU Xiaohong, et al DOI: 10.3969/j.issn.1006-6233.2019.01.013 Objective: To discuss the clinical efficacy of menorrine combined with small dose mifepristone in treatment adenomyosis patients and its influences on nerve growth factor (NGF), soluble CD147 (sCD147), vascular endothelial growth factor (VEGF) . Methods: 92 patients with adenomyosis who received therapy from April 2015 to April 2017 in our hospital were treated, according to simple random number table method, those patients were divided into control group and the research group, with 46 cases in each group. The control group was treated with mirena, and the research group was treated with low-dose mifepristone based on the control group. Then clinical outcomes, menstrual volume, menstrual pain score, endometrial thickness, uterine volume, serum NGF, sCD147, VEGF before treatment, 2 months, 4 months after treatment, and adverse reactions occurred between two group was compared. Results: Total effective rate in research group was higher than that the control group, and the difference was statistically significant (P<0.05). After treatment 2 months, 4 months, menstrual quantity, menstrual pain score, endometrial thickness, uterine volume, in both group was decreased, the research group was lower than the control group(P<0.05).serum levels of NGF, sCD147, VEGF in both group were decreased, the research group was lower than the control group, and the difference was statistically significant (P<0.05). The adverse reactions between the two groups was no difference (P>0.05). Conclusion: Manyuela combined with low-dose mifepristone in the treatment of adenomyosis has a definite effect. It can effectively improve the clinical symptoms and reduce the levels of serum NGF, Scd147 and VEGF. It can be used as an optimal treatment for adenomyosis. 2019 Vol. 25 (1): 50-53 [Abstract] ( 118 ) HTML (1 KB)  PDF (1209 KB)  ( 237 ) 54 Therapeutic Effect of Cyclophosphamide Combined with Low dose Hormone on Membranous Nephropathy and Analysis of Serum PLA2R 25 (OH) D3 and NGAL Levels WU Gang, WANG Liping, ZHAO Chengzhi, et al DOI: 10.3969/j.issn.1006-6233.2019.01.014 Objective: To analyze the efficacy of cyclophosphamide combined with low-dose hormone in the treatment of membranous nephropathy and the level of serum phospholipase A2 receptor (PLA2R), 25-dihydroxyvitamin D3 (25 (OH)D3), neutrophil gelatinase-associated lipocalin (NGAL) changes. Methods: Eighty-seven patients with membranous nephropathy admitted to our hospital from April 2015 to March 2018 were enrolled, they were divided into the observation group (42 cases) and the control group (45 cases) according to simple random grouping method. The control group was treated with cyclophosphamide, and the observation group was treated with small doses of hormone on the basis of control group. The clinical efficacy, 24h urine protein quantitation, serum total cholesterol, serum creatinine, serum albumin, serum PLA2R, 25(OH)D3, NGAL levels of the two groups was compared. Results: After treatment, the total clinical effective rate of the observation group was significantly higher than that of the control group (P<0.05). Before treatment, there was no significant difference in 24h urine protein quantitation, serum total cholesterol, serum creatinine and serum albumin between the two groups (P>0.05). After 1 month, 3 months and 6 months of treatment, the two groups of patients with 24h urine protein quantification showed a decreasing trend (P<0.05), but the observation group were always lower than the control group (P<0.05), serum albumin showed a increasing trend (P<0.05), and the observation group were always higher than the control group (P<0.05). There were significant differences in 24h urine protein quantitation and serum albumin between groups, at different time points, between groups, and at different time points (P<0.05). After the 1 month, 3 months, 6 months treatment, serum total cholesterol and serum creatinine showed a downward trend (P<0.05), but there was no significant difference between the two groups (P>0.05). Before treatment, there was no significant difference in serum levels of PLA2R, 25(OH)D3 and NGAL between the two groups (P>0.05). After 1 month, 3 months and 6 months of treatment, the levels of serum PLA2R and NGAL decreased. (P<0.05), the observation group was always lower than the control group (P<0.05), the serum 25(OH)D3 level of the two groups showed an increasing trend (P<0.05), and the observation group was always higher than the control group (P<0.05). There were significant differences in the interaction between the two groups at different time points, between groups, and at different time points (P<0.05). There was no significant difference in the adverse reaction rate between the observation group and the control group (P>0.05). Conclusion: Cyclophosphamide combined with low-dose hormones can effectively reduce the level of PLA2R and NGAL, increase the level of serum 25 (OH) D3 and improve the clinical symptoms of patients with membranous nephropathy. The clinical efficacy is good and the safety is high. 2019 Vol. 25 (1): 54-58 [Abstract] ( 94 ) HTML (1 KB)  PDF (1219 KB)  ( 258 ) 59 Effect of Azithromycin combined with Siqikang Injection on Bronchitis Asthma and the Influences on MDSCs IgE and Eotaxin XIA kui, et al DOI: 10.3969/j.issn.1006-6233.2019.01.015 Objective: To study the effect of Azithromycin combined with Skikang injection on bronchial asthma and its effects on Myeloid-derived suppressor cells (MDSCs), serum immunoglobulin E IgE and eosinophil activated chemotactic factor Eotaxin. Methods: 102 patients of Bronchitis asthma who received therapy from March 2017 to April 2018 in our hospital were selected as research objects. According to simplerandom number table, those patients were divided into the observation group (n=42) and the control group (n=38). The control group was treated with Skikang injection, while the observation group was treated with azithromycin on the basis of the control group. The curative effect, disappearance time of clinical symptoms, pulmonary function indexes (forced expiratory volume in one second, maximum expiratory volume in the first second, percentage of forced expiratory volume in the first second, MDSCs, IgE and Eotaxin levels) were observed before and after treatment. Results: After treatment, the total effective rate of observation group was statistically higher than that in the control group [95.23%(40/42)vs 73.68%(28/38)] (P<0.05); The time of disappearance of clinical symptoms was significantly lower than that of the control group [(2.98±0.87)d vs (6.90±1.32)d,(2.07±0.60)d vs(5.10±0.90)d,(3.97±1.02)d vs(6.70±1.58)d](P<0.05); FEV1、FEV1/FVC、PEF were higher than those of the control group [(3.02±0.78)L vs(2.47±0.50)L,(88.38±20.47)% vs(79.59±15.38)%, (7.32±1.90)% vs (6.37±1.51)%](P<0.05); The levels of FEV1, FEV1/FVC and PEF were higher than those of the control group [(3.02±0.78)L vs(2.47±0.50)L,(88.38±20.47)% vs(79.59±15.38)%,(7.32±1.90)% vs(6.37±1.51)%](P<0.05); The levels of MDSCs, IgE and Eotaxin were lower than those of the control group [(0.85±0.21)% vs(2.76±0.20)%,(78.19±14.02)% vs (91.45±17.71)%, (0.07±0.02)% vs (0.19±0.04)% ](P<0.05). Conclusion: Azithromycin combined with cichikang injection has a significant effect on bronchitis asthma. It can improve the clinical symptoms, inhibit the release of inflammation and reduce the level of MDSCs, IgE and Eotaxin. It can be used as a reliable method to treat bronchitis. 