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2021 Vol. 27, No. 8 Published: 2021-08-31 1233 Protective Effect of Electroacupuncture on Hypoxic Ischemic Brain Damage in Neonatal Rats by Regulating the Pyroptosis Mediated by TXNIP/NLRP3 Pathway DENG Hanbing, et al DOI: 10.3969/j.issn.1006-6233.2021.08.01 Objective: To explore the protective effect and mechanism of electroacupuncture on neonatal hypoxic ischemic brain damage (HIBD) rats. Methods: Neonatal SD rats were randomly divided into sham operation group, HIBD group, electroacupuncture group, electroacupuncture + TXNIP NC group and electroacupuncture + TXNIP OE group, HIBD model was established by modified RICE method in all but the sham groups. Rats in electroacupuncture group, electroacupuncture + TXNIP NC group and electroacupuncture + TXNIP OE group were treated with electroacupuncture. Rats in electroacupuncture + TXNIP NC group and electroacupuncture + TXNIP OE group were injected with TXNIP NC CRISPR plasmid and TXNIP OE CRISPR plasmid solution via cerebral ventricle respectively. Rats in electroacupuncture group were injected with sterile normal saline. At the end of the treatment cycle, Morris water maze was used to test the abilities of learning and memory; triphenyltetrazolium chloride (TTC) was used to measure the volume of cerebral infarction, Nissl and hematoxylin-eosin (HE) staining were used to observe the morphology of hippocampal neurons; immunofluorescence was used to detect the pyroptosis of hippocampal cells; western blot was used to detected the expressions of cleaved cysteinyl aspartate specific proteinase-1(cleaved caspase-1), pro-cysteinyl aspartate specific proteinase-1(pro-caspase-1), apotosis-associated speck-like protein (ASC), thioredoxin interacting protein (TXNIP) and Nod-like receptor protein 3 (NLRP3) in rat hippocampus; enzyme linked immunosorbent assay was used to detect the expression of interleukin (IL)-18 and IL-1β in rat hippocampus. Results: There was no cerebral infarction in the control group, and the arrangement of neurons in hippocampus was regular and dense. Compared with sham group, HIBD group had disordered and loose arrangement of nerve cells in hippocampus, cerebral infarction volume, escape latency, cleaved-caspase-1+TUNEL+ cells in hippocampus, cleaved-caspase-1/pro-caspase-1, ASC, TXNIP, NLRP3 protein, IL-18, IL-1 β levels were significantly increased, and times of crossing platform were significantly decreased (P<0.05). Compared with HIBD group, the injury of hippocampal cells in electroacupuncture group and electroacupuncture+TXNIP NC group was significantly improved, cerebral infarction volume, escape latency, cleaved-caspase-1+TUNEL+ cells in hippocampus, cleaved-caspase-1/pro-caspase-1, ASC, TXNIP, NLRP3 protein, IL-18, IL-1 β levels were decreased, and times of crossing platform were increased (P<0.05). Compared with electroacupuncture group and electroacupuncture+TXNIP NC group, electroacupuncture+TXNIP OE group had more cell damage in hippocampus, cerebral infarction volume, escape latency, cleaved-caspase-1+TUNEL+ cells in hippocampus, cleaved-caspase-1/pro-caspase-1, ASC, TXNIP, NLRP3 protein, IL-18, IL-1 β levels were increased, and times of crossing platform were decreased (P<0.05). Conclusion: In the HIBD model of rats, electroacupuncture may reduce the damage of nerve cells and improve the learning and memory abilities by inhibiting the pyroptosis mediated by TXNIP/NLRP3 pathway. 2021 Vol. 27 (8): 1233-1239 [Abstract] ( 197 ) HTML (1 KB)  PDF (2655 KB)  ( 275 ) 1239 Effect of Interference of TPX2 Gene on Cell Activity and Radiotherapy Sensitivity of Hela Cells QI Xiaoli, WANG Yuting, YANG Jie DOI: 10.3969/j.issn.1006-6233.2021.08.02 Objective: To analyze the effects of interference with TPX2 gene on the activity and radiotherapy sensitivity of HeLa cells. Methods: Cervical cancer Hela cell is cultured in vitro and divided into interference group, negative control group (NC group), blank control group (CON group), interference and CON group. Respectively the interference group had TPX2-siRNA interference plasmid; CON group had plasmid transfection, replacing the plasmid with PBS; NC group had blank load transfection. CCK 8 experimental detection of efficiency of cell proliferation, Transwell Chambers detection of invasion ability, clone forming experiments to detect radiation sensitivity were all conducted. Results: Compared with the CON group, the relative expression level of TPX2 mRNA, the relative expression level of TPX2 protein, and the cell invasion ability of the NC group did not change significantly (P>0.05); compared with the CON group and the NC group, the TPX2 of the interference group, the relative expression of mRNA, the relative expression of TPX2 protein, and the ability of cell invasion were all significantly reduced (P<0.05). Compared with the CON group, the cell viability of the NC group was not significantly different at each time point (P>0.05); compared with the CON group and the NC group, the culture time of the interference group was 48h, 72h, 96h. The cell viability at time was significantly reduced (P<0.05). Compared with the CON group, the proportion of cell cycles in the G0/G1, G2/M and S phases of the NC group did not change significantly (P>0.05); compared with the NC group, the S and G2/ The proportion of cells in M phase increased significantly, while the proportion of cells in G0/G1 phase decreased significantly (P<0.05). Compared with the CON group, the survival rate of the interference group cells at 4Gy, 6Gy, 8Gy, and 10Gy doses of radiotherapy decreased (P<0.05). Conclusion: Interference with TPX2 gene in cervical cancer Hela cells can effectively interfere with the expression of TPX2 gene and inhibit the cell activity of proliferation and migration of cervical cancer HeLa cells.Interference with TPX2 gene can effectively increase the radiotherapy sensitivity of cervical cancer HeLa cells and improve the curative effect of radiotherapy for cervical cancer. 2021 Vol. 27 (8): 1239-1243 [Abstract] ( 154 ) HTML (1 KB)  PDF (1925 KB)  ( 177 ) 1244 Silencing HMGB1 Improves Trophoblast Cell Proliferation Invasion Insulin Resistance and Inflammation by Downregulating NF-κB Signaling GAO Yanyu, LIN Juan, WANG Qiong, et al DOI: 10.3969/j.issn.1006-6233.2021.08.03 Objective: To investigate the effects of silencing high mobility group 1 (HMGB1) on trophoblast proliferation, invasion, insulin resistance and inflammatory response in insulin resistance (IR). Methods: Human chorionic trophoblast cell line htr-8 was cultured and the expression of HMGB1 was silenced by shRNA transient transfection; the IR model of trophoblast cells was established in vitro, and the cells were divided into four groups: control group, insulin resistance group (IR group), IR+shRNA-NC group and IR+shrna-HMGB1 group. Western blot and immunofluorescence staining were used to detect the expression of HMGB1 in trophoblasts; CCK-8, Transwell and ELISA were used to detect the effects of HMGB1 silencing on the proliferation and invasion of trophoblasts and the expression of TNF-α, IL-1β and IL-6; Western blot was used to detect the effects of HMGB1 silencing on the phosphorylation of insulin sensitivity related proteins IRβ and PI3K, the expression of ISR-1, ISR-2, GLUT4 and GLUT1, and the phosphorylation levels of IκBα and p65 in NF-κB signaling pathway. Results: Compared with the control group, the glucose consumption, cell proliferation, invasion and protein GLUT-1 expression level of trophoblast in IR model were significantly decreased (P<0.05), the protein expression and fluorescence activity of HMGB1, the secretion levels of inflammatory factors TNF-α, IL-1β, IL-6, phosphorylation levels of proteins IRβ, PI3K, IκBα and p65, and the expressions of ISR-1, ISR-2 and GLUT4 were significantly increased (P<0.05). Compared with IR group, the glucose consumption, cell proliferation, invasion ability and GLUT-1 expression level of IR+shRNA-HMGB1 cells were significantly increased (P<0.05), protein expression and fluorescence activity of HMGB1, secretion levels of inflammatory factors TNF-α, IL-1β, IL-6, phosphorylation levels of proteins IRβ, PI3K, IκBα and p65, and expressions of ISR-1, ISR-2 and GLUT4 were significantly decreased (P<0.05). Conclusion: It found that HMGB1 expression level was significantly increased in the trophoblasts under IR condition. Silencing HMGB1 expression can promote the proliferation and invasion of trophoblasts through NF-κB signaling pathway, improve the sensitivity of trophoblasts to insulin, and reduce the secretion of pro-inflammatory factors. 2021 Vol. 27 (8): 1244-1250 [Abstract] ( 166 ) HTML (1 KB)  PDF (1982 KB)  ( 280 ) 1251 The Roles of IL-23 and Th17 Cells in Brucella Spondylitis JIA Yongli, et al DOI: 10.3969/j.issn.1006-6233.2021.08.04 Objective: To investigate the roles of interleukin-23 (IL-23) and T helper cell 17 (Th17) in brucellosis spondylitis (BS). Methods: A total of 111 patients with BS admitted to the First Hospital Affiliated to Hebei North University from January 2015 to April 2020 were selected as the research objects, including 61 patients in acute phase (acute phase group) and 50 patients in chronic phase (chronic phase group), at the same time, 120 healthy controls were selected as the control group; the serum tube agglutination test (SAT) titer, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) were detected in patients with BS before treatment; the levels of serum L-23, IL-17, tumor necrosis factor-α (TNF-α), receptor activator of NF-κB ligand (RANKL) and matrix metalloproteinase-2 (MMP-2) were detected by enzyme linked immunosorbent assay (ELISA); Th17 cells level were detected by flow cytometry; Pearson method was used to analyze the correlation between serum IL-23 and Th17, between serum IL-23, Th17 and RANKL, MMP-2 in patients with BS. Results: The proportion of patients with SAT titer≥1∶100, CRP≥5mg/L and ESR≥20mm/h in acute phase group was higher than that in chronic phase group (P<0.05); compared with those in the control group, the Th17 cells, expression levels of serum TNF-α, IL-17, IL-23, RANKL and MMP-2 were higher in chronic phase group and acute phase group (P<0.05); compared with those in chronic phase group, the Th17 cells, expression levels