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2022 Vol. 28, No. 6 Published: 2022-06-30 881 Mechanism of RUNX1 Regulating Migration and Invasion of Laryngeal Squamous Cell Carcinoma Cells DING Wenyu, CHANG Xiao, YANG Yifei DOI: 10.3969/j.issn.1006-6233.2022.06.01 Objective: To explore the regulatory mechanism of runt related transcription factor 1 (Runx1) on the proliferation, cell cycle, apoptosis, migration and invasion of laryngeal squamous cell carcinoma (LSCC) Hep2 cells. Methods: Si-con group (transfected Si con) and Si-RUNX1 group (transfected Si-RUNX1) were transfected into Hep2 cells by liposome method; Real time fluorescence quantitative reverse transcription polymerase chain reaction (RT qPCR), western blotting (WB), cell counting kit 8 (CCK8), 5-ethynyl-2 '- deoxyuridine (EDU), flow cytometry, scratch test Transwell assay was used to detect the mRNA and protein expression of Runx1, cell proliferation, cell cycle, apoptosis, cyclin D1 (cyclin D1), cyclin D-dependent kinase (CDK4), cleaved caspase-3, bcl-2 related X protein (Bax), B lymphoma-2 (Bcl-2), protein expression of matrix metalloproteinase (MMP) - 2, MMP-9, phosphatidylinositol-3-kinase (PI3K), protein kinase B (Akt) and phosphorylation (P) - Akt. Results: Compared with Si-con group, the expression of Runx1 mRNA and protein, cell proliferation, S-phase arrest of cell cycle, apoptosis rate, scratch healing rate and the number of migrating and invading cells in Si-RUNS1 group were significantly decreased (P<0.05). Importantly, the intervention of RUNX1 also inhibited the protein expression of PI3K, p-Akt and p-Akt / Akt, the key factors of PI3K / Akt signaling pathway. Conclusion: The intervention of Runx1 is not conducive to the survival, migration and invasion of Hep2 cells, and its mechanism may be related to the inhibition of the activity of PI3K / Akt signaling pathway. 2022 Vol. 28 (6): 881-886 [Abstract] ( 172 ) HTML (1 KB)  PDF (2248 KB)  ( 209 ) 887 MiR-30a-5p Regulates Apoptosis and Glycolysis in Gastric Cancer Cells via Targeting URGCP YANG Meng DOI: 10.3969/j.issn.1006-6233.2022.06.02 Objective: To explore the effect of miR-30a-5p on apoptosis and glycolysis in gastric cancer (GC) cells by targeting up-regulated gene 4 (URGCP), and to elucidate its potential regulatory mechanisms. Methods: Quantificational real-time polymerase chain reaction (RT-PCR) was used to detect the expression of miR-30a-5p and URGCP in normal gastric epithelial cells (GES-1) and GC cells (AGS, HGC-27 and SGC-7901). HGC-27 cells were used in subsequent experiments and cells were randomly divided into six groups, namely, control group, miR-NC group (transfected with miR-NC), miR-30a-5p mimic group (transfected with miR-30a-5p mimic), pcDNA-NC group (transfected with pcDNA-NC), pcDNA-URGCP group (transfected with pcDNA-URGCP), and pcDNA-URGCP+miR-30a-5p mimic group (transfected with pcDNA-URGCP and miR-30a-5p mimic). CCK-8 assay was used to detect the proliferation activity. Flow cytometry was used to detect the apoptosis. ATP and lactate detection kit were used to detect the production of ATP and lactate. In addition, the luciferase reporter assay was used to verify the targeting relationship between miR-30a-5p and URGCP. Results: Compared with normal gastric epithelial cells (GES-1), the expression of miR-30a-5p in GC cells (AGS, HGC-27 and SGC-7901) was decreased significantly (P<0.01), while the expression of URGCP showed the opposite trend. Then, compared with miR-NC group, the proliferation ability of GC cells in miR-30a-5p mimic group was decreased (P<0.01), the level of apoptosis was increased (P<0.01), and the production of ATP and lactate was decreased (P<0.01). Additionally, miR-30a-5p could directly target URGCP, and there is a negative correlation between the expression of miR-30a-5p and URGCP. Finally, compared with pcDNA-NC group, the proliferation ability of GC cells in pcDNA-URGCP group was increased (P<0.01), the level of apoptosis was decreased (P<0.01), and the production of ATP and lactate was increased (P<0.01). However, these activity changes could be reversed by miR-30a-5p overexpression. Conclusion: MiR-30a-5p inhibited the growth and glycolysis in GC cells by targeting URGCP, indicating that miR-30a-5p/URGCP axis may be a new target for the treatment of GC in the future. 2022 Vol. 28 (6): 887-891 [Abstract] ( 96 ) HTML (1 KB)  PDF (1750 KB)  ( 276 ) 892 Prognostic Value of Central Venous-to-Arterial Carbon Dioxide Difference, Lactate and Procalcitonin in Septic Shock Patients YAN Si, ZHAN Wenshi, YAN Guanghuan, et al DOI: 10.3969/j.issn.1006-6233.2022.06.03 Objective: To explore the prognostic value of central venous-to-arterial carbon dioxide difference [P(cv-a)CO2], lactate and procalcitonin (PCT) in septic shock patients. Methods: The data of 141 septic shock patients admitted to the hospital between October 2017 and October 2020 was collected. The patients were divided into survival group (71 cases) and death group (70 cases) according to the prognosis. Multivariate logistic regression analysis was performed to analyze the relationship of serum P(cv-a)CO2, lactate and PCT levels with death of septic shock patients. Meanwhile, ROC curve analysis of serum P(cv-a)CO2, lactate and PCT levels was conducted. Results: The levels of P(cv-a)CO2, lactate and PCT in survival group were lower than those in death group (P<0.05). Multivariate logistic regression analysis found that serum P(cv-a)CO2, lactate and PCT were risk factors for death of patients with septic shock (P<0.05). ROC curve analysis showed that the area under the curve (AUC) values of serum P(cv-a)CO2, lactate and PCT to predict the prognosis were 0.951, 0.958, and 0.971, respectively. The 95%CIs were 0.901-0.980, 0.910-0.984, and 0.928-0.992. The cutoff values were 5.974, 5.257 and 9.381. The sensitivity was 87.142%, 90.001% and 92.861%. The specificity was 88.731%, 91.552% and 91.552 %. Conclusion: High serum levels of P(cv-a)CO2, lactate and PCT are related to poor prognosis of septic shock patients. All of the three have good prognostic value in septic shock patients. 2022 Vol. 28 (6): 892-895 [Abstract] ( 89 ) HTML (1 KB)  PDF (1358 KB)  ( 111 ) 896 Effect of Intensity Modulated Radiation Therapy Based on 4D-CT Scan Combined with TACE on Prognosis of Patients with Rectal Liver Metastasis LI Jia, YAN Qianying, CHEN Min, et al DOI: 10.3969/j.issn.1006-6233.2022.06.04 Objective: To analyze the effect of intensity modulated radiation therapy (IMRT) based on four dimensional computed tomography (4D-CT) scan combined with transarterial chemoembolisation (TACE) on prognosis of patients with rectal liver metastasis. Methods: Seventy patients with rectal liver metastasis treated in our hospital from January 2018 to July 2019 were prospectively enrolled for the research and divided into observation group and control group by simple random method, with 35 cases in each group. On the basis of whole-body radiotherapy, the observation group and the control group were treated with IMRT based on 4D-CT scan combined with TACE and IMRT based on 3D-CT scan combined with TACE respectively. The clinical efficacy and safety were compared between two groups. Results: The time of progression of observation group was significantly higher than that of control group (P<0.05). And there were no significant differences in ORR, DCR, 2-year survival rate and the incidence of adverse reactions between two groups (P>0.05). Conclusion: IMRT based on 4D-CT scan combined with TACE is a safe and effective method for patients with rectal liver metastasis, and its effect of delaying tumor progression is better than IMRT based on 3D-CT scan combined with TACE. 2022 Vol. 28 (6): 896-898 [Abstract] ( 150 ) HTML (1 KB)  PDF (1347 KB)  ( 168 ) 899 Effects of Vitamin B12 Combined with Lamotrigine on CREB/BDNF Pathway and Neurological Dysfunction in Rats with Trigeminal Neuralgia XIA Kehe, LI Wei DOI: 10.3969/j.issn.1006-6233.2022.06.05 Objective: To investigate the effects of vitamin B12 combined with lamotrigine on cyclic adenosine monophosphate response element-binding protein (CREB)/brain-derived neurotrophic factor (BDNF) pathway and neurological dysfunction in rats with trigeminal neuralgia. Methods: The rat models of trigeminal neuralgia were established by chronic constriction injury of infraorbital nerve (ION-CCI). The models were divided into model group, drug group and drug + H89 group, and the sham operation group was treated with corresponding treatment, with 12 rats in each group. In