Home  |  About Us  |  Editorial Board  |  Instruction  |  Subscribe  |  Advertisement  |  Messages  |  Contact Us  |  中文

Office Online         Journal Just Accepted Current Issue Archive Advanced Search Most Read Most Download Email Alert            Download More...              Links More...

2022 Vol. 28, No. 2 Published: 2022-02-28 177 Analgesic Effect and Mechanism of Ulinastatin on Neuropathic Pain Rat Model Based on CN / IL-10 Signaling Pathway HUANG Yuyuan, WEI Xuemei, ZHENG Yuxiu, et al DOI: 10.3969/j.issn.1006-6233.2022.02.01 Objective: To investigate the analgesic effect of ulinastatin (UTI) on rat model of neuropathic pain and its related molecular mechanism. Methods: Forty SD rats were randomly divided into sham group, CCI group, UTI group and UTI + Tacrolimus (FK506) group, with 10 rats in each group. Except sham group, chronic constriction injury (CCI) model was established in other groups, after the rats in each group were given the corresponding treatment, the changes of pain behavior were measured by pain behavior measurement, the morphological changes of sciatic nerve tissue were detected by hematoxylin eosin (HE) staining, and the levels of interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor- α(TNF- α) in sciatic nerve tissue were detected by enzyme-linked immunosorbent assay (ELISA); TdT-mediated dUTP nick end labeling (TUNEL) was used to detect the apoptosis of rat sciatic nerve; Western blot was used to detect the protein expression of calcineurin (CN) and interleukin-10 (IL-10). Results: UTI can reduce CCI induced neuropathic pain in rats, alleviate the pathological injury of sciatic nerve tissue, and reduce the levels of IL-6, IL-1β and TNF-α in sciatic nerve tissue, and decrease the number of apoptosis of sciatic nerve cells, the expression of CN and IL-10 protein in sciatic nerve tissue of rats with neuropathic pain was significantly up-regulated, the difference was statistically significant (P<0.05). FK506, an inhibitor of CN, attenuated the effect of UTI on neuropathic pain rats, and down-regulated the protein expression of CN and IL-10 in sciatic nerve tissue of neuropathic pain rats, the difference was statistically significant (P<0.05). Conclusion: UTI may reduce inflammation and apoptosis in neuropathic pain rats by regulating CN/IL-10 signaling pathway, and then alleviate the neuropathic pain of rats. 2022 Vol. 28 (2): 177-182 [Abstract] ( 148 ) HTML (1 KB)  PDF (1784 KB)  ( 243 ) 182 ZLN005 Alleviates Sepsis Induced Acute Lung Injury by Upregulating PGC-1α Expression to Induce M2-Type Differentiation of Macrophages ZHANG Hao, TAN Yun, YANG Luyu DOI: 10.3969/j.issn.1006-6233.2022.02.02 Objective: To explore the role and mechanism of ZLN005 in sepsis induced acute lung injury (ALI). Methods: Sepsis induced acute lung injury model in mice was established by cecal ligation and puncture (CLP), and the mice were divided into four groups according to different treatment. Methods: sham group, ZLN005 group, CLP Group and CLP +ZLN005 group; RT-PCR, immunofluorescence staining and Western blot were used to detect peroxisome proliferator activated receptor (PPAR) in lung tissue of mice γ coactivator-1 α( PGC-1 α). The mRNA and protein expression levels were measured; ELISA was used to detect the contents of TNF-α,IL-1β,IL-6 and IL-10 in BALF; HE staining was used to observe the histopathological damage of lung tissue; the survival rate of mice in each group after 7 days of CLP modeling was analyzed by statistical method; RAW264.7 was cultured in vitro and transfected with si-PGC-1α siRNA. RT-PCR and Western blot were used to detect the transfection efficiency. RAW264.7 cells were divided into five groups: NC group, ZLN005 group, LPS group, LPS+ZLN005+si-NC and LPS+ZLN005+si-PGC-1 α. RT-PCR was used to detect the mRNA expression levels of M1 macrophage markers iNOS and MHC-Ⅱ, M2 macrophage markers Arg1 and CD206. The phosphorylation level of p-AMPK-α/AMPK-α and the key proteins in mitochondrial biogenesis of Nrf1, Nrf2 and mtTFA was detected by Western blot. Results: Compared with sham group, the mRNA and protein expression levels and fluorescence intensity of PGC-1α in lung tissues of ZLN005 group and CLP+ZLN005 group were significantly increased (P<0.05), while those in CLP group were significantly decreased (P<0.05). Compared with the CLP group, the above detection indexes in the CLP+ZLN005 group were significantly increased (P<0.05). BALF, HE staining and survival rate 7 days after operation of mice in each group showed that the expressions of pro-inflammatory factors TNF-α, IL-1β and IL-6 in BALF and the pathological injury level of lung tissue in CLP group and CLP+ZLN005 group were significantly higher than those in sham group or ZLN005 group (P<0.05). However, the survival rate of anti-inflammatory factor IL-10 and postoperative 7 days were significantly decreased (P<0.05). Compared with the CLP group, the change trends of the above indexes in the CLP+ZLN005 group were significantly decreased (P<0.05). Compared with NC group, mRNA expression levels of M1 iNOS and MHC-Ⅱ in LPS group, ZLN005+LPS+si-NC group and ZLN005+LPS+si-PGC-1α group were significantly increased (P<0.05), meanwhile, the mRNA expressions of Arg1 and CD206 in Zln005+LPS+Si-NC group were significantly increased (P<0.05), while the protein expressions of p-AMPK-α/AMPK-α and NRF1, NRF2 and mtTFA were decreased (P<0.05). Compared with ZLN005+LPS+si-NC group, the mRNA expressions of iNOS and MHC-Ⅱ in LPS group and ZLN005+LPS+si-PGC-1α were significantly increased (P<0.05). The mRNA expression of Arg1 and CD206 and protein expression of p-AMPK-α/AMPK-α and NRF1, NRF2 and mtTFA were significantly decreased (P<0.05). Conclusion: ZLN005 can promote the expression of PGC-1α and promote the polarization of M2 macrophages to protect sepsis induced lung injury, and the mechanism may be related to the promotion of mitochondrial biogenesis by ZLN005 through AMPK signaling pathway. 2022 Vol. 28 (2): 182-189 [Abstract] ( 153 ) HTML (1 KB)  PDF (1931 KB)  ( 241 ) 189 Dexmedetomidine Protects Against Hepatic Ischemia/Reperfusion Injury in Rats via PI3K/AKT/CREB Signal Pathway HUANG Fuxiang, GAO Changsheng, ZHANG Shuang, et al DOI: 10.3969/j.issn.1006-6233.2022.02.03 Objective: To study the intervening effect of dexmedetomidine on hepatic ischemia/reperfusion injury rat model via PI3K/AKT/CREB signaling pathway. Methods: A total of 80 SPF SD rats underwent ischemia/reperfusion operation using a clamp occluding left portal and medial portal triad veins for 30 min, and then were randomly divided into a sham operation group (Sham), a model group (Model), a low-dose dexmedetomidine group (Dex-L), and a dexmedetomidine high-dose group (Dex-H); 10 animals sacrificed after reperfusion for 6h and 12h in each group. In the sham operation group, anesthesia followed by laparotomy was done withnot blocking the liver blood flow. The Dex-H group was intraperitoneally injected with 100μg/kg dexmedetomidine; the Dex-L group was intraperitoneally injected with 50μg/kg dexmedetomidine; the sham operation group and the model group were injected with solvent only. Automatic blood biochemical analyzer was used to detect serum Aspartate aminotransferase(AST) and Alanine aminotransferase(ALT) levels; HE staining was used to observe liver pathological changes; biochemical kits were used to detect serum Glutathione (GSH), Malondialdehyde (MDA), Superoxide dismutase (SOD)levels; Western Blot was used to detect PI3K, pAKT, AKT, CREB levels; PCR was used to detect the expressions of BAX and Bcl2. Results: Compared with the sham group, the serum ALT and AST levels in the model group significantly increased at different time points (P<0.05). Compared with the model group, the levels of ALT and AST after the intervention of different doses of dexmedetomidine both significantly reduced (P<0.05). The liver cells in the model group showed obvious swelling and degeneration, and the structure of the liver lobules was disordered. After 6 and 12 hours of intervention with different doses of dexmedetomidine, the liver pathology was improved, and the liver MDA level was significantly lower than that in the model group(P<0.05). The level of GSH significantly increased (P<0.05). Western blot results showed that compared with the model group, different doses of dexmedetomidine intervention for 6 and 12 hours, PI3K, phosphorylated AKT and CREB all significantly increased (P<0.05). The PCR results showed that compared with the model group, different doses of dexmedetomidine intervention for 6 and 12 hours and the expression of BAX significantly reduced (P<0.05), and the expression of Bcl2 significantly increased (P<0.05). Conclusion: Dexmedetomidine can significantly improve the serum and pathological indicators in hepatic I/R injury model rats, and inhibit oxidative stress and apoptosis Its mechanism may be related to the activation of PI3K/AKT/CREB signaling. 