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2020 Vol. 26, No. 5 Published: 2020-05-31 705 Application Value of Serum AFP AFU CEA and CA19-9 in the Diagnosis of Gastric Cancer SU Xiaolan, LONG Xiangyu, WANG Ying, et al DOI: 10.3969/j.issn.1006-6233.2020.05.001 Objective: To investigate the application value of serum alpha-fetoprotein (AFP), α-L-fucosidase (AFU), carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in the diagnosis of gastric cancer (GC), and provide references for early diagnosis of GC. Methods: 50 patients with GC admitted to the hospital between January 2018 and January 2019 were included in GC group. 50 patients with benign gastric lesions admitted during the same period were selected as the control group. The expression levels of serum AFP, AFU, CEA and CA19-9 were compared between the two groups. The expression levels in patients with GC and different clinical features were analyzed. Results: The expression levels of AFP, AFU, CEA and CA19-9 in GC group were significantly higher than those in the control group (P<0.05). ROC curve analysis indicated that the areas under the curves of serum AFP, AFU, CEA and CA19-9 and the combination of the four for detection of GC were 0.935, 0.943, 0.931, 0.996 and 0.998, respectively. The sensitivity, specificity and yoden index of AFP, AFU, CEA and CA19-9 combined detection were higher than those of other independent detection. Levels of AFP, AFU, CEA and CA19-9 in patients with GC decreased significantly with the increase of differentiation degree, and the levels in patients with lymph node metastasis were significantly higher than those without (all P<0.05). The combined detection of AFP, AFU, CEA and CA19-9 in the diagnosis of GC patients' differentiation, the area under the curve of lymph node metastasis, the specificity and the yoden index were higher than those detected separately. Conclusion: The levels of serum AFP, AFU, CEA and CA19-9 are high in patients with GC. The combined detection of AFP, AFU, CEA and CA19-9 can improve the diagnostic efficiency of GC and its progression. 2020 Vol. 26 (5): 705-709 [Abstract] ( 302 ) HTML (1 KB)  PDF (1424 KB)  ( 526 ) 709 Clinical Significance and Changes of Serum IL-17 IL-6 and TIMP-2 Levels in Elderly Patients with Inguinal Hernia Before and After Tension-Free Hernioplasty SHI Xuesong, CAO Hongyong, XIAO Hua DOI: 10.3969/j.issn.1006-6233.2020.05.002 Objective: To observe the changes in levels of serum interleukin-17 (IL-17), interleukin-6 (IL-6) and tissue inhibitor of metalloproteinase (TIMP-2) of elderly patients with inguinal hernia (IH) before and after tension-free hernioplasty (TFH), and to analyze their clinical significance. Methods: 96 elderly IH patients in the hospital who had undergone TFH were enrolled as observation group, and 47 healthy controls in the same period were enrolled as control group. The levels of serum IL-17, IL-6 and TIMP-2 before and after surgery in the observation group were compared with those in the control group. According to different postoperative complications and recurrence, the patients were divided into good prognosis group and poor prognosis group. The levels of serum IL-17, IL-6 and TIMP-2 were compared between the two groups and control group and correlation analysis was conducted. Results: The levels of serum IL-17 and IL-6 after surgery were higher than those before surgery, which were higher than those in control group (P<0.05). Arranging levels of serum IL-17 and IL-6 from low to high, the corresponding order was control group, good prognosis group and poor prognosis group (P<0.05). TIMP-2 level after surgery was lower than that before surgery, which was lower than that in control group (P<0.05). TIMP-2 level was the highest in control group, followed by good prognosis group and poor prognosis group (P<0.05). Serum IL-17 and IL-6 were negatively correlated with prognosis of elderly IH patients undergoing TFH (P<0.05), while serum TIMP-2 was positively correlated with prognosis (P<0.05). Conclusion: Compared with those before surgery, at 24h after surgery, levels of serum IL-17 and IL-6 are significantly increased in elderly IH patients who have undergone TFH, while serum TIMP-2 level is significantly decreased. Their changes are closely related to prognosis, which can provide effective guidance for clinical treatment and prognosis assessment. 2020 Vol. 26 (5): 709-713 [Abstract] ( 160 ) HTML (1 KB)  PDF (1200 KB)  ( 270 ) 713 Comparison of the Effect of Conbercept or Rapunzumab Combined with Laser in the Treatment of BRVO with Macular Edema SONG Qingxue, MA He DOI: 10.3969/j.issn.1006-6233.2020.05.003 Objective: To investigate the effect of conbercept or laser in the treatment of branch retinal vein occlusion (BRVO) with macular edema, and to analyze the relationship between visual acuity and the central macular thickness (CMT) and the outer nuclear layer thickness (ONLT). Methods: 89 cases (89 eyes) of BRVO patients with macular edema treated in our hospital from March 2016 to June 2019 were randomly divided into the observation group (45 cases and 45 eyes) and the control group (44 cases and 44 eyes). The observation group was treated with conbercept and fundus laser, and the control group was treated with leizhumab and fundus laser. BCVA, CMT, ONLT and macular leakage were observed. the relationship between BCVA, CMT andONLT were analyzed. Results: There was significant difference in BCVA at different time and time interaction between groups (P<0.05), but no significant difference between groups (P>0.05). CMT and ONLT had significant difference in different time (P<0.05), but no significant difference in the interaction between groups and time (P>0.05). The CMT and ONLT of the two groups decreased with the time after treatment, and BCVA increased. The CMT and ONLT of the two groups were lower than before treatment at different time points after treatment, and BCVA was higher than before treatment (P>0.05). The BCVA of the observation group was higher than that of the control group at 1, 2 and 3 months after treatment, the CMT of the observation group was lower than that of the control group at 3 months after treatment, and the ONLT of the observation group was lower than that of the control group at 2 and 3 months after treatment (P<0.05). Conclusion: The effect of conbercept combined with fundus laser in BRVO patients with macular edema is better than that of leizhumab combined with fundus laser. It has high security. 2020 Vol. 26 (5): 713-717 [Abstract] ( 169 ) HTML (1 KB)  PDF (1201 KB)  ( 364 ) 717 Therapeutic Effect of Thalidomide on Rheumatoid Arthritis and Its Effect on Serum Levels of Cys-C and Vascular Endothelial Growth Factor CHEN Guanya, XIE Ye DOI: 10.3969/j.issn.1006-6233.2020.05.004 Objective: To study the therapeutic effect of thalidomide on rheumatoid arthritis and its effect on serum levels of Cystatin C (Cys-C)and vascular endothelial growth factor (VEGF). Methods: 96 rheumatoid arthritis patients who received therapy from March 2017 to February 2018 in our hospital were selected as research objects. According to random number table method,those patients were divided into the observation group (n=50) and the control group (n=46). The control group was treated with methotrexate, and the observation group was treated with both methotrexate and thalidomide. Then the therapeutic efficacy, improvement of clinical symptoms, levels of related indicators, bone metabolism indicators, serum levels of Cys-C and vascular endothelial growth factor of two groups after treatment were compared. Results:After treatment, the total effective rate of observation group was significantly higher than that of control group[96.00%(48/50)vs76.08%(35/46)](P＜0.05). Joint tenderness index, joint swelling index and morning stiffness time were significantly lower than those in the control group[(1.71±0.50)vs (5.90±1.42),(1.42±0.32)vs (5.61±1.27),(8.03±1.20)min vs (21.74±5.40)min](P＜0.05). The levels of ESR and CRP were significantly lower than those of the control group[(3.05±0.92)mm/h vs (17.43±4.13)mm/h,(4.02±0.67)mg/L vs (12.01±1.35)mg/L](P＜0.05). N-MID and T-PINP were significantly higher than those in the control group[(20.13±3.72)mg/mL vs (14.63±2.70)mg/mL,(47.30±6.51)mg/mL vs (38.46±5.17)mg/mL](P＜0.05). The level of beta-CTX was significantly lower than that of the control group[(0.46±0.10)pg/mL vs (0.72±0.16)pg/mL](P＜0.05). Cys-C and vascular endothelial growth factor levels were significantly lower than those in the control group[(0.67±0.12)mg/L vs (1.35±0.30)mg/L,(32.76±7.42)μmol/L vs(50.95±10.64)μmol/L](P＜0.05).Conclusion:Thalidomide can improve the clinical symptoms and bone metabolism of patients with rheumatoid arthritis. It can regulate immunity, reduce the levels of Cys-C and VEGF. It has less adverse reactions and is safe and reliable. 2020 Vol. 26 (5): 717-721 [Abstract] ( 117 ) HTML (1 KB)  PDF (1197 KB)  ( 302 ) 721 Effects of Biapenem and Moxifloxacin on Inflammatory Parameters and Adverse Reactions in Elderly Patients with Severe Pneumonia GONG Jing, LU Wei, SHI Gang, et al DOI: 10.3969/j.issn.1006-6233.2020.05.005 Objective:To investigate the clinical effect of biapenem combined with moxifloxacin in the treatment of elderly severe pneumonia (SP). Methods: Eighty-one elderly patients with SP in our hospital from June 2016 to July 2019 were selected and divided into three groups according to different treatment, 27 cases in each. All three groups were treated with routine treatment. The control group one was treated with biapenem, the control group two was treated with moxifloxacin, and the observation group was treated with biapenem combined with moxifloxacin. Comparison was made in fficacy, clinical symptoms and signs improvement time, detection rate of pathogenic bacteria before and after treatment, inflammatory factors [serum calcitonin (PCT), white blood cell count (WBC), high-sensitivity C-reactive protein (hs-CRP)], T-lymph Cell subsets (CD3, CD4, CD8) levels in three groups.The incidence of adverse reactions in the three groups was counted. Results: The total effective rate of observation group was 92.59% (25/27) higher than that of control group one and control group two. The detection rate of gram-negative bacteria after treatment was 7.41% (2/27) lower than that of control group one and control group two (P<0.05); mechanical ventilation time, antipyretic time, sputum trait change time, leukocyte decline time, and significant pulmonary inflammation absorption time in the observation group were shorter than those in control group one and control group two (P<0.05); After treatment, the levels of PCT, WBC and hs CRP in the observation group were lower than those in the control group one and two, and the levels of CD3, CD4 and CD8 were higher than those in the control group one and two (P<0.05).Conclusion: Biapenem combined with moxifloxacin has significant curative effect on elderly SP. It can inhibit the inflammatory response and improve immune function, with less adverse reactions and high safety. 