the drug group, lamotrigine and vitamin B12 were given intramuscular injection; in drug + H89 group, 5μL CREB pathway inhibitor H89 was injected into lateral ventricle on the basis of drug group; the rats in the sham operation group and model group were intramuscularly injected with and orally taken the same volume of normal saline, for 15 days. The mechanical pain threshold and the frequency of face scratching were measured before and 1st, 3rd, 5th, 7th, 9th, 11th, 13th, 15th day after modeling; the morphology of semilunar ganglion and hippocampus was observed by scanning electron microscope; Western blot was used to detect the protein levels of p-CREB, CREB and BDNF pathway in semilunar ganglion and hippocampus. Results: Before modeling, there was no significant difference in the mechanical pain threshold and the frequency of grasping the face (P>0.05); after modeling, the mechanical pain threshold and the frequency of face scratching in model group, drug group and drug + H89 group were significantly increased (P<0.05), and with the extension of time, the mechanical pain threshold decreased and the number of face grabbing decreased first and then increased in the model group, the mechanical pain threshold and the frequency of face scratching gradually stabilized to a certain level in the drug group, the condition of drug + H89 group was between model group and drug group. On the 15th day of modeling, the semilunar ganglion in the model group was significantly damaged, the number of nerve fibers decreased, and some neurons in the hippocampus showed obvious vacuolar degeneration, the number of mitochondria decreased and the volume swelling; in the drug group, the semilunar ganglion was significantly improved, the vacuolar degeneration of hippocampal neurons and the swelling degree of mitochondria were reduced; in the drug + H89 group, the structure of semilunar ganglion was blurred, and there were still serious vacuolar degeneration and a serious decrease in the number of mitochondria in the hippocampus. Compared with those in the sham operation group, the protein levels of p-CREB/CREB and BDNF in semilunar ganglion and hippocampus in model group were decreased (P<0.05); compared with those in the model group, the protein levels of p-CREB/CREB and BDNF in the semilunar ganglion and hippocampus in the drug + H89 group were increased (P<0.05); compared with those in the drug group, the protein level of BDNF in semilunar ganglion and the protein level of p-CREB/CREB in semilunar ganglion and hippocampus were decreased in drug + H89 group (P<0.05). Conclusion: Vitamin B12 combined with lamotrigine can effectively improve neurological dysfunction, activate CREB/BDNF pathway and protect trigeminal neuralgia rats. 2022 Vol. 28 (6): 899-903 [Abstract] ( 103 ) HTML (1 KB)  PDF (1574 KB)  ( 174 ) 904 Influences of GSK343 on EZH2/STAT4/IFN-γ Pathway and the Killing Effect of γδT Cells in Glioma Cells XIA Liqiong, YANG Minghua, XIE Yan DOI: 10.3969/j.issn.1006-6233.2022.06.06 Objective: To investigate the influences of GSK343 on the enhancer of Zeste homolog 2 (EZH2)/signal transducer and activator of transcription 4 (STAT4)/interferon-γ (IFN-γ) pathway and the killing effect of γδT cells. Methods: Human glioma cell line U373 was cultured in vitro, and the control group (normal cell cultured, no drug treatment) and GSK343 group (GSK343 treatment) were set up. The proliferation of U373 cells and the killing effect of γδT cells on U373 cells were detected by CCK-8 method; the apoptosis of U373 cells was detected by flow cytometry; the cell morphology was observed by microscopy; and the expressions of EZH2, p-STAT4 and IFN-γ proteins in U373 cells were detected by Western blot. Results: With the increase of GSK343 concentration, the inhibition rate of U373 cell proliferation increased gradually, and the GSK343 half inhibition concentration (IC50) of U373 cells was in the range of 20-50 μmol/L. Therefore, 50μmol/L were selected as the best treatment concentration in the GSK343 group for subsequent experiments. Compared with the control group, the expression levels of EZH2 protein in GSK343 group decreased significantly (P<0.05), and the apoptosis rate, p-STAT4, IFN-γ protein expression level and the killing activity of γδT cells to U373 cells in each group were significantly increased (P<0.05), irregular morphology and cytoplasmic swelling U373 cells killing of γδT cells increased. Conclusion: GSK343 can inhibit the expressions of EZH2 proteins, promote the expression of STAT4 phosphorylation and IFN-γ protein, thus enhancing the killing effect of γδT cells on U373 cells, inhibit the proliferation and induce apoptosis of U373 cells. 2022 Vol. 28 (6): 904-908 [Abstract] ( 79 ) HTML (1 KB)  PDF (1626 KB)  ( 219 ) 909 Expression of Circ_0011385 and MiR-330-3p in Colon Cancer and the Influence on the Malignant Behavior of Colon Cancer Cells DONG Jinhua, WU Baohua, YAN dancuo DOI: 10.3969/j.issn.1006-6233.2022.06.07 Objective: To investigate the expression of circ_0011385 and miR-330-3p in colon cancer tissues, and further study the effect of circ_0011385 targeting miR-330-3p on the malignant behavior of colon cancer cells (SW1116). Methods: RT-qPCR was performed to detect circ_0011385 and miR-330-3p expression in colon cancer tissues, and further analyze the relationship between the expression levels of circ_0011385 and miR-330-3p and the clinico- pathological characteristics of colon cancer patients. The relationship between circ_0011385 and miR-330-3p was confirmed by dual luciferase reporter assays. SW1116 cells were transfected with si-circ_0011385, si-NC, si-circ_0011385+anti-miR-NC, or si-circ_0011385+anti-miR-330-3p, respectively. Transwell and flow cytometry analysis were used to analyze cell migration, invasion and apoptosis. Results: In colon cancer tissues, circ_0011385 was highly expressed, while miR-330-3p was lowly expressed, and the expression levels of the two were negatively correlated (r=-0.8924). Circ_0011385 and miR-330-3p expression was not correlated with the age and tumor size of colon cancer patients (P>0.05), but it was significantly correlated with the degree of differentiation, TNM stage, and lymph node metastasis (P<0.05). MiR-330-3p is a target gene of circ_0011385. After silencing the expression of circ_0011385, the apoptosis rate of SW1116 cells and the expression level of miR-330-3p were significantly increased (P<0.05), and the number of cell migration and invasion was significantly reduced (P<0.05). Inhibition of miR-330-3p expression significantly reduced the effect of silencing circ_0011385 on SW1116 cell apoptosis, migration and invasion (P<0.05). Conclusion: Circ_0011385 is highly expressed, while miR-330-3p is lowly expressed in colon cancer. Silencing circ_0011385 induces cell apoptosis and inhibit the migration and invasion in colon cancer by up-regulating miR-330-3p expression. 2022 Vol. 28 (6): 909-913 [Abstract] ( 78 ) HTML (1 KB)  PDF (1613 KB)  ( 135 ) 914 Correlation Analysis of NLR Gal-9 Expression in Peripheral Blood with Pelvic Pain and Adhesions in Patients with Endometriosis ZHU Hui, ZHAO Chun, CAO Xixia, et al DOI: 10.3969/j.issn.1006-6233.2022.06.08 Objective: To explore and analyze the correlation between the expression of NLR and Gal-9 in peripheral blood and pelvic pain and adhesions in patients with endometriosis. Methods: A total of 124 patients with endometriosis who underwent surgical treatment in our hospital from July 2019 to July 2020 were selected as the observation group and 60 patients with non-endometriosis who were hospitalized during the same period were selected as the control group. During the operation, the clinical stage of the patients was determined according to the American Residual Association's revised standard staging method (RAFS), and the pelvic pain degree of the patients was graded according to the pain degree classification method (VRS), and the pelvic viscosity degree was graded according to the Hobson score method. The peripheral blood neutrophil-to-lymphocyte ratio (NLR) was calculated based on the results of routine blood tests, and the level of galactose lectin-9 (Gal-9) was measured using a double antibody sandwich enzyme immunoassay to analyse the correlation between its expression level and the patients' pelvic pain and adhesions. Results: The peripheral blood NLR (2.67±0.64) and Gal-9 (687.34±126.51) ng/L levels of the observation group were significantly higher than those of the control group (2.13±0.38) and (329.56±94.23) ng/L, and the difference reached statistical significance ( P<0.05); the expression levels of NLR and Gal-9 in peripheral blood of patients in the severe pelvic pain group were significantly higher than those in the pelvic moderate pain group and mild pain group, and the difference between the groups was statistically significant (P<0.05); the expression levels of NLR and Gal-9 in peripheral blood were significantly higher in the group with severe pelvic adhesions than in the group with mild pelvic adhesions, and the difference between the groups reached statistical significance (P<0.05); the expression of NLR and Gal-9 in peripheral blood was included in the logistic regression equation, and the results showed that the expression of NLR and Gal-9 in peripheral blood was positively correlated with the degree of endometriosis (P<0.05). Conclusion: The expression of NLR and Gal-9 in peripheral blood is positively correlated with the degree of pelvic pain and adhesion in patients with endometriosis. The detection of their levels can provide guidance for early diagnosis and evaluation of disease severity in patients with endometriosis. 