2022 Vol. 28 (2): 189-194 [Abstract] ( 191 ) HTML (1 KB)  PDF (1605 KB)  ( 208 ) 194 Mechanism of Empagliflozin Regulating Proliferation and Apoptosis of Human Glomerular Microvascular Endothelial Cells Induced by High Glucose Through MiR-497-3p/GPLD1 Pathway GAO Ruichao, LI Min, JIN Pengran, et al DOI: 10.3969/j.issn.1006-6233.2022.02.04 Objective: To explore the mechanism of empagliflozin (EMPA) regulating the proliferation and apoptosis of human glomerular microvascular endothelial cells (HRGEC). Methods: HRGEC was induced by 30 mmoL/L glucose to establish the renal injury cell model in high glucose environment. The damaged cells were treated with englitazin (250, 500, 1000nmoL/L). HRGEC cells were transfected with miR-NC group (transfected miR-NC), miR-497-3p group (transfected miR-497-3p), si-NC group (transfected si-NC), si-fish glycosylphosphatidylinositol specific phospholipase D1 (GPLD1) group (transfected si-GPLD1), EMPA + miR-497-3p + pcDNA group (co-transfected miR-497-3p and pcDNA), EMPA + miR-497-3p + pcDNA-GPLD1 group (co-transfected miR-497-3p and pcDNA-GPLD1), were all treated with 30mmoL/L glucose or 500 nmol / L empagliflozin. The cell proliferation rate and apoptosis rate were detected by cell counting kit (CCK-8) method and flow cytometry. The expressions of GPLD1, proliferating cell nuclear antigen (PCNA), cell cycle dependent protein kinase inhibitor 1a (p21), Caspase-3 and Caspase-9 were detected by western blotting (WB) assay. The binding ability of miR-497-3p to GPLD1 was detected by dual luciferase assay and RNA binding protein immunoprecipitation assay (RIP). Results: Compared with NG group, the proliferation rate significantly decreased in HG group, the apoptosis rate significantly increased, and the expression of miR-497-3p significantly decreased (P<0.05). Compared with HG group, the cell proliferation rate, apoptosis rate and the expression of miR-497-3p were significantly increased in empagliflozin (250, 500 and 1000nmoL/L) group (P<0.05). The optimal concentration of empagliflozin was 500 nmol/L. MiR-497-3p significantly inhibited the fluorescence activity of wild-type GPLD1 cells, promoted the expression of Ago2-GPLD1, and negatively regulated the protein expression of GPLD1. Overexpression of miR-497-3p and knockdown of GPLD1 had similar effects on promoting the proliferation and inhibiting apoptosis, up-regulating PCNA protein and down-regulating p21, caspase-3 and caspase-9 protein of HRGEC cells induced by high glucose. Overexpression of GPLD1 significantly weakened the regulatory effects on the proliferation and apoptosis of empagliflozin and overexpression of miR-497-3p in HRGEC cells induced by high glucose. Conclusion: Empagliflozin could promote the proliferation and inhibit apoptosis of HRGEC cells induced by high glucose, and its mechanism is related to the regulation of miR-497-3p / GPLD1 signal pathway. 2022 Vol. 28 (2): 194-201 [Abstract] ( 94 ) HTML (1 KB)  PDF (2023 KB)  ( 283 ) 201 Research of the Mechanism of Akebia Trifoliata Koidz Aqueous Extract on Glial Cells EMT LIU Jun, et al DOI: 10.3969/j.issn.1006-6233.2022.02.05 Objective: To investigate the effect and mechanism of Akebia trifoliata Koidz aqueous extract on epithelial-mesenchymal transformation of glioma cell line SHG-44 through long non-coding RNA(LncRNA) tumor susceptibility gene(CASC11)/microRNA-641 signaling axis. Methods: SHG-44 cells were cultured in medium containing 0, 30, 60, 90, 120 and 180 μg/mL Akebia trifoliata Koidz aqueous extract, respectively, and the cell survival rate was detected by MTT assay after 24 h. SHG-44 cells were randomly divided into control group, Akebia trifoliata Koidz aqueous extract group (treated with 90μg/mL Akebia trifoliata Koidz aqueous extract for 24h), NC group (transfected with NC for 24h), CASC11 mimic group (transfected with CASC11 mimic for 24h) and Akebia trifoliata Koidz aqueous extract +CASC11 mimic group (after transfecting with CASC11 mimic for 24h, treated with 90μg/mL Akebia trifoliata Koidz aqueous extract for 24h). Dual luciferin reporter gene was used to detect the targeting relationship between CASC11 and miR-641, the expression levels of CASC11 and miR-641 were detected by qRT-PCR, the cell migration ability was detected by scratching experiment, the cell invasion ability was detected by Transwell experiment, and epithelial cadherin (E-cad), nerve cadherin (N- cad) and Vimentin levels were detected by Western blot assay. Results: With the increase of aqueous extract concentration, the cell survival rate decreased in a dose dependent manner (P<0.05). Compared with the control group, the CASC11 expression level, the percentage of wound healing area, the number of invasive cells and the relative expression levels of N-cad and Vimentin proteins were decreased, while the miR-641 expression level and the relative expression level of E-cad protein were increased in Akebia trifoliata Koidz aqueous extract group(P<0.05). Compared with the Akebia trifoliata Koidz aqueous extract group, the expression level of CASC11, the percentage of wound healing area, the number of invasive cells and the relative expression levels of N-cad and Vimentin were increased in the aqueous extract group +CASC11 mimic group, while the expression level of miR-641 and the relative expression level of E-cad protein were decreased (P<0.05). Compared with NC group, the expression level of CASC11, the percentage of wound healing area, the number of invasive cells and the relative expressions of N-cad and Vimentin in CASC11 mimic group were increased, while the expression level of miR-641 and the relative expression level of E-cad protein were decreased (P<0.05). Compared with CASC11 mimic group, the expression level of CASC11, the percentage of scratch healing area, the number of invasive cells and the relative expression levels of N-cad and Vimentin in the group of Akebia trifoliata Koidz aqueous extract +CASC11 mimic were decreased, while the expression level of miR-641 and the relative expression level of E-cad protein were increased (P<0.05). Conclusion: The inhibitory effect of Akebia trifoliata Koidz aqueous extract on the epithelial-mesenchymal transformation of glioma cell line SHG-44 may be achieveded by decreasing the expression of CASC11 while increasing the expression of miR-641. 2022 Vol. 28 (2): 201-207 [Abstract] ( 77 ) HTML (1 KB)  PDF (1735 KB)  ( 149 ) 208 Apoptosis of Cutaneous Squamous Cell Carcinoma Cell Line SCL-1 Induced by Hedysari Polysaccharide Through Mitochondrial Pathway LU Qinglian, LIU Linli, JIANG Yahui, et al DOI: 10.3969/j.issn.1006-6233.2022.02.06 Objective: To observe the regulatory effect of Hedysari polysaccharide on SCL-1 cell apoptosis and explore its mechanism. Methods: SCL-1 cells were treated with radix Hedysari polysaccharide (25, 50, 100 μg/mL); 0 μg/ml SCL-1 cells treated with hedysari polysaccharide were set as the control group. The cell proliferation inhibition rate and apoptosis rate were detected by cell counting method (CCK8) and annexin V-fluorescein isothiocyanate propidium iodide (annexin V-FITC/PI). 50 μg/mL was the optimum concentration of Hedysari polysaccharide. The mitochondrial membrane potential was detected by JC-1 staining. Protein expression of cleaved poly DNA ribose polymerase (cleaved PARP), cleaved cysteine aspartate protease (caspase)-3, cleaved caspase-9 and cytochrome C in cytoplasm, mitochondria, second mitochondrial derived caspases activator (SMAC), B-cell lymphoma/leukemia 2 related X protein (Bax), pro-apoptotic gene (bak) were detected by Western blotting (WB). Results: Compared with the control group, the proliferation inhibition rate and apoptosis rate of SCL-1 cells significantly increased in Hedysari polysaccharide (25, 50, 100 μg/mL) group (P<0.05). 50 μg/mL hedysarum polysaccharide was affirmed the optimum concentration. Compared with the control group, the mitochondrial membrane potential decreased significantly (P<0.05), the expression of mitochondrial apoptosis related proteins cleaved PARP, cleaved caspase-3 and cleaved caspase-9 substantially increased (P<0.05), the expression of cytochrome c and Smac released by mitochondria obviously increased (P<0.05), and the expression of mitochondrial Bax and Bak protein significantly increased in hedysari polysaccharide group (P<0.05). Conclusion: Hedysari polysaccharide could promote the apoptosis of skin squamous cell carcinoma cell line SCL-1 by activating mitochondrial pathway. 2022 Vol. 28 (2): 208-213 [Abstract] ( 91 ) HTML (1 KB)  PDF (1705 KB)  ( 254 ) 213 LncRNA UC.48+ Promotes Cartilage Inflammation in Osteoarthritis by Activating the P2X7R/NF-κB Pathway LIU Jingxin, CHEN Yuxing, WANG Gui DOI: 10.3969/j.issn.1006-6233.2022.02.07 Objective: To study the regulatory effect of LncRNA uc.48+ on inflammation of knee osteoarthritis (OA) and explore its mechanism. Methods: Sodium iodoacetate (MIA) was injected into the joint cavity to induce OA in SD rats. The mechanical withdrawal threshold (MWT) and paw withdrawal thermal latency (PWTL) on the injection side of the knee joint were recorded within 21 days after injection. OS staining was used to observe the pathological changes of 21d joint tissues, and real-time quantitative PCR (qRT-PCR) was used to detect the levels of cartilage LncRNA uc.48+ and P2X7R. Plasmid pcDNA3.1 was used to construct LncRNA uc.48+ overexpression vector (pc-LncRNA uc.48+) and empty vector (pc-null). The rats were divided into sham group (n=10) and MIA group (n=50). Among them, 40 rats were randomly selected from the MIA group and randomly divided into pc-null group, pc-LncRNAuc.48+ group, pc-LncRNA uc .48++ Nucleotide P2X receptor (P2X7R) channel antagonist (AZD9056) group, pc-LncRNA uc.48++ nuclear factor κB (NF-κB) inhibitor (Helenalin) group (n=10). Western blot was used to detect the levels of P2X7R, P65, phosphorylated P65 (p-P65), matrix metalloproteinase (MMP)-13 and substance P (SP) in the above groups. ELISA was used to detect cartilage tissue prostaglandin (PG) E2, tumor necrosis factor (TNF)-α, and interleukin (IL)-1β. In vitro chondrocytes were transfected with pc-LncRNA uc.48+ or pc-null for 24h to detect the expression of P2X7R, P65, and p-P65. Results: Compared with the pre-modeling, MWT and PWTL of rats after 1d-21d of MIA injection decreased, and the joint PGE2, TNF-α, IL-1β all increased (all P<0.05). LncRNA uc.48+ continued to be up-regulated from 1d to 21d in the MIA group, and P2X7R mRNA was also up-regulated (all P<0.05). In MIA rats, the levels of PGE2, TNF-α, IL-1β, P2X7R, P65, and p-P65 in the pc-LncRNAuc. 48+ group were higher than those in the pc-null group (all P<0.05), while the levels of PGE2, TNF-α, IL-1β, P65, p-P65, MMP-13 and SP in the uc.48++AZD9056 group were lower than those in the pc-LncRNAuc.48+ group (all P<0.05). In addition, the levels of PGE2, TNF-α, IL-1β, MMP-13 and SP in the pc-LncRNA uc.48++ Helenalin group were lower than those in the pc-LncRNAuc.48+ group (all P<0.05). However, the P2X7R level of the pc-LncRNA uc.48++ Helenalin group and the pc-LncRNAuc.48+ group were not different (P>0.05). Conclusion: LncRNA uc.48+ promotes the inflammation of osteoarthritis cartilage tissue by activating the P2X7R/NF-κB signaling pathway. 