2019 Vol. 25 (1): 59-62 [Abstract] ( 135 ) HTML (1 KB)  PDF (1200 KB)  ( 284 ) 63 Effect of Somatostatin on Abdominal Infection after Abdominal Surgery and its Influence on Serum AMS YANG Zhigang DOI: 10.3969/j.issn.1006-6233.2019.01.016 Objective: To study effect of somatostatin on abdominal infection after abdominal operation and its influence on serum amylase. Methods: 79 abdominal operations who received therapy from March 2013 to February 2018 in our hospital were selected as research objects. According to simple random number table, those patients were divided into the observation group (n=37) and the control group (n=42). The control group was treated with conventional therapy, while the observation group was on the basis of the control group, somatostatin was used. Then the therapeutic effect, disappearance time of clinical symptoms (nausea and vomiting, abdominal distension and abdominal pain, anal exhaust time), hospitalization time, serum AMS, ascites AMS level, incidence of adverse reactions of two groups after treatment were compared. Results: After treatment, the total effective rate of observation group was statistically higher than that in the control group [94.59% (35/37)vs 66.66%(28/42)](P<0.05); The time of disappearance of clinical symptoms and the time of hospitalization were lower than those of the control group [(1.89±0.70)d vs(4.01±1.21)d, (2.90±0.58)d vs(6.27±1.34)d, (3.76±0.82)d vs (5.80±1.35)d,(4.59±1.02)d vs(7.40±2.15)d](P<0.05); The levels of serum AMS and ascites AMS were significantly lower than those in control group [(142.01±19.42)U/L vs(297.46±26.04)U/L,(124.21±18.47)U/L vs(305.98±31.27)U/L](P<0.05); The total incidence of adverse reactions was lower than that of the control group [8.10%(3/37) vs 28.57%(12/42)](P<0.05). Conclusion: Somatostatin is effective in the treatment of abdominal infection after abdominal surgery. It can effectively improve clinical symptoms, promote postoperative recovery, reduce adverse reactions, and reduce serum AMS. It is safe and reliable. 2019 Vol. 25 (1): 63-65 [Abstract] ( 79 ) HTML (1 KB)  PDF (1195 KB)  ( 232 ) 66 Effect of Ultrasound-guided Lower Limb Nerve Block combined with Dexmedetomidine Continuous Pump on Analgesia, Stress Level and Respiratory Circulation in Elderly Patients Received Hip Replacement YU Fanting DOI: 10.3969/j.issn.1006-6233.2019.01.017 Objective: To explore the effect of continuous ultrasound guided lower limb nerve block combined with dexmedetomidine continuous infusion on pain relief, stress level and respiratory and circulatory function in elderly patients undergoing hip replacement. Methods: A total of 128 patients undergoing unilateral hip arthroplasty from January 2016 to August 2017 were selected as the subjects. According to the random number table method, 128 patients were divided into the observation group and the control group, 64 cases in each group. The observation group was treated with ultrasound guided lumbar plexus and sciatic nerve block combined with dexmedetomidine (DEX) continuous infusion. The control group received general anesthesia combined with DEX intravenous infusion. After operation, the two groups continued intravenous analgesia 48h.The analgesic effect, stress level and respiratory and circulatory function were compared between the two groups. Results: All the patients completed the operation successfully. There was no significant difference in the basic operation between the two groups (P>0.05). The scores of 2, 4, 8, 12, 24 and 48hVAS in the observation group were significantly lower than those in the control group (P<0.05). At the time of TO, there was no difference in Cor level between the two groups (P>0.05), and the Cor level of the two groups decreased at all other times, which was significantly lower in the observation group than in the control group (P<0.05). Two groups of MAP, HR and RR decreased to varying degrees. The levels of MAP and RR in the observation group were significantly higher than those in the control group (P<0.05). HR had no significant difference compared with the control group (P>0.05), and there was no difference in SpO2 between the two groups at different time periods (P>0.05). Conclusion: Ultrasound-guided lower extremity nerve block combined with dexmedetomidine continuous pump has good effect in elderly hip surgery, which can maintain the stability of respiratory and circulatory function, less stress response, good analgesic effect after operation, and effectively reduce the occurrence of adverse reactions after operation. 2019 Vol. 25 (1): 66-69 [Abstract] ( 103 ) HTML (1 KB)  PDF (1214 KB)  ( 222 ) 70 Efficacy of Elemene Injection Assisted Cisplatin in Patients with Non-small Cell Lung Cancer and Influence on the Expression of Mismatched Repair Proteins ZHANG Li, ZHANG Jing, WANG Yuan, et al DOI: 10.3969/j.issn.1006-6233.2019.01.018 Objective: To study the effect of elemene injection assisted cisplatin in patients with non-small cell lung cancer and the effect of mismatch-cleaved repair protein (ERCC1) expression. Methods: 73 patients with postoperative lung cancer admitted to our hospital from June 2013 to February 2016 were randomly divided into observation group (n=40 ) and control group (n=33). The control group received chemotherapy with cisplatin. The observation group was intravenously instilled with elemene injection on the basis of the control group. The clinical treatment effect, long-term survival rate, ERCC1 expression and toxic side effects were observed and compared between the two groups. Results: After treatment, the total effective rate was 80% in the observation group and 72.7% in the control group. There was no significant difference between the two groups (P>0.05). The positive rate of ERCC1 in the observation group was 100% (40/40), the high expression rate was 65% (26/40), the positive rate in the control group was 78.8% (26/33), and the high expression rate was 24.2% (8/33), the positive rate and high expression rate of the two groups were significantly different (P<0.05). Gastrointestinal reactions, myelosuppression, allergic reactions and renal dysfunction were observed in both groups, but the incidence of toxic and side effects in the observation group was significantly lower than that in the control group [(55%), (45%). (2.5%), (20%) vs (84.8%), (75.8%), (9.1), (45.5%)], there were significant differences in toxicity and side effects between the two groups (P<0.05). After 2 years of follow-up, the overall survival rate of the observation group was 37.5%, the median survival time was 19.5 months, and the 1-year survival rate was 67.5%. The overall survival rate of the control group was 18.2%, the median survival time was 9.2 months, and the 1-year survival rate was 42.4%. There was significant difference in survival rate between the two groups (P<0.05). Conclusion: Elemene injection can alleviate the toxicity and side effects of patients with non-small cell lung cancer and improve the therapeutic effect. It can also reduce the drug resistance of cancer cells and increase the expression of mismatch cutting repair protein. 2019 Vol. 25 (1): 70-74 [Abstract] ( 104 ) HTML (1 KB)  PDF (1311 KB)  ( 265 ) 75 Clinical Comparison of Repairing Perforation of Pulp Floor with two kinds of Materials GUO Yan DOI: 10.3969/j.issn.1006-6233.2019.01.019 Objective: To explore the clinical comparison of repairing perforation of medullary floor with two different materials. Methods: 107 teeth were randomly divided into two groups: experimental group (n=56 teeth) and control group (n=51 teeth). MTA and calcium hydroxide were used to repair and supplement the perforation site of pulp floor. The clinical effect was observed one year after restoration. Results: One year after repairing perforation of the floor of the skull chamber with two kinds of materials, the success rate was 78.43% in group A and 94.64% in group B, respectively. The power of group B was higher than that of group A. Conclusion: Under the same conditions, the defect sites of the experimental group and the control group are almost the same. The data show that MTA is more effective than calcium hydroxide in repairing perforation of the medullary floor. It has clinical application value and reference. 