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2020 Vol. 26, No. 6 Published: 2020-06-30 887 The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases(COVID-19) in Chegnde City WU Yanling, WEI Feng, LI Qi, et al DOI: 10.3969/j.issn.1006-6233.2020.06.002 Objective:Describe and analyze epidemiological characteristics of 2019 novel coronavirus diseases(COVID-19) in Chegnde city to provide evidence for prevention and control. Methods: All COVID-19 cases from Chegnde city reported through March 31,2020 were extracted from China's Infectious Disease Information System. Descriptive epidemiological methods were used to analyse the epidemic status and distribution characteristics of cases. Result: Through March 31, 2020, a total of 8 patient records 7 confirmed cases(87.5%), 1 asymptomatic case(12.5%), no critical and deaths case contributed data for the analysis. On the whole, the imported cases were indentified as the first source,accounting for 62.5%, all of cases epidemic spread to one-third of counties in Chegnde city, and the most were aged 40~59 years(75%) and the median ages were 48 years. The total infection rate was 1.03% of close contacts for confirmed and asymptomatic cases. Among confirmed cases, the majority clinical types of confirmed cases were severe pneumonia(57.14%), who the most person with underlying diseases. In addition, the average interval from onset to first visiting doctor behavior was 0.5 days, that from first visiting doctor behavior to diagnosis was 1 days, and that from onset to diagnosis was 2 days. As time went on, the above time interval were significantly shortened. There was a family clusters outbreak involving 4 cases. Conclusion: The main source of infection is imported for COVID-19 epidemic in Chegnde city, and the area is in the low risk level. So, comprehensive strategies for prevention and control of COVID-19 epidemic include preventing spread in external and rebound in internal, and do the prevention and control work by classification. 2020 Vol. 26 (6): 887-891 [Abstract] ( 247 ) HTML (1 KB)  PDF (1602 KB)  ( 283 ) 892 Clinical Features and Clinical Experience of COVID - 19 in 5 Cases from Haian Nantong FENG Jianchun, WANG Huayu, XIE Qun, et al DOI: 10.3969/j.issn.1006-6233.2020.06.003 Objective:To enhance the understanding of novel coronavirus pneumonia (COVID-19), to prevent misdiagnosis and to provide reference for the early diagnosis and treatment. Methods: All the COVID-19 patients who were isolated and treated in the department of infectious diseases of hai 'an hospital affiliated to nantong university and the infectious diseases department of the third people's hospital of nantong from January 21, 2020 to March 3, 2020 were selected, and their clinical characteristics including epidemiology, signs and symptoms, laboratory and imaging examinations were retrospectively analyzed. Results: A total of 5 confirmed COVID-19 patients were included in the study, including 4 males and 1 female. The age ranged from 32 to 59 years old, with an average of (43.6±5.7) years old. The time from onset to diagnosis was 5 ~ 10d, with an average of (7.8±1.5) d. Three patients had a history of residence or sojourn in wuhan, one had a history of close contact with a locally confirmed patient, and one female medical worker had a history of suspicious contact with a locally confirmed patient.There were 3 cases of normal type, 1 case of heavy type and 1 case of critical type. There were 5 cases of fever, 5 cases of cough, 4 cases of sputum, 5 cases of fatigue, 3 cases of muscle soreness, 3 cases of headache, 4 cases of shortness of breath, 4 cases of chest tightness, 1 case of mild abdominal pain and diarrhea. There were 2 cases of LYMPH decline, 1 case of accelerated ESR, 5 cases of abnormal myocardial enzyme spectrum, 3 cases of abnormal liver function, 3 cases of decreased PO2 and 2 cases of decreased SO2. Hs-crp increased in 2 cases and il-6 increased in 2 cases. Five patients tested positive for nucleic acid. MSCT showed 4 cases of bilateral pulmonary change and 1 case of right pulmonary change, most of which were segmental or subsegmental ground-glass like localized inflammatory infiltration. After receiving high flow oxygen therapy, assisted breathing, integrated traditional Chinese and western medicine and supportive treatment, they were cured and discharged from the hospital. The length of stay ranged from 16 to 34d, with an average of (17.8±3.7) d. No significant sequelae were found after 1 month of follow-up. Conclusion: The COVID-19 in hai 'an area was dominated by common cases with fever as the first symptom. In critical and severe cases, the course of disease is short, and the degree of inflammation and organ damage is significant. All cases were cured and discharged. Clinicians should improve the disease prevention and treatment level of COVID-19 in this region by combining the epidemiological history and clinical characteristics, nucleic acid detection and chest MSCT examination. 2020 Vol. 26 (6): 892-896 [Abstract] ( 121 ) HTML (1 KB)  PDF (2696 KB)  ( 315 ) 897 Analysis of Clinical Characteristics and Prognostic Factors in COVID-19 Patients with Cardiovascular Disease LI Aixin, LIANG Lianchun, LI Tongzeng, et al DOI: 10.3969/j.issn.1006-6233.2020.06.004 Objective: To summarize and analyze the clinical characteristics of patients with COVID-19 combined with cardiovascular disease (CVD) treated in our hospital. Methods: Retrospective analysis of the clinical data of COVID-19 patients with CVD admitted to the Department of Infectious Diseases, Beijing You'an Hospital, Capital Medical University from January 21, 2020 to February 24, 2020. General demographic data, epidemiology, clinical characteristics, laboratory testing indicators, treatment and outcomes were collected and analyzed. The last follow-up date was March 5. Results: There were 11 cases of common type, 9 cases of severe type, and 10 cases of critical type. 14 males and 16 females, aged 46~94 years, with an average age of (71.1±13.2) years, the mean age of critically ill patients was significantly higher than that of common and severe patients (P<0.05). 40.0% of patients had at least one underlying disease, and the proportion of critically ill patients with cerebrovascular disease and chronic obstructive pulmonary disease was significantly higher than that of common and severe patients (all P<0.05). Fever was the most common clinical manifestation. Most patients had cough, sputum, and dyspnea. In this group of patients, there were fewer symptoms of muscle soreness and nasal congestion. Laboratory tests showed that 80.0% of patients had a decrease in lymphocyte count (L), and most patients experienced varying degrees of albumin (ALB) decline, increased C-reactive protein (CRP), and decreased prothrombin activity (PTA). L, arterial oxygen pressure (PaO2), and blood oxygen saturation (SPO2) of critically ill patients were significantly lower than those of common patients, while neutrophil / lymphocyte ratio (NLR), CRP, and myocardial enzymes were significantly higher in common patients (all P<0.05). Of the 30 patients in this group, 7 with acute respiratory distress syndrome and 5 with shock. Severe and critically ill patients receiving glucocorticoids, antibiotics, albumin, and the incidence of various comorbidities were significantly higher than that of common patients (all P<0.05). As of March 5, 2020, 23 patients have been discharged from hospital, 3 have been hospitalized, 4 have died. The age, NLR, serum sodium (Na), troponin I (TNI) and the proportion of patients with acute respiratory distress syndrome, shock and acute myocardial injury in the death group were significantly higher than those in the survival group (all P<0.05). Conclusion: COVID-19 with CVD is severe and has a poor prognosis. Old age, high NLR, hypernatremia, and comorbidities may be risk factors for poor prognosis. 2020 Vol. 26 (6): 897-904 [Abstract] ( 138 ) HTML (1 KB)  PDF (1351 KB)  ( 289 ) 905 Clinical Significance of Corona Virus Disease 2019(COVID-2019)T lymphocyte Subsets WU Wei, HUANG Hesong, YU Qiao, et al DOI: 10.3969/j.issn.1006-6233.2020.06.005 Objective: To investigate novel coronavirus pneumonia T lymphocyte subsets and its clinical significance. Methods: 88 novel coronavirus pneumonia patients were selected as the observation group, and 30 healthy people as control group. There was no significant difference in gender and age between the two groups (P > 0.05).The T lymphocyte subsets were detected by flow cytometry, and their clinical significance was analyzed. Results: The absolute numbers of CD4 + and CD8 + in peripheral blood of 88 patients were 335.000 (196.000,499.000) and 223.000 (118.000,324.000) respectively, which were significantly lower than those of healthy control group (1027.933 ± 235.014 and 727.033 ± 210.633), the difference between groups was statistically significant (P<0.01) There was no significant difference in the percentage of CD4 +, CD8 + and the ratio of CD4 + / CD8 + between the two groups (P>0.05). There was significant difference in the absolute number of CD4 + and CD8 + T cells among the three groups (P<0.01). ROC analysis showed that CD4 + and CD8 + had clinical significance in judging disease aggravation, and the best critical values were 362 / UL and 222 / UL respectively. Conclusion: The absolute numbers of CD4 + and CD8 + T in the peripheral blood of COVID-2019 are reduced to some extent, which may help to predict the development and prognosis of the disease and guide the clinical treatment. 