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2021 Vol. 27, No. 12 Published: 2021-12-30 1937 Effects of LncRNA H19 on Proliferation Invasion and Radiotherapy Sensitivity of Glioma T98G Cells Through MiR-370-3p/RAF1 Axis and the Mechanism XU Hua, et al DOI: 10.3969/j.issn.1006-6233.2021.12.001 Objective: To analyze the effects of lncRNA H19 on proliferation, invasion and radiotherapy sensitivity of brain glioma T98G cells and its mechanism. Methods: The differential expressions of lncRNA H19, miR-370-3p and RAF1 in glioma tissues and adjacent tissues were detected by real-time fluorescence quantitative PCR. The expression levels of lncRNA H19, miR-370-3p and RAF1 were detected after T98G cells were irradiated with X-ray (0, 2, 4, 6 Gy). T98G cells were transfected with H19 siRNA, miR-370-3p inhibitor and RAF1 siRNA plasmid, respectively, after 6 Gy X-ray irradiation, the effects of down-regulation of H19, miR-370-3p and RAF1 on the proliferation, invasion and apoptosis of T98G cells were detected by CCK-8, Transwell and flow cytometry, respectively. The target and correlation between lncRNA H19 and miR-370-3p, miR-370-3p and RAF1 were analyzed by miRcode, TargetScan and dual luciferase reporter gene assay. The effects of upregulated lncRNA H19 on the proliferation, invasion and radiotherapy sensitivity of T98G cells via miR-370-3p were examined. RT-qPCR and Western blot were used to detect the effect of lncRNA H19 on the expression of RAF1 via miR-370-3p. Results: The expressions of lncRNA H19 and RAF1 in glioma tissues were up-regulated (P<0.01), and the expression of miR-370-3p was down-regulated (P<0.01). The expressions of lncRNA H19 and RAF1 decreased after radiation in a dose dependent manner. The expression of miR-370-3p increased after radiation in a dose dependent manner. Downregulation of lncRNA H19 or RAF1 inhibited proliferation and invasion of T98G cells and enhanced radiotherapy sensitivity. LncRNA H19 targeted miR-370-3p and miR-370-3p targeted RAF1. Downregulation of miR-370-3p promoted the proliferation and invasion of T98G cells, and reduced the radiotherapy sensitivity. The up-regulation of lncRNA H19 promoted the proliferation and invasion of T98G cells through miR-370-3p, and reduced the radiotherapy sensitivity. Conclusion: LncRNA H19 regulated the proliferation, invasion and radiotherapy sensitivity of T98G cells through miR-370-3p/RAF1 axis. 2021 Vol. 27 (12): 1937-1942 [Abstract] ( 185 ) HTML (1 KB)  PDF (2334 KB)  ( 205 ) 1943 COX-2/PGE2 Activates the JAK/STAT3 Signaling Pathway to Regulate the Proliferation Invasion and Metastasis of KB Cells in Human Oral Cancer ZHOU Tao, QIAN Yong, LIU Weisong, et al DOI: 10.3969/j.issn.1006-6233.2021.12.002 Objective: To investigate the expression of COX-2 in human oral cancer KB cells and its mechanism of regulating the proliferation, invasion and metastasis of cancer cells. Methods:The differential expression of COX-2 in human oral cancer and adjacent normal tissues, human oral cancer KB cells and human oral epithelial HIOEC cells were detected by qRT-PCR and Western blot. The KB cell line with high COX-2 expression was established by lentivirus transfection or COX2 inhibitor (celecoxib) was added, the expression levels of COX-2 in KB cell lines were detected by RT-qPCR and Western blot, CCK-8 assay was used to detect cell proliferation, Transwell assay was used to detect cell invasion, and Western blot was used to analyze the expression of EMT-related proteins in cells,PGE2 content in cell culture medium was detected by ELISA, and the expression levels of JAK, P-JAK, STAT3 and P-STAT3 proteins were detected by Western blot. Proliferation, invasion, and EMT of KB cells were measured after PGE2 receptor PTGER2 inhibitor (AH6809)or JAK/STAT3 pathway inhibitor (AG490) acted on KB cell lines. Results:The expression of COX-2 in human oral cancer tissues was significantly higher than that in adjacent normal tissues(P<0.05). Compared with HIOEC cells, the expression of COX-2 in KB cells was significantly increased (P<0.01). KB cell lines with high COX-2 expression were successfully constructed. Overexpression of COX-2 promoted proliferation, invasion and EMT of KB cells, significantly increased the expression of p-JAK and p-STAT3 proteins, and up-regulated the expression of PGE2 in cell culture medium. AH6809 or AG490 could significantly inhibit the proliferation, invasion and EMT of KB cells. Conclusion:COX-2/PGE2 activates the JAK/STAT3 signaling pathway to promote the proliferation, invasion and EMT of KB cells in human oral cancer. 2021 Vol. 27 (12): 1943-1947 [Abstract] ( 264 ) HTML (1 KB)  PDF (1768 KB)  ( 707 ) 1948 Gastric Cancer Exosomal lncRNA CASC11 Regulates the TLR4/NF-κB Pathway to Induce Polarization of M2 Macrophages ZHOU Anfu, TAN Yan, et al DOI: 10.3969/j.issn.1006-6233.2021.12.003 Objective: To explore the effect and mechanism of gastric cancer exosomal lncRNA CASC11 on the polarization of M2 macrophages. Methods: Human monocyte THP-1 was added to PMA to induce differentiation into M0 macrophages, M0 macrophages and gastric cancer cells MGC-803 were transfected with blank plasmids (Vector group) and lncRNA CASC11 overexpression plasmids (lncRNA CASC11) Group). The expression of iNOS, CD16, CD206, Arg-1, Ym1, TNF-α, IL-1β, TGF-β and IL-10 mRNA in macrophages was detected by qRT-PCR. Proportion of CD206+CD14+ cells was detected by flow cytometry. Extract the exosomes secreted by human gastric mucosal cells GES-1, human gastric cancer cell lines MGC-803, SGC7901, MKN45, and MGC803 cells in Vector and lncRNA CASC11 group (GES-1 exo, MGC-803 exo, MKN45 exo, SGC7901 exo, Vector exo, CASC11exo), qRT-PCR was used to detect the expression of lncRNA CASC11 in GES-1, MGC-803, SGC7901, MKN45 cells, transfected MGC-803 cells and their exosomes. M0 macrophages was co-incubated with PBS, GES-1 exo, MGC-803 exo, MKN45 exo, SGC7901 exo, Vector exo, CASC11exo, qRT-PCR was used to detect the expression of lncRNA CASC11, iNOS, CD16, CD206, Arg-1, Ym1, TNF-α, IL-1β, TGF-β and IL-10, and the proportion of CD206+CD14+ cells. Western blot was used to detect the expression of TLR4 and the level of NF-κB phosphorylation. Results: lncRNA CASC11 is highly expressed in gastric cancer cells and their exosomes. Compared with the Vector group, in the lncRNA CASC11 group, the expressions of iNOS, CD16, TNF-α and IL-1β were significantly down-regulated, and the expressions of CD206, Arg-1, Ym1, TGF-β and IL-10 were significantly up-regulated, and the proportion of CD206+ CD14+ cells has increased significantly. Compared with the PBS group, the expressions of iNOS, CD16, TNF-α and IL-1β in macrophages of MGC-803 exo, MKN45 exo and SGC7901 exo groups were significantly down-regulated, lncRNA CASC11, CD206, Arg-1, Ym1, TGF-β and IL-10 expression was significantly up-regulated, the proportion of CD206+ CD14+ cells was significantly increased, and TLR4 expression and NF-κB phosphorylation levels were significantly reduced. Compared with Vector exo, the expression of lncRNA CASC11 in CASC11 exo was significantly increased. Compared with the Vector exo group, the expression of iNOS, CD16, TNF-α and IL-1β in the macrophages of the CASC11 exo group was significantly down-regulated, and the expression of lncRNA CASC11, CD206, Arg-1, Ym1, TGF-β and IL-10 were significantly up-regulated, the proportion of CD206+CD14+ cells was significantly increased, and the expression of TLR4 and NF-κB phosphorylation levels were significantly reduced. Conclusion: Gastric cancer exosomal lncRNA CASC11 inhibits the TLR4/NF-κB signaling pathway and induces polarization of M2 macrophages. 2021 Vol. 27 (12): 1948-1956 [Abstract] ( 172 ) HTML (1 KB)  PDF (1894 KB)  ( 459 ) 1957 The Expressions of MiR-27a and MiR-625 in Serum of Patients with Hepatitis B and Their Correlations with Liver Cirrhosis and Liver Cancer WU Pan, LIU Chengmin, YE Zhiyao, et al DOI: 10.3969/j.issn.1006-6233.2021.12.004 Objective: To investigate the expression levels of microRNA-27a (miR-27a) and microRNA-625 (miR-625) in serum of patients with hepatitis B and their correlations with liver cirrhosis and liver cancer. Methods: From November 2019 to February 2021, 67 patients with chronic hepatitis B were selected as hepatitis B group, 63 patients with post hepatitis B cirrhosis as cirrhosis group, 65 patients with post hepatitis B liver cancer as liver cancer group in department of gastroenterology, the Third Affiliated Hospital of Chengdu Medical College, and 65 healthy people as control group. The levels of serum miR-27a and miR-625 were detected by real-time fluorescent quantitative PCR; and multivariate Logistic regression analysis was used to analyze the factors influencing the occurrences of cirrhosis and liver cancer after hepatitis B; and receiver operating characteristic curve was used to evaluate the value of serum miR-27a, miR-625 levels predicting the occurrences of cirrhosis and liver cancer after hepatitis B. Results: The levels of miR-27a in control group, hepatitis B group, liver cirrhosis group and liver cancer group were increased in turn, while the levels of miR-625 were decreased in turn (P<0.05). Serum miR-27a level was an independent risk factor for the occurrence of liver cirrhosis and liver cancer after hepatitis B (P<0.05), serum miR-625 level was a protective factor for the occurrence of liver cirrhosis and liver cancer after hepatitis B (P<0.05). The area under the curve (AUC) of serum miR-27a, miR-625 and their combination in predicting the occurrence of liver cirrhosis after hepatitis B were 0.708 (95% CI: 0.620~0.797), 0.761 (95% CI: 0.680~0.843) and 0.815 (95% CI: 0.743~0.888), respectively. The sensitivity was 73.02%, 68.25% and 65.08%, and the specificity was 61.19%, 73.13% and 85.07%, respectively. The AUC of serum miR-27a, miR-625 and their combination in predicting HCC after hepatitis B were 0.870 (95% CI: 0.812~0.929), 0.913 (95% CI: 0.864~0.963) and 0.966 (95% CI: 0.938~0.993), respectively, with sensitivity of 79.23%, 76.92% and 73.64%, specificity of 66.57%, 72.54% and 89.55%, respectively. Conclusion: The expression of miR-27a in serum of patients with hepatitis B is up-regulated, the expression of miR-625 is down-regulated, and