2019 Vol. 25 (1): 75-77 [Abstract] ( 149 ) HTML (1 KB)  PDF (1181 KB)  ( 551 ) 78 Efficacy of Ambroxol Hydrochloride Combined with Fiberoptic Bronchoscopy in the Treatment of Elderly Patients with Severe Pneumonia and its Effects on APACHE III Score and Oxygenation Index HE Fang, LIU Meicheng DOI: 10.3969/j.issn.1006-6233.2019.01.020 Objective: To observe the efficacy of ambroxol hydrochloride combined with fiberoptic bronchoscopy in the treatment of elderly patients with severe pneumonia and its effects on acute physiology and chronic health evaluation III (APACHEIII) score and oxygenation index. Methods: A total of 90 elderly patients with severe pneumonia in our hospital were selected and divided into two groups according to the odd and even admission sequence, with 45 cases in each group. Control group was treated with conventional dose of ambroxol hydrochloride combined with vibration sputum elimination, and observation group was treated with high-dose ambroxol hydrochloride combined with fiberoptic bronchoscopy. The inflammatory indexes [C-reactive protein (CRP), white blood cell count (WBC), procalcitonin (PCT)], pulmonary function indexes[1st forced expiratory volume (FEV1), forced vital capacity (FVC), percentage of 1st forced expiratory volume in forced vital capacity (FEV1%)], APACHE III score, oxygenation index, recovery process ( mechanical ventilation duration, ICU stay), multiple organ failure (MOF) during hospitalization and 28d mortality rate were compared between the two groups before and after treatment. Results: The levels of CRP, WBC and PCT in observation group were significantly lower than those in control group after 1w of treatment (P<0.05) while the FEV1, FVC and FEV1% were significantly higher than those in control group (P<0.05). The APACHEIII score in observation group was significantly lower than that in control group (P<0.05) while the oxygenation index was significantly higher than that in control group (P<0.05). The mechanical ventilation duration and ICU stay in observation group were shorter than those in control group (P<0.05), and the incidence rate of MOF during hospitalization and 28d mortality rate were lower than those in control group (P<0.05). Conclusion: Ambroxol hydrochloride combined with fiberoptic bronchoscope sputum aspiration in the treatment of senile severe pneumonia can obtain good curative effect, promote the recovery of pulmonary function, reduce inflammation, improve prognosis and reduce mortality. 2019 Vol. 25 (1): 78-81 [Abstract] ( 122 ) HTML (1 KB)  PDF (1216 KB)  ( 229 ) 82 Curative Efficacy of Anerning Granules combined with Budesonide in treatment of Bronchopneumonia and Effects on Serum IGF- II GM-CSF and sIL-2R levels HOU Xiaoyan, GAO Guangchuan, FENG Qin DOI: 10.3969/j.issn.1006-6233.2019.01.021 Objective: To study the curative efficacy of anerning granules combined with budesonide in treatment of bronchopneumonia and effects on serum insulin-like growth factor(IGF)- II, granulocyte-macrophage colony-stimulating factor(GM-CSF) and Solubility interleukin-2 receptor(sIL-2R) levels. Methods: 90 patients of bronchopneumonia who received therapy from March 2015 to March 2018 in our hospital were selected as research objects, according to the simple random number table, those patients were divided into the 44 cases of the observation group and the 46 cases of the control group, on the basis of routine treatment, the control group was treated with budesonide suspension, while the observation group was treated with anerning granules on the basis of the control group, they were treated continuously for 7 days. The clinical efficacy, the changes of the laboratory indexes, serum levels of IGF-II, GM-CSF, sIL-2R and adverse reactions were compared between the two groups. Results: The total effective rate of the observation group was 93.18%, which was significantly higher than that of the control group 73.91% (P<0.05); there were significant differences in C-reactive protein (CRP), white blood cell count (WBC), serum levels of IGF-II, GM-CSF and sIL-2R between the observation group and the control group after treatment [(1.79±0.30)mg/L vs (5.11±0.31)mg/L,(5.49±1.14)×109/L vs(7.26±1.52)×109/L,(0.39±0.04)ng/ml vs(0.67±0.08)ng/ml,(0.43±0.05)μg/L vs(0.71±0.09)μg/L, (132.83±11.51)pg/ml vs (159.47±14.74)pg/ml](P<0.05). The fever, cough, shortness of breath and lung rales disappeared times in the observation group were significantly shorter than that of the control group [(2.89±0.30)d vs (4.11±0.47)d, (4.05±0.49)d vs(5.29±0.55)d,(3.48±0.37)d vs(4.82±0.48)d,(3.27±0.40)d vs(4.71±0.45)d](P<0.05). There was no obvious adverse reaction in the two groups during treatment. Conclusion: In children with bronchial pneumonia, the use of Anerning Granule combined with budesonide suspension has a significant effect, which can help to reduce the expression of serum IGF-II, GM-CSF, sIL-2R, and promote the recovery of disease. It is safe and worthy of application and promotion. 2019 Vol. 25 (1): 82-85 [Abstract] ( 108 ) HTML (1 KB)  PDF (1216 KB)  ( 399 ) 86 Analysis of the Efficacy and Mechanism of Acetylglutamine Combined with Edaravone in the treatment of Cerebral Infarction LIU Yuan, DAI Taicheng, SHI Peng DOI: 10.3969/j.issn.1006-6233.2019.01.022 Objective: To analyze the efficacy and mechanism of acetylglutamine combined with edaravone in treatment of cerebral infarction. Methods: 400 patients of cerebral infarction who received therapy from February 2017 to February 2018 in our hospital were selected as research objects, according to the simple random number table, those patients were divided into the 210 cases of the observation group and the 190 cases of the control group, on the basis of routine treatment, the control group was treated with edaravone, and the observation group was treated with acetylglutamine on the basis of the control group, continuous treatment of 14d. The clinical efficacy, the changes of serum Galectin-3, NPY, GM-CSF, neurological function (NIHSS score), activity of daily living (Barthel index) and adverse reactions were compared between the two groups. Results: After treatment, the total effective rate of the observation group was 91.43% (192/210), which was significantly higher than that of the control group 84.21% (160/190) (P<0.05). There were significant differences in serum Galectin-3, NPY, GM-CSF, NIHSS score and Barthel index between the observation group and the control group after treatment [(7.89±1.15)μg/L vs(9.65±1.70)μg/L, (51.82±4.57)ng/Lvs(70.51±6.82)ng/L,(0.42±0.05)μg/L vs(0.67±0.09)μg/L,7.08±1.17)scores vs(8.29±1.64)scores,(64.02±8.41)scores vs(57.39±7.23)scores](P<0.05). During treatment, the total incidence of adverse reactions was 6.67% (14/210) and 5.79%(11/190) respectively, there was no significant difference between the two groups(P＞0.05). Conclusion: The use of Acetylglutamide combined with edaravone in patients with cerebral infarction has a significant effect and can promote the recovery of nervous function. Its internal mechanism may be related to the reduction of the expression of serum Galectin-3, NPY and GM-CSF. It has high clinical value. 2019 Vol. 25 (1): 86-89 [Abstract] ( 148 ) HTML (1 KB)  PDF (1216 KB)  ( 332 ) 90 Clinical Efficacy of Nerve Growth Factor Combination with Nimodipine in treatment Neonatal Intracranial Hemorrhage and Influence on Plasma PAF CNP MMP-2 and Nerve Function WU Tingting, HE Qiaofeng DOI: 10.3969/j.issn.1006-6233.2019.01.023 Objective: To investigate Clinical efficacy of nerve growth factor (NGF) combination with nimodipine in treatment neonatal intracranial hemorrhage (ICH) and influence on plasma platelet activating factor (PAF), c-type natriuretic peptide (CNP), matrix metalloproteinase-2 (MMP-2) and nerve function. Methods: 100 children with ICH in Chuxiong Hospital were randomly divided into observation group and control group. The control group was given basic treatment, while the observation group was given mouse nerve growth factor combined with nimodipine on the basis of the above conventional treatment. The clinical efficacy, plasma levels of PAF, CNP, MMP-2, NABA score and bed performance recovery time before and after treatment were compared between the two groups. Results: After treatment, the total effective rate in observation group was significantly better than the control group ( 92.00% vs 72.00%) (P<0.05). Before treatment, levels of plasma PAF, CNP and MMP-2 and NABA score in the both groups were no significant difference (P>0.05). After treatment 7d and 14d, levels of plasma PAF, CNP and mmp-2 in both groups were decreased and NABA scores was increased, with