2020 Vol. 26 (6): 905-907 [Abstract] ( 233 ) HTML (1 KB)  PDF (1334 KB)  ( 518 ) 908 Common Novel Coronavirus Pneumonia(COVID-19):Clinical and Imaging Features SUN Zhe, ZHANG Yujiao, YANG Juan, et al DOI: 10.3969/j.issn.1006-6233.2020.06.006 Objective: To analyze the clinical and imaging data of common COVID-2019 patients, analyze their characteristics, and explore the change process . Methods: According to the progress of pulmonary lesions during hospitalization, 21 patients with COVID-2019 were divided into stable group and progressive group,analysed and compared the clinical and imaging data of two groups . Results: ①Fever (52.38%) and cough (38.09%) were the main symptoms in the first diagnosis, and 4 cases (19.04%) had no obvious symptoms; ②The pulmonary lesions in the stable group began to absorb on the (13.06 ± 5.41) day of the total course of disease, the progressive group began to absorb on the (12.80 ± 7.19) day, and the progressive group began to absorb on the (17.20 ± 7.40) day; There was no statistical difference in the course of disease, length of hospitalization and the total course of disease between the two groups before hospitalization. ③ There were no statistical differences in WBC count, neutrophil count, lymphocyte count and NLR group in different periods between the general group and the progress group; There were statistical differences between the NLR group at admission, and the progress group was higher than the stable group. ④ Pulmonary lesions involved one lobe in 5 cases (26.32%), two lobes in 2 cases (10.53%), three lobes in 3 cases (15.79%), four lobes in 5 cases (26.32%), five lobes in 4 cases (21.05%); imaging manifestations: simple ground glass shadow in 8 cases (42.11%), ground glass shadow with solid components in 11 cases (57.89%); paver sign in 5 cases (26.31%), dandelion fruit sign in 16 cases (84.21%), Seed sign of dandelion in 10 cases (52.63%) and 10 cases (52.63%) had pleural thickening. Conclusion: Comprehensive analysis of clinical manifestations, laboratory and CT manifestations can improve the diagnostic ability of common COVID-2019. NLR has a certain predictive value for the progress of the disease when admitted. 2020 Vol. 26 (6): 908-911 [Abstract] ( 106 ) HTML (1 KB)  PDF (1497 KB)  ( 274 ) 912 Tetramethylpyrazine Alleviates Cerebral Ischemia-Reperfusion Injury by Activating VEGF Mediated PI3K /Akt Signaling Pathway in Rats ZHU Baike, et al DOI: 10.3969/j.issn.1006-6233.2020.06.007 Objective: To investigate the effect and mechanism of tetramethylpyrazine on cerebral ischemia-reperfusion injury in rats. Methods: A rat model of cerebral ischemia-reperfusion injury was established by suture-occluded method. The effects of tetramethylpyrazine on the infarct size, brain water content, neurological symptoms and pathological morphology of brain, as well as the expression of IL-6, TNF-α and MCP-1 in serum and brain tissue of rats were evaluated. The protein expression levels of VEGF, PI3K, P-AKT and AKT in rat brain were detected by Western Blot. Results: Tetramethylpyrazine has protective effects on cerebral ischemia-reperfusion injury, which can alleviate cerebral infarct size , brain water content, neurological symptoms and pathological morphology (P<0.05). In addition, it can down-regulate the expression of pro-inflammatory cytokines IL-6, TNF-α and MCP-1 and increase the expression of VEGF, PI3K and P-AKT/AKT in brain tissue (P<0.05). Conclusion: Tetramethylpyrazine pretreatment has a protective effect on cerebral ischemia-reperfusion, which may be related to the activation of VEGF-mediated PI3K-AKT signaling pathway. 2020 Vol. 26 (6): 912-916 [Abstract] ( 169 ) HTML (1 KB)  PDF (1895 KB)  ( 353 ) 917 Paeonol Alleviates Myocardial Ischemia Reperfusion Injury in Rats by Promoting SIRT1 LIU Chao, et al DOI: 10.3969/j.issn.1006-6233.2020.06.008 Objective: To detect the protective effects of paeonol on myocardial ischemia reperfusion (IR) in rats and explore the underlying mechanism. Methods: Sprague Dawley (SD) rats were used to establish myocardial ischemia-reperfusion injury model. Western blot was used to determine the expression level of sirtuin1 (SIRT1). Reactive oxygen species (ROS) of rats' myocardium tissue was analyzed by DCFDA. Oxidative stress markers malondialdehyde (MDA) and superoxide dismutase (SOD) and myocardial injury markers lactate dehydrogenase (LDH) and creatine kinase (CK) were evaluated by ELISA. Echocardiography was used for determining myocardial functions and left ventricular remodeling. Results: ROS generation was significantly decreased by paeonol pre-treatment. Besides, after paeonol treatment, MDA, LDH and CK were notably inhibited and SOD was elevated. Myocardial functions and left ventricular remodeling were improved by paeonol. Furthermore, paeonol significantly promoted SIRT1 and the effects were reversed by knocking down SIRT1. Conclusion: Paeonol alleviates oxidative stress and myocardial injury led by ischemia reperfusion, and thus improves myocardial functions and ventricular remodeling by promoting SIRT1. 2020 Vol. 26 (6): 917-920 [Abstract] ( 140 ) HTML (1 KB)  PDF (1379 KB)  ( 316 ) 921 Effects of miR-655-3p on the Cellular Proliferation and Invasion of Head and Neck Squamous Cell Carcinoma Through ZEB1 Targeted Inhibition ZHAO Lei, XIAO Erbin, LIANG Jingwei, et al DOI: 10.3969/j.issn.1006-6233.2020.06.009 Objective: To study the expression of miR-655-3p in head and neck squamous cell carcinoma (HNSCC) tissues and cell lines and its effects on the biological functions of HNSCC cell lines. Methods: The expression levels of miR-655-3p in HNSCC tissues and cell lines (FaDu, SCC-9, TU686, TU212) were measured by qRT-PCR, and the effects of miR-655-3p on cellular proliferation, migration and invasion were evaluated by a series of assays. The possible target gene of miR-655-3p was further screened and its mechanism was explored. Results: The expression level of miR-655-3p in HNSCC was lower than that in control group, P<0.05. And the over-expression of miR-655-3p in HNSCC cell lines significantly inhibited the proliferation, migration and invasion of cell lines. Further mechanism studies showed that ZEB1, as the target gene of miR-655-3p, was negatively regulated by miR-655-3p. Even, miR-655-3p inhibited the epithelial mesenchymal transformation of HNSCC cell lines by targeting ZEB1 expression directly. Conclusion: MiR-655-3p is down-regulated in HNSCC cancer tissues and cell lines, which could target the expression of ZEB1 directly and inhibit the progression of malignant phenotype of cell lines. 2020 Vol. 26 (6): 921-924 [Abstract] ( 91 ) HTML (1 KB)  PDF (1502 KB)  ( 317 ) 925 Bioinformatic Analysis on Related MiRNA of Esophageal Quamous Cell Carcinoma CAO Shiru, LI Yan, ZHOU Rongmiao, et al DOI: 10.3969/j.issn.1006-6233.2020.06.010 Objective: To screen the differentially expressed miRNAs(DE-miRNAs) associated with the esophageal squamous cell carcinoma (ESCC) and to analyze their biological functions by using various bioinformatics analysis tools. Methods: The expression profiles of GSE114110 were downloaded from the Gene Expression Omnibus (GEO) database; GEO2R tool was used to analyze the data and to screen DE-miRNAs; The miRNA expression profiles of esophageal squamous cell carcinoma (GSE97049, GSE59973, GSE55856 and GSE43732 )were used to verify the selected DE-miRNAs; the potential target genes were predicted by miRNet ; DAVID was introduced to perform functional annotation and pathway enrichment analysis for these potential targets of DE-miRNAs; String and Cytoscape were used to construct protein-protein interaction (PPI) network and identify the key Hub genes, and further to construct miRNA-Hub gene network; the expression of Hub genes were verified by the starBase analysis tool. Results: A total of 159 DE-miRNAs were screened out, including 86 upregulated miRNAs and 73 downregulated miRNAs in ESCC tissues compared with normal esophageal epithelia. 1700 target genes of the top three upregulated and downregulated miRNAs were predicted, and they were involved in ESCC-related pathways, such as pathway in cancer, focal adhesion and p53 signaling pathway. In the PPI network, the top 10 hub nodes with higher degrees were identified as hub genes, such as MAPK1. Through constructing the miRNA-hub gene network, we found that most of hub genes could be potentially modulated by hsa-miR-196a-5p and hsa-miR-1. The expression of target gene (CDC42,POLR2K,PIK3CA,POLR2I,HIST2H2AC,FN1,VEGFA) of hsa-miR-1 was significantly upregulated in ESCC tissue than normal tissue. There is an inverse relationship between miRNA expression and target gene expression. Thus, these significantly upregulated genes including CDC42,POLR2K,PIK3CA,POLR2I,HIST2H2AC,FN1 and VEGFA may be the most potential targets for the downregulated hsa-miR-1 in theory. Conclusion: Through bioinformatics analysis of the differentially expressed miRNAs between esophageal squamous cell carcinoma tissues and normal epithelial tissues, two DE-miRNAs and seven key hub genes were finally screened to provide theoretical guidance for further research on molecular marker screening and molecular mechanisms of ESCC. 2020 Vol. 26 (6): 925-931 [Abstract] ( 122 ) HTML (1 KB)  PDF (2312 KB)  ( 408 ) 932 Analysis of the Levels of Serum IL-17 IL-35 in Patients with Ventilator-Associated Pneumonia Caused by Acinetobacter Baumannii and Their Connection with Prognosis LUO Yutian, LV Changyan, XIE Yisong, et al DOI: 10.3969/j.issn.1006-6233.2020.06.011 Objective: To detect the levels of IL-17 and IL-35 in patients with ventilator-associated pneumonia (VAP) caused by Acinetobacter baumannii (AB), and to study the connection between them and the prognosis. Methods: 127 patients with VAP caused by AB in Shenzhen People's Hospital from July 2016 to October 2018 were selected as the subjects for the retrospective analysis. According to the 30-day survival of patients, they were divided into survival group (84 cases) and death group (43 cases). The general data of the two groups were collected and compared, which include:the levels of IL-17 and IL-35 in serum were detected by enzyme-linked immunosorbent assay (ELISA); T lymphocyte subsets were detected by flow cytometry; Pearson method was used to analyze the correlations between IL-17, IL-35 and T lymphocyte subsets, APACHE II score; Logistic analysis was used to analyze the factors influencing