of serum TNF-α, IL-17, IL-23, RANKL and MMP-2 in acute phase group were significantly higher (P<0.05); the level of IL-23 in BS patients was positively correlated with Th17 cells, RANKL and MMP-2 (P<0.05), and Th17 cells was positively correlated with RANKL and MMP-2 (P<0.05). Conclusion: IL-23 and Th17 may be involved in the pathogenesis of BS. This study may provide clinical basis for the study of BS. 2021 Vol. 27 (8): 1251-1255 [Abstract] ( 119 ) HTML (1 KB)  PDF (1247 KB)  ( 155 ) 1256 Efficacy of Recombinant Human Thrombopoietin Combined with Rituximab in the Treatment of Immune Thrombocytopenia and Its Influence on Coagulation Function and Adverse Reactions LIU Dan, FU Xiangjun, CHEN Wenting, et al DOI: 10.3969/j.issn.1006-6233.2021.08.05 Objective: To explore the efficacy of recombinant human thrombopoietin (rhTPO) combined with rituximab in the treatment of immune thrombocytopenia (ITP) and its influence on coagulation function and adverse reactions. Methods: A total of 198 patients with ITP in our hospital were retrospectively analyzed, and they were grouped according to the treatment regimens. Propensity score matching was conducted according to the general data of patients, and finally 61 cases in control group and 63 cases in study group with balanced general data were obtained. Control group was treated with rituximab, and observation group was treated with rhTPO combined with rituximab. The clinical efficacy, platelet count (PLT), coagulation function and adverse reactions were compared between the two groups. Results: After treatment, the clinical total effective rate was 68.85% in study group and 80.95% in control group (P>0.05), but the complete response rate of patients in study group was significantly higher than that in control group (P<0.05), and the onset time was significantly shorter than that in control group (P<0.05). The PLT levels after 1 week, 2 weeks, 4 weeks, 8 weeks and 12 weeks of treatment in the two groups were all higher than those before treatment (P<0.05), and the PLT levels in study group after 2 weeks, 4 weeks, 8 weeks and 12 weeks of treatment were higher than those in control group (P<0.05). Before and after treatment, there were no significant differences in the levels of activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB) between the two groups (P>0.05), and there were no statistically significant differences in the levels of indicators between the groups (P>0.05). During treatment, there was no significant difference in the incidence rate of adverse reactions between control group and observation group (19.67% vs 25.40%) (P>0.05). Conclusion: RhTPO combined with rituximab has a significant efficacy in the treatment of ITP. It can increase the level of PLT in a short period of time, and it does not adversely affect the coagulation function, with clinical safety of medication. 2021 Vol. 27 (8): 1256-1260 [Abstract] ( 126 ) HTML (1 KB)  PDF (1199 KB)  ( 308 ) 1260 Observation on Application of Carbon Nanoparticles Suspension Injection labeling in laparoscopic Radical Gastrectomy XIAO Hua, CAO Hongyong, SHI Xuesong DOI: 10.3969/j.issn.1006-6233.2021.08.06 Objective: To analyze the application value of Carbon Nanoparticles Suspension Injection labeling in laparoscopic radical gastrectomy. Methods: The clinical data of 86 patients who underwent D2 radical resection of laparoscopic distal gastric cancer in our hospital were retrospectively analyzed. Among them, 46 patients were given intraoperative Carbon Nanoparticles Suspension Injection labeling (observation group) and 40 patients were not treated with intraoperative Carbon Nanoparticles Suspension Injection labeling (control group). The perioperative status, lymph node dissection and metastasis, postoperative complications and survival at 1 year after operation were recorded in the two groups. The differences of traumatic stress status [cortisol (Cor), β-endorphin (β-EP)] were compared between the two groups before operation and at 1 d after operation. Results: There were no significant differences in operative time, intraoperative blood loss, postoperative exhaust time, postoperative hospital stay and incidence rates of postoperative complications between the two groups (P>0.05). The quantities of lymph nodes and micro-lymph nodes dissection, quantity of lymph node metastasis and lymph node metastasis rate in observation group were higher than those in control group (P<0.05). At 1 year after operation, there were no death cases in both groups, but there were recurrence cases. Kaplan-Meier survival curve and Log Rank test showed that the tumor-free survival rate of observation group was significantly higher than that of control group (93.5% vs 77.50%) (P<0.05). At 1 d after operation, the traumatic stress (Cor, β-EP) was higher than that before operation (P<0.05), but there were no significant differences in serum Cor and β-EP levels between the two groups (P>0.05). Conclusion: Intraoperative Carbon Nanoparticles Suspension Injection labeling can enhance the lymph node dissection effects of laparoscopic radical gastrectomy, increase the rate of lymph node dissection, and improve the postoperative tumor-free survival rate of patients, with a high application value. 2021 Vol. 27 (8): 1260-1264 [Abstract] ( 207 ) HTML (1 KB)  PDF (1306 KB)  ( 721 ) 1265 Systematic Evaluation of Anlotinib in Treatment of Advanced Non-small Cell Lung Cancer XU Chen, et al DOI: 10.3969/j.issn.1006-6233.2021.08.07 Objective: To evaluate the efficacy and safety of anlotinib in the treatment of advanced non-small cell lung cancer. Methods: The randomized controlled trial (RCT) was searched from PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang, VIP, CNKI, SinoMed and other databases from January, 2018 to March, 2020. Two researchers independently screened and evaluated the literature quality according to the inclusion and exclusion criteria, Revman 5.3 statistical software was used for meta-analysis of the included randomized controlled trials. Results: A total of 8 randomized controlled trials involving 784 patients, 474 patients in the experimental group and 310 patients in the control group were included. The results of meta-analysis showed that anlotinib could prolong progression free survival (PFS) [HR = 0.34,95% CI (0.30,0.39), P<0.00001] and overall survival (OS) [HR = 0.73, 95% CI (0.63, 0.85), P<0.0001]. Anlotinib also has advantages in improving disease control rate (DCR) [RR = 1.66, 95% CI (1.06, 2.58), P=0.03],objective response rate(ORR) [RR = 2.03, 95% CI (1.06, 3.58), P=0.03] and the adverse reactions were controllable. Conclusion: Compared with placebo or systemic chemotherapy, anlotinib can effectively improve the disease control rate and objective efficiency of advanced non-small cell lung cancer, and prolong the median progression free survival and median overall survival of patients. However, the number of included literature is small, the number of samples is small, and the analysis results indicate that the heterogeneity is large, so clinical randomized controlled trials with larger sample sizes and higher quality are still needed to further demonstrate the results. 2021 Vol. 27 (8): 1265-1271 [Abstract] ( 141 ) HTML (1 KB)  PDF (1947 KB)  ( 231 ) 1271 Forecast on the Mode of SP Delivery after Cesarean Section by TVS Combined with Real-time Shear Wave Elastography ZHAO Yanyan, NAN Ruixia, WAN Ying, et al DOI: 10.3969/j.issn.1006-6233.2021.08.08 Objective: To study the predictive value of transvaginal ultrasonography (TVS) combined with real-time shear wave elastography (TVE) on the mode of re delivery of scar pregnancy (SP). Methods: 105 patients with SP pregnancy after cesarean section in our hospital from October 2017 to October 2020 were selected. All patients were examined by TVs with Voluson730 ultrasonic diagnostic instrument, and then real-time shear wave elastography was performed by Mindray Resona 7 ultrasonic diagnostic instrument to observe the thickness of lower uterine muscle layer. The scar grading, delivery outcome and elasticity score were statistically analyzed. Results: The scar development rate of TVS combined with real-time shear wave elastic imaging was 100.00% (105/105)(P<0.05). 79 cases were classified as grade I, 17 cases as grade II, 7 cases as grade III and 2 cases as grade IV. With the increase of scar grade, the thickness of lower uterine segment gradually decreased, and the amount of bleeding increased during cesarean section (P<0.05). Compared with scar grade I, the cesarean section rate and vaginal delivery rate of patients with grade II, grade III and grade IV were lower than those with grade II scar (P<0.05). Compared with cesarean section, vaginal delivery patients had no 3-point elasticity score, 1-point elasticity score was higher, and 2-point elasticity score was lower (P<0.05). Conclusion: Transvaginal TVs combined with real-time shear wave elastography can improve the development of uterine scar, and has an advantage in detecting the thickness of lower uterine muscle layer. The combination of the two methods has a certain predictive value for the choice of delivery mode of SP after cesarean section. 