more significant changes in the observation group and statistically significant differences (P<0.05). The clinical performance in the observation group was significantly shorter than the control group (P<0.05). Conclusion: NGF combined with nimodipine in the treatment of ICH can significantly reduce the levels of plasma PAF, CNP and MMP-2, repair nerve injury, shorten the time of nerve repair and improve the prognosis of ICH, and provide relevant reference for the clinical treatment of ICH. 2019 Vol. 25 (1): 90-93 [Abstract] ( 93 ) HTML (1 KB)  PDF (1217 KB)  ( 248 ) 94 Effects of Dexmedetomidine on the Plasma hs-CRP PCT IL-6 TFC levels and Oxygenation of Patients with ARDS Induced by Sepsis ZHENG Chun, et al DOI: 10.3969/j.issn.1006-6233.2019.01.024 Objective: To study the effects of dexmedetomidineon the plasma high sensitive C reactive protein(hs-CRP), procalcitonin(PCT), interleukins(IL-6), thoracic Fluid(TFC) levels and Oxygenation of Patients with ARDS Induced by Sepsis. Methods: A total of 62 ARDS patients with sepsis admitted to intensive care unit from February 2016 to February 2018 were divided into observation group (n =32) and control group (n = 30) by simple random number table method. On the basis of conventional mechanical ventilation, the control group was given midazolam sedative treatment, while the observation group was given dexmedetomidine sedative treatment, they were combined with fentanyl for analgesia. The clinical efficacy and levels of plasma hs-CRP, PCT, IL-6, TFC, oxygenation index and acute physiology and chronic health scoring system II (APACHE II) score before and after treatment and the ICU length of stay, weaning time and fatality ratewere recorded. Results: After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05). The reduction amplitude of the plasma hs-CRP, PCT, IL-6, TFC, APACHE II scores in the observation group were significantly higher than those in the control group (P<0.05), the increase amplitude of the SaO2, PaO2 PaO2/FiO2 were also significantly higher than those of the control group (P<0.05). The ICU length of stay and weaning time of the observation group were significantly shorter than those of the control group, and the mortality was significantly lower than that of the control group (P<0.05). Conclusion: Dexmedetomidine sedation can reduce the levels of hs-CRP, PCT, IL-6 and TFC in plasma of sepsis-induced ARDS patients, alleviate inflammation, improve oxygenation index, shorten ICU hospitalization time and reduce mortality. 2019 Vol. 25 (1): 94-98 [Abstract] ( 132 ) HTML (1 KB)  PDF (1234 KB)  ( 237 ) 99 Effects of CLIC1 on Proliferation, Invasion and MAPK/ERK Pathway of Cobalt Chloride-induced Gastric Cancer Cells WANG Zhiqiang, SUN Peng, GAO Chun, et al DOI: 10.3969/j.issn.1006-6233.2019.01.025 Objective: To study the effects of CLIC1 on the proliferation, invasion and MAPK/ERK pathway of gastric cancer cells induced by cobalt chloride, so as to provide certain ideas for the treatment of diseases. Methods: After cultured gastric cancer cells SGC-7901 in vitro, they were divided into 4 groups, the normal group (group control) and the cobalt chloride treatment group (150um CoCl2 treatment); in the negative transfection group (group si-NC, CoCl2 was treated with 48h and transfected with NC siRNA); CLIC1 interference group (group si-CLIC1, CoCl2 after treatment continued to cultivate 48h, transfected CLIC1siRNA). The cell supernatants were collected, the viability of SGC-7901 cells was detected by MTT; colony formation assay was used to detect colony formation; the scratch test was used to detect the cell transfer ability; transwell cell was used to detect cell migration and invasion; Western blot (WB) was used to detect the expression of MAPK/ERK pathway related proteins. Results: Compared with control group, the inhibition rate, metastasis inhibition rate and E-cadherin protein expression in CoCl2 group and si-NC group increased, the number of colonies, migration and invasion decreased, while the expression of p-ERK1/2, MMP-9 and N-cadherin protein decreased (P<0.05). After inhibiting CLIC1 expression, the inhibition rate, metastasis inhibition rate and E-cadherin protein expression increased further, and the number, migration and invasion of colonies increased. The number and expression of p-ERK1/2, MMP-9 and N-cadherin protein were further decreased (P<0.05). Conclusion: CoCl2 treatment can inhibit the proliferation and invasion of gastric cancer cells, and the inhibition of CLIC1 expression can further inhibit the proliferation and invasion of gastric cancer cells in coordination with CoCl2, which may be related to the inhibition of MAPK/ERK pathway. 2019 Vol. 25 (1): 99-103 [Abstract] ( 86 ) HTML (1 KB)  PDF (2087 KB)  ( 270 ) 104 Clinical Study of Metalloproteinase-9 Combined with Serum Cholesterol in Predicting Early Hematoma Expansion in Cerebral Hemorrhage YUAN Yang, GUO Zheng, LUAN Xinping DOI: 10.3969/j.issn.1006-6233.2019.01.026 Objective: To explore the feasibility of predicting early hematoma enlargement in intracerebral hemorrhage (ICH) with serum cholesterol and matrix metalloproteinase-9 (MMP-9). Methods: From November 2015 to December 2017, all ICH cases in neurosurgery department of our hospital were sorted out and classified. 162 patients who met the exclusion criteria were selected and grouped according to the results of CT examination at admission and 24 hours after admission. There were 114 patients in group A without bleeding and 48 patients in group B with rebleeding. The levels of TC, HDL-C, LDL-C and MMP-9 in serum of all patients in the two groups were compared and analyzed. Results: The serum TC content (6.02±0.53) mmol/L and LDL-C (3.43±0.88) mmol/L were significantly higher in group A than in group B (4.11±0.38) mmol/L and LDL-C. The content was (2.12±0.49) mmol/L (P<0.05); while in Group A, the serum HDL-C (1.01±0.25) mmol/L and MMP-9 (97.6±36.1) mmol/L were significant. There was a statistically significant difference between the two groups in terms of the content of HDL-C (1.98±0.41) mmol/L and MMP-9 (127.6±31.5) mmol/L in the B group (P<0.01). Conclusion: The combination of serum cholesterol (TC, HDL-C, LDL-C) and MMP-9 levels may have a predictive effect on the early hematoma volume changes in ICH, which can provide new ideas for the treatment of early ICH. It is of significance to the prognosis of this disease. 2019 Vol. 25 (1): 104-107 [Abstract] ( 89 ) HTML (1 KB)  PDF (1222 KB)  ( 248 ) 108 Clinical Analysis of the Diagnosis and Treatment of Children's Merkel's Diverticulum by Laparoscopic Single Site Laparoscopy Aerxin·habuding, YAN Jinghao, LI Kai, et al DOI: 10.3969/j.issn.1006-6233.2019.01.027 Objective: To explore the application of transumbilical laparoscopy in the diagnosis and treatment of Meckel’s diverticulum (MD) in children. Methods: The data of 29 cases of Meckel’s diverticulum in children who underwent transumbilical laparoscopic Meckel's diverticulectomy in our hospital from May 2013 to May 2018 were analyzed retrospectively. Of 29 cases, 19 cases complained of intermittent hematochezia (group A), 10 cases were admitted with abdominal pain (group B). Preoperative electronic gastroscopy and fiberoptic colonoscopy were perfected in 19 children with intermittent hematochezia history, but the cause of hematochezia history could not be determined. Preoperative isotope digestive tract scanning was perfected. Eleven children showed high concentration of isotopes in the lower abdomen, and eight children showed no accumulation of isotopes in the digestive tract. Ten children who complained of abdominal pain were admitted to hospital. No Meckel's diverticulum was detected by B-mode ultrasound before operation. Result: All the children recovered well after operation. Follow-up for 3 months showed that there was no hematochezia in group A and no abdominal pain in group B. Conclusion: In the diagnosis and treatment of Meckel's diverticulum in children, transumbilical single-site laparoscopy has the advantages of scarless, less trauma, and has a certain clinical value. 