the prognosis of VAP patients caused by AB. Results: There was no significant difference in gender, age, time of tracheotomy, incision size and intraoperative hemorrhage between the two groups (P > 0.05); compared with the survival group, the APACHE II score, the levels of IL-17, IL-35 and CD8+ T lymphocyte in the dead group increased (P < 0.05); the levels of CD3+ T, CD4+ T lymphocytes and the ratio of CD4+/CD8+ decreased (P < 0.05). Pearson analysis showed that IL-17 and IL-35 were negatively correlated with CD3+ T, CD4+ T and CD4+/CD8+ (P < 0.05), and positively correlated with CD8+ T and APACHE II score (P < 0.05). The IL-17, IL-35 and APACHE II score were the risk factors for the prognosis of VAP induced by AB, and CD4+/CD8+ was the protective factor for the prognosis of VAP induced by AB. Conclusions: The increase of the levels of IL-17 and IL-35 in VAP patients is closely related to immune function factors, which is the risk factor for death. They can be used as indicators to predict the prognosis of VAP patients induced by AB. 2020 Vol. 26 (6): 932-935 [Abstract] ( 112 ) HTML (1 KB)  PDF (1235 KB)  ( 318 ) 936 The Effect of Naloxone Combined with Shuxuening on SOD GSH and iNOS of Patients with Acute Alcohol Intoxication YAN Jianhui, HE Hebin, et al DOI: 10.3969/j.issn.1006-6233.2020.06.012 Objective: To analyze the effect of Naloxone combined with Shuxuening on duper oxide dismutase (SOD), GSH, induced nitric oxide synthase (iNOS) of patients with acute alcohol intoxication (AAI), and to provide guidance for clinical treatment. Methods:110 AAI patients having been treated in our hospital from April 2017 to July 2019 were divided into two groups according to the treatment method. Besides routine basic treatment, the control group was administrated Naloxone, and the observation group was administrated Naloxone combined with Shuxuening. The curative effect, awakening time and clinical symptom incidence after treatment were analyzed, and the expression of SOD,GSH,iNOS, creatine kinase isoenzyme MB (CK-MB) and cardiac troponin I (cTnI), glutamic pyruvic transaminase (ALT), glutamic oxaloacetic transaminase (AST) were detected. Results:The total effective rate of the observation group (94.55%) was higher than that of the control group (88.82%). The awakening time of the observation group (75.24 ±24.11min) was shorter than that of the control group (148.47 ±36.89min) . The clinical symptoms incidence of the observation group (14.55%) was significantly lower than that of the control group (30.91%), and it is statistically significant(P<0.05).There was no significant difference in SOD,GSH,iNOS,CK-MB,cTnI,ALT,AST level between the two groups before treatment (P > 0.05). After treatment, the level of SOD,GSH in the observation group was higher than those in the control group, and the level of iNOS,CK-MB,cTnI,ALT,AST in the observation group was lower than those in the control group (P<0.05). Conclusion: Naloxone combined with Shuxuening alleviated myocardial injury, oxidative stress injury, improved liver function, promoted recovery and reduced the incidence of clinical symptoms of AAI patients. 2020 Vol. 26 (6): 936-940 [Abstract] ( 86 ) HTML (1 KB)  PDF (1237 KB)  ( 284 ) 941 Efficacy of Mosapride Combined with Traditional Chinese Medicine Sticking to Shenque Acupoint in the Treatment of Functional in the Elderly and its Effects on Serum NO and SP Levels YAN Xiaochun, et al DOI: 10.3969/j.issn.1006-6233.2020.06.013 Objective: To explore the efficacy of mosapride combined with traditional Chinese medicine sticking to Shenque acupoint in the treatment of functional constipation (FC) in the elderly and its effects on serum enteric neurotransmitters and quality of life. Methods: A total of 106 elderly patients with FC who were admitted to gastroenterology department of our hospital from June 2018 to June 2019 were selected and randomly divided into observation group (n=53) and control group (n=53). Control group was treated with mosapride, and observation group was given traditional Chinese medicine sticking to Shenque acupoint besides mosapride. The clinical efficacy, total colonic transit time and segmental colonic transit time were compared between the two groups. Serum intestinal neurotransmitters [nitric oxide (NO), substance P (SP), vasoactive intestinal peptide (VIP)], daily defecation time, weekly defecation frequency, abdominal pain [visual analogue scale (VAS)], stool traits [Bristol stool trait scale] and quality of life [quality of life questionnaire of patients with constipation (PAC-QOL)] before and after treatment were observed. Results: The total effective rate of treatment in observation group was higher than that in control group (P<0.05), and the transit time of right hemicolon, sigmoid rectum, left hemicolon and total colon were lower than those in control group (P<0.05). After 4 weeks of treatment, the levels of serum NO and VIP and PAC-QOL scale score in observation group were lower than those in control group (P<0.05) while the SP level was higher than that in control group (P<0.05), and the differences before and after treatment in observation group were larger than those in control group (P<0.05). After 4 weeks of treatment, the daily defecation time was shortened, and the weekly defecation frequency was increased, and the abdominal pain VAS score was decreased and the Bristol score was increased in observation group compared with those in control group (P<0.05), and the differences before and after treatment in observation group were larger than those in control group (P<0.05). Conclusion: On the basis of mosapride for elderly FC, traditional Chinese medicine sticking on Shenque acupoint has good treatment effects. It can promote intestinal function recovery and improve prognosis and quality of life by regulating intestinal neurotransmitters levels. 2020 Vol. 26 (6): 941-945 [Abstract] ( 110 ) HTML (1 KB)  PDF (1240 KB)  ( 600 ) 946 Expression of LncRNA MEG3 in Peripheral Blood Mononuclear Cells and Sputum of Children with Viral Bronchiolitis and Its Significance ZHU Lianhai, HE Changsheng, et al DOI: 10.3969/j.issn.1006-6233.2020.06.014 Objective: To detect the expression of LncRNA MEG3 in peripheral blood mononuclear cells and sputum of children with viral bronchiolitis and analyze its clinical significance. Methods: 103 children with viral bronchiolitis admitted to Jiuting hospital and Songjiang Central Hospital from February 2017 to January 2019 were selected, and 103 healthy infants and children in the same period of physical examination were selected as the control group. After collecting peripheral blood mononuclear cells and sputum, the expression of LncRNA MEG3 was detected by qRT-PCR, and its relationship with clinicopathological characteristics and prognosis was analyzed. Results: The expression of LncRNA MEG3 in peripheral blood mononuclear cells and sputum of children in control, mild, moderate and severe groups decreased significantly in turn, and the differences between any two groups were statistically significant (P<0.05). The expression level of vascular endothelial growth factor (VEGF) mRNA in peripheral blood mononuclear cells and sputum of children in control, mild, moderate and severe groups increased significantly in turn, and the differences between any two groups were statistically significant (all P<0.05). The expression level of LncRNA MEG3 in peripheral blood mononuclear cells and sputum was negatively correlated with the expression level of VEGF mRNA (all P<0.05). The expression of LncRNA MEG3 in peripheral blood mononuclear cells and sputum of children with allergic history and post-discharge asthma was significantly lower than that of children without allergic history and concurrent asthma (P<0.05). Allergic history, high expression of VEGF and low expression of LncRNA MEG3 were risk factors for adverse prognosis in children with viral bronchiolitis (all P<0.05). Conclusions: The expression of LncRNA MEG3 in peripheral blood mononuclear cells and sputum decreased significantly in control, mild, moderate and severe groups, which may be related to the occurrence and development of viral bronchiolitis and the prognosis of children. 2020 Vol. 26 (6): 946-950 [Abstract] ( 94 ) HTML (1 KB)  PDF (1484 KB)  ( 288 ) 951 Diagnostic Value of Combined Detection of G Test and GM Test in Invasive Fungal Infections in Patients with Hematologic Malignancies XU Jianli, CHEN Gang, GU Libadanmu, et al DOI: 10.3969/j.issn.1006-6233.2020.06.015 Objective: To explore diagnostic value of combined detection of (1,3)-β-D-glucan (G test) and galactomannan antigen (GM test) for invasive fungal infections (IFI) in patients with hematologic malignancies. Methods: A total of 178 patients with hematologic malignancies who were admitted to the hospital from June 2018 to June 2019 were enrolled. According to traditional clinical diagnosis results, they were divided into IFI group (50 cases) and non-IFI group (128 cases). All underwent G test and GM test. The receiver operating characteristic (ROC) curves were applied to analyze critical values of G test and GM test. The value of G test, GM test and their combination for diagnosis of IFI and diagnosis time were analyzed. Results: ROC curve analysis showed that critical values of G test and GM test were 147.37 pg/mL and 0.88 ug/L, respectively. Compared with G test alone or GM test alone, sensitivity of combined diagnosis for IFI was significantly improved (P<0.05). Compared with clinical diagnosis, G test, GM test and their combination can shorten IFI diagnosis time (P<0.05). Conclusion: The combined detection of G test and GM test can effectively improve diagnostic sensitivity of patients with hematologic malignancies and IFI, and shorten waiting time of diagnosis. 