2021 Vol. 27 (8): 1271-1275 [Abstract] ( 112 ) HTML (1 KB)  PDF (1577 KB)  ( 157 ) 1275 Effect of MMP-9 and sFlt-1 in Peripheral Blood on Menstrual Cycle in Patients with Endometriosis WANG Jia, SHA Min, GE Hongshan, et al DOI: 10.3969/j.issn.1006-6233.2021.08.09 Objective: To analyze the influence of MMP-9 and sFlt-1 on menstrual cycle in patients with endometriosis. Methods: 113 patients with endometriosis admitted to our hospital from March 2017 to March 2020 were included in this study. Another 62 healthy women who came to our hospital for physical examination in the same period were selected as the control group. The levels of MMP-9 and sFlt-1 in peripheral blood were detected by ELISA. The levels of MMP-9 and sFlt-1 in peripheral blood of patients with different menstrual cycles, different R-AFS stages and endometriosis were compared between the two groups, and the correlation between the levels of MMP-9 and sFlt-1 in peripheral blood and R-AFS stages and menstrual cycle was analyzed. Results: The levels of MMP-9 and sFlt-1 in peripheral blood of endometriosis group were significantly higher than those of control group in proliferative phase and secretory phase, and the levels of sFlt-1 in peripheral blood of endometriosis group were significantly lower than those of control group. The differences were statistically significant (P<0.05), but the levels of MMP-9 and sFlt-1 in peripheral blood of endometriosis group and control group had no significant changes in proliferative phase and secretory phase, and the differences were not statistically significant (P>0.05). The level of MMP-9 in peripheral blood of patients with endometriosis increased with the increase of R-AFS stage, and the level of sFlt-1 in peripheral blood decreased with the increase of R-AFS stage (P<0.05). There was a negative correlation between MMP-9 and sFlt-1 (P<0.05), a positive correlation between MMP-9 and R-AFS stage (P<0.05), and a negative correlation between sFlt-1 and R-AFS stage (P<0.05), but there was no correlation between MMP-9 and sFlt-1 and menstrual cycle (P>0.05). Conclusion: The levels of MMP-9 and sFlt-1 in peripheral blood of patients with endometriosis are significantly higher than those of patients with endometriosis. The levels of MMP-9 and sFlt-1 are significantly correlated with the progress of endometriosis, but not with the menstrual cycle. 2021 Vol. 27 (8): 1275-1279 [Abstract] ( 102 ) HTML (1 KB)  PDF (1213 KB)  ( 141 ) 1279 Relationship between BMI and Embryo Chromosomal Karyotype Abnormality of Spontaneous Abortion after IVF/ICSI-ET WU Jun, CUI Yunjing, GUO Feibo, et al DOI: 10.3969/j.issn.1006-6233.2021.08.010 Objective: To detect the embryo chromosomal karyotype abnormality of patients with spontaneous abortion after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET), and to explore the relationship between body mass index (BMI) and embryo chromosomal karyotype abnormality of patients with spontaneous abortion after IVF/ICSI-ET. Methods: 280 cases of patients with spontaneous abortion after IVF/ICSI-ET from January 2018 to July 2020 in department of obstetrics and gynecology, Tianmen first people's hospital were analyzed retrospectively, including 96 cases of embryonic chromosome normal karyotype patients (normal karyotype group) and 184 cases of embryonic chromosome abnormal karyotype patients (abnormal karyotype group). General data were analyzed; embryo chromosomal karyotype abnormality of patients with spontaneous abortion after IVF/ICSI-ET was analyzed; and the relationships between BMI, abortion age, abortion times and embryo chromosomal karyotype abnormality of patients with spontaneous abortion after IVF/ICSI-ET was analyzed; Logistic regression analysis of the factors influencing the embryonic chromosome abnormal karyotype in patients with spontaneous abortion after IVF/ICSI-ET. Results: There was no significant difference between the two groups in infertility duration, causes of infertility, type of infertility, mode of pregnancy aid, dosage of gonadotropins(GN), days of GN use, basic follicle-stimulating hormone(FSH), number of oocytes obtained, thickness of endometrium on the day of transplantation, number of embryos transferred and number of high-quality embryos transferred (P>0.05); the proportions of normal karyotype group and abnormal karyotype group were 34.29% and 65.71% respectively, and aneuploidy was the main karyotype in abnormal karyotype group (41.07%); the percentage of abnormal karyotypes in patients with spontaneous abortion after IVF/ICSI-ET whose BMI < 21.4 kg/m2 or > 24.2 kg/m2 was significantly higher than that in patients whose BMI of 21.4 kg/m2~24.2 kg/m2 (P<0.05); the percentage of abnormal karyotype in patients with spontaneous abortion after IVF/ICSI-ET whose abortion age ≥ 36 years old was significantly higher than that in patients whose abortion age < 36 years old (P<0.05); the percentage of abnormal karyotype in patients with spontaneous abortion after IVF/ICSI-ET whose abortion times > 2 times was significantly higher than that in patients whose abortion times ≤ 2 times (P<0.05); BMI is an independent risk factor that affects the abnormal karyotype of embryos in spontaneous abortion patients after IVF/ICSI-ET (P<0.05). Conclusions: After IVF/ICSI-ET operation, most of the spontaneous abortion patients are embryo chromosomal karyotype abnormality, and the BMI of the patients was related to the embryo chromosomal karyotype abnormality. 2021 Vol. 27 (8): 1279-1284 [Abstract] ( 118 ) HTML (1 KB)  PDF (1217 KB)  ( 198 ) 1285 Efficacy of Alanyl-Glutamine in the Treatment of Patients with Sepsis in ICU and Its Influence on Serum CRP, ETX and HBP Levels CHEN Yusheng, LIU Xiaomin DOI: 10.3969/j.issn.1006-6233.2021.08.011 Objective: To investigate the efficacy of alanyl-glutamine in the treatment of patients with sepsis in ICU, and its influence on serum C-reactive protein (CRP), endotoxin (ETX) and heparin-binding protein (HBP) levels. Methods: From February 2019 to February 2021, 152 patients with sepsis in ICU of the hospital were selected and divided into observation group and control group, 76 cases in each group, with random number table for simple random grouping. The control group received conventional treatment, and the observation group was treated with alanyl-glutamine on the basis of conventional treatment. Clinical effects, mechanical ventilation time, hospitalization time, acute physiology and chronic health evaluation II (APACHEII) scores, serum CRP, ETX and HBP levels, liver function indicators [lactate (LAC), aspartate aminotransferase (AST), alanine aminotransferase (ALT)], nutritional indicators [albumin (ALB), hemoglobin (Hb), transferrin (TF)], and immune indicators [immunoglobulins (IgA, IgG, IgM) and complements (C3, C4)] were compared between the two groups. Results: The effective rate of treatment in the observation group was higher than that in the control group (84.00% vs. 66.77%) (P<0.05). The mechanical ventilation time and hospital stay of the observation group were shorter than those of the control group (P<0.05). After treatment, the levels of serum CRP, ETX, HBP, LAC, AST and ALT were reduced, while the levels of ALB, Hb, TF, IgA, IgG, IgM, C3 and C4 were increased (P<0.05). Meanwhile, the APACHEⅡ score and levels of serum CRP, ETX, HBP, LAC, AST and ALT in the observation group were lower than those in the control group, while the levels of ALB, Hb, TF, IgA, IgG, IgM, C3 and C4 were higher than those in the control group (P<0.05). Conclusion: Alanyl-glutamine is effective in the treatment of patients with sepsis in ICU. It can lower serum CRP, ETX and HBP levels, improve nutritional status and liver function, and improve immune function. 2021 Vol. 27 (8): 1285-1290 [Abstract] ( 102 ) HTML (1 KB)  PDF (1210 KB)  ( 204 ) 1290 Comparison of Fluorescence in Situ Hybridization Detection of HER-2 Gene Amplification and Immunohistochemical Detection of C-erbB-2 Protein Expression CHEN Xu, et al DOI: 10.3969/j.issn.1006-6233.2021.08.012 Objective: To compare the differences and correlation between fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) in the detection of HER-2 gene and protein in breast cancer. Methods: Taking the surgical pathological slices of 98 breast cancer patients as the test objects, FISH and IHC were performed respectively, and the test results were analyzed. Results: IHC test results showed that 53 cases (54.08%) were positive and 45 cases (45.92%) were negative. FISH test results showed that 29 cases (29.59%) were positive and 69 cases (70.41%) were negative. With FISH as the gold standard, the coincidence rate of negative (-) for IHC is 42 (93.33%), the coincidence rate of positive (+) is 5 (17.86%), the coincidence rate of ++ is 11 (78.57%), and the coincidence rate of +++ is 10 (90.91) %). Conclusion: In IHC preliminary screening of C-erbB-2 protein, the coincidence rate of -, +++ is relatively high, and the coincidence rate of IHC in the screening of ++ and + is low. It is recommended to do FISH screening on the basis of IHC screening to clarify the HER-2 gene status. 2021 Vol. 27 (8): 1290-1294 [Abstract] ( 81 ) HTML (1 KB)  PDF (2354 KB)  ( 285 ) 1294 Correlation Analysis of Serum GLP-1 ICAM-1 Levels and Degree of Nerve Injury in Patients with Acute Cerebral Infarction ZHANG Xiang, CHEN Xinxu, LI Xiating, et al DOI: 10.3969/j.issn.1006-6233.2021.08.013 Objective: To investigate the correlation between the levels of serum glucagon like peptide-1 (GLP-1) and intercellular adhesion factor-1 (ICAM-1) and the degree of nerve injury in patients with acute cerebral infarction (ACI). Methods: A total of 67 patients with ACI in our hospital from October 2018 to December 2019 were selected as the research objects, according to National Institute of Health stroke scale (NIHSS) score, ACI patients were divided into 23 cases in mild group (NIHSS score < 5), 28 cases in moderate group (5 ≤ NIHSS score < 20), and 16 cases in severe group (NIHSS score ≥ 20), and 50 healthy volunteers in our hospital were randomly selected as the control group. The levels of serum GLP-1, ICAM-1, S100 calcium binding protein B (S100B) and neuron specific enolase (NSE) were detected by enzyme-linked immunosorbent assay and compared between the study group and the control group, the serum index levels of each groups were compared. Pearson method was used to analyze the correlation of serum GLP-1, ICAM-1 levels with S100B, NSE levels and NIHSS score. Results: The level of serum GLP-1 in the study group was significantly lower than that in the control group (P<0.05), and the levels of ICAM-1, S100B and NSE in the study group were significantly higher than those in the control group (P<0.05); compared with those in mild group, the level of GLP-1 in moderate group and severe group was significantly lower (P<0.05), and the levels of ICAM-1, S100B and NSE were significantly higher (P<0.05); compared with those in the moderate group, the level of GLP-1 in the severe group was significantly lower (P<0.05), and the levels of ICAM-1, S100B and NSE were significantly higher (P<0.05); compared with before treatment, the level of GLP-1 in ACI patients increased significantly after treatment (P<0.05), the levels of ICAM-1, S100B and NSE and NIHSS score decreased significantly (P<0.05); Pearson results showed that serum GLP-1 level was negatively correlated with ICAM-1, S100B, NSE