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2021 Vol. 27, No. 4 Published: 2021-04-30 529 Promoting Antitumor Immune Effect of NK Cells by Inhibiting sMICA Secretion of Lung Cancer Cells with Silencing ADAM17 PENG Fei, LU Jingwei, LI Yong, et al DOI: 10.3969/j.issn.1006-6233.2021.04.01 Objective: To investigate the effect of silenced disintegrin-metalloproteinase 17 (ADAM17) on the anti-tumor immune effect of natural killer (NK) cells by inhibiting the secretion of soluble major histocompatibility complex class I related molecule A (sMICA) of lung cancer cells.Methods: Immunohistochemistry was used to detect the expression of ADAM17 in lung cancer tissues and adjacent tissues. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the mRNA expression of ADAM17 in lung cancer cells A549 and human normal lung epithelial cells BEAS-2B. Small interfering RNA (siRNA) endogenously knocks down ADAM17, qRT-PCR detects the mRNA expression of ADAM17 and major histocompatibility complex class I related molecule A (MICA), Western blot detects ADAM17 and MICA The protein expression of NK cells was detected by enzyme-linked immunosorbent assay (ELISA) to detect the expression of sMICA in the supernatant of A549 cells, flow cytometry was used to detect the expression of MICA, and the lactate dehydrogenase release method was used to detect the killing sensitivity of NK cells to lung cancer cells. Results: ADAM17 was highly expressed in lung cancer tissues and lung cancer cell A549. siRNA endogenously knocked down ADAM17, the content of sMICA in the supernatant of A549 cells decreased (P<0.05), the expression of MICA in A549 cells increased (P<0.05), and the killing activity of NK cells on A549 cells was significantly enhanced (P<0.05). Conclusion: Silencing ADAM17 promotes the expression of MICA of lung cancer cells, inhibits the shedding of sMICA, and enhances the killing sensitivity of NK cells to lung cancer cells. 2021 Vol. 27 (4): 529-534 [Abstract] ( 138 ) HTML (1 KB)  PDF (1802 KB)  ( 182 ) 534 MicroRNA-216b Targets DCLK1 Regulating the Proliferation, Migration and Invasion of Ovarian Cancer HO-8910 Cells FAN Tao, LI Jiangpeng DOI: 10.3969/j.issn.1006-6233.2021.04.02 Objective: To investigate the effect of MicroRNA-216b (miR-216b) on the proliferation, migration and invasion of ovarian cancer HO-8910 cells.Methods: The expression of miR-216b in cancer and paracancerous tissues of 30 patients with ovarian cancer was detected by qPCR. Experimental cells were divided into four groups: control group (normal HO-8910 cells), negative control group (transfected empty plasmid HO-8910 cells), overexpression group (transfected miR-216bmimicHO-8910 cells), low expression group (transfected miR-216binhibitorHO-8910 cells). CCK8 assay, scratch test, plate cloning and Transwell were used to detect the ability of cell proliferation, migration and invasion. Westernblot and qPCR were used to detect the expression of biscorticoid kinase 1 (Doublecortinlikekinase1, DCLK1) protein and mRNA. Results: The expression of miR-216b in ovarian cancer tissues was significantly lower than that in paracancerous tissues, and the results of CCK8 assay, scratch test and Transwell showed that the ability of cell proliferation, migration and invasion in miR-216bmimic group was significantly lower than that in control group and negative control group, while that in miR-216binhibitor group was significantly higher than that in control group and negative control group. The results of Western and qPCR showed that the expression levels of DCLK1 protein and mRNA in miR-216bmimic group were significantly lower than those in control group and negative control group, while those in miR-216binhibitor group were significantly higher than those in control group and negative control group. Conclusion: MiR-216b can target DCLK1 to inhibit the proliferation, migration and invasion of ovarian cancer HO-8910 cells. MiR-216b may be a new target for diagnosis and treatment of ovarian cancer. 2021 Vol. 27 (4): 534-538 [Abstract] ( 109 ) HTML (1 KB)  PDF (1635 KB)  ( 170 ) 539 The Correlation Between Type 2 Diabetic Peripheral Neuropathy and Serum 25(OH) Vitamin D3 Level ZHANG Jinhui, WANG Chunyan DOI: 10.3969/j.issn.1006-6233.2021.04.03 Objective: To investigate the correlation between serum 25 (OH) vitamin D3 (VD3) levels and peripheral neuropathy (DPN) of patients with type 2 diabetes, and to analyze the related influencing factors of DPN.Methods: A total of 135 type 2 diabetes inpatients in the Aviation General Hospital from January 2018 to January 2019 were collected as research subjects. One group included 57 cases of diabetes without type 2 peripheral neuropathy (NDPN), and the other group included 78 patients of diabetes mellitus combined with type 2 peripheral neuropathy (DPN). The clinical data of all subjects for were collected for analysis, the HbA1c, FBG, PBG, Cr, ALT, LDL-C, and VD3 levels of the tested patients were measured, the proportion of the lack of VD3 levels in the NDPN group and the DPN group were counted, and VD3 level of patients in the two groups was compared. Logistic regression was used to analyze the independent risk factors of patients with DPN, and the possible causes of DPN were preliminarily discussed. Results: There was a certain difference in the course of disease and the level of glycosylated hemoglobin between the DPN group and the NDPN group (P<0.05). The average serum VD3 level in the DPN group was (24.55±11.27) ng/ml, and the level in the NDPN group was (50.43±18.48) ng/ml. The VD3 level in the DPN group was lower than that in the NDPN group (P<0.05). 93.6% of the patients in the DPN group had VD3 deficiency, 22.8% of NDPN patients had VD3 deficiency, and the proportion of VD3 deficiency in the DPN group was higher (P<0.05). Regression analysis showed that the course of disease and VD3 are independent risk factors for DPN. Conclusion: VD3 deficiency is relatively common in patients with DPN. In addition, VD3 deficiency is related to the occurrence of DPN. The occurrence and progression of DPN is related to VD3 deficiency. 2021 Vol. 27 (4): 539-542 [Abstract] ( 89 ) HTML (1 KB)  PDF (1209 KB)  ( 266 ) 542 Relationship between Aggressive Behavior and Plasma IL-6 IL-10 and Serum Thyroid Hormone Levels in Patients with Schizophrenia DAI Jinglan, HE Jinquan, LUO Jun, et al DOI: 10.3969/j.issn.1006-6233.2021.04.04 Objective: To explore the relationship between aggressive behavior and plasma IL-6, IL-10 and serum thyroid hormone levels in patients with schizophrenia.Methods: The clinical data of 118 patients with schizophrenia admitted to our hospital from February 2018 to February 2020 were analyzed. According to their MOAS scores, they were divided into 51 cases of aggressive behavior (group A) and 66 cases of non-aggressive behavior (group B) ), measure the levels of IL-6, IL-10 and thyroid hormone (T3, T4, TSH) in all patients and compare them between groups. Use Spearman to analyze the correlation between each index and aggressive behavior in patients with schizophrenia. Results: The scores of the MOAS scale in group A were higher than those in group B (P<0.05); the IL-6 index of group A was higher than that of group B (P>0.05), and the IL-10 index was lower than group B (P<0.05) ; Thyroid hormones (T3, T4, P>0.05; TSH, P<0.05) in group A were higher than those in group B; Aggressive behavior in schizophrenia patients was correlated with IL-6 (r=0.309), IL-10 (r =0.523) significantly correlated (P<0.05); Aggressive behavior T3 (r=0.540) and T4 (r=0.605, P<0.05) are significantly correlated with TSH (r=0.214) , (P>0.05). The correlation is not significant. Conclusion: Plasma IL-6, IL-10 and serum thyroid hormone T3 and T4 indicators are significantly correlated with aggressive behavior in patients with schizophrenia. In the future, more attention should be paid to these indicators in order to provide patients with better quality diagnostic and prognostic services. 2021 Vol. 27 (4): 542-546 [Abstract] ( 95 ) HTML (1 KB)  PDF (1224 KB)  ( 465 ) 546 Expression and Clinical Significance of Muscarinic Acetylcholine Receptor M3 in Hilar Cholangiocarcinoma ZHANG Hongwei, WANG Cairu, MIAO Guodong, et al DOI: 10.3969/j.issn.1006-6233.2021.04.05 Objective: To investigate the expression of muscarinic acetylcholine receptor m3 (CHRM3) in hilar cholangiocarcinoma and its relationship with prognosis.Methods: A total of 69 cases of hilar cholangiocarcinoma and 69 cases of normal cholangiocarcinoma adjacent to cholangiocarcinoma resected by surgery in our hospital from January 2013 to April 2017 were selected as research objects. The expression of CHRM3 in hilar cholangiocarcinoma and paracancerous tissues was detected by immunohistochemistry, the relationship between the expression level of CHRM3 and the clinicopathological features of hilar cholangiocarcinoma were analyzed, and the relationship between the expression of CHRM3 and the prognosis of hilar cholangiocarcinoma was explored after follow-up for 3 years. Results: The positive rate of CHRM3 in the adjacent tissues and hilar cholangiocarcinoma was 7.25% and 84.06%, respectively; the difference was statistically significant (P<0.05). The expression level of CHRM3 in hilar cholangiocarcinoma was not related to age and gender (P>0.05), but related to pathological stage, pathological grade, lymph node metastasis and nerve infiltration (P<0.05). Kaplan-Meier method showed that the mean survival time of patients with CHRM3 negative hilar cholangiocarcinoma was (33.69 ± 0.76) months, which was significantly longer than (23.37 ± 1.02) months of CHRM3 positive patients (P<0.05). Multivariate analysis showed that nerve infiltration and positive CHRM3 were independent risk factors for poor prognosis in patients with hilar cholangiocarcinoma (P<0.05). Conclusions: The positive expression rate of CHRM3 in hilar cholangiocarcinoma is significantly increased, which is related to pathological stage, pathological grade, lymph node metastasis and nerve infiltration. The increased expression rate of CHRM3 is an independent risk factor for poor prognosis in hilar cholangiocarcinoma. 