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2022 Vol. 28, No. 3 Published: 2022-03-31 353 Effect of MiR-182 on the Proliferation Apoptosis and Migration of Prostate Cancer PC-3 Cells and Its Mechanism GAN Zhuo, LI Yanping, SHI Bing, et al DOI: 10.3969/j.issn.1006-6233.2022.03.01 Objective: To investigate the effect of microRNA-182 (miR-182) on the proliferation, apoptosis and migration of prostate cancer PC-3 cells and its possible mechanism. Methods: Prostate cancer PC-3 cells in logarithmic growth stage were randomly divided into control group, miR-182 low expression vector (miR-182 inhibitor) group and miR-182 overexpression vector (miR-182 mimics) group. After corresponding treatment, each group was cultured for 72 hours; the cell survival rate, monoclonal forming number, apoptosis rate, migration ability, miR-182, metadherin (MTDH) mRNA and protein expression level were measured. Results: Compared with the control group, the cell survival rate, monoclonal forming number, number of membrane penetration, the expression levels of miR-182, MTDH mRNA and protein in miR-182 inhibitor group were significantly lower (P<0.05), and the apoptosis rate was significantly higher (P<0.05); the cell survival rate, monoclonal forming number, number of membrane penetration, the expression levels of miR-182, MTDH mRNA and protein in miR-182 mimics group were significantly higher (P<0.05), and the apoptosis rate was significantly lower (P<0.05). Compared with miR-182 inhibitor group, the cell survival rate, monoclonal forming number, number of membrane penetration, the expression levels of miR-182, MTDH mRNA and protein in miR-182 mimics group were significantly higher (P<0.05), and the apoptosis rate was significantly lower (P<0.05). Conclusion: Down regulation of miR-182 expression can inhibit the proliferation, migration and induce apoptosis of prostate cancer PC-3 cells; the mechanism may be related to the inhibition of MTDH mRNA and protein expression; up regulation of miR-182 expression can reverse the biological behavior of prostate cancer PC-3 cells. 2022 Vol. 28 (3): 353-357 [Abstract] ( 187 ) HTML (1 KB)  PDF (1661 KB)  ( 227 ) 358 Study of the Effect of Carnosine on Vascular Smooth Muscle Cell Calcification and Its Mechanism JIN Zhaoxia, XU Chengsheng DOI: 10.3969/j.issn.1006-6233.2022.03.02 Objective: To investigate the effect and mechanism of carnosine on vascular calcification in β-glycerophosphate (β-GP)-induced vascular smooth muscle cells (VSMCs). Methods: Primary isolated and cultured rat aortic VSMCs were divided into 3 groups, the control group (normal culture medium), calcification group (10mM β-GP), and carnosine group (10mM β-GP+10mM carnosine). The cells were treated consecutively for 10 days. Alkaline phosphatase (ALP) activities and alizarin red staining were used to detect the calcification of VSMCs. The expression levels of BMP-2, Runx2, Cleaved-caspase3, β-catenin and GSK-3β(Ser9) proteins in the VSMCs in various groups were measured by Western blotting method. Results: After β-GP treatment, calcification occured in VSMCs. Compared with control group, calcium salt deposition and ALP activity increased significantly, and osteogenic marker BMP-2 and Runx2 proteins were significantly upregulated in calcification group. Compared with calcification group, carnosine markably reduced the calcium salt deposition, inactivated the ALP activity, and downregulated BMP-2 and Runx2 proteins. The apoptosis result showed that Cleaved-caspase3 protein was increased in calcification group and decreased in carnosine group. The signal pathway protein analysis revealed that β-GP downregulated GSK-3β(Ser9) and upregulated β-catenin, while carnosine reversed the proteins expression obviously. Conclusion: Carnosine inhibits VSMCs calcification induced by hyperphosphate and may be related to inhibition of β-catenin signaling pathway and its upregulating osteogenic factor transcription and apoptosis. 2022 Vol. 28 (3): 358-362 [Abstract] ( 154 ) HTML (1 KB)  PDF (2119 KB)  ( 333 ) 362 Effects of β-Cryptoxanthin on RANKL/RANK/OPG Pathway and Osteoclast Formation in Orthodontic Tooth Movement Model of Rats WANG Shuai, CHANG Ying, XI Guangwei, et al DOI: 10.3969/j.issn.1006-6233.2022.03.03 Objective: To investigate the effects of β-cryptoxanthin on receptor activator of NF-κB ligand (RANKL)/receptor activator of NF-κB (RANK)/osteoprotegerin (OPG) and osteoclast formation in orthodontic tooth movement model of rats. Methods: The rats were divided by random number table method into normal group, model group, β-cryptoxanthin low (3 μg), medium (6 μg) and high (12 μg) dose groups, with 10 rats in each group. Except for the normal group, all the other groups were established as orthodontic tooth movement models, and the administration of β-cryptocanthin was started on the first day after the installation of orthodontic appliances. 3μg, 6μg and 12μg of β-cryptocanthin were injected under the gingival mucosa of the left maxillary first molar near the middle of the rats in the low, medium and high dose groups respectively; the normal and model groups were injected with equal amounts of saline; the drug was administered once every 2 days for 28 days. The orthodontic tooth movement distance was measured 24h after the last dose in each group of rats. Periodontal membrane and alveolar bone tissues at the roots of maxillary first molars were taken from both sides and stained with hematoxylin-eosin (HE) and anti-tartrate acid phosphatase (TRAP), and the number of osteoclasts on the surface of alveolar bone on the pressure and tension sides were counted under light microscope. The expression levels of RANKL, RANK and OPG proteins in periodontal ligament and alveolar bone tissue at root were detected by Western blot. Results: Compared with the normal group, the periodontal space was narrowed on the pressure side and the periodontal ligament was widened on the tension side, osteogenic reactions were seen, TRAP staining was strongly positive on the pressure and tension sides, and TRAP staining was deeper on the pressure side than on the tension side. The levels of RANKL, RANK, OPG and RANKL/OPG ratio were all increased (P<0.05). Compared with the model group, the formation of new bone on the tension side of rats in the β-cryptoxanthin low, medium and high dose groups was gradually obvious, TRAP staining on the pressure side was strongly positive, TRAP staining on the tension side was weakly positive, and orthodontic tooth movement distance, the expression levels of RANKL and OPG protein in periodontal ligament and alveolar bone tissue at root were increased (P<0.05), and the number of osteoclasts on the surface of alveolar bone on the tension side, RANKL/ the number of osteoclasts and RANKL/OPG ratio on the alveolar bone surface on the tension side decreased (P<0.05). The changes of β-cryptoxanthin in each dose group were dose-dependent (P<0.05). Conclusions: β-cryptoxanthin may maintain the dynamic balance of osteogenesis and osteoclast resorption in periodontal ligament remodeling and alveolar bone reconstruction by up-regulating the expressions of RANKL and OPG, reducing the ratio of RANKL/OPG, blocking the combination of RANKL and RANK, promoting orthodontic tooth movement and inhibiting the further activation of osteoclasts. 2022 Vol. 28 (3): 362-367 [Abstract] ( 91 ) HTML (1 KB)  PDF (2100 KB)  ( 162 ) 368 FOXM1 Ameliorates Mitochondrial Dysfunction by Targeting Upregulation of PHB2 Transcription to Protect Against Lipopolysaccharide-Induced Renal Tubular Epithelial Cell Injury CHEN Juan, CHEN Lasi, CHEN Li, et al DOI: 10.3969/j.issn.1006-6233.2022.03.04 Objective: To explore the role of FOXM1 in lipopolysaccharide (LPS)-induced renal tubular epithelial cell injury and its possible mechanism. Methods: Human renal tubular epithelial cells HK-2 were cultured in vitro. QRT-PCR and Western blot were used to detect the expression of FOXM1 and PHB2; CCK-8 was used to detect cell viability; flow cytometry was used to detect cell apoptosis; JC-1 staining was used to detect the mitochondrial membrane potential; the reagent kit was used to detect cellular ATP content; the luciferase reporter experiment and ChIP-PCR experiment were used to detect the regulatory effect of FOXM1 on the PHB2 promoter. Results: Compared with the control group, the expression of FOXM1 and PHB2, cell viability, red/green fluorescence intensity ratio and ATP content in the cells of the LPS group were significantly reduced (P<0.05), and the apoptosis rate was significantly increased (P<0.05); compared with the LPS group, there was no significant difference in FOXM1 and PHB2 expression, cell viability, red/green fluorescence intensity ratio, ATP content and apoptosis rate in the cells of the LPS+oe-NC group (P>0.05); compared with the LPS+oe-NC group, the expression of FOXM1 and PHB2, cell viability, red/green fluorescence intensity ratio and ATP content in the cells of the LPS+oe-FOXM1 group were significantly increased (P<0.05), and the apoptosis rate was significantly reduced (P<0.05). FOXM1 targeted the PHB2 promoter region. Compared with the LPS+oe-NC+sh-NC group, the FOXM1 and PHB2 protein expression, cell viability, red/green fluorescence intensity ratio and ATP content in the cells of the LPS+oe-FOXM1+sh-NC group were significantly increased (P<0.05), the cell apoptosis rate was significantly reduced (P＜0.05); compared with the LPS+oe-NC+sh-NC group, the expression of PHB2 protein, cell viability, red/green fluorescence intensity ratio and ATP content in the cells of the LPS+oe-NC+sh-PHB2 group were significantly reduced (P＜0.05), the apoptosis rate was significantly increased (P<0.05), and the difference in FOXM1 protein expression was not statistically significant (P>0.05); sh-PHB2 can partially reverse the effect of oe-FOXM1 on HK-2 cells treated with LPS. Conclusion: FOXM1 promotes PHB2 expression by targeting the PHB2 promoter region to improve mitochondrial dysfunction, and then to inhibit LPS-induced renal tubular epithelial cell damage. 