2020 Vol. 26 (5): 721-727 [Abstract] ( 264 ) HTML (1 KB)  PDF (1222 KB)  ( 718 ) 727 Effect of Concurrent Radiotherapy and Chemotherapy on Survival Rate and Serum TSP-1 and MicroRNA-21 Levels in Patients with Esophageal Cancer JI Xiang, ZHOU Linlin, PAN Jiqun, et al DOI: 10.3969/j.issn.1006-6233.2020.05.006 Objective: To study the effect of concurrent radiotherapy and chemotherapy on survival rate and serum TSP-1 and microRNA-21 levels in patients with esophageal cancer. Methods: 110 esophageal cancer patients who received therapy from February 2015 to January 2017 in our hospital were selected as research objects. According to simple random grouping method,those patients were divided into the observation group (n=59) and the control group (n=51). The control group was treated with sequential chemoradiotherapy, while the observation group was treated with concurrent radiotherapy and chemotherapy. Post-treatment comparison between both groups was made in the total remission rate, 1-year and 2-year survival rate, serum TSP-1, microRNA-21 level, Karnofsky(KPS) score, and adverse reactions. Results:After treatment, the total remission rate of the observation group was significantly higher than that of the control group[88.14％(52/59)vs66.67％(34/51)](P＜0.05). There was no significant difference in 1-year survival rate between the two groups (P>0.05). The 2-year survival rate of the observation group was significantly higher than that of the control group[71.19％(42/59)vs33.3％(17/51)](P<0.05). Serum Thrombin sensitive protein-1(TSP-1) and microRNA-21 levels were significantly higher than those in the control group[(189.63±9.20)ng/mL vs(145.86±7.49)ng/mL,(6.96±1.05)-log vs(12.82±2.04)-log](P<0.05). KPS score was significantly higher than that of the control group[(75.38±3.59)ng/mL vs(64.92±3.05)ng/mL](P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Synchronous radiotherapy and chemotherapy can effectively improve the clinical symptoms, improve the survival rate of patients, inhibit tumor recurrence and metastasis, and promote the prognosis of patients. 2020 Vol. 26 (5): 727-731 [Abstract] ( 122 ) HTML (1 KB)  PDF (1199 KB)  ( 263 ) 731 Analysis of the Clinical Effect of Medloratadine Combined with Endoscopic Sinus Surgery on Chronic Sinusitis and the Improvement of Allergy and Olfactory Function LI Jun DOI: 10.3969/j.issn.1006-6233.2020.05.007 Objective: To analyze the clinical effect of medloratadine combined with endoscopic sinus surgery on chronic sinusitis and the improvement of allergy and olfactory function. Methods: 79 chronic sinusitis patients who received therapy from March 2017 to February 2018 were selected as research objects and divided into the observation group (n=41) and the control group (n=38) with simple random grouping method. The control group was given endoscopic sinus surgery, and the observation group was treated with medloratadine on the basis of the control group. The control group was given endoscopic sinus surgery, and the observation group was treated with medloratadine on the basis of the control group. The post-treatment comparison was made between both groups on treatment efficacy, smell, Lund-Mackay, Lund-Kennedy scores, allergy, and inflammation. Results: The post-treatment evaluation reveals that, in comparison with the control group, the total effective rate of observation group was significantly higher [92.68％(38/41)vs68.42%(26/38)](P＜0.05＝; smell, Lund-Mackay and Lund-Kennedy scores were significantly lower [(2.51±0.70)scores vs(4.03±0.92)scores,(4.32±0.51)scores vs(6.56±0.83)scores,(2.46±0.12)scores vs(4.03±0.26)scores] (P＜0.05); serum TIgE and ECP were significantly lower [(57.98±4.91)kU/L vs(63.75±7.02)kU/L,(4.02±0.50)ng/L vs(5.38±0.92)ng/L] (P＜0.05); serum levels of TNF-alpha, IL-6 and IL-8 were significantly lower [(1.19±0.52)ng/ml vs(2.70±0.81)ng/ml,(5.10±1.05)pg/ml vs(10.26±2.01)pg/ml,(281.96±30.49)ng/L vs(316.30±42.80)ng/L](P＜0.05).Conclusion:Medloratadine combined with endoscopic sinus surgery can alleviate the clinical symptoms, improve the ventilation function of the nasal cavity and sinuses, restore the olfactory function, reduce the allergic reaction, promote the recovery, and the treatment effect is significant. 2020 Vol. 26 (5): 731-735 [Abstract] ( 114 ) HTML (1 KB)  PDF (1200 KB)  ( 391 ) 735 Effects of RhBNP on Myocardial Enzymes and NT-proBNP in Elderly Patients with Acute Decompensated Heart Failure KONG Haiying, YANG Guanglong, YIN Qiong, et al DOI: 10.3969/j.issn.1006-6233.2020.05.008 Objective: To study the effects of recombinant human brain natriuretic peptide (rhBNP) on myocardial enzymes and N-terminal pro-brain natriuretic peptide (NT-proBNP) in elderly patients with acute decompensated heart failure (ADHF). Methods: A total of 150 elderly ADHF patients admitted to our hospital from June 2017 to June 2018 were enrolled in the study. They were divided into control group and study group by simple random number table method, with 75 cases in each group. Control group was treated with conventional methods while study group was treated with rhBNP on the basis of conventional treatment, and they were treated for 1 week. The efficacy, and cardiac function indexes, 24h urine volume, myocardial enzymes, and NT-proBNP before and after treatment were compared between the two groups, and the occurrence of adverse reactions was monitored. Results: The total post-treatment effective rate in study group was higher than that in control group(P<0.05). The post-treatment evaluation reveals the following facts, compared to pre-treatment: the left ventricular ejection fraction (LVEF) in both groups was higher while the left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) were lower, and the LVEF in study group was higher than that in control group while the LVESV and LVEDV were lower than those in control group (P<0.05). The 24h urine volume in both groups was higher and the 24h urine volume in study group was higher than that in control group (P<0.05).The levels of lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme MB (CK-MB) and α-hydroxybutyrate dehydrogenase (α-HBD) in both groups were lower and the above indexes in study group were lower than those in control group (P<0.05). The level of NT-proBNP in both groups was lower and the level of NT-proBNP in study group was lower than that in control group (P<0.05). The incidence rates of adverse reactions in both groups during treatment were 18.67% and 21.33% respectively (P>0.05). Conclusion: RhBNP has significant efficacy in the treatment of elderly patients with acute decompensated heart failure. It helps improve the level of myocardial enzymes, increase urine output and improve cardiac function, and it proves to be highly safe and applicable. 2020 Vol. 26 (5): 735-740 [Abstract] ( 112 ) HTML (1 KB)  PDF (1222 KB)  ( 224 ) 740 Effect of Trimebutin Maleate and Stomach Granules Combined with Mosapride on Functional Dyspepsia and Its Effects on Serum 5-HT NO SP and Gastrointestinal Hormone LI Wen, DING Yuanyuan, LIU Chenchen, et al DOI: 10.3969/j.issn.1006-6233.2020.05.009 Objective: To discuss the therapeutic effect of trimebutin maleate and stomach granules combined with mosapride on functional dyspepsia and its effects on serum 5-hydroxytryptamine (5-HT), nitric oxide (NO) and substance P (SP) and gastrointestinal hormone. Methods: 82 patients with functional dyspepsia admitted to our hospital from March 2015 to March 2016 were selected and divided into control group and research group according to simple random method, 41 in each. The control group was given medication treatment of mosapride, and the research group was additionally given trimebutin maleate on the basis of control group.Then the clinical curative effect, changes of symptom score, the serum levels of 5-HT, NO and SP, motilin (MTL), gastrin (GAS), gastric antrum movement index (MI), amplitude (ΔA/A), the contraction frequency (F), gastric half emptying time (T1/2) before and after the treatment, and incidence of adverse reactions were compared between both groups. Results: The total effective rate of research group was higher than that of the control group (P<0.05); After treatment, the levels of serum 5-HT, NO, T1/2 in both groups decreased, and the levels of serum SP, MTL, GAS, MI, ΔA/A, F in both groups increased. Moreover, the differences between the above indexes in the research group before and after treatment were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion: The therapeutic effect of trimebutin maleate combined with mosaprib in the treatment of functional dyspepsia is superior to that of mosaprib alone, which may be related to the effective regulation of serum 5-ht, NO and SP levels in patients and the improvement of gastrointestinal hormones 2020 Vol. 26 (5): 740-744 [Abstract] ( 177 ) HTML (1 KB)  PDF (1196 KB)  ( 287 ) 744 Clinical Effect of Carboprost Tromethamine on Postpartum Hemorrhage in High-risk Pregnancy LIANG Hongyan DOI: 10.3969/j.issn.1006-6233.2020.05.010 Objective:To investigate the clinical effect of carboprost tromethamine in the treatment of postpartum hemorrhage in high-risk pregnancy. Methods:In this study, 50 high-risk pregnant women who delivered in the country hospital from March 2018 to September 2018 were selected as the research objects and divided into two groups with random number method (n=25).Both groups underwent cesarean section after combined spinal-epidural anesthesia. After the delivery, the control group received an intrauterine injection of 10U oxytocin and misoprostol tablets for anal plugging, while the observation group received an intrauterine injection of 10U oxytocin and another injection of 1ml carboprost tromethamine. Results:24 hours after delivery, the hemoglobin levels of the two groups were lower than those before delivery (P<0.05), and hemoglobin level of the observation group was higher than that of the control group (P<0.05). 24 hours after delivery, there was no significant difference in systolic and diastolic blood pressure between the two groups (P>0.05). The amount of bleeding during operation, 2 hours after delivery and 24 hours after delivery in the observation group was lower than that in the control group (P<0.05). Conclusions:Carboprost tromethamine can inhibit the decrease of hemoglobin level, which is conducive to reducing intraoperative and postpartum hemorrhage in high-risk pregnancies. 