2022 Vol. 28 (6): 914-917 [Abstract] ( 91 ) HTML (1 KB)  PDF (1242 KB)  ( 123 ) 918 Effect and Prognosis of Endoscopic Submucosal Dissection in the Treatment of Early Gastric Carcinoma with Different Infiltration Depths QU Hui, DING Yun, XIA Chao DOI: 10.3969/j.issn.1006-6233.2022.06.09 Objective: To explore the effect and prognosis of endoscopic submucosal dissection (ESD) in the treatment of early gastric carcinoma (GC) with different infiltration depths. Methods: A total of 141 patients with early GC admitted to the hospital were enrolled between January 2018 and December 2020. According to different infiltration depths, they were divided into group mucosa (M, 112 cases) and group submucosa (SM, 29 cases). All patients underwent ESD. The intraoperative blood loss, operation time, gastrointestinal ventilation time, hospitalization time, complete resection rate, curative resection rate, incidence of postoperative complications and tumor recurrence during 12-month follow-up were compared between the two groups. The general data such as age, gender and tumor infiltration depth were compared between non-recurrence and recurrence patients. The influencing factors of recurrence in early GC patients after ESD were analyzed by binary Logistic regression analysis. Results: The blood loss during ESD, diameter of resection lesions and operation time in group M were significantly lower than those in group SM, and curative resection rate was significantly higher than that in group SM (P<0.05). There was no significant difference in incidence of complications during ESD between groups M and SM (P>0.05). Of the 141 patients, there were 22 cases with recurrence after ESD. At 3-12 months after ESD, recurrence rate in group M was significantly lower than that in group SM (P<0.05). The postoperative recurrence was related to age, diabetes mellitus, tumor infiltration depth, tumor diameter, tumor differentiation, operation time and diameter of resection lesions (P<0.05). Logistic regression analysis showed that diabetes mellitus, SM infiltration and low differentiation or non-differentiation were independent risk factors of recurrence in patients with early GC after ESD (P<0.05). Conclusion: Curative effect of ESD is more significant on patients with early GC of M infiltration, with lower recurrence rate. Diabetes mellitus, SM infiltration and low differentiation or non-differentiation are independent risk factors of postoperative recurrence. 2022 Vol. 28 (6): 918-923 [Abstract] ( 126 ) HTML (1 KB)  PDF (1278 KB)  ( 120 ) 924 Effects of Early Intermittent Blue Light Irradiation Combined with Probiotics and Jaundice Yinchen Granule on Immune Competence Jaundice Index and Clinical Efficacy in the Treatment of Neonatal Jaundice SHI Haitang, YANG Tingting, LIU Jing, et al DOI: 10.3969/j.issn.1006-6233.2022.06.010 Objective: To investigate the effects of early intermittent blue light irradiation combined with probiotics and jaundice Yinchen Granule on immune ability and jaundice index of neonatal jaundice.Methods: Totally 125 children with neonatal jaundice diagnosed and treated in our hospital from August 2017 to December 2020 were randomly divided into 63 cases in the study group and 62 cases in the control group. All children were treated with intermittent blue light irradiation. The patients in the study group were treated with probiotics and jaundice Yinchen Granule on the basis of phototherapy. The clinical effects of the two groups were evaluated and the total effective rate was calculated. The changes of immune function levels before and after treatment were compared and observed, mainly including immunoglobulin A (IGA) and immunoglobulin G (IgG). At the same time, the levels of superoxide dismutase (SOD), malondialdehyde (MDA) and catalase enzymes (CAT) were compared between the two groups. The changes of jaundice index in the two groups were compared, and the jaundice regression time and discharge time of the two groups were recorded.Results: After treatment, the levels of IgA, IgG and MDA in the two groups increased significantly, and the levels of CAT and SOD in the children decreased significantly. At the same time, the levels of IgA, IgG and MDA in the study group were significantly higher than those in the control group, and the levels of CAT and SOD were significantly lower than those in the control group. At the same time, the differences in the levels of IgA, IgG, CAT, SOD and MDA in the study group after treatment were significantly higher than those in the control group. The difference was statistically significant (P<0.05). After treatment, the jaundice index of children in the study group was significantly lower than that in the control group, while the jaundice index of children in the study group did not decrease after treatment, and the difference was significantly higher than that in the control group (P<0.05). The total effective rate of the study group was significantly higher than that of the control group, and the total incidence of adverse reactions was significantly lower than that of the control group (P<0.05).Conclusion: Early intermittent blue light irradiation combined with probiotics and jaundice Yinchen granule can significantly improve the immune function of newborn jaundice children, reduce jaundice index, reduce oxidative stress injury, and promote the recovery of children. It has high clinical value. 2022 Vol. 28 (6): 924-929 [Abstract] ( 120 ) HTML (1 KB)  PDF (1253 KB)  ( 216 ) 930 Dosimetric Study of Intensity-Modulated Radiotherapy to the Axilla after Breast-Conserving Surgery for Breast Cancer NI Wenjie, WANG Qin, WANG Xiunan, et al DOI: 10.3969/j.issn.1006-6233.2022.06.011 Objective: To evaluate the dosimetric characteristics of axillary nodes with intensity modulated radiotherapy after breast conserving surgery. Methods: From November 2020 to November 2021, 16 consecutive left breast cancer patients were enrolled after breast conserving surgery. According to the ESTRO guidelines, the axillary level I and level II + interpectoral nodes were delineated. Four regimens are prepared: intensity-modulated radiotherapy based on tangential field for whole breast target (IMRT) or whole breast + axillary nodes target (IMRTn), volume modulated arc therapy for whole breast target (VMAT) or whole breast + axillary nodes target (VMATn). The prescription dose is 50 Gy per 25 fractions, and the relevant dosimetric parameters of each regimen are recorded. Results: The mean doses delivered to axillary nodes by IMRT and VMAT were (33.2±7.3) Gy and (32.6±7.4) Gy for level I (P = 0.477), (32.4±7.5) Gy and (30.2±7.8) Gy for level II + interpectoral nodes (P<0.001), respectively. The conformal index of IMRTn and IMRT were (0.698±0.05) and (0.753±0.03), (P = 0.001), (0.835±0.03) for VMATn and (0.857±0.04) for VMAT, (P = 0.018). The mean doses to ipsilateral lung by IMRT, IMRTn, VMATn were (10.3±1.2) Gy, (11.2±1.0) Gy and (10.5±0.8) Gy, respectively (P = 0.040). The V5 (volume receiving 5 Gy) to ipsilateral lung by IMRT, IMRTn, VMATn were (33.4±3.5)%, (38.5±3.7)% and (40.5±3.1)%, respectively (P<0.001). The mean doses to contralateral breast were (1.5±0.4) Gy, (1.7±0.7) Gy and (2.3±0.8) Gy, respectively (P = 0.006). Conclusion: The dose of axillary nodes was insufficient during whole breast radiotherapy. Whole breast + axillary area irradiation could deliver adequate prescription dose, and increase little dose to the normal tissues, but they were all lower than required dose constraints. 