2019 Vol. 25 (1): 108-110 [Abstract] ( 100 ) HTML (1 KB)  PDF (1202 KB)  ( 134 ) 111 Relationship between Homocysteine Level and Insulin Resistance in Patients with Type 2 Diabetic Nephropathy CHEN Lu, et al DOI: 10.3969/j.issn.1006-6233.2019.01.028 Objective: To investigate the relationship between homocysteine level and insulin resistance in patients with diabetic nephropathy and to provide evidence for early clinical evaluation of insulin resistance in patients with diabetic nephropathy. Methods: A total of 128 patients with diabetes admitted to the hospital between January 2017 and June 2017 were divided into simple type 2 diabetes group(set to A group), microal-buminuria group (set to B group), and macro-albuminuria group(set to C group) according to the results of urinary albumin excretion rat(UAER). Equilibrium between groups and The difference was not statistically significant. The three groups were collected and analyzed for blood homocysteine(Hcy), triglyceride(TG), total cholesterol(TC), urea nitrogen(BUN), creatinine(CR),glycosylated hemoglobin(HbA1c), fasting plasma glucose(FPG)and general indicators. Results: In addition to FPG no difference, the other indicators (Hcy, TG, TC, BUN, CR, HbA1c and FPG) in the three groups were group A < group B < group C and were positively correlated with insulin resistance. Group A Hcy and HOMA-IR (R=0.530, P=0.003), group B Hcy and HOMA-IR (R=0.645, P<0.001), group C Hcy and HOMA-IR (R=0.734, P<0.001). Conclusions: With the development of diabetic nephropathy, the levels of Hcy and HOMA-IR is increasing, and there is a correlation between Hcy and HOMA-IR. 2019 Vol. 25 (1): 111-114 [Abstract] ( 148 ) HTML (1 KB)  PDF (1216 KB)  ( 322 ) 115 Evaluation of Rational Use of Antibiotics in Perioperative Period of Class I Incision Surgery in Our Hospital YAN Jiang, XU Fei, WANG Ping, et al DOI: 10.3969/j.issn.1006-6233.2019.01.029 Objective: To investigate the status of rationality in perioperative use of antibacterials in patients undergoing type Ⅰ incision operation in a hospital, and to discuss the ways to improve the rational use of antibiotics during the perioperative period. Methods: The perioperative data of 1,023 patients undergoing type Ⅰ incision operation in our hospital from December 2016 to December 2017 were retrospectively analyzed. The preventive medication and rational administration were analyzed. Results: In the perioperative period of type I incision, 436 patients (42.62%) were treated with antibacterial drugs, and the preventive use rate of neurosurgical antibiotics was 93.25%, which was higher than other departments. In the selection of antibacterial drugs, the use rate of etimicin was the highest, accounting for 16.81%, followed by cefamandole and piperacillin and sulbactam, accounting for 16.23% and 11.63%, respectively; The timing of drug administration in 387 cases was 0.5 to 2 hours before operation, accounting for 88.76%. In 219 cases, the course of treatment with antimicrobial agents was <24 hours, accounting for 50.22%; The reasonable rates of indications for drug use, variety selection, timing of administration, dosage, administration route, drug type, dosing duration, and combination use were 73.85%, 16.28%, 88.76%, 73.62%, 98.17%, and 86.93%, respectively. 50.22%, 97.48%. Conclusion: In our hospital, the use rate of antibiotics for patients undergoing type Ⅰ incision operation is high, but the reasonable rate is low, moreover, the reasonable rate of selection and administration of the drug is particularly low, so the management of antibacterial drugs and the rationalization of the use of antibacterial drugs during the perioperative period of physicians should be strengthened. 2019 Vol. 25 (1): 115-118 [Abstract] ( 72 ) HTML (1 KB)  PDF (1208 KB)  ( 249 ) 119 Application of Unilateral and Bilateral Percutaneous Vertebroplasty in the Treatment of Elderly Patients with Lumbar Vertebral Compression Fractures DONG Bozan, JIANG Dianming DOI: 10.3969/j.issn.1006-6233.2019.01.030 Objective: To evaluate the clinical effects of single and bilateral percutaneous vertebroplasty (PVP) in the treatment of senile vertebral compression fractures. Methods: 386 elderly patients with lumbar vertebral compression fractures who received PVP treatment in our hospital from Jun. 2016 to Feb. 2018 were divided into unilateral group(n=230, unilateral approach PVP treatment) and bilateral group(n=156, bilateral approach to PVP treatment), the curative effect and prognosis of the 2 groups were reviewed and analyzed. Results: Unilateral group operation and X-ray irradiation time were shorter than bilateral group, bone cement injection less than bilateral group (t=29.128、29.676、57.365,P<0.05),VAS score of 6 and 12 months after operation was significantly lower than that of bilateral group (t=19.851、45.307, P<0.05); The Cobb angle, vertebral height and ODI of the 2 groups were significantly improved after operation, but there was no significant difference between the groups (P>0.05); The QUALEFFO score of the unilateral group at 6 and 12 months after operation was significantly higher than that of the bilateral group (t=8.116、12.226, P<0.05); After treatment, the incidence of complications in unilateral group and bilateral group was 20% and 50.64% respectively. The incidence of unilateral group was significantly lower than that of bilateral group (χ2=39.856, P<0.05), The satisfaction degree of patients in unilateral group was 96.52%, which was significantly higher than 80.13% in bilateral group (χ2=27.503,P<0.05). Conclusion: The single and bilateral pedicle approach PVP can provide good results for the treatment of lumbar vertebral compression fractures in the elderly, but unilateral approach can achieve better results in relieving pain and improving the quality of life. 2019 Vol. 25 (1): 119-122 [Abstract] ( 85 ) HTML (1 KB)  PDF (1213 KB)  ( 209 ) 123 Clinical Study of Edaravone combined with Vinpocetine Injection in the treatment of Acute Cerebral Hemorrhage and its effect on Neurological Function GAO Shoujun, et al DOI: 10.3969/j.issn.1006-6233.2019.01.031 Objective: To study the clinical efficacy of edaravone combined with vinpocetine injection in the treatment of acute cerebral hemorrhage and its effect on neurological function. Methods: A total of 86 patients who underwent acute cerebral hemorrhage in our hospital from March 2015 to March 2018 were selected,they were randomly divided into observation group (43 cases) and control group (43 cases). All the patients were given routine treatment, the control group was given vinpocetine injection , the observation group was combined with edaravone. NIH Stroke Scale (NIHSS) score, clinical efficacy, neuron-specific enolated alcohol (NSE), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) were compared between two groups. Results: After 2 weeks and after 4 weeks of treatment, The NIHSS score in the observation groups was lower than that of the control group [(11.87 ± 1.22)points, (7.12 ± 0.73)points VS(14.98 ± 1.43)points, (10.98 ± 1.26)points] (P<0.05). After treatment, the total effective rate of the observation group was higher than that of the control group [83.72% (36/43) VS 65.11% (28/43)] (P<0.05). The levels of NSE, TNF-α and IL-6 in the observation group were lower than those in the control group [(8.54±0.76) ug/L,(14.87±1.34) ng/L,(32.54±3.17) ng/L VS (19.43±1.53) ug/L,(24.32±2.76 )ng/L,(47.65±4.22) ng/L] (P<0.05). Conclusion: Acute cerebral hemorrhage using edaravone combined with vinpocetine injection, can effectively improve the patient's neurological function, clinical efficacy is good. 2019 Vol. 25 (1): 123-126 [Abstract] ( 79 ) HTML (1 KB)  PDF (1217 KB)  ( 196 ) 127 Exploration on Curative Effect of Different Thrombolytic Time of Ateplase on Serum PRDX1 and LPA in patients with Acute Ischemic Stroke HE Yuanfa, CAO Qun, GAO Hong'an DOI: 10.3969/j.issn.1006-6233.2019.01.032 Objective: To investigate the effects of different thrombolytic time of ateplase on serum peroxidoreduct protein 1 (PRDX1) and lysophosphatidic acid (LPA) in patients with acute ischemic stroke. Methods: 400 cases of acute ischemic stroke patients admitted to our