2020 Vol. 26 (5): 744-747 [Abstract] ( 96 ) HTML (1 KB)  PDF (1175 KB)  ( 295 ) 747 Effects of Different Hemostatic Methods Used in Laparoscopic Cystectomy for Ovarian Endometriosis Cyst on Ovarian Reserve Function, Menstruation and Sex Hormone Levels LUO Aimin, DU Zhen, CHEN Zhimei, et al DOI: 10.3969/j.issn.1006-6233.2020.05.011 Objective: To investigate the effects of different hemostatic methods used in laparoscopic cystectomy for ovarian endometriosis cyst (OEC) on ovarian reserve function, menstruation and sex hormone levels. Methods: 106 patients with OEC who were admitted to the hospital from January 2016 to January 2019 were selected as the subjects. They were divided into the control group (bipolar coagulation hemostasis, n=53) and the observation group (suture hemostasis under laparoscope, n=53) according to the operation method. The ovarian reserve function [antral follicle count (AFC), ovarian artery peak systolic velocity (PSV) at affected side ovarian artery], sex hormones [follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2)], menstrual recovery and follow-up pregnancy outcomes were compared between the two groups. Results: There were no significant differences in AFC, PSV, FSH, LH, E2, menstrual time or menstrual cycle between the two groups before operation (P>0.05). There was no significant difference in AFC or PSV in the observation group at 3rd and 6th month months after operation, compared with those before operation (P>0.05). AFC and PSV in the control group were significantly lower than those before operation (P<0.05). Besides, AFC and PSV in the observation group were significantly higher than those in the control group (P<0.05). The difference of menstrual duration and menstrual cycle of the observation group before and after treatment was bigger than that of the control group (P<0.05). There was no significant difference in the level of FSH, LH or E2 in the observation group at 6th month after operation, compared with those before operation (P>0.05). The levels of FSH and LH in the control group were significantly increased and E2 levels were significantly decreased (P<0.05). The difference of L2, LH and E2 in the observation group before and after treatment was smaller than that in the control group (P<0.05). The natural pregnancy rate of the observation group was 33.96% at 1 year after operation, significantly higher than that of the control group (15.09%) (P<0.05). Conclusion: Compared with bipolar coagulation hemostasis, suture hemostasis causes less damage to the ovarian reserve function in patients having undergone laparoscopic cystectomy for OEC. It is more conducive to menstrual recovery and stable sex hormone levels, and the clinical positive effect is more obvious 2020 Vol. 26 (5): 747-751 [Abstract] ( 107 ) HTML (1 KB)  PDF (1200 KB)  ( 278 ) 751 Effects of Single and Continuous Injection of Dexmedetomidine on Hemodynamics in Patients Undergoing Laparoscopic Myomectomy MA Fuying, WANG Shengbin DOI: 10.3969/j.issn.1006-6233.2020.05.012 Objective: To analyze the effect of single and continuous injection of dexmedetomidine on hemodynamics in patients undergoing laparoscopic myomectomy. Methods: From August 2017 to August 2019, 100 patients with laparoscopic myomectomy were randomly divided into study group and control group, 50 cases in each. Patients in the control group were given continuous injection of dexmedetomidine, while those in the study group were given single injection of dexmedetomidine. The operation time, extubation time, recovery time, observers assessment of alertness/sedation scale (OAA/S) score, perioperative heart rate, systolic blood pressure, diastolic blood pressure and adverse reactions were compared between the two groups. Results: There was no significant difference in operation time between the two groups (P>0.05). The recovery time, extubation time and recovery time of anesthesia in the study group were significantly shorter than those in the control group (P<0.001). Compared with the control group, the proportion of4 and 5 points on OAA/S scores in the study group was significantly increased, and the proportion of one point on OAA/S score was significantly decreased (P<0.05). There was no statistical significance in the difference of perioperative blood pressure between the two groups (P>0.05). The heart rate of the two groups at the time of extubation and 5 minutes after extubation was significantly faster than that before operation (P<0.05). The total incidence of adverse reactions in the study group was 12.00%, which was significantly lower than that in the control group (32.00%) (P<0.05). Conclusion: Single injection of dexmedetomidine has a good anesthetic effect on patients undergoing laparoscopic myomectomy, which is conducive to maintaining hemodynamic stability. 2020 Vol. 26 (5): 751-754 [Abstract] ( 89 ) HTML (1 KB)  PDF (1179 KB)  ( 244 ) 755 Relationship Between Levels of Serum UA, CK, Cys-C and APN and Carotid Atherosclerosis in Elderly Patients with Hypertension MA Zhan, LEI Hailing, SUN Huayi DOI: 10.3969/j.issn.1006-6233.2020.05.013 Objective: To analyze the relationship between levels of serum uric acid (UA), creatine kinase (CK), cystatin C (Cys-C), adiponectin (APN) and carotid atherosclerosis in elderly patients with hypertension. Methods: A total of 110 elderly patients with hypertension admitted to our hospital from April 2018 to April 2019 were selected for the study. The patients were divided into normal IMT group (36 cases), IMT thickening group (31 cases) and plaque formation group (43 cases) according to the carotid intima-media thickness (IMT). The levels of serum UA, CK, Cys-C and APN were detected, and the correlation between IMT and above indicators was analyzed, and the factors affecting carotid atherosclerosis in elderly hypertensive patients were analyzed by Logistic regression model. Results: With the increase of IMT thickening, the levels of serum UA, CK and Cys-C were increased gradually, and the levels showed normal IMT group<IMT thickening group<plaque formation group (P<0.05), and the APN level was gradually decreased, and the level showed normal IMT group>IMT thickening group>plaque formation group (P<0.05). Pearson correlation analysis showed that IMT was positively correlated with UA, CK and Cys-C (P<0.05), and was negatively correlated with APN (P<0.05). Binary Logistic regression model analysis showed that serum UA, CK, Cys-C and APN were independent risk factors for carotid atherosclerosis in elderly hypertensive patients (P<0.05). Conclusion:The degree of carotid atherosclerosis in elderly hypertensive patients is related to the increases of serum UA, CK and Cys-C and the decrease of APN. 2020 Vol. 26 (5): 755-758 [Abstract] ( 104 ) HTML (1 KB)  PDF (1179 KB)  ( 301 ) 758 Expression of HOTAZR, EZH2 and VEGF in Nasopharyngeal Carcinoma and Their Influence on Prognosis YE Beihua, FU Ming, HE Jintian, et al DOI: 10.3969/j.issn.1006-6233.2020.05.014 Objective: To analyze the expression of vascular endothelial growth factor (VEGF), enhancer of zeste homolog 2 (EZH2) and long-chain noncoding RNA Hox transcript antisense RNA (HOTAIR) in nasopharyngeal carcinoma and its effect on prognosis. Methods: The clinical data of 72 patients with nasopharyngeal carcinoma (NPC group) and 54 patients with chronic inflammation of nasopharynx (control group) were collected by retrospective study. The expression of VEGF and EZH2 were detected by immunohistochemistry, and the expression of VEGF, EZH2 and HOTAIR mRNA were detected by real-time fluorescence quantitative polymerase chain reaction. According to the expression of hotair in nasopharyngeal carcinoma, nasopharyngeal carcinoma patients were divided into low expression group and high expression group. Results: The expression of VEGF and EZH2 in nasopharyngeal carcinoma group was significantly higher than that in control group (P<0.001). Compared with the control group, the relative expression of VEGF, EZH2 and HOTAIR mRNA in nasopharyngeal carcinoma group was significantly increased (P<0.05). There were significant differences in pathological grade, N stage, M stage, short-term efficacy between the high-expression group and the low-expression group (P<0.05); there were no significant differences in age, gender, pathological type between the two groups (P>0.05). Conclusion: VEGF, EZH2 and HOTAIR are highly expressed in nasopharyngeal carcinoma, and hotair may play a role in inducing distant metastasis of nasopharyngeal carcinoma through EZH2 and VEGF, which is closely related to poor prognosis. 2020 Vol. 26 (5): 758-762 [Abstract] ( 99 ) HTML (1 KB)  PDF (1193 KB)  ( 291 ) 763 Therapeutic Effect of Febuxostat Combined with Hydrochlorothiazide on Chronic Kidney Disease and its Efect on Serum Cys-C and NT proBNP ZHANG Suming, YE Liping, CHENG Wei, et al DOI: 10.3969/j.issn.1006-6233.2020.05.015 Objective: To investigate the therapeutic effect of non bustatin combined with hydrochlorothiazide on chronic kidney disease and its effect on serum cystatin C (Cys-C) and N-terminal pro brain natriuretic peptide (NT proBNP). Methods: 80 patients with chronic kidney disease admitted to our hospital from June 2017 to June 2019 were selected for the study,they were divided into observation group (n=41) and control group (n=39) by simple random grouping. The control group was treated with hydrochlorothiazide and the observation group was treated with febuxostat on the basis of the control group. The clinical efficacy, serum cys-c, nt-probnp, urea nitrogen (BUN), serum creatinine (SCr), urinary albumin (Upro) levels and adverse reactions were compared between the two groups. Results: The total effective rate in the observation group was 85.37%, significantly higher than 64.10% in the control group (P<0.05). Before treatment, there was no significant difference in the levels of cys-c and nt-probnp between the two groups (P>0.05). After treatment, the levels of cys-c and nt-probnp in both groups decreased significantly, and the observation group was lower than the control group (P<0.05). Before treatment, there was no significant difference in renal function between the two groups (P>0.05). After treatment, the levels of BUN, SCr and Upro in both groups were significantly improved, and the levels of BUN, SCr and Upro in the observation group were lower than those in the control group (P<0.05). The total incidence of adverse reactions was 14.63% in the observation group and 20.51% in the control group, with no significant difference (P＞0.05). Conclusion: Febuxostat combined with hydrochlorothiazide has a significant effect in patients with chronic kidney disease, which can effectively improve the serum cys-c, nt-probnp and renal function of patients without increasing adverse reactions. 