2022 Vol. 28 (6): 930-933 [Abstract] ( 78 ) HTML (1 KB)  PDF (1584 KB)  ( 128 ) 934 Clinical Efficacy of Closed Reduction and Pin Fixation Under the Guidance of C-Arm X-Ray Machine and Open Reduction and Internal Fixation in the Treatment of Closed Phalangeal Fractures CHI Haotian, YANG Guoyong, TANG Xiaoyu, et al DOI: 10.3969/j.issn.1006-6233.2022.06.012 Objective: To observe the clinical efficacy of closed reduction and pin fixation under the guidance of C-arm X-ray machine and open reduction and internal fixation in the treatment of closed phalangeal fractures. Methods: A total of 131 patients with closed phalangeal fractures in the hospital between April 2017 and April 2021 were selected as the research subjects and were grouped according to the non-randomized concurrent control and principle of voluntariness of patients. Among them, 70 cases underwent closed reduction and pin fixation under the guidance of C-arm X-ray machine and were included in observation group, and 61 cases underwent open reduction and internal fixation and were enrolled as control group. The reduction success rate, surgery-related indicators (surgical time, fracture healing time), occurrence of postoperative complications and total active motion (TAM) recovery of hand joints at 6 months after surgery were compared between the two groups. Results: There was no statistical significance in the reduction success rate between the two groups (P>0.05). The surgical time and fracture healing time in observation group were shorter than those in control group (P<0.05). The total incidence rate of postoperative infection and internal fixation loosening was lower in observation group than that in control group (P<0.05). The excellent and good rate of TAM evaluation in observation group was higher than that in control group at 6 months after surgery (P<0.05). Conclusion: Closed reduction and pin fixation under the guidance of C-arm X-ray machine has the same reduction effect with open reduction and internal fixation on closed phalangeal fractures, but the former one has faster postoperative fracture healing, better functional recovery and fewer complications. 2022 Vol. 28 (6): 934-938 [Abstract] ( 86 ) HTML (1 KB)  PDF (1474 KB)  ( 130 ) 939 Effect of Knee Valgus Correction on Prognosis of Total Knee Arthroplasty WU Di, LI Jia, LUO Jinwei, et al DOI: 10.3969/j.issn.1006-6233.2022.06.013 Objective: To investigate the effect of knee valgus correction on the prognosis of total knee arthroplasty (TKA). Methods: A total of 102 patients with knee osteoarthritis (KOA) complicated with knee valgus deformity in our hospital from January 2018 to January 2021 were included. They were treated with TKA. Hip knee ankle angle (HKA) was measured one week after operation. According to HKA angle ≤3° and >3°, 78 cases and 24 cases were set as normal group and residual valgus group, respectively. The knee scoring system of American Hospital of special surgery (HSS), osteoarthritis score of Western Ontario and McMaster University (WOMAC) and knee range of motion (ROM) were compared between the two groups before and one year after operation. The femoral angle, tibial angle and patellar inclination angle were measured one year after operation. Results: The WOMAC score after operation was significantly lower than that before operation, and the HSS score and knee ROM increased significantly (P<0.05). There was no significant difference in WOMAC score, HSS score and knee ROM (P>0.05). The femoral angle, tibial angle, patellar inclination angle and HKA angle decreased significantly in the two groups (P<0.05), and the four indexes in the normal group were lower than those in the residual valgus group (P<0.05). Conclusion: The residual valgus after KOA combined with knee valgus after TKA has no significant impact on the recent knee function and pain. It can be considered that there is no need to completely correct the knee valgus. Although the recovery of lower limb force line after operation is less than that of normal knee valgus, whether it affects the long-term curative effect needs to be further evaluated. 2022 Vol. 28 (6): 939-942 [Abstract] ( 80 ) HTML (1 KB)  PDF (1223 KB)  ( 216 ) 943 Correlation between Serum Interleukin-6 Level and Myocardial Damage in Paediatric Mycoplasma Pneumonia XU Li, ZHANG Rui, SHI Qingkang, et al DOI: 10.3969/j.issn.1006-6233.2022.06.014 Objective: To analyze the correlation between serum Interleukin-6 (IL-6) level and myocardial damage (MD) in paediatric mycoplasma pneumonia (MPP). Methods: One hundred and thirty-eight children with MPP treated in our hospital from June 2019 to June 2021 were enrolled for the research and divided into MD group and non-MD group according to the disease process. The gender, age, blood leukocyte (WBC), procalcitonin (PCT), C-reactive protein (CRP), creatine kinase-MB isoenzyme (CK-MB), cardiac troponin I (cTnI), IL-6 levels and hospitalization time were compared between the two groups. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic value of these indexes for MD. Pearson correlation was used to analyze the relationship between serum IL-6 level and hospitalization time. Results: Myocardial damage occurred in 33 of 138 children, with an incidence of 23.9%. The serum levels of CRP, PCT, CK-MB, cTnI, IL-6 and hospitalization time in MD group were significantly higher than those in non-MD group (P<0.05). There were no significant differences in gender, age and WBC between two groups (P>0.05). The results of ROC curve showed that IL-6, CK-MB and cTnI had high diagnostic value for myocardial damage (AUC > 0.9) while CRP and PCT had certain diagnostic value (AUC 0.7 ~ 0.9), but age and WBC had no obvious diagnostic value (AUC < 0.7). Pearson correlation analysis showed that the serum IL-6 level of all children was significantly positively correlated with the length of hospital stay (r = 0.328, P = 0.001 <0.05). Conclusion: Serum level of IL-6 has a potential diagnostic value for the occurrence of myocardial damage in children with MPP, and it is related to the length of hospital stay, which is worthy of clinical reference. 2022 Vol. 28 (6): 943-945 [Abstract] ( 81 ) HTML (1 KB)  PDF (1219 KB)  ( 110 ) 946 Application of Modern Dynamic Conformal Arc Technique for Stereotactic Body Radiation Therapy of Peripheral Lung Cancer WEI Peng, et al DOI: 10.3969/j.issn.1006-6233.2022.06.015 Objective: To compare the dosimetric differences of two dynamic conformal arc technologies in stereotactic body radiation therapy (SBRT) for peripheral lung cancer so as to provide reference for better selection. Methods: A total of fifteen patients with peripheral lung cancer were evaluated respectively for classical dynamic conformal arc (CDCA) technique and modern dynamic conformal arc (MDCA) technique during SBRT plan optimization. The dosimetric differences in Dmax, Dmean, Dmin, conformity index (CI),heterogeneity index(HI),gradient index(GI)of targets, dose volume histogram (DVH)of organs at risk, monitor unit(MU), and beam on time were compared. Results: There showed significant differences in Dmean, Dmin, CI and GI of targets among plans optimized with MDCA and CDCA technique (t=-2.766,4.774,15.791,-12.055,P<0.05). Compared with CDCA plans,there were no significant differences in Dmax of targets,heart,esophagus and spinal cord, and MU(P>0.05).Plans with MDCA technique achieved less Dmean,V13.5 and V12.5 of the lung, Dmax of ribs ,great vessel, and Dmean of healthy tissues (t=-4.712, -3.604, -2.923, -5.799, -3.943, -4.774,P<0.05), but increased beam on time(t = 8.824,P<0.05). Conclusion: MDCA plans significantly improved target conformity and gradient and reduced the doses to organs at risk. Therefore, it is recommended to choose MDCA plan for peripheral lung cancer. 