2021 Vol. 27 (4): 546-551 [Abstract] ( 74 ) HTML (1 KB)  PDF (1565 KB)  ( 170 ) 551 Effect of Different Root Canal Fillings on Masticatory Function of Patients with Dehiscence Pulp Disease after Crown Restoration WANG Jian, et al DOI: 10.3969/j.issn.1006-6233.2021.04.06 Objective: To compare and analyze the effects of cortisomol paste, vitapex paste and zinc oxide clove oil paste root canal filling on the masticatory function of patients with cracked pulp disease.Methods: A total of 106 patients with dehiscence pulp disease (125 teeth in the first molar area) admitted to our hospital from October 2017 to August 2018 were selected as the research objects, and they were divided into group A according to random sampling method 38 Cases (43 teeth in total), 37 cases in group B (42 teeth in total), 31 cases in group C (35 teeth in total); group A used crown restoration combined with Cortisomol paste root canal filling, group B used Vitapex Root canal filling with paste, group C was filled with zinc oxide clove oil paste. Observe the clinical treatment effects of the three groups of patients after treatment, pain at various points before treatment, masticatory function before and after treatment, and related indexes of abutment teeth. Results: The difference between the three groups of patients in markedly effective, effective, and ineffective indicators was statistically significant (P<0.05); the total effective rate of treatment was compared between the three groups, and the difference was statistically significant (P<0.05); Group A and Group B, C Pairwise comparison, the difference was statistically significant (P<0.05). Pain scores at each point of treatment were analyzed by repeated measures analysis of variance, and the difference was statistically significant in time-point factors, time-point interaction factors, and group factors (P<0.05); at the time points of treatment 1d, 3d, 5d, and 7d group A compared with groups B and C, the difference was statistically significant (P<0.05). After treatment, the differences in chewing function, language function, immobilization, and aesthetics of the three groups of patients were statistically significant (P<0.05) compared with those before treatment (P<0.05); the single-factor variance before treatment showed no statistical significance (P>0.05); One-way variance after treatment showed that there was a statistically significant difference in chewing function between the three groups (P<0.05), and there was no statistically significant difference in language function, fixation, and aesthetics of the three groups (P>0.05); group A chewing There were no statistically significant differences in function, language function, fixation, and aesthetics between groups B and C (P>0.05). Conclusion: The treatment effect of crown restoration combined with Cortisomol paste in the treatment of dehiscence pulp disease and the recovery of masticatory function is better than the treatment of crown restoration combined with Vitapex paste and zinc oxide clove oil paste. 2021 Vol. 27 (4): 551-555 [Abstract] ( 95 ) HTML (1 KB)  PDF (1225 KB)  ( 187 ) 556 The Effect of Modified Posterior Lumbar Interbody Fusion on Patients with Lumbar Disc Herniation and Influencing Factors of Complications DU Zhuoshu, NI Dongbei, ZHANG Lun DOI: 10.3969/j.issn.1006-6233.2021.04.07 Objective: To analyze the therapeutic effect of modified posterior lumbar interbody fusion on patients with lumbar disc herniation and analyze the multivariate logistic regression of complications.Methods: The clinical data of 243 patients with lumbar disc herniation treated in our hospital from May 2018 to May 2019 were analyzed. Random number table method was used for simple random grouping. The patients treated with posterior lumbar interbody fusion were selected as the control group (n= 121),and the patients treated with modified posterior lumbar interbody fusion were selected as the study group (n=122). The clinical efficacy,complications,functional recovery and pain in different periods were compared between the two groups. Logistic regression analysis was used to determine the risk factors of postoperative complications after modified posterior lumbar interbody fusion in patients with lumbar disc herniation. Results: The excellent and good rate of patients in the study group was significantly higher than that in the control group (97.80% vs 78.51%) (P<0.05). The VAS score and ODI score of the two groups one month,three months and half a year after surgery gradually decreased,and the decreasing of the study group was more significant (P<0.05). There was no significant difference in the incidence of complications such as transient neurological deficit,dural tear,nerve root injury,infection,etc. between the two groups (P>0.05). According to the analysis of unconditional multi-factor Logistic regression model,the risk factors affecting postoperative complications of patients with lumbar disc herniation after modified posterior lumbar interbody fusion are:BMI≥25kg / m2,long operation time,heavy bleeding,large postoperative drainage volume and long time in bed (P<0.05). Conclusion: Modified posterior lumbar interbody fusion in the treatment of patients with lumbar disc herniation has good clinical efficacy and significant effect on postoperative pain and functional recovery. At the same time,controlling the patient's BMI value before operation,reducing the operation time and blood loss during operation,reducing the drainage volume after operation and shortening the time in bed can effectively reduce the occurrence of postoperative complications. 2021 Vol. 27 (4): 556-562 [Abstract] ( 109 ) HTML (1 KB)  PDF (2905 KB)  ( 238 ) 562 Changes and Clinical Significance of Inflammatory Factors and Immune Function in Children with OSAHS after Tonsillectomy HOU Le, TAI Xuhui, ZHANG Wei DOI: 10.3969/j.issn.1006-6233.2021.04.08 Objective: To explore the changes and clinical significance of inflammatory factors and immune function in children with obstrective sleep apnea-hypopnea syndrome (OSAHS) after tonsillectomy. Method: 110 cases with obstructive sleep apnea hypopnea syndrome clinically diagnosed and treated with tonsillectomy in our hospital from June 2018 to June 2019 were selected.110 cases with health examinations at the same time were selected as the control group. The changes of T cell subsets, inflammatory factors and immune function before surgery and half a year after surgery were compared, and the expression and clinical significance of each cytokine in apnea hyponea index (AHI) were analyzed. Results: Before surgery, the levels of CD3+, CD4+, CD8+, CD4+ / CD8+ in the study group were significantly lower than those in the control group, and the levels of TNF-α, IL-6, hn-CRP, IgG, IgM, and IgA were significantly higher than those in the control group (P<0.05). Six months after surgery, there was no significant difference in the levels of CD3+, CD4+, CD8+, CD4+/ CD8+, TNF-α, IL-6, hn-CRP, IgG, IgM, and IgA between the study group and the control group (P>0.05). In patients with OSAHS after tonsillectomy, the levels of IgG, IgM, IgA, TNF-α, IL-6, and hn-CRP increased with the severity of AHI, and the levels of CD3+, CD4+, CD8+, CD4+ / CD8+ decreased with the severity of AHI (P<0.05). According to Spearman correlation analysis, TNF-α, IL-6, hs-CRP, IgA, IgG, IgM were positively correlated with AHI in patients with OSAHS after tonsillectomy, while CD3+, CD4+, CD8+, CD4 + / CD8+ was negatively correlated with AHI (P<0.05). Conclusion: The expression of inflammatory factors and immune function is correlated with the AHI of OSAHS children. According to the expression level, the child's condition can be effectively evaluated. 2021 Vol. 27 (4): 562-567 [Abstract] ( 98 ) HTML (1 KB)  PDF (1250 KB)  ( 288 ) 567 The Analgesic Effect Hemodynamics and Serum Inflammatory Factors of PCIA Combined with TPVB or ESPB in Thoracotomy for Lung Cancer FAN Chenglong, et al DOI: 10.3969/j.issn.1006-6233.2021.04.09 Objective: To investigate the analgesic effect, hemodynamics and serum inflammation of patient-controlled intravenous analgesia (PCIA) combined with thoracic paravertebral nerve block (TPVB) or erector spinal muscle plane block (ESPB) on lung cancer thoracotomy The influence of factors.Methods: 126 patients who underwent thoracotomy for lung cancer in Nanchong Central Hospital and Leshan People's Hospital from January 2017 to December 2019 were selected as the research objects, and were simply randomly divided into the PE group (PCIA combined with ESPB) and the PT group (PCIA combined with TPVB) based on the random number table method. 63 cases each group. To compare the analgesic effect, serum inflammatory factor levels, and blood flow force at the time of administration, induction, intubation, and extubation of the two groups immediately after surgery, 12h after surgery, 24h after surgery, and 48h after surgery Learning changes. Results: The visual analogue scale (VAS) scores of resting state and coughing state of the two groups increased with time and then decreased (P<0.05). The PT group was significantly lower than the PE group at 12h, 24h, and 48h after operation (P<0.05). There were no significant differences in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) in the PT group during induction, intubation, extubation, and block administration (P>0.05). In the PE group, HR, SBP and DBP tend to change with time (P<0.05). HR, SBP induction and intubation in the PT group were significantly lower than those in the PE group (P<0.05), and DBP induction was significantly lower than in the PE group (P<0.05) . The tumor necrosis cell α (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) in the two groups at 12h, 24h, and 48h after surgery were significantly higher than those immediately after surgery (P<0.05), TNF-α and IL-6 in the PT group were significantly lower than those in the PE group (P<0.05), and IL-10 was significantly higher than the PE group (P<0.05). Conclusion: Compared with PCIA combined with TPVB, PCIA combined with ESPB has a better analgesic effect on lung cancer thoracotomy, and has more stable hemodynamics, which can effectively reduce inflammatory reactions. 2021 Vol. 27 (4): 567-571 [Abstract] ( 101 ) HTML (1 KB)  PDF (1230 KB)  ( 145 ) 571 Ultrasound-Guided Pectoral Nerve Block I and Serratus-Intercostal Plane Block Alleviate Postoperative Pain in Patients After Modified Radical Mastectomy YANG Kunhong, LI Yang, YI Qinmei DOI: 10.3969/j.issn.1006-6233.2021.04.010 Objective: To investigate the effect of ultrasound-guided pectoral nerve block I and serratus-intercostal plane block alleviate postoperative pain in patients after modified radical mastectomy.Methods: 80 patients with breast cancer who sought medical care in our hospital from Feb. 2016 to Feb. 2018 were enrolled and divided into PECSI block group (observation group) and only general anesthesia group (control group) via block randomized grouping method, 40 cases in each group. The observation group had anesthesia combining PECSI with SPB. 2 groups of patients had static absorption composite after anesthesia induction, the analgesic effect and safety were compared between the 2 groups of patients. Results: Visual analogue scale (VAS) after 4h, 8h, 12h and 24h of surgery and daily sleep disturbance quality score (DSIS) in the observation group were significantly lower than those in the control group (all P<0.05). Compared with the control group, patients in the observation group had a longer postoperative analgesia time and a higher degree of satisfaction with analgesia, and the difference was statistically significant (P<0.05). The incidence of postoperative adverse reactions, such as nausea and vomiting, skin itching and dizziness, was significantly lower in the observation group than in the control group (all P<0.05). Conclusion: Ultrasound-guided PECSI combined with SPB by ropivacaine has a significant analgesic effect on radical mastectomy, which can be promoted in clinical practice. 