2020 Vol. 26 (5): 763-766 [Abstract] ( 141 ) HTML (1 KB)  PDF (1179 KB)  ( 384 ) 766 Effects of Alprostadil Combined with Fenofibrate on Urinary Podocyte Associated Proteins and Renal Function Protection in Patients with Diabetic Nephropathy SUN Feng, ZHANG Rui, ZHAO Yusong DOI: 10.3969/j.issn.1006-6233.2020.05.016 Objective: To investigate the effect of alprostadil combined with fenofibrate on urinary podocyte related protein and renal function protection in diabetic nephropathy patients. Methods: 112 patients with diabetic nephropathy were divided into control group (n=54) and observation group (n=58) according to simple random method. The control group was treated with fenofibrate, while the observation group was treated with alprostadil on the basis of the control group. The clinical effects, and the changes of urinary podocyte related protein, renal function, renal blood flow parameters and blood glucose indexes before and after treatment, and adverse reactions of the two groups were compared. Results: After treatment, the total effective rate of the observation group was higher than that of the control group (P<0.05). Before treatment, there was no significant difference in urinary podocyte related protein, renal function, renal blood flow parameters and blood glucose indexes between the two groups (P>0.05). After treatment, urinary podocyte related protein and renal function indexes of the two groups decreased and renal blood flow parameter indexes increased compared with those before treatment. the difference between the above indexes before and after treatment in the observation group was significantly higher than that in the control group (P<0.05). There was no significant change in blood glucose index between the two groups after treatment (P>0.05). There was no significant difference in total rate of adverse reactions between the two groups (P>0.05). Conclusion: Alprostadil combined with fenofibrate can improve the curative effect of diabetic nephropathy, reduce the level of urinary podocyte related protein and protect renal function. 2020 Vol. 26 (5): 766-771 [Abstract] ( 97 ) HTML (1 KB)  PDF (1219 KB)  ( 321 ) 771 Effects of T-tube Sinoscope Combined with Holmium Laser in the treatment of Intrahepatic and Extrahepatic Bile Duct Residual Stones and the Level of Bilirubin Total Bile Acid and Alkaline Phosphatase in Patients WANG Zhigang, DENG Jianjun, YUE Qijun, et al DOI: 10.3969/j.issn.1006-6233.2020.05.017 Objective: To observe the efficacy of T-tube sinus choledochoscopy combined with holmium laser in the treatment of residual stones of intrahepatic and extrahepatic bile ducts and its effects on levels of related serum biochemical markers. Methods: The clinical data of 50 patients with residual stones of intrahepatic and extrahepatic bile ducts in our hospital from April 2014 to April 2019 were retrospectively analyzed. According to the treatment procedures,they were divided into T-tube sinus choledochoscopy combined with holmium laser group (combined group,n=23) and conventional lithotomy under choledochoscopy group (conventional group, n=27). The operation was observed, and the levels of serum bile biochemical markers [total bilirubin (TBil), total bile acid (TBA), combined bilirubin (DBil)] and hepatic enzyme indicators [alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST)] were compared between the two groups before operation and at 3d after operation. The occurrence of complications was recorded. Results: The operative time and hospital stay in combined group were shorter than those in conventional group, and the success rate of stone removal was higher than that in conventional group (P<0.05). At 3d after operation, the levels of serum TBil, TBA, DBil, ALP, ALT and AST in the two groups were lower than those before operation, and the levels in combined group were lower than those in conventional group (P<0.05). The incidence rate of postoperative complications in combined group was lower than that in conventional group (P<0.05). Conclusion: Compared with conventional stone removal under choledochoscopy, T-tube sinus choledochoscopy combined with holmium laser for residual stones of intrahepatic and extrahepatic bile ducts can significantly improve the operation, enhance the success rate of stone removal, and help regulate bile components, improve liver function and reduce the incidence rate of complications, and it is more advantageous. 2020 Vol. 26 (5): 771-775 [Abstract] ( 107 ) HTML (1 KB)  PDF (1198 KB)  ( 301 ) 775 Clinical Comparison of Two Technology Assay Results in Detection of the Blood Type Antibody IgG Subsets MA Yintu, et al DOI: 10.3969/j.issn.1006-6233.2020.05.018 Objective: Apply the micro column gel technique assay ( MGTA) and the ELISA in detection the blood type antibody IgG subsets,evaluate the application effect to screening the antibody IgG subsets and the relationship between the antibody IgG subsets and HDN.Methods: By means of microcolum gel test and ELISA,IgG subsets were analyzed in 62 pregnant women who had the IgG anti-A(B) titer higher than 512 in 57 cases O maternal serum and the IgG anti-D titer higher than 64 in 5 cases Rh negative maternal serum.The 27 newborn cases were screened the IgG subsets and the three tests. The consistency and relativity of two methods were compared. Results:The consistency of two tests was well. The results of 5 cases Rh and 44 in 57 ABO cases were accorded.The results higher of MGTA were 6 cases and lower were 7 cases compared to ELISA, while there was no significant difference between MGTA and ELISA(P>0.05).The content of antibody IgG subsets in newborn was closely related with the mather.The IgG1 and IgG3 in postnatal haemolytic newborns were higher distinctly and the more content high the more jaundice early and serious.Conclusion: The two technology all should be used in screening the IgG antibody subsets. As for a general clinical application,the MGTA was more advantaged than ELISA because of higher accuracy and easier procedure in screening the contents of IgG antibody subsets. The method may provide a directional significance in early intervention of blood group incompatibility hemolytic disease of the newborns. 2020 Vol. 26 (5): 775-778 [Abstract] ( 213 ) HTML (1 KB)  PDF (1184 KB)  ( 592 ) 778 Application Value of IMRT and Three-dimensional Conformal Technique of Tangent Field in Breast Cancer Patients after Breast Conserving Surgery TONG Wei, ZHENG Jie, et al DOI: 10.3969/j.issn.1006-6233.2020.05.019 Objective: To explore the application value of intensity modulated radiation technology and three-dimensional conformal technique with tangent field in breast cancer patients after breast conserving surgery. Methods: 82 patients with breast cancer after breast-conserving surgery in our hospital from November 2017 to November 2019 were selected. They were divided into intensity-modulated group and conformal group, with 41 patients in each group. The conformal group adopts the tangent field three-dimensional conformal technology, and the intensity-modulated group adopts the intensity-modulated radiation technology. The dose distribution of whole milk target area, total lung volume, cardiac volume, relative expression levels of miR-765 and miR-21 before and after treatment, levels of T cell subgroup indicators, and occurrence of toxicities were calculated. Results: CI and Dmean in the intensity-modulated group were higher than those in the conformal group, HI and Dmax were lower than those in the conformal group (P<0.05), and there was no significant difference in Dmin between the two groups (P>0.05); Dmean and V5 in the intensity-modulated group were lower than those in the conformal group (P<0.05), and there was no significant difference in V20 between the two groups (P>0.05); Dmean, V20 and V40 in the intensity-modulated group were lower than those in the conformal group (P<0.05); After treatment, the relative expression of miR-765 in the two groups was higher than that before treatment, and miR-21 was lower than that before treatment, the relative expression of miR-765 in the intensity-modulated group was higher than that in the conformal group, and miR-21 was lower than that in the conformal group (P<0.05);After treatment, the CD3+, CD4+, and CD4+/CD8+ in the two groups were lower than before treatment, and the CD8+ was higher than before treatment, but the CD3+, CD4+, CD4+/CD8+ in the IM group were higher than the conformal group, and the CD8+ was lower than the conformal group (P<0.05);The incidence of myelosuppression (29.27%) and acute skin reaction (63.41%) in the intensity-modulated group was lower than that in the conformal group (53.66%, 82.93%) (P<0.05). Conclusion: The results of intensity-modulated radiation therapy for breast cancer patients after breast conserving surgery are better than the three-dimensional conformal technique of tangent field, which can ensure the rationality of radiation dose in each region, have little impact on the immune function of patients, regulate the relative expression of miR-765 and miR-21, and reduce the risk of side effects to a certain extent, and ensure the safety. 2020 Vol. 26 (5): 778-784 [Abstract] ( 113 ) HTML (1 KB)  PDF (1235 KB)  ( 220 ) 784 Application of Rat Neural Factor Combined with Creatine Phosphate in Neonatal HIE WANG Ju, JIANG Xiaohong, QIAN Qingyan DOI: 10.3969/j.issn.1006-6233.2020.05.020 Objective: To investigate the clinical effects of murine nerve growth factor (M-NGF) combined with sodium creatine phosphate in the treatment of neonatal hypoxic ischemic encephalopathy (HIE). Methods: From June 2017 to December 2018, 62 neonates with HIE were simple random number table method divided into two groups (31 cases each).The children in the control group were treated with routine treatment, and the study group was treated with M-NGF combined with creatine phosphate on the basis of the control group for 10 days. Neonatal behavioral nerve score (NBNA), myocardial markers (cTnI, CK-MB, CK), clinical efficacy, and safety were compared between the two groups. Results: Repeated measurement analysis of variance showed that there were significant differences in NBNA score, myocardial between the two groups, and the interaction between the two groups (P<0.05).The results of pairwise comparison within the group showed that the NBNA scores at different time points in the two groups showed a significant upward trend (P<0.05), and cTnI, CK-MB and CK all showed a significant downward trend (P<0.05). Coupled comparisons between groups showed, before treatment, there was no significant difference in NBNA score, myocardial between the two groups (P>0.05).On the 5th and 10th day of treatment, the NBNA score in the study group were higher than those in the control group, and the cTnI,CK-MB,CK levels were lower than those in the control group (P<0.05).The total effective rate of treatment in the study group (96.77%) was higher than that in the control group (70.97%), the difference was statistically significant (χ2=7.631, P<0.05). There were no serious adverse reactions during treatment in both groups. Conclusion: M-NGF combined with creatine phosphate in the treatment of neonatal HIE can significantly improve myocardial function, reduce myocardial injury, promote the recovery of nerve function, improve the clinical efficacy, and has high safety. 