2022 Vol. 28 (6): 946-949 [Abstract] ( 91 ) HTML (1 KB)  PDF (1456 KB)  ( 229 ) 950 Characteristics and Clinical Features of Mutations in the SCN1A and CDKL5 Genes in Children with Early-Onset Epilepsy Encephalopathy LIAO Zhaomei, CAI Siming, CHEN Jianbiao, et al DOI: 10.3969/j.issn.1006-6233.2022.06.016 Objective: To investigate the characteristics of SCN1A,CDKL5 gene mutation in children with early epileptic encephalopathy and summarize its clinical characteristics. Methods: The clinical data of 40 children with early-onset epileptic encephalopathy treated in our hospital from April 2018 to April 2019 were selected, the peripheral blood of children and related family members were collected respectively. The peripheral blood of children were analyzed by targeted second-generation sequencing technique. The peripheral blood of family members was examined by sanger sequencing and the multiple-connection-dependent probe amplification technique (Multi-Ieligation- dependen,probe amplification,MLPA) was used to screen large gene fragments in children negative for mutations in the SCN1A and CDKL5 genes. Results: Among the 40 children with EOEE, there were 12 males and 28 females. The onset time of the disease was 6 days to 18 months after birth (10.11 ±4.29 months).There were 23 cases of infant spasm, 10 cases of nonspecific EOEE disease, 4 cases of Dravet syndrome and 3 cases of Daejeon syndrome.A total of 32 (80.00%) SCNIA,CDKL5 gene mutations were found in 40 children, including 17 (42.50%) SCNIA gene mutations, 15 (37.50%) CDKL5 gene mutations, or, 17 (42.50%) missense mutations, 3 (7.50%) insertion mutations, 3 (7.50%) nonsense mutations, 3 (7.50%) shear site mutations and 6 (15.00%) microdeletion mutations.Of the 32 children with SCNIA,CDKL5 gene mutation, 27 (84.38%) had no febrile convulsion for the first time, 6 (18.75%) had tonic clonus, 3 (9.38%) had systemic spasm, and 5 (15.63%) had spasm with the development of the disease.Of the 32 children with SCNIA,CDKL5 gene mutation, no significant language and independent walking ability were found. 21 cases (65.63%) had significantly lower sitting time than those of normal children of the same age, 28 cases (87.50%) had symptoms of autism, and 11 cases (34.38%) had low hand and foot function and slow body development.Conclusion: SCN1A, CDKL5 gene mutation related to EOEE disease in children with early onset, and the clinical manifestations are various, which will seriously affect the growth and development of children. Therefore, it is necessary to explore more targeted treatments on the basis of early antiepileptic drugs and dietetic therapy. 2022 Vol. 28 (6): 950-954 [Abstract] ( 216 ) HTML (1 KB)  PDF (1252 KB)  ( 351 ) 955 Clinical Efficacy of Percutaneous Pedicle Screw Fixation Combined with Self-Curing Calcium Phosphate in Intensive Treatment of Thoracolumbar Vertebral Fracture WANG Jing, LIU Jiaji, SUN Yanbao, et al DOI: 10.3969/j.issn.1006-6233.2022.06.017 Objective: To evaluate the clinical efficacy of percutaneous pedicle screw fixation combined with self-curing calcium phosphate in intensive treatment of thoracolumbar vertebral fracture. Methods: A total of 61 patients with thoracolumbar fracture admitted between June 2019 and June 2020 were enrolled in this study. Thirty-one patients were treated with percutaneous pedicle screw fixation(simple internal fixation group), thirty patients were treated with percutaneous pedicle screw fixation combined with minimally invasive self-curing calcium phosphate for intensive treatment (internal fixation and strengthening group). All patients were followed up for 13～25 months, with an average of (15.95±0.76) months. Perioperative indicators, follow-up indicators and imaging data were compared between the two groups. Results: The operation time of simple fixation group was less than that of the internal fixation and strengthening group (P<0.05). There were no statistical significance between the two groups in incision length, intraoperative blood loss and length of hospital stay (P>0.05). There was no statistical significance in the incidence of internal fixation failure between the two groups (P>0.05). There was no statistical significance in postoperative VAS score and ODI score between the two groups (P>0.05). At the last follow-up, the VAS score and ODI score of the simple fixation group were higher than those in the internal fixation and strengthening group (P<0.05). In terms of imaging, there was no statistical significance in compression ratio of the anterior edge of the injured vertebra and sagittal Cobb Angle between the two groups (P>0.05). At the last follow-up, the compression ratio of the anterior edge of the injured vertebra loss and Cobb Angle loss in the simple fixation group were greater than those in the internal fixation and strengthening group (P<0.05). Conclusion: Percutaneous pedicle screw fixation combined with minimally invasive self-curing calcium phosphate for intensive treatment can reduce the incidence of late vertebral height loss, reduce postoperative residual lumbago, so that patients can get better function. 2022 Vol. 28 (6): 955-959 [Abstract] ( 99 ) HTML (1 KB)  PDF (1604 KB)  ( 128 ) 960 Effects of Drugcoated Balloon Dilation and Percutaneous Intraluminal Balloon Dilation Combined with Stent Implantation on Clinical Indexes of Patients with Lower Extremity Arteriosclerosis Occlusive Lesions ZHANG Kaixin, ZHANG Ming, CHEN Jun, et al DOI: 10.3969/j.issn.1006-6233.2022.06.018 Objective: To study the effect of drug-coated balloon dilation (DCB) and percutaneous intraluminal balloon dilation combined with stent implantation in the treatment of lower extremity arteriosclerosis occlusive lesions (LEAOD). Methods: A retrospective analysis was performed on 88 patients with LEAOD admitted from March 2017 to February 2022, who were divided into study group (44 cases) and control group (44 cases) according to different treatment methods. The study group was treated with DCB and remedial stenting if necessary; the control group was treated with percutaneous intracavitary balloon dilation combined with stenting. The clinical indicators of "late lumen loss (LLL) value, degree of lower limb artery stenosis, minimum lumen diameter of lower limb artery (MLD), ankle-brachial index (ABI)" and postoperative recovery (incidence of malignant events, revascularization rate of target lesion vessels, restenosis rate, Rutherford grade) were compared between the two groups. Results: The difference in ABI between the two groups on the first day after surgery was not statistically significant (P>0.05); the ABI at 3 months after surgery was higher than that on the first day after surgery in both groups, and the difference was higher in the study group at 3 months after surgery compared with the control group (P<0.05). The differences in LLL values, lower limb artery stenosis and MLD on the first day after surgery were not statistically significant between the two groups (P>0.05); LLL values, lower limb artery stenosis and MLD at 3 months after surgery were lower than on the first day after surgery in both groups, and LLL values and lower limb artery stenosis were lower and lower limb artery MLD was higher in the study group than in the control group at 3 months after surgery, and the differences were statistically significant (P<0.05). The LLL values, lower limb artery stenosis and MLD at 3 months after surgery were lower than those at the first postoperative day in both groups, and the LLL values and lower limb artery stenosis at 3 months after surgery were lower and the lower limb artery MLD was higher in the study group than in the control group, and the differences were statistically significant (P<0.05). There was no statistically significant difference in the incidence of malignant events between the two groups at 3 months postoperatively (P>0.05); the rate of revascularisation of the target lesion, the rate of restenosis and the rate of uterford classification ≤3 were lower in the study group at 3 months postoperatively, all with statistically significant differences (P<0.05). Conclusion: DCB has been shown to be effective in the treatment of LEAOD, further improving arterial stenosis, raising ABI values, accelerating restoration of lower limb arterial flow and reducing restenosis and malignant events 2022 Vol. 28 (6): 960-963 [Abstract] ( 67 ) HTML (1 KB)  PDF (1240 KB)  ( 185 ) 964 Efficacy and Safety Analysis of DSN Block Combined with General Anesthesia Under Ultrasound Guidance in Scapula Fracture Patients LI Shiying, CHAI Bin, SHAO Zhongxin DOI: 10.3969/j.issn.1006-6233.2022.06.019 Objective: To investigate the effect of ultrasound-guided scapular dorsal nerve (DSN) block combined with general anesthesia on postoperative analgesia of scapular fracture. Methods: A total of 152 patients with scapular fracture who were admitted to our hospital from March 2018 to October 2021 for surgical treatment were selected. The patients were divided into control group and observation group by random number table method, with 76 cases in each group. The control group was treated with scapular internal fixation under