2020 Vol. 26 (6): 951-953 [Abstract] ( 102 ) HTML (1 KB)  PDF (1423 KB)  ( 254 ) 954 A Study of the Role and Molecular Mechanism of Allicin on the Proliferation of Rat Vascular Smooth Muscle Cells XIONG Wen, WEI Wen, et al DOI: 10.3969/j.issn.1006-6233.2020.06.016 Objectives: To investigate the effect and mechanism of allicin on the proliferation of rat vascular smooth muscle cells. Methods: Rat thoracic aortic vascular smooth muscle cells (VSMCs) were cultured in vitro, and 20 ng/mL platelet-derived growth factor BB (PDGF-BB) was used to induce proliferation of VSMCs. The experiment subject was divided into 4 groups: control group (group A), PDGF-BB stimulation group (group B), PDGF-BB + allicin treatment group (group C), PDGF-BB + allicin + lipopolysaccharide treatment group (group D). The proliferation of each group was detected by CCK-8 assay and flow cytometry. Western blotting was used to detect the expression levels of total nuclear factor kappa B p65 (NF-κB p65) and phosphorylated NF-κB p65 (P-p65) in each group. The contents of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the cell culture supernatants of each group were detected by ELISA. Results: The results of cell proliferation assay showed that compared with group A, the proliferation activity of VSMCs in group B was significantly enhanced. Compared with group B, the proliferation activity of VSMCs in group C was inhibited. Compared with group C, the proliferation activity of VSMCs in group D was enhanced (P<0.05). Western Blot results showed that compared with group A, the expression level of P-p65 protein in group B was significantly increased. Compared with group B, the expression level of P-p65 protein in group C was decreased. Compared with group C, the expression level of P-p65 protein in group D was higher than that in group C (P<0.05). In addition, the total of NF-κB p65 protein levels in each group showed no significant difference (P>0.05).The results of ELISA showed that compared with group A, the levels of TNF-α and IL-1β in group B were increased significantly. Compared with group B, the levels of TNF-α and IL-1β in group C were lower. Compared with group C, the levels of TNF-α and IL-1β in group D were increased (P<0.05). Conclusions:Allicin can inhibit the proliferation of VSMCs induced by PDGF-BB, and the mechanism is related to the inhibition of NF-κB pathway and the reduction of inflammatory response. 2020 Vol. 26 (6): 954-958 [Abstract] ( 134 ) HTML (1 KB)  PDF (1524 KB)  ( 260 ) 959 An Analysis of the Diagnostic Value of Transient Elastography in the Staging of Liver Fibrosis in CHB Patients with Alcoholic Liver Disease LIU Pinlan, JIANG Linlin DOI: 10.3969/j.issn.1006-6233.2020.06.017 Objective: To analyze the diagnostic value of liver transient elastography in the staging of liver fibrosis in patients with chronic hepatitis B (CHB) and alcoholic liver disease. Methods: A retrospective study was carried out to collect the clinical data of 67 patients with CHB and alcoholic liver disease in our hospital. All patients were examined by transient elastic ultrasound and liver biopsy. According to Ishak score, liver fibrosis was periodized. The differences of baseline data, blood biochemical indexes and liver hardness values of patients with different stages of liver fibrosis were compared. Through Spearman correlation analysis, the relationship between the liver hardness and the stage of liver fibrosis was analyzed. The receiver operating characteristic (ROC) curve of the subjects was plotted to evaluate the predictive value of liver hardness on liver fibrosis, and the sensitivity and specificity were calculated. Results: Of the 67 patients, there were 8 cases in stage 0, 15 cases in stage 1, 17 cases in stage 2, 9 cases in stage 3, 8 cases in stage 4, 7 cases in stage 5 and 3 cases in stage 6. The differences of ages, albumin, total bilirubin, alanine aminotransferase (ALT) and prothrombin activity (PTA) in different stages of liver fibrosis were statistically significant (P<0.05); the differences of gender, body mass index and aspartate aminotransferase (AST) in different stages of liver fibrosis were not statistically significant (P>0.05). There was a significant difference in the hardness of liver between the patients with different stages of fibrosis (P<0.001). The Spearman correlation analysis showed that there was a positive correlation between liver hardness and fibrosis stage (P<0.001). When the threshold value of liver hardness was 7.75 kPa, the sensitivity and specificity of liver fibrosis were 89.83% and 75.00%, respectively, and the area under ROC curve was 0.84 (P<0.001). Conclusion:Transient elastic ultrasound imaging of liver has a high diagnostic value for the degree of liver fibrosis in CHB patients with alcoholic liver disease, which is applicable in evaluating the stage of liver fibrosis in early stage. 2020 Vol. 26 (6): 959-962 [Abstract] ( 106 ) HTML (1 KB)  PDF (1346 KB)  ( 351 ) 963 Effects of Shenmai Injection on Inflammatory Markers, Cardiac Function and Prognosis of Acute Coronary Syndrome After PCI ZHOU Linghua, JING Xiumei, GU Yongmei, et al DOI: 10.3969/j.issn.1006-6233.2020.06.018 Objective: To explore the effect of using Shenmai injection as an adjuvant therapy in patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI). Methods: In recent years, 84 ACS patients having undergoing PCI were randomly divided into two groups. The control group was given standardized treatment with western medicine, and the observation group was treated with Shenmai injection. Changes in inflammation, cardiac markers and cardiac function indicators, rates of cardiovascular adverse events and adverse drug reactions were observed. Results:After 2 weeks of treatment, hypersensitive c-reactive protein (hs-crp), endothelin-1 (et-1) and D- were detected in the observation group- D dimer (D) inflammatory indicators, such as superoxide dismutase (SOD), creatine kinase isoenzyme (CK - MB) and troponin -i cardiac markers, such as (cTn - I) levels, and each cardiac output (SV), left ventricular ejection fraction (LVEF), ventricular wall motion index (WMSI) and Seattle angina questionnaire (SAQ) score indicators, improved significantly, compared with the control group (P < 0.05). The rate of adverse cardiovascular events in the observation group was significantly lower than that in the control group (P < 0.05), and there was no difference in the rate of adverse drug reactions between the groups (P > 0.05). Conclusion: The adjuvant therapy of Shenmai injection for ACS patients undergoing PCI can inhibit the inflammatory response of the body, improve the level of cardiac markers, improve the cardiac function, improve the prognosis of the disease, and improve the drug safety. 2020 Vol. 26 (6): 963-966 [Abstract] ( 123 ) HTML (1 KB)  PDF (2377 KB)  ( 214 ) 967 The Effects of Autotransfusion on the Levels of IL-8 and CRP in Patients Undergoing Cardiac Surgery Under CPB in Variant Time Courses XIA Xia, HUANG Ming, et al DOI: 10.3969/j.issn.1006-6233.2020.06.019 Objective:To investigate the effect of autotransfusion on interleukin-8 (IL-8) and C-reactive protein (CRP) in patients undergoing cardiopulmonary bypass (CPB). Methods:100 patients who underwent CPB cardiac surgery in our hospital from March 2018 to March 2019 were selected,who were treated with self blood recovery and transfusion. According to the estimated CPB time courses, they were divided into group A (n=32, time course>120min), group B (n=30, time course:60 min~120 min) and group C (n=38, time course<60 min). The IL-8 and CRP were detected in each group, and the blocking time of ascending aorta and the bleeding volume during operation and related indicators were observed. Results:The blocking time and bleeding volume of ascending aorta in group A were (103.30 ± 25.50) min and (810.01 ± 101.11) ml, which were significantly higher than those in group B and group C (P < 0.05); The blocking time of ascending aorta and bleeding volume in group B were (63.30 ± 19.28) min and (430.02 ± 101.11) ml, which were significantly higher than those in group C (P < 0.05); The levels of IL-8 and CRP in group A at 24 and 48 hours after CPB were (18.30 ± 2.20) ng / L and (16.80 ± 1.88) ng/L, (65.59 ± 11.29) ng/L and (48.89 ± 12.10) ng/L, which were significantly higher than those in group B and C (P < 0.05); The levels of IL-8 and CRP in group B 24 and 48 hours after CPB were (15.50 ± 1.88) ng/L and (13.38 ± 2.01) ng/L, (49.89 ± 12.10) ng/L and (30.28 ± 10.11) ng/L, which were significantly higher than those in group C (P < 0.05); The time of tracheal extubation and postoperative hospitalization in group A were (19.20 ± 2.10)h and (12.10 ± 2.10) d, which were significantly longer than those in group B and group C (P < 0.05); The incidence of postoperative neurological complications in group A was 28.13%, which was significantly higher than that in group C (P < 0.05). Conclusion:The longer the CPB time course, the more serious the inflammatory response of patients under the condition of autotransfusion. 2020 Vol. 26 (6): 967-970 [Abstract] ( 86 ) HTML (1 KB)  PDF (1230 KB)  ( 235 ) 971 An Analysis of the Effects of Repetitive Transcranial Magnetic Stimulation on Cognitive Function and Serum Pro-Inflammatory Cytokines in Patients with Post-Traumatic Stress Disorder LI Yang, WANG Xue, et al DOI: 10.3969/j.issn.1006-6233.2020.06.020 Objective: To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive function and serum pro-inflammatory cytokines in patients with post-traumatic stress disorder (PTSD). Methods: 96 patients with PTSD were randomly divided into low frequency treatment group, high frequency treatment group and sham stimulation group, 32 cases in each group. For the low-frequency and high-frequency treatment groups, 0.5 Hz and 10 Hz rTMS were given to the right dorsolateral frontal lobe respectively. In the sham stimulation group, no current, but current sound, was given. The treatment lasted for 3 weeks. The clinical symptoms and cognitive functions of patients in the three groups were evaluated by PCL-C and MoCA scales, meanwhile, the serum levels of interleukin-2(IL-2), interleukin-6 (IL-6) and tumor necrosis factor (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA) one day before treatment and three weeks after treatment. Results: Before treatment, the indexes of the three groups were comparable. After treatment, the scores of PCL-C scale in the low-frequency and high-frequency treatment groups were lower than those in the sham-stimulation group, and the scores of MoCA scale were higher than those in the sham-stimulation group; the levels of IL-2, IL-6 and TNF-a in the low-frequency and high-frequency treatment groups were lower than those in the sham-stimulation group. The difference was statistically significant (P<0.05). In addition, serum levels of IL-2, IL-6 and TNF-a were negatively correlated with total scores and factor scores of MoCA scale. But there was no significant difference in the above aspects between the low-frequency and high-frequency treatment groups (P>0.05). Conclusions: It's proved that rTMS could effectively improve the cognitive impairment of PTSD patients, which may be achieved by inhibiting the secretion of pro-inflammatory factors in serum. 