2022 Vol. 28 (2): 213-219 [Abstract] ( 108 ) HTML (1 KB)  PDF (1921 KB)  ( 149 ) 220 The Effect of Per1 Gene on Cell Proliferation, Invasion and Migration of Oral Squamous Cell Carcinoma XU Gang, et al DOI: 10.3969/j.issn.1006-6233.2022.02.08 Objective: To investigate the effect and mechanism of Per1 gene on cell proliferation, invasion and migration of oral squamous cell carcinoma by regulating the Wnt/β-catenin signaling pathway. Methods: Human oral squamous cell carcinoma cells SCC-15 were cultured, and si-Per1 and si-NC were transfected into SCC-15 cells, as si-Per1 group and si-NC group. Per1 gene expression level was detected by RT-qPCR, cell proliferation ability was detected by MTT, cell invasion and migration ability were detected by Transwell chamber, and Ki-67, CyclinD1, MMP-2, MMP-9, β-catenin protein expression were detected by Western blot test. Results: Compared with the HOK group, the expression level of Per1 gene in Cal-27, SCC-4 and SCC-15 was significantly reduced (P<0.05). Compared with adjacent tissues, the expression level of Per1 gene in oral squamous cell carcinoma tissues was significantly reduced (P<0.05). Compared with the si-NC group, the OD value of the si-Per1 group was significantly increased (P<0.05), and the expression of Ki-67 and CyclinD1 protein was significantly increased (P<0.05). Compared with the si-NC group, the invasive and migration cells in the si-Per1 group were significantly increased (P<0.05), and the protein expression of MMP-2 and MMP-9 was significantly increased (P<0.05). Compared with the si-NC group, the β-catenin protein expression in the si-Per1 group was significantly reduced (P<0.05). Conclusion: High expression of Per1 gene can inhibit the proliferation, invasion and migration of oral squamous cell carcinoma cells, which is related to the inhibition of Wnt/β-catenin signaling pathway. 2022 Vol. 28 (2): 220-224 [Abstract] ( 117 ) HTML (1 KB)  PDF (1518 KB)  ( 267 ) 224 Effects of EPO (Erythropoietin) on the Expression of SDF-1 and VEGF and Pain After Pulp Revascularization in Molar Rats WANG Qin, LI Liheng, WANG Zhonghua, et al DOI: 10.3969/j.issn.1006-6233.2022.02.09 Objective: To investigate the effects of EPO (erythropoietin) on the expression of SDF-1 and VEGF and pain after pulp revascularization in molar rats. Methods: Totally 48 rats were randomly divided into normal group, model group (molar pulp revascularization rats), EPO-A group (molar pulp revascularization rats intraperitoneal injection of 250IU/Kg EPO) and EPO-B group (molar pulp revascularization rats intraperitoneal injection of 500IU/Kg EPO). ELISA method was used to detect the expression of TNF-α, IL-6 and IL-1β in the serum of each group of rats. HE staining was used to observe the morphology of root canal tissue. Western blotting was used to detect the protein levels of SDF-1 and VEGF in the root canal tissue. Human dental pulp cells were divided into normal group (human dental pulp cells), EPO group (human dental pulp cells given EPO intervention), VEGF group (human dental pulp cells given VEGF intervention) and SDF-1 group (human dental pulp cells given SDF-1 intervention). CCK-8 was used to detect the relative proliferation rate of 24h, 48h and 72h cells. qRT-PCR detects the relative expression of SDF-1 and VEGF mRNA. Results: Compared with the normal group, the serum levels of TNF-α, IL-6 and IL-1β in the model group increased (P<0.05).Compared with the model group, the inflammatory indexes in the serum of rats in the EPO-A group and EPO-B group were reduced (P<0.05), and the EPO-B group was lower than the EPO-A group (P<0.05); the expression level of SDF-1 and VEGF protein in the root canal tissue of the model group was lower than that of the normal group (P<0.05).The protein expression levels of SDF-1 and VEGF in the EPO-A and EPO-B groups were higher than those in the model group (P<0.05), and there was a significant difference between the EPO-B group and the EPO-A group (P<0.05). When the human dental pulp cells were cloned to the second generation, the morphology of the cells was observed under inverted microscope. It was found that the cells were in good growth condition, showing spindle shape or star shape. The cells were closely arranged, the cytoplasm was abundant, the processes of the cytoplasm were interconnected, and the nuclei were oval and located in the center of the cells, with obvious nucleoli. The relative proliferation rate of human dental pulp cells in EPO group, SDF-1 group and VEGF group at 24h, 48h and 72h was higher than that in normal group (P<0.05). Compared with the normal group, the mRNA expressions of SDF-1 and VEGF in EPO, SDF-1 and VEGF groups were increased (P<0.05), but the mRNA levels of SDF-1 and VEGF in EPO, SDF-1 and VEGF groups were not significant (P>0.05). Sdf-1 mRNA was positively correlated with VEGF mRNA (r=0.576, P=0.003). Conclusion: Eerythropoietin can reduce IL-1Β level and relieve pain after molar pulp revascularization in rats, and promote angiogenesis to participate in revascularization by up-regulating the expression of SDF-1 and VEGF. 2022 Vol. 28 (2): 224-229 [Abstract] ( 83 ) HTML (1 KB)  PDF (1939 KB)  ( 172 ) 230 Histogram Analysis of Gd-EOB-DTPA Enhanced MRI Hepatobiliary Phase for Diagnosing Liver Fibrosis DENG Leijiao, LIANG Xiaolei, WEI Yuhui, et al DOI: 10.3969/j.issn.1006-6233.2022.02.010 Objective: To explore the value of histogram analysis based on Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DPTA) enhanced MRI hepatobiliary phase in diagnosing and staging liver fibrosis (LF). Methods: Hepatobiliary phase image of 83 patients with pathologically confirmed LF were retrospectively reviewed. MaZda software was used to extract histogram analysis parameters including minimum, maximum, mean, skewness, kurtosis, variance, and nth percentiles. Parameters were compared among different LF stages using receivers operating characteristic curve. Results: Eighty-three patients were included, and 17, 15, 21, 16, and 14 cases were pathologically diagnosed as F0-F4, respectively. Histogram analysis parameters including the 90th (r= 0.554), variance (r= 0.484), mean (r=0.387), 50th (r=0.347), kurtosis (r=0.279) and 99th parameter (r=0.255) of hepatobiliary phase demonstrated significant positive correlation with increasing fibrosis stage (P<0.05). The 90th parameter demonstrated higher diagnostic efficacy than other histogram analysis parameters in fibrosis staging, with an AUC value of 0.79 for ≥ F1, 0.78 for ≥ F2, 0.76 for ≥ F3, and 0.82 for ≥ F4, respectively. Conclusion: Histogram analysis of Gd-EOB-DPTA enhanced MRI hepatobiliary phase provides higher diagnostic value in predicting LF progression and distinguishing LF stages, which may be served as effective imaging alternative in staging HF. 2022 Vol. 28 (2): 230-235 [Abstract] ( 82 ) HTML (1 KB)  PDF (1719 KB)  ( 161 ) 236 Expression and Significance of C-erbB-2 and NuSAP1 in Triple Negative Breast Cancer with Axillary Lymph Node Metastasis LIU Xianghua, LV Yonggang, MENG Qingjie, et al DOI: 10.3969/j.issn.1006-6233.2022.02.011 Objective: To investigate the expression of epidermal growth factor receptor 2 (C-erbB-2) and nuclear spindle associated protein 1 (NuSAP1) in tumor tissues and paracancer tissues of triple negative breast cancer patients with axillary lymph node metastasis and to analyze their significance. Methods: Clinical data of 150 breast cancer patients treated in our hospital from July 2016 to October 2020 were retrospectively selected, and the patients were divided into observation group (triple negative breast cancer) and control group (non triple negative breast cancer) according to immunohistochemistry, with 49 cases in observation group and 101 cases in control group. The expression levels of C-erbB-2 and NuSAP1 were compared between the two groups, and their relationship with axillary lymph node metastasis was analyzed. Results: The high expression rate of C-erbB-2 in observation group was 87.76%, which was significantly higher than that in control group (63.37%) (P<0.05). The positive high expression rate of NuSAP1 in observation group was 79.59%, which was significantly higher than that in control group (61.39%) (P<0.05). Among the 49 patients with triple negative breast cancer, 22 had no axillary lymph node metastasis and 27 had axillary lymph node metastasis. The axillary lymph node metastasis rate of c-erbB-2 and NuSAP1 high expression group was significantly higher than that of low expression group (P<0.05). Conclusion: The positive overexpression rate of C-erbB-2 and NuSAP1 in triple negative breast cancer is higher than that in non triple negative breast cancer, and the positive overexpression rate of C-erbB-2 and NuSAP1 in axillary lymph node metastasis is significantly higher than that in non-axillary lymph node metastasis, which may be a new prognostic indicator. 2022 Vol. 28 (2): 236-240 [Abstract] ( 150 ) HTML (1 KB)  PDF (1237 KB)  ( 157 ) 240 Effects of Continuous Renal Replacement Therapy Combined with Hemadsorption on Renal Function and Levels of Serum TLR4 and CTnI in Treating Septic Shock LI Yan DOI: 10.3969/j.issn.1006-6233.2022.02.012 Objective: To observe the effects of continuous renal replacement therapy (CRRT) combined with hemadsorption on renal function and levels of serum Toll-like receptor 4 (TLR4) and cardiac troponin I (cTnI) in the treatment of septic shock. Methods: A total of 139 patients with septic shock treated in the hospital between October 2018 and October 2020 were selected as the research subjects, and they were divided into control group (69 cases) and observation group (70 cases) according to the stratified randomization of the random number table method. The control group was given conventional treatment, and the observation group was given CRRT combined with hemadsorption on the basis of conventional treatment. The perioperative basic status (shock duration, ambulation time, hospital stay) were compared between the two groups, and the renal function [serum cystatin C (cysC), neutrophil gelatinase-associated lipocalin (NGAL)], immune function [TLR4, nuclear factor-κB (NF-κB)] and myocardial function [cTnI, creatine kinase isoenzyme MB (CK-MB)] of the two groups of patients were compared before treatment and 1 week after treatment. Results: The shock duration, ambulation time and hospital stay in observation group were significantly shorter than those in control group (P<0.05). 