2022 Vol. 28 (3): 368-374 [Abstract] ( 134 ) HTML (1 KB)  PDF (1968 KB)  ( 238 ) 374 Effects of Sevoflurane on Cerebral Ischemia-Reperfusion Injury in Rats Possibly Through Modulation of SIRT1-FOXO1-Mediated Autophagy CHEN Jian, LI Chengjie, et al DOI: 10.3969/j.issn.1006-6233.2022.03.05 Objective: To explore the effects of sevoflurane on cerebral ischemia-reperfusion injury in rats and its mechanism. Methods: SD rats were randomly divided into sham operation group (Sham), ischemia-reperfusion injury group (I/R), ischemia-reperfusion injury+sevoflurane group (I/R+Sev) and ischemia-reperfusion injury+sevoflurane+EX527 group (I/R+Sev+EX527). Morris Water Maze test and TTC staining were used to observe the cerebral ischemia reperfusion injury. The apoptosis of nerve cells was detected by TUNEL staining. Transmission electron microscopy was used to detect autophagy. Western blotting was used to detect the expression of autophagy, apoptosis-related proteins and SIRT1-FOXO1 pathway proteins. Results: Compared with the sham group, the escape latency of rats in the I/R group was prolonged, the number of crossing the platform was decreased, the volume of cerebral infarction was significantly increased, the rate of neuronal apoptosis was significantly increased, and the number of autophagic vacuoles was significantly increased. The expression of Bad, cleaved-caspase-3, LC3-II/I protein were increased significantly, the expression of Bcl-2, p62, SIRT1, FOXO1 protein were decreased significantly, and the differences were statistically significant (P<0.05). Compared with the I/R group, the escape latency of rats in the I/R+Sev group was reduced, the number of crossing the platform was increased, the volume of cerebral infarction was significantly decreased, the rate of neuronal apoptosis was significantly decreased, and the number of autophagic vacuoles was significantly decreased. The expression of Bad, Cleaved-caspase-3, LC3-II/I was significantly decreased, and the protein expressions of Bcl-2, p62, SIRT1 and FOXO1 were significantly increased, and the differences were statistically significant (P<0.05). Compared with the I/R+Sev group, the escape latency of the I/R+Sev+EX527 group was prolonged, the number of crossing the platform was decreased, the volume of cerebral infarction was increased, the rate of neuronal apoptosis was increased, and the number of autophagic vacuoles was increased. The expression of cleaved-caspase-3, LC3-II/I protein were increased, and the protein expression of Bcl-2, p62, SIRT1, FOXO1 were decreased, and the differences were statistically significant (P<0.05). Conclusion: Sevoflurane treatment may protect rats from cerebral ischemia-reperfusion injury by inhibiting autophagy and apoptosis by a mechanism related to the SIRT1-FOXO1 signalling pathway. 2022 Vol. 28 (3): 374-379 [Abstract] ( 115 ) HTML (1 KB)  PDF (1918 KB)  ( 189 ) 379 Detection of Serum IGF-1 S-100B and GFAP Levels in Term Infants with Hypoxic-Ischemic Encephalopathy and Its Clinical Significance LI Wenlin, YANG Ling, ZHONG Lihua, et al DOI: 10.3969/j.issn.1006-6233.2022.03.06 Objective: To detect serum insulin-like growth factor-1 (IGF-1), S-100B protein and glial fibrillary acidic protein (GFAP) levels in term infants with hypoxic-ischemic encephalopathy (HIE), and analyze their clinical significance. Methods: Totally 106 term infants with HIE admitted to the hospital from January 2018 to January 2021 were selected as the observation group. Meanwhile, 30 healthy full-term newborns were made the control group. Subjects in the observation group were divided into survival group (n=91) and death group (n=15) based on improvement after treatment. Serum IGF-1, S-100B and GFAP levels were detected. ROC curve was used to analyze the diagnostic value and prognostic value of serum IGF-1, S-100B and GFAP levels in HIE. Results: Serum IGF-1 level in observation group was lower than that in control group, and the levels of S-100B and GFAP were higher than those in control group (P<0.05). ROC curve analysis showed that the sensitivity of the concurrent diagnosis of HIE was 93.40% with an AUC of 0.886, higher than that of the individual tests(P<0.05). Serum IGF-1 level in survival group was higher than that in death group, and the levels of S-100B and GFAP were lower than those in death group (P<0.05). ROC curve analysis showed that tthe sensitivity of the concurrent diagnosis of HIE with serum IGF-1, S-100B and GFAP levels were 91.50% with an AUC of 0.864, which were higher than those of individual detection (P<0.05). Conclusion: The level of serum IGF-1 is low, and the levels of S-100B and GFAP are high in term infants with HIE. The detection is helpful for early diagnosis and prognosis of HIE. 2022 Vol. 28 (3): 379-383 [Abstract] ( 109 ) HTML (1 KB)  PDF (1525 KB)  ( 173 ) 383 Changes in Peripheral Blood Lymphomonocyte Ratio and Lymphocyte Subsets and the Relationship with Prognosis in Patients with Multiple Myeloma Complicated with Invasive Fungal Infection CHEN Lijuan, ZHANG Jiayou, HAN Shaoling, et al DOI: 10.3969/j.issn.1006-6233.2022.03.07 Objective: To analyze the changes in peripheral blood lymphomonocyte ratio (LMR) and lymphocyte subsets [T lymphocyte (CD3+), B lymphocyte (CD19+), NK lymphocyte (CD16+56+)] in patients with multiple myeloma (MM) complicated with invasive fungal infection (IFI) and their relationship with prognosis. Methods: A total of 105 patients with MM complicated with IFI treated in the hospital between January 2016 and March 2018 were selected as observation group, and another 98 patients with MM but without IFI were enrolled as control group. According to Durie-Salmon staging (DS staging), the patients in the observation group were divided into 46 cases in stage I-II and 59 cases in stage III. Flow cytometry was used to detect the levels of LMR, CD3+, CD19+ and CD16+56+ in each group. The levels of the above parameters in patients with MM and IFI and their relationship with DS staging was analyzed. According to the follow-up status within 3 years, the patients were classified into survival group and death group, and the differences in the above indicators of patients with different prognosis status were analyzed. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of the above parameters on DS staging of patients with MM and IFI and predictive value on prognosis. Results: ① The levels of peripheral blood LMR and CD19+ and CD16+56+ of observation group were reduced, while the CD3+ level was risen compared with those of control group (P<0.05). ② The levels of LMR, CD19+ and CD16+56+ of patients with DS stage III were lower than those of patients with stage I-II while the level of CD3+ was higher than that of patients with stage I-II (P<0.05). ③ Peripheral blood LMR, CD19+ and CD16+56+ levels were negatively correlated with DS staging of patients with MM complicated with IFI (rs=-0.686, -0.659, -0.661, P<0.01), and CD3+ was positively correlated with DS staging (rs=0.551, P<0.05). ④ Peripheral blood LMR, CD3+, CD19+ and CD16+56+ levels had higher efficiency in guiding the DS stages I-II and III in patients with MM and IFI. When LMR was ≤ 6.14, the diagnostic efficiency on DS stage III in patients with MM complicated with IFI was the highest, with sensitivity of 91.53% and specificity of 89.13% respectively. ⑤ The levels of peripheral blood LMR, CD19+ and CD16+56+ in death group were lower, while the level of CD3+ was higher than in survival group (P<0.05). Peripheral blood LMR, CD3+, CD19+ and CD16+56+ have high efficiency on guiding the prognosis of patients with MM complicated with IFI. When LMR was ≤ 4.02, the efficiency of predicting the poor prognosis of patients with MM and IFI was high with sensitivity of 79.56% and specificity of 88.42%. Conclusion: Peripheral blood LMR, CD19+ and CD16+56+ are decreased while CD3+ is increased in patients with multiple myeloma complicated with invasive fungal infection. In addition, the above indicators are related to disease progression and prognosis, and can guide the identification of DS staging of patients with MM complicated with IFI and can be used as an auxiliary basis to evaluate the disease condition changes and prognosis of MM with IFI. 2022 Vol. 28 (3): 383-389 [Abstract] ( 114 ) HTML (1 KB)  PDF (1504 KB)  ( 303 ) 390 Diagnostic Value of Fine Needle Aspiration Cytology Combined with Eluate Thyroglobulin Test for Thyroid Cancer Neck Lymph Node Metastasis CHAI Jixin, QI Yantao, WANG Jingjing, et al DOI: 10.3969/j.issn.1006-6233.2022.03.08 Objective: To explore the diagnostic value of fine needle aspiration cytology combined with eluate thyroglobulin test for thyroid cancer neck lymph node metastasis. Methods: A total of 90 patients with suspected thyroid cancer who were treated in our hospital from April 2016 to June 2019 were selected and divided into group A, group B and joint group according to different detection methods. Patients in group A underwent fine needle biopsy, patients in group B underwent eluent thyroglobulin assay, and patients in the joint group underwent both tests. The gold standard for diagnosis was the pathological findings after surgery. The diagnosis results of patients with different diagnosis methods were compared. Results: Group A patients had 5 lymph node samples from zone II, 13 from zone III and 12 from zone IV. Postoperative pathological findings: 27 positive, 3 negative Group B patients had 3 lymph node samples from zone II, 14 from zone III, and 13 from zone IV, with postoperative pathological findings: 25 positive and 5 negative. The joint group patients had 4 lymph node samples from zone II, 12 from zone III, and 14 from zone IV. The postoperative pathological findings were 28 positive cases and 2 negative cases. The specificity and yoden index of the joint group were significantly higher than those of group A and group B (P<0.05), the negative predictive value and sensitivity of group A were significantly lower than those of group B and the joint group (P<0.05), and the positive predictive value of the joint group was significantly higher than that of group B (P<0.05), with no significant difference from group A (P>0.05). According to the test results of group B and the joint group, FNA-Tg concentration was (171.45 ± 42.33) μg/L in 51 patients with positive PTC, and (20.63 ± 11.57) μg/L in 9 patients with negative PTC. The ROC curve was plotted with FNA-Tg concentration as the classification standard (lower area 0.972 ± 0.020, P=0.000, 95%CI=0.932~1.000), and the diagnostic cut-off value was 98.5μg /L, with a sensitivity of 86.27% and specificity of 100.00%. Using the pathology test as the standard, the Kappa value of the test in group A = 0.103 and the Kappa value of the test in group B = 0.280, the consistency between the two groups and the pathology test standard was poor (P>0.05); the consistency between the joint group and the pathology test results was high (P<0.05) and the consistency was average (Kappa value = 0.634) Conclusion: FNAC combined with FNA-Tg is consistent with pathological diagnosis, and the combination of the two methods can complement each other, which is of certain value for the diagnosis of lymph node metastasis in TC patients. 