2020 Vol. 26 (6): 971-974 [Abstract] ( 100 ) HTML (1 KB)  PDF (1235 KB)  ( 249 ) 975 A Study on the Correlation Between CDKN2B-AS1 Gene Polymorphism and Endometriosis HAO Na, et al DOI: 10.3969/j.issn.1006-6233.2020.06.021 Objective: To study the correlation between the gene polymorphism of cyclin dependent kinase inhibitor 2B antisense RNA 1 (CDKN2B-AS1) and endometriosis (EM). Methods: From December 2017 to July 2019, 112 patients with endometriosis admitted to Handan Central Hospital and the Fourth Hospital of Hebei Medical University were selected as the case group, and another 112 patients who were operated on due to ectopic pregnancy and tubal adhesion were selected as the control group. Detection of CDKN2B-AS1 gene polymorphism in blood of all subjects was made by DNA PCR sequencing, the relationship between rs10965235 polymorphism of CDKN2B-AS1 gene and clinical stage of EM was analyzed, and Logistic regression was used to analyze the effect of CDKN2B-AS1 gene polymorphism on EM susceptibility. Results: There was no significant difference in age, BMI, menstrual cycle, frequencies of allele A, G, AA, AG+GG at rs4977574 loci on CDKN2B-AS1 between the case group and the control group (P>0.05). Compared with the control group, the frequencies of alleles C and CC at rs10965235 on CDKN2B-AS1 gene in the case group were higher, and the frequencies of alleles A and CA+AA were lower (χ2=4.397, 4.075, P=0.036, 0.044) . Compared with AA genotype, GA + GG genotype at rs4977574 on CDKN2B-AS1 gene was not related to EM susceptibility (OR=1.105, 95% CI: 0.819~1.491; P=0.124). Compared with I ~ II phase, the frequency of CC genotype at rs10965235 on CDKN2B-AS1 gene in III ~ IV phase EM patients was higher, and the frequency of CA + AA genotype at rs10965235 loci on CDKN2B-AS1 gene was lower, and the differences were statistically significant (χ2=5.168, P=0.023). Compared with CC genotype, CA + AA genotype at rs10965235 on CDKN2B-AS1 gene could reduce EM susceptibility (OR=0.564, 95% CI: 0.347~0.917, P=0.000). Conclusions: The rs4977574 loci on CDKN2B-AS1 gene is not related to EM susceptibility, and the rs10965235 loci polymorphism is related to EM susceptibility of women in northern China. 2020 Vol. 26 (6): 975-979 [Abstract] ( 161 ) HTML (1 KB)  PDF (1259 KB)  ( 307 ) 980 An Observation of Cataract with Primary Angle Closure Glaucoma by UBM on the Shape of Lens Suspensory Ligament Before and After Surgery CUI Dongmei, WU Xiaohong, HE Yan DOI: 10.3969/j.issn.1006-6233.2020.06.022 Objective: To investigate and observe the configuration of preoperative suspensory ligament of lens and postoperative chamber angle with low frequency ultrasound biological microscope (UBM) applied in surgery of cataract with primary angle-closure glaucoma (PACG). Methods: A total of 50 patients (50 eyes) with PACG and cataract and undefined configuration of preoperative suspensory ligament of lens and postoperative chamber angle who were prepared for cataract surgery from January 2016 to December 2019 were selected. Preoperative UBM examination was performed on all patients, and abnormalities of the lens suspensory ligament and postoperative chamber angle were observed and recorded to evaluate the accuracy of UBM examination. Results: UBM examination showed that among the 50 patients with cataract combined with PACG, 29 eyes (58%) had abnormal suspensory ligament, 9 eyes (18%) had detached suspensory ligament, and 20 eyes (40%) had loose ligament. Surgical results showed that 27 eyes (54%) of the 50 patients with cataract combined with PACG had abnormal suspensory ligament, among which 8 eyes (16%) had detached suspensory ligament, and 19 eyes (38%) had loose ligament. The difference between the two examination methods was not statistically significant and the accuracy was high. In addition, the quantitative detection of the patient's chamber angle by UBM showed that the postoperative ACD, AOD500 and TCPD of the patient's chamber angle were significantly increased, with statistically significant difference (P<0.05), while the difference of ID1 before and after surgery was not statistically significant (P>0.05). Conclusions: UBM can accurately observe and locate the abnormal situation of the lens suspensory ligament, and provide a quantitative basis for the observation of the shape of the angle of the affected eye, which is of great clinical significance. 2020 Vol. 26 (6): 980-982 [Abstract] ( 180 ) HTML (1 KB)  PDF (1214 KB)  ( 523 ) 983 Effect of Ulinastatin on Serum Inflammatory Indexes and Intestinal Barrier Function in SAP Patients CHEN Ying, LIU Zheng'ai, FANG Liang, et al DOI: 10.3969/j.issn.1006-6233.2020.06.023 Objectives: To investigate the effect of ulinastatin on serum inflammatory factors and intestinal mucosal barrier function in patients with severe acute pancreatitis (SAP). Methods:From January 2015 to January 2019, 80 patients with SAP in Gastroenterology Department of our hospital were selected as the main subjects of study and divided into treatment group (n=41, treated with ulinastatin on the basis of routine treatment) and control group (n=39, treated with routine treatment) according to the random digital table method. Analysis was applied to the changes of serum inflammatory factors [tumor necrosis factor-α (TNF- α) and IL-6, 10, 17 (IL-6,IL-10,IL-17)] in the two groups before and after treatment, and the changes of intestinal barrier function index [endotoxin (ET), serum intestinal fatty acid binding protein (IFABP), diamine oxidase (DAO), D-lactic acid (D-Lac)]. The therapeutic effect and mortality after 7 days of SAP were observed. Results: The total effective rate in the treatment group was 92.68%, which was significantly higher than that in the control group (76.92%, P<0.05). Comparatively, the levels of TNF-1, IL-6, IL-10, IL-17, ET, IFABP, DAO and D-Lac in both groups decreased significantly, while IL-10 increased significantly (Pall< 0.01), after treatment. Compared with the control group, the levels of serum inflammatory factors and intestinal barrier function in the treatment group were significantly improved(Pall< 0.01).The 7-day-mortality rate of the treatment group was 4.88%, which was significantly lower than that of the control group (20.51%,P<0.05). Conclusion: Ulinastatin could significantly inhibit the level of serum inflammatory factors in patients with SAP, improve the protective effect of intestinal mucosal barrier and reduce the short-term mortality of SAP patients. The curative effect is ideal.So it has clinical application value. 2020 Vol. 26 (6): 983-987 [Abstract] ( 102 ) HTML (1 KB)  PDF (1230 KB)  ( 350 ) 988 Diagnostic Value of Dynamic Contrast Enhanced MRI in Examination of BI-RADS 4-5 Non-mass Microcalcification Lesions on FFDM XIE Lili, BAI Renjing, et al DOI: 10.3969/j.issn.1006-6233.2020.06.024 Objective:To investigate the diagnostic value of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in the diagnosis of BI-RADS 4-5 non-mass microcalcification lesions on full-field digital mammography (FFDM). Methods: Conduct retrospective analysis of 148 patients with 152 lesions, who were examined by bilateral breast DCE-MRI and all had pathological results,from January 2017 to August 2019. Plot the receiver operator characteristic curve (ROC) of the two diagnostic methods, and verify the best diagnostic threshold according to the most approximate index, which was used to judge the benign and malignant boundary of the BI-RADS classification of breast lesions. With histopathological results as the golden standard, the sensitivity, specificity and positive predictive value (PPV), negative predictive value (NPV) and accuracy of the two methods for different BI-RADS classification were calculated and compared with χ2 test or Fisher exact test, and the area under the ROC curve (AUC) of the two diagnostic methods were compared with Z test. Results: There were 152 lesions in 148 patients including 62 benign lesions and 90 malignant lesions confirmed by pathological biopsy. The ROC curves of the two diagnostic methods were plotted, and the best diagnostic threshold was 4b, the BI-RADS below 4b was benign and the BI-RADS 4b or above was malignant of the two diagnostic methods. For 152 cases of breast BI-RADS 4-5 non-mass microcalcification lesions on FFDM, the sensitivity, specificity, PPV, NPV and accuracy of FFDM were 86.7%, 53.2%, 72.9%, 73.3%, 73.0%, DCE-MRI was 93.3%, 83.9%, 89.4%, 89.7%, 89.5%, respectively. The sensitivity of the two methods was not significantly different (χ2=2.222, P>0.05), and the specificity, PPV, NPV and accuracy of the two methods were statistically significantly different (χ2=13.503, 8.674, 4.681, 13.495,respectively, all P<0.05). For 125 cases of breast BI-RADS 4 non-mass microcalcification lesions on FFDM, the sensitivity, specificity, PPV, NPV and accuracy of FFDM were 82.4%, 57.9%, 70.0%, 73.3%, 71.2%, DCE-MRI was 92.6%, 86.0%, 88.7%, 90.7%, 89.6%, respectively. The sensitivity of the two methods was not significantly different (χ2=3.294, P>0.05), the specificity, PPV, NPV and accuracy of the two methods were statistically significantly different (χ2=11.122, 7.903, 5.299, 13.428, respectively, all P<0.05). For 27 cases of breast BI-RADS 5 non-mass microcalcification lesions on FFDM, the sensitivity, specificity, PPV, NPV and accuracy of FFDM were 100.0%, 0, 81.5%, 0, 81.5%, DCE-MRI was 95.5%, 60.0%, 91.3%, 75.0%, 88.9%, respectively. The sensitivity specificity, PPV and accuracy of the two methods were not significantly different (all P＞0.05). For breast BI-RADS 4-5 non-mass microcalcification lesions on FFDM, the areas under the ROC curve (AUC) of FFDM and DCE-MRI diagnostic methods were 0.752 and 0.907, respectively. The difference between the two AUC was statistically significant. (Z=4.068, P＜0.0001, 95% confidence interval CI was 0.0804~0.230). Conclusion: For breast BI-RADS 4-5 non-mass microcalcification lesions on FFDM, DCE-MRI can effectively improve the diagnostic efficiency of lesions; for breast BI-RADS 4-5 non-mass microcalcification lesions on FFDM, DCE-MRI has no obvious advantage. 