level and NIHSS score (all P<0.05), and ICAM-1 level was positively correlated with S100B, NSE level and NIHSS score (all P<0.05). Conclusion: With the aggravation of nerve injury in patients with ACI, the level of serum GLP-1 gradually decreases, and the level of ICAM-1 gradually increases, they are closely related to the levels of S100B and NSE, and may be used as potential biological indicators of nerve injury in patients with ACI. 2021 Vol. 27 (8): 1294-1299 [Abstract] ( 152 ) HTML (1 KB)  PDF (1230 KB)  ( 171 ) 1299 Relationship Between Levels of Serum Amyloid A and Homocysteine and Cognitive Impairment in Subcortical Ischemic Vascular Disease ZHOU Huayong, YANG Xu, ZHANG Yi, et al DOI: 10.3969/j.issn.1006-6233.2021.08.014 Objective: To analyze the relationship between levels of serum amyloid A (SAA) and homocysteine (Hcy) and cognitive impairment (CI) in subcortical ischemic vascular disease (SIVD). Methods: The clinical data of 152 patients with SIVD in our hospital were retrospectively analyzed. According to the occurrence of CI, they were divided into non-CI group and CI group. The baseline data, levels of serum SAA and Hcy and intracranial hemodynamic indicators [middle cerebral artery (MCA)-pulsatility index (PI), anterior cerebral artery (ACA)-PI] were compared between the two groups. Receiver operating characteristic curve (ROC curve) was used to assess the diagnostic value of serum SAA, Hcy and intracranial hemodynamic indicators on CI in SIVD, and Logistic regression model was used to analyze the risk factors of CI in SIVD. Results: Among 152 patients with SIVD, there were 63 cases (41.45%) in CI group and 89 cases (58.55%) in non-CI group. There were no statistically significant differences between the two groups in terms of gender, age, smoking history, drinking history, hypertension and lipid metabolism disorders (P>0.05). The years of education in CI group was lower than that in non-CI group (P<0.05), and the prevalence rate of diabetes mellitus, serum SAA, Hcy, MCA-PI and ACA-PI were higher than those in CI group (P<0.05) . By ROC curve analysis, serum SAA, Hcy, MCA-PI and ACA-PI had high diagnostic value on CI in SIVD (AUC=0.859, 0.847, 0.871, 0.666, P<0.05), and their cut-off values were 291.58 mg/L, 19.77 μmol/L, 1.04 and 0.96 respectively. Logistic regression analysis showed that education < 9 years, diabetes mellitus, SAA≥291.58mg/L, Hcy≥19.77μmol/L, MCA-PI≥1.04 and ACA-PI≥0.96 were all independent risk factors for CI in SIVD (OR=2.113, 2.596, 2.201, 2.151, 2.275, 1.925, P<0.05). Conclusion: SIVD patients with low education level or diabetes mellitus are at higher risk of CI. The detection of serum SAA, Hcy and intracranial hemodynamics is beneficial to determine the occurrence of CI in patients with SIVD. It is necessary to actively monitor the above indicators in clinical practice so as to detect CI in time. 2021 Vol. 27 (8): 1299-1303 [Abstract] ( 124 ) HTML (1 KB)  PDF (1345 KB)  ( 215 ) 1304 Relationship Between Serum SFRP1 Level and Inflammatory Response and Pulmonary Function in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease HAN Xiang, WU Weiqin, ZHAO Hongmei DOI: 10.3969/j.issn.1006-6233.2021.08.015 Objective: To investigate the relationship between serum SFRP1 level and inflammatory response and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods: 150 patients of COPD in our hospital from March 2019 to October 2020 were selected, including 86 patients in acute exacerbation stage and 64 patients in stable stage, and 60 healthy people in the same period as the control group. The levels of serum SFRP1, inflammatory factors [interleukin-17 (IL-17), IL-33, high sensitivity reactive protein (hs-CRP), tumor necrosis factor - α (TNF - α)] and lung function [the first group] were compared. The correlation was analyzed between serum SFRP1 level and inflammatory factors, lung function in patients with acute exacerbation of COPD. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of serum SFRP1 in acute exacerbation of COPD. Results: Levels of serum SFRP1 and inflammatory factors of the acute exacerbation group were significantly higher than those in the stable group and the control group, and the above indexes in the stable group were also higher than those in the control group(P<0.05).The lung function of acute exacerbation group were significantly lower than those of stable group and control group, and lung function of stable group was significantly lower than that of control group(P<0.05). Serum SFRP1 level of acute exacerbation patients was positive correlated with serum IL-17, IL-33, hs-CRP and TNF-α (r=0.537, 0.508, 0.403, 0.442,P<0.05),and was negative correlated with FEV1,FEV1/FVC(r=-0.524, -0.576, P<0.05). ROC curve showed that the cut-off value of serum SFRP1 level for predicting acute exacerbation of COPD was 75.43 pg/ml, the sensitivity and specificity for predicting acute exacerbation of COPD were 89.78% and 92.03%, which were consistent with the diagnostic criteria of acute exacerbation of COPD (kappa=0.835). Conclusion: The serum SFRP1 level in patients of acute exacerbation of COPD is positively correlated with serum inflammatory factors, negatively correlated with FEV1 and FEV1 / FVC. The serum SFRP1 level has a good diagnostic value for acute exacerbation of COPD. 2021 Vol. 27 (8): 1304-1308 [Abstract] ( 90 ) HTML (1 KB)  PDF (1240 KB)  ( 156 ) 1308 Effectiveness of Semiconductor Laser Therapy in Elderly Patients with Chronic Periodontitis and Its Effect on PD CAL and SBI LI Shuhua, ZHOU Yongmin, DING Hongzhong DOI: 10.3969/j.issn.1006-6233.2021.08.016 Objective: To investigate the efficacy of semiconductor laser in the treatment of elderly chronic periodontitis and its effects on periodontal probing depth (PD), clinical attachment loss (CAL) and gingival crevicular bleeding index (SBI). Methods: A total of 148 elderly patients with chronic periodontitis admitted to our hospital from January 2018 to December 2020 were randomly divided into control group and study group, with 74 cases in each group. The control group was treated with subgingival curettage, and the research group was treated with semiconductor laser. PD, Cal and SBI were detected by periodontal probe. The levels of high-sensitive C-reactive protein (hs-CRP), tumor necrosis factor (TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) were determined by radioimmunoassay. PI value was evaluated by probe. Superoxide dismutase (SOD) was determined by xanthine oxidase method. Glutathione peroxidase (GSH-Px) was determined using a reduced glutathione (GSH) detection kit. Nitric oxide (NO) was used by nitrate reductase method. Results: The indexes of PD (3.18±1.02), CAL (3.24±1.21) and SBI (0.58±0.16) in the study group were lower than those in the control group (3.79±1.01), (3.92±1.32) and (1.12±0.23), and the difference was statistically significant (P<0.05). The levels of hs-CRP (10.3±2.1), TNF-α (12.3±4.1), IL-6 (2.8±0.2) and IL-8 (2.5±0.1) in the study group were lower than those in the control group (14.7±3.1) (19.2±6.3) (4.4±0.9) (4.6±0.2). The difference was statistically significant (P<0.05). The PI values of grade 0 (58.1%), grade 1 (37.8%), grade 2 (2.7%) and grade 3 (1.4%) in the study group were higher than those of grade 0 (51.4%), grade 1 (28.4%), grade 2 (12.2%) and grade 3 (8.1%) in the control group, with statistical significance (P<0.05). Conclusion: Semiconductor laser is effective in treating chronic periodontitis in the elderly. 2021 Vol. 27 (8): 1308-1312 [Abstract] ( 116 ) HTML (1 KB)  PDF (1210 KB)  ( 247 ) 1312 Efficacy of Continuous Renal Replacement Therapy on Acute Renal Failure and Its Effects on Levels of T Lymphocytes Inflammatory Factors and Serum Electrolytes HAN Ruiping, et al DOI: 10.3969/j.issn.1006-6233.2021.08.017 Objective: To observe the efficacy of continuous renal replacement therapy (CRRT) on acute renal failure (ARF) and its effects on levels of T lymphocytes, inflammatory factors and serum electrolytes. Methods: A total of 161 patients with ARF treated in the hospital were randomly divided into observation group (n=81) and control group (n=80) according to simple random sampling. On the basis of conventional treatment, patients in control group were treated with intermittent hemodialysis (IHD), and patients in observation group were administered CRRT. The clinical efficacy of the two groups of patients was compared, and the changes in immune function indicators (CD3+, CD4+, CD8+, CD4+/CD8+), inflammatory factors [interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α)], serum electrolytes [potassium (K+), sodium (Na+), chlorine (Cl-)] and renal function indicators [blood urea nitrogen (BUN), serum creatinine (Scr), endogenous creatinine clearance rate (Ccr), β2 microglobulin (β2-MG)] were observed in the two groups before treatment and after 3 months of treatment. Results: The total clinical effective rate of observation group was significantly higher than that of control group (96.3% vs 87.5%) (P<0.05). After 3 months of treatment, the levels of CD3+, CD4+, CD4+/CD8+ and Ccr in the two groups of patients were higher than those before treatment, and the differences before and after treatment between the two groups were statistically significant (P<0.05). The levels of CD8+, IL-1, IL-6 , IL-8, TNF-α, K+, Na+, Cl-, BUN, Scr and β2-MG were lower in the two groups of patients than those before treatment, and the differences before and after treatment were statistically significant between the two groups (P<0.05). Conclusion: CRRT has a significant effect in the treatment of patients with ARF. It can reduce the levels of inflammatory factors, regulate the levels of electrolytes, enhance the body’s immunity, and improve the renal function. 