hospital from June 2013 to June 2018 were selected as the study subjects, among them, 150 patients with onset to administration time < 3h were set as group A. 130 patients who were given medicine for 3~4.5h were set as group B. 120 patients received routine treatment at > 4.5h from onset to hospitalization were set as group C. Observe the clinical effect after treatment, serum PRDX1, LPA level, obstruction recanalization, 1 month after treatment three sets of the scale for assessment of modified Barthel index (MBI) evaluation of daily life activities ability, the United States national institutes of health stroke scale (NIHSS) scores. Results: After treatment, the total clinical efficacy rate of group A was 88.00% higher than 70.77% of group B and 53.33% of group C (P<0.05). There was no significant difference in serum PRDX1 and LPA between the three groups before treatment. After treatment, serum PRDX1 and LPA levels of the three groups decreased significantly, and serum PRDX1 and LPA levels of group A were significantly lower than those of group B and group C (P<0.05). After treatment, the good rate of vascular recanalization in group A was 78.00%, significantly higher than 58.46% in group B and 42.50% in group C (P<0.05). There was no significant difference in NIHSS and MBI scores between the three groups before treatment. After treatment, the MBI score of the three groups increased significantly, and the NIHSS score decreased significantly. Moreover, the MBI score of group A was significantly higher than that of group B and group C, and the NIHSS score was significantly lower than that of group B and group C (P<0.05). Conclusion: The early use of atpase in patients with acute ischemic stroke has a significant effect, which can improve the serum PRDX1 and LPA levels and quality of life of patients, which is worthy of clinical promotion. 2019 Vol. 25 (1): 127-130 [Abstract] ( 69 ) HTML (1 KB)  PDF (1217 KB)  ( 268 ) 131 The Correlation between the Levels of miR-145 and IGF1R and Carotid Artery Stenosis in Elderly Patients with Cerebral Infarction HE Qianghua, WANG Yihong, LIU Qiang, et al DOI: 10.3969/j.issn.1006-6233.2019.01.033 Objective: To study the correlation between serum levels of microRNA-145 and insulin-like growth factor-1 receptor (IGF1R) and carotid artery stenosis in elderly patients with cerebral infarction. Methods: 181 elderly patients with cerebral infarction admitted to our hospital from March 2016 to March 2018 were divided into 47 patients with no stenosis of carotid artery and 134 patients with stenosis of carotid artery according to the results of carotid ultrasonography. 134 patients with carotid stenosis were divided into mild group (52 cases), moderate group (43 cases) and severe group (39 cases) by NASCET. Serum levels of miR-145 and IGF1R were measured. The changes of serum levels of miR-145 and IGF1R in patients with different degrees of carotid artery stenosis were analyzed. The risk factors of carotid artery stenosis in elderly patients with cerebral infarction were analyzed. Results: The relative expression of serum microRNA-145 in stenosis group was significantly lower than that in non-stenosis group, and the level of serum IGF1R was significantly higher than that in non-stenosis group (P<0.05). Serum microRNA-145 decreased gradually with the severity of carotid stenosis (P<0.05). Serum IGF1R level increased with the severity of carotid stenosis (P<0.05). Serum microRNA-145 level was negatively correlated with IGF1R level (r=0.539, P=0.000). Mir-145 was a protective factor for carotid stenosis, and IGF1R was a risk factor for carotid stenosis. Conclusion: The expression of serum microRNA-145 is down-regulated and the level of IGF1R is significantly increased in elderly patients with cerebral infarction, which is closely related to the degree of carotid artery stenosis and could be used as a therapeutic target for elderly patients with cerebral infarction. 2019 Vol. 25 (1): 131-134 [Abstract] ( 80 ) HTML (1 KB)  PDF (1312 KB)  ( 196 ) 135 Clinical Study of Intertan Static Fixation Assisted with Caltrate D in the Treatment of Osteoporotic Femoral Intertrochanteric Fracture HENG Dezhong, ZHAI Jiangbo, WANG Hongjun, et al DOI: 10.3969/j.issn.1006-6233.2019.01.034 Objective: To observe the clinical effect of intertan static fixation assisted with caltrate D in the treatment of osteoporotic femoral intertrochanteric fracture. Methods: From March 2013 to January 2017, 92 cases of patients with osteoporotic femoral intertrochanteric fracture were selected and randomly divided into two groups, the control group was treated with PFNA operation combined with calcium D, and the study group was given Intertan static fixation assisted with Caltrate D, with 46 patients in each group. The two groups of hip joint function, operation time, amount of intraoperative bleeding, bone healing time, bone pain score, various indexes of bone density (BMD), bone metabolism markers, and serum bone sclerosis protein (SO) were compared. Results: The Harris scores in the two groups at 6 months after the operation were significantly higher than those at 1 month after the operation, and the Harris scores of the study group at 1 month and 6 months after the operation were significantly higher than those of the control group (P<0.05). The operative time, intraoperative blood loss and bone healing time in the study group were significantly lower than those in the control group (P<0.05). The bone pain scores in the two groups after treatment were significantly lower than those before treatment (P<0.05), and the bone pain score in the study group was significantly lower than that in the control group (P<0.05). After 1 year of treatment, the indexes of BMD in the two groups were significantly higher than those before treatment (P<0.05), and the indexes of BMD in the study group were significantly better than those in the control group (P<0.05). After treatment for 3 months, the levels of serum TRAP5b, β-CTX and SO in the two groups were significantly lower than those before treatment (P<0.05), and the differences between the two groups were statistically significant (P<0.05). The serum T-PINP and N-MID levels in the two groups were significantly higher than those before treatment (P<0.05), and the differences between the two groups were statistically significant (P<0.05). Conclusion: Intertan static fixation assisted with Caltrate D in the treatment of osteoporotic femoral intertrochanteric fracture is effective. It can effectively promote the recovery of hip joint function and promote postoperative fracture healing. 2019 Vol. 25 (1): 135-139 [Abstract] ( 105 ) HTML (1 KB)  PDF (2444 KB)  ( 274 ) 140 Application of OCT in Early Stage of High Myopia and Suspicious Open Angle Glaucoma WEI Xiaodan, GAN Yaping, WANG Xuemei, et al DOI: 10.3969/j.issn.1006-6233.2019.01.035 Objective: To investigate the application of OCT in early stage of high myopia and suspicious open angle glaucoma. Methods: Fifty patients with high myopia combined with early open angle glaucoma and 100 eyes with high myopia combined with suspected open angle glaucoma were enrolled in this study. There were 73 eyes in 50 patients with normal myopia and 50 eyes (100 eyes) Group A, Group B, Group C. OCT was used to detect the optic disc, RNFL thickness, macular and so on in the three groups. Results: The area ratio of cup/plate in group A was greater than that in group B and group C, the difference was statistically significant (P<0.05). The average RNFL thickness of group A was less than that of group B and group C, the difference was statistically significant (P<0.05). The thickness of macula in group A was smaller than that in group B and group C, the difference was statistically significant (P<0.05). Conclusion: OCT can be used to distinguish patients with high myopia and early open-angle glaucoma from those with high myopia and suspicious open-angle glaucoma, which has important clinical diagnostic value. 