1 week after treatment, the levels of cysC, NGAL, TLR4, NF-κB, cTnI and CK-MB in the two groups were significantly decreased compared with those before treatment (P<0.05), and the decrease ranges of cysC, NGAL and NF-κB in observation group were significantly higher than those in the control group (P<0.05). Conclusion: CRRT combined with hemadsorption has a significant efficacy on patients with septic shock, and it can effectively improve the renal function, remove the inflammatory mediators, and reduce the levels of serum TLR4 and cTnI, with high clinical application value. 2022 Vol. 28 (2): 240-244 [Abstract] ( 94 ) HTML (1 KB)  PDF (1233 KB)  ( 147 ) 244 Construction of a Predictive Model for Congenital Heart Malformations Based on Fetal Ultrasound Soft Indicators and Metabolic Factors in the First Trimester CHEN Congli, QU Dongying DOI: 10.3969/j.issn.1006-6233.2022.02.013 Objective: To explore the value of the predictive model constructed by fetal ultrasound soft index and metabolic index in the prediction of congenital heart malformations. Methods: Totally 200 cases of pregnant women with high risk factors for CHD who received prenatal examinations in the Department of Obstetrics and Gynecology of our hospital from April 2018 to May 2020 were included. The urine of all pregnant women at the 11~13+6 weeks of pregnancy was collected during the obstetric examination, and liquid chromatography -Mass spectrometry (LC-MS) method was used to detect the levels of 4-hydroxyphenylacetic acid, acrylic acid, malonic acid and uric acid in urine; fetal echocardiography is used to check the thickness of fetal neck transparent layer (Nuchal translucency, NT) and cardiac tricuspid regurgitation Abnormal flow and venous catheter blood flow. According to whether the fetus was diagnosed with CHD in the later follow-up, the pregnant women were divided into CHD group and control group; the clinical data of the two groups of pregnant women were compared, and the multivariate logistic regression equation was used to analyze the relevant factors affecting the fetal heart malform R software was used to build a nomogram prediction model based on the training set, and the effectiveness of the model was evaluated on the test set. Results: The urine levels of 4-hydroxyphenylacetic acid, acrylic acid, malonic acid, and uric acid of the observation group were higher than those of the control group, and the NT thickness, the proportion of tricuspid regurgitation, and the proportion of abnormal blood flow in the venous catheter were higher than those of the control group. The difference was statistically significant (P<0.05); Multivariate logistic regression analysis showed that urine levels of 4-hydroxyphenylacetic acid (OR=2.740), high acrylic acid levels (OR=3.242), high uric acid levels (OR=1.013) and NT values increased (OR=20.411) and tricuspid regurgitation (OR=9.028) are independent risk factors for fetal congenital heart malformations in the first trimester (P<0.05); by constructing a nomogram prediction model, the results show that the model predicts fetal CHD risk with the consistency index (C-index) 0.915. External verification showed that the sensitivity was 88.00%, the specificity was 96.36%, the accuracy rate was 93.75%, the positive predictive value was 91.67%, and the negative predictive value was 94.64%. Conclusion: Early pregnancy ultrasound examination of NT thickness, tricuspid regurgitation, and the levels of 4-hydroxyphenylacetic acid, acrylic acid and uric acid in the urine of pregnant women are related to the risk of fetal CHD. The prediction model based on ultrasound soft indicators and metabolic indicators has a good predictive performance for higher risk of fetal CHD. 2022 Vol. 28 (2): 244-249 [Abstract] ( 140 ) HTML (1 KB)  PDF (1307 KB)  ( 222 ) 250 Effect of Different Doses of Propofol on Emergence Agitation, Sedative Effect and Vital Signs of Children After Sevoflurane Anesthesia ZHAO Jianghe, WU Xiaole, LI Li, et al DOI: 10.3969/j.issn.1006-6233.2022.02.014 Objective: To investigate the effect of different doses of propofol on emergence agitation, sedative effect and vital signs of children after sevoflurane anesthesia. Methods: Totally 173 children who underwent elective tonsillectomy in the hospital between February 2018 and July 2020 were randomly divided into group A (n=55), group B (n=60) and group C (n=58). All were given general anesthesia with sevoflurane. Children in group A were injected intravenously with 0.10ml/kg of 0.90% sodium chloride injection, while children in group B and group C were injected intravenously with 1.00mg/kg and 2.00 mg/kg of propofol, respectively. Postoperative recovery and changes in vital signs before induction of anesthesia (T0), immediately after operation (T1), at extubation (T2), 5min after extubation (T3) and 10min after extubation (T4) were observed. The Pediatric Anesthesia Emergence Delirium Scale (PAED) scores, Ramasay sedation scores (RSS) and the Face, Legs, Activity, Cry and Consolability (FLACC) scores at T2~T4 were recorded. Adverse reactions were observed. Results: The length of PACU stay of group C was significantly shorter than that of the other two groups (P<0.05); there were no significant differences in other indicators (P>0.05). Compared with T0, HR and MAP of group A and group B increased significantly at T, T2 and T3. HR and MAP of group C increased significantly at T1 and T2 (P<0.05). Compared with group A and group B, HR and MAP of group C were significantly lower at T1, T2 and T3 (P<0.05). Compared with T2, the PAED scores and FLACC scores of the three groups decreased significantly, and the RSS scores increased at T3 and T4 (P<0.05). The PAED scores and FLACC scores of group C at T2, T3 and T4 were significantly lower than those of group A and group B, and the RSS scoreswere significantly higher than those of group A and group B (P<0.05). No adverse reactions such as vomiting, spasm, hypoxia and asphyxia were observed in the three groups after operation. Conclusion: Intravenous injection of 2.00 mg/kg of propofol after operation can effectively prevent postoperative emergence of agitation and maintain stable vital signs of the children, with obvious sedative and analgesic effects and high safety. 2022 Vol. 28 (2): 250-254 [Abstract] ( 121 ) HTML (1 KB)  PDF (1238 KB)  ( 259 ) 254 The Relationship Between Serum Ficolin-3, ADAM10 Levels and Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus XU Lingyan, YOU Shiyao, NING Jie DOI: 10.3969/j.issn.1006-6233.2022.02.015 Objective: To investigate the relationship between serum Ficolin-3, A disintegrin and metalloproteinase 10 (ADAM10) levels and carotid atherosclerosis (CAS) in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 234 T2DM patients were selected as the T2DM group, and were divided into the CAS group (n=68) and the non-CAS group (n=166) according to whether or not they had CAS. In addition, 78 healthy people for physical examination during the same period were selected as the control group. The clinical data of T2DM patients were collected, and the serum Ficolin-3 and ADAM10 levels of all subjects were determined by enzyme-linked adsorption method. Pearson correlation was used to analyze the correlation between serum Ficolin-3, ADAM10 levels and carotid artery intima-media thickness in T2DM patients. Multivariate Logistics regression was used to analyze the relationship between serum Ficolin-3, ADAM10 levels and CAS in T2DM patients, and ROC curve was used to analyze their predictive value for CAS in T2DM patients. Results: Compared with the control group, the serum Ficolin-3 and ADAM10 levels in the T2DM group were significantly increased (P<0.05); compared with the non-CAS group, the serum Ficolin-3 and ADAM10 levels in the CAS group were significantly increased (P<0.05). Serum Ficolin-3 and ADAM10 levels in patients with T2DM were positively correlated with carotid artery intima-media thickness (r=0.576, 0.630, all P<0.05). Ficolin-3 (OR=1.196, 95%CI: 1.104～1.295) and ADAM10 (OR=2.896, 95%CI: 1.497～4.602) were independent influencing factors of CAS in T2DM patients (P<0.05). Ficolin-3 combined ADAM10 predicts that the area under the curve (AUC) of CAS in T2DM patients is significantly greater than Ficolin-3 , ADAM10 prediction (P<0.05). Conclusion: Serum Ficolin-3 and ADAM10 levels in T2DM patients are elevated, which are independent risk factors for CAS and can be used as predictive indicators of CAS in T2DM patients. 