2020 Vol. 26 (6): 988-993 [Abstract] ( 132 ) HTML (1 KB)  PDF (1707 KB)  ( 304 ) 994 The Curative Effect of Modified PPH on Circumferential Mixed Hemorrhoid of Connective Tissue Type and Its Influences on Serum HIF-1a VEGF and MMP-9 Levels LIANG Jiadi, SU Jinhua, LI Xiaolan DOI: 10.3969/j.issn.1006-6233.2020.06.025 Objective: To explore curative effect of modified procedure for prolapse and hemorrhoids (PPH) on circumferential mixed hemorrhoid of connective tissue type and its influences on levels of serum hypoxia-inducible factor-1a (HIF-1a), vascular endothelial growth factor (VEGF) and matrix metalloproteinase 9 (MMP-9). Methods:The clinical data of 80 patients with circumferential mixed hemorrhoid of connective tissue type who were admitted to the hospital from September 2018 to June 2019 were retrospectively analyzed. According to different treatment methods, they were divided into control group (n=40) and observation group (n=40).The control group was treated with traditional Milligan-Morgan, while observation group was treated with modified PPH. The perioperative indexes, clinical curative effect, score of visual analogue scale (VAS), levels of serum HIF-1a, VEGF and MMP-9, incidence of complications and anal function score were compared between the two groups. Results:The operation time, hospitalization time and wound healing time in observation group were shorter than those in control group, and intraoperative blood loss was less than that in control group (P<0.05). The total response rate in observation group was higher than that in control group (95.00% VS 77.50%) (P<0.05). After treatment, VAS scores in observation group were lower than those in control group(P<0.05). After treatment, levels of serum HIF-1a, VEGFand MMP-9 in observation group were lower than those in control group(P<0.05). The incidence of complications in observation group was lower than that in control group (7.50% VS 30.00%) (P<0.05). The anal function score in observation group was lower than that in control group (P<0.05). Conclusion:The curative effect of modified PPH is significant on circumferential mixed hemorrhoid of connective tissue type, which can alleviate pain, reduce levels of serum HIF-1a, VEGF and MMP-9, improve anal function, with high safety. 2020 Vol. 26 (6): 994-997 [Abstract] ( 112 ) HTML (1 KB)  PDF (1230 KB)  ( 235 ) 998 Levels and Clinical Significance of Serum Hs-CRP IL-6 TNF-α and PCT in Pregnant Women with Premature Rupture of Membranes HUANG Hui, CHEN Liyuan, WANG Han DOI: 10.3969/j.issn.1006-6233.2020.06.026 Objective:To explore levels and the clinical significance of serum hs-CRP, IL-6, TNF-α and PCT in pregnant women with premature rupture of membranes (PROM). Methods:During the period from January 2018 to June 2019, 38 pregnant women with PROM and intrauterine infection who were admitted to obstetrics and gynecology department of the hospital were enrolled as infection group. 54 pregnant women with PROM and without intrauterine infection were enrolled as non-infection group. 60 healthy pregnant women who underwent production inspection and delivery during the same period in the hospital were enrolled as control group. The fasting elbow venous blood in the morning of the three groups was collected. The levels of serum hs-CRP, IL-6, TNF-α and PCT were detected by enzyme-linked immunosorbent assay. Results:The levels of serum hs-CRP, IL-6, TNF-α and PCT were the highest in infection group, followed by non-infection group and control group (P<0.05). The levels of serum hs-CRP, IL-6, TNF-α and PCT of full-term and incomplete pregnant women in infection group were higher than those in non-infection group. The levels of serum hs-CRP, IL-6, TNF-α and PCT of incomplete pregnant women were higher than those of full-term pregnant women in infection group and non-infection group (P<0.05). In infection group, levels of serum hs-CRP, IL-6, TNF-α and PCT were the highest in pregnant women with severe infection, followed by moderate infection and mild infection (P<0.05). ROC curve analysis showed that serum hs-CRP, IL-6, TNF-α and PCT levels were of relatively higher diagnostic value for predicting intrauterine infection of PROM pregnant women. AUC of their combined prediction was the largest. The sensitivity and specificity were 90.6% and 92.7%, respectively. Conclusion:The combined detection with serum hs-CRP, IL-6, TNF-α and PCT levels is of positive predictive value for early intrauterine infection in pregnant women with PROM. 2020 Vol. 26 (6): 998-1001 [Abstract] ( 142 ) HTML (1 KB)  PDF (1367 KB)  ( 313 ) 1005 An Analysis of the Effects of the Terrible Elbow Triad Treated Through the Lateral Approach and the Combination of Lateral Approach and Anterior-Medial Approach ZHANG Zhiwen, HUANG Yuliang, QIU Longhai, et al DOI: 10.3969/j.issn.1006-6233.2020.06.028 Objective: To investigate the clinical curative effects of terrible triad of elbow treated through lateral approach alone and through the combination of lateral approach and anterior-medial approach. Methods:Retrospective and cohort study was adopted in this research, which involved 43 patients from May 2015 to March 2018 in our department. Patients were randomly assigned to group A(n=24) and group B(n=19). Clinical curative effects were evaluated, including operation time, blood loss volume, postoperative complications, range of motion of elbow joint and Mayo elbow performance score(MEPS). Results: There was no statistical difference between group A and group B(P>0.05). After a mean follow-up of 24.6 months, elbow motion range in group A was better than that in group B(P<0.05). The score of motion in group A were higher, compared with group B(P<0.05). Mayo elbow performance in group A was lower in group A, with no stastistical difference (P>0.05). Conclusion:Both single approach and combined approach could achieve satisfactory effects. Single lateral approach seemed to associate with better motion range, lower ulnar damage and elbow stiffness than combined approach in treating triad of the elbow. 2020 Vol. 26 (6): 1005-1009 [Abstract] ( 95 ) HTML (1 KB)  PDF (1731 KB)  ( 249 ) 1010 The Effect of Pramiphene Eye Drops on Corneal Endothelium and Lacrimal Inflammatory Index During Cataract Surgery Perioperative Period ZHANG Juanjuan, XUE Tao, WANG Sheng, et al DOI: 10.3969/j.issn.1006-6233.2020.06.029 Objective: To observe the effect of Pramiphene eye drops on the corneal endothelium and lacrimal inflammatory index during cataract surgery perioperative period. Methods: Totally 580 cases (610 eyes) of cataract patients in our hospital, from January 2018 to September 2019, were randomly divided into two groups. Levofloxacin Eye Drops and Tobramycin & Dexamethasone Eye Drops were administrated to the control group (290 cases (302 eyes). On the basis of control group treatment, Pramiphene Eye Drops was administrated to the observation group (290 cases, 308 eyes). The corneal endothelium and lacrimal inflammation indexes were compared between the two groups. Results: There was no significant difference between the observation group and the control group in the loss rate of corneal endothelial cells at 1 week, 1 month and 3 months after operation (P > 0.05); there was no difference between the two groups in the index of lacrimal inflammatory factor IL-6 before operation, and the index of TNF in the observation group was significantly lower than that in the control group (P < 0.05). The difference was statistically significant (P < 0.05). Conclusion: The administration of Pramiphene Eye Drops in the perioperative period of cataract surgery does not increase the loss rate of corneal endothelial cells, which is beneficial to reducing the level of lacrimal inflammatory factors, and is worthy of clinical reference. 