2022 Vol. 28 (3): 390-394 [Abstract] ( 177 ) HTML (1 KB)  PDF (1360 KB)  ( 725 ) 394 Effects of Different Anesthesia Methods on Intestinal Barrier Function and Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Colorectal Cancer Surgery CHEN Hong, LI Shiyong, LUO Ailin, et al DOI: 10.3969/j.issn.1006-6233.2022.03.09 Objective: To explore whether different anesthesia methods affect the intestinal barrier function and postoperative cognitive function of elderly patients undergoing colorectal cancer surgery. Methods: A total of 100 elderly patients with colorectal cancer undergoing radical resection from March 2018 to March 2021 were selected as the research subjects and divided into group A and group B according to the simple random number table method, with 50 cases in each group. Patients in group B were given general anaesthesia and patients in group A were given epidural compound general anaesthesia. The intestinal barrier function, postoperative cognitive dysfunction score, and anesthesia effect score were observed and compared. Results: From the comparison of intestinal barrier function scores, there was no significant difference in the levels of serum diamine oxidase, D-lactic acid, and endotoxin between the two groups before surgery (P>0.05), while the corresponding levels after surgery decreased significantly in both groups and the levels of serum diamine oxidase, D-lactic acid, and endotoxin of group A decreased more than group B (P<0.05). From the comparison of the incidence of postoperative cognitive dysfunction between the two groups of patients, the results of the generalized estimation equation test showed: ① the results of the comparison between the groups: wald=8.366, P=0.004<0.05, and the comparison between the groups was statistically significant. Compared with group B, the probability of group A is 0.004; ②repeated measurement time comparison results: wald=11.540, P=0.003<0.05, the comparison between groups is statistically significant. There are differences in the occurrence of cognitive function in patients with different anesthesia methods at different time points. Compared with T4, T2 and T3 are 0.001 and 0.077 respectively. It can be seen from the line chart of the incidence of POCD of the two groups of patients that the patients in group A showed a linear downward trend in T2-T4, which was significantly faster than the patients in group B. From the comparison of the surgical anesthesia effect of the two groups of patients, the anesthesia time, wake-up time, and extubation time of the patients in group A were less than those in group B, and the difference between the two groups of patients was statistically significant (P<0.05). Conclusion: Different anesthesia methods have certain effects on the intestinal barrier function and postoperative cognitive function of elderly patients undergoing colorectal cancer surgery. Epidural combined with general anaesthesia is of greater safety, with lower incidence of POCD, and shorter time of wake-up and extraction, which can improve the intestinal barrier function. 2022 Vol. 28 (3): 394-398 [Abstract] ( 144 ) HTML (1 KB)  PDF (1228 KB)  ( 169 ) 398 Analysis of the Short-Term Curative Effect of Different Treatment Regimens on Patients with Aneurysm at the M1 Bifurcation of the Middle Cerebral Artery and Their Influence on Postoperative Infection and Recurrence BIN Zaiqing, YIN Dianmin, TANG Qiyong DOI: 10.3969/j.issn.1006-6233.2022.03.010 Objective: To explore the short-term curative effect of different treatment regimens for patients with M1 bifurcation aneurysm of the middle cerebral artery and their influence on postoperative infection and recurrence. Methods: The clinical data of 46 patients with middle cerebral artery M1 bifurcation aneurysm who were treated between February 2015 and February 2020 were retrospectively analyzed. According to the treatment regimens, they were divided into craniotomy group (26 cases) and interventional embolization group (20 cases). The operation-related indicators and short-term efficacy of the two groups were compared. The patients were followed up for 1 year, and the postoperative infection and recurrence were recorded. Results: The operation time, intraoperative blood loss and hospital stay in the interventional embolization group were significantly shorter, and the treatment cost was significantly higher than those in the craniotomy group, and the differences were statistically significant (All P<0.05). At 1 and 3 months after surgery, there was no significant difference in the clinical efficacy between the two groups of patients (All P>0.05). The clinical efficacy of the two groups at 3 months after surgery was significantly better than that at 1 month after surgery, and the difference was statistically significant (All P>0.05); the postoperative infection rate in the craniotomy group was higher than that in the interventional embolization group (15.38% vs 5.00%), while the postoperative recurrence rate was lower than that in the interventional embolization group (0.00% vs 10.00%), but there was no significant difference between groups (All P>0.05). Conclusion: Both craniotomy and interventional embolization for the treatment of middle cerebral artery M1 bifurcated aneurysms have good short-term curative effects. The former has the advantages of lower postoperative recurrence rate and lower treatment cost, and the latter has lower postoperative infection rate and shorter hospitalization. The optimal treatment regimen should be chosen in the clinical setting, taking into account the patient's actual condition and financial situation. 2022 Vol. 28 (3): 398-402 [Abstract] ( 137 ) HTML (1 KB)  PDF (1222 KB)  ( 294 ) 403 Application of Antibiotic Bone Cement Technology in the Treatment of Wanger 2-4 Diabetic Foot SHEN Xiaozhen, ZHENG Yanfeng, CHEN Zongxiang, et al DOI: 10.3969/j.issn.1006-6233.2022.03.011 Objective: To observe application effect of antibiotic bone cement technology in the treatment of Wanger 2-4 diabetic foot (DF). Methods: A total of 40 patients with Wanger 2~4 DF were selected and randomly divided into 2 groups by random number table method, with 20 cases in each. The control group was treated with vacuum sealing drainage (VSD). On this basis, the experimental group was treated with antibiotic bone cement. Before and after treatment, scores of American Orthopaedic Foot and Ankle Society (AOFAS) and visual analog scale (VAS) were compared between the two groups. The related indexes at 7d after treatment, hospitalization time, treatment cost and complications in the 2 groups were observed. Results: At 3 months after treatment, AOFAS score in the experimental group was significantly higher, while VAS score was significantly lower, than the control group (P<0.05). The coverage rate of granulation tissue and survival rate of stage II wound repair in experimental group were significantly higher than those in control group (P<0.05). The hospitalization time in experimental group was significantly shorter than that in control group (P<0.05), and wound infection rate and total treatment cost were significantly lower than those in control group (P<0.05). Conclusion: The application of antibiotic bone cement technology in treatment of Wanger 2-4 DF can effectively promote recovery of ankle-hind foot function and pain, shorten rehabilitation process and reduce treatment cost. 2022 Vol. 28 (3): 403-407 [Abstract] ( 117 ) HTML (1 KB)  PDF (2127 KB)  ( 411 ) 407 Relationship Between CT Signs and Differentiation Degree and Lymph Node Metastasis of Ground-Glass Nodular Multifocal Lung Adenocarcinoma PENG Xi, FU Lihui, HUANG Pengda DOI: 10.3969/j.issn.1006-6233.2022.03.012 Objective: To explore the relationship between CT signs and differentiation degree and lymph node metastasis of ground-glass nodular multifocal lung adenocarcinoma (MLA). Methods: The clinical data of 156 patients with MLA treated in the hospital between January 2016 and July 2021 were retrospectively analyzed. Patients were grouped according to the differentiation degree and lymph node metastasis into high differentiation subgroup (n=48), moderate differentiation subgroup (n=65), low differentiation subgroup (n=43), metastasis subgroup (n=81) and non-metastasis subgroup (n=75). The differences in CT signs were compared among patients with MLA of different differentiation degrees and metastasis status, and spearman correlation analysis was used to explore the relationship between CT signs and differentiation degree and lymph node metastasis. Results: The occurrence rate of lesions≥3cm in high differentiation subgroup was lower than that in low differentiation subgroup. The occurrence rate of pGGN in high differentiation subgroup was higher than that in moderate and low differentiation subgroups. The occurrence rates of spicule sign, lobulation sign, cavitation sign, vascular convergence sign and pleural indentation in high differentiation subgroup were lower than those in low differentiation subgroup. The occurrence rate of vascular convergence sign in moderate differentiation subgroup was lower than that in low differentiation subgroup (all P<0.05). According to spearman correlation analysis, the length of the lesion in patients with MLA was negatively correlated with the differentiation degree (r=-0.337, P<0.05). There were significant differences in the length of the lesion≥3cm and occurrence rates of round or round-like shape, lobulation sign and vascular convergence sign between metastasis subgroup and non-metastasis subgroup (all P<0.05), but there were no statistical differences in the occurrence rates of pGGN, spicule sign, cavitation sign and pleural indentation between the two subgroups (all P>0.05). By spearman correlation analysis, the length of the lesion in patients with MLA was related to lymph node metastasis (r=0.429, P<0.05). Conclusion: The length of the lesion and occurrence rates of pGGN, spicule sign, lobulation sign, cavitation sign, vascular convergence sign and pleural indentation are related to the degree of differentiation. The length of the lesion and occurrence rates of round or round-like shape, lobulation sign and vascular convergence sign are related to lymph node metastasis. According to some CT signs of patients with MLA, differentiation degree and lymph node metastasis can be preliminarily judged. 