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2018 Vol. 24, No. 10 Published: 2018-10-15 1585 Experimental Study of Inhibited Myocardial Fibrosis by Liraglutide Following Acute Myocardial Infarction in Rats QIAO Huiying, et al DOI: 10.3969/j.issn.1006-6233.2018.10.001 Objective: To investigate the effects of Liraglutide on myocardial fibrosis in rats after acute myocardial infarction (AMI). Methods: The rat model of AMI was established by occlusion of the left anterior descending artery. The AMI rats were randomly divided into 3 groups: Control group (n=6), Low dose liraglutide (LS) group (n=6, 0.09mg·kg-1·d-1) and high dose liraglutide (HS) group (n=6, 0.18mg·kg-1·d-1). Sham operation group (n=6), rats received normal saline. 4 weeks later, cardiac structure and function were assessed by echocardiography; collagen volume fraction was calculated by Sirius-redstaining; the apoptotic myocardial cells were detected by TUNEL method; Pro caspase3, cleaved caspase3, PARP, TGF-β and MMP-9 were determined by Western blotting. Results: Compared with Sham operation group, control group showed decreased LVEF, LVFS and increased LVEDd, LVESd (P<0.05). Compared with control group, LS group and HS group had obviously increased LVEF, LVFS and decreased LVEDd, LVESd (P<0.05). Collagen volume fraction and apoptotic index were significantly decreased in LS group and HS group when compared with control group (P<0.05). The expression of Pro caspase3, cleaved caspase3, PARP, TGF-β and MMP-9 were significantly decreased in LS group and HS group in compared with control group (P<0.05). Conclusion: Liraglutide can reduce myocardial fibrosis in rats after AMI which partly contributes to attenuate the expression of TGF-β and MMP-9 and reduce myocardial cell apoptosis. 2018 Vol. 24 (10): 1585-1588 [Abstract] ( 115 ) HTML (1 KB)  PDF (1728 KB)  ( 154 ) 1589 Application of Low Temperature Plasma Tonsillectomy in Children with OSAHS and its Influence on Serum Immunoglobulins and T Lymphocyte Subsets DAI Hongying, LIN Yong DOI: 10.3969/j.issn.1006-6233.2018.10.002 Objective: To study the application of low temperature plasma tonsillectomy in children with obstructive sleep apnea hypopnea syndrome (OSAHS) and the effect on serum immunoglobulin and T lymphocyte subsets. Methods: 88 cases of children with OSAHS from September 2016 to August 2017 were selected in our hospital. All the children were divided into observation group and control group according to random number method. The control group was treated with the traditional tonsillectomy, and the observation group was given low-temperature plasma tonsillectomy. Two groups of patients with intraoperative and postoperative situation, as well as postoperative pain were analyzed, the levels of serum immunoglobulins and T lymphocyte subsets were compared between the two groups before and after 1 month of treatment. Results: The blood loss, operation time and length of hospital stay in the observation group were significantly shorter than the control group (P<0.05), but the time of alopecia in the observation group was longer than the control group (P<0.05). On the 1st, 3rd, 5th and 7th day postoperatively, the pain scores of the observation group were significantly lower than the control group (P<0.05). The levels of IgA, IgG and IgM immunoglobulins in the two groups were not significantly different (P> 0.05). After one month of treatment, IgA, IgG and IgM immunoglobulin levels in the control group were significantly higher than before treatment, IgM, IgG and IgM immunoglobulins in the observation group were not significantly different compared with before treatment (P<0.05). The levels of IgA, IgG and IgM immunoglobulins in the observation group were significantly higher than the control group (P<0.05). There was no significant difference in the percentage of CD3 +, CD4 +, CD8 + and CD4 + / CD8 + between the two groups before treatment (P> 0.05). After one month of treatment, the ratio of CD3 +, CD4 +, CD4 + / CD8 + CD8 + and CD4 + / CD8 + ratio in the treatment group were significantly lower than those before treatment (P<0.05), but there was no significant difference in CD3 +, CD4 +, CD8 + (P<0.05). The percentage of CD8 +, CD8 + and CD4 + / CD8 + in observation group were significantly higher than control group (P<0.05). Conclusion: Low temperature plasma tonsillectomy in children with OSAHS does not affect serum immunoglobulin and T lymphocyte subsets, less intraoperative bleeding, operation time and hospital stay, postoperative pain is less. 2018 Vol. 24 (10): 1589-1593 [Abstract] ( 105 ) HTML (1 KB)  PDF (1291 KB)  ( 139 ) 1594 Comparative Study between the Value of Magnetic Resonance SWI Sequence Imaging and Conventional MRI Sequence in the Diagnosis of Cerebral Cavernous Malformation JI Lv, HU Xing DOI: 10.3969/j.issn.1006-6233.2018.10.003 Objective:To compare the value of magnetic susceptibility weighted imaging (SWI) sequence imaging and conventional MRI sequence in the diagnosis of cerebral cavernous malformation (CCM). Methods:The clinical data of 75 patients with intracranial CCM confirmed by operation who were admitted to the hospital from September 2013 to August 2017 were retrospectively analyzed. All patients underwent brain MRI conventional sequence and SWI sequence scan, and the imaging data were complete and clear. The effects of SWI sequence and MRI conventional sequence (T1WI, T2WI) in displaying cerebral vascular lesions were analyzed. Results: There were 115 lesions in 75 patients with intracranial CCM, including 97 supratentorial lesions and 18 subtentorial lesions. Lesions detected by SWI sequence were the most (115), more than those detected by T1WI sequence or T2WI sequence (93 and 101 respectively). The maximum diameter of supratentorial lesions displayed by SWI sequence was significantly longer than that by T1WI sequence or T2WI sequence (P<0.05), but there was no significant difference in the maximum diameter of subtentorial lesions (P > 0.05). Conventional MRI sequences showed low signal rings around CCM lesions, showing T1WI high signal, T2WI high or mixed signal, and enhanced scan sequence did not show significant enhancement. The extent of lesion displayed by SWI was larger than that by conventional T1WI or T2WI sequence. It could clearly showed single or multiple patchy low signal with venous malformation and bleeding, and CCM which were difficult to be displayed by conventional MRI sequence showed small nodular low signal on SWI. Conclusion: SWI sequence imaging is superior to conventional MRI sequences in displaying the range, quantity and small lesions of CCM. It is of great value in the qualitative and quantitative diagnosis of CCM. 2018 Vol. 24 (10): 1594-1596 [Abstract] ( 59 ) HTML (1 KB)  PDF (1564 KB)  ( 209 ) 1597 Effects of Tacrolimus combined with Huaiqihuang Granule on Primary Nephrotic Syndrome in Children and its Influence on Serum VEGF TGF-β1 IL-1β and IFN-γ ZHOU Wubin DOI: 10.3969/j.issn.1006-6233.2018.10.004 Objective: To study the efficacy of tacrolimus combined with Huaiqihuang granule in children with primary nephrotic syndrome and the effects of serum vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1), interleukin 1β (IL-1β), interferon-γ (IFN-γ). Methods: From September 2016 to March 2017, 80 children with primary nephrotic syndrome were selected and divided into control group and experimental group, 40 cases in each group. On the basis of routine treatment, the control group was treated with tacrolimus, and the experimental group was treated with tacrolimus combined with Huaiqi Huang granules for 12 weeks. The clinical efficacy, serum levels of VEGF, TGF-beta 1, IL-1beta, IFN-gamma and adverse reactions were observed and compared between the two groups. Results: At the 4th week, the time of edema subsided and urinary protein was shorter than that of the control group, the difference was statistically significant (P <0.05). The blood cholesterol level of the experimental group was slightly higher than that of the control group (P <0.05). At the 12th week, the effective rate of the experimental group was 95.00%, which was higher than that of the control group (77.50%). The level of serum albumin in the experimental group was significantly higher than that in the control group (P<0.05). The level of serum albumin was slightly higher than that of the control group, the difference was not statistically significant (P>0.05). Before treatment, the levels of serum VEGF, TGF-β1, IL-1β and IFN-γ were not statistically significant (P>0.05). After treatment, the levels of serum VEGF, TGF-β1, IL-1β and IFN-γ were decreased in both groups (P<0.05). The difference between the two groups was significant (P<0.05). The total adverse reaction rate was 15.00% in the experimental group, which was lower than that in the control group, of which was 35.00% (P <0.05). Conclusion: The clinical effect of tacrolimus combined with Huaiqihuang granule in the treatment of children with primary nephrotic syndrome is better, which can effectively reduce the serum levels of VEGF, TGF-β1, IL-1β, IFN-γ level. 2018 Vol. 24 (10): 1597-1601 [Abstract] ( 109 ) HTML (1 KB)  PDF (1288 KB)  ( 313 ) 1602 Effect of Argatroban Combined with Alteplase Intravenous Thrombolysis on Acute Cerebral Infarction and Cerebrovascular Reserve Function XIE Jianguo, LIU Feng DOI: 10.3969/j.issn.1006-6233.2018.10.005 Objective: To investigate the effect of argatroban combined with alteplase intravenous thrombolysis in the treatment of acute cerebral infarction and the influence of cerebrovascular reserve function. Results: 122 patients with acute cerebral infarction admitted to our hospital from July 2016 to December 2017 were analyzed retrospectively. All the patients were divided into control group and study group, The patients in control group were treated with alteplase intravenous thrombolytic therapy, and the patients in study group were treated with argatroban. the clinical efficacy. The neurological function score, serum BNP, CRP level and cerebrovascular reserve function were compared between the two groups. Results: The total efficiency of Agha Argatroban combined with intravenous thrombolytic therapy in acute cerebral infarction in the study group was significantly higher than that in the control group (P＜0.05). The clinical efficacy of argatroban combined with alteplase intravenous thrombolysis in the study group was significantly better than that in the control group ( P<0.05 ). There was no significant difference in GCS score and ADL score between the two groups before treatment ( P > 0.05 ). After treatment, GCS score and ADL score of patients with acute cerebral infarction in the study group were significantly higher than those in the control group ( P<0.05 ). There was no significant difference in serum BNP and CRP levels between the two groups before treatment ( P > 0.05 ). after treatment, the serum BNP and CRP levels in the study group were significantly lower than those in the control group ( P<0.05 ). There was no significant difference in cerebrovascular reserve function between the two groups before treatment ( P > 0.05 ), and the cerebrovascular reserve function of the study group was significantly better than that of the control group after treatment ( P<0.05 ). Conclusion: Argatroban combined with alteplase intravenous thrombolysis in the treatment of acute cerebral infarction curative effect is remarkable. It can effectively strengthen the patient's nerve function and cerebrovascular reserve function, and improve the serum BNP, CRP levels, safe and reliable, It's worthy of clinical promotion. 