2021 Vol. 27 (8): 1312-1316 [Abstract] ( 130 ) HTML (1 KB)  PDF (1198 KB)  ( 243 ) 1317 An Analysis of Single Nucleotide Polymorphism at Rs3114018 of ABCG2 Gene in Patients with Primary Gout in Haikou City ZHOU Weiwen, TANG Xiaobo, SUN Shaoqing, et al DOI: 10.3969/j.issn.1006-6233.2021.08.018 Objective: To clarify the correlation between ATP binding cassette transporter G2 (ABCG2) rs3114018 and primary gout and provide genetic markers for the early diagnosis of primary gout in Haikou. Methods: A total of 177 patients with gout admitted to our hospital from January 2019 to June 2020 were selected as the experimental group, and 191 healthy controls as the healthy group. Peripheral blood was extracted for detection. High throughput sequencing was used to genotype the rs3114018 locus of ABCG2.The correlation between the genotypes of rs3114018 and the occurrence of primary gout in Haikou was analyzed by statistical method. Results: The frequency of AC type was 35.02% in gout patients and 10.99% in normal population. The frequency of CC type was 35.59% in gout patients and 21.98% in the normal population. The frequency of each genotype in the gout group was statistically different from that in the normal group (P<0.001). The polymorphism of ABCG2 gene rs3114018 was significantly correlated with serum uric acid, blood glucose, creatinine, alanine aminotransferase and glutamate aminotransferase. Compared with AA genotype, the incidence risk of AC carriers increased by 3.273 times, which was 2.642 times after correction, and the incidence risk of CC carriers increased by 3.825 times, which was 3.281 times after correction. Conclusion: The polymorphism of ABCG2 gene rs3114018 is associated with the incidence of primary gout in Haikou, which is a risk factor for the incidence of gout, and is expected to provide a new genetic diagnostic marker for primary gout in Haikou. 2021 Vol. 27 (8): 1317-1321 [Abstract] ( 104 ) HTML (1 KB)  PDF (1199 KB)  ( 176 ) 1321 An Investigation of the Effect of High-Flow Humidified Oxygen Therapy on the Clinical Efficacy and the Expression of IL-8 and IL-6 in Elderly Patients with Pneumonia WANG Guoyu, QU Zhonghui, LI Wei, et al DOI: 10.3969/j.issn.1006-6233.2021.08.019 Objective: To investigate the effect of high-flow humidified oxygen therapy on the clinical efficacy and the expression of IL-8 and IL-6 in elderly patients with pneumonia. Methods: 80 elderly patients with pneumonia admitted to our hospital from January 2017 to August 2019 were randomly divided into two groups, 40 cases in each group. Both groups were administered antitussive, expectorant, anti-inflammatory and other treatment measures. 40 patients of the control group were given traditional artificial airway humidification method, while 40 patients of the study group were given high flow humidified oxygen therapy.The clinical symptoms, heart rate, suction frequency, SPO2, serum IL-6 and serum IL-8 levels of the two groups were observed and compared before and after treatment. Results: Before treatment, there were no significant difference in serum IL-6 and IL-8 between the two groups (P>0.05). After clinical application of high-flow humidified oxygen therapy, Hypothermic time, time of change of character and viscosity from sputum, decreased or disappearance time of lung rales in the study group were significantly shorter than those of the control group; heart rate and aspiration frequency were lower and SPO2 was higher than those of the control group(P<0.05). The decrease of serum IL-6 and IL-8 in the study group were significantly lower than those in the control group. (P<0.05). Conclusion: Application of high flow humidified oxygen therapy can significantly improve the clinical efficacy, increase oxygenation, reduce the expression of inflammatory factors IL-6,IL-8. 2021 Vol. 27 (8): 1321-1325 [Abstract] ( 114 ) HTML (1 KB)  PDF (1211 KB)  ( 168 ) 1325 Predictive Energy Efficiency of Serum SPD-L1 Combined with Balthazar CT Grading in Patients with Acute Pancreatitis in the Late Stage of Peripancreatic Necrosis Infection ZHANG Yi, TAN Hui DOI: 10.3969/j.issn.1006-6233.2021.08.020 Objective: To investigate the predictive energy efficiency of serum soluble programmed death ligand 1 (sPD-L1) combined with Balthazar CT grading in patients with acute pancreatitis (AP) in the later\ stage of peripancreatic necrosis infection. Methods: 202 cases of AP patients admitted to our hospital from January 2018 to February 2020 were selected and were divided into peripancreatic necrosis and infection group (n = 53) and non peripancreatic necrosis and infection group (n = 149) according to whether there was peripancreatic necrosis and infection after 14 days. General data of the two groups of patients were collected. Multivariate Logistics regression was used to analyze the influencing factors of late peripancreatic necrosis infection in AP patients. The ROC curve was used to analyze the predictive value of sPD-L1 and Balthazar CT grading for the later period of peripancreatic necrosis infection in AP patients. Results: Univariate analysis showed that C-reactive protein (CRP), procalcitonin (PCT), absolute lymphocyte count (ALC), acute physiology and chronic health assessment Ⅱ (APACHE Ⅱ) score, sPD-L1, and Balthazar CT classification were Influencing factors of peripancreatic necrosis infection in AP patients (P<0.05); Multivariate logistic regression analysis showed that APACHE Ⅱ score , sPD-L1 , Balthazar CT grade were independent risk factors for peripancreatic necrosis infection in AP patients (P<0.05); The area under the curve (AUC) of sPD-L1 combined with Balthazar CT classification was 0.878, which was higher than that of sPD-L1 (AUC=0.818), Balthazar CT classification (AUC=0.744) alone(P<0.05). Conclusion: The increase of serum sPD-L1 level and Balthazar CT grading are independent risk factors for later peripancreatic necrosis infection in AP patients. SPD-L1 combined with Balthazar CT grading can improve the predictive value of later peripancreatic necrosis infection in AP patients. 2021 Vol. 27 (8): 1325-1329 [Abstract] ( 105 ) HTML (1 KB)  PDF (1280 KB)  ( 182 ) 1330 Efficacy and Safety of Radiofrequency Catheter Ablation Under Pressure Monitoring and Pressure-Independent Radiofrequency Catheter Ablation in the Treatment of RVOT-VAs:a Comparative Study LI Zuoling, PEI Xiaoling, LIN Yan, et al DOI: 10.3969/j.issn.1006-6233.2021.08.021 Objective: To compare the clinical effects and safety of radiofrequency catheter ablation under pressure monitoring and pressure-independent radiofrequency catheter ablation in the treatment of right ventricular outflow tract ventricular arrhythmias(RVOT-VAs). Methods: From June 2016 to March 2021, 309 patients with RVOT-VAs scheduled to be treated with radiofrequency ablation were selected and randomly divided into pressure group (n=167) and non-pressure group (n=142). Patients in the pressure group underwent high-power ThermoCool SmartTouch catheter radiofrequency ablation under pressure monitoring, while patients in the non-pressure group underwent NaviStar ThermoCool saline-irrigated catheter radiofrequency ablation. The operation indicators, success rate of ablation, postoperative complications and recurrence rate were compared between the two groups. Results: The operation time, ablation discharge time and X-ray exposure time of the pressure group were significantly shorter than those of the control group, and the number of invalid discharges was significantly smaller than that of the control group(P<0.05). The success rate of ablation after operation in the pressure group was higher than that in the non-pressure group (P<0.05). After operation, the total incidence of complications, recurrence rate and re-ablation rate in the pressure group were lower than those in the non-pressure group (P<0.05). Conclusion: Radiofrequency catheter ablation under pressure monitoring reveals good clinical effects in the treatment of RVOT-VAs. It can significantly shorten the operation time, ablation discharge time and X-ray exposure time, with a lower incidence of postoperative complications and a lower recurrence rate. The success rate and safety of long-term ablation are better than pressure-independent radiofrequency catheter ablation. 2021 Vol. 27 (8): 1330-1334 [Abstract] ( 168 ) HTML (1 KB)  PDF (1198 KB)  ( 293 ) 1334 Effect of Biofeedback Electrical Stimulation Combined with Vaginal Dumbbell Training on Clinical Efficacy Pelvic Floor Muscle Strength and Quality of Sexual Life in Patients with Postpartum Stress Urinary Incontinence After Natural Delivery MING Xue, LIU Xiaofang, LU Zongjie, et al DOI: 10.3969/j.issn.1006-6233.2021.08.022 Objective: To explore the effect of biofeedback electrical stimulation combined with vaginal dumbbell training on the clinical efficacy, pelvic floor muscle strength and quality of sexual life in patients with postpartum stress urinary incontinence after natural childbirth. Methods: 114 cases of postpartum urinary incontinence patients who received treatment in our hospital from October 2018 to June 2020 were selected for research. The patients were divided into 2 groups by random number table method, 57 cases in each group. The control group received vagina dumbbell training, and the observation group performed biofeedback electrical stimulation on this basis. The clinical efficacy, pelvic floor muscle strength, quality of sexual life, urodynamic parameters and oxidative stress response indexes were compared between the two groups. Results: Compared with the control group, the improvement rate of the observation group was significantly higher, with statistical difference (96.49%vs85.96% P<0.05). After treatment, the maximum value of fast muscle contraction, the average value of slow muscle contraction in 10s and the average value of slow muscle contraction in 60s were significantly increased in the two groups, but the increase was greater in the observation group, the difference was statistically significant (P<0.05). After treatment, the quality of sexual life, average urine flow rate and maximum bladder volume of the two groups were significantly increased, but the increase in the observation group was greater. After treatment, the residual urine volume of the two groups decreased significantly, but the decrease in the observation group was greater, the difference was statistically significant (P<0.05). After treatment, the SOD and GSH levels of the two groups were significantly increased, but the increase in the observation group was greater. After treatment, the MDA levels of the two groups of patients decreased significantly, but the observation group decreased more significantly, the difference was statistically significant (P<0.05). Conclusion: Biofeedback electrical stimulation combined with vaginal dumbbell training can effectively improve the efficacy of postpartum stress urinary incontinence in patients with postpartum natural childbirth, improve pelvic floor muscle strength and quality of sexual life, improve urodynamic parameters, and relieve oxidative stress. 