2021 Vol. 27 (4): 571-575 [Abstract] ( 83 ) HTML (1 KB)  PDF (1229 KB)  ( 273 ) 575 Comparative Study on the Effect of the Bone Grafting through Fenestration at High Level and Allogeneic Fibula Support in the Treatment of Early Femoral Head Necrosis WANG Zhaohe, et al DOI: 10.3969/j.issn.1006-6233.2021.04.011 Objective: To compare the curative effect of debridement of high head and neck fenestration and bone grafting with core decompression and allograft fibula support in the treatment of ARCO stage II femoral head necrosis.Methods: 60 patients (68 hips) with osteonecrosis of femoral head in our hospital from January 2015 to June 2019 were retrospectively analyzed. Among them, 24 cases (26 hips) were treated with high head and neck fenestration, debridement and bone grafting (group A), 36 cases (42 hips) were treated with core decompression and allograft fibula support (group B). Harris score and VAS score were used to evaluate the clinical effect after operation. The morphological changes of the femoral head could be observed by reexamination of X-ray film, and the clinical effect of hip preservation was evaluated. Results: Patients in both groups were followed up. Patients in group A were followed up for 12~40 months with an average of (26.2±1.7) months; patients in group B were followed up for 12 to 38 months with an average of (25.4±1.2) months. In group A, 4 patients failed to preserve hips, and the success rate of hip preservation was 84.6%; in group B, 12 hips failed to preserve hips, and the success rate of hip preservation was 71.4%. At the last follow-up of the two groups of patients with successful hip preservation, Harris score: group A (93.23±2.19) points, group B (85.46±2.32) points, the scores of the two groups were higher than those before surgery, and the difference was statistically significant (t=27.652, P<0.05; t=25.527, P<0.05); VAS score: group A (1.21±0.54) points, group B (2.43±0.60) points, the scores of the two groups were lower than those before surgery, the difference was statistically significant (t =16.743, P<0.05; t=17.514, P<0.05); the difference in scores between the groups was statistically significant (P<0.05). Conclusion: For the treatment of early avascular necrosis of the femoral head, the clinical effect of high head and neck fenestration debridement and bone grafting is better than core decompression and allograft fibula support, which can improve the symptoms of hip joint. 2021 Vol. 27 (4): 575-579 [Abstract] ( 105 ) HTML (1 KB)  PDF (1860 KB)  ( 262 ) 579 Predictive Value of Uterine Artery Blood Flow Parameters in Early Pregnancy on Adverse Pregnancy Outcomes in Patients with Recurrent Spontaneous Abortion LU Wei, LIU Honghong, YANG Weihao, et al DOI: 10.3969/j.issn.1006-6233.2021.04.012 Objective: To investigate the predictive value of ultrasound parameters of uterine artery in patients with recurrent spontaneous abortion (RSA) for pregnancy outcomes.Methods: 100 RSA patients with 6~10 weeks of pregnancy in our hospital from August 2016 to August 2019 were selected as the observation group, and 120 cases of normal pregnant women with 6~10 weeks of pregnancy were selected as the control group. The uterine artery hemodynamic parameters (PI, RI, S/D) of pregnant women were monitored by Doppler ultrasound. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of ultrasound parameters for adverse pregnancy outcomes. The relationship between ultrasound parameters and adverse pregnancy outcomes was analyzed by logistic regression. Results: The PI, RI and S/D value in RSA group were higher than those of control group (P<0.05). PI, RI, S / D, PI + RI, PI + S / D, RI + S / D and PI + RI + S / D had high sensitivity and specificity in predicting adverse pregnancy outcomes. The area under the curve (AUC) was 0.638, 0.801, 0.816, 0.832, 0.827, 0.881 and 0.962, respectively. PI, RI and S / D were high risk factors of adverse pregnancy (P<0.05). Conclusion: Compared with normal pregnant women, uterine artery Doppler ultrasound blood flow index of RSA patients in early pregnancy is higher, which has higher predictive value for adverse pregnancy. 2021 Vol. 27 (4): 579-583 [Abstract] ( 98 ) HTML (1 KB)  PDF (1578 KB)  ( 334 ) 583 Correlation between Bone Marrow NOV Gene Expression and Prognosis in Patients with Acute Myelomonocytic Leukemia PENG Enlan, JI Jianfeng, XIONG Xie, et al DOI: 10.3969/j.issn.1006-6233.2021.04.013 Objective: To observe the expression of nephroblastoma over expressed gene (Nov) in the bone marrow of patients with acute myelomonocytic leukemia (AML), and to explore the relationship between the expression of nov gene in bone marrow and the prognosis of patients with AML.Methods: 41 patients with amml in our hospital from January 2015 to December 2018 were selected as the research objects, All patients were treated with supportive therapy, chemotherapy and other comprehensive therapy intervention, and were followed up for 17 months. The expression of nov gene messenger RNA (mRNA) was measured by fluorescence quantitative PCR method before chemotherapy, one cycle of chemotherapy and the end of chemotherapy respectively. The prognosis of amml patients was judged by reference to relevant standards; the correlation between the expression of nov gene and pre-treatment was analyzed. Results: After one cycle of chemotherapy and at the end of chemotherapy, the expression of NOV gene mRNA was lower than before chemotherapy, and the expression level was the lowest at the end of chemotherapy (P<0.05); Among the 41 patients with AMML, 30 had a good prognosis and 11 had a poor prognosis; after 1 cycle of chemotherapy and after the end of chemotherapy, the expression of bone marrow NOV gene of both groups was lower than that before chemotherapy, and the expression of bone marrow NOV gene in poor prognosis group was higher than that in good prognosis group at each time point (P<0.05); Logistics regression analysis showed that before chemotherapy, after 1 cycle of chemotherapy, at the end of chemotherapy, NOV gene expression was the influencing factor of poor prognosis in patients with AMML (OR>1, P<0.05). Among them, the expression of NOV before chemotherapy had the most obvious effect on the poor prognosis of patients with AMML. By drawing the ROC curve, the results showed that the expression of NOV gene mRNA which predicted the prognosis of AUC for AMML patients before chemotherapy was 0.879, which had a good predictive value. Conclusion: The prognosis of patients with AMML may be related to bone marrow NOV gene expression. Overexpression of NOV gene may indicate a high risk of poor prognosis in AMML patients. Detection of NOV gene expression has an important role in guiding clinical early assessment of the prognosis of AMML patients. 2021 Vol. 27 (4): 583-588 [Abstract] ( 83 ) HTML (1 KB)  PDF (1439 KB)  ( 252 ) 588 A Study on the Effect of Dexmedetomidine on the Agitation of Sevoflurane Anesthesia in Children WANG Qiufeng, et al DOI: 10.3969/j.issn.1006-6233.2021.04.014 Objective: To investigate the role of dexmeditomidine (Dex) in preventing agitation during the resuscitation period of sevoflurane anesthesia in children.Methods: 100 cases of pediatric laparoscopic hernia surgery with sevoflurane anesthesia from January 2018 to January 2019 in our hospital were selected and sub-grouped into Dex group (n = 50) and control group (n = 50) according to admission sequence of odd or even numbers. Normal saline and Dex pump were administered to both groups. Incidence of restlessness and awakening time were recorded. Results: The incidence of agitation in the Dex group was 4.0%, lower than that in the control group (26.0%), and the difference was statistically significant (P<0.05).The scores of agitation and pain in the Dex group were lower than those in the control group when they were just admitted to the recovery room, 5 min after entry, 10 min after entry, and Ramsay sedation scores at 1-3 h after extubation were higher than those in the control group (P<0.05).There was no statistically significant difference between the two groups in the time of anesthesia recovery and time to leave the recovery room (P>0.05). Conclusion: Dex can prevent the occurrence of sevoflurane agitation during the awaking period of anesthesia in children and ensure the safety of surgery. 2021 Vol. 27 (4): 588-592 [Abstract] ( 131 ) HTML (1 KB)  PDF (1225 KB)  ( 187 ) 592 The Efficacy of Different Thrombolytic Techniques in Treating Acute Deep Vein Thrombosis of Lower Lime and the Effects on Circumference Difference of the Affected and Normal Limbs and Plasma D-D PC PC and PS Levels ZHANG Qingyun, DING Meng, JING Yang, et al DOI: 10.3969/j.issn.1006-6233.2021.04.015 Objective: To investigate the efficacy of different thrombolytic techniques in the treatment of patients with acute deep venous thrombosis (DVT) of lower extremity and the effects on the circumference difference of the affected and healthy the legs and the plasma D-dimer (D-D), protein C (PC) and protein S (PS) levels.Methods: According to the 1:1 matching principle, the clinical data of 128 patients with acute DVT treated in our hospital from June 2017 to June 2020 who were treated with different surgical plans were collected retrospectively. They were divided into group A (n=32, anterograde popliteal vein thrombolysis), group B (n=32, anterograde saphenous vein thrombolysis), group C (n=32, retrograde thrombolysis), and group D (n=32, systemic thrombolysis). The perioperative conditions, the incidence of complications, and the incidence of post-thrombotic syndrome (PTS), the circumference difference of the affected and healthy the legs, the plasma D-D, PC, PS levels, and the hemodynamics of the deep veins of the lower limbs before and 7 days after the operation in the four groups were counted. Results: The thrombolytic time and symptom resolution time of group A were shorter than those of group B, C, and D, and group B and C were shorter than group D. The patency rate of vein was higher than that of group B, C, and D, and group B and C were higher than group D (P<0.05). At 7 days after operation, the circumference difference of the affected and healthy the legs in group A was smaller than that of group B, C, and D, and group B and C were smaller than that of group D (P<0.05). Plasma DD levels in group A were lower than groups B, C, and D at 7 days postoperatively, PC and PS were higher than groups B, C, and D. The plasma D-D levels in groups B and C were lower than those in group D, and PC and PS were higher than those in group D (P<0.05). At 7 days after operation, the blood flow velocity of femoral vein and popliteal vein in group A was greater than that of group B, C, and D, and the blood flow velocity of femoral vein and popliteal vein of group B and C was greater than that of group D (P<0.05). There was no significant difference in the incidence of complications in the four groups and the incidence of PTS at 1 month after operation (P＞0.05). Conclusion: Catheter-directed thrombolysis (CDT) in the treatment of acute DVT is more advantageous than systemic thrombolysis in terms of symptom resolution time, thrombolysis time, venous patency rate, circumference difference of the affected and healthy the legs, hemodynamics of the deep veins of the lower limbs, plasma D-D, PC, and PS levels, among which anterograde thrombolysis of popliteal vein has the best effect. 