2022 Vol. 28 (3): 407-412 [Abstract] ( 107 ) HTML (1 KB)  PDF (1416 KB)  ( 234 ) 412 Analysis of Clinical Characteristics and Factors Influencing the Long-Term Prognosis of Patients with Premature Coronary Artery Disease by Gender After Percutaneous Coronary Intervention HUO Mingyan, ZHANG Na, LIU Yahuan, et al DOI: 10.3969/j.issn.1006-6233.2022.03.013 Objective: To investigate the clinical characteristics of patients with premature coronary artery disease (PCAD) by gender after percutaneous coronary intervention (PCI), to analyze factors influencing long-term prognosis, and to provide guidance for the treatment of patients. Methods: Totally 150 patients admitted to the Affiliated Hospital of Chengde Medical University from February 2018 to February 2020 who were diagnosed with coronary heart disease and underwent percutaneous coronary intervention were selected as research subjects and divided into male and female groups. The clinical data, interventional treatment data and follow-up of all patients were recorded, the clinical characteristics of premature coronary artery disease (PCAD) were analyzed, and the influencing factors of long-term prognosis were further explored. Results: In the male group, the age of onset was younger (P＜0.01), the proportion of smoking was higher (P＜0.05), the BMI index was higher, and the proportion of ST-segment elevation myocardial infarction (P＜0.05), the glomerular filtration rate (P＜0.01) ), left ventricular end-diastolic diameter (P<0.01), and hyperlipidemia (P<0.05) were all high, while the incidence of hypertension (P<0.05) and diabetes (P<0.05) was low, and the incidence of previous stroke was high. (P<0.05), which was statistically significant after statistical analysis. However, there was no statistical difference in the left ventricular ejection fraction and GRACE score between the two groups (P>0.05); the incidence of adverse events between the two groups ( including MACCE, death, myocardial infarction, revascularization, and stroke) showed no significant difference (P>0.05), but the bleeding rate in the female group was significantly higher than that in the male group. Bleeding differences are mainly manifested in the distinction between BARC levels 1-2. Statistical analysis showed statistical difference (P<0.05). Conclusion: The clinical characteristics of patients with premature coronary artery disease of different genders after percutaneous coronary intervention are different. Individualized treatment regimens should be followed for patients of different genders, and patients should be encouraged to develop a good life style and reduce their stress. Metabolic abnormalities are expected to reduce the incidence of premature coronary artery disease. Secondly, women and myocardial infarction are the influencing factors of postoperative bleeding after PCI. Identifying these postoperative factors can provide certain guidance for the later treatment of patients. 2022 Vol. 28 (3): 412-417 [Abstract] ( 95 ) HTML (1 KB)  PDF (1334 KB)  ( 142 ) 417 Correlation Between Dynamic Changes of Serum PTX3 and Neuroprotection After Remote Ischemia in Patients with Acute Cerebral Infarction YAO Xiaomeng, et al DOI: 10.3969/j.issn.1006-6233.2022.03.014 Objective: To study the correlation between dynamic changes of serum pentraxin 3 (PTX3) and neuroprotection after remote ischemia in patients with acute cerebral infarction (ACI). Methods: A total of 150 patients with ACI treated in the hospital between June 2019 and June 2021 were enrolled and divided into experimental group and control group by simple random grouping method, 75 cases in each group. The control group was given standardized treatment, while the experimental group was given ischemic preconditioning treatment on the basis of the control group. The level of serum PTX3 was compared between the two groups. The nerve function was assessed by NIHSS score, and its correlation with serum PTX3 was analyzed. At 90d after treatment, short-term prognosis was assessed by mRS score and BartheI index. The prognosis between the two groups was compared. The correlation between serum PTX3 and prognosis and its predictive value for prognosis were analyzed. Results: After treatment, level of serum PTX3 and NIHSS score in both groups were significantly decreased, which were lower in experimental group than in control group at 7d and 14d after treatment (P<0.05). After treatment, the experimental group had significantly lower mRS scores, and higher BartheI index than the control group. The changes were greater in the experimental group than in the control group (P<0.05). The level of serum PTX3 was positively correlated with NIHSS and mRS scores, while negatively correlated with BartheI index (P<0.05). The area under the ROC curve (AUC), sensitivity, and specificity of serum PTX3>3.34μg/L to predict the prognosis of patients with ACI were 0.948, 92.86%, and 82.26% (P<0.05). Conclusion: The level of serum PTX3 is significantly correlated with neurological deficits and prognosis in ACI patients, which can be applied to assessing neurological deficits and predict short-term prognosis in ACI patients after RIC. 2022 Vol. 28 (3): 417-421 [Abstract] ( 81 ) HTML (1 KB)  PDF (1396 KB)  ( 192 ) 422 Efficacy of T-Plate Combined with Herbert Screw Internal Fixation for Mason Ⅲ Radial Head Fractures and Its Influence on Perioperative Indicators Elbow Function Score and Complications CHEN Shuzhen, HUANG Yuliang, ZHANG Lixuan DOI: 10.3969/j.issn.1006-6233.2022.03.015 Objective: To explore the efficacy of T-plate combined with Herbert screw internal fixation in the treatment of Mason Ⅲ radial head fractures and its influence on perioperative indicators, elbow function score and complications. Methods: A total of 118 patients with Mason Ⅲ radial head fractures in the hospital were randomly selected as the research subjects, and they were divided into observation group and control group according to the simple random method. The control group (n=58) was treated with T-plate fixation, and the observation group (n=60) was given T-plate combined with Herbert screw internal fixation. Perioperative indicators, pain score, postoperative complications and elbow function were compared between the two groups. Results: The clinical effective rate was 93.33% in observation group and 77.59% in control group, with a statistical difference (P<0.05). The surgical time and postoperative starting exercise time in observation group were significantly shorter or less than those in control group (P<0.05), and there were no statistical differences in intraoperative blood loss, surgical incision length, and treatment cost between the two groups (P>0.05). The differences were statistically significant (P<0.05) when comparing VAS scores between groups, time points and between groups x time points. The VAS scores of the two groups were decreased sequentially at 1d, 3d, and 7d after surgery (P<0.05). There was no statistically significant difference in the score at 1d after surgery (P>0.05), and the VAS scores at 3d and 7d after surgery were significantly lower than those in control group (P<0.05). The total incidence rate of complications was 10.00% in observation group and 18.97% in control group (P>0.05) with no significant statistical difference. At 6 months in follow-up after surgery, the range of motion of elbow joint and Mayo score of observation group were significantly wider or higher than those of control group (P<0.05). Conclusion: T-plate combined with Herbert screw internal fixation in the treatment of Mason Ⅲ radial head fractures can significantly improve the clinical efficacy and postoperative starting exercise time, reduce postoperative pain and restore good postoperative elbow function. 2022 Vol. 28 (3): 422-427 [Abstract] ( 82 ) HTML (1 KB)  PDF (1394 KB)  ( 195 ) 427 Effects of Minimally Invasive Wrist Arthroscopic Surgery on the Improvement of Wrist Joint Function and Postoperative Complications in Patients with Unstable Distal Radius Fractures LI Xinxia, SHEN Lilin, LIU Yong DOI: 10.3969/j.issn.1006-6233.2022.03.016 Objective: To observe the effect of minimally invasive wrist arthroscopic surgery on the improvement of wrist joint function and postoperative complications in patients with unstable distal radius fractures. Methods: Clinical data of 151 patients with unstable distal radius fractures treated in Jinan People's Hospital from January 2018 to January 2021 were collected. According to the surgical regimens, patients were divided into minimally invasive group (n=73) and traditional group (n=78). The traditional group received traditional open reduction and internal fixation surgery, and the minimally invasive group received minimally invasive wrist arthroscopic surgery. The function of wrist joint, the effect of fracture reduction, the related recovery indicators and the incidence of complications before and after operation were statistically compared. Results: The operation time of minimally invasive group was significantly longer than that of control group (P<0.05), but the amount of intraoperative blood loss, length of hospital stay and fracture healing time were significantly less or shorter than those of traditional group (P<0.05). Six months after surgery, the excellent and good rate of wrist joint function in the minimally invasive group was significantly higher than that in the traditional group, the degree of shortening of VA radius and palm angle was significantly lower than that in the traditional group, and the ulnar angle was significantly higher than that in the traditional group, with statistical significance (P<0.05). There was no statistical significance between the two groups in the above indexes (P>0.05). The incidence of postoperative complications in minimally invasive group was significantly lower than that in traditional group (P<0.05). Conclusion: Minimally invasive wrist arthroscopic surgery can effectively promote the postoperative recovery of patients with unstable distal radius fracture, and the reduction effect is obvious, which is conducive to fracture healing and wrist joint function recovery with fewer complications. It can be promoted in clinical practice. 