general anesthesia, while the observation group was treated with DSN block combined with general anesthesia under ultrasound guidance. The differences of operation time, recovery time, utilization rate of vasoactive drugs, amount of remifentanil used during operation, postoperative analgesic remedy times, postoperative rehabilitation exercise time, pain degree, range of motion of shoulder joint and complications were compared between the two groups. Results: The time of postoperative awakening, the amount of remifentanil, the number of postoperative analgesia, the amount of sufentanil and the time of postoperative rehabilitation exercise in the observation group were all lower than those in the control group (P<0.05). VAS scores in both groups decreased gradually (P<0.05), and passive flexion, extension, internal rotation and external rotation of shoulder joint increased gradually (P<0.05). VAS scores of the observation group at 4h (T0), 8h (T1), 16 h (T2), 24h (T3) and 48h (T4) were lower than those of the control group (P<0.05). The activity of passive flexion, extension, internal rotation and external rotation in the observation group was greater than that in the control group at T3, 36h (M0), T4 and 72h (M1) postoperatively (P<0.05). There was no significant difference in complications between the two groups (P>0.05). Conclusion: DSN block combined with general anesthesia under ultrasound guidance can reduce postoperative pain degree of scapular fracture patients, shorten the start time of postoperative shoulder rehabilitation exercise, and increase the passive motion of shoulder joint, which is safe and reliable. 2022 Vol. 28 (6): 964-967 [Abstract] ( 106 ) HTML (1 KB)  PDF (1241 KB)  ( 157 ) 968 Analysis of High Risk Factors of Elderly Lower Extremity Arteriosclerosis Obliterans and the Therapeutic Effect of Lower Extremity Arterial Bypass Grafting ZHANG Xiong, et al DOI: 10.3969/j.issn.1006-6233.2022.06.020 Objective: To analyze the risk factors of lower extremity arteriosclerotic occlusive disease (PAD) in elderly patients and the therapeutic effect of lower extremity arterial bypass grafting. Methods: A total of 90 elderly patients with PAD admitted to our hospital from January 2019 to January 2020 were selected as the case group, and another 90 elderly patients who underwent physical examination in our hospital during the same period were selected as the physical examination group. The factors that may affect the incidence of the elderly were collected, and the risk factors for the incidence of PAD were analyzed by univariate and multivariate Logistic regression. Patients in the case group were divided into observation group (n=45) and control group (n=45) by simple random grouping.The observation group underwent lower limb artery bypass grafting, and the control group underwent endovascular angiogenesis. The indexes of posterior tibial and dorsal foot arteries, oxidative stress response [superoxide dismutase (SOD), malondialdehyde (MDA)] and postoperative adverse reactions were compared between the two groups. Results: Univariate results showed that the incidence of smoking history, hypertension, diabetes, coronary heart disease and chronic renal insufficiency were 16.67%、28.89%、27.78%、 12.22% and 18.89% in case group, significantly higher than 4.4%、15.56%、15.56%、3.33% and 5.56% of physical examination group (P<0.05); multivariate Logistic regression analysis showed that hypertension, diabetes, coronary heart disease and chronic renal insufficiency were independent risk factors for PAD in the elderly (P<0.05). After treatment, the difference of posterior tibial artery and dorsal foot artery before and after treatment in the observation group was significantly higher than that in the control group (P<0.05), SOD level was significantly lower than that in control group (P<0.05), MDA level was significantly higher than that in control group (P<0.05), and the total incidence of adverse reactions was significantly higher than that in control group (26.67% vs 8.89%, P<0.05). Conclusion: Hypertension, diabetes, coronary heart disease and chronic renal insufficiency are the high risk factors for elderly patients with PAD. Lower limb artery bypass grafting has a good effect on the treatment of elderly patients with PAD, and the oxidative stress reaction is more serious, and the incidence of postoperative adverse reactions is high. Therefore, the treatment plan can be selected according to the actual situation of patients. 2022 Vol. 28 (6): 968-973 [Abstract] ( 54 ) HTML (1 KB)  PDF (1262 KB)  ( 135 ) 974 Correlation Study Between Quantitative Parameters of MRI and Degenerative Rotator Cuff Tears WANG Tenghui, DU Yuanliang, XIAO Tianjie, et al DOI: 10.3969/j.issn.1006-6233.2022.06.021 Objective: To analyze the correlation between quantitative parameters related to MRI and degenerative rotator cuff tear. Methods: From May 2021 to July 2021, 40 patients with degenerative rotator cuff tear diagnosed by MRI or shoulder arthroscopy in the Affiliated Hospital of Chengde Medical College were selected as the case group, and 40 healthy volunteers as the control group. Both groups were examined by MRI, and measured for the acromion–greater tuberosity impingement index (ATI), acromion index (AI) and glenoid inclination (GI). The statistical differences of the parameters of the two groups were analyzed, and the correlation analysis was carried out between the parameters. Results: The mean ATI, AI and GI was 0.87±0.04, 0.70±0.10, 13.11°±5.62°in the case group. And the mean ATI, AI and GI was 0.84±0.05, 0.65±0.07, 10.43°±4.92°in the control group. There were significant differences between the two groups (t = 2.264, 2.301, 2.179, P<0.05). And the correlation analysis showed that ATI was positively correlated with AI and GI, while AI and GI had a moderate positive correlation (r = 0.452, 0.283, 0.254, P<0.05). Conclusion: ATI, AI and GI measured with MRI can be used as good parameters for predicting degenerative rotator cuff tears. 2022 Vol. 28 (6): 974-976 [Abstract] ( 71 ) HTML (1 KB)  PDF (2167 KB)  ( 160 ) 977 Effect of Orthodontic Traction Extraction of Mandibular Low Third Molars on Mouth Restriction WANG Liuhong, YANG Hui, WANG Yilin, et al DOI: 10.3969/j.issn.1006-6233.2022.06.022 Objective: To study the effect of orthodontic traction in removing the impacted lower mandibular third molar on the patient's mouth opening restriction. Methods: Totally 126 patients with low mandibular impacted third molars who were treated in our hospital from October 2019 to October 2020 were selected. According to different treatment methods, they were divided into a control group and a study group with 63 cases each. The control group was treated with conventional tooth extraction, and the study group was treated with orthodontic traction. Statistics were recorded of mouth opening, pain, swelling, and mesial and distal alveolar bone density of the two groups of patients before orthodontic treatment, before tooth extraction, and 1 week after tooth extraction. Results: The mouth opening limitation and pain scores of the study group before and 1 week after tooth extraction were lower than those of the control group before and 1 week after tooth extraction (P<0.05). In the study group, the mouth opening limitation and pain score before and 1 week after tooth extraction were lower than those before orthodontic treatment; the mouth opening limitation and pain score 1 week after tooth extraction were lower than those before tooth extraction (P<0.05). One week after tooth extraction, the degree of mouth opening limitation of the study group was 0 degree higher than that of the control group, I degree lower than that of the control group; the degree of pain - higher than that of the control group, + + lower than that of the control group; the degree of swelling - higher than that of the control group, + lower than that of the control group (P<0.05). The bone mineral density of distal and mesial alveolar in the study group before and 1 week after tooth extraction was higher than that in the control group before and 1 week after tooth extraction (P<0.05). In the study group, the bone mineral density of distal and mesial alveolar before and 1 week after tooth extraction was higher than that before orthodontic treatment; the bone mineral density of distal and mesial alveolar 1 week after tooth extraction was higher than that before tooth extraction (P<0.05). Conclusion: Orthodontic traction and extraction of low-mandibular impacted third molars can improve the patient's mouth opening, relieve pain, reduce the patient's soft tissue swelling, improve the patient's alveolar bone density, and promote the patient's recovery. 