2018 Vol. 24 (10): 1602-1605 [Abstract] ( 122 ) HTML (1 KB)  PDF (3101 KB)  ( 426 ) 1606 Changes and Significance of Sensitive Indexes in Early Diagnosis of Intestinal Mucosal Injury after Traumatic Hemorrhagic Shock in rats LIU Hai DOI: 10.3969/j.issn.1006-6233.2018.10.006 Objective: To observe the changes of sensitive indexes in early diagnosis of intestinal mucosal injury and the effect on intestinal mucosal barrier function in rats with traumatic hemorrhagic shock. Methods: 50 adult male Sprague-Dawley rats were selected and randomly divided into control group (N=10), 1h shock group (N=10), 4h shock group (N=10), 8h shock group (N=10), 16h shock group (N=10). After the traumatic hemorrhagic shock model was established in rats, colorimetric assay was used to measure the DAO activity in rat plasma. The endotoxin and D-lactate levels in rat plasma were determined by spectrophotometry. Rat ileum tissue was harvested and the histopathological changes were observed. Venous blood and ileal tissue were collected at the same time points in the control group and the shock 1h group for detection and observation. The data were analyzed by SAS 9.4 professional statistical software. Measured data were expressed as mean±standard deviation. The comparison between groups was performed using one-way analysis of variance, and the comparisons between groups were made using the LSD test The shock group was compared with the control group using the SNK method. P<0.05 (both sides) was statistically significant. Results: With the extension of time of shock, the D- lactic acid, diamine oxidase and endotoxin content of each observation groups were gradually increased. And the differences between them were significant (P<0.05). In the control group, the intestinal epithelium was structurally intact and no villus was absent and the morphology was normal. In the observation group, the intestinal mucosal structure was intact and the intestinal villi were irregular in the 1h shock group; part of the intestinal epithelium was shed in the 4h shock group, with local edema and no obvious inflammatory cell infiltration; the epithelial shedding of the 8h group was increased, and the local edema was obvious. There was obvious inflammatory cell infiltration in the lamina propria; the epithelial tissue in the 16h group was severely shedding, and the edema was severe. The infiltration of inflammatory cells in the lamina propria was more obvious than that in the 8h group. Conclusion: In the early stage of traumatic hemorrhagic shock, intestinal barrier dysfunction occurs. Plasma D-lactate, DAO and endotoxin are sensitive indicators for the early diagnosis of intestinal mucosal injury, and their levels are positively correlated with the pathological changes of intestinal mucosal tissues. 2018 Vol. 24 (10): 1606-1609 [Abstract] ( 83 ) HTML (1 KB)  PDF (1830 KB)  ( 258 ) 1610 The Clinical Effect of Total Endoscopic Surgery and Traditional Surgical Treatment for Early Differentiated Thyroid Adenocarcinoma QIU Hongbo, TANG Le, DOU Gang, et al DOI: 10.3969/j.issn.1006-6233.2018.10.007 Objective: To compare the clinical effect of total endoscopic surgery and traditional surgical treatment for early differentiated thyroid adenocarcinoma. Methods: 92 cases of early differentiated thyroid adenocarcinoma treated in our hospital from January 2014 to June 2017 were retrospectively analyzed. According to different treatment methods, they were divided into control group (n=48) and study group (n=44). The control group was treated with traditional surgery, and the study group was treated with total endoscopic surgery. The operation condition, stress reaction, complications, cosmetic effect and follow-up of the two groups were compared. Results: Operation time, postoperative 24 hours flow rate in research group were more than the control group, incision length, intraoperative blood loss, postoperative 24 hours VAS and length of hospital stay were lower than the control group, there was statistically significant differences (P<0.05), central lymph node dissection between two group was no difference (P>0.05). 12h, 24h after surgery, the CD4+, CD4+/CD8+ in both group were lower, the research group were higher than the control group, CD8+, c-reactive protein (CRP) and interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) in both group were rised, the research group were lower than the control group, there was a statistically significant difference between the two groups in postoperative 12h and 24h (P<0.05). Total complication rate in both group was no statistical difference (P>0 0.05). The total satisfaction of research group was higher than that of the control group (P<0.05). during the follow-up, there was no tumor recurrence and metastasis in both groups, and there was no statistical difference (P>0.05). Conclusion: Long-term efficacy of total endoscopic surgery in the treatment of early differentiated thyroid adenocarcinoma is similar with traditional surgical treatment, however, full-endoscopic surgery has advantages, such as beauty and minimally invasive surgery, it's a better technique for patients with this indication. 2018 Vol. 24 (10): 1610-1614 [Abstract] ( 62 ) HTML (1 KB)  PDF (1266 KB)  ( 136 ) 1615 Effect of GnRH-a combined with LNG-IUS on Serum CA125 VEGF FSH and LH in Patients with Adenomyosis QI Jin, DENG Xiaohong DOI: 10.3969/j.issn.1006-6233.2018.10.008 Objective: To study curative efficacy of GnRH-a combined with LNG-IUS in treatment of uterine adenomyosis and its effects on level of CA125,VEGF,FSH and LH. Methods: 60 patients of uterine adenomyosis who received therapy from June 2015 to June 2017 in our hospital were selected as research objects. According to the different treatment plan divided into observation group and control group, the control group to hysterectomy, the observation group given GnRH-a combined with LNG-IUS treatment. The levels of serum CA125, VEGF, FSH and LH were measured before and after treatment, and the dysmenorrhea, uterine volume and menstrual flow were observed. Results: After treatment, the total effective rate (90.0%) in the observation group was significantly higher than that in the control group (73.3%) (P<0.05). The levels of serum CA125, VEGF, FSH and LH were significantly lower than those in the control group (P<0.05). The incidence of dyspepsia in the observation group was significantly lower than that in the control group (P<0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05) The reaction rate was 26.7%, and the difference was significant (P<0.05). Conclusion: Shenfu injection unite recombinant human brain natriuretic peptide treatment of patients with chronic heart failure can effectively improve on cardiac function, the BNP, mmp-9, CypA levels were to reduce, significantly improve the clinical curative effect, and can reduce adverse reaction. GnRH-a combined with LNG-IUS treatment of patients with AM, effectively reduce serum CA125, VEGF, FSH and LH levels and reduce dysmenorrhea rating, uterine volume and menstrual score, and can reduce adverse reactions. 2018 Vol. 24 (10): 1615-1618 [Abstract] ( 64 ) HTML (1 KB)  PDF (1269 KB)  ( 137 ) 1619 Appliation Value in Diagnosis Value of Lung Biopsy Combined with Tumor Markers in Lung Cancer SHUAI Xuefen, CHEN Xuedong, WEI Jun DOI: 10.3969/j.issn.1006-6233.2018.10.009 Objective: To investigate the value of microscopic lung biopsy combined with tumor markers in the diagnosis of lung cancerr. Methods: Using electrochemiluminescence immunoassay for 132 newly diagnosed pulmonary lesions treated in our hospital from April 2013 to September 2017. Serum CEA levels of neuron-specific enolase (NSE), cytokeratin 19 (CYFRA21-1) and squamous cell carcinoma associated antigen (SCC) were detected. At the same time through the electronic bronchoscopy. Results: The levels of serum tumor markers CEA, NSE, CYFRA21-1 and SCC in benign group were significantly lower than those in lung cancer group (P<0.05). The sensitivity of the four combined detection of tumor markers was 80.00%, which was significantly higher than that of individual tumor markers.The difference was statistically significant (P<0.05).The sensitivity of electronic bronchoscopy was 90.00%, and its combined detection with four tumor markers increased the sensitivity to 94.44%. There was no significant difference in the detection specificity of various methods (P>0.05). Conclusion: Electronic bronchoscope combined with tumor markers can effectively increase the detection rate of lung cancer and is worthy of clinical application. 2018 Vol. 24 (10): 1619-1622 [Abstract] ( 91 ) HTML (1 KB)  PDF (1201 KB)  ( 109 ) 1623 Analysis of Urinary NGAL and KIM-1 Expression in Children with Acute Kidney Injury after Congenital Heart Surgery WANG Jing DOI: 10.3969/j.issn.1006-6233.2018.10.010 Objective: To investigate the expression characteristics of urine neutrophil gelatinase associated apolipoprotein (NGAL) and Kidney Injury Molecule-1 (KIM-1) in children with acute kidney injury (AKI) after congenital heart surgery. Methods:160 cases children with congenital heart disease undergoing surgical treatment included in the study from April 2014 to March 2017 were divided into AKI group and N-AKI group according to whether the postoperative acute kidney injury, (61 cases and 99 cases respectively).And 60 healthy children were selected as healthy group during the same period.The levels of urinary NGAL and KIM-1 in 3 groups were detected at different time points. Results: ①The baseline urinary NGAL levels in AKI group, AKI-free group and healthy group were (9.52+1.26), (9.45+1.33), (9.48+1.30) ng/mL, respectively, with no significant difference (P > 0.05). At 6h, 12h, 24h and 48h after operation, the levels of NGAL in AKI group were (25.17 [8.72], (40.14 [16.52], (31.17 [10.64], (30.54 [11.50] ng / mL, respectively, while those in AKI group were (10.29 [3.13, (13.05 [3.25, (11.39 [2.77, (10.65 [3.05] ng / mL, respectively. There was significant difference in urinary NGAL levels between AKI group and non-AKI group at 6 hours after operation (Fgroup= 31.315, P<0.05). The urinary NGAL levels of the two groups increased first and then decreased with the prolongation of time (Ftime= 21.073, P<0.05). The increase in AKI group was greater than that of the control group (Finteraction= 17.746, P<0.05). ② The baseline levels of urinary KIM-1 in AKI group, N-AKI group and healthy group were(281.63±24.77), (279.07±25.01),(280.48±23.80)ng/L, respectively, with no statistical difference (P>0.05); The levels of urinary KIM-1 in AKI group were (313.17±35.46),(496.16±35.21),(613.17±43.19), (582.33±37.13) at postoperative 6h, 12h, 24h and 48H, respectively, and those of N-AKI group were (290.69±26.14),(294.75±27.50),(286.32±23.34),(283.29±21.81)ng/L. There was significantly difference of urinary KIM-1 in these two groups (Fgroup=34.827,P<0.05), and were showed a inclined trend over time (Ftime=25.031,P<0.05), the changed amplitude in AKI group was higher than N-AKI group (Finteraction=23.847,P<0.05). Conclusion: Urinary NGAL and KIM-1 levels in children with congenital heart disease were similar to those in normal children; both indicators were increased after surgery, but the incidence of AKI was more significant, which could be used for early diagnosis of AKI in children with congenital heart disease. 