2022 Vol. 28 (3): 427-431 [Abstract] ( 114 ) HTML (1 KB)  PDF (1751 KB)  ( 293 ) 432 Clinical Efficacy and Safety Analysis of the Combined Kocher-Langenbeck (K-L) Approach for Complex Acetabular Fractures via the Ilioinguinal Groin YANG Xiaozhong, DENG Zhangyun, HU Song DOI: 10.3969/j.issn.1006-6233.2022.03.017 Objective: To evaluate the effect of combined ilioinguinal and Kocher-Langenbeck (K-L) approach in the treatment of complex acetabular fractures. Methods: The clinical data of 75 patients with complex acetabular fractures admitted to the hospital between January 2018 and June 2020 were collected , and the patients were divided into observation group (combined ilioinguinal and K-L approach, 38 cases) and control group (KL approach, 37 cases) according to the two different surgical approaches. The two groups of patients were followed up for 1 year, and Matta imaging was used to evaluate and observe the postoperative fracture reduction and evaluate the clinical efficacy. The occurrence of postoperative complications (heterotopic ossification, osteoarthritis, avascular necrosis of the femoral head, neurovascular injury) were compared between the two groups. Merle d’ Aubigne and Postel scoring system was used to evaluate the hip function, and Barthel index (BI) and the MOS item short from health survey (SF-36) were applied to assess the hip function and quality of life of patients. Results: ① In terms of clinical efficacy, the 94.74% clinical effective rate in observation group was higher than 75.68% in control group (P<0.05), and the efficacy grading in observation group was better than that in control group (P<0.05). ② The incidence rate of postoperative complications was 7.89% in observation group, which was significantly lower than 27.03% in control group (P<0.05). ③ In terms of hip function, the differences of the above-mentioned scores after treatment and before treatment in observation group were higher than those in control group (P<0.01). ④ From the aspects of ability of daily living and quality of life, the differences of scores of BI and SF-36 after treatment and before treatmentwere were higher in observation group compared to control group (P<0.01). Conclusion: Combined ilioinguinal and K-L approach has good clinical efficacy and safety and few postoperative complications in the treatment of complex acetabular fractures, and can improve the hip function and enhance the ability of daily living and quality of life. 2022 Vol. 28 (3): 432-436 [Abstract] ( 107 ) HTML (1 KB)  PDF (1356 KB)  ( 382 ) 437 Therapeutic Effect of Laparoscopic Cholecystectomy on Patients with Acute Biliary Pancreatitis and Its Influence on Serum Amylase Levels RUAN Qing, WANG Tao DOI: 10.3969/j.issn.1006-6233.2022.03.018 Objective: To investigate the therapeutic effect of laparoscopic cholecystectomy in patients with acute biliary pancreatitis and the effect on serum amylase levels. Methods: A total of 133 patients with acute biliary pancreatitis who underwent laparoscopic cholecystectomy in our hospital from August 2017 to October 2020 were selected as the study subjects and divided into observation group (n=69, laparoscopic cholecystectomy performed within 5d of onset) and control group (N=64, surgery delayed). The surgical situations and clinical recovery of the two groups were compared, and the rate of complications and recurrence was recorded. Results: The observation group, compared with the control group, had shorter operation time (t=2.198, P=0.030), more intraoperative bleeding (t=2.275, P=0.025), and shorter hospital stay (t=16.865, P<0.001). The serum AMS recovery time, abdominal pain relief time and gastrointestinal ventilation recovery time in the observation group were shorter than those in the control group (t=8.269, 8.484, 7.490, P<0.001, 0.01, 0.001). There was no significant difference in the incidence of complications between the two groups (P>0.05). The recurrence rate of the observation group was lower than that of the control group one year after operation (χ2=4.250, P=0.039). Conclusion: Compared with delayed operation, early laparoscopic cholecystectomy for acute biliary pancreatitis can effectively relieve clinical symptoms, shorten operative time and total hospital stay, increase intraoperative bleeding without increasing the incidence of complications, and significantly reduce the recurrence rate of pancreatitis. 2022 Vol. 28 (3): 437-440 [Abstract] ( 101 ) HTML (1 KB)  PDF (1203 KB)  ( 258 ) 441 Early Efficacy of Different Fluid Resuscitation Methods on Severe Acute Pancreatitis and Its Influence on Intra-Abdominal Pressure and Intestinal Dysfunction of Patients CHEN Meng'e, MO Cuiyi, et al DOI: 10.3969/j.issn.1006-6233.2022.03.019 Objective: To explore the efficacy of different fluid selections on early fluid resuscitation of severe acute pancreatitis (SAP) as well as the influence on intra-abdominal pressure and intestinal dysfunction of patients. Methods: The various clinical data of 154 patients with severe pancreatitis admitted to the hospital between January 2018 and December 2020 were retrospectively analyzed. Different fluid resuscitation methods were used as the basis for grouping. The patients with Lactated Ringers solution (LR) were set as monotherapy group (n=74), and the patients with LR+6% hydroxyethyl starch (Hetastarch, HES) were selected as combination group (n=80). The continuous blood purification (CBP) time, mechanical ventilation time, wake-up time, biochemical indicators, intra-abdominal pressure and intestinal function were compared between the two groups. Results: ① Comparison of recovery showed that the CBP time and mechanical ventilation time of combination group were shorter than those of monotherapy group, and the wake-up time of combination group was earlier(P<0.05). ② At different time points, there was a statistically significant difference in the intra-abdominal pressure (IAP) between the two groups, with time-point effect (P<0.01). ③ In terms of interleukin 10 (IL-10), white blood cells (WBC), blood urine amylase (AMS) and serum lipase (LPS), the increase of IL-10 after intervention in the combination group was greater than that in the monotherapy group, and the decrease of WBC, AMS and LPS of the combination group were greater (P<0.05). ④ As for intestinal dysfunction, the incidence rates of abdominal pain, constipation, abdominal distension and abdominal tenderness in combination group after intervention were lower compared with that in monotherapy group (P<0.05). ⑤ The 90.00% effective rate of resuscitation in combination group was higher than 81.08% in monotherapy group after intervention (χ2=2.497; P=0.114>0.05). Conclusion: In the early fluid resuscitation of patients with SAP, LR+6% Hetastarch has a better efficacy. It can promote the resuscitation, reduce the intra-abdominal pressure and intestinal dysfunction, maintain the plasma colloidal osmotic pressure, and keep the acid-base balance, thus it is suitable for clinical promotion. 2022 Vol. 28 (3): 441-445 [Abstract] ( 92 ) HTML (1 KB)  PDF (1226 KB)  ( 172 ) 445 The Effect of Preservation Versus Removal of the Uterus on Pelvic Floor Electromyography Sex Hormones and Urodynamic Parameters in Patients with Menopausal Uterine Prolapse REN Jun, ZHOU Xiufen DOI: 10.3969/j.issn.1006-6233.2022.03.020 Objective: To explore the effects of uterine preservation and removal on pelvic floor electromyography, sex hormones and urodynamic parameters in patients with menopausal uterine prolapse. Methods: A total of 100 patients with menopausal uterine prolapse in our hospital from May 2015 to May 2019 were selected and divided into uterine removal group (n=50) and uterine preservation group (n=50) according to the surgical regimens. Vaginal hysterectomy + anterior and posterior vaginal wall repair and simple anterior and posterior vaginal wall repair were performed respectively. Clinical data were observed including the perioperative indicators, complications, recurrence rate and pelvic floor electromyography (rapid contraction, tension contraction value, endurance test value), sex hormone indicators [estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH)], urodynamic parameters [maximum urethral closure pressure (MUCP), abdominal pressure leaking urine point pressure (ALPP), maximum urethral pressure (MUP)] before and 1 month after operation in the two groups. Results: The operation time of the uterine removal group was longer than that of the uterine preservation group (P＜0.05). There was no significant difference in the amount of blood loss, hospital stay, and time to get out of bed between the two groups (P＞0.05); one month after operation, the values of tension contraction, rapid contraction and endurance in the uterine removal group were higher than those in the uterine preservation group (P＜0.05); one month after operation, the E2 level of the uterine removal group was lower than that of the uterine preservation group, and the levels of LH and FSH were higher than that of the uterine preservation group (P＜0.05); the MUCP, ALPP and MUP of the uterine removal group were higher than those of the uterine preservation group at 1 month after operation (P＜0.05); there was no significant difference in the incidence of complications between the two groups (P>0.05); after 12 months of follow-up, the recurrence rate of the uterine removal group was lower than that of the uterine preservation group (P＜0.05). Conclusion: Simple anterior and posterior vaginal wall repair, vaginal hysterectomy combined with anterior and posterior vaginal wall repair in the treatment of menopausal uterine prolapse patients have equivalent effects in surgical trauma and postoperative recovery. Combined surgery can improve pelvic floor electromyography and urodynamic parameters, and reduce the recurrence rate, but it can have a certain impact on sex hormone levels. 