2022 Vol. 28 (2): 254-259 [Abstract] ( 98 ) HTML (1 KB)  PDF (1287 KB)  ( 189 ) 259 Relationship of Serum YKL-40 and Irisin Levels with Glucose and Lipid Metabolism and Insulin Resistance in Pregnant Women with Gestational Diabetes Mellitus SONG Jie, et al DOI: 10.3969/j.issn.1006-6233.2022.02.016 Objective: To investigate the correlation of serum human cartilage glycoprotein-39 (YKL-40) and irisin levels with glucose and lipid metabolism and insulin resistance (IR) in pregnant women with gestational diabetes mellitus (GDM). Methods: A total of 148 pregnant women with GDM (GDM group) admitted to Hainan Provincial People's Hospital between January 2018 and January 2021were enrolled in this study. Meanwhile, with the gestational age matching principle, 50 healthy pregnant women who received routine examinations in obstetric department of the hospital were selected as the control group. The levels of serum YKL-40, irisin, fasting plasma glucose (FPG), 2 hours postprandial plasma glucose (2hPG), glycosylated hemoglobin (HbAlc), total cholesterol (TC), high/low density lipoprotein cholesterol (H/LDL-C), triglyceride (TG) and fasting insulin (FINS) were compared between the two groups. The insulin resistance index (HOMA-IR) and insulin secretion index (HOMA-B) were calculated. Pearson correlation analysis was performed to test the correlation of serum YKL-40 and irisin with other indicators. Results: Compared with the control group, the GDM group had higher levels of serum YKL-40, FPG, 2hFPG, HbAlc, TC, LDL-C, TG, FINS and HOMA-IR, and lower levels of irisin, HDL-C and HOMA-B (P<0.05). Pearson correlation analysis showed that serum YKL-40 was positively correlated with FPG, 2hFPG, TC, LDL-C, TG, FINS and HOMA-IR, and negatively correlated with HDL-C and HOMA-B (P<0.05). Serum irisin was negatively correlated with FPG,2hFPG, HbAlc, TC, LDL-C, TG, FINS and HOMA-IR, and positively correlated with HDL-C and HOMA-B (P<0.05). Conclusion: Pregnant women with GDM have high serum YKL-40 level and low irisin level. The two are closely related to glucose and lipid metabolism and insulin resistance, with certain clinical value in the diagnosis and treatment of GDM. 2022 Vol. 28 (2): 259-263 [Abstract] ( 87 ) HTML (1 KB)  PDF (1250 KB)  ( 151 ) 263 Comparison of the Values of Thromboelastogram and Traditional Coagulation Index in Monitoring Coagulation Function of Pregnant Women with Gestational Diabetes Mellitus ZHANG Yang, et al DOI: 10.3969/j.issn.1006-6233.2022.02.017 Objective: To compare the monitoring value of thrombolysis and traditional coagulation indexes in pregnant women with gestational diabetes mellitus (GDM). Methods: A total of 86 GDM patients admitted to our hospital between January 2019 and November 2020 were selected as observation group, and 70 healthy pregnant women in the same period for pregnancy test were selected as control group. Both groups had traditional coagulation indexes and thrombus elastic graph (TEG) monitoring, the test results were compared and correlation of TEG and traditional coagulation index was analyzed. Results: Fibrinogen (FIB) and platelet (PLT) in the observation group were higher than those in the control group, and activated partial thrombin time (APTT) was lower than that in the control group, between-group variance showed P<0.05, but there were no significant differences in prothrombin time (PT) and D-dimer (D-D) between the two groups (P>0.05); the coagulation time (K value) and reaction time (R value) in observation group were lower than those in control group, while the Angle, maximum amplitude (MA) and coagulation composite index (CI value) in observation group were higher than those in control group, and the differences were statistically significant (P<0.05); Pearson correlation analysis showed that PLT and FIB were negatively correlated with K, and positively correlated with Angle, MA and CI (P<0.05). Conclusion: TEG index can reflect the coagulation function of pregnant women with GDM, and has higher predictive value than traditional coagulation indexes, which can be used as an auxiliary means for monitoring coagulation function indexes and provide reference for the early treatment of pregnant women with GDM. 2022 Vol. 28 (2): 263-267 [Abstract] ( 131 ) HTML (1 KB)  PDF (1241 KB)  ( 306 ) 267 The Predictive Value of Serum IL-17A and OXA for Postoperative Cognitive Dysfunction in Elderly Patients of Hip Fracture Undergoing General Anesthesia CHEN Meizhu, LUO Lin, TIAN Yi DOI: 10.3969/j.issn.1006-6233.2022.02.018 Objective: To investigate the predictive value of serum interleukin-17A (IL-17A) and orexin A (OXA) for postoperative cognitive dysfunction in elderly patients of hip fracture undergoing general anesthesia and analyze the influencing factors. Methods: A total of 185 elderly patients of hip fracture undergoing general anesthesia were selected as the research subjects. According to their postoperative cognitive dysfunction, they were divided into cognitive dysfunction group (POCD group, 51 cases) and non-cognitive dysfunction group (NPOCD group, 134 cases). The serum levels of IL-17A and OXA were detected by ELISA. The receiver operating characteristic (ROC) curve were used to analyze the predicting value of serum IL-17A and OXA levels on POCD, and multivariate logistic regression analysis was used to analyze the influencing factors of POCD. Results: The levels of IL-17A and OXA in the two groups were significantly higher than those before operation (P<0.01). The level of OXA in POCD group was significantly higher than that in NPOCD group (P<0.01), while the level of OXA in POCD group was lower than that in NPOCD group (P<0.01). The ROC curve analysis showed that the cutoff values of serum IL-17A and OXA for POCD prediction were 33.96 ng/ml and 249.70 pg/ml, respectively, and AUC were 0.843 and 0.799, respectively. The logistic regression analysis showed that age, preoperative complications≥3, serum IL-17A≥33.96pg/ml, OXA≤249.70pg/ml were the influencing factors of POCD. Conclusion: Serum IL-17A and OXA levels are the influencing factors of cognitive dysfunction in elderly patients of hip fracture after general anesthesia. They are closely related to cognitive dysfunction and could be used as biomarkers for predicting POCD. 2022 Vol. 28 (2): 267-271 [Abstract] ( 94 ) HTML (1 KB)  PDF (1313 KB)  ( 193 ) 271 Effect of Single- and Bilateral-Injection and Trans-Injury Nail on the Curative Effect and Prognosis of A1 Thoracolumbar Fractures WANG Lishan, LU Haibo, QIAN Hao DOI: 10.3969/j.issn.1006-6233.2022.02.019 Objective: To explore the effect of single, bilateral nail and trans-nail on the efficacy and complications of type A1 thoracolumbar fracture. Methods: A total of 129 patients with A1 thoracolumbar fractures admitted from May 2019 to May 2020 were selected as the subjects who were simply randomly divided into group A, B and C, 43 cases in each. Patients in group A were treated with trans-vertebral screw placement, patients in group B with trans-vertebral screw placement on one side, patients in group C with trans-vertebral screw placement on both sides. The three groups were followed up for 1 year to compare the differences in surgical indexes, efficacy and complication. Results: During the follow-up, all patients had no serious complications such as vascular, nerve and visceral injuries during the operation. The amount of intraoperative blood loss and duration of operation in group A were lower than those in group B and C (P<0.05); walking time, full weight bearing time, hospital stay, ratio loss rate of anterior edge height and sagittal Cobb Angle loss rate of injured vertebrae were higher than those of B and C groups(P<0.05), but there was no significant difference between group B and group C (P>0.05).Repeated measures of ANOVA showed that 1 week and 1 year after surgery, Cobb Angle of sagittal position, high compression rate of anterior edge of injured vertebrae and Oswestry dysfunction score of injured vertebrae in group A were all higher than those in group B and C, and the differences were statistically significant(P>0.05). Conclusion: The treatment of injured vertebral nail in patients with A1 thoracic and lumbar fracture is better than the trans-injured vertebral nail, which can effectively prevent the late vertebral height loss and posterior protrusion deformity, and improve the prognosis of patients. Moreover, there is no obvious difference between single vertebra and bilateral nailing, which can be selected according to the patient's condition. 2022 Vol. 28 (2): 271-277 [Abstract] ( 84 ) HTML (1 KB)  PDF (1701 KB)  ( 168 ) 277 Effects of Ultrasound-Guided Lumbosacral Plexus Block Combined with Inhalation Anesthesia on Oxidative Stress, Immune Function and Cognitive Function in Patients Undergoing Total Hip Arthroplasty DONG Biqian, FAN Wanqiu, GAO Qin DOI: 10.3969/j.issn.1006-6233.2022.02.020 Objective: To investigate the effects of ultrasound-guided lumbosacral plexus block combined with inhalation anesthesia on oxidative stress, immune function and cognitive function in patients with total hip arthroplasty. Methods: 120 patients undergoing total hip arthroplasty in our hospital from December 2018 to December 2020 were selected. According to the random number table, they were divided into control group and study group, 60 cases in each. The patients in the control group were treated with inhalation anesthesia, and the patients in the study group were treated with ultrasound-guided lumbosacral plexus block combined with inhalation anesthesia, to compare the data of oxidative stress, immune function and cognitive function between the two groups before operation and 1d, 3d after operation. Results: There was no significant difference in SOD,MDA,CD3+,CD4+,CD8+,NK level and MMSE score between the two groups before operation (P>0.05). The SOD,CD3+,CD4+,NK level and MMSE score of the study group 1 d after operation were higher than those of the control group, and the MDA, CD8+ level were lower than those of the control group (P>0.05). Conclusion: Ultrasonic guided lumbosacral plexus block combined with inhalation anesthesia in patients with total hip arthroplasty can effectively reduce oxidative stress response, alleviate immunosuppression and reduce cognitive impairment, which is worthy of clinical application. 