they are the independent risk factor and protective factor that affect the progression of hepatitis B to cirrhosis and liver cancer, which have certain predictive value for the occurrence of liver cirrhosis and liver cancer after hepatitis B. 2021 Vol. 27 (12): 1957-1961 [Abstract] ( 146 ) HTML (1 KB)  PDF (1303 KB)  ( 119 ) 1962 Changes of Serum Cholinesterase Serum Albumin and Prothrombin Time in Elderly Patients with Liver Cirrhosis and Their Relationship with Child-Pugh Classification DONG Jing, DUAN Yajie DOI: 10.3969/j.issn.1006-6233.2021.12.005 Objective: To observe the changes of serum cholinesterase (Che), serum albumin (Alb) and prothrombin time (PT) in elderly patients with liver cirrhosis, and research their relationship with Child-Pugh classification. Methods: A total of 120 elderly patients with liver cirrhosis admitted to the hospital from May 2017 to May 2020 were selected as the study group. The patients were divided into grade A (43 cases), grade B (38 cases), and grade C (39 cases) . Meanwhile, 50 healthy controls were made the control group. Changes of serum Che, Alb, coagulation function-related indicators PT, activated partial thromboplastin time (APTT) and thrombin time (TT) were determined. Pearson correlation analysis was performed to analyze the relationship between the above indicators and Child-Pugh classification. Results: Serum Che and Alb levels in the study group were significantly lower than those in the control group (P<0.05), while coagulation function indicators, PT, APTT and TT were significantly longer than those in the control group (P<0.05). As the Child-Pugh grade of liver cirrhosis increased, the levels of Che and Alb decreased. Pairwise comparison of different Child-Pugh grades of liver cirrhosis showed statistically significant differences (P<0.05). PT, APTT and TT were prolonged as the Child-Pugh grade of liver cirrhosis increased. Pairwise comparison showed that the differences were statistically significant (P<0.05). Spearman correlation analysis found that Che and Alb were negatively correlated with Child-Pugh classification (P<0.05), while PT, APTT and TT were positively correlated with Child-Pugh classification (P<0.05). Conclusion: The improvement of Child-Pugh grade in patients with cirrhosis, serum Che and Alb levels were decreased, while PT, APTT and TT increase.The above indicators were all related to the severity of liver cirrhosis. Therefore, the detection of the above indicators in clinic has a certain positive significance for the assessment of the condition of patients with liver cirrhosis, the formulation of diagnosis and treatment plan and the judgment of prognosis. 2021 Vol. 27 (12): 1962-1964 [Abstract] ( 183 ) HTML (1 KB)  PDF (1196 KB)  ( 267 ) 1965 Expression Value of ADMA and DDAH2 in Early Onset Severe Preeclampsia WANG Yu, ZHOU Dujuan, HUANG Yan, et al DOI: 10.3969/j.issn.1006-6233.2021.12.006 Objective: To observe the expression levels of asymmetric dimethylarginine (ADMA) and dimethylarginine dimethylamine hydrolase (DDAH) in serum and placenta of patients with severe preeclampsia, and the correlation between ADMA and DDAH. Methods: 62 patients with severe preeclampsia admitted to Suzhou Hospital Affiliated to Anhui Medical University from January 2017 to October 2020 were prospectively selected as the research subjects, including 32 cases of early-onset severe preeclampsia and 30 cases of late-onset severe preeclampsia. 30 healthy pregnant women in our hospital during the same period were selected as the control group. The serum ADMA and ddah2 expression levels and placental ADMA and ddah2 expression levels of the three groups were detected. The correlation between the expression of ADMA and ddah2 in serum was analyzed. Results: The level of serum ADMA in early-onset severe preeclampsia group was significantly higher than that in late-onset severe preeclampsia group and control group, and the level of serum ddah2 was lower than that in late-onset severe preeclampsia group and control group, with statistical significance (P<0.05); the positive expression rate of ADMA in placental tissue in early-onset severe preeclampsia group (93.75%) was significantly higher than that in late-onset severe preeclampsia group (66.67%) and control group (P<0.05) .The positive expression rate of ddah2 in placenta (37.50%) was significantly lower than that in late-onset severe preeclampsia group (66.67%) and control group (80.00%) (P<0.05). Pearson correlation coefficient analysis showed that serum ADMA level was negatively correlated with ddah2 in early-onset and late-onset severe preeclampsia (r=-0.71,-0.77,P<0.05). Conclusion: Compared with normal pregnant women and late-onset preeclampsia pregnant women, early-onset severe preeclampsia patients showed high expression of ADMA and low expression of ddah2. Both of them were involved in the formation and development of early-onset severe preeclampsia, which should be paid attention to. 2021 Vol. 27 (12): 1965-1968 [Abstract] ( 110 ) HTML (1 KB)  PDF (1224 KB)  ( 159 ) 1969 The Relationship Between C242T Gene Polymorphism and Coronary Heart Disease MAO Shan, ZHOU Ming, WANG Junfeng, et al DOI: 10.3969/j.issn.1006-6233.2021.12.007 Objective: To explore and analyze the correlation between C242T gene polymorphism and coronary heart disease. Methods: A total of 79 patients with coronary heart disease admitted to our hospital from October 2019 to October 2020 were selected as the observation group, and another 96 cases with no coronary heart disease were made the control group. All the enrolled subjects underwent detection of C242T gene polymorphism (gene subtype and allele frequency) with the American OMEGA gene extraction reagent Box. The general data of the two groups of research subjects were compared, and the frequency distribution of different subtypes and alleles in the C242T gene were compared, and the correlation between the C242T gene and coronary heart disease was analyzed by Logistic regression. Results: The incidence of history of hypertension and diabetes in the observation group was higher than that of the control group, and the levels of TG, TC, HDL-C, Hs-CRP, BNP, HCY, LP(a), WBC and other indicators were higher than those of the control group (P<0.05) ; the frequency distribution of TT type, CT type gene and T allele frequency in the C242T gene of the observation group were significantly higher than those of the control group (P<0.05);the level of HDL-C in patients with TT+CT gene carriers was significantly lower than that in patients with CC gene carriers (P<0.05), while there was no significant difference in the levels of other blood lipid indexes among patients with different genotypes (P＞0.05) ;logistic regression analysis was performed on the relevant factors with statistical differences, and the results showed, diabetes (OR=1.422, 95%CI: 1.164～1.737), HDL-C (OR=1.534, 95%CI: 1.011～2.329), HCY (OR=1.241, 95%CI) ：1.159～1.329), carrying T-type gene (OR=1.265, 95%CI: 1.151～1.390) are independent risk factors for coronary heart disease (P<0.05). Conclusion: The TT and CC genotypes in the C242T gene are related to the occurrence of coronary heart disease. TT and CC types are distributed more frequently in patients with coronary heart disease, and T-type gene carriers are at higher risk of coronary heart disease, which can provide clinical diagnosis and prevention and treatment. Guidance basis. 2021 Vol. 27 (12): 1969-1973 [Abstract] ( 99 ) HTML (1 KB)  PDF (1237 KB)  ( 326 ) 1974 The Role of LFA-1 in the Neutrophilic Inflammatory Response of Chronic Obstructive Pulmonary Disease LIN Yuting, LI Weijian, HUANG Peikai DOI: 10.3969/j.issn.1006-6233.2021.12.008 Objective: To investigate the expression of lymphocyte function-associated antigen-1 (LFA-1) in chronic obstructive pulmonary disease (COPD) neutrophilic inflammation and its clinical significance. Methods: A total of 40 patients with acute exacerbation of COPD (AECOPD) who were in the Huizhou Central People's Hospital from January 2019 to December 2020 were made the AECOPD group, another 40 patients with stable COPD were made the stable COPD group, and 20 healthy volunteers served as a control group. Comparison was conducted among groups on LFA-1 with neutrophilic factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), inflammatory Protein thymic stromal lymphopoietin (TSLP), high mobility group protein 1 (HMGB1)] and their correlations, and different clinical characteristics of LFA-1 levels and their independent influencing factors were analyzed. Results: Comparison of the levels of LFA-1, TNF-α, IL-6, IL-8, TSLP and HMGB1 in the three groups: AECOPD group>COPD stable>control group, all were statistically significant (P<0.05). According to Pearson analysis, LFA-1 is not correlated with TNF-α, TSLP, HMGB1 (P>0.05), and LFA-1 is positively correlated with IL-6, IL-8 (P<0.05). According to univariate analysis, smoking, chronic obstructive pulmonary disease assessment test (CAT) score, modified version of British Medical Research Council respiratory questionnaire (mMRC) classification, Global Initiative for Chronic Obstructive Lung Diseas (GOLD) classification are the factors that affect LFA-1 levels (P<0.05); After multiple linear regression analysis, smoking, CAT score, mMRC classification, and GOLD are independent risk factors that affect LFA-1 levels(P<0.05). Conclusion: COPD patients have high expression of LFA-1 and neutrophilic factors, and AECOPD is higher than that of patients with stable COPD. COPD patients LFA-1 and LFA-1 are related to neutrophilic factors. Smoking, CAT score ≥10, mMRC grade ≥ 2, GOLD grade ≥2 are the reasons for the high level of LFA-1. 