2018 Vol. 24 (10): 1623-1626 [Abstract] ( 82 ) HTML (1 KB)  PDF (1262 KB)  ( 213 ) 1627 Clinical Significance of Plasma BNP Level in Pulmonary Hypertension in Elderly COPD Patients WANG Tong, LI Yanwen, YU Xiyan, et al DOI: 10.3969/j.issn.1006-6233.2018.10.011 Objective:To investigate the clinical significance of plasma brain natriuretic peptide (BNP) level in elderly patients with chronic obstructive pulmonary disease (COPD) with pulmonary hypertension (PAH). Methods:75 aged COPD patients and 30 healthy peers who were enrolled in the hospital during the period of ~2017 in January 2017 were selected as the COPD group and the control group. According to the detection level of pulmonary artery systolic pressure (PASP), 39 cases of group COPD were not PAH (PASP < 35mmHg), and PAH group (PASP > 35mmHg) were divided into 14 cases of mild group (35mmHg < PASP < 50mmHg), 15 cases of moderate group and 10 cases of severe group. The BNP expression characteristics of COPD in the above groups were observed, and the correlation between BNP and PASP levels was analyzed. Results: The blood BNP and PASP levels in group COPD were higher than those in the control group, and the difference was statistically significant (P<0.05). The level of BNP and PASP in COPD combined with PAH group was higher than that in the non PAH group, and the difference was statistically significant (P<0.05). Linear correlation analysis and partial correlation analysis excluded gender and age factors, and there was a significant positive correlation between BNP and PASP levels (P<0.05). Conclusion: The blood BNP of the elderly COPD patients showed an abnormal rising state, and the expression was more obvious with the combination of PAH; the blood BNP and PASP levels were significantly positive correlation, which was of important guiding significance for the clinical assessment of the risk of PAH and the degree of the disease. 2018 Vol. 24 (10): 1627-1629 [Abstract] ( 88 ) HTML (1 KB)  PDF (1260 KB)  ( 375 ) 1630 The effect of 5-HT Reuptake Inhibitors on Sleep Quality and Clinical Efficacy in Depression Patients YANG Xiaozhong, MA Wenxia DOI: 10.3969/j.issn.1006-6233.2018.10.012 Objective: To investigate the effect of 5-HT reuptake inhibitors on sleep quality and clinical efficacy in patients with depression. Methods: From June 2016 to May 2018, 124 patients with moderate to severe depression were selected as subjects. They were divided into experimental group (68 cases) and control group (56 cases) by random number table. Patients in the experimental group were treated with 5-HT reuptake inhibitor (SRI), and patients in the control group were treated with tricyclic antidepressants. The overall effectiveness and the Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD) and Self-rating Depression Scale (SDS) scores of the two groups after 1, 2 and 4 weeks of treatment were comparative analyzed. Results The overall effective rates of patients in the experimental group after 1, 2 and 4 weeks of treatment were 85.29%, 92.65% and 97.05%, respectively, which were significantly higher than that in the control group with the overall effective rates after treatment were 73.21%, 82.14% and 89.29%, respectively. The difference was statistically significant (P<0.05). In addition, the Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD), and Self-rating Depression Scale (SDS) scores were significantly lower in the experimental group than that in the control group after 1, 2 and 4 weeks of treatment and the long-term efficacy of the experimental group was better after treatment for different periods of time. The difference were statistically significant (P<0.05). Conclusion: 5-HT reuptake inhibitors have significant clinical efficacy and safety in patients with depression, which could effectively relieve patients' depressive symptoms and improve their sleep quality, providing a strong theoretical basis for improving the quality of life of depression patients in the future, is worthy for clinical promotion and application. 2018 Vol. 24 (10): 1630-1633 [Abstract] ( 82 ) HTML (1 KB)  PDF (3651 KB)  ( 224 ) 1634 Risk Factors and Intervention of Cardiovascular Disease in Patients with Chronic Kidney Disease ZHANG Li, JIN Chun DOI: 10.3969/j.issn.1006-6233.2018.10.013 Objective: To explore the risk factors for cardiovascular disease (CVD) in patients with chronic kidney disease (CKD) and to formulate interventions to provide evidence for early clinical prevention and treatment. Methods: We retrospectively analyzed the medical records of 498 patients who were treated for chronic kidney disease in our hospital from March 2016 to March 2017. According to whether the patients had cardiovascular events, they were divided into CVD group (192 cases) and non-CVD group (306 cases). To observe the past history of the two groups of patients, homocysteine (Hcy), hemoglobin (Hb), serum creatinine (Ser), estimated glomerular filtration rate (eGFR), electrolyte (blood potassium, serum calcium, phosphorus) Levels, glucose and lipid metabolism, heart function, and blood lipids were assessed using univariate and Logistic regression analysis to analyze risk factors for CVD in CKD patients. Results: There was no significant difference in the history of coronary heart disease, blood calcium, blood calcium, blood phosphorus, serum β2 microglobulin (β2-M), parathyroid hormone (PTH), left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) in two groups (P>0.05); The two groups were significantly different in Hb, Hcy, Scr, eGFR, fasting blood glucose, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C), and the difference was statistically significant (P<0.05). Logistic regression analysis showed that hypertension, diabetes, blood lipids, Hcy, and eGFR were independent risk factors for cardiovascular events in CKD patients. Active intervention in hypertension, diabetes, blood lipids, Hcy levels, eGFR levels can significantly reduce the incidence of CVD in patients with CKD. Conclusion: Actively improve the risk factors associated with concurrent CVD, such as blood pressure, lipid-lowering, hypoglycemic, improve Hcy levels and eGFR levels, can significantly reduce the risk of CVD events in CKD patients, improve the prognosis of CKD patients. Conclusion: Patients with chronic kidney disease accompanied by hypertension, diabetes mellitus and serum hyperlipidemia, Hcy and eGFR should be closely monitored to guard against the occurrence of cardiovascular diseases. 2018 Vol. 24 (10): 1634-1638 [Abstract] ( 88 ) HTML (1 KB)  PDF (2428 KB)  ( 150 ) 1639 Effect of Tongnao Decoction in Treating Acute Cerebral Infarction and Its Effect on Hemorrheology ZHU Yuan, CHANG Cheng, WANG Xintong DOI: 10.3969/j.issn.1006-6233.2018.10.014 Objective: To investigate the clinical efficacy of Tongnao Decoction in the treatment of acute cerebral infarction (ACI) and its effect on blood circulation in patients with this disease. Methods: The randomized method was used to divide the 100 patients admitted into the group into two groups. The control group selected western medicine for routine symptomatic treatment, and the observation group took Tongnao Decoction on the basis of western medicine for routine symptomatic treatment. The changes of hemodynamics ηb, HCT, Fib, PAG, MST, serum D-D and VEGF were measured before and after treatment. The change of cerebral hemodynamic parameters MPV, DBFV, MBF, VPI and RI before and 3 months after treatment were compared between the two groups. The NHISS scores were compared between the two groups. The clinical efficacy of the two groups was statistically analyzed. Results: The cure rate (54.00%) and total effective rate (94.00%) in the observation group were significantly higher than those in the control group (30.00% and 78.00% respectively). The difference between the two groups was statistically significant (P<0.05). Analysis of variance of two-factor repeated measures showed that there were statistically significant differences in ηb, HCT, Fib, PAG, MST, MPV, DBFV, MBF, VPI and RI before and after treatment (P<0.05); There was significant difference between the control group and the observation group in ηb, HCT, Fib, PAG, MST, MPV, DBFV, MBF, VPI and RI (P<0.05). Conclusion: Tongnaoyin treatment of ACI, can effectively reduce blood viscosity, improve hemodynamics, accelerate blood circulation of brain tissue, promote the repair of nerve function in patients, the curative effect is definite. 2018 Vol. 24 (10): 1639-1642 [Abstract] ( 89 ) HTML (1 KB)  PDF (1270 KB)  ( 210 ) 1643 Effect of 23GTVS on Macular Function and Morphology in Patients with Complex Rhegmatogenous Retinal Detachment ZHU Yanni, LIU Huifeng, KOU Zhangfeng, et al DOI: 10.3969/j.issn.1006-6233.2018.10.015 Objective: To investigate the effect of conjunctival sutureless vitrectomy (23GTVS) on macular function and morphology in patients with complicated rhegmatogenous retinal detachment (RD). Methods: 104 patients with complex conjunctival retinal detachment according to treatment mode was divided into control group (n=52) and the treatment group (n=52), the control group conventional treatment, the experimental group treatment with 23 GTVS. Then operation result, the vision, intraocular pressure, corneal dispersion and corneal curvature before and after surgery, macular function and form, and complications occurred in both group were compared. Results: Effective rate of treatment group was significantly higher than the control group 92.30% vs 76.92%, the difference was statistically significant (P<0.05). After surgery, visual acuity in the treatment group was significantly higher than in the control group (P<0.05). The corneal astigmatism and corneal curvature of the control group increased after surgery, and the corneal astigmatism and corneal curvature of the treatment group did not change. The intraocular pressure in both group was no difference statistically significant (P<0.05). The rate of neuroedema, submacular hydrops and retinal epithelial thickness in the treatment group were lower than the control group 3.84% vs 15.38%, 7.69% vs 23.07%, (152.45±18.11) vs (162.21±20.23)μm (P<0.05). The incidence of complications in the treatment group was lower than that in the control group 9.62% vs 25.00%, and the difference was statistically significant (P<0.05). Conclusion: The application of 23GTVS in complex rhegmatogenous retinal detachment is effective, and has little effect on macular function and morphology. 