2020 Vol. 26 (5): 784-788 [Abstract] ( 98 ) HTML (1 KB)  PDF (1244 KB)  ( 261 ) 788 Efficacy of Hemodialysis and Continuous Blood Purification Dialysis on Acute Renal Failure and its Influence on Toxin Clearance Rate and Renal Function Indexes WANG Kekun, et al DOI: 10.3969/j.issn.1006-6233.2020.05.021 Objective: To explore the efficacy of intermittent hemodialysis (IHD) and continuous blood purification dialysis (CBP) in the treatment of acute renal failure (ARF) and its influence on toxin clearance rate and renal function indexes. Methods: 96 patients with ARF were randomly divided into CBP group (given CBP therapy, 48 cases) and IHD group (given IHD therapy, 48 cases). Blood gas indexes, renal function indexes, toxin clearance rate, treatment recovery and incidence rate of complications were compared between the two groups. Results: After treatment, the heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly deScreased in the two groups (P<0.05) while the blood oxygen saturation (SpO2) was significantly inScreased (P<0.05), and there were no significant differences between the two groups (P>0.05). After treatment, the levels of urea nitrogen (BUN), Screatinine (Scr), blood phosphorus, blood uric acid and β2-miScroglobulin (β2-MG) were significantly deScreased in the two groups (P<0.05), but the deScreases in CBP group were greater than those in IHD group (P<0.05). The clearance rates of BUN, Scr, blood phosphorus, blood uric acid and β2-MG in CBP group were significantly higher than those in IHD group (P<0.05). The treatment time in CBP group was shorter than that in IHD group (P<0.05). The acute physiology and chronic health evaluation II (APACHE II) scores in the two groups were significantly deScreased after treatment, and the reduction in CBP group was greater than that in IHD group (P<0.05). The incidence rate of complications in CBP group was significantly lower than that in IHD group (P<0.05). Conclusion: CBP can effectively improve the dialysis effects of ARF patients, enhance the toxin clearance rate, promote the recovery of renal function and reduce complications. 2020 Vol. 26 (5): 788-792 [Abstract] ( 145 ) HTML (1 KB)  PDF (1197 KB)  ( 335 ) 792 Clinical Value of ESD Guided by Mini-probe Endoscopic Ultrasonography in the Diagnosis and Treatment of Gastric Mucosal Protrusion Lesions ZHOU Xiangrong, XU Dahai, PENG Qinghai, et al DOI: 10.3969/j.issn.1006-6233.2020.05.022 Objective: To investigate the clinical value of endoscopic submucosal dissection (ESD) guided by mini-probe endoscopic ultrasonography in the diagnosis and treatment of gastric mucosal protrusion lesions. Methods: The clinical data of 194 patients with gastric mucosal protrusion confirmed by operation and pathology were analyzed retrospectively. The diagnostic value of micro probe endoscopic ultrasonography and general gastroscopy in gastric mucosal protuberant lesions were analyzed. 194 patients were divided into ESD group (n=102) and EMR group (n=92) according to the operation mode. The operation related indexes (whole resection rate, operation time, intraoperative bleeding volume) and complications were recorded. The difference of stress response (noradrenaline (NE), cortisol (COR)) between the two groups before and 1 day after operation was compared. Results: Of the 194 patients with gastric mucosal protrusion lesions, there were 78 cases of polyps, 51 cases of interstitialoma, 42 cases of liomyoma and 23 cases of lipomyoma. The diagnostic accuracy rate of mini-probe endoscopic ultrasonography was significantly higher than that of common gastroscopy in the diagnosis of gastric mucosal protrusion lesions (P<0.05). The block resection rate in ESD group was significantly higher than that in EMR group (P<0.05), and the surgery time and intraoperative blood loss were lower than those in EMR group (P<0.05). There were no significant differences in the perioperative complications between the two groups (P>0.05). At 1d after surgery, the stress response indexes (serum NE, Cor) were higher than those before surgery (P<0.05), and the indexes in EMR group were higher than those in ESD group (P<0.05). Conclusion: ESD by mini-probe endoscopic ultrasonography has significant effects in the diagnosis and treatment of gastric mucosal protrusion lesions, and can reduce the surgical stress response, and it is of positive significance in promoting postoperative recovery. 2020 Vol. 26 (5): 792-796 [Abstract] ( 99 ) HTML (1 KB)  PDF (1203 KB)  ( 378 ) 796 The Significance of Combined Indocyanine Green and Isosulfan Blue Tracing Sentinel Lymph Nodes in Open Surgery of Uterine Malignant Carcinoma ZHUANG Xinrong, LI Shumei, ZHANG Guixiang DOI: 10.3969/j.issn.1006-6233.2020.05.023 Objective: To evaluate the value of indocyanine green(ICG) and isosulfan blue(ISB) for identifying sentinel lymph node (SLN) in uterine malignant carcinoma. Methods: 60 patients (34 cases of endometrial cancer and 26 cases of cervical cancer) who underwent open surgery in affiliated hospital of chengde medical college were selected. ISB and ICG were injected into the cervix of cervical cancer and around the lesion in the patients with endometrial cancer. All the SLN and other lymph nodes were labeled postoperatively and sent for routine pathological examination. Results: The total detection rate of pelvic SLN was 91.7% (55 / 60) using ICG combined with ISB, the sensitivity and negative predictive value were all 100%. The detection rate of ICG and ISB was 81.7% (49/60) and 71.7% (43/60), respectively. Detection rate of SLN with combined technique was higher than that with single technique, ICG detection rate was higher than ISB technique (P<0.05). Conclusion: ICG combined with ISB tracing SLN showed high sensitivity and negative predictive value. Combined detection method is superior to single technique and will have a certain application prospect in prediction of lymph node metastasis in open surgery of uterine malignant carcinoma. 2020 Vol. 26 (5): 796-800 [Abstract] ( 118 ) HTML (1 KB)  PDF (1490 KB)  ( 386 ) 800 Levels and Clinical Significance of Peripheral Blood Mononuclear Cells Treg and Th17 Cells before and after treatment of Severe Bronchiolitis in Children WANG Wenhui, LI Minfu, WANG Ru, er al DOI: 10.3969/j.issn.1006-6233.2020.05.024 Objective: To explore the changes of levels of peripheral blood mononuclear cells Treg and Th17 cells before and after treatment of severe bronchiolitis in children. Methods: A total of 106 children patients with severe bronchiolitis who were admitted between September 2017 and September 2018 were selected for the study. All patients were closely monitored for disease changes, and given symptomatic supportive therapy, antiviral therapy and aerosol inhalation of budesonide or ipratropium bromide. The efficacy was evaluated in the two groups, and the levels of Treg and Th17 and related cytokines [interleukin-17 (IL-17), interleukin-23 (IL-23), interleukin-10 (IL-10), transforming growth factor-β (TGF-β)] were compared before treatment and after 1w of treatment, and the levels of Treg and Th17 were evaluated in children patients with different efficacy. Spearman correlation analysis was used to analyze the correlation between efficacy and Treg and Th17 levels after treatment. Results: After 7d of treatment, the level of Treg was higher than that before treatment (P<0.05) while the level of Th17 was lower than that before treatment (P<0.05). After 7d of treatment, the levels of IL-10 and TGF-β were higher than those before treatment (P<0.05) while the levels of IL-17 and IL-23 were lower than those before treatment (P<0.05). After 7d of treatment, the Treg levels in markedly effective children patients and effective children patients were higher than those before treatment (P<0.05) while the Th17 levels were lower than those before treatment (P<0.05).There were no significant differences in the levels of Treg and Th17 of ineffective children patients compared with those before treatment (P>0.05) There were statistically significant differences in the levels of Treg and Th17 after treatment among markedly effective, effective and ineffective children patients (P<0.05). Conclusion: The levels of Treg and its cytokines in children patients with severe bronchitis after treatment are higher than those before treatment, and Th17 cytokines are lower than those before treatment, and the efficacy of children patients is related to the balance of Th17/Treg. 2020 Vol. 26 (5): 800-803 [Abstract] ( 78 ) HTML (1 KB)  PDF (1177 KB)  ( 376 ) 804 Levels and Clinical Significance of Secretory Frizzled Related Protein 5 and N-terminal Pro-brain Natriuretic Peptide in Patients with Chronic Heart Failure AN Yu, et al DOI: 10.3969/j.issn.1006-6233.2020.05.025 Objective: To investigate the correlation between serum sFRP5 and NT-proBNP and prognosis for chronic heart failure patients. Methods: During the period from May 2018 to August 2019, 75 patients who were admitted to the Affiliated Hospital (south branch) of CDMC and diagnosed as negative for heart failure were made the control group. 89 patients with chronic heart failure were selected as the observation group. According to the NYHA (New York Heart Association) classification, the observation group was divided into three subgroups: NYHA II, III, and IV. All subjects were asked to fast for 10 to 12 hours. Fasting venous blood was taken in the morning, and fasting sFRP5 and NT-proBNP were measured and recorded. Results: The serum levels of sFRP5 and NT-proBNP in the observation group were significantly higher than those in the control group. Serum levels of sFRP5 and NT-proBNP increased with the severity of heart failure. Conclusion: sFRP5 and NT-proBNP are associated with the severity of chronic heart failure. 