2021 Vol. 27 (12): 1974-1978 [Abstract] ( 141 ) HTML (1 KB)  PDF (1243 KB)  ( 174 ) 1979 Correlation Between Serum Parathyroid Hormone 25-Hydroxyvitamin D Bone Metabolism Markers and Bone Mineral Density in Patients with Postmenopausal Osteoporosis XIE Shuyong, et al DOI: 10.3969/j.issn.1006-6233.2021.12.009 Objective: To investigate the correlation between levels of serum parathyroid hormone (PTH), 25-hydroxyvitamin D [25(OH)D3] and bone metabolism markers and bone mineral density in patients with postmenopausal osteoporosis. Methods: 108 patients with postmenopausal osteoporosis admitted to the hospital between July 2019 and June 2021 were selected as observation group, and another 108 normal menopausal women undergoing physical examination during the same period were included in control group. The levels of PTH, 25(OH)D3 and bone metabolism markers were detected between observation group and control group, and their correlation with bone mineral density was analyzed. Results: Comparison of levels of PTH and 25(OH)D3 showed that compared with control group, there was no statistical significance in the level of PTH in observation group (P>0.05), and the level of 25(OH)D3 was lower (P<0.01). In terms of levels of bone metabolism markers in the two groups, the levels of N-terminal propeptide of type I procollagen, β-cross-linked C-terminal telopeptide of type I collagen, bone alkaline phosphatase, and osteocalcin were higher in observation group than those in control group (P<0.01). Comparison of bone mineral densities of different parts showed that the bone mineral densities of total hip bone, femoral neck and lumbar L1-4 in observation group were lower compared to control group (P<0.01). The bone mineral density of patients with postmenopausal osteoporosis was positively correlated with parathyroid hormone and 25-hydroxyvitamin D (P<0.01), and was negatively correlated with age, N-terminal propeptide of type I procollagen, β-cross-linked C-terminal telopeptide of type I collagen, bone alkaline phosphatase and osteocalcin (P<0.01). Conclusion: The bone mineral density in patients with postmenopausal osteoporosis is related to serum 25-hydroxyvitamin D and bone metabolism markers. 2021 Vol. 27 (12): 1979-1982 [Abstract] ( 128 ) HTML (1 KB)  PDF (1212 KB)  ( 241 ) 1983 Correlation Between Serum Hcy, PCT, HCT Levels and Severity of Intestinal Mucosal Injury in Patients with Severe Acute Pancreatitis ZHAO Bing, LIU Wei, LIU Dan DOI: 10.3969/j.issn.1006-6233.2021.12.010 Objective: To study the correlation between serum homocysteine (Hcy), procalcitonin (PCT), hematocrit (HCT) levels and severity of intestinal mucosal injury in patients with severe acute pancreatitis (SAP). Methods: A total of 152 patients (SAP group) with SAP treated in the hospital were enrolled for retrospective analysis between March 2018 and April 2021. According to presence or absence of intestinal mucosal injury, they were divided into injury group (110 cases) and non-injury group (42 cases). Other 92 healthy volunteers undergoing physical examination during the same period were enrolled as control group. The levels of serum Hcy, PCT and HCT were detected and compared among all groups. The predictive value of the above indexes for intestinal mucosal injury, and their relationship with severity of intestinal mucosal injury were analyzed. Results: The levels of serum Hcy, PCT and HCT in SAP group were significantly higher than those in control group, which were significantly higher in injury group than in non-injury group (P<0.05). AUC value and sensitivity of serum Hcy combined with PCT and HCT for predicting intestinal mucosal injury were significantly higher than those of single index (P<0.05). With the aggravation of intestinal mucosal injury, levels of serum Hcy, PCT and HCT were gradually increased (P<0.05). The levels of serum Hcy, PCT and HCT were positively correlated with the severity of intestinal mucosal injury in SAP patients (P<0.05). Conclusion: There are abnormal changes in serum Hcy, PCT and HCT levels in SAP patients. The detection of the above indexes is not only conducive to predicting the occurrence of intestinal mucosal injury, but also can better reflect the severity of intestinal mucosal injury. 2021 Vol. 27 (12): 1983-1986 [Abstract] ( 118 ) HTML (1 KB)  PDF (1255 KB)  ( 120 ) 1987 Expression Analysis of VTRNA2-1 in Peripheral Blood T Lymphocytes of Patients with Atopic Dermatitis WAN Mengjie, WANG Wei, FAN Xiuhong DOI: 10.3969/j.issn.1006-6233.2021.12.011 Objective: To investigate the expression characteristics of fornix ribonucleic acid 2-1 (VTRNA2-1) in peripheral blood T lymphocytes of patients with Atopic Dermatitis (AD) and its clinical significance. Methods: AD patients (AD group, 50 cases) and healthy controls (control group, 30 cases) admitted to the dermatology department of our hospital from January 2018 to December 2020 were selected as the research subjects. AD patients were divided according to the dermatitis score index (SCORAD) into mild AD group, moderate AD group, and severe AD group. Peripheral blood of all patients was collected to isolate CD4+ T lymphocytes, detect the expression of VTRNA2-1 gene in CD4+ T lymphocytes by real-time fluorescent quantitative PCR, and compare the differences of VTRNA2-1 levels between each group; Western blot and immunoprecipitation experiments were used to analyze the level of VTRNA2-1 protein and its direct-acting proteins. Results: The expression level of VTRNA2-1 gene in CD4+ T lymphocytes of patients in AD group was significantly higher than that in control group (P<0.05); the level of VTRNA2-1 in the mild AD group and the moderate AD group was significantly lower than that of the severe AD group, while the VTRNA2-1 level of the mild AD group was significantly lower than that of the moderate AD group (P<0.05); VTRNA2-1 gene expression level was significantly positively correlated with SCORAD score (r=0.619, P<0.05); co-immunoprecipitation experiments confirmed that VTRNA2-1 exerts biological functions through specific binding to protein kinase R (PKR). Conclusion: VTRNA2-1 gene is highly expressed in CD4+ T lymphocytes of patients with AD. Increased expression of VTRNA2-1 may aggravate the severity of clinical symptoms in patients. The mechanism may be through activation of PKR, which may play a role in the pathological process of AD Regulation. 2021 Vol. 27 (12): 1987-1990 [Abstract] ( 120 ) HTML (1 KB)  PDF (1429 KB)  ( 168 ) 1991 The Expression and Correlation of MiR-29a MiR-126a-5p and MiR-21-3p in Severe Acute Pancreatitis ZHANG Qianqian, WANG Chengli, Fu Tian, et al DOI: 10.3969/j.issn.1006-6233.2021.12.012 Objective: To explore the expression and correlation of microRNA-29a (miR-29a), microRNA-126a-5p (miR-126a-5p) and microRNA-21-3p (miR-21-3p) in severe acute pancreatitis. Methods: A total of 82 patients with acute pancreatitis in our hospital from March 2020 to March 2021 were selected as the observation group, including 43 patients with mild acute pancreatitis, 39 patients with severe acute pancreatitis, and 40 normal physical examinees in the same period were selected as the control group. The expressions of miR-29a, mir-126a-5p and mir-21-3p were detected by real-time fluorescence quantitative method. The severity of patients was evaluated by acute physiology and chronic health assessment (APACHE II) and Ranson scoring system. Pearson correlation was used to analyze the correlation of miR-29a, mir-126a-5p and mir-21-3p. Results: Compared with the control group, the expression levels of miR-29a and miR-21-3p in the observation group increased, and the expression levels of miR-126a-5p decreased, with statistical significance (P<0.05). Compared with patients with mild acute pancreatitis, the expression levels of miR-29a and miR-21-3p reduce in patients with severe acute pancreatitis, and the expression levels of miR-126a-5p rise, with statistical significance (P<0.05). With the exacerbation of severe acute pancreatitis, the expression levels of miR-29a and miR-21-3p increased, and the expression levels of miR-126a-5p decreased, with statistical significance (P<0.05). The results show that the negative phase of miR-29a is related to mir-126a-5p (r=-0.447; P = 0.003); the positive correlation of miR-29a with mir-21-3p (r=0.534; P = 0.001);the negative phase of mir-126a-5p was related to mir-21-3p (r=-0.517; P = 0.001). Conclusion: MiR-29a and miR-21-3p are highly expressed in the serum of patients with severe acute pancreatitis, and miR-126a-5p is low expressed in the serum of patients with severe acute pancreatitis, and abnormal levels of miR-29a, miR-126a-5p and miR-21-3p were risk factors for severe acute pancreatitis. It can be used as an indicator for the detection of severe acute pancreatitis. 2021 Vol. 27 (12): 1991-1995 [Abstract] ( 107 ) HTML (1 KB)  PDF (1316 KB)  ( 177 ) 1996 Analysis of POP-Q Score and Four-Dimensional Ultrasound in Pelvic Diaphragmatic Hiatus in Patients with Pelvic Organ Prolapse HAO Rui, et al DOI: 10.3969/j.issn.1006-6233.2021.12.013 Objective: To analyze the changes in anatomical shape of pelvic diaphragmatic hiatus in patients with pelvic floor organ prolapse(POP) by transperineal four-dimensional ultrasound. Methods: Fifty-four patients with POP who were diagnosed by clinical examination in gynecological clinic were selected as the prolapse group. All patients were quantified by POP-Q score. There were 26 patients,who were included into mild-moderate group (I-II degree), and 28 patients in severe group (Ⅲ-Ⅳdegree). Sixty non-sterile healthy women were selected as the control group. Four-dimensional ultrasound examination was performed to compare the differences in pelvic diaphragmatic hiatus parameters among patients with different degrees of prolapse in the resting state, Valsalva movement, and constricted movement. Results: The pelvic diaphragmatic hiatus area, perimeter, and changes in the resting, Valsalva, and constricted movement were significantly different between the prolapse group and control group(P<0.05). The area of pelvic diaphragmatic hiatus and perimeter of the patients in the mild-moderate prolapse group were relatively smaller than the severe prolapse group at rest, Valsalva, and constricted movement. The differences were statistically significant (P<0.05). Conclusion: The examination of anatomical structure and functional changes of the pelvic diaphragmatic hiatus by four-dimensional ultrasound is an effective imaging method to observe POP. The prolapse is related to the size of pelvic diaphragmatic hiatus, four-dimensional ultrasound can provide an important anatomical basic for clinical diagnosis. 