2021 Vol. 27 (4): 592-598 [Abstract] ( 97 ) HTML (1 KB)  PDF (1458 KB)  ( 324 ) 598 Relationship Between Plasma Brain Natriuretic Peptide MiR-29b Levels and Short-Term Prognosis in Patients with Ischemic Cerebral Infarction WU Lili, WANG Junlan DOI: 10.3969/j.issn.1006-6233.2021.04.016 Objective: To analyze the relationship between plasma brain natriuretic peptide (BNP), miR-29b levels and short-term prognosis in patients with ischemic cerebral infarction (ICI).Methods: A total of 108 acute ICI patients who were admitted to the hospital within 24h after onset during the period from February 2017 to May 2019 were enrolled as case group, while 40 normal healthy people who underwent physical examination during the same period were enrolled as control group. The levels of plasma BNP and miR-29b were detected. The differences in the above indexes between the two groups were compared. In case group, nerve function was evaluated by National Institutes of Health Stroke Scale (NIHSS). According to scores of modified Rankin Scale (mRS) at 90d after discharge, they were divided into poor prognosis group (mRS higher 2 points, n=39) and good prognosis group (mRS not higher than 2 points, n=69). The relationship between BNP, miR-29b and nerve function, short-term prognosis was analyzed. The influencing factors of short-term prognosis were screened by multivariate logistic analysis. Results: The level of serum BNP in case group was higher than that in control group, while expression quantity of miR-29b was lower than that in control group (P<0.05). BNP concentration and NIHSS score in good prognosis group were lower than those in poor prognosis group (P<0.05), while relative expression quantity of miR-29b was higher than that in poor prognosis group (P<0.05). Age, hypertension, infarct size, NIHSS score, BNP and miR-29b were all influencing factors of short-term prognosis in ICI patients (P<0.05). BNP was negatively correlated with NIHSS and mRS scores (r=0.467, 0.523, P<0.05), while miR-29b was negatively correlated with them (r=-0.375, -0.413, P<0.05). Conclusion: Patients with acute ICI are characterized by increased plasma BNP and decreased miR-29b. And the abnormal changes of the two are closely related to nerve function and short-term prognosis. 2021 Vol. 27 (4): 598-604 [Abstract] ( 70 ) HTML (1 KB)  PDF (1263 KB)  ( 150 ) 604 Efficacy of High-flow Nasal Cannula on Chronic Obstructive Pulmonary Disease with Hypercapnia and Its Effects on Levels of Plasma EOS Level and Blood Gas Analysis Indicators ZHOU Xiaoman, LIN Mei, ZHANG Yutian DOI: 10.3969/j.issn.1006-6233.2021.04.017 Objective: To investigate the efficacy of high-flow nasal cannula (HFNC) in the treatment of chronic obstructive pulmonary disease (COPD) with hypercapnia and its effects on levels of plasma eosinophils (EOS) and blood gas analysis indicators.Methods: The clinical data of 162 patients with severe COPD complicated with hypercapnia during stable stage who received pulmonary rehabilitation therapy in our hospital from January 2015 to June 2020 were retrospectively analyzed. The patients were divided into HFNC group (n=88) and traditional group (n=74) according to the treatment methods after discharge. Both groups were given conventional treatment, and traditional group was additionally treated with traditional nasal catheter oxygen therapy, and HFNC group was additionally treated with HFNC. The lung function [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC], blood gas analysis indexes [PH value, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), pulse oxygen saturation (SpO2)], plasma EOS and exercise endurance [Activities of daily living (ADL), 6min walking test (6MWT)] were compared between the two groups before treatment and after 6 months of treatment. Results: Before treatment, there were no statistical differences in FEV1, FVC, FEV1/FVC, pH value, PaO2, PaCO2, SpO2, EOS, scores of ADL scale and 6MWT between the two groups (all P>0.05). After 6 months of treatment, the FEV1, FVC, FEV1/FVC, PH value, PaO2, SpO2 and 6MWT in HFNC group were significantly higher than those in traditional group (P<0.05) while the PaCO2, EOS and scores of subscales of ADL scale (physical self-care ability, instrumental activities of daily living) were significantly lower than those in traditional group (P<0.05), and the differences before and after treatment were significantly higher than those in control group (P<0.05). Conclusion: HFNC is more effective than traditional low-flow oxygen therapy in pulmonary rehabilitation after discharge in patients with severe COPD complicated with hypercapnia during stable stage, thus it is worthy of promotion. 2021 Vol. 27 (4): 604-609 [Abstract] ( 131 ) HTML (1 KB)  PDF (1257 KB)  ( 268 ) 609 Comparison of Clinical Efficacy of Percutaneous Endoscopic Interlaminar Discectomy and Traditional Interlaminar Fenestration Discectomy for the Treatment of L5S1 Single-Segment Lumbar Disc Herniation ZHANG Hui, LIU Shenpeng, SONG Kai, et al DOI: 10.3969/j.issn.1006-6233.2021.04.018 Objective: To compare the clinical efficacy of percutaneous endoscopic interlaminar discectomy (PEID) and traditional interlaminar fenestration discectomy (FD) in the treatment of L5S1 single-segment lumbar disc herniation (LDH) patients.Methods: A retrospective analysis of 66 patients with L5S1 single-segment lumbar disc herniation who underwent percutaneous endoscopic interlaminar discectomy or traditional interlaminar fenestration discectomy from January 2018 to May 2019 were enrolled and divided into PEID group(35 cases)and FD group(31 cases)based on different surgical methods. Local anesthesia was applied to PEID group and general anesthesia to FD group. The incision length, operative time, intraoperative blood loss, postoperative bed time, duration of hospitalization and complications between two groups were compared. The Visual Analogue Score (VAS) and the Oswestry disability index (ODI) of two groups were evaluated preoperatively, postoperatively and in last follow-up. The Modified Macnab criteria was used to evaluate the clinical effects at the last follow-up. the changes of serum Creatine Kinase (CK) activity and C-Reactive Protein (CRP) concentration in two groups were compared pre- and postoperatively. Results: According to the modified Macnab criteria, the excellent and good rates in the two groups were 88.57% and 87.09%; the difference was not statistically significant (χ2 = 0.034, P=0.855). There were no statistically significant difference between the two groups in age and gender (P>0.05). The intraoperative blood loss in the PEID group was less than that in the FD group. The incision length, operation time, postoperative bed time, and the duration of hospitalization in the PEID group were shorter than the FD group; the differences were statistically significant (P<0.05). VAS scores (back pain) in the PEID group at various postoperative time point were lower than those in the FD group (P<0.05). VAS (back-leg pain) score and ODI index of the two groups at various postoperative time point were lower than those before operation; the difference was statistically significant (P<0.05). The serum Creatine Kinase (CK) activity and C-Reactive Protein (CRP) concentration in the PEID group were significantly lower than those in the FD group after surgery, and the difference was statistically significant (P<0.05). Comparison of the total incidence of complications was made, and the difference was not statistically significant(χ2=0.053,P=0.818). Conclusion: Both surgical methods can effectively treat L5S1 lumbar disc herniation, but PEID technology has less trauma, less bleeding, shorter bed rest, faster recovery after surgery, and is worth popularizing and applying. 2021 Vol. 27 (4): 609-614 [Abstract] ( 81 ) HTML (1 KB)  PDF (1816 KB)  ( 206 ) 614 The Clinical Value of Pelvic Ultrasound in the Diagnosis of Idiopathic Central Precocious Puberty Girls YAO Huaiqi, et al DOI: 10.3969/j.issn.1006-6233.2021.04.019 Objective: To explore the clinical value of pelvic ultrasound in the diagnosis of idiopathic central precocious puberty (ICPP) girls.Methods: A retrospective analysis was conducted with the clinical data of 20 cases of ICPP diagnosed by pelvic ultrasound in the First Affiliated Hospital and Shantou Chaonan Minsheng Hospital from January 2019 to January 2020 . 27 cases of normal precocious puberty diagnosed clinically and laboratorily were enrolled as controls. The girl underwent a pelvic ultrasound examination to check the upper and lower diameters, anteroposterior diameter, left and right diameters, volume of the uterus, left and right ovarian size, volume, and maximum follicle diameter exceeding 4mm. Correlation analysis of pelvic ultrasound measurement data and diagnosis of its work was carried out using ROC curve. For efficiency, the area under the curve was calculated. Result: Using the Mann-Whitney U method to analyze, the values of the uterus and left and right ovaries of the true precocious puberty group and the normal group are higher than the latter; the correlation analysis results show that the pelvic ultrasound measurement results of the left and right ovaries and uterus have positive correlation. The AUCs of the effectiveness of pelvic acoustic detection of the uterus (upper and lower diameter, anterior and posterior diameter, left and right diameter, volume) are 0.985, 0.822, 0.967, 0.831, and the sensitivity data are 95%, 80%, 90%, 85%, specificity data are 92.6%, 77.8%, 100%, 70.4%;The AUCs of the left ovary (upper and lower diameter, left and right diameter, anteroposterior diameter, volume) of patients detected by pelvic ultrasound are 0.976, 0.805, 0.946, 0.784, and the sensitivity data are 95%, 75%, 85%, 50%, the specificity data are 100%, 74.1%, 85.2%, 100%; the AUCs of the right ovary (upper and lower diameter, anteroposterior diameter, left and right diameter, volume) of patients detected by pelvic ultrasound are 0.991, 0.839 , 0.983, 0.828, the sensitivity data are 90%, 75%, 95%, 60%, and the specificity data are 100%, 77.8%, 88.9%, 96.3%, and the differences between groups are statistically significant (P<0.05) . Conclusion: The effectiveness of pelvic ultrasound in diagnosing ICPP girls is high, which is worthy of reference for clinical practice. 