2022 Vol. 28 (2): 277-281 [Abstract] ( 104 ) HTML (1 KB)  PDF (1229 KB)  ( 138 ) 282 Effects of Ropivacaine Combined with Fentanyl Spinal Anesthesia and Bupivacaine Spinal Anesthesia on Anesthesia Effect and Postoperative Analgesia of Elderly Patients Undergoing Percutaneous Transforaminal Endoscopic Discectomy YANG Baizhu,YANG Lulu DOI: 10.3969/j.issn.1006-6233.2022.02.021 Objective: To analyze the effects of ropivacaine combined with fentanyl spinal anesthesia and bupivacaine spinal anesthesia on the anesthesia effect and postoperative analgesia of elderly patients undergoing percutaneous transforaminal endoscopic discectomy. Methods: 149 elderly patients who underwent percutaneous transforaminal endoscopic discectomy in this hospital between July 2019 and July 2020 were divided into control group (n=74) and observation group (n=75) with the random number table method. The control group underwent percutaneous transforaminal endoscopic discectomy under spinal anesthesia with pure bupivacaine, and the observation group underwent percutaneous transforaminal endoscopic discectomy under spinal anesthesia with ropivacaine combined with fentanyl. The anesthesia effect, postoperative analgesia effect, stress response indicators and postoperative cognitive function of the two groups were compared. Results: The anesthesia onset time, anesthesia block completion time and anesthesia recovery time of observation group were all faster than those of control group (P<0.05). At 4h, 12h and 24h after surgery, the postoperative sedation score (Ramsay) and facial expression grading score (FRS) were lower in observation group than those in control group (P<0.05). There were no statistical differences in the heart rate (HR), blood oxygen saturation (SpO2) and mean arterial pressure (MAP) in observation group compared with those before anesthesia (P<0.05), and the above values at 2h and 4h after anesthesia were higher than those in control group (P<0.05). At 7d, 14d and 28d after surgery, the Montreal Cognitive Assessment Scale (MoCA) score of observation group was significantly higher than that of control group (P<0.05). Conclusion: Percutaneous transforaminal endoscopic discectomy under ropivacaine combined with fentanyl spinal anesthesia has better anesthesia effect and postoperative analgesia effect than surgery under bupivacaine spinal anesthesia, and the former one can more effectively reduce the intraoperative stress response and has less impact on cognitive function of patients, thus it is worthy of clinical promotion. 2022 Vol. 28 (2): 282-287 [Abstract] ( 90 ) HTML (1 KB)  PDF (1240 KB)  ( 192 ) 287 Effect of Nalbuphine as an Adjuvant to Local Wound Infiltration Anesthesia Versus Quadratus Lumborum Block in Patients Undergoing Laparoscopic Radical Resection of Colon Cancer XU Jianfeng, HONG Min, HU Jian, et al DOI: 10.3969/j.issn.1006-6233.2022.02.022 Objective: To compare the effect of nalbuphine as an adjuvant to local wound infiltration anesthesia and quadratus lumborum block in patients undergoing laparoscopic radical resection of colon cancer. Methods: A total of 150 patients who planned to undergo laparoscopic radical resection of colon cancer in the Lishui Hospital of Zhongda Hospital affiliated to Southeast University from July 2019 to April 2021 were selected. The patients were randomly assigned to the local wound infiltration anesthesia group (L group), the nalbuphine adjuvant to local wound infiltration anesthesia group (N group) or the quadratus lumbar muscle block group (Q group), 50 patients in each group. Patients in group Q underwent ultrasound-guided bilateral quadratus lumbar muscle block after the operation; group L and group N underwent local infiltration anesthesia of incision, group L had 0.375% ropivacaine, total 40ml; group N had 0.375% ropivacaine + 20mg nalbuphine mixed solution, totally 40ml. NRS was used to evaluate the pain levels of the two groups of patients immediately after returning to the ward in a quiet state and an active state, 2h, 4h, 12h, and 24h after the operation. The number of PCIA compressions within 24 hours after surgery, postoperative nausea and vomiting (PONV), postoperative hypotension, dizziness, skin itching, and lower limb motor function block were recorded. Results: NRS scores in group N and Q at 12h postoperatively quiet state were significantly lower than those in group L, with statistical significance (P<0.05), while there was no statistical significance in NRS scores at 12h postoperatively quiet state between group N and Q (P>0.05). There was no significant difference in NRS scores between the three groups at each time point after operation (P>0.05). The number of PCIA pressing in group L within 24h after surgery was significantly higher than that in group N and Q, with statistical significance (P<0.05). The incidence of lower limb motion block in group Q was significantly higher than that in group L and group N, the difference was statistically significant (P<0.05). The incidence of pruritus in group N was significantly lower than that in group L and Q, with statistical significance (P<0.05). Conclusion: Nalbuphine as an adjuvant to local wound infiltration anesthesia can provide postoperative analgesic effect and duration similar to that of quadratus lumborum block in patients undergoing laparoscopic radical resection of colon cancer, and reduce the incidence of pruritus without affecting the lower limb movement function. 2022 Vol. 28 (2): 287-291 [Abstract] ( 113 ) HTML (1 KB)  PDF (1241 KB)  ( 177 ) 292 Clinical Observation of CYP2C9 and VKORC1 Gene Polymorphism Guiding Postoperative Anticoagulant Therapy in Patients with Heart Valve LIN Shengxiong, WU Danna, CAO Yiqiu DOI: 10.3969/j.issn.1006-6233.2022.02.023 Objective: To study the clinical value of CYP2C9 and VKORC1 gene polymorphisms in guiding postoperative anticoagulation therapy in patients with heart valves. Methods: A retrospective analysis was performed on AIS patients admitted to our hospital from March 2014 to July 2017. 95 patients undergoing CYP2C9 and VKORC1 gene polymorphism detection were selected as the study group, and 95 patients without detection were selected as the control group. The CYP2C9 and VKORC1 genotypes of the patients in the study group were observed, the warfarin dosage and the international normalized ratio (INR) compliance time of the patients with different genotypes were compared, and the INR compliance time of the study group and the control group were compared. Results: In the study group, 85 patients were of CYP2C9 *1/*1 type, 9 were of CYP2C9 *1/*3 type, 1 was of CYP2C9 *3/*3 type; 77 were of VKORC1 type AA, 18 were of VKORC1 AG type, VKORC1 GG type was not found. In the study group, patients with CYP2C9 *1/*1 type had a higher actual dose of warfarin than CYP2C9 *1/*3 patients, and the time for INR to reach the standard was shorter, and the difference was significant (P<0.05); patients of VKORC1 AA type had lower actual dose of warfarin, compared with VKORC1 AG patients, and the INR compliance time was shorter, and the difference was significant (P<0.05). The study group had shorter INR compliance time than the control group, and the difference was significant (P<0.05). Conclusion: The detection of CYP2C9 and VKORC1 gene polymorphisms in the postoperative anticoagulation therapy of heart valve patients plays an important role in the formulation and adjustment of the initial treatment plan, and can provide an important reference for the early clinical plan formulation. 2022 Vol. 28 (2): 292-295 [Abstract] ( 117 ) HTML (1 KB)  PDF (1220 KB)  ( 272 ) 295 Related Factors of Low Cardiac Output Syndrome in Patients with Mitral Regurgitation After Cardiac Valve Replacement and the Construction of Prediction Model LI Ling, LIU Zunji, GUO Yongzhong DOI: 10.3969/j.issn.1006-6233.2022.02.024 Objective: To analyze the related factors of low cardiac output syndrome (LCOS) in patients with mitral regurgitation (MR) after cardiac valve replacement (CVR), and to build the prediction model. Methods: A total of 163 patients with MR admitted to our hospital from January 2018 to December 2020 were selected as the research subjects. The baseline data of patients were recorded. All patients were treated with CVR. The operation related data were recorded, and the occurrence of LCOS was counted. The patients were divided into LCOS group and non-LCOS group. The baseline data and operation related data were compared between the two groups. Logistic regression analysis was used to examine the risk factors of LCOS in patients with MR after CVR; the LCOS prediction model was built. Hosmer-Lemeshow goodness-of-fit test was used, and the ROC curve was plotted, to evaluate the prediction efficiency of LCOS prediction model. Results: Among 163 MR patients in this study, LCOS occurred in 28 patients after CVR treatment, the incidence was 17.18%; the proportions of New York Heart Association (NYHA) classification, preoperative B-type natriuretic peptide (BNP), preoperative cardiac troponin T (cTnT) and water electrolyte disturbance in LCOS group were higher than those in non-LCOS group; cardiopulmonary bypass (CPB) time and aortic occlusion (ACC) time were longer than those in non-LCOS group; the postoperative blood loss was greater than that in non-LCOS group, and the preoperative LVEF was lower than that in non-LCOS group (P<0.05); the results of logistic regression analysis showed that high NHYA grade, low preoperative LVEF, high preoperative BNP, high preoperative cTnT, disturbance of water and electrolyte, long CPB time, long ACC time and large postoperative blood loss were risk factors for LCOS after CVR in MR patients (OR>1, P<0.05). The predictive model LCOS=0.951*NHYA classification (grade II=0, grade III=1)-0.179* preoperative LVEF + 0.015* preoperative BNP+3.869 * preoperative cTnT+1.014 * water electrolyte disorder (no=0, yes=1)+0.084 * CPB time+0.129 * ACC time+0.298 * postoperative blood loss was established, with the predictive risk value P=e (-17.813+LCOS)/[e (-17.813+LCOS)+1]*100%. The receiver operating curve (ROC) was plotted which showed that the AUC of LCOS prediction model for predicting the risk of LCOS after CVR in MR patients was 0.895, >0.80, which had certain predictive value; the LCOS prediction model tested by Hosmer-Lemeshow goodness-of-fit test found that χ2=3.324, P=0.912, P>0.05, the model had good correction ability and satisfactory fitting. Conclusion: The occurrence of LCOS after CVR in MR patients is affected by multiple risk factors. Combined with multiple risk factors, the LCOS prediction model is built, which has certain efficiency in predicting the LCOS of MR patients after CVR. 2022 Vol. 28 (2): 295-301 [Abstract] ( 113 ) HTML (1 KB)  PDF (1373 KB)  ( 166 ) 301 Correlation Between Serum CXCL-10 and IL-27 Levels and Severity of Diarrhea Patients with Clostridium Difficile Infection ZHANG Jinfang, et al DOI: 10.3969/j.issn.1006-6233.2022.02.025 Objective: To study the changes of serum CXCL chemokine ligand-10 (CXCL-10) and interleukin-27 (IL-27) levels in diarrhea patients with Clostridium difficile infection (CDI) and their correlation with the severity of the disease. Metods: A total of 150 patients with diarrhea were divided into observation group (positive Cd culture,n=90) and control group (negative Cd culture,n=60) according to the results of Cd culture. The patients in observation group were further divided into mild subgroup (score<4,n=38) and moderate-severe subgroup (score≥4,n=52) according to the severity score (SSI) of CDI. The serum levels of CXCL-10 and IL-27 were detected in all the three groups, and the correlation between the serum levels of CXCL-10 and IL-27 and the severity of CDI diarrhea was analyzed. Results: The serum levels of CXCL-10 and IL-27 in the three groups were as follows: observation group>control group>healthy group (P<0.05);the serum levels of CXCL-10 and IL-27 in the moderate-severe subgroup were significantly higher than those in the mild subgroup (P<0.05).The SSI score of the observation group was (4.68±1.73), the SSI score of the mild subgroup was (3.02±0.89), and the SSI score of the moderate-severe subgroup was (5.13±1.09). Spearman linear correlation analysis showed that there was a positive correlation between serum CXCL-10 and IL-27 levels and SSI score in the observation group (r=0.317 and 0.368,P=0.002 and 0.000). ROC curve analysis showed that the area under curve (AUC) of serum CXCL-10, IL-27 and their combination in the diagnosis of CDI diarrhea were 0.846, 0.853 and 0.874 respectively, the diagnostic sensitivity was 85.25%, 80.30% and 82.75% respectively, and the diagnostic specificity was 78.50%, 82.55% and 85.85% respectively. Conclusion: Serum CXCL-10 and IL-27 can help judge the severity of diarrhea in patients with Clostridium difficile infection, which has clinical application value. 2022 Vol. 28 (2): 301-305 [Abstract] ( 123 ) HTML (1 KB)  PDF (1422 KB)  ( 137 ) 305 Expression and Role of CK10 and CK19 in SK and BCC SUN Yexiao, SHEN Zhihua, ZHANG Yanfeng, et al DOI: 10.3969/j.issn.1006-6233.2022.02.026 Objective: To investigate the difference between two proteins in cell proliferation and differentiation by analyzing the expression of Keratin CK10 and CK19 in SK and BCC. And to analyze the diagnosis, treatment and prognosis of the two diseases according to the different expression of CK10 and CK19 in different tissues. Methods: The expression of CK10 and CK19 in 40 cases of SK and 40 cases of BCC were observed by immunohistochemistry, and analyzed statistically. Results: The expression of CK10 in SK was significantly higher than that in BCC (P<0.01).The expression of CK19 in BCC was significantly higher than that in SK (P<0.01) . Conclusion: The study further demonstrated that the SK was well differentiated and benign; the basal-cell Carcinoma cells remain undifferentiated and malignant; there are obvious differences. 2022 Vol. 28 (2): 305-307 [Abstract] ( 121 ) HTML (1 KB)  PDF (1464 KB)  ( 194 ) 308 An Investigation on the Distribution of Bacteria Isolation in a Grade A Hospital in Ganzi Tibetan Prefecture and the Resistance to Antibacterial Drugs in Common Use CHEN Shanshan, DUAN Fengmei, DANZHEN Zhuoma, et al DOI: 10.3969/j.issn.1006-6233.2022.02.027 Objective: To investigate the distribution of bacteria isolation in a grade A hospital in Ganzi Tibetan Prefecture, and analyze the resistance to commonly used antibacterial drugs. Methods: The clinically isolated strains between 2017 and 2020 were collected and analyzed from perspectives of specimen source, detection of bacteria, and drug sensitivity test results. Results: A total of 2,946 non-repetitive strains were isolated, most of which were from ICU, department of gastrointestinal surgery, department of hepatobiliary surgery, department of neurosurgery, department of orthopedics, and department of urology. Gram-positive bacteria and gram-negative bacteria accounted for 31.40% and 68.60%, mainly including Escherichia coli, Klebsiella pneumoniae, and staphylococcus aureus. Escherichia coli and Klebsiella pneumoniae were highly sensitive to carbapenems, and the drug resistance rates of most bacteria were lower than 10%. Staphylococcus aureus and staphylococcus epidermidis were highly resistant to penicillin G, followed by erythromycin. No vancomycin or linezolid-resistant staphylococcus aureus was detected. 1,068 (36.25%) extended-spectrum β-lactamase (ESBLs) strains, 159 (5.40%) strains of methicillin-resistant staphylococcus (MRS), and 248 (8.42%) strains of methicillin-resistant staphylococcus aureus (MRSA), and 2 (0.07%) strains of vancomycin-resistant enterococcus (VRE) were detected. MRS and MRA both were completely resistant to penicillin G and oxacillin, but sensitive to vancomycin, teicoplanin, linezolid, and sulfamethoxazole/trimethoprim. Conclusion: Escherichia coli, Klebsiella pneumoniae, and staphylococcus aureus were main bacteria isolated in a grade A hospitals in Ganzi Tibetan Prefecture from 2017 to 2020. ESBLs. MRS, MRSA and VRE were detected, with drug resistance. Therefore, antibacterial drugs are recommended to be used rationally. 2022 Vol. 28 (2): 308-313 [Abstract] ( 77 ) HTML (1 KB)  PDF (1458 KB)  ( 170 ) 314 Clinical Analysis of 8 Cases of Hemophagocytic Lymphohistiocytosis Secondary to Tsutsugamushi Disease LI Xin, TAN Li, LI Ming, et al DOI: 10.3969/j.issn.1006-6233.2022.02.028 Objective: To investigate the clinical features and treatment experience of children with tsutsugamushi disease complicated with hemophagocytic lymphohistiocytosis (HLH). Methods: The epidemiology, general data, clinical manifestations, laboratory results, treatment and outcome of 8 cases of tsutsugamushi disease with HLH in our hospital from January 2014 to December 2020 were analyzed retrospectively. Results: All 8 children with tsutsugamushi disease met the diagnostic criteria of HLH. Eight cases were accompanied by varying degrees of abnormal transaminase, abnormal myocardial zymogram, hypoproteinemia and the proportion of CD4+ decreased significantly; 5 cases were accompanied by lacunar effusion and 3 cases were accompanied by abnormal cerebrospinal fluid. 7 of the cases were given doxycycline anti infection, IVIG combined with glucocorticoid and other supportive treatment in the early stage. 1 of the cases was given dexamethasone + etoposide induction chemotherapy in the early stage, and doxycycline was added to anti infection after the diagnosis of tsutsugamushi disease. The indexes of peripheral blood, liver function, myocardial enzyme spectrum of 8 cases were significantly improved, the liver and spleen were shrunk, and hemophagocytosis disappeared. No doxycycline related adverse reactions or hematologic diseases were found in the short-term follow-up. Conclusion: HLH is a rare complication of tsutsugamushi disease, which can be associated with multiple organ injuries. Effective anti-infection and combined treatment with IVIG and glucocorticoid can effectively alleviate HLH while chemotherapy may be not necessary. 2022 Vol. 28 (2): 314-318 [Abstract] ( 91 ) HTML (1 KB)  PDF (1234 KB)  ( 311 ) 318 Effect of Clopidogrel Combined with Butylbenzene Peptide on Serum Levels of VEGF bFGF Ang-1 and Cognitive Function in Patients with Acute Cerebral Infarction NIU Xiang, WANG Benxiao, BU Hongwei DOI: 10.3969/j.issn.1006-6233.2022.02.029 Objective: To investigate the effect of clopidogrel combined with butylbenzene peptide on serum levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), angiopoietin-1 (Ang-1) and cognitive function in patients with acute cerebral infarction (ACI). Methods: One hundred and fifty-two patients with ACI admitted to Anhui Wanbei Coal and Electricity Group General Hospital from January 2018 to May 2020 were collected and divided into observation group (n=76) and control group (n=76) with simple random grouping method. Patients in the control group were given routine treatment and clopidogrel. On this basis, patients in observation group were given butylbenzene peptide capsule. The score of National Institutes of Health Stroke Scale (NIHSS), Montreal Cognitive Assessment (MoCA), serum levels of VEGF, bFGF and Ang-1 before and after intervention and the clinical effect were compared between two groups. Results: There were no significant differences in baseline data, NIHSS score, MoCA score, serum levels of VEGF, bFGF and Ang-1 before intervention between the two groups (P>0.05). For intra-group comparison, the NIHSS score at 1 and 3 months after intervention of two groups were apparently lower than those before intervention, and MoCA score, serum levels of VEGF, bFGF and Ang-1 were apparently higher than those before intervention (P<0.05). For inter-group comparison, the NIHSS score in observation group at 1 and 3 months after intervention was apparently lower than that in control group, and the MoCA score, serum levels of VEGF, bFGF and Ang-1 were apparently higher than those in control group (P<0.05). The total efficacy of observation group at 3 months after intervention was apparently higher than that in control group (P<0.05). Conclusion: Clopidogrel combined with butylbenzene peptide could apparently improve the cognitive function of patients with ACI, elevate serum levels of vascular growth related factors such as VEGF, bFGF and Ang-1, whose clinical effect is significant and worthy of clinical application. 