2021 Vol. 27 (12): 1996-2000 [Abstract] ( 205 ) HTML (1 KB)  PDF (1775 KB)  ( 109 ) 2001 Predictive Value of Blood Flow Indicators of Middle Cerebral Artery Combined with Ductus Venosus on Fetal Intrauterine Hypoxia in Gestational Diabetes Mellitus KE Fengmei, SU Ruifen, SHUI Chengyu, et al DOI: 10.3969/j.issn.1006-6233.2021.12.014 Objective: To investigate the predictive value of blood flow indicators of middle cerebral artery (MCA) combined with ductus venosus (DV) on fetal intrauterine hypoxia in gestational diabetes mellitus (GDM). Methods: 48 GDM pregnant women with fetal intrauterine hypoxia who were treated and delivered in our hospital between July 2019 and July 2020 were selected as the case group, and 48 normal singleton pregnant women were selected as the control group. Color Doppler ultrasound was applied to detect the fetal MCA and DV blood flow indicators in the two groups of fetuses, including resistance index (RI), pulsatility index (PI) and peak systolic velocity/end diastolic velocity (S/D), and comparative analysis was conducted. Results:Compared with the control group, the RI, PI and S/D values of MCA in the case group were significantly decreased (P<0.05), the RI, PI and S/D values of DV were significantly increased (P<0.05), and the RIMCA/RIDV, PIMCA/PIDV and (S/D) MCA/(S/D)DV were also significantly decreased (P<0.05). Logistic regression analysis showed that the ratios of RIMCA/RIDV, PIMCA/PIDV and (S/D) MCA/(S/D)DV were 1.385, 1.602 and 1.480 respectively, which were independent predictors of fetal intrauterine hypoxia in GDM (P<0.05). ROC curve analysis showed that the areas under the curves of RIMCA/RIDV, PIMCA/PIDV, (S/D)MCA/(S/D)DV and the combination of the three in predicting fetal intrauterine hypoxia in GDM were 0.869, 0.870, 0.897 and 0.975 respectively, and the predictive value of the combination of the three was the largest. Conclusion: MCA combined with DV blood flow indicators have important reference value in predicting fetal intrauterine hypoxia in GDM. 2021 Vol. 27 (12): 2001-2005 [Abstract] ( 96 ) HTML (1 KB)  PDF (1399 KB)  ( 154 ) 2006 The Value of CLEC-2 in Peripheral Blood in Predicting the Death Risk of Patients with Traumatic Brain Injury LI Fang, TANG Shijun, DU Wei, et al DOI: 10.3969/j.issn.1006-6233.2021.12.015 Objective: To investigate the value of peripheral blood C-type leetin-like receptor-2 (CLEC-2) levels in early prediction of the 30-day risk of death in patients with traumatic brain injury. Methods: 113 patients with TBI were included in from March 2018 to January 2020. The clinical data of the patients were collected. After admission, the level of CLEC-2 in plasma was detected by enzyme-linked immunosorbent assay; the deaths of 113 patients within 30 days were recorded and divided accordingly. The general clinical data such as gender, age and injury type of the two groups of patients were compared, and multivariate logistic regression was used to analyze the relevant factors that increase the 30-day mortality risk of TBI patients; the receiver operating characteristic curve was plotted to analyze the diagnostic value of CLEC-2 in the early assessment of the 30-day mortality risk of TBI patients. Results: There were 35 deaths within 30 days, with a case fatality rate of 30.97%. Based on this, they were divided into death group (n=35) and survival group (n=78). The GCS score of the death group was lower than that of the survival group, and the proportion of intraventricular hemorrhage, APACHE-II score, age, serum CRP level and CLEC-2 level were higher than those of the survival group, the difference was statistically significant (P<0.05); multivariate logistic regression analysis shown that intraventricular hemorrhage (OR=1.845), older age (OR=1.122), and higher CLEC-2 level (OR=1.022) were independent risk factors leading to an increased risk of 30-day death in TBI patients (P<0.05); The higher GCS score (OR=0.303) is an independent protective factor for 30-day death of TBI patients (P<0.05). ROC curve analysis shows that the area under the curve for early prediction of TBI patients' death by CLEC-2 level is 0.910, which is higher than the GCS score, age and intraventricular hemorrhage; the cut-off point of CLEC-2 for early assessment of the increased risk of death in TBI patients was 314pg/mL, the diagnostic sensitivity was 71.43%, and the specificity was 94.87%. Conclusion: The increase in plasma CLEC-2 concentration is closely related to 30-day death, and it can be used as a new biomarker for clinical evaluation of the risk of death in patients with TBI. 2021 Vol. 27 (12): 2006-2009 [Abstract] ( 86 ) HTML (1 KB)  PDF (1433 KB)  ( 123 ) 2010 The Correlation Between NLR PCT HMGB1 and Severity of Neonatal Septicemia WEN Yan, LIU Jun, WANG Fengdong, et al DOI: 10.3969/j.issn.1006-6233.2021.12.016 Objective: To observe the value of NLR、PCT combined with HMGB1 in severity assessment of Neonatal septicemia. Methods:A total of 76 children with Neonatal septicemia were enrolled as examination group from October 2016 to March 2021. According to the Neonatal septicemia critical illness score, they were divided into critical group (n=38) and non-critical group (n=38). Blood was collected and tested for abnormal values, HMGB1 and PCT. Receiver operating characteristic (ROC) curve was employed to analyze the cut-off value of NLR、HMGB1 and PCT. Results: The level of NLR, PCT and HMGB1 in critical group were higher than the non-critical group(t=15.424,6.206,9.994,P<0.001,0.001,0.001). Serum PCT, HMGB1 and CRP levels are negatively correlated with NICS of Neonatal septicemia. The sensitivity and specificity of NLR, PCT, HMGB1 by parallel test are 78.9%, 57.9%. The sensitivity and specificity of NLR,PCT,HMGB1 by series test are 71.1%,97.4%. Conclusion: The sensitivity and specificity of NLR, PCT, HMGB1 by series rest are 71.1%, 97.4%, which shows that the series test can obviously improve the specificity. The series application of NLR、PCT、HMGB1 can be considered clinically to reduce the occurrence of misdiagnosis. 2021 Vol. 27 (12): 2010-2013 [Abstract] ( 82 ) HTML (1 KB)  PDF (1347 KB)  ( 111 ) 2014 Analysis of Related Factors Influencing the Effect of Upper Urinary Rract Stone Removal LI Wei, HE Linrui, LUO Xiong, et al DOI: 10.3969/j.issn.1006-6233.2021.12.017 Objective: To explore the related factors that affect the effect of stone removal in patients with upper urinary tract stones, in order to provide reference for clinical treatment. Methods: A retrospective analysis of 217 patients with upper urinary tract stones admitted to our hospital from May 2018 to May 2020 were divided into two groups according to the stone removal effect, namely the success group (n=165, removal success) and the failure group (N=52, clearance failure), and the factors affecting patient clearance were analyzed by binary Logistic regression. Results: After binary logistic regression analysis, the stone length>2cm, CT value>750HU, hydronephrosis state, multiple stones, BMI≥24kg/m2 are independent factors influencing the stone removal rate, and the course of the disease is a suspicious factor (P<0.05). Conclusion: The number of stones, length of stones, BMI, course of disease, CT value, and hydronephrosis are important factors affecting the rate of one-time removal of stones. Therefore, it is necessary to reasonably choose minimally invasive surgery according to the actual situation of the patient, and do a good job of screening for surgical indications, so as to effectively increase the rate of one-time stone removal, reduce the risk of reoperation, and have high safety and worthy of clinical promotion. 2021 Vol. 27 (12): 2014-2017 [Abstract] ( 103 ) HTML (1 KB)  PDF (1203 KB)  ( 142 ) 2018 Clinical Effect of Multistep Continuous Physiotherapy Combined with Anti-Mite and Anti-Inflammation in the Treatment of Demodex Blepharitis HU Xiaojuan, et al DOI: 10.3969/j.issn.1006-6233.2021.12.018 Objective: To investigate the clinical effect of multistep continuous physiotherapy combined with anti-mite and anti-inflammation in the treatment of demodex blepharitis. Methods: The clinical data of 76 patients (152 eyes) with demodex blepharitis admitted from January 2018 to October 2020 were retrospectively analyzed. Patients were divided into groups A and B according to their different treatment methods. Group A was selected to complete physical mite removal and anti-inflammatory in the treatment at home by themselves(4- Turpentine alcohol wipes and Tobramycin dexamethasone eye cream). Group B was selected for the multistep continuous physiotherapy with the combination of anti-mite and anti-inflammation(4- Turpentine alcohol wipes and Tobramycin dexamethasone eye cream). Multistep continuous physiotherapy was conducted clinically. Patients were instructed to complete eyelid cleaning and anti-mite and anti-inflammatory at home. The symptoms and signs(under the slit lamp examination eyelid edge clean degree, meibomian gland abnormalities and conjunctival congestion situation) of the two groups were observed before and after treatment for 1 month and 3 months and the results of light microscope examination of demodex were recorded, and statistical analysis was performed. Results: Before the treatment, symptoms and signs of the two groups of patients were close, and there was no statistically significant difference (P>0.05). At the end of 1 month and 3 month, symptoms and signs scores decreased significantly in both groups, and the decrease was outstanding in group B. Compared with before treatment in both groups, the difference had statistical significance (P<0.05). After 3 months, scores comparison between the two groups was statistically significant (P<0.05). The effective treatment rate of group B was 84.2%, and that of group A was 42.1%, the difference was statistically significant (P<0.05). Treatment for 3 months, creep mite count in both groups was significantly decreased, the difference was statistically significant (P<0.05). The treating process shows no complications such as glucocorticoid-induced high intraocular pressure and allergic reactions. Conclusion: Multi-step continuous physical therapy combined with anti-mite and anti-inflammatory therapy can significantly improve the therapeutic efficiency of patients with demodex blepharitis and improve the patient's symptoms and signs, which can be used as a routine physical therapy. 