2021 Vol. 27 (4): 614-620 [Abstract] ( 82 ) HTML (1 KB)  PDF (1844 KB)  ( 244 ) 620 An Analysis of Pathogenic Bacteria Distribution and Influencing Factors of Intervertebral Space Infection After Lumbar Disc Herniation ZHAO Bing, HUANG Haifeng, YIN Zhenyu, et al DOI: 10.3969/j.issn.1006-6233.2021.04.020 Objective: To explore the distribution of pathogenic bacteria associated with intervertebral space infection after lumbar disc herniation (LDH) and analyze its influencing factors.Methods: From March 2013 to March 2020, 895 patients with LDH who were admitted to our hospital and underwent surgical treatment were screened out. Based on whether they had postoperative complications of intervertebral space infection, they were divided into observation group (complicated infection, 38 cases) and control group (857 cases without concurrent infection). Statistics of postoperative LDH complicated intervertebral space infection and the distribution of pathogenic bacteria were recorded, the clinical data of the two groups were reviewed, and the influencing factors were analyzed. Results: Among the 895 cases of LDH patients, 38 cases (4.25%) had postoperative complications of intervertebral space infection, 8 cases failed to detect pathogenic bacteria, and 33 pathogenic bacteria were detected in the other 30 cases. The detection rate of Staphylococcus aureus was the highest, accounting for 30.30%, followed by Staphylococcus epidermidis (21.21%) and Escherichia coli (15.15%). The univariate results showed that age, history of diabetes, BMI, malnutrition, operation time, and postoperative infections of other systems were the influencing factors of intervertebral space infection after LDH. Multivariate logistic regression analysis showed that age ≥55 years old, history of diabetes, BMI≥27kg/m2, malnutrition, operation time ≥3h, postoperative infection of other systems were independent risk factors for postoperative LDH complicated with intervertebral space infection. Conclusion: In clinical practice, LDH is not easy to be complicated with intervertebral space infection, and the incidence is at a low level. However, it is still necessary to pay attention to the independent risk factors of complicated intervertebral space infection during postoperative rehabilitation, and it can be reasonably applied based on the distribution of pathogens. Antibiotics are used to prevent and standardize operations to reduce or avoid postoperative intervertebral space infection. 2021 Vol. 27 (4): 620-625 [Abstract] ( 103 ) HTML (1 KB)  PDF (1238 KB)  ( 385 ) 625 Comparative Analysis of the Diagnostic Value of Dynamic Enhanced MRI and CT in Adrenal Tumors ZHAO Dingxu, XIA Xiaoliang, GENG Chengjun DOI: 10.3969/j.issn.1006-6233.2021.04.021 Objective: To explore the differential diagnosis value of dynamic enhanced MRI and CT for adrenal tumors.Methods: A total of 49 patients with adrenal tumor admitted to our hospital from October 2013 to September 2018 were selected. Pathological examination results showed that 45 patients had adrenal adenoma (18 cases of aldosterone adenoma, 17 cases of cortisol adenoma, 10 cases of non-functional adenoma), and 4 cases of metastatic tumor. Pathological examination results were taken as the "gold standard" to compare the diagnostic accuracy of the two examination methods, and to compare the location and qualitative diagnosis of adrenal tumor patients with MRI and CT examination. Results: The diagnostic accuracy of enhanced MRI plain scan was 83.67%, and that of CT plain scan was 57.14%. The diagnostic accuracy of MRI was significantly higher than that of CT, with statistically significant difference (χ2=10.825, P<0.05). Among the 49 patients diagnosed by surgery, 31 were benign adrenal tumors and 18 were malignant adrenal tumors. The location detection of adrenal tumors indicated that the detection accuracy of CT was significantly higher than that of MRI, with statistically significant differences (P<0.05). The qualitative detection of adrenal tumor showed that the accuracy of MRI was significantly higher than that of CT, and the difference was statistically significant (P<0.05). Among benign tumors, the sharpness of MRI images was better than that of CT, and there was no statistically significant difference between the two inspection methods in malignant tumors (P<0.05). Conclusion: For diagnosis of adrenal tumors, CT and MRI both have advantages and deficiencies. CT determines more accurately the tumor location, and MRI helps more accurately identify tumor to be benign or malignant. The option should be made according to the actual circumstance of patients. 2021 Vol. 27 (4): 625-628 [Abstract] ( 117 ) HTML (1 KB)  PDF (1210 KB)  ( 190 ) 628 Clinical Value of CTPI in the Evaluation of Cerebral Hemodynamics in Patients with Ischemic Cerebrovascular Disease ZHU Youyi, GAO Lvping, CAO Chengying, et al DOI: 10.3969/j.issn.1006-6233.2021.04.022 Objective: To explore the clinical value of CT perfusion imaging (CTPI) in the evaluation of cerebral hemodynamics in patients with ischemic cerebrovascular disease.Methods: A total of 140 patients with ICVD were selected. All patients underwent cerebral CTPI examination, and the cerebral hemodynamic parameters [cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), time to peak (TTP)] were obtained in the healthy side and the affected side of the abnormal perfusion area, and the relative values of perfusion parameters (rCBF, rCBV, rMTT, rTTP, rCBV-rCBF) were calculated in region of interest of the large cerebral hemispheres on both sides. Results: The levels of MTT and TTP in the affected side of the abnormal perfusion area of transient ischemic attack (TIA) patients were higher than those in the healthy side (P<0.05) while the CBF level was lower than that in the healthy side (P<0.05). There was no statistically significant difference in the CBV level compared with that in the healthy side (P>0.05). The levels of MTT and TTP in the affected side of the abnormal perfusion area of cerebral infarction (CI) patients were higher than those in the healthy side (P<0.05) while the levels of CBF and CBV were lower than those in the healthy side (P<0.05). The levels of MTT and TTP in the healthy side or the affected side of the abnormal perfusion area of CI patient were higher than those of TIA patients while the levels of CBF and CBV were lower than those of TIA patients (P<0.05). The levels of rMTT, rCBF, rCBV and rCBV-rCBF of CI patients were lower than those of TIA patients (P<0.05), and there was no significant difference in rTTP level compared with that of TIA patients (P>0.05). The proportion of NIHSS score ≥5 points of CI patients was higher than that of TIA patients (P<0.05). Conclusion: There are abnormal changes in CPTI cerebral hemodynamics in TIA patients and CI patients. The brain reserve capacity and nerve function damage in CI patients are more serious than those in CI patients. CTPI can be used to provide effective hemodynamic information in ischemic cerebrovascular diseases and help to evaluate the disease condition. 2021 Vol. 27 (4): 628-632 [Abstract] ( 87 ) HTML (1 KB)  PDF (1229 KB)  ( 224 ) 633 The Related Factors and the Effect of Low Tidal Volume Ventilation on Children with Acute Hypoxic Respiratory Failure WANG Baodan, et al DOI: 10.3969/j.issn.1006-6233.2021.04.023 Objective: To explore the related factors and the effect of small tidal volume ventilation in the treatment of children with acute hypoxic respiratory failure.Methods: 100 children with acute hypoxic respiratory failure from January 2018 to December 2019 were selected and randomly divided into observation group (treated with low tidal volume ventilation) and control group (treated with conventional ventilation) based on random number table, with 50 cases in each group. The changes of blood gas index, serum inflammatory factor index and cure effect were compared between the two groups before and after treatment; based on the observation of cure results, univariate and multivariate logistic regression analysis was used to explore the high-risk factors affecting the cure effect of neap tide ventilation. Results: There was no significant difference in PO2 / FiO2 and OI between the two groups (P>0.05) at the time of operation. At 24h, 48h and 72h after the operation, the observation group had significantly higher PO2 / FiO2 and OI was significantly lower than the control group. It has statistical significance (P<0.05). Before treatment, there was no significant difference in the levels of IL-6, IL-8 and TNF-α between the two groups (P>0.05). After treatment, the levels of IL-6, IL-8 and TNF-α in the observation group were significantly lower than those in the control group , The differences were statistically significant (P<0.05). The cure rate of the observation group (72.00%) was significantly higher than that of the control group (42.00%), the difference was statistically significant (P<0.05). The results of single factor analysis showed that there were significant differences in the age of cured and uncured children, the time from onset to presentation, ventilation time, acute lung injury, sepsis, and severe pneumonia in the observation group (P<0.05). Multivariate logistic regression analysis showed that age ≤20 months, time from onset to visit> 3d, ventilation time ≤48h, deformed lung injury, and sepsis were independent risk factors that affected the curative effect of the observation group (P<0.05). Conclusion: The small tidal volume ventilation program has a significant clinical effect on children with acute hypoxic respiratory failure, which can improve blood gas indexes, effectively reduce inflammatory reactions, and facilitate the recovery of children; age ≤20 months, time from onset to visit> 3d, ventilation time ≤48h, deformed lung injury, and sepsis are independent risk factors that affect the curative effect of the small tidal volume ventilation program. Therefore, targeted interventions can be taken to improve the prognosis of children. 