2021 Vol. 27 (8): 1334-1338 [Abstract] ( 111 ) HTML (1 KB)  PDF (1209 KB)  ( 199 ) 1339 Relationship Between Serum Vitamin D and Airway and Respiratory Parameters in Children with Bronchial Asthma and Its Influence on Prognosis QIU Meng DOI: 10.3969/j.issn.1006-6233.2021.08.023 Objective: To explore the relationship between serum vitamin D (VITD) and airway hyperresponsiveness and respiratory mechanical parameters in children with bronchial asthma (BA), as well as its influence on the therapeutic effect. Methods: A total of 113 children with BA from March 2018 to August 2020 in our hospital were selected as the study group, and another 113 children for healthy physical examination during the same period were selected as the control group. The serum VitD levels of the two groups were compared. According to the serum VitD levels, the study group was divided into normal VitD children (n=35) and VitD deficient children (n=78). Clinical data, airway hyperresponsiveness [minimum induced cumulative dose (Dmin) by bronchial stimulation test (Astograph), serum total immunoglobulin E (IgE)], respiratory mechanical parameters [intraairway pressure (PAW), respiratory viscosity resistance (R), total static compliance (CST), platform pressure (PLAT)] of the children with normal and deficient VitD in the study group were compared. The correlation between serum VitD and airway hyperresponsiveness and respiratory mechanical parameters was analyzed. All the study groups were given routine treatment. The treatment effect of children with normal and deficient VitD in the study group was compared, and the influence of serum VitD level on the treatment effect of children with BA was analyzed. Results: The level of serum VitD in the study group was lower than that in the control group (P<0.05). In the study group, Dmin and CST of children with VITD deficiency were lower than those with normal VITD, and serum total IgE, PAW, R and Plat were higher than those with normal VITD (P<0.05). Serum VitD was positively correlated with Dmin and CST, and negatively correlated with serum total IgE, PAW, R and Plat (P<0.05). In the study group, the total effective rate of patients with normal VITD was higher than that of patients with VITD deficiency (P<0.05). There was a significant correlation between serum VitD and BA (P<0.05). Conclusions: The serum VITD in BA children is significantly reduced, which is closely related to airway hyperresponsiveness and respiratory mechanical parameters. Supplementation of VITD can help improve the therapeutic effect, which is of great significance in clinical diagnosis and treatment. 2021 Vol. 27 (8): 1339-1343 [Abstract] ( 97 ) HTML (1 KB)  PDF (1585 KB)  ( 300 ) 1344 Comparison of Efficacy of Continuous Blood Purification and Ordinary Hemodialysis on Patients with Uremia LI Gang, GUO Hao DOI: 10.3969/j.issn.1006-6233.2021.08.024 Objective: To observe the effect of continuous blood purification and ordinary hemodialysis on patients with uremia, and to conduct a comparative study. Methods: 180 cases of uremia patients treated in our hospital were selected and randomly divided into control group and observation group, 90 cases in each group. The control group underwent conventional dialysis treatment, with each dialysis of 4 hours, 3 times a week, and the intervention lasted 3 months. The observation group underwent a continuous blood purification dialysis treatment, 3 times during the day and 1 time at night in a day, and the intervention lasted 3 months. The clinical efficacy and serum HMG-1 and TNF-α levels in the two groups were observed. Results: The observation group had 85 effective cases, accounting for 94.4%; the control group had an effective rate of 76.6% (P<0.05). After treatment, the renal function indexes of the two groups decreased; difference before and after treatment in the observation group was greater than that in the control group (P<0.05). After treatment, difference before and after treatment of HMG-1 and TNF-α in the observation group was significantly greater than that in the control group (P<0.05). After treatment, the levels of LA, CRP, and PCT in the two groups decreased compared with those before treatment. After treatment, difference before and after treatment of LA, CRP, and PCT in the treatment group was greater than that in the control group (P<0.05). The outcome of the patients was followed up for 28 days. As a result, there were 10 deaths in the control group, with a case fatality rate of 11.1%; 2 cases in the treatment group died, with a case fatality rate of 2.22% (P<0.05). Conclusion: Continuous blood purification is effective in treating uremia and can effectively reduce the levels of HMG-1 and TNF-α in serum, at the same time improve the survival rate of patients. 2021 Vol. 27 (8): 1344-1347 [Abstract] ( 129 ) HTML (1 KB)  PDF (1182 KB)  ( 272 ) 1348 The Diagnostic Value of Serum OPG BSAP and FGF-23 for Vascular Calcification in Patients Under Hemodialysis SONG Juxiang, XIA Weiqing, WANG Tianzhi, et al DOI: 10.3969/j.issn.1006-6233.2021.08.025 Objective: To investigate the diagnostic value of serum Osteoprotegerin (OPG), bone specific alkaline phosphatase (BSAP) and fibroblast growth factor 23 (FGF-23) for vascular calcification (VC) in patients under hemodialysis. Methods: A total of 133 patients under hemodialysis were selected from January 2018 to October 2020, of which 58 patients with VC were in the calcification group and 75 patients without VC were in the non-calcification group. The levels of serum OPG, BSAP and FGF-23 in the two groups were determined by enzyme linked immunosorbent assay (ELISA). The diagnostic values of serum OPG, BSAP and FGF-23 in VC were explored by ROC curve. Results: The levels of serum OPG, BSAP and FGF-23 in the calcification group were higher than those in the non-calcification group (P<0.05). With the aggravation of calcification, the levels of serum OPG, BSAP and FGF-23 were significantly increased (P<0.05). Spearman correlation analysis showed that OPG, BSAP and FGF-23 were positively correlated with VC score of dialysis patients (P<0.05). Logistic regression analysis showed that longer dialysis age and elevated of OPG, BSAP, FGF-23 were risk factors for VC in dialysis patients (P<0.05). The AUC of serum OPG, BSAP and FGF-23 were 0.853, 0.864 and 0.866 respectively. The AUC and specificity of the combined test in VC were significantly higher than that of the single test (P<0.05). Conclusion: The expression of serum OPG, BSAP and FGF-23 is closely related to VC in patients under hemodialysis. The combined detection is of great significance for the diagnosis and evaluation of VC. 2021 Vol. 27 (8): 1348-1352 [Abstract] ( 98 ) HTML (1 KB)  PDF (1319 KB)  ( 248 ) 1353 Influencing Factors of Emphysema and Radiation Pneumonia After Radiotherapy in Non-Small Cell Lung Cancer Patients MA SongKun, ZHANG Weilin, MA Zhiping, et al DOI: 10.3969/j.issn.1006-6233.2021.08.026 Objective: To explore the related factors of emphysema and radiation pneumonia after radiotherapy in patients with non-small cell lung cancer. Methods: From January 2012 to December 2018,166 patients with locally advanced non-small cell lung cancer (NSCLC) were diagnosed by pathology. Patients were divided into RP group (N=40) and NON-RP group (N=126) according to the occurrence of grade 2 radiation pneumonia (RP) 3 months after radiotherapy. The purpose of this study was to explore the related factors of radiation pneumonia after radiotherapy in patients with locally advanced non-small cell lung cancer, and analyze the correlation between emphysema and RP grades. Results: Multivariate Logistic regression analysis showed that emphysema, concurrent radiotherapy and chemotherapy, mean lung dose, CTV volume, and V5、V20、V30、V40 were related factors for RP after radiotherapy (P<0.05). Spearman correlation showed that emphysema grade was significantly positively correlated with RP grade of NSCLC patients (P<0.05). Conclusion: Emphysema, simultaneous radiotherapy and chemotherapy, mean lung dose, CTV volume, V5、V20、V30、V40 are related factors for ≥ grade 2 RP after radiotherapy in patients with local advanced stage. Clinical treatment of patients with local advanced stage should fully consider all factors and formulate reasonable radiotherapy plan to reduce the occurrence of RP. 2021 Vol. 27 (8): 1353-1358 [Abstract] ( 172 ) HTML (1 KB)  PDF (1838 KB)  ( 263 ) 1358 The Diagnosis Value of Urinary RBP Urinary L-FABP Serum FGF-21 and TGF-β in Combination for Early Diabetic Nephropathy MEI Xiaoxue, MA Yumin, ZHAO Yusong DOI: 10.3969/j.issn.1006-6233.2021.08.027 Objective: To analyze the value of urinary retinol binding protein (RBP), urinary liver-type fatty acid binding protein (L-FABP), blood fibroblast growth factor-21 (FGF-21) and transforming growth factor-β (TGF-β) in the diagnosis of early diabetic nephropathy (DN). Methods: The clinical data of 124 patients with type 2 diabetes mellitus treated in the hospital from January 2018 to January 2020 were retrospectively analyzed. The occurrence of DN in all patients was counted and divided into groups. Referred to the guidelines, the patients with DN were divided into different stages. Enzyme linked immunosorbent assay was used to analyze the levels of urinary RBP, urinary L-FABP, serum FGF-21 and TGF-β of patients. The levels of urinary RBP, urinary L-FABP, serum FGF-21 and TGF-β in the DN group and the non DN group were compared. The levels of urinary RBP, urinary L-FABP, serum FGF-21 and TGF-β of DN with different stages, the diagnostic efficacy of urinary RBP, urinary L-FABP, serum FGF-21 and TGF-β levels in patients with diabetes mellitus were analyzed. Results: Among 124 patients with type 2 diabetes mellitus, there were 35 patients with DN and 89 patients without DN; the levels of urinary RBP, urinary L-FABP, serum FGF-21 and TGF-β in DN group were all higher than those in non DN group, with a statistical significant difference (P<0.05); among the 35 cases of patients with DN, 12 cases were DN stage 1, 13 cases were