2021 Vol. 27 (12): 2018-2022 [Abstract] ( 125 ) HTML (1 KB)  PDF (1215 KB)  ( 474 ) 2023 The Predictive Value of Wells Score Combined with Adjusted D-Dimers for Lung Cancer with Acute Pulmonary Embolism WANG Shaofei, CHEN Wenli, LI Jinling, et al DOI: 10.3969/j.issn.1006-6233.2021.12.019 Objective: To investigate the predictive value of Wells score combined with adjusted D-dimers for lung cancer complicated with acute pulmonary embolism. Methods: From November 2013 to November 2020, 130 lung cancer patients suspected for APE were admitted to the affiliated hospital of Chengde Medical University. The predictive value of Wells score, adjusted D-dimer and combination of the above were respectively estimated. Results: Among 130 APE suspected cases, 67 were confirmed. After Wells scoring, patients were divided into low-potential group (41 cases), medium-potential group (72 cases), high-potential group (17 cases), and confirmed APE were 14 cases,39 cases,33 cases respectively. The sensitivity of diagnosis of lung cancer combining APE was 20.90%,58.21%,20.90% respectively. The specificity was 57.14%,47.62%, 95.24% respectively. The positive predictive values were 34.15%,54.17%, 82.35% respectively. The negative predictive values were 65.85%,45.83% and 7.65% respectively. The adjusted D-dimer value (981ng/mL), compared with the traditional D-dimer value (500ng/mL), has an increased specificity of diagnosis of lung cancer with APE (42.86% vs23.81%, P<0.05). To the negative patients whose Wells score revealed low potential of combining adjusted D-dimer negative, the negative predictive value of diagnosis of lung cancer combining APE can rise to 99.45%. ROC curves of D-dimers in 130 lung cancer patients with suspected APE reveal that the critical value of D-dimer is 1975ng/mL, higher than the conventional 500ng/mL. Conclusion: Wells score of low potential of combining adjusted D-dimer negative is effective to exclude suspected APE patients with lung cancer. Lung cancer patients with APE often have a high level of D-dimer. 2021 Vol. 27 (12): 2023-2026 [Abstract] ( 98 ) HTML (1 KB)  PDF (1339 KB)  ( 160 ) 2027 Comparative Analysis of Scleral Buckling and Vitrectomy in the Treatment of Rhegmatogenous Retinal Detachment and Postoperative Complications LV Tingting, NIU Tongtong, WANG Hailin, et al DOI: 10.3969/j.issn.1006-6233.2021.12.020 Objective: To observe and compare the clinical efficacy and postoperative complications of scleral buckling (SB) and vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). Methods: The clinical data of 93 patients (93 eyes) with RRD who underwent surgery in our hospital from June 2019 to January 2021 were retrospectively selected, among which 41 patients (41 eyes) were treated with SB as SB group and the remaining 52 patients (52 eyes) were treated with PPV as PPV group. The patients were followed up for 3 months, and the retinal reattachment, BCVA and complications were observed. Results: There were statistically significant differences in the number, location, type, retinal detachment range and special retinal detachment between the two groups (P<0.05). Three months after surgery, the good retinal reattachment rate in PPV group was 90.38%, slightly higher than that in SB group (78.05%), but there was no statistical significance between the two groups (P>0.05). There was no statistical significance in BCVA difference between PPV group and SB group before and after treatment (P>0.05). The complication rate was 42.31% in PPV group and 11.90% in SB group, with statistical significance (P<0.05). Conclusion: There is no significant difference in clinical efficacy between SB and PPV in the treatment of RRD patients. Both surgical methods have their own advantages and disadvantages, and appropriate choice should be made according to the condition. For complex cases, PPV should be selected; SB should be preferred for special groups such as the young or the one-eyed. 2021 Vol. 27 (12): 2027-2031 [Abstract] ( 106 ) HTML (1 KB)  PDF (1233 KB)  ( 227 ) 2032 An Analysis of the Value of Strain Rate Ratio of Elastosonography in the Correction of TI-RADS 4 Thyroid Nodules DING Huajie, NA Lei, YANG Shaoshi, et al DOI: 10.3969/j.issn.1006-6233.2021.12.021 Objective: To investigate the value of strain rate ratio of ultrasonic elastography in correcting TI-RADS 4 thyroid nodules classification. Methods: A total of 137 thyroid nodule patients who underwent surgery in the Affiliated Hospital of Chengde Medical University from January 2018 to June 2020 were collected. A total of 137 nodule were collected, all of which were TI-RADS 4. After correction of strain rate ratio of ultrasonic elastography, they were finally compared with the gold standard of postoperative histomathology. The grade correction value of strain rate ratio of ultrasonic elastography for TI-RADS 4 thyroid nodules was analyzed. Results:137 TI-RADS4 thyroid nodules include 67 TI-RADS 4a, 48 TI-RADS 4b, 22 TI-RADS 4c. After the strain rate ratio correction of ultrasonicelastography, there were 20 TI-RADS3,27 TI-RADS 4a,58 TI-RADS 4b,28 TI-RADS 4c,4 TI-RADS 5. Finally, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TI-RADS classification were 62.6%, 78.9%, 67.2%, 88.5% and 44.8%, respectively, when compared with postoperative histological pathology. After correction, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 85.8%, 86.8%, 86.1%, 94.4% and 70.2% respectively. There were significant differences in sensitivity (χ2=13.971, P<0.05), accuracy (χ2=13.782, P<0.05) and negative predictive value (χ2=7.229, P<0.05) between ti-RADS classification and elastography corrected. There was no significant difference in specificity (χ2=0.835, P>0.05) and positive predictive value (χ2=1.819, P>0.05). Conclusion: The strain rate ratio of ultrasonic elastography has certain clinical value for grading correction of TI-RADS 4 thyroid nodule. 2021 Vol. 27 (12): 2032-2034 [Abstract] ( 118 ) HTML (1 KB)  PDF (1204 KB)  ( 145 ) 2035 Clinical Value of Ultrasonic Superb Microvasular Imaging in the Diagnosis of Abdominal Aortic Branch Involvement in Stanford B Aortic Dissection SUN Meng, YANG Ping, SHANG Linan DOI: 10.3969/j.issn.1006-6233.2021.12.022 Objective: To observe the differential diagnosis effect of super mircovascular imaging (SMI) in Stanford B aortic dissection patients with true and false lumen and abdominal aortic branch artery involvement. Methods:Retrospective analysis was performed on the data of 100 patients with Stanford B aortic dissection admitted to Dandong First Hospital from December 2015 to December 2020,and, according to different imaging diagnosis methods, they were divided into SMI group (60 cases) and conventional ultrasound group (40 cases), both with digital subtraction angiography (DSA) as the "gold standard". True and false lumen, and abdominal aorta branch artery involvement were identified in both groups. Results: The coincidence rate of differential diagnosis of true and false cavities in SMI group (96.67%) was significantly higher than that of conventional ultrasound examination group (62.50%), and the difference was statistically significant (χ2=10.427, P<0.05); the coincidence rate of diagnosis of abdominal aortic branch artery involvement in group SMI group (83.33%) was significantly higher than that of conventional ultrasound examination group (65.00%), and the difference was statistically significant (χ2=4.423,P<0.05). Conclusion: Compared with conventional ultrasound diagnosis, ultrasonic super mircovascular imaging technology is used more accurately in the diagnosis of Stanford B-type aortic dissection, which can identify the true and false lumen of patients with aortic dissection and detect the involvement of abdominal aorta branch arteries in patients with aortic dissection, and the diagnostic coincidence rate is higher, which can provide a valuable basis for clinical diagnosis and treatment and prognosis evaluation. 2021 Vol. 27 (12): 2035-2038 [Abstract] ( 95 ) HTML (1 KB)  PDF (1217 KB)  ( 142 ) 2039 The Clinical Significance of the Detection of Peripheral Blood CD64 Index and Serum Amyloid A in the Diagnosis of Bacterial Infection in Preschool Children QU Xiaowei, et al DOI: 10.3969/j.issn.1006-6233.2021.12.023 Objective: To study the clinical significance of peripheral blood CD64 index and serum amyloid A (SAA) detection in the diagnosis of bacterial infections in preschool children. Methods: With the retrospective analysis method, 200 preschool children with infectious diseases admitted from January 2018 to January 2020 were selected as the research subjects. According to different pathogens, they were divided into children with viral infections (virus group, n=100) and children with bacterial infections(bacterial group, n=100); at the same time, healthy children who were admitted to the hospital for physical examination during the same period were selected as the research subjects as the healthy group (n=100). Comparison was conducted on the CD64 index, SAA level and positive rate of the three groups of subjects, the CD64 index and SAA level before and after antibiotic treatment in the bacterial group, and the efficacy of CD64 and SAA in the diagnosis of bacterial infections was analyzed. Results: The CD64 index and SAA level of the bacterial group were significantly higher, and the difference was significant (P<0.05); compared with the healthy group, the SAA level of the virus group was significantly higher, and the difference was significant (P<0.05) . The CD64 index and SAA levels of children in the bacterial group were significantly lower than those before treatment, and the difference was significant (P<0.05). Compared with the virus group and the healthy group, the bacterial group had a significantly higher CD64 index and SAA positive rate, and the difference was significant (P<0.016); compared with the healthy group, the virus group had a significantly higher SAA positive rate, and the difference was significant (P<0.016). The specificity and positive predictive value of CD64 index in the diagnosis of bacterial infection were significantly higher than SAA, and the difference was significant (P<0.05). Conclusion: CD64 index and SAA test have important clinical value in the diagnosis and evaluation of bacterial infection in preschool children, and CD64 index is more valuable in the diagnosis. 