2022 Vol. 28 (3): 445-451 [Abstract] ( 79 ) HTML (1 KB)  PDF (1251 KB)  ( 261 ) 451 Curative Effect of Cisplatin Hyperthermic Intraperitoneal Chemotherapy Combined with Intravenous Chemotherapy in the Treatment of Gastric Cancer and Its Influence on Serum IGF-1 VEGF and EGFR Levels MIN Tao, LIU Lihua, et al DOI: 10.3969/j.issn.1006-6233.2022.03.021 Objective: To investigate the curative effect of cisplatin hyperthermic intraperitoneal chemotherapy (HIPEC) combined with intravenous chemotherapy in the treatment of gastric cancer, and its influence on serum insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) levels. Methods: Totally 112 patients with gastric cancer were divided into observation group (n=60) and control group (n=52) according to the principle of voluntariness. The observation group was given cisplatin HIPEC combined with intravenous chemotherapy, while the control group was given intravenous chemotherapy alone. The short-term curative effect, quality of life and adverse reactions were compared between the two groups. The levels of serum IGF-1, VEGF and EGFR were determined before and after treatment. Results: The short-term total response rate in the observation group was 61.67%, which was significantly higher than the control group at 36.54%(P<0.05). The incidence of nausea, vomiting and bone marrow suppression in the observation group was slightly higher than that in the control group, with statistical differences (P<0.05). After treatment, serum IGF-1, VEGF and EGFR levels were significantly reduced in the two groups, and the difference of each index in the observation group was greater than that in the control group. (P<0.05). Conclusion: Cisplatin HIPEC in combination with intravenous chemotherapy can achieve better short-term curative effect than intravenous chemotherapy alone in the treatment of gastric cancer. The former can significantly improve serum IGF-1, VEGF and EGFR levels of patients without increasing side effects. 2022 Vol. 28 (3): 451-456 [Abstract] ( 77 ) HTML (1 KB)  PDF (1251 KB)  ( 126 ) 456 Analysis of the Value and Effect of Panavia F Resin Cementum in the Restoration of Patients with Dental Defects LI Yingying, et al DOI: 10.3969/j.issn.1006-6233.2022.03.022 Objective: To study the value of Panavia F resin cementum in the restoration of dental defects. Methods: A total of 94 patients with dental defects admitted to Chengde Stomatological Hospital from January 2019 to March 2020 were included in the study. In the order of the patients' visits, the odd numbers were included into the cementum group and the even numbers into the glass ionomer group, with 47 cases in each group. All subjects underwent dental implant restoration. The glass ionomer group was treated with multi-functional glass ionomer binder, while the cementum group was treated with Panavia F resin cementum. All subjects were followed up for 1 year to analyse the differences in clinical outcomes, changes in plaque index (PLI), probing depth (PD) and bleeding index (BI) before and after treatment, incidence of gingival discolouration, gingivitis and gingival bleeding in the affected teeth, and changes in dental aesthetic scores before and after treatment. Results: The total effective rate of treatment in the cementum group was 97.87%, higher than that of the glass ionomer group at 82.98% (P<0.05). The difference in PLI and BI values before and after treatment was higher in the cementum group than in the glass ionomer group (all P<0.05). The incidence of gingival discolouration, gingivitis and gingival bleeding was 4.26%, 2.13% and 4.26% respectively in the cementum group, all lower than the 17.02%, 14.89% and 19.15% in the glass ionomer group (all P<0.05). The difference between pre- and post-treatment dental aesthetic scores in the cementum group was (29.77±3.22) points, which was higher than that of the glass ionomer group (20.34±2.15) points (t-value=16.697, P=0.000). Conclusion: The use of Panavia F resin cementum in the restoration of patients with dental defects is of significant value, improving clinical efficacy, improving periodontal index levels, reducing the risk of gingival discolouration, gingivitis and gingival bleeding in affected teeth, and improving the aesthetic appearance of teeth.It is worthwhile to promote its clinical application. 2022 Vol. 28 (3): 456-460 [Abstract] ( 106 ) HTML (1 KB)  PDF (1228 KB)  ( 246 ) 460 Analysis on Relationship Between Ultrasonic Elastography Score and Pathological Characteristics of Breast Cancer and Its Value for Evaluating Lymphatic Metastases of Breast Cancer CHE Luquan, ZHANG Jie DOI: 10.3969/j.issn.1006-6233.2022.03.023 Objective: To study a relationship between ultrasonic elastography(UE) score and pathological characteristic of breast cancer and its value for evaluating lymphatic metastasis of breast cancer. Method: A total of 148 breast cancer patients treated in our hospital from May 2019 to May 2021 were taken for routine ultrasound with UE, and pathological findings were taken as the golden standards. The relationship between the UE score and histopathological characteristic of the breast cancer patients was analyzed, and the diagnostic value of two diagnostic methods on lymphatic metastasis of breast cancer were compared. Results: Among 148 cases of breast cancer, 8 cases were medullary carcinoma, 6 cases were invasive lobular carcinoma and 134 cases were invasive ductal carcinoma. 82 cases (55.41%) had metastatic axillary lymph nodes, and 66 cases (44.59%) had non-metastatic axillary lymph nodes. Correlation analysis showed that UE score had no correlation with tumor size (P>0.05). UE score was significantly correlated with tumor type, tumor grade and lymph node metastasis (P<0.05). The blood flow of metastatic axillary lymph nodes was mainly type III, accounting for 52.43%. Non-metastatic axillary lymph node blood flow was mainly type I, accounting for 53.03% (P<0.05). UE score of metastatic axillary lymph nodes was 3 or above, accounting for 82.93%. UE score of non-metastatic axillary lymph nodes was 2 or below, accounting for 77.27% (P<0.05). The average UE score of metastatic axillary lymph nodes was higher than that of non-metastatic lymph nodes (P<0.05). Among 148 breast cancer patients, UE showed metastatic axillary lymph nodes in 71 cases, which was consistent with pathology in 69 cases. Conventional ultrasound showed metastatic axillary lymph nodes in 69 cases, which was consistent with pathology in 66 cases. The sensitivity (84.15%), specificity (93.94%) and accuracy (88.51%) of UE diagnostic method were higher than those of conventional ultrasound group. Conclusion: UE score has a certain relationship with histopathology of breast cancer patients, and UE has higher diagnostic value for lymphatic metastasis of breast cancer than conventional ultrasound, there was no statistical significance between them (P>0.05). 2022 Vol. 28 (3): 460-465 [Abstract] ( 90 ) HTML (1 KB)  PDF (1543 KB)  ( 164 ) 465 Clinical Characteristics and Related Factors of Depression and Cognitive Dysfunction in Patients with Parkinson's Disease ZENG Min, LI Menglan, CHEN Jing, et al DOI: 10.3969/j.issn.1006-6233.2022.03.024 Objective: To explore the clinical characteristics and related influencing factors of depression and cognitive dysfunction in patients with Parkinson's disease (PD). Methods: A total of 117 PD patients treated in the hospital from January 2019 to June 2020 were enrolled as the research subjects. The depression of patients was evaluated by Hamilton Depression Scale (HAMD), and the clinical characteristics and influencing factors of depression were analyzed. The cognitive status of patients was assessed by Montreal Cognitive Assessment (MOCA), and the clinical characteristics and influencing factors of cognitive dysfunction were analyzed. Results: The average score of HAMD and detection rate of depression were (17.64±3.26) points and 58.12%, respectively. Depression was related to course of disease, Hoehn-Yahr staging, education level and MoCA score (P<0.05). The results of multivariate Logistic regression analysis showed that course of disease, Hoehn-Yahr staging, education level and MoCA score were independent influencing factors of depression (P<0.05). The average score of MoCA and detection rate of cognitive dysfunction were (26.25±3.82) points and 53.85%, respectively. Cognitive dysfunction was related to gender, course of disease, age, Hoehn-Yahr staging, onset symptoms (festination, freezing, salivation and postural hypotension) and MoCA score (P<0.05). The results of multivariate Logistic regression analysis showed that Hoehn-Yahr staging and MoCA score were independent influencing factors of cognitive dysfunction (P<0.05). Conclusion: The detection rates of depression and cognitive dysfunction are relatively high in patients with Parkinson's disease. Depression is easily affected by course of disease, Hoehn-Yahr staging, education level, and MoCA score, while cognitive dysfunction is easily affected by Hoehn-Yahr staging and HAMD score, which deserves attention. 2022 Vol. 28 (3): 465-472 [Abstract] ( 88 ) HTML (1 KB)  PDF (1252 KB)  ( 174 ) 472 An Analysis of the Efficacy of Omeprazole Combined with Intestinal Microecological Regulator in the Treatment of Neonatal Necrotizing Enterocolitis YANG Xue, ZHAO Xujing DOI: 10.3969/j.issn.1006-6233.2022.03.025 Objective: To analyze the therapeutic effect of omeprazole combined with intestinal microecological regulator on neonatal necrotizing enterocolitis (NEC). Methods: Children with NEC who came to the hospital for treatment between January 2016 and July 2021 were selected as the research subjects, and they were divided into observation group and control group according to the principles of non-randomized clinical concurrent control and voluntariness of family members. The children in the control group were treated with intestinal microecological regulator, and the children in the observation group were given omeprazole on the basis of the control group. The relief time of clinical symptoms and clinical efficacy after 3d of treatment were compared between the two groups of children. The intestinal flora, immune function and imaging manifestations of the two groups were compared before and after treatment. Results: The diarrhea relief time, abdominal distension relief time and relief time of irregular bowel movement during treatment of observation group were shorter than those of control group, and the clinical efficacy after 3 d of treatment was better than that of control group (all P<0.05). The intestinal flora counts (total number of intestinal bacteria, total number of cocci, total number of bacilli), proportion of CD4+ and CD4+/CD8+ ratio after 3 d of treatment in the two groups were increased compared with those before treatment, and the differences before and after treatment were greater in observation group than those in control group (all P<0.05). The levels of serum CRP and PCT in the two groups were lower after 3d of treatment than those before treatment, and the differences before and after treatment between observation group and control group were significant (all P<0.05). The improvement ratios of intestinal wall thickening and fixed intestinal loop shadow before and after treatment in observation group were higher than those in control group (all P<0.05), but there was no statistical significance in the improvement ratio of portal venous gas between the two groups