2022 Vol. 28 (6): 977-982 [Abstract] ( 94 ) HTML (1 KB)  PDF (1381 KB)  ( 161 ) 983 Efficacy of C-Shaped Root Canal Filling with Hot Gutta-Percha Vertical Condensation and iRoot SP Cold Lateral Condensation in the Treatment of Periapical Periodontitis of Permanent Teeth and Its Influence on Pain and Prognosis YIN Qiurong, ZHANG Xufeng, WU Yunfei DOI: 10.3969/j.issn.1006-6233.2022.06.023 Objective: To observe and explore the efficacy of C-shaped root canal filling with hot gutta-percha vertical condensation and iRoot SP cold lateral condensation in the treatment of periapical Periodontitis of permanent teeth and the influence on pain and prognosis. Methods: Totally 146 patients with periapical periodontitis of permanent teeth treated in the hospital between March 2018 and March 2021 were selected as the observation subjects, and they were divided into hot vertical condensation group (73 cases) and cold lateral condensation group (73 cases) according to different treatment method. Both groups were subjected to routine oral examination, and on this basis, the hot vertical condensation group was given hot gutta-percha vertical condensation method for root canal filling treatment, and the cold lateral condensation group adopted iRoot SP cold lateral condensation for root canal filling treatment. The filling effect, clinical efficacy, periodontal pain degree, periodontal indexes and prognosis were compared between the two groups. Results: There was no statistical difference in filling effect between cold lateral condensation group and hot vertical condensation group (P>0.05). After 3 months of treatment, the total effective rate was 93.15% in cold lateral condensation group and was 82.19% in hot vertical condensation group (P<0.05). There was a statistical significance in the periodontal pain VAS score in terms of between-group effect, time-point effect and interaction effect of between-group and time-point (P<0.05), and the periodontal pain VAS score in the two groups showed a decreasing trend after treatment, and the decreasing degree in cold lateral condensation group was significantly greater than that in hot vertical condensation group (P<0.05). Before treatment, the differences in the levels of periodontal indexes were not statistically significant between cold lateral condensation group and hot vertical condensation group (P>0.05). After 3 months of treatment, the periodontal indexes of the two groups were significantly decreased compared to before treatment (P<0.05), and the decreasing degrees of indexes before and after treatment of cold lateral condensation group were significantly greater than those of hot vertical condensation group (P<0.05). At 6 months of follow-up after treatment, the recurrence rate of 2.00% in cold lateral condensation group was lower than 12.50% in hot vertical condensation group (P<0.05). Conclusion: Hot gutta-percha vertical condensation and iRoot SP cold lateral condensation for C-shaped root canal filling have a good filling effect in the treatment of periapical periodontitis of permanent teeth, but iRoot SP cold lateral condensation has a more significant therapeutic effect and can effectively reduce the pain degree and re-infection rate of patients, and it has a better prognosis and is worthy of clinical promotion and application. 2022 Vol. 28 (6): 983-987 [Abstract] ( 223 ) HTML (1 KB)  PDF (1245 KB)  ( 335 ) 988 Analysis of the Relationship Between PE and Pregnancy Outcome in Advnanced Pregnant Women and the Effect of Calcium Combined with Aspirin on the Prevention of PE ZHANG Xiaofeng, LIU Xiaojing, JIA Xiufeng, et al DOI: 10.3969/j.issn.1006-6233.2022.06.024 Objective: To explore the relationship between preeclampsia (PE) and pregnancy outcome in advanced pregnant women and to analyze the preventive effect of calcium combined with aspirin on PE. Methods: A retrospective analysis was conducted of the clinical data of 169 advanced pregnant women who underwent obstetrics and delivery from March 2019 to December 2020 in the Department of Obstetrics and Gynecology of our hospital, and the subjects were divided into PE group (68 cases) and non-PE group (101 cases) according to whether PE developped. The 68 patients in the PE group were divided into the intervention group (37 patients) and the non-intervention group (31 patients) according to whether they had calcium combined with aspirin intervention or not. The differences in singleton live births, gestational weeks of delivery and neonatal weight between the PE and non-PE groups were compared, as well as the pregnancy outcomes of the different groups. Results: Gestational weeks of delivery and neonatal weight were significantly lower in the PE group than in the non-PE group, P<0.05. The incidence of preterm delivery, fetal distress and fetal growth restriction in the PE group was higher than that in the non-PE group, P<0.05. The incidence of preterm delivery, fetal distress, fetal growth restriction in the non-intervention group was higher than that in the intervention group, P<0.05. Conclusion: PE has significant adverse effects on pregnancy outcome in advanced pregnant women. The combination of oral calcium and low-dose aspirin in advanced pregnant women with PE can effectively improve pregnancy outcomes, reduce the incidence of preterm births and stillbirths, improve the quality of newborn births, and achieve a more desirable maternal and infant outcome. 2022 Vol. 28 (6): 988-991 [Abstract] ( 67 ) HTML (1 KB)  PDF (1236 KB)  ( 125 ) 992 Analysis of Risk Factors Associated with Hospital Readmission Within 6 Months After PCI Treatment for Patients with Aacute Coronary Syndrome and Diabetes YIN Yuhua, et al DOI: 10.3969/j.issn.1006-6233.2022.06.025 Objective: To analysize the risk factors associated with re-admission within 6 months after percutaneous coronary intervention for patients with acute coronary syndrome and diabetes, and to provide a reliable basis for improving the quality of life and prognosis of patients. Method: A total of 300 patients were selected, who were diagnosed with ACS and diabetes in our hospital from May 2019 to November 2021 and undergone percutaneous coronary intervention. According to whether the patients had unplanned readmissions 6 months after surgery, they were divided into a control group (216 cases, no re-admission to hospital) and a study group (84 cases, re-admitted). The patient’s age, disease history, medication history, laboratory test results, vascular disease and other clinical data were analyzed retrospectively. Reasons for admission and risk factors were analyzed. Results: Reasons for re-admission of 84 patients in the study group: 27 cases of chest pain (32.14%), 21 cases of chest tightness (25.00%), 9 cases of acute myocardial infarction (10.71%), 9 cases of pulmonary infection (10.71%) %), 6 cases of unstable angina (7.14%), 6 cases of heart failure (7.14%), and 6 cases of other reasons (7.14%); re-admission time: 18 (21.43%) readmissions in ≤30 days, 30 (35.71%) readmissions in 31-60 days and 36 (42.86%) readmissions in ≤180 days; the study involved 300 subjects, of which the 84 cases in the study group were treated twice or more ( readmission rate, 28.00%); univariate analysis showed obvious statistical difference on items of age, myocardial infarction, angina pectoris, preoperative blood glucose, smoking history, low-density lipoprotein cholesterol, ECG ST segment changes, Gensini score, and aspirin(P<0.05); Logistic multivariate regression analysis verified that age (OR=1.480, 95%cl:1.077 -2.033), myocardial infarction (OR=4.91, 95%cl: 1.52-15.98), angina (OR=1.679, 95%cl: 1.023-2.738), smoking history (OR=1.001, 95%cl: 1.000-1.002) , LDL (OR=2.327, 95%Cl: 2.003-3.018), ECG ST segment changes (OR=3.81, 95%Cl: 1.94-4.470), Gensini score (OR=1.580, 95%Cl: 1.166-2.140)were all independent risk factors for readmission of ACS patients within 6 months after PCI. Conclusion: Age, myocardial infarction, angina pectoris, smoking history, LDL, ECG ST segment change score, and Gensini score are independent risk factors for readmission within 6 months after percutaneous coronary intervention(PCI) in patients with ACS and diabetes mellitus. Early intervention with secondary prevention measures is expected to reduce the incidence of readmissions, thereby improving the quality of life of patients. 