2019 Vol. 25 (1): 140-142 [Abstract] ( 105 ) HTML (1 KB)  PDF (1194 KB)  ( 714 ) 143 Logistic Regression Analysis of Factors Associated with the Failure of Central Venous Catheterization Under Ultrasound Guidance DUAN Lijuan, ZHAO Kaifeng, XIA Jiading, et al DOI: 10.3969/j.issn.1006-6233.2019.01.036 Objective: To explore the factors associated with failure of central venous catheterization under ultrasound guidance and to conduct logistic regression analysis in order to reduce its failure rate. Methods: A retrospective analysis of 322 patients with central venous catheterization under ultrasound guidance from January 2014 to December 2016 was conducted' The main factors that lead to the failure of the catheterization were analyzed, and the single factor analysis and multivariate logistic regression analysis were performed. Results: ① In the 322 patients who underwent central venous catheterization under ultrasound guidance, 262 patients (81.37%) had successful initial catheterization, and 60 patients (18.63%) were failed. ② The results of single factor analysis showed that 8 factors including sex, age, blood vessel diameter, vascular location, edema, position, operator's working life, knowledge education and mental nursing before catheterization were all related to the failure of ultrasound guided central venous catheterization (P<0.05). ③ Logistic regression analysis showed that the factors such as sex, blood vessel diameter, vascular location, position and other factors were the risk factors for the failure of the central venous catheterization under ultrasound guidance (P<0.05). Conclusion: Ultrasound guided central venous catheterization has a certain failure rate, there are many factors affecting the failure of venous catheterization. Therefore, pertinent measures should be taken to prevent and correct so as to improve the success rate of central venous catheterization under ultrasound guidance. 2019 Vol. 25 (1): 143-146 [Abstract] ( 106 ) HTML (1 KB)  PDF (1213 KB)  ( 224 ) 147 Clinical Observation of rTMS combined with Sertraline in the treatment of Refractory Obsessive-compulsive Disorder WEI Xin, WEI Shaojun, ZHANG Huan DOI: 10.3969/j.issn.1006-6233.2019.01.037 Objective: To investigate the clinical efficacy of repeated transcranial magnetic stimulation (rTMS) combined with sertraline in the treatment of refractory obsessive-compulsive disorder. Methods: A total of 82 patients with refractory obsessive-compulsive disorder from May 20 to May 2017 were enrolled in this study. All the patients were randomly divided into observation group and control group, 41 cases in each group. The control group was treated with sertraline alone, while the observation group was treated with rTMS on the basis of the control group for 2 months. The Chinese version of Yale-Brown obsessive-compulsive symptoms scale (Y-BOCS) and Hamilton anxiety scale (HAMA) were used to evaluate the degree of obsessive-compulsive disorder symptoms and anxiety of the two groups before and after treatment for 2, 4, 6 and 8 weeks, respectively. The clinical therapeutic effects of the two groups were compared. The adverse reactions were assessed by the side effects scale (TESS). Results: The levels of Y-BOCS and HAMA in the observation group after treatment were significantly lower than those before treatment (P<0.05), and the control group except the first 2 weeks and before treatment was not obvious difference, but 4, 6, 8 weeks and before treatment was significantly obvious difference (P<0.05). The scores of Y-BOCS, HAMA and HAMA at the 4th, 6th and 8th week after treatment were significantly better than those of the control group at the 2nd, 4th, 6th and 8th week after treatment (P<0.05). After 8 weeks of treatment, the total effective rate was 95.1% in the observation group was significantly better than the control group of 70.7%, the two groups of patients with blood and urine routine examination and liver and kidney function tests, ECG were not found abnormal, TESS score was not significant (P>0.05). Conclusion: For patients with refractory obsessive-compulsive disorder, rTMS stimulation combined with sertraline can effectively improve the obsessive-compulsive symptoms and anxiety of patients. The clinical efficacy is remarkable, the adverse reactions are small, and the safety is high. It is worthy of clinical application. 2019 Vol. 25 (1): 147-150 [Abstract] ( 108 ) HTML (1 KB)  PDF (1219 KB)  ( 280 ) 151 Clinical Efficacy of Heparin combined with Dredge Injection in treatment of Pulmonary Embolismand its Effects on Serum TNI Hcy and D-dimer Levels XIANG Hai, GOU Huijun, LUO Jin, et al DOI: 10.3969/j.issn.1006-6233.2019.01.038 Objective: To investigate the clinical efficacy of heparin combined with Shuxuetong injection in the treatment of pulmonary embolism and its influence on serum troponin I (TNI), homocysteine (Hcy) and D-dimer levels. Methods: 90 patients with pulmonary embolism admitted to our hospital from April 2015 to April 2018 were selected as study objects. All the patients were randomly divided into control group and observation group, with 45 cases in each group. After the examination, the patients in both groups were diagnosed and treated according to the conventional western medical treatment. The patients in the control group were treated with shuxuetong injection, and the observation group was treated with heparin on the basis of the control group. The clinical efficacy of the two groups and the changes of troponin I (TNI), homocysteine (Hcy) and d-dimer levels before and after treatment were observed and analyzed. Results: After treatment, the total clinical efficiency of the observation group was significantly higher than that of the control group (P<0.05). PCO2 and PO2 in both groups were significantly higher than before treatment, and PO2 in the observation group was significantly higher than that in the control group. The serum TNI, Hcy and d-dimer levels of the two groups were significantly decreased after treatment compared with those before treatment, and the serum TNI, Hcy and d-dimer levels of the observation group were significantly lower than those of the control group. There was no significant difference in the occurrence of adverse reactions between the two groups (P>0.05). Conclusion: For patients with pulmonary embolism, the treatment of patients with pulmonary embolism with heparin combined with dredge injection can effectively improve the clinical efficacy and significantly reduce the levels of serum troponin I, homocysteine and d-dimer. 2019 Vol. 25 (1): 151-154 [Abstract] ( 101 ) HTML (1 KB)  PDF (1213 KB)  ( 236 ) 155 Closed Reduction and PFNA Internal Fixation for Osteoporotic Femoral Intertrochanteric Fractures in the Elderly XU Haiqiao, LIN Shibang, ZHANG Weibin DOI: 10.3969/j.issn.1006-6233.2019.01.039 Objective: To investigate the effect of closed reduction and anti rotation intramedullary nail (PFNA) internal fixation in the treatment of osteoporotic femoral trochanteric fracture in the elderly. Methods: 98 cases of senile osteoporotic fracture of femoral trochanter were divided into PFEN group (n=50) and control group (n=48), PFNA group closed reduction PFNA internal fixation treatment, the control group was given dynamic hip screw treatment. Comparing the excellent and good rate of the two groups after treatment, recording the related indicators of the patients, comparing the Lane-Sandhu X-ray callus growth score, ADL score changes and the quality of life score changes before and after surgery, comparing the incidence of complications. Results: The operation time, fracture healing time and hospitalization time of PFNA group were shorter than those of control group (P<0.05). The bleeding volume and hip function score of PFNA group were lower than those of control group (P<0.05), and the excellent and good rate of PFNA group was higher than that of control group (94.00% vs 70.83% P<0.05). The Lane-Sandhu X-ray callus growth score and ADL score of PFNA group were higher than those of control group at 8 and 12 weeks after operation (P<0.05), and the quality of life score of PFNA group was higher than that of control group (P<0.05). During the treatment, complications such as internal fixation breakage, delayed union, malunion, wound infection and wound swelling occurred in both groups. The total incidence of PFNA group was lower than that of control group (10.00% vs 29.17% P<0.05). Conclusion: Closed reduction and PFNA treatment for elderly patients with osteoporotic femoral trochanteric fracture can promote fracture healing, improve hip function and shorten hospitalization time. And the incidence of complications is low; the safety is high; the quality of life of patients is effectively improved; and the curative effect is remarkable. 