before and after treatment (P>0.05). Conclusion: Omeprazole combined with intestinal microecological regulator can effectively improve the immunity, relieve the inflammatory response, shorten the course of disease, and promote the rehabilitation of children with NEC. 2022 Vol. 28 (3): 472-477 [Abstract] ( 90 ) HTML (1 KB)  PDF (1247 KB)  ( 168 ) 477 Examination and Clinical Significance of 67 Gene Mutations in Acute Myeloid Leukemia HUANG Li, FU Xiangjun, GUO Li, et al DOI: 10.3969/j.issn.1006-6233.2022.03.026 Objective: To explore the occurrence and clinical significance of 67 gene mutations in patients with acute myeloid leukemia (AML). Methods: Totally 117 patients with AML admitted to the hospital between May 2018 and May 2019 were selected. All patients received clinical drug intervention. Mutant genes were screened by second-generation sequencing technology, and the relationship of gene mutations with clinical characteristics and prognosis of patients were analyzed. Results: Of the 117 patients, 108 (92.31%) had gene mutations, including 25 (21.37%) patients with single-gene mutation, 36 (30.77%) patients with 2 gene mutations, and 47 (40.17%) with ≥3 gene mutations. A total of 67 genetic mutations were detected. Among the 108 patients, the mutant genes with a mutation detection rate of ≥10% were as follows: NRAS (23.15%), NPM1 (19.44%), DNMT3A (15.74%), TET2 (14.81%), WT1 (12.03%), CEBPA (12.03%), FLT3-ITD+TKD (11.11%), GATA2 (11.11%), ASXL1 (10.19%), and BCORL1 (10.19%). Common pathways involved included epigenetics (57.41%), transcription regulation (49.07%), cell proliferation or apoptosis (25.00%) and shear factor (8.33%). The hemoglobin (HGB) level in patients with NRAS gene mutation was lower than that in patients without mutation, and white blood cell count (WBC) in patients with NPM1 gene mutation was higher than that in patients without mutation (P<0.05). The detection rates of NPM1 and DNMT3A gene mutations in the intermediate-risk group were higher than those in the low-risk group and the high-risk group (P<0.05). The two-year cumulative survival rates of patients with NPM1 was higher than that of patients without mutation, and the two-year cumulative survival rate of patients with DNMT3A gene mutations were lower than that of patients without mutation (P<0.05). The two-year cumulative survival rate of patients with gene mutations ≥3 was lower than that of patients with gene mutations <3 (P<0.05). The results of multivariate analysis showed that no NPM1 mutation,DNMT3A gene mutations and gene mutations ≥3 were associated with poorer OS of patients with AML (P<0.05). Conclusion: The gene mutation rate is relatively higher in patients with AML. The number and type of gene mutations are related to clinical characteristics and prognosis of patients. 2022 Vol. 28 (3): 477-482 [Abstract] ( 734 ) HTML (1 KB)  PDF (1517 KB)  ( 2470 ) 482 Efficacy of High-Intensity Focused Ultrasound Ablation in the Treatment of Uterine Fibroids and Its Influence on Levels of Serum VEGF and ER and Pregnancy Outcomes FAN Jingchun, JI Yanqin DOI: 10.3969/j.issn.1006-6233.2022.03.027 Objective: To study the efficacy of high-intensity focused ultrasound ablation on uterine fibroids and its influence on levels of serum vascular endothelial growth factor (VEGF) and estrogen receptor (ER) and pregnancy outcomes. Methods: Totally 121 patients with uterine fibroids of childbearing age admitted to the hospital from January 2019 to September 2020 were selected as the research subjects, and they were divided into control group (n=61) and observation group (n=60) according to the medical advices, progression of disease and patients’ desires. The control group was treated with conventional conservative drugs, and the observation group underwent high-intensity focused ultrasound ablation. The efficacy, uterine volume and uterine fibroids volume, levels of serum VEGF, ER and estradiol (E2) and postoperative pregnancy were compared between the two groups after treatment. Results: Before implementing the corresponding treatments, there were no significant differences in the uterine volume, uterine fibroids volume and levels of serum VEGF, ER and E2 between the two groups (P>0.05). After treatment, the uterine volume, uterine fibroids volume and levels of serum VEGF, ER and E2 were decreased in the two groups, and the difference of the above indexes in the observation group before and after treatment was significantly greater than that in the control group (P<0.05). After treatment, the efficacy and postoperative pregnancy of observation group were better than those of control group (P<0.05). Conclusion: High-intensity focused ultrasound ablation has a significant efficacy on uterine fibroids. It can reduce the levels of serum VEGF and ER and the volume of uterus andvolume of uterine fibroids, and it has a significant effect and the pregnancy outcomes of observation group are better than control group. Thus this kind of treatment method has clinical promotion value. 2022 Vol. 28 (3): 482-486 [Abstract] ( 87 ) HTML (1 KB)  PDF (1229 KB)  ( 162 ) 487 Correlation of Abnormal IgA1 Molecular Glycosylation with Th17 Cells in Patients with IgA Nephropathy HOU Jing, et al DOI: 10.3969/j.issn.1006-6233.2022.03.028 Objective: To investigate the correlation between abnormal glycosylation of IgA1 molecule and Th17 cells in patients with IgA nephropathy. Methods: The clinical data of 50 patients with IgA nephropathy (IgA nephropathy group) and 50 healthy people (healthy control group) were selected for retrospective analysis. The patients’ admission period was from February 2018 to May 2020. Th17 cells, Treg cells, Gd-IgA1, TGF-β, IL-6, IL-17, IL-21, IL-23, serum creatinine, albumin and urine protein quantification were compared; Pearson method was used to analyze Gd-IgA1 and Th17 correlation of cells, Treg cells, and correlation of cytokines with Gd-IgA1. Results: Th17 cells, Th17/Treg, Gd-IgA1, IL-6, IL-17, IL-21, IL-23, serum creatinine and urine protein in the IgA nephropathy group were all higher than those in the healthy control group, while Treg cells, TGF-β and albumin were lower than the healthy control group (P＜0.05). Pearson correlation showed that Gd-IgA1 was positively correlated with Th17 cells and Th17/Treg (r=0.737/0.810, P＜0.05), and negatively correlated with Treg cells (r=-0.487, P＜0.05). Gd-IgA1 was negatively correlated with TGF-β (r=-0.260, P＜0.05), and positively correlated with IL-6, IL-17, IL-21, and IL-23 (r=0.796/0.776/0.714/0.819, P<0.05). Conclusion: In patients with IgA nephropathy, Th17 cells are positively correlated with Gd-IgA1, and the expression of Th17 cells can be evaluated to provide a basis for clinical diagnosis and treatment. 2022 Vol. 28 (3): 487-490 [Abstract] ( 80 ) HTML (1 KB)  PDF (1209 KB)  ( 120 ) 490 Analysis of the Value of Different Pastes in Pulp Revascularization in the Treatment of Patients with Necrotic Pulpitis in Young Permanent Teeth LIU Xue, XU Yang, SUN Yana, et al DOI: 10.3969/j.issn.1006-6233.2022.03.029 Objective: To analyze the value of different pastes in pulp revascularization in the treatment of patients with necrotic pulpitis of young permanent teeth. Methods: A total of 92 patients with necrotic pulpitis of young permanent teeth admitted to our hospital from January 2019 to February 2020 were selected as the research subjects. They were randomly divided into control group (46 cases, 46 affected teeth) and observation group (46 cases, 46 affected teeth) by simple random grouping. Both groups were treated with pulp revascularization, the control group was treated with triple antibiotic paste, and the observation group was treated with calcium hydroxide paste. Both groups were followed up for 12 months after completion of treatment. Clinical efficacy, positive rate of bacteria after sealing, follow-up and incidence of adverse reactions during follow-up were counted in two groups 1 month after treatment. The scores of clinical symptom before treatment and 1 month after treatment, and scores of visual analogue scale (VAS) before treatment and 3, 6 and 12 months after treatment were compared between two groups. Results: The total effective rate at 1 month after treatment of observation group was 93.48%, which was significantly higher than control group at 78.26% (P<0.05). Compared with before treatment, the scores of gingival swelling, pain and tooth loosening in the two groups decreased 1 month after treatment, and gingival swelling, pain and tooth loosening scores decreased more significantly in the observation group than in the control group (P<0.05). When comparing VAS scores between the two groups, they were higher at 3, 6 and 12 months post-treatment than pre-treatment, 6 and 12 months post-treatment than 3 months post-treatment and 12 months post-treatment than 6 months post-treatment (p<0.05). 12 months after treatment, the score of VAS of observation group was lower than that of control group (P<0.05). After sealing, the positive rate of bacteria in the observation group was lower than the control group (P<0.05). During follow-up, there was no significant difference in the incidence of crown discoloration and total adverse reactions (0.00% and 4.35%, 4.35% and 10.87%) between the the observation group and the control group (P>0.05). Conclusion: The use of calcium hydroxide paste can effectively reduce the rate of bacterial positivity and post-treatment pain in patients with necrotic pulpitis in young permanent teeth, and improve the clinical symptoms of patients with better treatment effect and safety. 