2018 Vol. 24 (10): 1643-1646 [Abstract] ( 63 ) HTML (1 KB)  PDF (3591 KB)  ( 126 ) 1647 Effect of Propofol Anesthesia during Anesthesia on Recovery Period and Postoperative Cognitive Function in Patients Undergoing Total Hysterectomy DENG Weiwei DOI: 10.3969/j.issn.1006-6233.2018.10.016 Objective: To investigate the effect of propofol anesthesia maintenance on patients' anesthesia effect and postoperative cognitive function during total hysterectomy. Methods: 87 patients were treated with total hysterectomy from January 2017 to January 2018 in our hospital. According to the different methods of anesthesia, the patients were divided into the observation group (n=45) and the control group (n=42). The control group was given seven halothane during the operation, while the observation group was given propofol anesthesia during the operation. The changes of blood glucose, cortisol, heart rate, arterial pressure and cognitive function were observed before and after treatment in the two groups. The time of spontaneous breathing recovery, opening time, extubation time, setting time of force recovery were recorded, and the incidence of adverse reaction after treatment was compared. Results: After treatment, the levels of cortisol, blood sugar and other stress responses in the two groups were higher than those before treatment, but the above indexes in the observation group were significantly lower than those in the control group(P<0.05). After treatment, the heart rate and arterial pressure in the two groups were lower than those before the treatment, and the above indexes were significantly higher than those in the control group (P<0.05). After treatment, the cognitive work of the two groups of patients was found. They all decreased, but the observation group was higher than that of the control group (P<0.05). After treatment, the time of spontaneous breathing recovery, opening time, extubation time and restoring time were shorter in the observation group than in the control group (P<0.05). During the treatment, the two groups had adverse reactions such as extubation and choking, restlessness, malignant vomiting, waking delay and shivering. The total incidence of the observation group was 11.11%. 33.33% (P<0.05) was lower than that of the control group. Conclusion: The intervention of propofol anesthesia in patients with total hysterectomy can reduce the stress response and inflammatory reaction of the body. It has little effect on the cognitive function of the patients, the effect of anesthesia is good, the adverse reaction is small, and the effect is remarkable. It is worthy of clinical application. 2018 Vol. 24 (10): 1647-1650 [Abstract] ( 76 ) HTML (1 KB)  PDF (1265 KB)  ( 129 ) 1651 Clinical Efficacy of Citalopram Combined with Olanzapine in the Treatment of Depression and its Effects on Cognitive Function FAN Chuan, et al DOI: 10.3969/j.issn.1006-6233.2018.10.017 Objective: To explore the clinical efficacy of citalopram and olanzapine in the treatment of depression and its effects on cognitive function.Methods: Select 100 patients with depression from February 2017 to June 2018 in our hospital.Patients were randomly divided into two groups, the patients in the study group were treated with citalopram combined with olanzapine and thepatients in the control group was treated with only citalopram. The clinical efficacy and cognitive function of the two groups were compared after theropy.Results: The clinical efficacy of the study group was better than that of the control group (P< 0.05). The sleeping quality of the patients in the study group was significantly better than that of the control group (P<0.05). The cognitive function of the group was better than that of the control group (P<0.05).There was noh no statistic difference in the incidence of adverse reactions between the study group and the control group(P>0.05).Conclusion: In the treatment of patients with depression, the effect of citalopram combined with olanzapine is ideal, which should be further popularized in clinic. 2018 Vol. 24 (10): 1651-1655 [Abstract] ( 104 ) HTML (1 KB)  PDF (1293 KB)  ( 216 ) 1656 Effect of Shenmai Injection on Inflammatory Factors in Patients with Severe Pneumonia FAN Xiaochun, TU Su, CAO Futao DOI: 10.3969/j.issn.1006-6233.2018.10.018 Objective: To observe the clinical effect of Shenmai injection on tumor necrosis factor-alpha(TNF-α), IL-1β, IL-6, IL-10 in patients with severe pneumonia.Methods: A total of 60 patients with severe pneumonia were divided into routine group (n=30) and observation group (n=30). Patients in the routine group were in routine therapy. Treatment of routine therapy combined with Shenmai injection was applied in the observation group. The clinical effect and the levels of TNF-α, IL-1β, IL-6, IL-10 were compared between the two groups. Results: The effective rate was higher in observation group than that of the routine group (P<0.05). The levels of TNF-α, IL-1β,IL-6 decreased significantly and the level of IL-10 increased after the treatment (P<0.05). The levels of TNF-α, IL-1β,IL-6 were significantly lower than those in the control group, while the level of IL-10 was significantly higher than that in the control group (P<0.05). Conclusion: Treatment of routine therapy combined with Shenmai injection for severe pneumonia has certain clinical application value. 2018 Vol. 24 (10): 1656-1658 [Abstract] ( 106 ) HTML (1 KB)  PDF (2433 KB)  ( 356 ) 1659 Clinical Efficacy and Safety Observation of Calcium Sensitizer in the Treatment of Decompensated Patients with Chronic Heart Failure FANG Xiaowei, ZHANG Xiaoling, WANG Cuicui, et al DOI: 10.3969/j.issn.1006-6233.2018.10.019 Objective: To investigate the efficacy and safety of calcium sensitizer(levosimendan)in treatment of chronic decompensated congestive heart failure. Methods: 97 patients with decompensated NYHA grade III to IV heart function were enrolled in our hospital from October 2016 to October 2017. All the patients were randomly divided into comentional treatment group (45 cases) and levosimendan group (52 cases). The comentional treatment group was treated with standardized drugs (including diuretics, aldosterone receptor antagonists, digitalis, ACEI/ARB, beta blockers, etc.). Levosimendan group was treated with levosimendan pump on the basis of comentional treatment. Left ventricular ejection fraction (LVEF) was measured 24 hours after admission and 7 days after treatment. NT-proBNP and biochemical indexes (creatinine, ALT, AST) were measured in the morning plasma and glomerular filtration rate (eGFR) was calculated. The NYHA cardiac function grades of the two groups before and after treatment were evaluated. Results: On the 7th day of treatment, the LVEF, NT-proBNP, urine volume and NYHA cardiac function of the comentional treatment group and the levosimendan group were improved after treatment, and the difference was statistically significant (P<0.05). However, the levosimendan group had higher LVEF, lower NT-proBNP, and higher urine volume than the conventional treatment group,the cardiac function classification of New York improved more significantly (P<0.05).Before and after treatment,Two groups of patients liver function and renal function,eGFR there was no significant difference (P>0.05). Conclusion: Early application of levosimendan in the treatment of chronic heart failure decompensated patients can significantly improve heart failure index, such as LVEF, NT-proBNP, urine output, NYHA heart function classification. It dose not damage liver and kidney function, and have good clinical effect. 2018 Vol. 24 (10): 1659-1663 [Abstract] ( 118 ) HTML (1 KB)  PDF (3969 KB)  ( 220 ) 1664 Effect of Pedal Therapy on Shoulder Dislocation with Fracture of Greater Tubercle of Humerus and Its Influence on Joint Function HAN Chao, ZHENG Lianhe, ZHANG Hongtao, et al DOI: 10.3969/j.issn.1006-6233.2018.10.020 Objective: To investigate the effect of foot pedaling on the dislocation of the shoulder joint and the large nodule fracture of the humerus and the effect on the joint function. Methods: 100 patients with shoulder dislocation combined with ulnar joint fractures were randomly divided into two groups. The patients in the control group were treated with lever reduction method. The patients in the experimental group were treated with pedaling, The success rate, resetting time, complication, shoulder function and quality of life were compared between the two groups. Results: The success rate of primary reduction was significantly higher in the experimental group than that in the control group. The success rate and complication rate were significantly lower than those in the control group. The scores of shoulder pain, daily life ability and activity function were significantly higher than those of the control group (P<0.01), and there was significant difference between the two groups (P<0.01). The difference between GH and BP scores was significantly higher than that of the control group at 6 months after treatment. Conclusion: The effect of foot pedal treatment on the dislocation of the shoulder joint and the large nodule fracture of the humerus has a significant effect on the joint function of the patient. 2018 Vol. 24 (10): 1664-1667 [Abstract] ( 94 ) HTML (1 KB)  PDF (2454 KB)  ( 353 ) 1668 Juvenile Patellar Dislocation with Osteochondral Fracture Treated with MPFL Repair Method SHI Zhibin, NI Jianlong, FAN Lihong, et al DOI: 10.3969/j.issn.1006-6233.2018.10.021 Objective: To retrospective a patellar end insertion repair method of Medial Patellofemoral Ligament (MPFL) to primary patellar dislocation in adolescents with osteochondral fracture. Methods: From January 2014 to June 2017,12 cases of acute primary patellar dislocation from Second Affiliated Hospital of Xi'an Jiao Tong University were enrolled in the study,including 7 males and 5 females,with an average age of 14±3.1 years years (11~17 years old), 9 left knees and 3 in the right. All the patients were treated within 2 weeks after injury surgical treatment was performed under general anesthesia, After internal fixation of osteochondral fracture,2 suture anchors were inserted into the upper 1/3 of media side of patellar to repair MPFL,and suture the injury side of MPFL on the medial patella. The apprehension sign and patellar hypermobility were compared at 6 months and last follow-up. Patients were evaluated postoperatively with the Kujala scoring questionnaire,Lysholm scores and Tegner scores . Results: All patients were followed up for 12~16 months (average 14.2±2.5 months), 2 patients were positive apprehension sign and patellar hypermobility, no recurrent dislocation occurred. Lysholm, Kujala and Tegner scores were significantly increased (P<0.05), and the knee joint function recovered well at last follow-up. Conclusion: MPFL patellar end suturing repair method is simple and minimally invasive for the treatment of primary dislocation of patella in adolescents with osteochondral fracture. 