2021 Vol. 27 (12): 2039-2042 [Abstract] ( 99 ) HTML (1 KB)  PDF (1221 KB)  ( 280 ) 2043 The Relationship Between Body Mass Index and Weight Gain During Pregnancy and the Incidence of Gestational Diabetes MENG Xuelian, BAO Liping, XU Xiaoyan, et al DOI: 10.3969/j.issn.1006-6233.2021.12.024 Objective: To explore the relationship between body mass index (BMI) in early pregnancy, weight gain during pregnancy and the incidence of gestational diabetes (GDM). Methods: A total of 140 pregnant women with 24-28 weeks gestation during pregnancy check-ups in our hospital from February 2019 to October 2020 were selected as the research subjects, and they were divided into GDM group and non-GDM group according to whether they had gestational diabetes. The BMI and weight gain during pregnancy of the two groups of pregnant women were recorded, and the relationship between them and the incidence of GDM was analyzed. Results: After OGTT screening, there were 33 pregnant women in the GDM group and 107 pregnant women in the non-GDM group. There is a statistically significant difference in the incidence of GDM with different BMIs (χ2=67.613, P<0.001),the incidence of GDM is highest when BMI ≥ 28.0kg/m2 (86.67%). There is a statistical difference in the incidence of different weight gains and GDM in the first trimester (χ2=7.634, P=0.022), and the incidence of weight gain> 5 kg GDM was the highest (36.73) %. BMI and weight gain are independent risk factors for GDM (P<0.05). BMI and weight gain were correlated with the incidence of GDM (r=-0.417, -0.212, P<0.05). Conclusion: Pre-pregnancy body mass index ≥ 28/m2 increases the risk of GDM in pregnant women. At the same time, weight gain in the first trimester> 5kg will increase the incidence of GDM. Therefore, management of pre-pregnancy BMI and weight gain during pregnancy can reduce the occurrence of gestational diabetes and reduce pregnancy complications. The occurrence of complications ensures the safety of mothers and babies. 2021 Vol. 27 (12): 2043-2045 [Abstract] ( 88 ) HTML (1 KB)  PDF (1192 KB)  ( 146 ) 2046 Different Fixation Methods in the Treatment of Distal Tibiofibular Syndesmosis Injury CHEN Dingzhong, WANG Longhui, LI Chaoyi DOI: 10.3969/j.issn.1006-6233.2021.12.025 Objective: To observe the effect of Nice knot elastic fixation and screw rigid fixation in the treatment of distal tibiofibular syndesmosis injury. Methods: 167 patients with distal tibiofibular syndesmosis injury admitted to the hospital between December 2019 and December 2020 were retrospectively analyzed. Among them, 80 cases adopted screws to fix distal tibiofibular syndesmosis (screw group) and 87 cases were fixed with NICE knot for distal tibiofibular syndesmosis (NICE knot group). The intraoperative distal tibiofibular fixation time, intraoperative blood loss, wound healing time and postoperative walking time and weight-bearing time (time of walking down the ground, partial weight-bearing time, complete weight-bearing time) were compared between the two groups. Foot ankle score, ankle joint score, angle of dorsiflexion and angle of plantar flexion before surgery and at 6 months after surgery and occurrence of complications at half a year of follow-up were compared. Results: During surgery, the distal tibiofibular fixation time in NICE knot group was significantly shorter than that in screw group (P<0.05), and there were no significant differences in blood loss and significant wound healing time (P>0.05). After surgery, time of walking down the ground, partial weight-bearing time and complete weight-bearing time were significantly earlier in NICE knot group than those in screw group (P<0.05). After 6 months of surgical treatment, the foot ankle score (AOFAS) and ankle score (Kofoed) of the two groups were significantly enhanced compared with those before surgery (P<0.05), and the scores and ranges of score change of NICE knot group were significantly higher than those of screw group (P<0.05). After surgery, the dorsiflexion angle and plantar flexion angle of the two groups were significantly larger than those before surgery (P<0.05), and the two indicators were significantly larger in NICE knot group compared with those in screw group (P<0.05). The change range of plantar flexion Angle in NICE knot group was significantly higher than that in screw group (P<0.05), but there was no significant difference in change range of dorsiflexion angle (P>0.05). Within half a year of postoperative follow-up, the incidence rate of complications was 4.60% in NICE group and was 10.00% in screw group respectively (P>0.05). Conclusion: Compared with screw fixation, NICE knot fixation of distal tibiofibular syndesmosis injury is more beneficial to the early recovery of ankle joint function, and it has lower incidence of complications and is worthy of clinical promotion. 2021 Vol. 27 (12): 2046-2051 [Abstract] ( 114 ) HTML (1 KB)  PDF (2160 KB)  ( 173 ) 2052 The Efficacy of Butylphthalide in Patients with Mild Vascular Cognitive Dysfunction After Intracerebral Hemorrhage ZOU Jingjing, QI Yanchun, YIN Lixia DOI: 10.3969/j.issn.1006-6233.2021.12.026 Objective: To analyze the clinical efficacy of butylphthalide combined with donepezil hydrochloride in the treatment of patients with mild vascular cognitive impairment (MVCI). Methods: A total of 120 MVCI patients admitted to Chaoyang Central Hospital from January 2019 to December 2020 were randomly divided into observation group and control group (60 cases in each group). On the basis of supportive treatment, the control group was given donepezil hydrochloride treatment, and the observation group was given butylphthalide soft capsules on the basis of the control group for 12 weeks. The Mini Mental State Scale (MMSE) and Montreal Cognitive Assessment Scale (MOCA) were used before and after treatment. The two groups of patients were scored, the P300 latency and P300 amplitude, and the clinical efficacy were evaluated. Results: After treatment, the MMSE score and MOCA score were significantly increased (both P<0.05), but the change in the observation group was larger than that in the control group (all P<0.05); after treatment, the P300 latency were all shortened and the amplitude increased (all P<0.05), but the difference in the P300 latency of the observation group was more obvious, and the amplitude increased poorly. The value is more obvious (all P<0.05). There was no difference in the incidence of adverse reactions (P>0.05). Conclusion: Butylphthalide combined with donepezil hydrochloride treatment can significantly improve the clinical symptoms of patients and is worthy of promotion. 2021 Vol. 27 (12): 2052-2054 [Abstract] ( 139 ) HTML (1 KB)  PDF (1190 KB)  ( 169 ) 2055 Clinical Evaluation of Different Materials of CAD/CAM Pulp Hyperonlay in Repairing Tooth Defect After Root Canal Treatment XING Fuwen, CHEN Long, HE Xiaoning, et al DOI: 10.3969/j.issn.1006-6233.2021.12.027 Objective: To analyze and evaluate the clinical effect of different materials of computer aided design/manufacture (CAD/CAM) pulp superonlay in the restoration of tooth defect after root canal treatment. Methods: A total of 120 patients with dental defects after root canal treatment admitted to the Second Affiliated Hospital of Hainan Medical College from January 2019 to July 2020 were prospectively selected as the research subjects. They were simply randomly divided into two groups: group A (60 patients), who were treated with super inlays of Lava Ultimate nanocomposite porcelain, and group B (60 patients), who were treated with multilayer feldspar glass ceramics Vita TriLuxe. The clinical prosthetic efficacy of the two groups of patients 6 months after restoration and 12 months after restoration (including edge fit, shape, edge coloring, color matching, secondary caries, surface texture, food impaction, and antagonistic teeth Abrasion) and the patient’s satisfaction with the repair were compared and analyzed. Results: 6 months and 12 months after restoration, there was no statistically significant difference in the edge fit, shape, edge coloring, color matching, secondary caries, surface texture, and food impact ratio between group A and group B. (P>0.05), but the abrasion of jaw teeth in group A was significantly better than that in group B, and the difference was statistically significant (P<0.05). The satisfaction rate of patients in group A (96.67%) was significantly higher than that of group B (85.00%), the difference was statistically significant (χ2=4.092, P=0.043). Conclusion: There is no significant difference between Lava Ultimate nanocomposite porcelain and Vita TriLuxe TriLuxe multilayer color vitalite glass ceramics in the clinical efficacy of CAD/CAM pulp superonlay in the restoration of tooth defects after root canal treatment in the aspects of edge density, shape, edge coloring, color matching, secondary caries, surface texture and food inserts. However, Lava Ultimate nanocomposite porcelain has significantly lower tooth abrasion than Vita TriLuxe multilayer color feldspar glass ceramics, and significantly higher patient satisfaction rate, which is more worthy of promotion. 