2022 Vol. 28 (3): 490-494 [Abstract] ( 96 ) HTML (1 KB)  PDF (1232 KB)  ( 216 ) 494 Effects of Febuxostat Combined with Alprostadil on Renal Function Serum Uric Acid and EGFR in Patients with Chronic Kidney Disease ZHANG Xuefeng, QIU Yuhua, WANG Yiping, et al DOI: 10.3969/j.issn.1006-6233.2022.03.030 Objective: To study the effects of febuxostat combined with alprostadil on renal function, serum uric acid and Gglomerular filtration rate (eGFR) in patients with chronic kidney disease. Methods: A total of 103 patients with chronic kidney disease who received treatment in our hospital from January 2018 to January 2021 were selected and divided into combination group (n=52) and monotherapy group (n=51) by simple random grouping method. The monotherapy group was treated with alprostadil, and the combination group was treated with febuxostat on the basis of the monotherapy group. The clinical efficacy, serum uric acid, eGFR, serum creatinine (Scr), urea nitrogen (BUN), 24-hour urine protein level and the incidence of adverse reactions were compared between the two groups. Results: After treatment, there was statistical difference in the total effective rate between the two groups (P<0.05). Before treatment, there was no significant difference in renal function between the combination group and the monotherapy group. After treatment, Scr, BUN and 24-hour urine protein quantification were significantly decreased in both groups, and the combination group was lower than the monotherapy group; the difference was statistically significant (P<0.05). Before treatment, there was no significant difference in serum uric acid and eGFR between the two groups. After treatment, serum uric acid was significantly decreased in both groups, and eGFR was significantly increased in the combination group compared with the monotherapy group, with statistical significance (P<0.05). The total incidence of adverse reactions between the two groups was 5.77% and 15.69%, with no statistical significance (P>0.05). Conclusion: In patients with chronic kidney disease, febuxostat combined with aprostadil has a significant therapeutic effect, which can effectively improve the renal function and serum uric acid and eGFR levels. 2022 Vol. 28 (3): 494-498 [Abstract] ( 104 ) HTML (1 KB)  PDF (1229 KB)  ( 250 ) 498 Therapeutic Effect of Recombinant Human Brain Natriuretic Peptide Combined with Levosimendan on Senile Acute Anterior Myocardial Infarction with Decompensated Heart Failure in the Elderly and Its Influence on Serum NT-proBNP and Copeptin Levels LIU Yubin, LIAO Chunmei, ZHUANG Yanni, et al DOI: 10.3969/j.issn.1006-6233.2022.03.031 Objective: To analyze the therapeutic effect of recombinant human brain natriuretic peptide (rhBNP) combined with levosimendan in the treatment of senile acute anterior myocardial infarction with decompensated heart failure in the elderly and its influence on serum levels of NT-proBNP and Copeptin. Methods: Totally 151 elderly patients with acute anterior myocardial infarction and decompensated heart failure admitted in our hospital from September 2017 to March 2021 were randomly divided into the combination group (n=76) and the control group (n=75). Both groups were treated with levosimendan on the basis of routine anti-ischemia and anti-heart failure treatment, and the combined group was treated with rhBNP additionally. The treatment effect, adverse reactions, changes of serum NT-proBNP and Copeptin were compared between the combination group and the control group, and the clinical value of the combined treatment regimen was analyzed. Results: The left ventricular ejection fraction (LVEF), cardiac output (CO), cardiac index (CI) and peripheral vascular resistance index (SVRI) of both groups were higher after 3 days of treatment then before treatment, and the increase range of combination group was higher than that of control group with statistically significant difference(P<0.05). Three days after treatment, the total effective rate of the combination group was 88.16%, which was higher than the control group at 65.33% with statistically significant difference(P<0.05). The incidence rate of adverse reactions in combination group and control group during treatment was 5.26% and 5.33%, respectively, and there was no significant difference between groups(P>0.05). The levels of serum NT-proBNP and Copeptin in both groups decreased after 3 days of treatment, and the decrease range of combination group was higher than that of control group with statistically significant difference(P<0.05). Conclusion: On the basis of standardized treatment and levosimendan, rhBNP can further improve the cardiac function of elderly patients with acute anterior myocardial infarction and decompensated heart failure, reduce the levels of NT-proBNP and Copeptin, and improve the clinical treatment effect, with good safety. 2022 Vol. 28 (3): 498-503 [Abstract] ( 100 ) HTML (1 KB)  PDF (1254 KB)  ( 141 ) 503 Effects of Low Molecular Heparin Combined with Aspirin on Oxidative Stress, Uterine Artery Blood Flow TEG Parameters and Pregnancy Outcome in the Treatment of Pregnancy-Induced Hypertension XIAO Jin, DU Yun, HE Tongqiang, et al DOI: 10.3969/j.issn.1006-6233.2022.03.032 Objective: To explore the effect of low molecular heparin combined with aspirin in the treatment of pregnancy-induced hypertension on oxidative stress, uterine artery blood flow, TEG parameters and pregnancy outcome. Methods: A total of 126 patients with pregnancy-induced hypertension admitted between February 2019 and February 2021 were divided into 2 groups using a simple randomized grouping method, 64 in the control group were treated with conventional medication and 62 in the observation group were treated with low molecular heparin combined with aspirin, and the two groups were compared for TEG parameters, uterine artery blood flow, oxidative stress, and pregnancy outcome after treatment. Results: The R (6.95±1.22) min, K (2.15±0.11) min and α-Angle (72.12±4.63)°and MA (66.96 ± 3.32) mm parameters in the observation group was better than in the control group (P<0.05), and the stability of LPO, GSH-Px, Hcy, SOD, PI, RI and S/D in the observation group was better than in the control group (P<0.05). At the same time, in the observation group, 12.90% cesarean delivery, 3.23% postpartum haemorrhage, 1.61% placental abruption, 0.00% neonatal asphyxia, 3.23% preterm delivery and 1.61% fetal distress rate were lower than the control group with 32.81% cesarean delivery, 18.75% postpartum haemorrhage, 10.94% placental abruption, 9.38% neonatal asphyxia, 15.63% preterm delivery and 12.50% fetal distress rate (P<0.05). Conclusion: The treatment of low molecular heparin combined with aspirin in patients with pregnancy-induced hypertension can improve the oxidative stress response, stabilize the uterine artery blood flow, and reduce the occurrence of adverse pregnancy outcomes. 2022 Vol. 28 (3): 503-507 [Abstract] ( 97 ) HTML (1 KB)  PDF (1224 KB)  ( 189 ) 508 Effect of Pioglitazone and Metformin Tablets on Sex Hormones Insulin Resistance, Serum Inflammatory Parameters in Patients with Primary Polycystic Ovary Syndrome CHEN Xiaojun, CHAI Fang, et al DOI: 10.3969/j.issn.1006-6233.2022.03.033 Objective: To investigate the effect of pioglitazone and metformin tablets on sex hormones, insulin resistance, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α ( TNF-α) levels in patients with primary polycystic ovary syndrome (PCOS). Methods: A total of 97 patients with PCOS admitted to our hospital between January 2018 and October 2020 were analyzed retrospectively. According to the treatment regimens, the patients were divided into study group (47 cases) and control group (50 cases). All were treated with ethinylestradiol cyproterone tablets. On this basis, the control group was treated with metformin tablets, and the study group was treated with pioglitazone and metformin tablets, for 3 months. The curative effect, sex hormones, insulin resistance index, serum hs-CRP, IL-6 and TNF-α levels, and quality of life were compared between the two groups. Results: The total effective rate of treatment in the study group was 93.62%, higher than 78.00% in the control group (P<0.05). After treatment, the levels of luteinizing hormone, testosterone, fasting blood glucose, fasting insulin, insulin resistance index, serum hs-CRP, IL-6 and TNF-α were significantly reduced (P<0.05), and the total quality of life scores were significantly increased (P<0.05). Meanwhile, the difference before and after treatment of luteinizing hormone, testosterone, fasting blood glucose, fasting insulin, insulin resistance index, serum hs-CRP, IL-6, TNF-α and the total quality of life score in the study group were higher than those in the control group (P<0.05). Conclusion: Pioglitazone and metformin tablets are more advantageous than monotherapy in the treatment of primary polycystic ovary syndrome, significantly reducing luteinizing hormone and testosterone levels, improving insulin resistance, regulating inflammatory factors and improving quality of life. 2022 Vol. 28 (3): 508-513 [Abstract] ( 90 ) HTML (1 KB)  PDF (1243 KB)  ( 229 ) 513 Clinical Application of Treprostinil in Combination with Salmeterol and Ficasone in Patients with Chronic Obstructive Pulmonary Disease and Severe Pulmonary Hypertension HU Xiaochun, LIU Shiwu, TENG Lifeng, et al DOI: 10.3969/j.issn.1006-6233.2022.03.034 Objective: To explore the clinical effect of treprostinil in combination with salmeterol on patients with chronic obstructive pulmonary disease (COPD) and severe pulmonary hypertension (PAH). Methods: A total of 147 COPD patients with severe PAH admitted to our hospital from January 2018 to January 2021 were selected for the study. The random number table method was used for simple random grouping, and they were divided into two groups: study group and control group, with 77 cases in study group. In the control group, 70 cases were treated with Trepronil injection. The study group was combined with salmeterol and ticasone powder on this basis. Both groups were treated for 21 days. The clinical efficacy, pulmonary function parameters [1st second expiratory volume (FEV1) as a percentage of predicted value (FEV1%pred) and 1st second expiratory volume to expiratory spirometry ratio (FEV1/FVC)], plasma levels of nitric oxide (NO), endothelin (ET-1), soluble guanylate cyclase (cGMP), adenylate cyclase (cAMP), serum inflammatory factors [Apelin, tumour necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP)], and the occurrence of adverse reactions between the two groups were compared. Results: The total effective rates of the study group and the control group were 93.51% and 78.57% respectively (P＜0.05); the difference in FEV1/FVC and FEV1%pre, NO, ET-1, cGMP, cAMP, hs-CRP, TNF-αand Apelin before and after treatment in the study group was higher than the difference before and after treatment in the control group (P<0.05); there was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion: Treprostinil in combination with salmeterol and ticassone has significant effects in the treatment of chronic obstructive pulmonary disease complicated with severe pulmonary hypertension. It has great advantages in improving lung function and reducing inflammation, and is suitable for popularization and application. 2022 Vol. 28 (3): 513-518 [Abstract] ( 92 ) HTML (1 KB)  PDF (1246 KB)  ( 179 )

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