2020 Vol. 26 (5): 804-807 [Abstract] ( 105 ) HTML (1 KB)  PDF (1179 KB)  ( 225 ) 810 Clinical Study on the Changes of Hemorheology Indexes and Serum Inflammatory Factors in Patients with Delayed Union of Fracture XU Xiangyong, YU Yongbin DOI: 10.3969/j.issn.1006-6233.2020.05.027 Objective: To explore the clinical significance of changes of hemorheology indexes and serum inflammatory factors in patients with delayed union of fracture. Methods: The medical records of 120 fracture patients treated in our hospital from February 2018 to February 2019 were analyzed retrospectively. According to the condition of fracture healing within 4 months after operation, 68 cases in delayed healing group and 52 cases in normal healing group were divided into two groups. The hemorheology indexes, serum soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and tumor damage were analyzed by means of repeated measurement of variance analysis The levels of TNF-α, IGF-1, PDGF and ALP were measured. Results: The results of repeated measurement analysis of variance showed that there were statistical significance (P<0.05) in RBC rigidity index, RBC aggregation index, plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, sICAM-1, sVCAM-1, TNF-α, IGF-1, PDGF and ALP time factors, time factors and group interaction. After 4, 8 and 12 weeks of fracture, the RBC rigidity index, RBC aggregation index, plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, sICAM-1, sVCAM-1, TNF-α levels in the delayed healing group were significantly higher than those in the normal healing group, and the levels of IGF-1, PDGF and ALP were significantly lower than those in the normal healing group (P<0.05). Conclusion: With the prolongation of time, the cell rigidity index, RBC aggregation index, plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, sICAM-1, sVCAM-1, TNF-α, IGF-1, PDGF and ALP levels in the two groups increased first and then decreased, among which cell rigidity index, RBC aggregation index, plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, sICAM-1, s VCAM-1 and TNF-α fluctuated significantly with time in delayed union fractures, while IGF-1, PDGF and ALP levels fluctuated significantly in normal fractures. 2020 Vol. 26 (5): 810-815 [Abstract] ( 102 ) HTML (1 KB)  PDF (1217 KB)  ( 212 ) 815 The Influence of Laparoscopy and Laparotomy on the Trauma Stress and Prognosis of Colon Cancer Patients TIAN Bin, et al DOI: 10.3969/j.issn.1006-6233.2020.05.028 Objective: To analyze the influence of laparoscopy and laparotomy on the trauma stress and prognosis of colon cancer patients. Methods: 96 patients with colorectal cancer admitted to the hospital from August 2012 to March 2015 were selected for study. They were divided into minimally invasive group (laparoscopic surgery)and open surgery group(open surgery) according to simple random grouping method. The operation related indexes, trauma stress indexes, complications and prognosis related indexes of the two groups were compared. Results: In the minimally invasive group, the bleeding volume was lower than that in the open group, the incision length was shorter than that in the open group, and the anal recovery time was earlier than that in the open group (P<0.05). There was no significant difference between the two groups in operation time, lymphadenectomy and hospitalization time (P>0.05). The levels of aldosterone, cortisol and adrenaline in the minimally invasive group were lower than those in the open group on the 1st, 3rd and 5th day after operation (P<0.05). There was no significant difference in the total incidence of complications and the incidence of different types of complications between the two groups (P>0.05). One case of anastomotic leakage and two cases of intestinal obstruction in the open group were cured by operation, and the other complications improved after conservative treatment. There was no significant difference in the follow-up time between the two groups (P>0.05), 5 patients in the minimally invasive group lost the visit, 9 patients in the open group lost the visit. There was no significant difference in 5-year local recurrence rate, distant metastasis rate, overall survival rate and tumor free survival rate between the two groups (P>0.05). Conclusion: The prognosis of laparoscopic surgery for colon cancer is similar to that of open surgery, but the trauma stress caused by surgery is less 2020 Vol. 26 (5): 815-819 [Abstract] ( 129 ) HTML (1 KB)  PDF (1194 KB)  ( 244 ) 820 Comparison of Clinical Effect and VAS Score between Direct Anterior Approach and Posterolateral Approach in Supine Position in Total Hip Replacement TENG Lichu, CHEN Tuo, HUANG Shen, et al DOI: 10.3969/j.issn.1006-6233.2020.05.029 Objective: To explore the clinical effect of direct anterior approach and posterolateral approach in supine position in total hip replacement and the change of VAS score. Methods: From January 2017 to December 2019, 80 patients with osteonecrosis of the femoral head in our hospital were selected. All patients underwent total hip arthroplasty. They were simply random divided into front approach group and posterolateral approach group with 40 cases each. The front approach group adopted the direct anterior approach in a prone position, and the posterolateral approach group adopted the posterolateral approach. The clinical effects of the two groups were compared and the patients in the two groups were observed The changes of VAS score, Harris score, Barthel Index and inflammatory factor level were compared before and after the operation, and the incidence of complications was compared between the two groups. Results: There was no significant difference between the two groups (χ2= 0.538, P=0.764). The amount of bleeding, the length of incision, the time of descent and the time of hospitalization in the anterior approach group were less than those in the posterolateral approach group, and the operation time was more than those in the posterolateral approach group, the difference was statistically significant (P<0.05). The VAS score of the anterior approach group was significantly lower than that of the posterolateral approach group at 24 hours, 72 hours and 1 month postoperatively (P<0.05), but there was no significant difference between the two groups at 6 months postoperatively (P>0.05). Before the operation, there was no significant difference in Harris score and Barthel index between the anterior approach group and the posterolateral approach group (P>0.05); after the operation, the Harris score and Barthel index of the two groups were all increased, and the degree of increase in the anterior approach group was more significant, the difference was statistically significant (P<0.05). There was no significant difference in the level of inflammatory factors between the two groups (P>0.05); the levels of IL-1, IL-6 and TNF-α in the two groups decreased 24 hours after operation, and the levels of IL-1, IL-6 and TNF-α in the front approach group were lower than those in the rear lateral approach group (P<0.05). There were 3 adverse reactions in the anterior approach group and 12 in the posterolateral approach group. The incidence of complications in the anterior approach group (7.50%) was significantly lower than that in the posterolateral approach group (30.00%) (χ2=6.646, P=0.036). Conclusion: In total hip replacement, compared with posterolateral approach, direct anterior approach can shorten the operation time and intraoperative bleeding, relieve patients' pain, improve the function of hip joint, reduce patients' inflammatory reaction, and have fewer postoperative complications, which is worthy of further clinical promotion. 2020 Vol. 26 (5): 820-825 [Abstract] ( 184 ) HTML (1 KB)  PDF (1220 KB)  ( 1110 ) 825 Observation on the Effect of Propofol Combined with Dizosin and Different Doses of Naborphine in Painless Gastroscopy ZHU Heye, ZENG Weiyun, XU Xia, et al DOI: 10.3969/j.issn.1006-6233.2020.05.030 Objective: To investigate the effects of propofol combined with dizocine and different doses of nalbuphine in painless gastroenteroscopy. Methods: From April 2018 to April 2019, 117 patients undergoing gastroenteroscopy in our hospital were selected for prospective randomized controlled study. According to simple random number table method, the patients were divided into propofol combined with dizosin (n=39, group A), propofol combined with low-dose nabuchin (n=39, group B), propofol combined with high-dose nabuchin (n=39, group C). The vital signs, postoperative propofol dosage, pain, cognitive score, biochemical index and perioperative complications were compared among the three groups. Results: The vital sign parameters of three groups changed with time (f time point = 240.772, 542.149, 47.940, 70.877, P<0.05), and the systolic pressure (SBP), diastolic pressure (DBP), pulse oxygen saturation (SpO2), heart rate (HR) of three groups were significantly lower than t0 (P<0.05), and there was no significant difference between the three groups at the same time point (P>0.05). There were significant differences in propofol dosage, NRS score and serum biochemical indexes among the three groups (F=349.433, 56.720, 45.245, 136.645, 98.352, 29.738, P<0.05), and propofol dosage, NRS score and serum biochemical indexes in group C were significantly lower than those in group A and group B (P<0.05), while those in group B were significantly lower than those in group A (P<0.05). The incidence of complications in group C was significantly lower than that in group A (P<0.05), and there was no significant difference between group C and group B (P>0.05). Conclusion: In painless gastroscopy, the effect of propofol combined with high dose of nabufine is better than that of low dose of nabufine, which is significantly higher than that of propofol combined with dizosin. 