2021 Vol. 27 (12): 2055-2060 [Abstract] ( 171 ) HTML (1 KB)  PDF (1223 KB)  ( 318 ) 2061 Effect of Two Different Surgical Methods on Functional Recovery and Serum IL-1 IL-17 and ESR in Elderly Patients with Knee Osteoarthritis YANG Hui DOI: 10.3969/j.issn.1006-6233.2021.12.028 Objective: To investigate the effect of two different surgical methods on functional recovery and serum IL-1, IL-17 and ESR in elderly patients with knee osteoarthritis (KOA). Methods: This study retrospectively reviewed 153 elderly patients with KOA admitted to the department of joint surgery in the hospital between January 2018 and December 2020. The patients were divided into unicompartmental knee arthroplasty group (n=76) and total knee arthroplasty group (n=77) according to the surgical method. The operation time, length of hospital stay, hospitalization expenses, interleukin-1 (IL-1), interleukin-17 (IL-17), erythrocyte sedimentation rate (ESR), knee society score (KSS), Hospital for Special Surgery (HSS) score, Lysholm knee score, and complications were compared between the two groups. Results: The operation time and hospital stay of the unicompartmental knee arthroplasty group were significantly shorter than those of the total knee arthroplasty group (P<0.05), but there was no statistical difference in hospitalization expenses between the two groups (P>0.05). There was no significant difference in IL-1, IL-17 and ESR between the two groups before surgery (P>0.05). After surgery, the levels of serum IL-1 and IL-17 were reduced in the two groups (P<0.01), but no significant change in ESR was found (P>0.05), without statistically significant difference between the two groups (P>0.05). There was no statistically significant difference in KSS score, HSS score and Lysholm knee score between the two groups before surgery (P>0.05). After surgery, the above scores of the two groups were increased (P<0.01), but there was no statistically significant difference between the two groups (P>0.05). The incidence of complications in the unicompartmental knee arthroplasty group was significantly lower than that in the total knee arthroplasty group (P<0.05). Conclusion: Unicompartmental knee arthroplasty has the advantages of short duration, short hospital stay, quick wound healing, and few complications. 2021 Vol. 27 (12): 2061-2064 [Abstract] ( 89 ) HTML (1 KB)  PDF (1373 KB)  ( 105 ) 2065 Logistic Regression Analysis and Prediction Model Construction of Related Influencing Factors of Cervical Anastomotic Leakage After VATS Operation in Elderly Patients with Esophageal Cancer ZHAO Xiang, GU Yuanyuan, et al DOI: 10.3969/j.issn.1006-6233.2021.12.029 Objective: To investigate the influencing factors of cervical anastomotic leakage after video-assisted thoracoscopic radical resection of lung cancer (VATS) in elderly patients with esophageal cancer, and to establish a logistic regression prediction model. Methods: A total of 178 elderly patients with esophageal cancer who underwent VATS surgery in Nantong University Affiliated Hospital from January 2017 to December 2020 were selected. The incidence of postoperative cervical anastomotic leakage was calculated. A single-factor and multi-factor method was used to describe the postoperative neck of elderly esophageal cancer after VATS. Influencing factors of anastomotic fistula, a Logistic regression prediction model was established, and the specificity and sensitivity of the model for predicting postoperative cervical anastomotic fistula were evaluated. Results: In 178 elderly patients with esophageal cancer who underwent VATS surgery, the incidence of postoperative anastomotic leakage was 14.04%. Logistic regression analysis found that the history of abdominal surgery, hospital stay≥16 d, postoperative lung infection, postoperative ventilator use, and albumin level≥35 g/L on the first day after surgery are VATS in elderly patients with esophageal cancer Factors affecting postoperative cervical anastomotic leakage (P<0.05). Evaluation of the Logistic regression model showed that the model establishment is statistically significant. Wald test showed that the coefficient difference of the regression equation is statistically significant. The Hosmer-Lemeshow goodness-of-fit test showed that the model fits well. Logistic regression model statistical analysis of the data set found that the AUC for predicting postoperative cervical anastomotic leakage was 0.926, the prediction sensitivity was 92.00%, and the specificity was 80.26%. Conclusion: There are many factors related to cervical anastomotic fistula after VATS in elderly patients with esophageal cancer, including history of abdominal surgery, lung infection, length of hospitalization, etc. The Logistic prediction model constructed based on high-risk factors can diagnose cervical anastomotic fistula after VATS in elderly patients with esophageal cancer. It has high predictive value and helps guide clinical treatment. 2021 Vol. 27 (12): 2065-2070 [Abstract] ( 154 ) HTML (1 KB)  PDF (1253 KB)  ( 266 ) 2071 Effect of Continuous and Intermittent Blood Purification on Renal Hemodynamics and Glucose Metabolism Indicators in Patients with Acute Kidney Injury Caused by Septic Shock ZHAO Min, LI Jiming, YANG Yuying, et al DOI: 10.3969/j.issn.1006-6233.2021.12.030 Objective: To explore the therapeutic effects of continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) on patients with acute kidney injury (AKI) caused by septic shock, and their influence on renal hemodynamics and glucose metabolism indicators. Methods: 147 patients with AKI caused by septic shock treated in the hospital between March 2019 and March 2021 were selected as the research subjects, and were randomly divided into observation group (n=72) and control group (n=75). On the basis of conventional treatment, patients in the observation group were treated with CRRT and patients in the control group were treated with IHD. The relevant parameters were compared between the two groups before and after treatment. Results: The length of ICU stay, urine volume, recovery time, and organ support time of the observation group were shorter than those of the control group (P<0.05). 1 week after treatment, the levels of serum C-reactive protein (CRP) and serum creatinine (Scr) in the observation group were lower than those in the control group (P<0.05). The peak intensity (PI), mean transit time (MTT), and area under the curve (AUC) were higher or longer than those in the control group (P<0.05). The fasting blood glucose (FBG) and 2 hours postprandial blood glucose (2PBG) were lower than those in the control group (P<0.05). The different values of above indicators before and after treatment in the observation group were greater than those in the control group. Conclusion: CRRT can significantly improve inflammation, renal hemodynamics and glucose metabolism in patients with AKI caused by septic shock, and shorten the patients' recovery time. 2021 Vol. 27 (12): 2071-2074 [Abstract] ( 124 ) HTML (1 KB)  PDF (1212 KB)  ( 183 ) 2075 Combined Detection of Serum MiRNA-21 and IL-6 in Prognosis of Patients After Cardiopulmonary Resuscitation SUN Yan, ZHANG Yanli, YU Haixia, et al DOI: 10.3969/j.issn.1006-6233.2021.12.031 Objective: To study the importance of united gauging of serum microRNA-21 (miRNA-21) , interleukin -6 (IL-6) and echocardiography on cardiac function and prognosis of patients after cardiopulmonary resuscitation (CPR). Methods: 80 patients with cardiopulmonary arrest receiving successful CPR and 72 healthy participants were recruited in the study. Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and ELISA was used to examine the serum miRNA-21 level and IL-6.Echocardiography is used to assess cardiac function after cardiopulmonary resuscitation. Spearman correlation was used to analyze the correlation between serum miRNA-21 and IL-6 expression levels and cardiac function. Patients in the case group were followed up for half a year. The end point of the follow-up was heart failure readmission or all-cause death. ROC curve was plotted to analyze the value of miRNA-21 and IL-6 expression levels in the prognosis assessment of patients after cardiopulmonary resuscitation. Results: Compared with the control group, serum miRNA-21 expression level and IL-6、pro-BNP level in the case group were significantly increased, left ventricular end diastolic diameter (LVEDD) increased, and left ventricular ejection fraction (LVEF) descended (P<0.05). In addition, Spearman correlation analysis displayed that the standard of miRNA-21 and IL-6 was negatively connected with cardiac function index(r =- 0.722, 0.613, P = 0.007, 0.009). Stepwise regression analysis showed that miRNA-21 and IL-6 were independent risk factors for readmitted and death after cardiopulmonary resuscitation. The area under the ROC curve of miRNAa-21 and IL-6 combined for prognosis assessment of patients after cardiopulmonary resuscitation was 0.937 and the 95% confidence interval was 0.853 ~ 1.000. Conclusion: The elevation of miRNA-21 and IL-6 level after CPR is closely related to the severity of cardiac dysfunction detected by ultrasound and the prognosis of patients, suggesting that miRNA-21、IL-6 may serve as a potential biomarker. 2021 Vol. 27 (12): 2075-2078 [Abstract] ( 118 ) HTML (1 KB)  PDF (1326 KB)  ( 112 ) 2079 Effect of Sintilimab Combined with AP Chemotherapy in the Treatment of Advanced Lung Adenocarcinoma with Malignant Pleural Effusion LI Xiaoqin, HUANG Chunmei, LUO Juan, et al DOI: 10.3969/j.issn.1006-6233.2021.12.032 Objective: To investigate the short-term efficacy, long-term efficacy, and safety of sintilimab combined with AP chemotherapy in the treatment of advanced lung adenocarcinoma with malignant pleural effusion. Methods: 124 cases of advanced lung adenocarcinoma with malignant pleural effusion patients were selected as the study subjects,and were divided into chemotherapy group (n=63) and sintilimab group (n=61)according to the central stochastic system assignment methods. The chemotherapy group received pemetrexed + cisplatin chemotherapy and the sintilimab group was combined with sintilimab on the basis of the control group. The treatment for 4 cycles was conducted to observe the short-term efficacy of pleural effusion, tumor marker level, KPS score, long-term survival and adverse reactions in the two groups. Results: After 4 cycles of treatment, the objective effusion efficiency and disease control rate of the sintilimab group was significantly better than that of the chemotherapy group, with statistically significant differences (P<0.05). After treatment, the levels of tumor markers significantly decreased and they were significantly lower in sintilimab group than those in the chemotherapy group. In terms of patients' quality of life score, the sintilimab group showed significant improvement compared with the chemotherapy group, with statistically significant difference (P<0.05). The median survival time in sintilimab group was better than that in the chemotherapy