2020 Vol. 26 (6): 1010-1012 [Abstract] ( 112 ) HTML (1 KB)  PDF (1212 KB)  ( 314 ) 1013 Clinical Value of Early Diagnosis with Molybdenum X-rays Combined with Magnetic Resonance Imaging of Breast Cancer Patients ZHANG Cuijing, HUANG Tingwei, et al DOI: 10.3969/j.issn.1006-6233.2020.06.030 Objective:To explore the clinical value of early diagnosis with molybdenum x-rays combined with magnetic resonance imaging. Methods:99 patients with breast cancer in our hospital from January 2016 to December 2018 were selected as the observation group, and 83 patients with benign breast lesions during the same period were selected as the control group. All patients underwent molybdenum radiography and total breast MRI examination, and the results were classified by the Breast Imaging Reporting Data System (BI-RADS) and compared with pathological results to evaluate the diagnostic efficacy of molybdenum radiography combined with magnetic resonance imaging, and analyzed the related influencing factors. Results:In 182 patients, 190 lesions were detected by pathological diagnosis, including 5 bilateral lesions and 3 unilateral breast lesions; X-rays of breast cancer showed signs of typical masses, calcification, structural distortion, focal asymmetry, structural distortion with calcification, and diffuse density increase; the magnetic resonance parameters Slope and SlopeR in the observation group were higher than those in the control group (P<0.05); the combined diagnostic sensitivity, specificity, and accuracy were higher than X-rays and magnetic resonance alone, and the misdiagnosis rate and missed diagnosis rate were lower than X-rays and magnetic resonance alone (P<0.05); lesions with a maximum diameter <1.71 cm were independent risk factors affecting the sensitivity of breast cancer diagnosis (P<0.05). Conclusion:There may be multiple lesions in early breast cancer patients, with different typical morphological features in molybdenum target X-rays and magnetic resonance imaging, the combination of which can complement each other, improve the diagnostic sensitivity, and be more conducive to the detection of early small lesions and provides objective evidence for clinical treatment. 2020 Vol. 26 (6): 1013-1019 [Abstract] ( 118 ) HTML (1 KB)  PDF (1485 KB)  ( 363 ) 1020 The Effect of Nutritional Risk Screening and Sequential Treatment of Enteral Nutrition Combined with Parenteral Nutrition for Critical Patients on Clinical Outcomes WANG Kai, ZHENG Zhenru, et al DOI: 10.3969/j.issn.1006-6233.2020.06.031 Objective: To investigate the effect of nutritional risk screening and sequential treatment of early enteral nutrition combined with parenteral nutrition for critical patients on clinical outcomes. Methods: A total of 137 critical patients admitted to the Intensive Care Unit from December 2017 to December 2018 were enrolled in the study. All of them were screened for nutritional risk. 90 patients with nutritional risk were divided equally into control group, which was treated with total parenteral nutrition, and the observation group, which was given early enteral nutrition combined with parenteral nutrition sequential treatment. The levels of albumin (ALB), prealbumin (PA) and transferrin (TRF) were measured at admission and 14 days after treatment. Total hospitalization cost, ICU stays and hospital stays were compared. The occurrence of complications in patients were observed and recorded. Results: The NRS 2002 average score of 90 patients with nutritional risk was (5.26±1.02), and thereinto, 47 patients had the score of (2.35±0.68). There was a significant difference between the groups (t=-17.607, P=0.000).14 days after treatment, the levels of ALB, PA and TRF were increased in both groups. There was significant difference between the groups (P<0.05).The total hospitalization cost, ICU stays and hospital stays of the observation group were lower than the control group (P<0.05). The complication rate of the control group was 55.56%, which was significantly higher than the observation group (28.89%, χ2=6.559, P=0.010).There was a significant difference in the incidence of infection and stress-induced hyperglycemia (P<0.05). Conclusion: Early enteral nutrition combined with parenteral nutrition sequential treatment for critical patients with nutritional risk can improve the nutritional status, restore gastrointestinal function, reduce the incidence of complications, and shorten the length of hospital stay. 2020 Vol. 26 (6): 1020-1023 [Abstract] ( 110 ) HTML (1 KB)  PDF (1217 KB)  ( 240 ) 1024 An Analysis of the Relationship Between Blood Glucose Level and Postoperative Complications in Children Undergoing Thoracotomy and Cardiopulmonary Bypass LIU Chao, LIU Kai, LUO Gang, et al DOI: 10.3969/j.issn.1006-6233.2020.06.032 Objective: To analyze the correlation between blood glucose level and postoperative complications of thoracotomy and cardiopulmonary bypass (CPB), and to analyze the influencing factors of postoperative complications. Methods: A retrospective study was carried out to collect the clinical data of 100 children who underwent thoracotomy and CPB from May 2016 to may 2018 in our hospital. The patients were divided into complication group and complication-free group according to whether there were complications after operation. The baseline data, operation data and perioperative blood glucose level were collected, and then monofactor analysis and multivariate logistic regressive analysis were conducted to findout the influencing factors of postoperative complications . Results: There were 38 cases of complications during hospitalization, with the incidence of 38.00%. Compared with the complication-free group, the complication group were found younger and underweight, whose CPB time, aortic occlusion time, operation duration and hospital stays were significantly longer, and whose amount of blood transfusion during operation was significantly increased, so the Risk Adjustment for Congenital Heart Surgery (RACHS-1) of congenital heart disease was much higher (P < 0.05). The blood glucose level of the two groups was significantly higher, compared to pre-operation, at the beginning and the end of CPB, and 20 minutes after CPB, (P < 0.05), with the peak value being observed 20 minutes after CPB. The blood glucose level decreased after patients had been admitted to intensive care unit (ICU), but still higher then pre-operation when, and 24 hours after, being admitted to ICU (P < 0.05).No significant difference of blood glucose level was found between the two groups perioperatively (P > 0.05). Multivariate logistic regressive analysis showed that surgery duration, hospital stay and RACHS-1 score were all the influencing factors of postoperative complications (P < 0.05). Conclusion: The postoperative complications of thoracotomy and CPB may be closely related to the surgery duration, hospital stay and the score of RACHS-1, but may not be closely related to the perioperative blood glucose level. 2020 Vol. 26 (6): 1024-1028 [Abstract] ( 143 ) HTML (1 KB)  PDF (1246 KB)  ( 620 ) 1029 An Analysis of the Efficacy of Hemabate Combined with Ergotine Maleate in Preventing Postpartum Hemorrhage During Vaginal Delivery and the Effect of Postpartum Recovery LI Xiaoyan DOI: 10.3969/j.issn.1006-6233.2020.06.033 Objective: To investigate the effectiveness of Xinmupei combined with ergometrine maleate in preventing postpartum hemorrhage in vaginal delivery and the effect of postpartum recovery. Methods:A total of 166 patients with vaginal delivery who were admitted to our hospital from February 2017 to February 2018 were enrolled. The patients were divided into two groups according to the random number table, 83 cases in each group. The control group was given Xinmupei to prevent bleeding. The study group was given Xinmupei and ergometrine maleate to prevent bleeding. The postpartum hemorrhage, the height of the fundus, the number of contractions, and the changes of blood pressure are compared. Results:The bleeding volume of the control group was higher than that of the study group 2 hours after delivery and 1 day after delivery. The probability of bleeding after delivery was higher than that of the study group (P<0.05). There was no difference in the height of the anterior fundus and the number of uterine contractions between the two groups (P>0.05). ). 0.5 h and 1.0 h after the administration, the height of the fundus of the control group was higher than that of the study group, and the number of uterine contractions was less than that of the study group (P<0.05). Before the administration, 0.5 h after the administration, and 1.0 h after the administration, there was no difference in pressure and systolic pressure (P>0.05). Conclusion: In the process of preventing postpartum hemorrhage in vaginal delivery, the use of Xinmupei combined with ergometrine maleate has significant effects and is worthy of widespread promotion and application in clinical practice. 2020 Vol. 26 (6): 1029-1031 [Abstract] ( 135 ) HTML (1 KB)  PDF (1217 KB)  ( 444 ) 1032 An Analysis of the Clinical Significance of Ultrasonic Cardiogram in Evaluating Right Heart Function in Patients with Acute or Chronic Pulmonary Embolism QIN Shiyang, CAO Xuesong, FANG Liang, et al DOI: 10.3969/j.issn.1006-6233.2020.06.034 Objective: To study the clinical significance of ultrasonic cardiogram in evaluating right heart function in patients with acute or chronic pulmonary embolism (PE). Methods: 96 patients with PE in our hospital from October 2017 to October 2019 were selected for the study. Among them were 52 cases of acute pulmonary embolism (APE) and 44 cases of chronic pulmonary embolism (CPE). Another 50 cases of healthy examiners in our hospital at the same period were selected as control group. The two-dimensional ultrasound, tissue Doppler imaging (TDI) were performed, and the right ventricular anterior wall thickness (RVAWTd), right ventricular transverse diameter (RV), right atrial transverse diameter (RA), main pulmonary artery diameter (MPA), right ventricular end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (RVSV), right ventricular ejection fraction (RVEF), and right ventricular Tei index were compared and analyzed. Results: The RVAWTd, RV and RA in APE group were significantly higher than those in control group (P>0.05). The RVAWTd, RV and RA in CPE group were higher than those in APE group and control group (P<0.05). The RVEDV, RVESV and PASP in APE group were higher than those in control group, and the RVSV and RVEF were lower than those in control group, and the RVEDV, RVESV and PASP in CPE group were higher than those in APE group and control group, and the RVSV and RVEF were lower than those in APE group and control group (P<0.05). The ICT+IRT, ET and right ventricular Tei index in APE group were higher than those in control group, and the ICT+IRT, ET and right ventricular Tei index in CPE group were higher than those in APE group and control group (P<0.05). Conclusion: TDI and 2DE can accurately reflect the right ventricular systolic and diastolic function in patients with APE and CPE. Ultrasonic cardiogram evaluation of right heart function in PE patients can provide important reference information for clinical diagnosis and acute and chronic identification. 