2018 Vol. 24 (10): 1668-1671 [Abstract] ( 69 ) HTML (1 KB)  PDF (1530 KB)  ( 165 ) 1672 Clinical Significance of Detecting Leptin Hypersensitive C-reactive Protein in Patients with Impaired Glucose Tolerance and Sleep Disorders LIU Min, WANG Zhaopeng, FENG Yumei, et al DOI: 10.3969/j.issn.1006-6233.2018.10.022 Objective: To explore the clinical value of detecting leptin, hypersensitive c-reactive protein in serum in patients with Impaired glucose tolerance and sleep disorders. Methods: Choose hospitalized patients with no history of diabetes from May 2015 to May 2017.The oral glucose tolerance test (OGTT) was tested to assess blood glucose metabolism and Pittsburgh sleep quality index (PSQI)was evaluated to assess sleep status. 72 IGT patients were selected. According to the PSQI score, IGT patients were divided into IGT+ sleep disorder group and IGT+ non-sleep disorder group. In addition, 58 patients with normal glucose tolerance and no sleep disorder were selected as the control group. HsCRP, leptin and pancreas islet function were measured in each group. Results: The median levels of FPG, 2hPG and 2hIns in the IGT with non-sleep disorder group and the IGT with sleep disorder group were higher than those in the control group (P<0.05); the median level of HbA1c and HOMA-IR in IGT with non-sleep disorder group was higher than that in the control group (P<0.05).The median level of Leptin in the IGT with non-sleep disorder group and the IGT with sleep disorder group was higher than that in the control group (P<0.05);The median level of hsCRP in the IGT with sleep disorder group was higher than that in the IGT with non-sleep disorder group, the median hsCRP of the IGT with non-sleep disorder group was higher than that of the control group (all P <0.05).The median level of PSQI in the IGT with sleep disorder group was higher than in the IGT with non- sleep disorder group and the control group (P<0.05).Logistic regression analysis showed that sleep disorders was positively correlated with 2hPG and hsCRP (P<0.05);Hyperinsulinemia, PSQI and glucose tolerance were positively correlated (P<0.05). Conclusion: Levels of hsCRP and leptin were significantly increased in patients with IGT and sleep disorders, inflammation and leptin play a role in sleep disorders, which may further aggravate insulin resistance and thereby increase the risk of glucose tolerance reduction. 2018 Vol. 24 (10): 1672-1676 [Abstract] ( 114 ) HTML (1 KB)  PDF (1274 KB)  ( 225 ) 1677 Value Analysis of Maternal Serum Protein Expression and Quantitative Mass Spectrometry in Down Syndrome FU Jiuyuan, XIAO Yanping, et al DOI: 10.3969/j.issn.1006-6233.2018.10.023 Objective: To screen maternal serum protein markers in Down's syndrome.To analyze the expression characteristics of maternal serum proteins in Down's syndrome.Objective to study the value of quantitative mass spectrometry in the determination of serum proteins in Down syndrome patients.Methods: 30 pregnant women who received Down's syndrome in the middle of the pregnancy from June 2013 to August 2017 were selected as the observation group.30 healthy pregnant women were used as the control group.Isotope labeled absolute and relative quantitative mass spectrometry (iTRAQ) was used to determine the relative expression of serum protein and serum protein.The ELISA method was used to verify the content of the candidate protein in the maternal serum.Results: There were 26 high credible proteins, including 18 upregulated proteins and 8 down regulated proteins, by iTRAQ quantitative mass spectrometry.The PANTHER software analysis showed that 26 proteins involved 5 functions, including protein binding, antioxidant activity, catalytic function, structure and molecular activity and transport function.Compared with the control group, the serum CP and SOD levels in the observation group were significantly higher than those in the control group, and the difference was statistically significant between P < 0.05. Conclusion: Quantitative mass spectrometry can identify the difference of serum protein markers in the mother body of Down syndrome, and the serum peroxidase -1 protein and serum ceruloprotein are expected to be a marker for the maternal serum protein of Down's syndrome. 2018 Vol. 24 (10): 1677-1679 [Abstract] ( 69 ) HTML (1 KB)  PDF (1351 KB)  ( 173 ) 1680 Clinical Observation of Taking Metoprolol Tartrate Combined with Guipi Decoction by Mouth on Cervical-cardiac Syndrome MENG Aixia, et al DOI: 10.3969/j.issn.1006-6233.2018.10.024 Objective: To observe the clinical effect of taking metoprolol tartrate combined with Guipi decoction by mouth in treating Cervical-cardiac Syndrome.Methods: Choose 78 cases of Cervical-cardiac Syndrome who seeing a doctor in our department from Jun 2016 to Jan 2018. And divided them into treatment group and control group according to random number table.39 cases in each group. The treatment group was treated by metoprolol tartrate combined with Guipi decoction, while the control group was treated by Guipi decoction only. 4 weeks was a course of treatment. Then appraise the change of bearing premature and SF-36 quality of life score. And record the complications on course of the treatment.Results: After treatment, the bearing premature are decreased and the SF-36 quality of life score is higher than pretherapy in the two groups. the treatment group and control group all have statistical significance( P<0.05),and the treatment group is better than the control group.Possess the statistical significance(P<0.05).Conclusion: The method of taking metoprolol tartrate combined with Guipi decoction by mouth can decrease the frequency of bearing premature and improve the quality of life in Cervical-cardiac Syndrome patients. And have no obvious adverse reaction. 2018 Vol. 24 (10): 1680-1683 [Abstract] ( 73 ) HTML (1 KB)  PDF (1250 KB)  ( 202 ) 1684 Treatment Effect Analysis of Insulin Detemir combined with Metformin on Elderly Patients with New Onset Type 2 Diabetes XU Xin DOI: 10.3969/j.issn.1006-6233.2018.10.025 Objective: To observe the effect of insulin detemir combined with metformin on elderly patients with new onset type 2 diabetes treatment, in order to provide reference for clinical diagnosis and treatment. Methods: The clinical data of elderly patients with newly diagnosed type 2 diabetes in our hospital during the past 2015 to 2016 years were included and analyzed. The patients were divided into observation group (metformin combined with insulin detemir) and control group (metformin). Six months after treatment, total cholesterol (TC), low density lipoprotein (LDL-c), triglyceride (TG), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), glycosylated hemoglobin (HbA1c), insulin resistance index (HOMA-IR) and islet beta cell function index (HOMA-IR) were compared between the two groups. Changes in beta. Results: 45 cases were included in the observation group and 50 cases in the control group. After treatment, both HbA1c and HOMA-IR in the two groups were significantly decreased (P<0.05), but the observation group was significantly lower than the control group (P<0.05). After treatment, the levels of HOMA-β in both groups were significantly higher than those in the control group (P<0.05). After treatment, the levels of TG, TC and LDL-C were decreased in both groups (P<0.05), but those in the observation group were lower than those in the control group (P<0.05). After treatment, the levels of IL-8 and TNF-α in both groups were decreased (P<0.05), while those in the observation group were lower than those in the control group (P<0.05). Conclusion: In the treatment of new type 2 diabetes mellitus in the elderly, insulin detemir combined with metformin is better than metformin alone. 2018 Vol. 24 (10): 1684-1687 [Abstract] ( 94 ) HTML (1 KB)  PDF (1275 KB)  ( 176 ) 1688 Clinical Treatment Analysis on Effect of small Incision of Tarsal Sinus combined with Manipulative Reduction for Calcaneal Fractures LANG Yuezhong, HUANG Yongfeng, YAN Fei DOI: 10.3969/j.issn.1006-6233.2018.10.026 Objective: To analyze the effects of small incision of tarsal sinus combined with manipulation on the function of ankle-posterior foot and fracture healing in patients with calcaneal fracture. Methods: 66 cases of calcaneal fractures patients treated in our hospital from December 2011 to January 2016 were divided into 31 cases in the traditional group and 35 cases in the observation group according to the different operative methods. In the traditional group, the lateral "L" shaped incision was used for internal fixation, and in the observation group, the tarsal sinus small incision combined with manipulation and internal fixation was used, all the patients were followed up for 3~24 months. The curative effect, postoperative calcaneal width, Bohler angle and Gissane angle, operative time, fracture healing time, the occurrence of complications such as incision margin necrosis, incision infection, and so on were observed and compared between the two groups. Results: The excellent rate of the observation group was significantly higher than that of the traditional group. The calcaneus width, Bohler angle and Gissane angle in the observation group were significantly better than those in the traditional group. The operative time and fracture healing time in the observation group were significantly shorter than those in the traditional group. The incidence of complications in the postoperative group was significantly higher than that in the observation group. Conclusion: Compared with the lateral L type incision internal fixation, the tarsal sinus small incision combined with manipulation for the treatment of calcaneal fracture is more beneficial to the recovery of ankle-posterior foot function and fracture healing, which can be used as the first choice for calcaneal fracture. 2018 Vol. 24 (10): 1688-1691 [Abstract] ( 80 ) HTML (1 KB)  PDF (1466 KB)  ( 309 ) 1692 Comparison on Effect of Continuous Positive Airway Pressure and Conventional Surgery in the treatment of Obstructive Sleep Apnea LI Lihong, BAI Lu DOI: 10.3969/j.issn.1006-6233.2018.10.027 Objective: To compare the efficacy of continuous positive airway pressure and conventional surgery in the treatment of obstructive sleep apnea. Methods: 86 patients with obstructive sleep apnea were treated as the subjects. According to the random number table, the patients were randomly divided into the control group receiving conventional surgery, and the study group was treated with continuous positive airway pressure ventilation, with 43 cases in each group. The differences between the two groups before and after treatment were observed. Results: The apnea hypopnea index (ESS) score and apnea hypopnea index (AHI) in the two groups were significantly lower than those before treatment, and the lowset oxygen saturation (LSaO2) was significantly higher than before the treatment (P<0.01), while there was no significant difference between the two groups before and after the treatment (all P>0.05). 