2021 Vol. 27 (4): 633-639 [Abstract] ( 93 ) HTML (1 KB)  PDF (1559 KB)  ( 257 ) 639 Clinical Significance of Serum Ghrelin, Nesfatin-1 and Obestatin in Patients with Stable Coronary Heart Disease and Obesity LU Qinghu, LIU Shigang, et al DOI: 10.3969/j.issn.1006-6233.2021.04.024 Objective: To investigate the expression levels and significance of serum Ghrelin, nesfatin-1 and Obestatin in patients with stable coronary heart disease complicated with obesity.Methods: A total of 206 patients with stable coronary heart disease (CHD) admitted to Beijing Chaoyang emergency rescue center from September 2018 to August 2020 were selected and divided into normal group (87 cases), overweight group (72 cases) and obesity group (47 cases) according to the Guidelines for Prevention and Control of Overweight and Obesity in Chinese adults, the levels of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG) and fasting blood glucose (FBG) were measured, the serum levels of Ghrelin, nesfatin-1 and Obestatin were detected by enzyme-linked immunosorbent assay (ELISA); the basic data of patients were collected; coronary angiography was performed and SYNTAX score was calculated; Spearman was used to analyze the correlation between serum Ghrelin, nesfatin-1 levels and SYNTAX score; Logistic regression model was used to analyze the factors influencing the severity of stable coronary heart disease. Results: The BMI, LDL-C, TC and syntac of the normal group, the hyperrecombination group and the obesity group were increased (P<0.05). HDL-C, ghrelin and nesfatin-1 were decreased (P<0.05), and the serum obestatin levels were not statistically significant (P>0.05). And the difference of the number of pathological changes in the three groups was statistically significant (P<0.05). Spearman analysis showed that serum ghrelin and nesfatin-1 levels were negatively correlated with syntax score (r = -0.532, P = 0.000; r = -0.630, P = 0.000). Multivariate logistic regression analysis showed that BMI, LDL-C and TC were independent risk factors for severe lesions in patients with stable coronary heart disease (P<0.05). Ghrelin and nesfatin-1 were protective factors for severe lesions in patients with stable coronary heart disease (P<0.05). Conclusion: The expression levels of serum Ghrelin and nesfatin-1 in patients with stable coronary heart disease and obesity are closely related to the severity of the disease in patients with stable coronary heart disease, and may become biological auxiliary indicators for evaluating the condition. 2021 Vol. 27 (4): 639-644 [Abstract] ( 88 ) HTML (1 KB)  PDF (1348 KB)  ( 136 ) 644 An of the correlation between severity of heart failure and heart rate variability in patients with ventricular arrhythmia LIANG Jiandi, YE Jiliang, YAO Yongzhao, et al DOI: 10.3969/j.issn.1006-6233.2021.04.025 Objective: To analyze the correlation between the severity of heart failure and heart rate variability in patients with heart failure (hereinafter referred to as heart failure) with ventricular arrhythmia.Methods: 123 patients with heart failure and ventricular arrhythmia were selected prospectively as observation group, 30 patients without ventricular arrhythmia treated continuously in the same period were set as the control group. The basic diseases, NYHA cardiac function classification and left ventricular ejection fraction (LVEF) were compared between the two groups. The relationship between the severity of disease and heart rate variability (HRV) was analyzed based on the cardiac function classification. According to the follow-up results, the risk factors of cardiovascular composite endpoint events were analyzed. Results: In terms of HRV parameter time domain indexes (SDANN, SDNN Index, SDANN Index, RMSSD, PNN50) and frequency domain indexes (HF, LF, VLF), the indexes of the observation group were significantly lower than those of the control group (P<0.05). There were significant differences in the indicators of patients with different cardiac function classifications in the observation group (P<0.05). Among them, the HRV parameters of patients in grade Ⅳ were significantly lower than those in grades Ⅱ and Ⅲ (P<0.05). The classification showed a significant negative correlation (P<0.05). In terms of cardiovascular composite endpoint events, 68 cases (44.4%) occurred, combined ventricular arrhythmia occurred significantly more, and each HRV parameter index was significantly lower than the non-occurring group (P<0.05); COX analysis results showed that, SDANN Index, LF, and combined ventricular arrhythmia are risk factors (P<0.05). Conclusion: The severity of heart failure patients with ventricular arrhythmia is significantly negatively correlated with heart rate variability; SDANN index, LF, and ventricular arrhythmia are risk factors of cardiovascular composite endpoint events, HRV parameter detection could help to assess the condition and predict the prognosis, and the time period needed to be focused is 2-4 months after the first 12 lead Holter. 2021 Vol. 27 (4): 644-650 [Abstract] ( 91 ) HTML (1 KB)  PDF (1469 KB)  ( 211 ) 650 Effect Comparison of Three Different Materials in Concave Maxillary Sinus Floor Lifting HUANG Xianbo, DONG Shitao, DING Minghui, et al DOI: 10.3969/j.issn.1006-6233.2021.04.026 Objective: To compare the clinical effect of A-PRF, gelatin sponge and Bio Oss bone powder in the same period of implant placement in concave maxillary sinus floor external lift surgery.Methods: 108 patients with insufficient height of residual bone in maxillary posterior area and concave shape of maxillary sinus floorwere randomly divided into A-PARF group (A), gelatin sponge group (B) and Bio Oss bone powder control group (C). 145 implants were implanted at the same time. The degree of postoperative reaction and the new bone density in maxillary sinus at 4, 6 and 12 months were compared among the three groups. Results: The degree of postoperative complications was no obvious difference in the 3 groups (P>0.05). The group C of the HU was significantly higher than the group A and B at 4 m after the operation (P<0.05). The group A of the HU was significantly higher than the group B at 4 m after the operation (P<0.05), but the group A of the HU at 4m was close to the preoperative HU. There was no difference in the 3 groups at 6 m,12 m (P>0.05). Conclusion: A-PRF can promote the early formation of new bone, and can achieve good clinical results in the cases of simultaneous implantation of sinus-lifting operations which the sinus floor is concave by using A-PRF alone. 2021 Vol. 27 (4): 650-654 [Abstract] ( 88 ) HTML (1 KB)  PDF (1348 KB)  ( 283 ) 654 Expression of CDKN2A Gene in Lung Cancer and Its Clinical Significance ZHOU Xiaoyu, CHANG Jie, WANG Erxiao, et al DOI: 10.3969/j.issn.1006-6233.2021.04.027 Objective: To investigate the expression of cyclin-dependent kinase inhibitor 2 (CDKN2A) gene in lung cancer tissue and its relationship with pathological characteristics and prognosis.Methods: The clinical pathological data and follow-up data of 81 patients with lung cancer who were admitted to the hospital between January and December 2017 were retrospectively analyzed. Paraffin-embedded lung cancer tissues and adjacent tissues (about 2 cm from the edge of the cancer tissue) were collected from all the subjects. Immunohistochemical staining of CDKN2A in lung cancer and its adjacent tissues was observed. The relative expression levels of CDKN2A mRNA and CDKN2A protein in lung cancer and its adjacent tissues were compared. According to the expression level of CDKN2A in lung cancer, the subjects were divided into the high expression group and the low expression group. The two-year follow-up survival rate was compared between the two groups. Results: The expression rate of CDKN2A in lung cancer tissues was significantly lower than that in adjacent tissues (P<0.05). The relative expression levels of CDKN2A mRNA and CDKN2A protein in lung cancer tissues were significantly lower than those in adjacent tissues (P<0.05). The high expression rates of CDKN2A in patients with high differentiation degree and without lymph node metastasis were significantly higher than those with low differentiation degree and lymph node metastasis (P<0.05). The follow-up results showed that the 2-year survival rate of the high expression group [100.00% (8/8)] was significantly higher than that of the low expression group [65.67% (44/67)] (Log rank test value = 5.024, P<0.05). Conclusion: The expression of CDKN2A gene is low in lung cancer tissues, and its expression is closely related to the pathological characteristics and prognosis of patients with lung cancer, which can provide a reference for early diagnosis and treatment of lung cancer. 2021 Vol. 27 (4): 654-659 [Abstract] ( 165 ) HTML (1 KB)  PDF (1722 KB)  ( 474 ) 659 A Study on the Relationship Between Asthenia and Myopathy in Patients with Cerebral Infarction ZHANG Lei, ZHANG Xiaoming DOI: 10.3969/j.issn.1006-6233.2021.04.028 Objective: To study the relationship between asthenia and sarcopenia in patients with cerebral infarction.Methods: Eighty patients with cerebral infarction were selected as the research objects. According to the frailness index (FI), the patients were divided into non-frailness group (< 0.12), pre-frailness group (0.12–0.25) and frailness group (0.25). The patients' basic information, grip strength and 6m walk time were recorded in detail, and the body and limb skeletal muscle mass was measured by bioelectrical impedance spectroscopy. Multivariate logistic regression was used to analyze the risk factors for the occurrence of asthenia in patients with cerebral infarction, and Spearman's correlation was used to analyze the correlation between the degree of asthenia and muscular dystrophy in patients with cerebral infarction. Results: In 80 patients with cerebral infarction, 14 cases (17.5%) were suggested to be of frailty, 28 cases (35.0%) were in pre-frailty state, and 38 cases (47.5%) were not of frailty. The proportion of patients with age ≥60 years old, diabetes mellitus combined, highest NIHSS score ≥16 and myopathy in the frailty group was higher than that in the pre-frailty group and non-frailty group (P<0.05). The proportion of patients with age ≥60 years old, diabetes mellitus combined, highest NIHSS score ≥16 and myopathy in the pre-frailty group was higher than that in the non-frailty group (P<0.05). The circumference of lower leg, the volume of limbs and whole body skeletal muscle, and the grip strength in the frailty group were lower than those in the pre-frailty group and the non-frailty group (P<0.05), and the 6m walking time was longer than that in the pre-frailty group and the non-frailty group (P<0.05). The grip strength in the pre-frailty group was lower than that in the non-frailty group (P<0.05), and the 6m walking time was longer than that in the non-frailty group (P<0.05). Multivariate analysis found that sarcopenia, less skeletal muscle mass of the limbs, decreased grip strength and prolonged 6m walking time were risk factors for debilitating patients with cerebral infarction (P<0.05). Correlation analysis found that the frailty index FI was negatively correlated with limb skeletal muscle mass and grip strength (P<0.05); it was positively correlated with 6m walking time (P<0.05). Conclusion: There is a positive correlation between the frailness and sarcopenia in patients with cerebral infarction. The frailness in patients with cerebral infarction can be promoted by advanced age, high NIHSS score, diabetes, sarcopenia, small amount of skeletal muscle in four limbs, reduced grip strength and 6m walk time. 2021 Vol. 27 (4): 659-664 [Abstract] ( 65 ) HTML (1 KB)  PDF (1280 KB)  ( 258 ) 664 An Observation of the Effect of