2022 Vol. 28 (2): 318-322 [Abstract] ( 97 ) HTML (1 KB)  PDF (1243 KB)  ( 167 ) 322 Effects of Sevoflurane Anesthesia and Propofol Anesthesia on Hemodynamics Myocardial Protection and Adverse Events in Elderly Patients with Coronary Heart Disease Undergoing Non-Cardiac Surgery SHI Gaoyang, HUANG Liangcheng, GAN Changcai DOI: 10.3969/j.issn.1006-6233.2022.02.030 Objective: To explore the effects of sevoflurane anesthesia and propofol anesthesia on hemodynamics, myocardial protection and adverse events in elderly patients with coronary heart disease undergoing non-cardiac surgery. Methods: A total of 132 elderly patients with coronary heart disease admitted to the hospital between September 2017 and September 2020 were selected as the research subjects, and they were simply randomly divided into sevoflurane group (n=66) and propofol group (n=66), and respectively given continuous inhalation of 3% sevoflurane and continuous infusion of 3 μg/ml propofol for anesthesia during non-cardiac surgery. The surgical status, myocardial markers, hemodynamic parameters and occurrence of cardiac adverse events and other adverse events were compared between the two groups. Results: The awake time, extubation time and transfusion volume of sevoflurane group were significantly shorter or less than those of propofol group (P<0.05). Immediate measure after surgery showed that the level of cardiac troponin I (cTnI) was significantly lower in sevoflurane group than that in propofol group (P<0.05). The levels of cTnI and creatine kinase-MB (CK-MB) in sevoflurane group at 12h and 24h after surgery were significantly lower than those in propofol group (P<0.05). At T1, the SBP of sevoflurane group was significantly higher compared to propofol group (P<0.05). At T2, the heart rate (HR) of sevoflurane group was significantly lower than that of propofol group while the systolic blood pressure (SBP) was significantly higher than that of propofol group (P<0.05). At T3, the SBP was significantly higher in sevoflurane group compared with that in propofol group (P<0.05). At T4, the HR of sevoflurane group was significantly lower while the SBP and diastolic blood pressure (DBP) were significantly higher compared to propofol group (P<0.05). At T5, the SBP and DBP in sevoflurane group were significantly higher than those in propofol group (P<0.05). The total incidence rate of adverse cardiac reactions was 10.61% in sevoflurane group, which was significantly lower than 28.79% in propofol group. The total incidence rate of other adverse reactions in sevoflurane group was significantly higher than that in propofol group (19.70% vs 6.06%) (P<0.05). Conclusion: Sevoflurane for anesthesia has a more stable hemodynamic effect and shorter anesthesia time and recovery time in elderly patients with coronary heart disease undergoing non-cardiac surgery, and it better protects the myocardium and has less transfusion volume and lower incidence of cardiac adverse events. But it is prone to adverse events such as nausea and vomiting, thus it is suitable for patients with fear of injections, potential airway difficulties and heart risks. 2022 Vol. 28 (2): 322-327 [Abstract] ( 89 ) HTML (1 KB)  PDF (1254 KB)  ( 116 ) 327 Effect of Butylphthalide Combined with Aspirin and Clopidogrel Sulfate on NIHSS Score and MRS Score in Patients with Acute Cerebral Infarction WU Peipei, DONG Shaojun , SUN Tiantian, et al DOI: 10.3969/j.issn.1006-6233.2022.02.031 Objective: To study the effect of drugs on NIHSS score and mRS Score in patients with acute cerebral infarction. Methods: A total of 86 cases with acute cerebral infarction who were treated from August 2018 to June 2020 were selected as research subjects and divided into observation group (43 cases) and control group (43 cases) by simple random grouping.The control group was treated with aspirin and clopidogrel bisulfate. The clinical efficacy, NIHSS score, mRS score and changes in the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) before and after treatment were compared between the two groups. Results: The total effective rate of the observation group after treatment was significantly higher than that of the control group (93.02%VS72.09%) (χ2=6.541, P=0.011); the NIHSS and mRS scores of the two groups of patients after treatment were decreased (P<0.05), and the difference of NIHSS and mRS scores before and after treatment in the observation group was significantly higher than that in the control group (P<0.05); after treatment, the levels of TNF-α, IL-6 and hs-CRP in the two groups were lower than those before the treatment (P<0.05), and the difference of TNF-α, IL-6 and hs-CRP index levels in the observation group before and after treatment was significantly higher than that in the control group(P<0.05). Conclusion: The clinical effect of butylphthalide combined with aspirin and clopidogrel bisulfate in patients with acute cerebral infarction is better, which can effectively reduce the level of inflammation and promote the recovery of nerve function. 2022 Vol. 28 (2): 327-331 [Abstract] ( 165 ) HTML (1 KB)  PDF (1242 KB)  ( 457 ) 331 Effect of Piracetam Combined with Shuxuening Injection on Hemorheology and Levels of Serum Hcy and Hs-CRP in Patients with Hypertension Complicated with Cerebral Infarction JIANG Xue, JIANG Haiyan DOI: 10.3969/j.issn.1006-6233.2022.02.032 Objective: To investigate the effect of piracetam combined with Shuxuening injection on hemorheology and levels of serum homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in patients with hypertension complicated with cerebral infarction. Methods: A total of 86 patients with hypertension and cerebral infarction admitted to the hospital between January 2019 and October 2020 were selected and divided into combined group (n=43) and regular group (n=43) by simple random grouping. Patients in regular group were treated with piracetam, and patients in combined group were given piracetam combined with Shuxuening injection. The neurological function [National Institutes of Health Stroke Scale (NIHSS)], cognitive function [Mini-Mental State Examination(MMSE)], carotid artery ultrasound indicators [carotid artery intima-media thickness (IMI), carotid artery plaque area, carotid artery blood flow], hemorheology (plasma viscosity, high-shear whole blood viscosity, low-shear whole blood viscosity, hematocrit) and levels of serum Hcy, hs-CRP, neuron-specific enolase (NSE), myelin basic protein (MBP) and central nervous system specific protein (S100β) were observed in the two groups before and after treatment. Results: After 3 months of treatment, the NIHSS score of the two groups was lower than that before treatment while the MMSE score was higher than that before treatment (P<0.05), IMI and carotid artery plaque area were smaller than those before treatment, carotid artery blood flow was more than that before treatment (P<0.05), and the improvement status of the above indicators in combined group were better than those in regular group (P<0.05). After 3 months of treatment, the high-shear whole blood viscosity, low-shear whole blood viscosity, plasma viscosity, hematocrit and levels of serum Hcy, hs-CRP, NSE, MBP and S100β in the two groups were decreased compared with those before treatment, and the difference of each index before and after treatment in combined group were significantly higher than those in regular group (P<0.05). Conclusion: Piracetam combined with Shuxuening injection in the treatment of hypertension with cerebral infarction can effectively improve the neurological function and cognitive function, inhibit the atherosclerotic plaque formation and reduce blood viscosity and inflammation level, and it is beneficial to the outcomes of disease. 2022 Vol. 28 (2): 331-336 [Abstract] ( 116 ) HTML (1 KB)  PDF (1254 KB)  ( 281 ) 336 Effects of Isazomib Combined with Dexamethasone and Thalidomide in the Treatment of Refractory Multiple Myeloma WEI Bing, ZHU Taigang, LI Yuehong, et al DOI: 10.3969/j.issn.1006-6233.2022.02.033 Objective: To investigate the effects of isazomib combined with dexamethasone and thalidomide on bone metabolism, inflammatory state and the levels of serum fibrinogen degradation product (FDP), D-Dimer (D-D) and platelet factor 4 (PF4) in patients with refractory multiple myeloma (mm). Methods: 82 patients with refractory MM in our hospital from September 2019 to March 2021 were randomly divided into study group (n=41) and control group (n=41). The study group was treated with isazomib combined with dexamethasone and thalidomide, and the control group was treated with traditional VAD (vincristine + dexamethasone + adriamycin) for 4 weeks. The remission rates of the two groups were compared with the indexes of serum bone metabolism [Osteocalcin (BGP), alkaline phosphatase (ALP), type I collagen C-terminal peptide (CTX-I)] and inflammatory factor [tumor necrosis factor] before treatment, 2 courses of treatment and 4 courses of treatment-α( TNF-α),C-reactive protein (CRP), interleukin-6 (IL-6)], renal function indexes (blood urea nitrogen (BUN), blood creatinine (SCR)], FDP, D-D and PF4 levels, and the incidence of adverse reactions was counted. Results: Compared with the control group, the disease remission rate of the study group was significantly improved, with statistical difference (75.61%vs51.22%, χ2=5.256, P<0.05); compared with the control group, the study group had 2 courses of treatment and 4 courses of treatment, the serum BGP and ALP levels increased significantly, and the CTX-I level decreased significantly (P<0.05); compared with the control group, the serum CRP, TNF-α, FDP, DD, serum BUN, and SCr levels of the study group were significantly reduced after 2 courses and 4 courses of treatment (P<0.05); during the treatment period, the two groups had adverse reactions, but there was no statistically significant difference in incidence (P>0.05). Conclusion: The treatment of refractory MM patients with isazomib combined with dexamethasone and thalidomide can significantly improve the disease remission rate, further regulate the levels of serum FDP, D-D and PF4, reduce the inflammatory state and improve bone metabolism, and has a certain safety. 2022 Vol. 28 (2): 336-341 [Abstract] ( 159 ) HTML (1 KB)  PDF (1259 KB)  ( 373 )

Copyright © Editorial Board of HeBei Med Supported by:Beijing Magtech