1 month after treatment, the platelet (PLT) in the study group was significantly lower than that before treatment, while the control group was significantly higher than before treatment (P<0.01); there was no significant difference between the two groups before and after the treatment of antithrombin activity (AT:A), protein C activity (PC:A), and factor V coagulant activity (FV:C). The activity of coagulation factor II (F II: C) in the control group was significantly higher than that before treatment (P<0.01), but there was no significant change in the study group (P>0.05) before and after treatment. Conclusion: Continuous positive airway pressure ventilation and conventional surgery have both good clinical efficacy in patients with obstructive sleep apnea, but continuous positive airway pressure ventilation can improve the patients' coagulation system. 2018 Vol. 24 (10): 1692-1695 [Abstract] ( 55 ) HTML (1 KB)  PDF (1271 KB)  ( 112 ) 1696 Effect of three-way Hysterectomy on Uterine Leiomyoma and its Influeace on Ovarian Function in Women LI Rui DOI: 10.3969/j.issn.1006-6233.2018.10.028 Objective: To evaluate the efficacy of vaginal hysterectomy, laparoscopic hysterectomy and abdominal hysterectomy in the treatment of uterine fibroids and its effect on female ovarian function. Methods: Sixty patients who underwent hysterectomy for uterine fibroids treated in our hospital from March 2014 to March 2017 (with a three-year increase in time span) were selected as study subjects and were divided into vaginal hysterectomy according to the surgical procedure. According to different operation methods, 20 cases were divided into vaginal hysterectomy (vaginal group), laparoscopic hysterectomy (endoscopic group) and transabdominal hysterectomy (transabdominal group). The changes of E2, FSH, LH, ovarian function score and general sexual function score were compared before and 6 months after treatment. The incidence of perimenopausal symptoms and sexual life disorder was statistically analyzed. Results: The operation time, blood loss, anus exhaust time, length of hospital stay and total cost of the vaginal group were significantly less than those of the abdominal group. The amount of blood loss, hospitalization time and total cost were significantly less than those of the other two groups, and the differences were statistically significant. (P<0.05); E2 levels in the three groups decreased significantly compared with those before treatment, while FSH and LH levels increased significantly. There was a significant difference in E2, FSH, and LH levels between the three groups (P<0.05). After treatment, the ovarian function scores of all three groups were increased, and the overall sexual function scores were decreased. The total sexual function scores of the vaginal and endoscopic groups were significantly higher than that of the abdominal group (P<0.05). There was no significant difference in the incidence of perimenopausal symptoms and sexual dysfunction after treatment between the three groups (P>0.05). Conclusions: The three types of hysterectomy all have negative effects on the ovarian function of patients. Vaginal hysterectomy has good clinical effect on patients and has little effect on the ovarian function of patients. Worth promotion. 2018 Vol. 24 (10): 1696-1700 [Abstract] ( 85 ) HTML (1 KB)  PDF (1292 KB)  ( 336 ) 1701 Clinical Efficacy of Posterior Decompression with Different Laminectomy and Short Segment Pedicle Screw Fixation in Treatment of Thoracolumbar Burst Fracture MA Chao, WANG Wei, GAO Guiying, et al DOI: 10.3969/j.issn.1006-6233.2018.10.029 Objective: To explore clinical efficacy of posterior decompression with different laminectomy and short segment pedicle screw fixation in treatment of thoracolumbar burst fracture. Methods: 42 cases of patients with thoracolumbar burst fracture treated in Beijing Chaoyang emergency center were selected as the study objects. According to different surgical methods, all the patients were divided into direct decompression group (21 cases) and indirect decompression group (21 cases). The percentage changes of the anterior and posterior edge of the injured vertebra, the deformity angle of posterior arch (Cobb angle), cross-sectional area of injured vertebra and cross-sectional area of the upper and lower vertebral canal were detected by CT, and vertebral canal invasion rate was calculated. Modified Frankel grading method was used to evaluate the recovery of neurological function before and after operation, and low back pain and recovery of back function were evaluated by using Denis grading of pain and Oswestry dysfunction index evaluation method. Postoperative complications of the two groups were compared in the two groups. Results: The proportion of the leading edge of injured vertebra, the height of posterior injury and vertebral height increased, and Cobb angle and the rate of vertebral canal invasion decreased in the two groups, with statistically significant difference (P<0.05). Neurological function of the two groups improved after operation, and there was significant difference in Frankel grade (P<0.05). There was no significant difference between the two groups (P > 0.05). Waist pain relieved in the two groups, and there was statistically significant difference in Denis pain grade before and after operation (P<0.05). Total score of Oswestry dysfunction in indirect decompression group was higher than that in direct decompression group, and the total incidence rate was lower than that in direct decompression group, with statistically significant difference (P<0.05). Conclusion: Posterior decompression through laminectomy and short segment pedicle screw fixation is an effective treatment for thoracolumbar burst fractures, and compared with the direct decompression, postoperative lumbar function recovery of patients with indirect decompression is better, and complication rate is low, with higher safety. 2018 Vol. 24 (10): 1701-1706 [Abstract] ( 69 ) HTML (1 KB)  PDF (2155 KB)  ( 203 ) 1707 Characteristics of TG, TC, LDL-C, LDL-C/HDL-C in Preeclampsiaand the Relationship with Adverse Pregnancy Outcomes LIANG Qin, ZHOU La DOI: 10.3969/j.issn.1006-6233.2018.10.030 Objective:To analyze the characteristics of TG, TC, LDL-C, LDL-C/HDL-C in preeclampsia and its relationship with adverse pregnancy outcomes. Methods:A total of 98 cases of preeclampsia pregnant women were selected, the 98 cases healthy pregnant women of the hospital in the same period were randomly selected as the control group. The lipid levels of the two groups were measured, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and calculated blood lipid ratio TC/HDL-C, TG/HDL-C, LDL-C/HDL-C and were compared between the PE group and the control group. The pregnancy outcome of pregnant women with PE was observed, compare TC, TG, LDL-C, HDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C in pregnant women with adverse pregnancy outcomes and those without adverse pregnancy outcomes. And analyzed multivariate logistic regression analysis of adverse pregnancy outcomes. Results: There were no significant difference in serum TC, LDL-C and HDL-C between the two groups (P>0.05). The serum TG levels in PE group was significantly higher than that in control group (t=6.556, P<0.05). The TC/HDL-C, TG/HDL-C, and LDL-C/HDL-C in the PE group were significantly higher than those in the control group (t=4.723, 7.996, 5.445, P<0.05). Among 98 pregnant women with PE, the overall incidence of adverse pregnancy outcomes was 24.48% (24/98). There were no significant difference in the levels of TC, LDL-C and HDL-C between pregnant women with adverse pregnancy outcomes and those without adverse pregnancy outcomes (P>0.05), while the TG、TC/HDL-C、TG/HDL-C、LDL-C/HDL-C levels were statistically significant (P<0.05). The multivariate logistic regression analysis showed that TC/HDL-C, TG/HDL-C, and LDL-C/HDL-C were the influencing factors of adverse pregnancy outcome (P<0.05). Conclusion: The TG, TC/HDL-C, TG/HDL-C, and LDL-C/HDL-C in PE pregnant women were significantly higher than those in the control group, among which TC/HDL-C, TG/HDL-C, LDL-C/HDL-C Influencing factors for adverse pregnancy outcomes in PE pregnant women. 2018 Vol. 24 (10): 1707-1710 [Abstract] ( 83 ) HTML (1 KB)  PDF (1274 KB)  ( 252 ) 1711 Clinical Value Analysis of NT-proBNP and eGFR-CysC in Diagnosis of Cardiac Insufficiency in CRF Patients SONG Jiazhi, LIU Jing, et al DOI: 10.3969/j.issn.1006-6233.2018.10.031 Objective: To explore the early diagnostic efficacy of NT-proBNP and eGFR-CysC in patients with chronic renal failure complicated with cardiac insufficiency. Methods: A total of 147 patients with chronic renal failure diagnosed in our department from December 2015 to August 2017 were selected as the study subjects. 83 patients with cardiac insufficiency included in the study group, and the remaining 64 patients without cardiac insufficiency were treated as control group. Their baseline data, left ventricular end-diastolic diameter (LVDd), left atrial diameter (LADd), left ventricular ejection fraction (LVEF), troponin (cTnI), NT-proBNP, glomerular filtration rate (CysC) and eGFR-CysC were recorded. Univariate analysis and multivariate unconditional logistic regression were applied to select the factor that may affect chronic heart failure complicated with cardiac insufficiency. The relationship between eGFR-CysC and NT-proBNP was analyzed by Pearson analysis and ROC curve was used to show the sensitivity and specificity of above indicators in the diagnosis of patients with chronic renal failure complicated with cardiac insufficiency. Results: Univariate analysis showed that the levels of LVDd, cTnI, NT-proBNP, and CysC in patients with cardiac insufficiency were higher than those in control group; while the levels of LVEF and eGFR-CysC were lower than those in control group, and the differences were statistically significant (P<0.05); Multivariate Logistic regression analysis showed low LVEF, high NT-proBNP and Low levels of eGFR-CysC were risk factors for cardiac insufficiency in patients with renal failure. Pearson correlation analysis showed that the increase of eGFR-CysC was negatively correlated with the increase of NT-proBNP (r=-0.665, P=0.002). The AUC of eGFR-CysC under the ROC curve was the highest, with a specificity of 79.67% and a sensitivity of 82.89%. Conclusion: eGFR-CysC has a good diagnostic effect on patients with chronic renal failure complicated with cardiac insufficiency. It is expected to be used as one of the early detection indicators of cardiac insufficiency in patients with chronic renal failure. 