group, and the difference was statistically significant (P<0.05). Compared with the incidence of common clinical adverse reactions in the two groups, the incidence of bone marrow suppression and muscle pain in the sintilimab group was lower than that in the chemotherapy group, with statistically significant differences (P<0.05). Conclusion: Combined with sintilimab on the basis of AP chemotherapy, the short-term efficacy, tumor marker level, KPS score and long-term survival rate of pleural effusion were significantly improved ,and with less adverse reactions, worthy of clinical promotion 2021 Vol. 27 (12): 2079-2084 [Abstract] ( 298 ) HTML (1 KB)  PDF (1506 KB)  ( 185 ) 2085 Effects of Different Intracavitary Radiotherapy on Short-Term Curative Effect Dosimetry Comparison Toxicity and Immune Function in Locally Sdvanced Cervical Cancer XU Haibo, YAO Juan, WANG Junhui, et al DOI: 10.3969/j.issn.1006-6233.2021.12.033 Objective: To explore the effects of different intracavitary radiotherapy on short-term curative effect, dosimetry comparison, toxicity and immune function in locally advanced cervical cancer. Methods: A total of 50 patients with locally advanced cervical cancer undergoing three-dimensional implant after-loading radiotherapy between January 2019 and March 2021 was enrolled as 3D implant after-loading group, another 50 patients with balanced and comparable baseline data undergoing three-dimensional intracavitary after-loading radiotherapy during the same period were enrolled as three-dimensional after-loading group, and 50 more patients with balanced and comparable baseline data undergoing two-dimensional intracavitary after-loading radiotherapy during the same period were enrolled as two-dimensional after-loading group. The short-term curative effect, dosimetry comparison, toxicity and immune function before and after treatment were compared among three groups. Results: The total response rate in three-dimensional implant after-loading group was 96.00%, higher than that in three-dimensional after-loading group and two-dimensional after-loading group (84.00%, 72.00%) (P<0.017). The D90 and D100 of middle-risk clinical target and high-risk clinical target in three-dimensional implant after-loading group were higher than those in three-dimensional after-loading group and two-dimensional after-loading group (P<0.05), D2cm3 values of small intestine, sigmoid colon, rectum and bladder were lower than those in three-dimensional after-loading group and two-dimensional after-loading group (P<0.05). The incidence rates of radiation enteritis and radiation cystitis in three-dimensional implant after-loading group were 20.00% and 10.00%, lower than those in two-dimensional after-loading group (46.00%, 32.00%) (P<0.017). The difference values of CD3+, CD4+ andCD4+/CD8+ before and after treatment in three-dimensional implant after-loading group were lower than those in three-dimensional and two-dimensional after-loading groups (P<0.05). Conclusion: Three-dimensional implant after-loading radiotherapy can effectively improve short-term curative effect on patients with locally advanced cervical cancer, increase radiation dose of tumor tissues, reduce radiation dose of riskorgans and reduce toxicity, with few effects on immune function. And the incidence of toxicity is lower than that of two-dimensional after-loading radiotherapy. 2021 Vol. 27 (12): 2085-2089 [Abstract] ( 154 ) HTML (1 KB)  PDF (1223 KB)  ( 291 ) 2090 Efficacy and Safety of Pembrolizumab as Second-Line Treatment for Advanced Non-Small Cell Lung Cancer with Negative Driver Gene After Progression of Platinum-Based Chemotherapy CHEN Jiajie, et al DOI: 10.3969/j.issn.1006-6233.2021.12.034 Objective: To study the curative effect and adverse reactions of immune checkpoint inhibitor (ICI) pembrolizumab (pembrolizumab) in the second-line treatment on patients of advanced non-small cell lung cancer (non-small cell lung cancer, NSCLC), and guide its clinical treatment. Methods: The medical records of 7838 patients with advanced NSCLC admitted to our hospital from January 2018 to April 2021 were collected. After standardized screening, the pathological data of 104 patients were finally included, and 104 cases were divided, according to different treatment plans, into study group (n=51) and control group (n=53). The study group was treated with pembrolizumab, and the control group were treated with docetaxel. The objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS) and adverse events rate (adverse events rate) of the two groups were compared. Results: Compared with the control group, the DCR (90.2%) of the study group was significantly improved, with statistical difference (χ2=4.803, P=0.028). Compared with the control group, the median PFS (5.2 months) of the study group was significantly longer, but the difference was not statistically significant (χ2=3.560, P=0.059). Compared with the sub group with TPS 1~49%, the median PFS (6.0 months) of the subgroup with TPS≥50% in the study group was significantly longer, with statistical difference (χ2=4.223, P=0.040). In the subgroup for TPS≥50%, the median PFS (6.0 months) of the study group was significantly longer than that of the control group, with statistical difference (χ2=5.207, P=0.023). Compared with the control group, the incidence of immune pneumonia in the study group was higher with statistical difference (χ2=4.630, P=0.031). Conclusion: Pembrolizumab may have better short-term and long-term efficacy in patients with advanced NSCLC who have negative driver genes after the progression of platinum-containing chemotherapy, and for patients with PD-L1 TPS≥50%, pembrolizumab may be more effective, but at the same time attention should be paid to possible immune-related adverse reactions. 2021 Vol. 27 (12): 2090-2095 [Abstract] ( 190 ) HTML (1 KB)  PDF (1517 KB)  ( 173 ) 2096 Effects of Dexmedetomidine on Restlessness Stress Response and Immune Function in Elderly Patients with Lower Limb Fractures During Recovery from General Anesthesia LI Songlin, LI Xian, ZENG Bin, et al DOI: 10.3969/j.issn.1006-6233.2021.12.035 Objective: To explore the effect of general anesthesia of dexmedetomidine used in elderly patients with lower limb fractures on restlessness, stress response and immune function during the recovery period. Methods: A total of 128 elderly patients who underwent lower limb fracture surgery in our hospital from January 2020 to December 2020 were selected. According to different anesthetics, 67 patients who were given sodium chloride solution were included in the control group, and 61 patients who were given dexmedetomidine were included in the study group. The Riker Sedation and Restlessness Score (RSAS) was used to assess the agitation of the two groups of patients during the recovery period, and to compare the two groups of stress responses [norepinephrine (NE), epinephrine (E) and cortisol (Cor)], immune function [CD4+, CD4+/CD8+] changes and complications during recovery from anesthesia. Results: The RAS score of the study group was significantly lower than that of the control group at 30 min (T1), 60 min (T2) and the end of the operation (T3) after treatment (P<0.05). E, NE, and Cor increased at T1, T2, and T3 in the two groups compared with preoperative (T0) (P<0.05), but the E, NE, and Cor in the study group were significantly lower than those in the control group at T2, T3 (P<0.05). The levels of CD4+ and CD4+/CD8+ at the end of anesthesia, 24h after operation, and 48h after operation were lower in both groups than before induction of anesthesia (P<0.05), but the study group was significantly higher than the control group (P<0.05). The incidence of restlessness (1.64% vs 14.93%) and the incidence of complications (18.03% vs 35.82%) in the study group were significantly lower than those in the control group (P<0.05). Conclusion: Dexmedetomidine is used for general anesthesia in elderly patients with lower limb fractures, which can reduce restlessness during recovery, reduce postoperative complications, reduce stress response, and improve immune function. 2021 Vol. 27 (12): 2096-2100 [Abstract] ( 113 ) HTML (1 KB)  PDF (1210 KB)  ( 147 ) 2101 Effect of Jianpi Yishen Zhuanggu Decoction on Primary Osteoporosis and Its Influence on Serum IGF-1 MMP-9 and ET-1 WEI Haiying, et al DOI: 10.3969/j.issn.1006-6233.2021.12.036 Objective: To investigate the therapeutic effect of Jianpi Yishen Zhuanggu Decoction on primary osteoporosis. Methods: 200 patients with primary osteoporosis admitted to our hospital from March 2017 to March 2020 were selected as the research subjects and randomly divided into a control group (n=100) and an observation group (n=100); the control group was administered vitamin D calcium chewable tablets (0.6g / time, 1 time / day) and calcitriol capsules (0.25μg / time, 3 times / day), the observation group was administered Jianpi Yishen Zhuanggu Decoction (1 dose per day) on the basis of the control group. The total effective rate, TCM symptom score, pain visual analogue scale (VAS), lumbar bone mineral density (BMD), biochemical indicators of bone turnover [PINP,β-CTX] and serum levels of insulin-like growth factor-1 (IGF-1), matrix metalloproteinase-9 (MMP-9) and endothelin-1 (ET-1) were compared between the two groups. Adverse reactions were observed. Results: The total effective rate of the observation group was higher than that of the control group (94.00% vs 82.00%) (P<0.05). After 6 months of treatment, the TCM symptom score, VAS score, PINP and β-CTX levels in the observation group were lower than those in the control group (P<0.0 ). The serum IGF-1 in the observation group was higher than that in the control group, and MMP-9 and ET-1 levels were lower than those in the control group (P<0.05). Conclusion: Jianpi Yishen Zhuanggu Decoction has a significant effect on primary osteoporosis, effectively alleviating symptoms, increasing bone density, and improving bone metabolism. The mechanism may be related to the up-regulation of IGF-1 and down-regulation of MMP-9. ET-1 expression is related. 2021 Vol. 27 (12): 2101-2104 [Abstract] ( 111 ) HTML (1 KB)  PDF (1207 KB)  ( 214 )

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