Shenlingbaizhu Powder Combined with Acupoint Catgut Implantation in Treating Simple Obesity WANG Yufang, CHEN Fuchu, HE Lixin DOI: 10.3969/j.issn.1006-6233.2021.04.029 Objective: To observe the clinical efficacy of Shenlingbaizhu powder combined with acupoint catgut implantation in the treatment of simple obesity patients.Methods: 128 patients with simple obesity admitted to our hospital from June 2017 to March 2020 were randomly divided into a control group and a treatment group, with 64 cases in each group. The control group was given conventional treatment, and the treatment group was given Shenlingbaizhu powder decoction combined with acupoint implantation treatment on the basis of the control group. The course of treatment was 3 months. The clinical efficacy of the two groups before and after treatment were compared, as well as body weight, body mass index (BMI), waist circumference, waist to hip ratio (WHR), waist circumference to height ratio (WHtR), body fat rate (F%), fasting blood glucose (FBG), fasting insulin ( FINS), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C),tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), white blood cells Interleukin-2 (IL-2) levels, and calculate the insulin resistance index (HOMA-IR). Results: After treatment, the total effective rate of the treatment group was significantly higher than that of the control group (P<0.05); after treatment, the scores of TCM syndromes, weight, BMI, waist circumference, WHR, WHtR, and F% of the two groups were lower than before treatment (P<0.05), and the scores of the treatment group are lower than those of the control group (P<0.05). After treatment, serum FBG, FINS, TC, TG, LDL-C, TNF-, IL-2, HOMA-IR levels were lower than before treatment in both groups (P<0.05), and the treatment group had lower records than the control group (P<0.05). After treatment, serum IL-6 and HDL-C levels in both groups were higher than before treatment (P<0.05), and the treatment group had higher records than the control group (P<0.05). Conclusion: Shenlingbaizhu powder decoction combined with acupoint catgut implantation therapy could reduce the weight of simple obese patients, improve insulin resistance, and inhibit inflammation. 2021 Vol. 27 (4): 664-669 [Abstract] ( 77 ) HTML (1 KB)  PDF (1249 KB)  ( 200 ) 669 Effect of Total Glucosides of Paeony on Inflammatory Markers in Patients with Rheumatoid Arthritis (RA) WU Tingting, CHEN Fan, TANG Zongyi, et al DOI: 10.3969/j.issn.1006-6233.2021.04.030 Objective: To observe the effect of total glucosides of paeony on inflammatory markers in patients with rheumatoid arthritis (RA). Methods: The data of patients with RA were collected from January 2018 to December 2019. A total of 120 patients were randomly divided into the observation group and the control group, with 60 cases in each group. They were treated with TGP combined with leflunomide and with leflunomide alone. Inflammatory indexes, joint function improvement and total effective rate were compared between the two groups before and after treatment. Results: The serum rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), and serum C-reactive protein (CRP) indexes were all reduced after treatment, P<0.05, compared with before treatment. The inflammation indexes of the observation group were lower, compared with those of the control group. (P<0.05), statistically significant; there was no statistically significant difference in grip strength and morning stiffness time between the groups before treatment (P>0.05). After treatment, the observation group had improved grip strength and shortened morning stiffness time, which was better than the control group. The difference was statistically significant (P<0.05); the total effective rate of the observation group was significantly higher than that of the control group (93.3% vs 70.0%), and the difference was statistically significant (P<0.05). Conclusion: The total glucosides of paeony in the treatment of RA have a significant effect on the improvement of inflammatory indicators and morning stiffness symptoms in patients. It is beneficial to improve the level of grip strength and has a reliable therapeutic effect. It is worthy of clinical promotion. 2021 Vol. 27 (4): 669-672 [Abstract] ( 84 ) HTML (1 KB)  PDF (1205 KB)  ( 212 ) 673 Effects of Nimodipine Combined with Sodium Valproate on Hemodynamic Parameters Inflammatory Factors and Neurological Function in Patients with Acute Cerebral Hemorrhage LIANG Shuang, TUEERHONG·Tuerxun, LIU Bo DOI: 10.3969/j.issn.1006-6233.2021.04.031 Objective: To observe the effects of nimodipine combined with sodium valproate on hemodynamic parameters, inflammatory factors and neurological function in patients with acute cerebral hemorrhage.Methods: 160 patients with acute cerebral hemorrhage were divided into observation group and control group according to the simple random grouping, with 80 cases in each group. The two groups were given conventional neurological treatment, and control group was given sodium valproate, and observation group was combined with nimodipine on the basis of control group. The neurological function [National Institutes of Health Stroke Scale (NIHSS), neuron-specific enolase (NSE)], hemodynamic parameters [mean flow velocity (Vm), peak systolic blood velocity (Vs), pulsatility index (PI), resistance index (RI) ], intracranial state-related indicators (intracranial pressure, intracranial hematoma volume) and levels of inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor (TNF-α), high-sensitivity C-reactive protein (hs-CRP)] were compared between the two groups before treatment and after 2 weeks of treatment, and the safety of medication was evaluated through adverse reactions after treatment. Results: After 2 weeks of treatment, the NIHSS scale score, NSE, RI, intracranial pressure, intracranial hematoma volume, and levels of IL-6, TNF-α and hs-CRP in the two groups showed downward trends compared with those before treatment (all P<0.05), and the decreases were greater in observation group (P<0.05). The levels of Vm, Vs and PI showed upward trends compared with those before treatment (all P<0.05), and the increases were greater in observation group (P<0.05). There was no statistically significant differences in the total incidence rate of adverse reactions between the two groups (χ2=0.132, P=0.717). Conclusion: Nimodipine combined with sodium valproate can effectively improve cerebral blood perfusion and promote the recovery of neurological function in patients with acute cerebral hemorrhage, and can further reduce the inflammatory response and further lower intracranial pressure and intracranial hematoma volume. And it is favorable to disease outcomes. 2021 Vol. 27 (4): 673-677 [Abstract] ( 111 ) HTML (1 KB)  PDF (1231 KB)  ( 376 ) 678 Efficacy of Recombinant Human Interferon Alpha-2b Vaginal Effervescent Capsule Combined with Lactobacillus Vaginal Capsule in the Treatment of Cervical HPV Infection WANG Xiujuan DOI: 10.3969/j.issn.1006-6233.2021.04.032 Objective: To observe the efficacy of recombinant human interferon alpha-2b vaginal effervescent capsule combined with Lactobacillus vaginal capsule in the treatment of cervical HPV infection and the improvement of vaginal microecology. Methods: The subjects were selected from May 2016 to May 2018 in our hospital for the treatment of cervical high-risk HPV infection, including 140 cases. According to the different treatments, they were randomly divided into control group (70 cases) and treatment group (70 cases). Patients in the control group were given recombinant human interferon alpha-2b vaginal effervescent capsules, one capsule per day for a course of 10 days within a total of three courses of treatment. For the treatment group, Lactobacillus vaginal capsules were taken on the basis of the treatment of the control group, once a night for a course of 7 days within four courses of treatment; after one month of treatment, the effect of treatment was evaluated accordingly. The main method of evaluation is to reexamine the vaginal microorganisms of patients, at the same time to reexamine the cervical HPV negative transformation of patients, and to reexamine the expression of immunoinflammatory factors. Results: After treatment, 44 cases in the treatment group turned negative, and the effective rate was 90% (19 cases ), while 34 cases in the control group turned negative, 17 cases effective; the difference between the two groups was significant (P<0.05). After treatment of a month, for the treatment group, 64 cases of vaginal microbes returned to normal, with a return to normal rate of 91.4%, while 43 cases in the control group returned to normal, with a return to normal rate of 61.4%. The pH value of vaginal secretion in the treatment group was 4.1±0.6) and that in the control group was 4.6±0.7). The normal vaginal PH value was restored in the treatment group. Nugent score of the two groups was (2.2 ±0.4) in the treatment group, which was lower than (2.9 + 0.8) in the control group. There was a significant difference between the two groups (P<0.05). After one month of treatment, IL-4 decreased significantly in both groups, while IL-12 and IFN-gamma increased significantly in both groups. Compared with the control group, the treatment group had a much larger extent (P<0.05). Conclusion: Recombinant human interferon alpha-2b vaginal effervescent capsule combined with Lactobacillus vaginal capsule is effective in the treatment of cervical HPV infection and can improve vaginal microecosystem. 2021 Vol. 27 (4): 678-682 [Abstract] ( 174 ) HTML (1 KB)  PDF (1228 KB)  ( 507 ) 682 Effect of Budesonide Combined with Compound Ipratropium Bromide on TNF-α MMP-9 and PCT in Children with Mycoplasma Pneumonia XING Yaming, WANG Fengjuan, ZHANG Jing DOI: 10.3969/j.issn.1006-6233.2021.04.033 Objective: To explore the effect of budesonide combined with compound ipratropium bromide on tumor necrosis factor - α (TNF-α), matrix metalloproteinase-9 (MMP-9), procalcitonin (PCT) in children with mycoplasma pneumonia. Methods: A total of 70 children with MPP who were treated in our hospital from June 2016 to June 2020 were enrolled and divided into an observation group of 35 cases and a control group of 35 cases by stratified random grouping. The control group received compound ipratropium bromide spray for 1 month. In the treatment with chemical solution, the observation group was treated with budesonide combined with compound ipratropium bromide nebulized solution for 1 month. The clinical efficacy, the levels of serum TNF-α, MMP-9 and PCT before and after treatment, and the incidence of adverse reactions of the two groups were compared. Results: Compared with the control group (71.43%), the total clinical effective rate (94.29%) of the observation group was significantly higher, and the difference was statistically significant (P<0.05); after treatment, the two groups of serum TNF-α, MMP-9, The PCT level was significantly reduced, and the reduction in the observation group was significantly greater than that in the control group; the difference was statistically significant (P<0.05). During the treatment, there was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05). Conclusion: Budesonide combined with compound ipratropium bromide aerosol in the treatment of pediatric MPP can significantly improve its clinical effect, and is closely related to TNF-α, MMP-9, PCT, and has a higher clinical treatment for pediatric MPP Reference value. 