2018 Vol. 24 (10): 1711-1714 [Abstract] ( 99 ) HTML (1 KB)  PDF (1447 KB)  ( 218 ) 1715 Safety and Efficacy Analysis of High Dose Tranexamic Acid for Spinal Correction and Long Segment Fixation SHI Liang, DUAN Liang, DONG Xianghui DOI: 10.3969/j.issn.1006-6233.2018.10.032 Objective: To investigate the safety and effectiveness of high dose tranexamic acid in spinal surgery. Methods:80 patients admitted to the hospital from October 2015 to October 2017 underwent spine orthopedic surgery were randomly divided into two groups. The patients in the control group followed the normal surgical procedures. Patients in the tranexamic acid group were treated with high doses of tranexamic acid The blood transfusion parameters, Hb, HCT, disease-related parameters and complication were compared between the two groups. Results: The amount of tranexamic acid, autologous erythrocytes, allogeneic red blood cells, fresh frozen plasma FFP, cryoprecipitate, platelets and total transfusion volume of tranexamic acid group were significantly lower than those of the control group. The levels of HCT and HCT at 1 day after operation were significantly higher Which was significantly higher than that of the control group. The APTT level at the end of surgery was significantly lower than that of the control group. The PLT and blood clot time were significantly higher than those of the control group. The postoperative blood transfusion rate was significantly lower than that of the control group (P<0.01). The rate of hypotension was significantly lower than that of the control group (P<0.05). Conclusion: High dose of tranexamic acid used in spinal surgery is clinically effective and safe, with reference value. 2018 Vol. 24 (10): 1715-1718 [Abstract] ( 95 ) HTML (1 KB)  PDF (1272 KB)  ( 255 ) 1719 Curative Efficacy of Esomeprazole Magnesium Enteric-coated Tablets Combined with Cisapride in the Treatment of Reflux Esophagitis YUN Xiaojing, WANG Dongmei, BAI Yuhuan, et al DOI: 10.3969/j.issn.1006-6233.2018.10.033 Objective: To study the curative efficacy of Esomeprazole Magnesium Enteric-coated Tablets combined with cisapride in the treatment of reflux esophagitis. Methods: 270 cases of patients with reflux esophagitis from November 2015 to November 2016 in our hospital were selected as the research objects and randomly divided into the observation group and the control group. The control group was treated with Esomeprazole Magnesium Enteric-coated Tablets, while the observation group was treated with Esomeprazole Magnesium Enteric-coated Tablets combined cisapride. At two months after treatment, the clinical curative effect, changes of serum IL-17 and IL-23, endoscopic grading integral, and clinical symptom scores before and after treatment were compared between two groups. Results: After treatment, the total effective rate of observation group was statistically higher than that of the control group (P<0.05); After treatment, the serum IL-17,IL-23 in Observation group was less than the control group (P<0.05); After treatment ,endoscopic grading integral, clinical symptom scores in Observation group was less than the control group (P<0.05). Conclusion: Esomeprazole Magnesium Enteric-coated Tablets combined with cisapride could effectively inhibit the inflammatory response, reduce the grading score of endoscopy, relieve the clinical symptoms of patients, and thereby significantly improve its clinical efficacy. 2018 Vol. 24 (10): 1719-1721 [Abstract] ( 97 ) HTML (1 KB)  PDF (1247 KB)  ( 465 ) 1722 Observation on Curative Effect of TKI Combined with S-1 Chemotherapy in Treatment of EGFR-TKI Acquired Resistance to Patients with Non-small Cell Lung Cancer ZHANG Jingjie, MA Jianxin, WANG Mu, et al DOI: 10.3969/j.issn.1006-6233.2018.10.034 Objective: To explore clinical effect of tyrosine kinase inhibitor (TKI) combined with S-1 chemotherapy in treatment of EGFR-TKI acquired resistance to patients with non-small cell lung cancer. Methods: 64 cases of patients with mutations in NSCLC and EGFR genes treated in our hospital were selected as the study objects, and were divided into control group and the study group according to different treatment methods, 32 cases in each group. Control group were given S-1 combined with cisplatin chemotherapy. the study group were combined with TKI treatment on the basis of control group. Tumor remission rate and serum tumor markers, carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA211), and carbohydrate antigen (CA199) levels before and after treatment were contrasted in the two groups. Types of adverse reactions were reported, and patients without progression of survival (PFS) within 1 years were analyzed by using Kaplan-Meier survival analysis. Results: The tumor remission rate in the study group was higher than that in the control group, and the difference was statistically significant.(75.00%VS46.88% P＜0.05). After treatment, serum CEA, CYFRA211 and CA199 levels decreased in the two groups, and the decreasing in the study group was higher than that in control group (P<0.05). Diarrhea, nausea, vomiting, myalgia, hair loss, fever, fatigue, anemia, thrombocytopenia, granulocyte reduction, and transaminase abnormalities occurred in the two groups after treatment. There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05).The PFS of the study group was higher than that of the control group, and the difference between the two groups was statistically significant.(6.83±1.62VS 8.71±1.85 P＜0.05). Conclusion: Patients with mutations in NSCLC and EGFR genes treated by TKI combined with S-1 chemotherapy after EGFR-TKI acquired resistance, it can delay the progression of the disease and prolong patients' survival time, with mild adverse reactions. It is a highly effective treatment. 2018 Vol. 24 (10): 1722-1726 [Abstract] ( 113 ) HTML (1 KB)  PDF (1342 KB)  ( 157 ) 1727 Clinical Efficacy and Safety Analysis of Loratadine and Azelastine Nasal Spray in the treatment of Allergic Rhinitis ZHU Dan DOI: 10.3969/j.issn.1006-6233.2018.10.035 Objective: To study the clinical efficacy of loratadine combined with azelastine nasal spray in the treatment of allergic rhinitis. Methods: 243 patients with allergic rhinitis were enrolled in our hospital from February 2015 to January 2017. All patients were divided into control group (n=119) and study group (n=124) according to the random number table method. The patients in the control group were treated with azelastine nasal spray. The patients in the study group were treated with desloratadine and azelastine nasal spray, and the IL-4, IL-6, IL-10 and other inflammations were compared between the two groups before and after treatment. Factor levels, VCAM-1, IgE levels before and after treatment, symptom scores before and after treatment, and clinical efficacy after treatment. Results: There was no significant difference in the levels of IL-4, IL-6 and IL-10 before treatment between the two groups (P>0.05). The levels of IL-4, IL-6 and IL-10 were significantly lower in the study group than in the control group after treatment. Group, and two groups of patients after treatment significantly lower than their respective treatment, and were statistically significant (P<0.05). There was no significant difference in the levels of VCAM-1 and IgE between the two groups before treatment (P>0.05). The levels of VCAM-1 and IgE in the study group were significantly lower than those in the control group after treatment, and the two groups were significantly lower than the respective treatment after treatment. Before and with statistical differences (P<0.05). There was no significant difference in symptom scores before treatment between the two groups in terms of nasal itching, nasal congestion, runny nose, and sneezing (P>0.05). Symptom scores after treatment in the study group were significantly lower than those in the control group, and both groups were significantly lower after treatment. Before each treatment, there was a statistical difference (P<0.05). The total effective rate of the control group was 79.83%; the total effective rate of the study group was 96.77%. There was a statistically significant difference in the total effective rate between the two groups (P<0.05). The incidence of adverse reactions in the control group was 3.36%; the incidence of adverse reactions in the study group was 4.03%. Adverse reactions resolved spontaneously after the end of treatment, and no abnormalities of kidney, liver and heart function were seen. Conclusion: Desloratadine combined with azelastine nasal spray can reduce inflammatory reactions, reduce serum inflammatory factors, VCAM-1 and IgE levels, significantly improve clinical symptoms, improve treatment efficiency, and have good therapeutic effect. 2018 Vol. 24 (10): 1727-1730 [Abstract] ( 75 ) HTML (1 KB)  PDF (1269 KB)  ( 237 ) 1731 Effect of Dexmedetomidine on Perioperative Platelet Activity and Cellular Immunity Function for Patients Undergoing Colon Cancer Radical Surgery CAO Bingyu, et al DOI: 10.3969/j.issn.1006-6233.2018.10.036 Objective: To investigate the effect of dexmedetomidine (DEX) on perioperative platelet activity and cellular immunity for patients undergoing colon cancer radical surgery. Methods: 60 patients undergoing colon cancer radical surgery were assigned into two groups using random table method: DEX group (n=30) and control group (n=30). DEX group was given intravenous infusion of DEX with loading dose of 1μg/kg 10 min before anesthesia induction, and then at 0.5μg·kg-1·h-1 till completing the surgery; the control group was given intravenous infusion of 0.9% sodium chloride. The levels of P-selection (CD62P), glycoprotein(GP) II b/III a, IgM, IgG, IgA, CD3+, CD4+, CD8+, and CD4+/CD8+ at 5 min before anesthesia induction (T0), immediately after the surgery (T1), 12h after the surgery (T2), 24h after the surgery (T3) were compared between the two groups. And the adverse events of the two groups were compared. Results: There were no differences in the levels of CD62P, GP II b/III a, IgM, IgG, IgA, CD3+, CD4+, CD8+ and CD4+/8+ at T0 between the two groups (P>0.05). CD62P and GP II b/III at T1, T2 and T3 of the two groups were significantly higher those at T0 and their levels of the control group were significantly higher than those of DEX group (P<0.05). IgM, IgG, IgA, CD3+, CD4+, CD8+ and CD4+/8+ of the DEX group at T1, T2 and T3 were similar to those at T0. IgM, IgG, IgA, CD3+, CD4+, CD8+ and CD4+/8+ of the control group at T1, T2 and T3 were significantly lower than those at T0, and lower than those of the DEX group (P<0.05), while the levels of CD8+ strongly increased and were higher than those of the control group (P<0.05). There were no difference in the adverse events rates between the two groups (P>0.05). Conclusions: DEX can inhibit platelet hyperactivation and stabilize immune function of patients undergoing radical resection of colon cancer without increasing adverse reactions. It has certain clinical value in preventing and treating perioperative hematogenous metastasis of tumor cells in patients undergoing radical resection of colon cancer. 