DN stage 2 and 10 cases were DN stage 3; the levels of urinary RBP, urinary L-FABP, serum FGF-21 and TGF-β in DN stage 3 group respectively higher than those in DN stage 1 group and DN stage 2 group, with a statistical significant difference (P<0.05); comparing the levels of urinary RBP, urinary L-FABP, serum FGF-21 and TGF-β in DN stage 1 and 2 groups, there was no statistical significant difference (P>0.05); the area under the curve (AUC) of urinary RBP, urinary L-FABP, serum FGF-21, TGF-β alone and in combination of detection for the diagnosis of DN in patients with diabetes mellitus and the differentiation of DN stages were all >0.80, all with certain diagnostic and differential value. Conclusion: The combination of urinary RBP, urinary L-FABP, serum FGF-21 and TGF-β has high application value in the diagnosis of early DN, and can be used to differentiate the stages of DN. 2021 Vol. 27 (8): 1358-1363 [Abstract] ( 128 ) HTML (1 KB)  PDF (1310 KB)  ( 130 ) 1363 The Predictive Value of Diaphragmatic Ultrasound for Weaning from Mechanical Ventilation in Obese Patients ZHAO Yonghua, JIN Lizhen, YU Qiaoqing, et al DOI: 10.3969/j.issn.1006-6233.2021.08.028 Objective: To evaluate the performance of diaphragmatic excursion-time index to predict the outcome of extubation. Methods: This was a prospective observation study. Respiratory rate and tidal volume were recorded at the end of spontaneous breathing trial (SBT). Both M-Mode and B-Mode ultrasonography were used to assess the right diaphragmatic displacement. Meanwhile, duration of mechanical ventilation, length of stay in ICU and outcome of the weaning were recorded. The receiver operator characteristic curves were used to evaluate the diagnostic accuracy of diaphragmatic E-T index measured during a spontaneous breathing trial and changes between A/C and SBT in diaphragm excursion, TI, and diaphragmatic E-T index. Results: During SBT, DE, Ti,E-T index in the successful weaning group were higher than those in the weaning group (P<0.05), duration of mechanical ventilation was shorter than those in the failure weaning group(P<0.05). ΔDE,ΔTi andΔE-T index in the successful weaning group was statistically different from the failure weaning group (p<0.05). The area under the ROC curve of E-T index measured during a spontaneous breathing trial was 0.78(95%CI:0.59-0.96),the optimal thresholds were 1.02(cm·s)with a sensitivity of 75% and a specificity of 85%. The area under the ROC curve of E-T index during transition from A/C to SBT was 0.82(95%CI:0.68~0.92),the optimal thresholds were -0.20(cm·s)with a sensitivity of 87.5% and a specificity of 75%. Conclusion: Diaphragm E-T index measured during SBT may help predict the outcome of extubation increase in diaphragm E-T index between A/C and SBT increases the likelihood of successful extubation. 2021 Vol. 27 (8): 1363-1367 [Abstract] ( 93 ) HTML (1 KB)  PDF (1415 KB)  ( 163 ) 1367 Study on the Prognostic Value of Plasma (1-3)-β-D Glucan in AIDS Complicated with Cryptococcal Meningitis TU Wenyao, et al DOI: 10.3969/j.issn.1006-6233.2021.08.029 Objective: To study the value of plasma (1-3)-β-D glucan in evaluating the prognosis of acquired immune deficiency syndrome (AIDS) complicated with Cryptococcal meningitis (CM). Methods: The clinical data of 66 AIDS patients complicated with CM from January 1, 2015 to December 31, 2020 were analyzed retrospectively, and they were divided into survival group (56 cases) and death group (10 cases) according to their living conditions within one year. We collected the gender, age, route of transmission, clinical symptoms (headache, fever, vomiting and disturbance of consciousness), head imaging examination, laboratory examination at admission (CD4+T lymphocyte count, plasma HIV-RNA viral load, peripheral blood hemoglobin, peripheral white blood cell count, peripheral blood neutrophil count, C-reactive protein, ESR, procalcitonin, cerebrospinal fluid glucose, cerebrospinal fluid chloride and cerebrospinal fluid protein, cerebrospinal fluid culture, cerebrospinal fluid smear, culture of Cryptococcus in blood, plasma (1-3)-β-D glucan concentration) and the first plasma (1-3)-β after antifungal treatment. Multivariate Logistic regression analysis of death risk factors in AIDS patients complicated with CM. The value of receiver operating characteristic curve ROC in predicting the death of AIDS patients complicated with CM by analyzing plasma (1-3)-β-D glucan. Results: Univariate analysis showed that PCT, CD4+ lymphocyte and plasma (1-3)-β-D glucan concentration were the risk factors for death of AIDS patients with CM (P<0.05). Multivariate Logistic regression analysis showed that high concentration of plasma (1-3)-β-D glucan is an independent risk factor for death in patients with AIDS complicated with CM (P<0.05). ROC curve analysis showed that the area under the curve was the largest (0.787, 95%CI 0.665～0.910). when plasma (1-3)-β-d glucan was 65.63pg/ml before antifungal treatment, and its sensitivity and specificity were higher (90.0% and 76.8%, respectively) (P<0.05). Conclusion: Plasma (1-3) -β-D-glucan has a high value in evaluating the prognosis of patients with AIDS complicated with CM, and plasma (1-3) -β-D-glucan > 65.63pg/ml indicates a high risk of death. 2021 Vol. 27 (8): 1367-1372 [Abstract] ( 96 ) HTML (1 KB)  PDF (1339 KB)  ( 191 ) 1373 Application of Composite Transplantation of Allograft Dermal Matrix and Autologous Split-Thickness Skin in Treating Burn Scars OUYANG Wenjuan, CHEN Junchao DOI: 10.3969/j.issn.1006-6233.2021.08.030 Objective: To observe the application effect of composite transplantation of allograft dermal matrix (ADM) and autologous split-thickness skin in treating burn scars. Methods: Using random number table method, 42 patients with scar contracture after burn were divided into 2 groups. The observation group was treated with composite transplantation of ADM and autologous split-thickness skin, while the control group was treated with autologous split-thickness skin alone. The patients were followed up for 2 years to observe the survival rate of skin graft, recovery of transplanted skin, scar degree, postoperative range of motion and adverse reactions. Patient satisfaction was investigated. Results: The skin grafts in both groups survived, with a survival rate of 100%. There were no significant differences in skin color score (t=1.522, P=0.133) and sensory score (t=1.566, P=0.122) between the two groups (P>0.05). The scores of skin graft texture (t=10.916, P<0.05), flatness (t=7.817, P<0.05) and contracture (t=5.519, P<0.05) of the observation group were significantly lower than those of the control group (P<0.05). The scar degree of skin graft in the observation group was significantly milder than that in the control group (z=4.926, P=0.026). The range of motion of both groups recovered well (P>0.05). There were no significant differences in the incidences of pain (χ2=0.096, P=0.757) and itching (χ2=0.697, P=0.404) between the two groups. The satisfaction rate in the observation group was 90.91%, significantly higher than 50.00% in the control group (z=8.922, P=0.003). Conclusion: Applying composite transplantation of ADM and autologous split-thickness skin to treat burn scars can achieve better recovery effect of appearance, milder scar degree and good recovery of joint function, thereby improving patient satisfaction. 2021 Vol. 27 (8): 1373-1377 [Abstract] ( 99 ) HTML (1 KB)  PDF (2383 KB)  ( 237 ) 1377 The Metagenomic Next-Generation Sequencing Technology for Diagnosis of Tuberculosis: 4 Cases Report and Literature Review ZHANG Yijie DOI: 10.3969/j.issn.1006-6233.2021.08.031 Objective: To evaluate the value of metagenomic next generation sequencing (mNGS) in the diagnosis of tuberculosis. Methods: 4 suspected tuberculosis patients were collected, and their alveolar lavage fluid (BALF) or pleural effusion were detected by mNGS. Chinese and English literatures from Wanfang, CNKI and PubMed databases were searched and analyzed. Results: 2 of the 4 patients with pleural effusion mNGS indicated Mycobacterium tuberculosis (MTB) and MTB complex, clinically diagnosed as tuberculous pleurisy. BALF acid-fast staining was positive in 2 patients, and the result of BALF mNGS indicated MTB complex group, which confirmed the diagnosis of pulmonary tuberculosis. A total of 154 literatures in Chinese and English were searched to provide mNGS, traditional culture, and GeneXpert MTB/RIF (Xpert) detection data as inclusion criteria. Finally, a total of 453 patients diagnosed with MTB infection were included. Conclusion: mNGS is more sensitive to the diagnosis of MTB infection than Xpert and traditional culture. Combined application can significantly improve the sensitivity of tuberculosis detection. 2021 Vol. 27 (8): 1377-1382 [Abstract] ( 394 ) HTML (1 KB)  PDF (3809 KB)  ( 543 ) 1383 Efficacy of Loratadine Combined with Levocetirizine in the Treatment of Chronic Refractory Urticaria in Children and Its Effects on Levels of Serum IgE and IFN-γ LIAO Xueli, ZHU Canyang, MAI Biwei, et al DOI: 10.3969/j.issn.1006-6233.2021.08.032 Objective: To investigate the efficacy of loratadine combined with levocetirizine in the treatment of chronic refractory urticarial (CRU) in children and its effects on levels of serum IgE and IFN-γ. Methods: A total of 151 children patients with CRU who were treated in the hospital between January 2018 and January 2021 were selected as observation subjects. According to the simple randomization of the random number table method, the patients were divided into mono-drug group (75 cases) and combined drug group (76 cases). The children patients in mono-drug group were administered levocetirizine oral liquid, and the children patients in combined drug group were treated with loratadine combined with levocetirizine. The clinical efficacy, clinical symptoms scores, T lymphocyte subsets(CD3+,CD4+,CD8+and CD4+/CD8+), immunoglobulin E(IgE)and serum cytokines[interleukin-4(IL-4), interleukin-13(IL-13), interferon-γ(IFN-γ)]were compared between the two groups of children patients after treatment, and the adverse reactions rates were statistically analyzed in the two groups. Results: After treatment, the total effective rate of children in combined group was significantly higher than that in mono-drug group (93.42%vs 81.33%)(P<0.05). The scores of various clinical symptoms and total score of the two groups of children were significantly decreased compared with those before treatment, and the decreases in combined drug group were greater than those in mono-drug group (P<0.05). The CD3+ and CD8+ in the two groups were significantly increased compared to before treatment, and the increases were greater in combined drug group compared to mono-drug group (P<0.05). The CD4+ and CD4+/CD8+ were significantly reduced compared to before treatment, and the reductions were greater in combined drug group than those in mono-drug group (P<0.05). The levels of IgE,IL-4 and IL-13 in the two groups were significantly lower than those before treatment, and compared with mono-drug group, the decreases in combined drug group were greater (P<0.05). The level of IFN-γ was significantly higher than that before treatment, and the increase in combined drug group was higher than that in mono-drug group(P<0.05).The total incidence rate of adverse reactions was 9.21%in combined drug group and was 14.67% in mono-drug group, and the difference in adverse reaction rate between two groups was not statistically significant(P>0.05). Conclusion: Loratadine combined with levocetirizine has a significant clinical efficacy in the treatment of CRU in children, and it can improve the clinical symptoms and immune function disorders, and has medication safety. 