2020 Vol. 26 (5): 825-829 [Abstract] ( 174 ) HTML (1 KB)  PDF (1204 KB)  ( 425 ) 833 Effect of febrile convulsion with abnormal 脑电图 at different sites on the occurrence of post-epilepsy XIAO Guanhua, et al DOI: 10.3969/j.issn.1006-6233.2020.05.032 Objective: To analyze the effect of febrile convulsion children with abnormal electroencephalogram in different parts on the later epilepsy. Methods: 100 cases of children with convulsions were selected from November 2016 to November 2018 in our hospital. According to the result of the electroencephalogram examination can be divided into normal electroencephalogram group (63 cases), abnormal electroencephalogram group (37 cases). Different parts in children with abnormal electroencephalogram group, children with abnormal rate of electroencephalogram and the incidence of epileptic events occurring in the late was analyzed. Results: There were 37 cases (37.00%) with abnormal electroencephalogram, including 16 cases (43.24%) with focal abnormality and 21 cases (56.76%) with diffuse abnormality. Among the children with focal abnormalities, there were 7 cases (18.92%) of abnormalities in the parietal and occipital lobes, and 9 cases (24.32%) of abnormalities in the frontotemporal lobes. The abnormality rates of children with frontotemporal and parietal lobe abnormalities were significantly lower than those with diffuse abnormality (χ2=9.374, χ2=11.293, all P<0.05). Children with a total of 12 cases (12.00%) appeared in the late epilepsy, from group b, there are 7 cases (77.78%) were of frontal temporal lobe area children with abnormal electroencephalogram, 3 cases (14.29%) for diffuse abnormal electroencephalogram in children with children, there were 2 cases (28.57%) for top occipital area for children with abnormal electroencephalogram in children with the late diffuse abnormal children with epilepsy was significantly lower than the forehead temporal anomalies in children (χ2= 11.203, P<0.05). Conclusion: Children with abnormal electroencephalogram in frontotemporal lobe are more likely to have epilepsy in the later period, which has a high reference value and is worth popularizing in clinical practice. 2020 Vol. 26 (5): 833-836 [Abstract] ( 107 ) HTML (1 KB)  PDF (2979 KB)  ( 247 ) 836 Analysis on the Incidence of Osteoporosis and Osteopenia and The Related Influencing Factors in 1 Month Postpartum Women XI Liang, LIANG Wei DOI: 10.3969/j.issn.1006-6233.2020.05.033 Objective: To analyze the incidence of osteoporosis and osteopenia and the related influencing factors in 1 month postpartum women. Methods: The clinical data of 100 cases of parturient in our hospital were studied retrospectively. According to the measurement results of BMD in one month after delivery, the parturient were divided into group A (normal bone mass), group B (decreased bone mass) and group C (osteoporosis). The age, gestational age, gestational times, birth times, body mass index (BMI), birth weight of newborn, family history of osteoporosis, milk intake per week during pregnancy and calcium supplement of the three groups were compared. The influencing factors of postpartum osteoporosis were analyzed by multivariate logistic regression. Results: Of the 100 cases, 57 (57.00%) had normal bone mass, 35 (35.00%) had decreased bone mass and 8 (8.00%) had osteoporosis. There was no significant difference between the three groups in terms of age, pregnancy, birth and birth weight (P>0.05). There were significant differences among the three groups in BMI, family history of osteoporosis, milk intake per week during pregnancy and calcium supplementation after childbirth (P<0.05). Multiple logistic regression analysis showed that BMI < 18.5 kg/m2, family history of osteoporosis and no calcium supplementation were independent risk factors of osteoporosis (P<0.05). Conclusion: The decrease of bone mass and osteoporosis account for a certain proportion in the women one month after delivery, which is closely related to the factors such as low BMI, family history of osteoporosis, lack of calcium supplementation after delivery. It is suggested that postpartum calcium supplementation and maintenance of BMI in the normal range should be paid attention to, at the same time, the monitoring of bone density value should be strengthened, and osteoporosis should be diagnosed timely, treated and intervened as soon as possible. 2020 Vol. 26 (5): 836-840 [Abstract] ( 118 ) HTML (1 KB)  PDF (1200 KB)  ( 282 ) 840 Analysis of Logistic Factors Influencing the Prognosis of Severe Neonatal Hypoxic-ischemic Encephalopathy WENG Haimei, LIN Mingjing, ZHOU Lixia DOI: 10.3969/j.issn.1006-6233.2020.05.034 Objective: To explore the related factors that affected the prognosis of severe hypoxic-ischemic encephalopathy (HIE). Methods: A total of 134 children with severe HIE who were treated in our hospital from January 2016 to April 2019 were enrolled. All patients were followed up for 6 months without any loss of follow-up. According to the prognosis, the children were divided into a good prognosis group and a poor prognosis group. The clinical data of the children were collected. The factors affecting the prognosis of children with severe HIE were analyzed by single factor and multivariate logistic regression. Results: The follow-up results showed that the prognosis was good in 103 cases (76.87%), and the prognosis was poor in 31 cases (23.13%). The prognosis group included 4 deaths, accounting for 2.99%.Univariate analysis showed that the 5 min Apgar score, organ injury, starting treatment age, and serum tau protein levels were significantly different between the patients with severe HIE prognosis and those with poor prognosis (P<0.05). There was no significant difference in gestational age, birth weight, mode of delivery, and 1 min Apgar score (P>0.05).Multivariate logistic regression analysis showed that 5 min Apgar score ≤ 3 points (OR=58.658, 95% CI=6.984~492.682), organ damage ≥ 2 (OR=31.145, 95%CI=3.522~275.415), starting treatment Age≥48h (OR=33.747, 95% CI=5.992~190.066), serum tau ≥8ng/L (OR=5.846, 95% CI=1.372~24.918) are risk factors for the prognosis of children with severe HIE (all P<0.05). Conclusion: Patients with 5 min Apgar score ≤ 3, organ injury ≥ 2, age ≥ 48h, and serum tau protein ≥ 8ng / l have a higher risk of poor prognosis. Therefore, clinical monitoring and timely intervention should be strengthened. 2020 Vol. 26 (5): 840-845 [Abstract] ( 107 ) HTML (1 KB)  PDF (1219 KB)  ( 241 ) 845 The Predictive Value of Four Different Scales for Deep Vein Thrombosis in Hospitalized Tumor Patients DAI Junli, et al DOI: 10.3969/j.issn.1006-6233.2020.05.035 Objective: To compare the predictive value of evaluating deep vein thrombosis (DVT) in hospitalized patients with Padua, Caprini, Wells DVT and Autar scoring scales. Methods: 150 hospitalized tumor patients diagnosed with DVT by doppler ultrasound in Chengde Central Hospital from January 2013 to March 2019 were selected as the thrombus group, and 150 hospitalized tumor patients without DVT were selected as the negative control. Padua, Caprini, Wells DVT and Autar scales were used to score and compare the two groups of patients, and then the ROC was plotted and the AUC under the curve was measured. Results: The scores of the two groups were compared according to the scale: the scores of Padua, Caprini and Wells DVT were significantly higher in the thrombus group than in the control group (P<0.001), while there was no significant difference in the scores of the Autar scale between the two groups (P=0.704). AUC of Padua scale was significantly higher than that of Caprini (P<0.0001) and Wells DVT (P<0.0001). AUC of Caprini scale was significantly higher than that of Wells DVT scale, and the difference was statistically significant (P=0.0012). Conclusion: the Padua, Caprini and Wells DVT scoring scales can accurately predict the risk of DVT in hospitalized tumor patients, among which the Padua scale has the highest prediction value, followed by the Caprini scale. 2020 Vol. 26 (5): 845-850 [Abstract] ( 229 ) HTML (1 KB)  PDF (1396 KB)  ( 710 ) 850 Analysis of the Clinical Characteristics and Gastroscopic Changes of Children with Upper Gastrointestinal Hemorrhage in Hunan Province TAO Jia, HE Zhigang DOI: 10.3969/j.issn.1006-6233.2020.05.036 Objective: To analyze the clinical characteristics and gastroscopic changes of children with upper gastrointestinal hemorrhage. Methods: The clinical data of 95 children with upper gastrointestinal hemorrhage were collected by retrospective study. According to the age of the children, they were divided into three groups: the < 1-year-old group (13 cases), the 1-2-year-old group (9 cases), the 3-5-year-old group (22 cases), the 6-13-year-old group (51 cases). The symptoms, gastroscopic characteristics and the predisposing factors of the children in each group were analyzed, and the data were included in the statistical analysis. Results: Black stool and hematemesis were found in all groups, and shock, dizziness, weakness and abdominal pain were found in all the children aged 1-13 years. The incidence of black stool and hematemesis in the 1-2-year-old group was significantly higher than that in the < 1-year-old group and the 3-5-year-old group (P<0.05), but there was no significant difference compared with the 6-13-year-old group (P>0.05); there was no significant difference in other clinical manifestations in each group (P>0.05). Gastroscopy showed that the main gastroscopic characteristics of children with upper gastrointestinal hemorrhage were cardia mucosa tearing syndrome, esophageal stenosis, erosive or hemorrhagic gastritis, duodenal bulitis, gastroesophageal varices, duodenal bulbar ulcer, erosive or reflux esophagitis. The incidence of erosive or reflux esophagitis in the 1-2-year-old group was significantly higher than that in the 6-13-year-old group (P<0.05), but there was no significant difference in the characteristics of gastroscopy in the other groups (P>0.05). The incidence of children's misuse of chemicals in the 1-2-year-old group was significantly higher than that in the other groups (P<0.05); however, there was no significant difference in other predisposing factors (P>0.05). There was no significant difference in the total effective rate (P>0.05). Conclusion: Black stool and hematemesis are the first symptoms in children under 14 years old with upper gastrointestinal hemorrhage in Hunan Province. Gastroscopy is characterized by hemorrhagic or erosive gastritis. However, most of the children have no obvious inducement, but there are high cure rate inendoscopic and drug treatment. 