2018 Vol. 24 (10): 1731-1735 [Abstract] ( 87 ) HTML (1 KB)  PDF (1275 KB)  ( 259 ) 1736 Observation Curative Effect of Percutaneous Pedicle Screw Combined with Intervertebral Foraminoscopy in the treatment of Lumbar Burst Fractures with Neurological Impairment ZHU Naiqiang, et al DOI: 10.3969/j.issn.1006-6233.2018.10.037 Objective: To explore the therapeutic effect of percutaneous pedical screw internal fixation combined with percutaneous transforaminal endoscopic decompression for lumbar fracture complicated with neurological deficits. Methods: From August 2015 to February 2017, 5 cases of lumbar vertebral fractures with neurological impairment were treated by percutaneous pedicle screw fixation combined with intervertebral foraminoscopy. General clinical data were recorded. The percentage of anterior vertebral height, Cobb angle of sagittal kyphosis, neurological function and VAS pain score were recorded. Results: 5 cases were smoothly performed the procedure. No surgery related complains were found.The anterior height of fracture vertebral body, Sagittal kyphposis Cobb angle, the function of nerve and VAS score all got ideal recoveries after 2-stage operation.At the 3-month follow-up,there was no loss of sagittal plane alignment, and spinal cord achieved effective decompression. More than one grade of neurofunction recovery was observed at final follow-up. Conclusion: Percutaneous pedicle screw fixation combined with intervertebral foraminoscopic spinal canal decompression can ensure adequate nerve decompression and significantly reduce surgical trauma. It is a safe and effective surgical method for the treatment of lumbar fracture with nerve function impairment. 2018 Vol. 24 (10): 1736-1738 [Abstract] ( 91 ) HTML (1 KB)  PDF (1959 KB)  ( 211 ) 1739 Clinical Effect Analysis of Neuroendoscopic Resection of Pituitary Tumor with Single Nostrils Sphenoid Sinus Approach FENG Bin, HUANG Lichao, CAI Ming, et al DOI: 10.3969/j.issn.1006-6233.2018.10.038 Objective:To investigate the clinical effect of transnasal endoscopic resection of pituitary tumor with single nostrils. Methods:80 patients with pituitary tumor were enrolled from January 2014 to January 2017 were randomly divided into two groups. Endoscopic patients underwent endoscopic sinus surgery with a single nostrils. The clinical parameters, short-term prognosis, hormone level, postoperative complications and quality of life were compared between the two groups. Results: The intraoperative blood loss, operation time and hospitalization time were significantly lower in the endoscopic group than in the microscope group. The levels of GH, PRL and ACTH were significantly lower than those of the microscope group. The overall complication rate was significant (P<0.01). The difference of body function, body pain, overall health, vitality and quality of life between the two groups was significantly higher than that of the microscopic group (P<0.01). Conclusion: Compared with the microscope, the clinical effect of pituitary tumor resection under nasal transsphenoidal approach is more significant, less complication and higher quality of life in patients with endoscopic sinus surgery. 2018 Vol. 24 (10): 1739-1742 [Abstract] ( 73 ) HTML (1 KB)  PDF (1259 KB)  ( 190 ) 1743 Clinical Study of Rifabutin Combined with Antiviral in the Treatment of AIDS with Tuberculosis HE Huawei, LU Xiangchan, HUANG Aichun, et al DOI: 10.3969/j.issn.1006-6233.2018.10.039 Objective: To explore rifabutin combined with antiviral drug clinical effect in the treatment of AIDS with tuberculosis. Methods: 80 AIDS patients with pulmonary tuberculosis admitted to our hospital from January 2014 to December 2015 were selected as the subjects of this study. According to the difference of clinical medication, they were divided into observation group and reference group. There were 40 cases in each group of two groups. The observation group was given the anti-tuberculosis regimen containing forbestine plus the anti-tuberculosis regimen containing efoviran or cleistogen, and the control group was given the anti-tuberculosis regimen containing rifampicin plus the anti-virus regimen containing efoviran. Both groups were given anti-tuberculosis and anti-HIV treatment. The anti-tuberculosis, anti-virus and total adverse reactions of the two groups were observed. Situation. Results: The effective rate of anti-tuberculosis treatment, negative rate of sputum examination, closure rate of pulmonary cavity and absorption of pulmonary lesions in the study group were significantly higher than those in the control group (P<0.05). There was no significant difference in the CD4+T lymphocyte between the two groups before treatment (P>0.05). After treatment, CD4 + T lymphocytes in both groups were significantly higher than those in the control group (P<0.05). The incidence of immune reconstitution inflammatory syndrome and total adverse reactions in the study group were significantly lower than those in the control group (P<0.05). Conclusion: Rifambutin combined with antiviral treatment of pulmonary tuberculosis with significant clinical effect, can effectively improve the cure rate of patients, reduce adverse reactions, reduce the incidence of immune reconstruction inflammatory syndrome, increase the anti-tuberculosis and antiviral efficacy. 2018 Vol. 24 (10): 1743-1747 [Abstract] ( 98 ) HTML (1 KB)  PDF (1265 KB)  ( 214 ) 1748 Effect of Traditional Chinese Medicine "Puren Dan" on Retinal Hemodynamics in Diabetic Retinopathy WANG Haibin, FENG Peiming, DONG Zhijun, et al DOI: 10.3969/j.issn.1006-6233.2018.10.040 Objective: To observe the effect of traditional Chinese medicine "Purendan" on retinal hemodynamics in patients with simple diabetic retinopathy. Methods: The peak systolic velocity (Vs), end diastolic velocity (Vd), and obstruction of central retinal artery (CRA) and central retinal vein (CRV) were measured by color Doppler flow imaging (CDFI) in 20 normal subjects. Force index (RI) was measured by fundus fluorescence angiography (FFA) in 20 patients with diabetes mellitus. Patients with stage I and stage II diabetic retinopathy were treated with Borendan for 6 months. The central retinal artery was performed by color Doppler flow imaging (CDFI) before and after treatment. The peak systolic velocity (Vs), end diastolic velocity (Vd) and resistance index (RI) of CRA and CRV were measured. Results: Before treatment, the blood flow velocity of central retinal artery and central retinal vein in diabetic patients was significantly lower than that of normal people, and the resistance index was higher than that of normal people (P<0.05). After treatment, the parameters of central retinal artery blood flow basically returned to normal, and the velocity of central retinal vein blood flow was significantly improved, but still lower than normal. The resistance index of central retinal artery and central vein changed significantly before and after treatment (P<0.05). Conclusion: Retinal hemodynamics of diabetic retinopathy patients treated with traditional Chinese medicine Bo Ren Dan has been significantly improved, thus confirming the effectiveness of traditional Chinese medicine Bo Ren Dan on DR treatment. 2018 Vol. 24 (10): 1748-1750 [Abstract] ( 82 ) HTML (1 KB)  PDF (1249 KB)  ( 191 ) 1751 Comparison of Adverse Reactions between Vindesine and Vincristine in Children with Acute Lymphoblastic Leukemia WANG Xing, BAI Minghui, JI Jia, et al DOI: 10.3969/j.issn.1006-6233.2018.10.041 Objective: To study comparison of adverse reactions between changchun dixin (VDS) and vincristine (VCR) in the application of acute lymphocytic leukemia in children. Methods: 90 patients with acute lymphoblastic leukemia in our hospital were selected from February 2013 to February 2015, there were 45 cases in VDS group and 45 in the VCR group. VDS group was treated with VDS3mg/m2. VCR group was treated with vcr1.5mg /m2. The clinical efficacy and clinical characteristics of the two groups were compared with the average hospitalization expenses. The adverse reactions of the two groups were recorded. Results: After treatment, there was no statistically significant difference between CR rate, early death rate and remission time in both groups (P >0.05). After treatment, there was no significant difference in clinical features between the two groups (P>0.05); In the two groups of patients, the hospitalization expenses include drug charge, examination fee, treatment fee, nursing fee, blood transfusion fee, material fee and bed fee. The average hospitalization expense of the VDS group was 25,995 yuan/person, and the average hospitalization expense of the VCR group was 34245 yuan/person, and the difference between the two groups was statistically significant (P=0.001). The incidence of thrombocytopenia, anemia and neurotoxin in the VDS group was lower than that in the VCR group, and the difference was statistically significant (P<0.05). Conclusion: VDS and VCR early curative effect of treatment of children with acute lymphocytic leukemia has no obvious difference, but the use of VDS for children with acute lymphocytic leukemia incidence of adverse reactions and hospitalization costs are lower than using a VCR. 2018 Vol. 24 (10): 1751-1754 [Abstract] ( 153 ) HTML (1 KB)  PDF (1261 KB)  ( 348 ) 1755 Nursing Key Points and Measures of Ureteroscopic Lithotripsy Complicated with Extracorporeal Shock Wave Lithotripsy for the treatment of Children with Upper Urinary Calculi LI Xiuhong DOI: 10.3969/j.issn.1006-6233.2018.10.042 Objective: To explore the nursing points and measures for the treatment of complicated upper urinary calculi in children with ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy, and to analyze the nursing effect. Methods: From January 2016 to January 2018, 90 children with complicated upper urinary tract calculi treated by flexible ureteroscopic lithotripsy combined with extracorporeal shock wave lithotripsy were selected as the study subjects. The patients were randomly divided into control group and observation group. The control group received routine nursing and the observation group received pertinent nursing. The complications and nursing satisfaction of the two groups were observed and compared. Results: The incidence of complications in the observation group was 6.67%, which was significantly lower than that in the control group (22.22%) (χ=4.406, P<0.05). The overall nursing situation of the observation group was better than that of the control group (Z=-7.2234, P<0.001), and the difference was statistically significant. Conclusion: During the treatment of upper urinary tract calculi with ureteroscopic lithotripsy combined with extracorporeal shock wave lithotripsy, it is important to analyze the nursing essentials and adopt pertinent nursing measures to promote the recovery of the children, improve nursing satisfaction and reduce complications. 2018 Vol. 24 (10): 1755-1757 [Abstract] ( 86 ) HTML (1 KB)  PDF (1277 KB)  ( 263 )

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