2021 Vol. 27 (8): 1383-1389 [Abstract] ( 219 ) HTML (1 KB)  PDF (1224 KB)  ( 370 ) 1389 Efficacy of Omeprazole Sodium Combined with Cimetidine in the Treatment of Elderly Peptic Ulcers and Its Effects on Levels of Serum Ghrelin and Leptin HUANG Lina, XU Shuhui, ZHONG Shaojin, et al DOI: 10.3969/j.issn.1006-6233.2021.08.033 Objective: To explore the efficacy of omeprazole sodium combined with cimetidine in the treatment of elderly peptic ulcers and its effects on levels of serum growth hormone releasing polypeptide (Ghrelin) and Leptin of patients. Methods: The elderly patients with peptic ulcer admitted to our hospital from April 2018 to January 2020 were numbered, and 146 cases were randomly selected by computer and divided into the combined group and the control group, 73 cases in each, according to the random number table method. Control group was treated with cimetidine sodium, and combined group was additionally administered omeprazole on the basis of control group. The efficacy after 3 weeks of treatment, symptom relief time, levels of gastrointestinal function [Leptin, gastrin, growth hormone releasing polypeptide (Ghrelin), motilin] and serum biochemical indicators [serum interleukin 6 (IL-6), high-sensitivity C-reaction protein (hs-CRP), superoxide dismutase (SOD), vascular endothelial growth factor (VEGF)] before and after treatment, adverse reactions and recurrence rates were compared between the two groups. Results: After treatment, the clinical efficacy of combined group was significantly better than that of control group (P<0.05). The hematochezia time, hematemesis time and melena disappearance time of combined group were shorter than those of control group while the Hp eradication rate was higher than that in control group (P<0.05), and there was no statistically significant difference in hospital stay between the two groups (P>0.05). After 3 weeks treatment, the levels of serum Leptin and gastrin in the two groups were significantly reduced (P<0.05) while the levels of Ghrelin and motilin were significantly increased (P<0.05), and the levels of serum IL-6 and hs-CRP were significantly decreased (P<0.05) while the levels of SOD and VEGF were significantly increased (P<0.05), and there were significant differences in the above indexes between the groups after treatment (P<0.05). During treatment, the incidence rate of adverse reactions was 5.48% in combined group and was 8.22% in control group, and there was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05). Within 6 months of follow-up after treatment, there were 2 cases of recurrence in combined group, the incidence rate was 2.74%, and there were 8 cases in control group, the incidence rate was 10.96%(P<0.05). Conclusion: Omeprazole sodium combined with cimetidine can significantly improve the clinical efficacy of elderly peptic ulcers, reduce serum inflammation and improve gastric function, with fewer adverse reactions and a lower recurrence rate. 2021 Vol. 27 (8): 1389-1394 [Abstract] ( 278 ) HTML (1 KB)  PDF (1214 KB)  ( 208 ) 1394 Efficacy of Peg-IFNα-2a Combined with ADV on Hepatitis B Virus E Antigen-Positive Chronic Hepatitis B with High Viral Load ZHOU Juan, ZHANG Wenfang DOI: 10.3969/j.issn.1006-6233.2021.08.034 Objective: To explore the efficacy of Peg-interferon α-2a (Peg-IFNα-2a) combined with adefovir dipivoxil (ADV) on HbeAg-positive chronic hepatitis B patients with high viral load. Methods: 132 cases of HbeAg-positive chronic hepatitis B patients with high viral load were randomly divided into interferon group, ADV group and combined group, with 44 cases in each group. Interferon group was administered Peg-IFNα-2a, and ADV group was administered ADV, and combined group was firstly treated with ADV to control the reduction of viral load, and then Peg-IFNα-2a was administered additionally. Hepatitis B virus marker conversion, serological marker conversion, virological and serological response after 48 w of treatment, levels of serum interferon-γ (INF-γ) and interleukin-10 (IL-10) before treatment and after 48 w of treatment were observed among the three groups. Results: The alanine aminotransferase (ALT) reversion rate, HBV-DNA negative conversion rate and HBsAg negative conversion rate in combined group were significantly higher than those in interferon group and ADV group (P<0.0167), and the HBeAg seroconversion rate was significantly higher than that in ADV group (P<0.0167), and the differences among the three groups were statistically significant (P<0.0167). The complete virological response rate in combined group was significantly higher than that in interferon group and ADV group (P<0.0167) while the non-response rate was significantly lower than that in interferon group and ADV group (P<0.0167), and there were statistically significant differences among the three groups in the improvement of virological and serological response (P<0.05). After treatment, the INF-γ level in the three groups was significantly increased (P<0.05) while the IL-10 level was significantly decreased (P<0.05), and the changes in combined group were significantly greater than those in interferon group and ADV group (P<0.05). There were no statistically significant differences in the incidence rates of influenza-like symptoms, insomnia, alopecia, neutropenia and platelet count reduction between combined group and interferon group (P>0.0167), and the incidence rates were significantly higher than those in ADV group (P<0.0167). Conclusion: Peg-IFNα-2a combined with ADV for HbeAg-positive chronic hepatitis B patients with high viral load can improve ALT reversion rate, HBV-DNA negative conversion rate, HBsAg negative conversion rate and HBeAg seroconversion rate, and it is conducive to inhibiting viral replication capacity and virological and serological response rates, thus it can be safely promoted in the clinical practice. 2021 Vol. 27 (8): 1394-1399 [Abstract] ( 130 ) HTML (1 KB)  PDF (1221 KB)  ( 184 ) 1399 Efficacy of Acetylcysteine Inhalation Combined with Tiotropium Inhalation in the Treatment of Acute Exacerbation of COPD and Its Influence on Oxidative Stress Factors and Inflammatory Factors KUANG Xiangdong, CAI linzai, XIE Jingchen, et al DOI: 10.3969/j.issn.1006-6233.2021.08.035 Objective: To explore the effect of acetylcysteine inhalation combined with tiotropium inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) and its influence on oxidative stress factors and inflammatory factors. Methods: A total of 163 patients with acute exacerbation of COPD between January 2019 and January 2021 were enrolled as the research subjects, and they were divided into two groups based on nonrandomized clinical concurrent control study. Among them, 92 cases in the observation group were administered acetylcysteine inhalation combined with tiotropium inhalation, and 71 cases in the control group were treated with tiotropium inhalation. The clinical efficacy after 2 weeks’ treatment, as well as lung function [forced expiratory volume in the first second (FEV1), peak expiratory flow (PEF), expiratory flow rate at 50% vital capacity (PEF50), total lung capacity (TLC)], arterial blood gas indexes [oxygen saturation (SaO2), partial pressure of blood oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), PH], serum oxidative stress indicators [malondialdehyde (MDA),superoxide dismutase (SOD), nitric oxide (NO)] and inflammatory factors [procalcitonin (PCT),hypersensitive C-reactive protein (hs-CRP)] before treatment and after 2 weeks’ treatment were compared between the two groups. Results: After 2 weeks’ treatment, the total clinical effective rate of observation group was higher than that of control group (P<0.05). The FEV1, PEF, PEF50 and TLC of the two groups were improved compared with those before treatment, and the changes of observation group were greater than those of control group (P<0.05). The SaO2, PaO2 and PH of the two groups were increased while the PaCO2 was decreased compared to before treatment, and the changes were greater in observation group compared to control group (P<0.05). The level of serum SOD of the two groups was higher than that before treatment while the levels of MDA and NO were lower than those before treatment, and the changes of observation group were greater compared with those of control group (P<0.05). The levels of serum hs-CRP and PCT in the two groups were lower than those before treatment, and the changes were greater in observation group than those in control group (P<0.05). Conclusion: Acetylcysteine inhalation combined with tiotropium inhalation in the treatment of acute exacerbation of COPD can enhance the efficacy, with anti-inflammatory and antioxidant effects. 2021 Vol. 27 (8): 1399-1405 [Abstract] ( 145 ) HTML (1 KB)  PDF (1219 KB)  ( 188 )

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