2020 Vol. 26 (5): 850-854 [Abstract] ( 101 ) HTML (1 KB)  PDF (1207 KB)  ( 263 ) 854 Therapeutic Effect of ESD in Rectal Neuroendocrine Tumors and Influencing Factors of Incomplete Resection QING Hongyi, WEI Shoujiang, LI Xun DOI: 10.3969/j.issn.1006-6233.2020.05.037 Objective: To investigate the effect of endoscopic submucosal dissection (ESD) on rectal neuroendocrine tumors and to analyze the influencing factors of incomplete resection. Methods: 120 patients with rectal neuroendocrine tumors admitted to our hospital from April 2016 to April 2019 were treated with ESD. The resection and complications of ESD were observed. According to the resection of ESD, the patients were divided into complete resection group and incomplete resection group. In the groups, single factor and multivariate logistic regression were taken to analyze the related factors affecting the incomplete resection of ESD. Results: The patient's ESD operation time was 32~68min, with an average of (45.28±6.93) min. 120 cases of ESD completed complete resection (100%), complete resection of 101 cases (84.17%), and incomplete resection of 19 cases (15.83%).There were no complications such as perforation and hemorrhage during and after operation. The patients were followed up for 6 months to 12 months, with an average of (1.95±0.39) years. There were no lost cases of follow-up and no recurrence or metastasis appeared during the follow-up period. Univariate analysis showed that tumor diameter, depth of invasion, central depression of lesion surface mucosa were associated with incomplete resection of ESD in patients with rectal neuroendocrine tumors (P<0.05), but not with gender, age, chromogranin (CGA), bulging morphology, etc. (P>0.05).Further multivariate logistic regression analysis showed infiltration to the submucosa (OR=7.179, 95% CI=1.206~42.748), tumor diameter>1.5cm (OR=15.709, 95% CI=2.162~114.126), and a central mucosal surface of the lesion with a depression (OR=18.191, 95% CI=4.063~81.456) were risk factors for incomplete resection of ESD in patients with rectal neuroendocrine tumors (P<0.05).Conclusion: ESD is safe and effective in the treatment of rectal neuroendocrine tumors; patients with rectal neuroendocrine tumors infiltrating into the submucosa, tumor diameter >1.5cm, and a central mucosal surface of the lesion with a depression have a high risk of incomplete resection of ESD. 2020 Vol. 26 (5): 854-858 [Abstract] ( 237 ) HTML (1 KB)  PDF (1203 KB)  ( 845 ) 859 Effect of Stellate Ganglion Block on Cognitive Function in Elderly Patients Undergoing Laparoscopic Radical Gastrectomy LUO Hongli, TAO Zhiguo, HAN Xue, et al DOI: 10.3969/j.issn.1006-6233.2020.05.038 Objective: To analyze the effect of stellate ganglion block (SGB) on cognitive function in elderly patients undergoing laparoscopic radical gastrectomy. Methods: Sixty elderly patients undergoing laparoscopic radical gastrectomy in our hospital from July 2017 to June 2019 were randomly divided into study group and control group with 30 cases in each group. In the study group, 1% lidocaine was injected into the right 6th cervical transverse process for SGB, while in the control group, 0.9% NaCl solution was injected into the same part. The central rate, mean arterial pressure, intraoperative bleeding volume, intraoperative infusion volume and operation time of the two groups were recorded. The cognitive function of the two groups was assessed by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at 1 day before and 1, 3 and 7 days after the operation. Results: There was no significant difference in intraoperative bleeding volume, intraoperative infusion volume and operation time between the two groups (P>0.05). The heart rate and mean arterial pressure in the study group were more stable at different time points, while the heart rate and mean arterial pressure in the control group were significantly different at different time points (P<0.05). The scores of MMSE and MoCA in the two groups were significantly lower than those before operation (P<0.05). The scores of MMSE and MoCA in the study group were significantly higher than those in the control group (P<0.05). The incidence of cognitive impairment in the study group was 13.33% (4/30) on the first day after operation, which was significantly lower than that in the control group which was 43.33% (13/30) (P<0.05). Conclusion: SGB can improve the cognitive function of elderly patients after laparoscopic radical gastrectomy. 2020 Vol. 26 (5): 859-862 [Abstract] ( 111 ) HTML (1 KB)  PDF (1181 KB)  ( 304 ) 863 The Effect of Surgical Options on the Quality of Sexual Life and Pregnancy of Infertile Patients with Endometrial Polyp LIU Jingjing, ZHANG Xiaoguang, YUAN Fengyun DOI: 10.3969/j.issn.1006-6233.2020.05.039 Objective: To observe the effect of different surgical methods on the quality of sexual life and pregnancy outcome of infertile patients with endometrial polyp (EP). Methods:A retrospective analysis was made, involving 106 EP infertility patients having hospitalized from May 2017 to August 2018 who were grouped according to the surgical protocol, 53 cases in each of the clamping group and the resection group. The clamping group demanded mechanical removal with hysteroscopic polyp clamp and the resection group demanded hysteroscopic endometrial polypectomy through electrosurgical. Endometrial thickness,menstrual hemorrhage map (PBAC) score, intrauterine cytokines [interleukin-1β(IL-1β), interferon gamma (IFN-γ), insulin-like growth factor-1(IGF-1)] level, quality of sexual life, recurrence rate at one year follow-up, and pregnancy outcome were compared between the two groups before and after surgery. Results:Three months after operation, the resection group was reported with the endometrial thickness smaller and the PBAC score lower than clamping group(P<0.05) ; Cytokines in the uterine fluid: Three months after operation, the resection group was reported with levels of IL-1β, IFN-γ, and IGF-1 in the uterine fluid lower than clamping group(P<0.05); Quality of sexual life: six months after operation, the resection group reported higher sexual satisfaction and weekly frequency of sexual life, shorter sexual arousal time and longer orgasm duration than clamping group(P<0.05);Recurrence rate: Nine and twelve months after operation, the resection group reported lower recurrence rate than the clamping group (P<0.05); Outcome of pregnancy: After 12 months of follow-up, the intrauterine pregnancy rate in the resection group (74.51%) was higher than that in the clamping group (52.00%) (P<0.05). Conclusion:Compared with hysteroscopic polypectomy,hysteroscopic endometrial polypectomy can significantly improve the endometrial thickness of EP infertile patients, reduce menstrual volume, improve the quality of sexual life and intrauterine pregnancy rate, and has higher safety. 2020 Vol. 26 (5): 863-868 [Abstract] ( 89 ) HTML (1 KB)  PDF (1212 KB)  ( 325 ) 868 Correlation between Vascular Endothelial Growth Factor Expression and Gene Polymorphism and Risk of Gestational Diabetes WANG Yanyan, et al DOI: 10.3969/j.issn.1006-6233.2020.05.040 Objective: To investigate the correlation between vascular endothelial growth factor (VEGF) expression and genetic polymorphism of gestational diabetes mellitus (GDM). Methods: 76 patients with GDM pregnant women who came to our hospital during the two-year period from February 2016 to 2018 and 76 normal pregnant women with normal pregnancy were selected for study. Among them, GDM pregnant women were used as observation group, and normal pregnant women were used as control group. The level of serum VEGF was determined by immunosorbent assay. The VEGF-460C/T gene polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism. The serum VEGF level and the distribution of vegf-460c / T genotype were compared between the two groups. Results: The levels of FPG, glycated hemoglobin and VEGF in the observation group were significantly higher than those in the control group, but the HDL-C level was significantly lower than that in the control group (P<0.05). There were no significant differences in age, BMI, neonatal birth weight, TC, TG and LDL-C between the two groups (P>0.05). The distribution of VEGF-460C/T genotype CC, CT, TT and allele C and T in the two groups of pregnant women accorded with Hardy-Weinberg equilibrium. The CC genotype and C allele frequency (27.63%, 51.32%) of the observation group were significantly higher than those of the control group (10.53%, 34.87%) (P<0.05). The incidence rates of GDM in pregnant women with CC, CT and TT were 72.41 (21/29), 49.31% (36/73) and 47.50% (19/40), respectively. The incidence of GDM in CC women was significantly higher than that in CT and TT. Pregnant women (χ2=4.492, χ2=4.283, P<0.05). The results of binary logistic multivariate regression analysis showed that serum VEGF levels, HDL-C and VEGF gene polymorphisms were independent risk factors for GDM in pregnant women. Conclusion: In summary, serum VEGF level and VEGF gene polymorphism are independent risk factors for GDM in pregnant women, and C allele may be the susceptible gene of GDM. 2020 Vol. 26 (5): 868-872 [Abstract] ( 120 ) HTML (1 KB)  PDF (1200 KB)  ( 346 ) 872 Clinical Effect of Naloxone Combined with Xingnaojing on Acute Alcoholism Complicated with Arrhythmia LIU Yan, GUO Yan DOI: 10.3969/j.issn.1006-6233.2020.05.041 Objective:To investigate the effects of combination therapy of crotonone and Xingnaojing in the treatment of acute alcoholism with arrhythmia. Methods: A total of 130 patients with acute alcoholism and acute alcoholism with arrhythmia were enrolled in our hospital from January 2016 to December 2018. They were divided into control group and treatment group. For the control group, naloxone was administered mainly on the basis of conventional treatment, and for the treatment group, naloxone combined with Xingnaojing was used for the combined treatment. The clinical treatment effects of the two groups of patients were compared to analyze the effects of drug onset and symptom improvement and consciousness recovery, and to compare the occurrence of adverse conditions. Results: In the treatment group, 28 patients were cured and 32 were improved. The effective rate was 92.31% in the treatment group, better than that of the control group, which was 70.77% (P<0.05).The duration of central arrhythmia in the treatment group was (58.88±14.13) min (P<0.05), and in the control group it was comparatively significantly longer (P<0.05). The onset time of the treatment group was (38.74±5.25) min, which was significantly shorter than that of the control group (P<0.05), and the symptom improvement time of the treatment group was also lower than that of the control group (P<0.05). The disappearance time of excitatory and ataxia symptoms in the treatment group was (80.23±10.25) min. The treatment group was superior to the control group in the time of excitement and ataxia disappearance and the conscious time (P<0.05). In the treatment group, there were 6 cases of palpitations, 1 case of hypotension, 3 cases of nausea and vomiting, which were different from the control group, and the incidence of adverse reactions was significantly lower (P<0.05). Conclusion: In the treatment of patients with acute alcoholism complicated with arrhythmia, naloxone combined with Xingnaojing treatment has significant clinical effects, which can significantly improve a series of side effects caused by alcoholism and reduce the occurrence of adverse symptoms. 2020 Vol. 26 (5): 872-876 [Abstract] ( 97 ) HTML (1 KB)  PDF (1186 KB)  ( 358 )

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