2020 Vol. 26 (6): 1032-1035 [Abstract] ( 123 ) HTML (1 KB)  PDF (2338 KB)  ( 521 ) 1036 Surgery Optimization and Postoperative Recovery of Lumbar Disc Herniation After Posterolateral Percutaneous Transforaminal Endoscopic Discectomy LI Guangbao, YIN Jianwen, ZHANG Yiqun, et al DOI: 10.3969/j.issn.1006-6233.2020.06.035 Objective: To explore the surgical optimization and postoperative recovery of lumbar disc herniation after the posterolateral percutaneous transforaminal endoscopic discectomy. Methods: A total of 128 patients with lumbar disc herniation who were treated in our hospital from June 2015 to September 2018 were selected as the research subjects and divided into a control group and an observation group according to the random number table method, with 64 patients in each group. For surgery, the observation group had percutaneous lateral posterior intervertebral foramina. The bone recovery and dysfunction of the two groups of patients were compared, and the treatment effects of the two groups of patients were compared. Results:The subjective symptoms, clinical signs, and limits of daily activities in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). The waist and leg pain, lifting weights, personal living conditions, sitting conditions and the standing status, walking status, sleeping status, and standing status scores were significantly lower than those in the control group, and the differences were statistically significant (P<0.05). There was no significant difference in the efficacy, effective, and ineffective rates between the two groups of patients and the difference was not statistically significant (P>0.05). There was no significant difference in the total effective rate between the two groups of patients, and the difference was not statistically significant (P>0.05). Conclusion: Percutaneous posterior intervertebral foraminal technology has significant curative effect and complete pressure release, and has the advantages of minimally invasive and clear surgical field. The postoperative bone recovery is faster and the incidence of dysfunction is lower. 2020 Vol. 26 (6): 1036-1038 [Abstract] ( 242 ) HTML (1 KB)  PDF (2518 KB)  ( 987 ) 1039 Analysis of the Efficacy of Low Molecular Weight Heparin Combined with Acetylcysteine in the Treatment of Idiopathic Interstitial Pneumonia CAI Yan, SONG Linfeng, WANG Lu DOI: 10.3969/j.issn.1006-6233.2020.06.036 Objective:To investigate the efficacy of low molecular heparin combined with acetylcysteine (AC) in the treatment of idiopathic interstitial pneumonia (IIP). Methods: A total of 62 patients with IIP treated in the First Hospital of Dandong City from January 2016 to February 2019 were selected and were divided into two groups for prospective study, 31 cases each, with the random number table method. The control group was given comprehensive treatment, and the observation group was added with low-molecular-weight heparin combined with AC. On the basis of this, the total effective rate, pulmonary function indicators [maximum voluntary ventilation (MVV), total lung capacity (TLC), and forced vital capacity (FVC) of the two groups were compared. ], carbon monoxide dispersion per unit of alveolar volume as a percentage of predicted value (DLco / VA% pred)], blood gas indicators [arterial blood oxygen partial pressure (PaO2), arterial blood carbon dioxide partial pressure (PaCO2)], serum transforming growth factor-β1 (TGF-β1), sialylated glycin 6 (KL-6), peroxisome proliferator-activated receptor gamma (PPARγ) levels, adverse reactions,are compared. And Pearson analysis was performed to analyze the correlation between serum TGF-β1, KL-6, PPARγ before treatment and pre-treatment clinical-imaging-physiological (CRP). Results: The CRP score of the observation group after treatment was lower than that of the control group, and the total effective rate (83.87%) was higher than that of the control group (61.29%, P <0.05). The MVV, TLC, FVC, and DLco / VA% pred of the observation group were higher than the control group after treatment (P <0.05); PaO2 was higher in the observation group after treatment, PaCO2 was lower than the control group (P <0.05); serum TGF-β1, KL-6 were lower in the observation group after treatment, and PPARγ was higher than the control group. (P <0.05); serum TGF-β1 and KL-6 before treatment were positively correlated with CRP score before treatment, and serum PPARγ before treatment was negatively correlated with CRP score before treatment (P <0.05). Conclusion:Low-molecular-weight heparin combined with AC in the treatment of IIP can significantly effectively inhibit the progression of pulmonary fibrosis, improve clinical symptoms and blood gas indicators, and improve pulmonary function. The mechanism may be related to up-regulation of PPARγ and down-regulation of TGF-β1 and KL-6 2020 Vol. 26 (6): 1039-1044 [Abstract] ( 131 ) HTML (1 KB)  PDF (1382 KB)  ( 317 ) 1045 A Research on Genotype Distribution of Partial D Variants in Hebei Province QIAO Fang, WANG Ning, Wang Yuanhua, et al DOI: 10.3969/j.issn.1006-6233.2020.06.037 Objective: To study the genotype distribution of partial D variants in Hebei Province. Methods: The five antigens in Rh blood type system of test models were tested serologically,and the RHD genotype was detected by PCR-SSP. Results: 14 partial D samples were found among 107 cases of RhD varients, including 11 D cat.VI type3 cases, 2 D cat.Va type2 cases and 1 D cat.IIIc case. Conclusion:The partial D genotype polymorphisms is detectable in Hebei. Especially D cat.VI type3 is the common genotype. 2020 Vol. 26 (6): 1045-1047 [Abstract] ( 144 ) HTML (1 KB)  PDF (2556 KB)  ( 498 ) 1048 Study on the Effective Control of Postoperative Pneumonia by Digital Hospital Sense Monitoring CHI Shuijing, et al DOI: 10.3969/j.issn.1006-6233.2020.06.038 Objective: To reduce the incidence of nosocomial infections by monitoring the occurrence of nosocomial infections in thoracic surgery and formulating corresponding prevention and control and intervention measures. Methods: Targeted surveillance of nosocomial infections was performed on all patients admitted to thoracic surgery in 2019. The whole process was divided into 4 stages: data and statistics collection, prevention and control measures formulation, field intervention, and results feedback. Statistical analysis was performed using SPSS19.0 software. Results: By selecting 1020 patients admitted to thoracic surgery from January to December 2019, the incidence of nosocomial infection, pathogen distribution, infection site and route were monitored and recorded. Secondly, according to the monitoring results, formulate prevention and control measures and implement specific intervention measures. Finally, evaluate, improve and feedback the intervention results. Through monitoring the incidence of nosocomial infection in thoracic surgery, the corresponding prevention, control and intervention measures were formulated to reduce the incidence of nosocomial infection. Using digital hospital sense monitoring management, the incidence of nosocomial infection in thoracic surgery was significantly reduced, but there was no statistical difference (3.52% vs 2.94%, χ2= 0.138 P>0.05); the surgical site infection rate (SSI) was significantly reduced, with statistical difference (4.35% vs 3.85%, χ2=0.048, P<0.05); the incidence of postoperative pneumonia (POP) was from (5.8% vs 2.56%, χ2= 0.368, P>0.05). The main infection was pop and SSI, 8 cases of SSI, accounted for 0.78%, 16 cases of pop, accounted for 1.18%;. The main pathogens were gram negative bacteria, including 9 Pseudomonas aeruginosa (26%), 8 Klebsiella pneumoniae (23%). Conclusion: The implementation of digital nosocomial surveillance management measures can effectively improve the level of nosocomial infection diagnosis and reduce the incidence of related nosocomial infections. 2020 Vol. 26 (6): 1048-1052 [Abstract] ( 131 ) HTML (1 KB)  PDF (1245 KB)  ( 280 ) 1053 An Analysis of the Epidemic Characteristics of MSM with HIV/AIDS from 2004 to 2016 in Tangshan City WEI Xueqian, MAO Lichao, SHANG Xiuli, et al DOI: 10.3969/j.issn.1006-6233.2020.06.039 Objective: To describe the epidemic characteristics of MSM with HIV/AIDS from 2004 to 2016 in Tangshan, in order to provide scientific evidence for improving the prevention and control strategy of AIDS among men who have sex with men. Methods:Collect the history data of Tangshan as of 2016 from the information system for prevention and control of AIDS and conduct an analysis of reported homosexual transmission of HIV/AIDS. Results:A total of 581 cases of homosexual transmission were recorded from 2004 to 2016. Young patients 15 to 24 years old accounted for 34.4%. Unmarried patients accounted for 60.8%. Of all patients, 34.3% had college degree or above. Workmen accounted for 20.8%. The main data origin was VCT, which contributed 44.1% of the cases. Younger MSM with HIV/AIDS had more homosexual companions (χ2=4.416,P＜0.05). More younger MSM with HIV/AIDS were detected by VCT clinic, while more older cases were detected by medical institutions(χ2=6.035,P＜0.05). Conclusion: The homosexual transmission of HIV/AIDS were increasing significantly in resent years in Tangshan. VCT clinic has low utilization rate among men who have sex with men, especially in middle-aged MSM. Greater efforts should be made to strengthen the publicity and construction of VCT and meanwhile carry out PITC service in depth in order to find more HIV-infection early and reduce the spread of HIV between men. 2020 Vol. 26 (6): 1053-1056 [Abstract] ( 160 ) HTML (1 KB)  PDF (1300 KB)  ( 209 )

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