2019 Vol. 25 (1): 155-159 [Abstract] ( 95 ) HTML (1 KB)  PDF (1213 KB)  ( 256 ) 160 Diagnostic Value of MRI and MR Arthrography in Rotator Cuff Tears LI Xiao, XU Fan, LI Guiping, et al DOI: 10.3969/j.issn.1006-6233.2019.01.040 Objective: To evaluate the effect of magnetic resonance shoulder arthrography in the diagnosis of partial tears of rotator cuff. Methods: 124 patients with partial rotator cuff injury were selected as the research object. All the patients were diagnosed by arthroscopy, Arthroscopic surgery as a control group,and the patients were diagnosed by magnetic resonance imaging and magnetic resonance shoulder arthrography. Results: Magnetic resonance shoulder arthrography is superior to conventional magnetic resonance imaging in the diagnosis of partial tear, sensitivity, specificity, accuracy, positive prediction and negative prediction of the rotator cuff,but the outer layer of the tear in the tendon tear and magnetic resonance arthrography can not effectively diagnose. Conclusion:Magnetic resonance shoulder arthrography can accurately diagnose the extent and extent of internal tear of the rotator cufftear.It can be used as a rotator cuff injury supplement conventional MRI diagnosis.It can provide a more reliable basis for clinical diagnosis and treatment if their combination. 2019 Vol. 25 (1): 160-161 [Abstract] ( 120 ) HTML (1 KB)  PDF (1172 KB)  ( 254 ) 162 Effect of Rehabilitation Physiotherapy combined with Pelvic Floor Muscle Training on Female Pelvic Organ Prolapse JIANG Huiyu, WANG Li, CHEN Juan DOI: 10.3969/j.issn.1006-6233.2018.10.041 Objective: To investigate the therapeutic effect of rehabilitation therapy combined with pelvic floor muscle training on pelvic organ prolapse in women. Methods: From July 2015 to June 2016, 76 female patients with pelvic floor organ prolapse admitted to our department were studied. According to the method of lottery, they were randomly divided into experimental group and control group, with 38 cases in each group . The control group was treated with pelvic floor muscle training. The experimental group was treated with rehabilitation therapy combined with pelvic floor muscle training. Both groups were treated for 12 weeks and followed up for 3 months. The clinical efficacy of the two groups were compared. Functional indicators, pelvic organ prolapse affect the questionnaire score. Results: After treatment, the effective rate of clinical curative effect in the control group and experimental group were 76.32% and 94.74% respectively, which was significantly higher in the experimental group than in the control group (P<0.05). Contractility of pelvic floor muscles in both groups continued [ (31.21 ± 3.27) VS (25.37 ± 3.58), (41.55 ± 9.29) VS (32.91 ± 8.31)], the difference was statistically significant (P<0.05 ). The scores of questionnaire of pelvic organ prolapse in both groups decreased significantly after treatment and at follow-up, and the decrease was more significant in observation group [(41.59 ± 6.08) VS (72.12 ± 3.33), (49.45 ± 5.65) vs (74.34 ± 8.27) ], The difference was statistically significant (P<0.05) .Conclusion: Rehabilitation physiotherapy combined with pelvic floor muscle training has a significant effect on female pelvic floor organ prolapse patients. It can obviously improve the pelvic floor muscle strength and alleviate the muscle fatigue of patients, and improve the quality of life of patients. It is worthy of clinical application. 2019 Vol. 25 (1): 162-166 [Abstract] ( 92 ) HTML (1 KB)  PDF (1213 KB)  ( 321 ) 167 Effect of PCV-VG Mode on Correlation between PaCO2 and PetCO2 During One-lung Ventilation WANG Kun, WANG Liping, et al DOI: 10.3969/j.issn.1006-6233.2019.01.042 Objective: To analyze the effect of the pressure-controlled volume-guaranteed (PCV-VG) mode on the correlation between PaCO2 and PetCO2 during one lung ventilation. Methods: A total of 60 patients with radical resection of esophageal carcinoma were selected, aged 35-65 yr, were divided into 2 groups (n=30 each) using a random number table: volume-controlled ventilation group (group V) and PCV-VG group (group P). The ventilator settings were adjusted, with a tidal volume 8 mL/kg and respiratory rate 12 breaths/min during two-lung ventilation (TLV), and with a tidal volume 6 mL/kg and respiratory rate 15 breaths/min during OLV. The inspiratory/expiratory ratio was 1:2 and 75% fraction of inspired oxygen(FiO2) at 1.5L/min. Arterial blood gas analysis and respiration parameter were determined 15 minutes after TLV (T0), 15 min (T1), 30 min (T2), 60 min (T3), 90 min (T4) after OLV. Results: Ppeak and Pplat in group V were higher than that in group P at all time points.There was no statistical difference in PaO2 between the two groups at each time point (P=0.612), and PaO2 at t1-t4 was lower than that of the same group (P <0.001).The correlation coefficient between PaCO2 and PetCO2 in P group was higher than that in V group at each time point, but the correlation between PaCO2 and PetCO2 in the other two groups was lower than that in T0 group. Conclusion: Compared with VCV ventilation, single lung ventilation with PCV-VG model can better maintain the correlation between PaCO2 and PetCO2. Compared with double lung ventilation, the correlation between PaCO2 and PetCO2 in the two ventilation modes are both decreased. In addition, the PCV-VG model can effectively reduce the peak airway pressure and airway plateau pressure and reduce the risk of lung pressure injury while ensuring oxygen supply. It can be safely used in one-lung ventilation after radical resection of esophageal cancer. 2019 Vol. 25 (1): 167-170 [Abstract] ( 90 ) HTML (1 KB)  PDF (1213 KB)  ( 307 ) 171 Investigation of the Bacterial Species and Drug Resistance after Hand Injury in Different Injury Mechanisms LIU Shibo, SUN Bo, LI Xiaodong, et al DOI: 10.3969/j.issn.1006-6233.2019.01.043 Objective: To provide a more accurate guidance for the control of hand-surgical infections and clinical rational drug use by retrospective analysis of the cases of hand injury infections with different injury mechanisms. Methods: The specimens of patients with hand injury from different injuries were collected from January 2014 to December 2016. The bacteria were cultured, the pathogens were isolated, and the distribution and drug resistance of the strains were statistically analyzed. Results: A total of 582 strains of bacteria were isolated, of which 398 were Gram-negative bacteria, accounting for 68.38%, and 184 were Gram-positive bacteria, accounting for 31.62%. There were differences in the types of infected bacteria among different injury mechanisms. Among the different injury mechanisms, the detection rate of Pseudomonas aeruginosa was 127 (21.82%), followed by 87 Staphylococcus aureus (14.95%). Different types of wounds detected different types of bacteria, but the main pathogens were common bacteria in nosocomial infections and the difference in drug resistance of the same pathogens was not significant. Conclusion: The distribution of fungi in different hand injury injuries is nosocomial infection with Gram-negative bacteria. Different kinds of injury mechanisms need to prevent different types of bacteria. Severe trauma should be based on Gram-negative bacteria, but for postoperative Prevention, different injury mechanisms, especially special types of trauma should be used as a reference for the use of antibacterial drugs in bacterial culture and drug susceptibility testing. 2019 Vol. 25 (1): 171-176 [Abstract] ( 98 ) HTML (1 KB)  PDF (1216 KB)  ( 195 )

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