2021 Vol. 27 (4): 682-686 [Abstract] ( 83 ) HTML (1 KB)  PDF (1226 KB)  ( 166 ) 686 Effects of Tenofovir Disoproxil Fumarate Combined with Fuzheng Huayu on Liver Fibrosis Degree and Immune Status of Patients with Hepatitis B Cirrhosis HU Huifen, LIU Wen, TAN Lin DOI: 10.3969/j.issn.1006-6233.2021.04.034 Objective: To observe the effects of tenofovir disoproxil fumarate combined with Fuzheng Huayu on liver fibrosis degree and immune status of patients with hepatitis B cirrhosis.Methods: A total of 150 patients with hepatitis B cirrhosis who were treated in our hospital from January 2018 to June 2019 were selected as subjects, and they were divided into observation group and control group according to the simple random grouping, with 75 cases in each group. Control group was treated with tenofovir disoproxil fumarate, and observation group was combined with Fuzheng Huayu on the basis of control group, and the two groups took 24 weeks as a course of treatment. The liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB)], liver fibrosis indicators [hyaluronic acid (HA), laminin (LN), type III procollagen (PC III), type IV collagen (IV-C)], virological indicators [negative conversion rate of hepatitis B virus gene (HBV DNA negative conversion rate), negative conversion rate of hepatitis B virus e antigen (HbeAg negative conversion rate)], imaging indicators (portal vein diameter, portal vein blood flow velocity, spleen thickness, spleen length, portal blood flow) and immune function (CD3+, CD4+, CD8+, CD4+/CD8+) were compared between the two groups before treatment and after 24 weeks of treatment, and the occurrence of adverse reactions during treatment were recorded in the two groups. Results: Before treatment, there were no statistically significant differences in the ALT, AST, TBIL, ALB, HA, LN, PC III, IV-C, portal vein diameter, portal vein blood flow velocity, spleen thickness, spleen length, portal blood flow, CD3+, CD4+, CD8+ and CD4+/CD8+ between the two groups (all P>0.05). After 24 weeks of treatment, the ALT, AST, TBIL, HA, LN, PC III, IV-C, portal blood flow and CD8+ in the two groups were significantly lower than those before treatment (all P<0.05) while the ALB, portal vein blood flow velocity, CD3+, CD4+ and CD4+/CD8+ were significantly higher than those before treatment (all P<0.05). There were no statistically significant differences in the differences of ALT, AST, TBIL and ALB before and after treatment between the two groups (all P>0.05), and the differences of HA, LN, PC III, IV-C, portal vein blood flow velocity, portal blood flow, CD3+, CD4+, CD4+/CD8+ and CD8+ before and after treatment in observation group were significantly higher than those in control group (P<0.05). After 24 weeks of treatment, there were no statistically significant differences in the HBV DNA negative conversion rate and HbeAg negative conversion rate between the two groups (P>0.05). The total incidence rate of adverse reactions was 6.67% in observation group and was 4.00% in.control group (χ2=0.528, P=0.467). Conclusion: Tenofovir disoproxil fumarate combined with Fuzheng Huayu can indeed effectively improve the liver function, alleviate the liver fibrosis degree, accelerate portal vein blood flow and help improve the immune function, and it is safe and reliable, and is beneficial to the disease outcomes. 2021 Vol. 27 (4): 686-692 [Abstract] ( 272 ) HTML (1 KB)  PDF (1262 KB)  ( 902 ) 693 Clinical Value of Rho Kinase Inhibitor in the Treatment of Acute Left Heart Failure (ALHF) ZHANG Shenghong, ZHU Fangyi, ZHU Cunkui DOI: 10.3969/j.issn.1006-6233.2021.04.035 Objective: To study the application value of Rho kinase inhibitor in the treatment of acute left heart failure (ALHF).Methods: Retrospective analysis was performed on 62 ALHF patients admitted from January 2019 to January 2020. The subjects were divided into control group and study group by referring to the random number table method, with 31 patients in each group. Both groups were given conventional treatment. The control group was treated with furtimox and spironolactone based on conventional treatment, while the study group was treated with furtimox, spironolactone and Rho kinase inhibitor (Fasudil hydrochloride) based on conventional treatment. Cardiac function index, myocardial enzyme spectrum index, total effective rate and adverse reaction rate were compared between the two groups before and after treatment. Results: Before treatment, there was no difference between the two groups in left ventricular end-systolic volum (LVSDV), left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), Creatine Kinase Isoenzyme-MB (CK-MB), lactate dehydrogenase, LDH and Aspartate aminotransferase (AST) levels (P>0.05).LVEF after treatment was higher, and LVSDV, LVEDV, CK-MB, LDH and AST levels were lower than those before treatment in both groups (P<0.05).After treatment, LVEF and total effective rate in the study group were higher than those in the control group, and LVSDV, LVEDV, CK-MB, LDH and AST levels were lower (P<0.05). The difference values between the two groups before and after treatment were compared, and the differences were statistically significant (P<0.05).There was no difference in the incidence of adverse reactions after treatment between the two groups (P>0.05). Conclusion: The application of Rho kinase inhibitor in ALHF treatment has a significant effect, can effectively improve the level of myocardial enzyme spectrum, and can promote the recovery of cardiac function, with fewer adverse reactions. 2021 Vol. 27 (4): 693-697 [Abstract] ( 92 ) HTML (1 KB)  PDF (1228 KB)  ( 142 ) 697 Effect of Icotinib Combined with SBRT on Serum Tumor Markers in Patients with NSCLC ZHAO Jie, NING Peng, LIU Haiming DOI: 10.3969/j.issn.1006-6233.2021.04.036 Objective: To study the effect of Icotinib tablets combined with stereotactic body radiotherapy (SBRT) on patients with non-small cell lung cancer (NSCLC) serum tumor markers, and to provide a reference for better treatment of the disease. Method: A total of 65 NSCLC patients diagnosed and treated in our hospital from August 2017 to April 2020 were prospectively studied. They were randomly divided into a control group of 33 cases with SBRT as treatment, and an observation group of 32 cases with Icotinib tablets for combination therapy on the basis of SBRT treatment. Both groups were treated for one month. The serum tumor marker levels of patients were compared before treatment and within 4 to 12 hours after treatment. Results: After treatment, the levels of serum tumor markers CEA, CA125, CYFRA21-1 [(3.12 ± 1.45), (30.12 ± 3.25), (5.27 ± 1.89), μg / L] were significantly lower than the control group [(5.34 ± 1.83 ), (45.34 ± 4.87), (8.74 ± 2.15), μg / L]; the difference is statistically significant (P<0.05). Conclusion: The combination of Icotinib and SBRT can reduce the level of serum tumor markers to a greater extent and has a better effect. 2021 Vol. 27 (4): 697-700 [Abstract] ( 119 ) HTML (1 KB)  PDF (1207 KB)  ( 135 ) 700 Effects of Sevoflurane Combined with Propofol Inhalation Duration on Postoperative Cognitive Function in Patients Undergoing Radical Mastectomy CUI Dezhuang, FANG Liang, FENG Chunlin DOI: 10.3969/j.issn.1006-6233.2021.04.037 Objective: To observe the effect of sevoflurane combined with propofol inhalation duration on postoperative cognitive function in patients with radical mastectomy.Methods: 104 cases of breast cancer patients who underwent surgery in our hospital from August 2016 to August 2019 were selected and randomly divided into observation group and control group, 52 cases in each group. Both groups were given low-flow inhaled sevoflurane and pump propofol for anesthesia maintenance, while continuous intravenous infusion of remifentanil for analgesia.In the control group, sevoflurane was stopped after inhalation for 2h and only pumped propofol was used for anesthesia maintenance. In both groups, all anesthetic drugs were stopped at the time of surgical suture and oxygen supply was given. Observed two groups of patients with connecting electrical double frequency index (BIS) monitor (T0), 3 min after anesthesia induction (T1), 1 min after intubation (T2), cut skin (T3), sewing leather after 1 min after 1 min (T4) BIS index, compared two groups of patients with postoperative spontaneous breathing recovery time, open time, extubation time and language can be stated time, compared two groups of patients before and after 1~12h operation, Montreal cognitive scale (MoCA) score, compared two groups of patients with postoperative hypotension, vomiting, bronchospasm, incidence of adverse reactions such as tachycardia. Results: There was no significant difference in body mass index (BMI), male proportion and man proportion between the two groups, all with P>0.05. The BIS index of two groups of patients changed with time, and the role of time factors varied with different groups, P<0.05; the BIS index at each time pant (T1, T2, T3, T4) in the two groups were significantly decreased, P<0.05; At the same time,there was no significantly difference in T0, T1, T2, T3 between the two groups (P>0.05). The BISindex at T4 in the observation group was significantly higher than that in the control group (P<0.05). The recovery time of spontaneous breathing, eye opening time, extubation time and verbal statement time in the observation group were significantly shorter than those in the control group, P<0.05. MOCA scores of the two groups were changed with time, and the effect of time factor was different with different groups, P<0.05; at the same time, MOCA scores of the observation group at 1h, 6h, 12h after operation were significantly higher than those of the control group, all P<0.05. The total incidence of postoperative adverse reactions in the observation group was not significantly different from that in the control group, P>0.05. Conclusion: The inhalation of sevoflurane for anesthesia during the whole course of radical mastectomy for breast cancer has little impact on the cognitive function of breast cancer patients, and the recovery time of inhalation anesthesia during the whole course is fast, without increasing adverse reactions, which is worthy of clinical promotion. 2021 Vol. 27 (4): 700-704 [Abstract] ( 103 ) HTML (1 KB)  PDF (1231 KB)  ( 243 )

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