2022 Vol. 28 (6): 992-996 [Abstract] ( 87 ) HTML (1 KB)  PDF (1245 KB)  ( 137 ) 997 Analysis of the Effects of Different Nucleoside (Acid) Analogues on Viral Load and Liver Function in HBV-Infected Pregnant Women CHEN Zhiying, LI Yan, GU Jinyu, et al DOI: 10.3969/j.issn.1006-6233.2022.06.026 Objective: To compare the effects of tenofovir and tebivudine on serum viral load and liver function of pregnant women in preventing mother-to-child transmission of hepatitis B. Methods: A total of 249 pregnant women with HBsAg and HBeAg double positive and HBV DNA≥1×106IU/mL who were admitted to our hospital from June 2018 to December 2019 were retrospectively analyzed. They were divided into three groups according to whether or not they were taking antiviral drugs and the different types of antiviral drugs: Group A (oral tenofovir, n=123), group B (oral tebivudine, n=85), and group C (no antiviral drugs, n=41). Group A and group B began taking medication in the middle and late trimester of pregnancy and stopped taking medication until delivery. All newborns were injected with hepatitis B immunoglobulin 100IU within 24 hours of birth, and hepatitis B vaccine was administered according to standard immunization procedures. The changes of HBV DNA levels in pregnant women before and after treatment and the effect of mother-to-child transmission blocking were compared, as well as the changes of liver function during pregnancy and postpartum. Results: Before delivery, there were statistically significant differences in the overall distribution of HBV DNA in groups A, B and C(H =109.006,P<0.001). Before delivery, 98.4% and 97.7% of pregnant women in group A and B had HBV DNA levels below 1×106IU/mL, respectively. There was no significant difference in the distribution of serum HBV DNA levels between group A and B (P>0.05). Before delivery, serum ALT and AST levels of pregnant women in groups A and B were significantly lower than those before treatment, and lower than those in group C (P<0.05). There was no significant difference in the incidence of abnormal liver function among all groups after delivery (χ2=0.215, P>0.05), and there was no significant difference in the overall distribution of serum ALT levels among the three groups (P>0.05). The success rate of mother-to-child transmission blocking was 100% in group A and B, and 97.6% in group C. Conclusion: Both tenofovir and tebivudine can effectively reduce viral load of hepatitis B, and there is no difference in reducing viral load and improving liver function during pregnancy. The use of antiviral drugs does not increase the risk of hepatitis flare after postpartum withdrawal, but it is necessary to pay close attention to the changes of postpartum liver function regardless of whether antiviral drugs are used. 2022 Vol. 28 (6): 997-1001 [Abstract] ( 73 ) HTML (1 KB)  PDF (1250 KB)  ( 123 ) 1002 Analysis of the Efficacy of Singulair in Combination with Symbicort in Elderly Patients with Stable COPD ZHANG Qilong, MA Yanmei, MA Honghong, et al DOI: 10.3969/j.issn.1006-6233.2022.06.027 Objective: To investigate the effect of Singulair combined with Symbicort on elderly patients with stable chronic obstructive pulmonary disease (COPD). Methods: Prospectively, 198 elderly patients with stable COPD admitted to our hospital between January 2019 and May 2021 were selected for the study, and all patients were divided into groups A, B and C using simple random grouping, and were given cisplatin (montelukast sodium tablets), cisplatin duplex (budesonide formoterol inhaler), cisplatin + cisplatin duplex, respectively, on the basis of conventional symptomatic management for 12 weeks. The respiratory function, inflammatory response, disease control status, clinical efficacy and incidence of adverse effects were compared before and after the intervention in the three groups. Results: In all three groups, FEV1, FVC, FEV1/FVC ratio and PaO2 were significantly higher than before the intervention, while PaCO2, sputum neutrophils, eosinophil ratio, IL-8, MPO level and total CAT questionnaire score were significantly lower than before the intervention (P<0.05). When comparing between groups, the differences in FEV1, FVC, FEV1/FVC, PaO2, PaCO2, sputum neutrophils, eosinophil ratio, IL-8, MPO level and total CAT questionnaire score before and after intervention were significantly higher in group C than in groups A and B during the same period, and the differences in FEV1/FVC, PaO2, PaCO2, sputum neutrophil ratio, IL-8, MPO level and total CAT questionnaire score before and after intervention were significantly higher in group B. The overall effective rate of group C was 95.5%, which was significantly higher than that of group A (74.2%) and group B (80.3%) (P<0.017). All patients did not suffer from serious complications such as liver and kidney function damage, cardiac arrhythmia and skeletal muscle tremor, etc. The difference in the incidence of each complication among the three groups was not statistically significant (P>0.05), and all patients recovered after symptomatic treatment without affecting the treatment process. Conclusion: Singulair combined with Symbicort could significantly improve the symptoms, respiratory function and airway inflammation of elderly patients with stable COPD, which is safe, effective and worthy of clinical application. 2022 Vol. 28 (6): 1002-1006 [Abstract] ( 155 ) HTML (1 KB)  PDF (1228 KB)  ( 168 ) 1007 Effects of Diazepam on Fever Regression Rever and Convulsion Recurrence Immunoglobulin Level and Serum NSE Level in Children with Recurrent Febrile Convulsion ZHANG Jing, WANG Fengjuan, SUN Yanyan DOI: 10.3969/j.issn.1006-6233.2022.06.028 Objective: To analyze the effects of diazepam on fever regression, fever and convulsion recurrence, immunoglobulin level and serum NSE level in children with recurrent febrile convulsion. Methods: A total of 200 children with convulsion admitted to our hospital from January 2019 to January 2021 were randomly divided into control group (given general treatment) and experimental group (given diazepam + general treatment), with 100 cases in each group. The fever regression, fever and convulsion recurrence, immunoglobulin level and serum NSE level of children with recurrent febrile convulsion in the two groups were recorded. Results: Analysis of variance (ANOVA) on repeated measurements showed statistically significant differences in body temperature between the 2 groups, in time and in the interaction between groups and time (P<0.05). There was no significant difference in IgG levels and IgA levels between the 2 groups 1 d before and 3 weeks after treatment compared to the control group (P>0.05).There was no significant difference in IgG levels and IgA levels between the 2 groups 1 d before and 3 weeks after treatment (P>0.05).There was no significant difference in serum NSE levels between the 2 groups before treatment (P>0.05). The serum NSE level was lower in both groups 3 weeks after treatment than before treatment, and the serum NSE level was lower in the test group than in the control group after treatment (P<0.05). In the control group, there were 10 cases of fever recurrence and 7 cases of convulsion recurrence; in the test group, there were 2 cases of fever recurrence and 0 cases of convulsion recurrence. The difference in the incidence of fever recurrence and convulsion recurrence between the 2 groups was statistically significant (χ2=5.674, 7.254; P<0.05). Conclusion: Diazepam improves clinical outcomes and reduces clinical symptoms in children with recurrent febrile convulsions, and the therapy has a high degree of efficacy and safety, with no significant improvement in immune function. 2022 Vol. 28 (6): 1007-1010 [Abstract] ( 76 ) HTML (1 KB)  PDF (1233 KB)  ( 116 ) 1011 The Impacts of Dexmedetomidine on Cerebral Oxygen Saturation and Postoperative Cognitive Function in Elderly Patients Undergoing Laparoscopic Hepatedctomy GUO Yunfei, WEI Wenxin, HU Nannan, et al DOI: 10.3969/j.issn.1006-6233.2022.06.029 Objective: To investigate the impacts of dexmedetomidine on cerebral oxygen saturation and postoperative cognition in elderly patients undergoing laparoscopic hepatectomy. Methods: One hundred elderly patients who were to undergo laparoscopic hepatectomy were selected, and the patients were randomly divided into experimental group and blank group using the random number table method, with 50 cases in each group. In the experimental group, dexmedetomidine 0.2ug·kg-1·h-1 was pumped intravenously and maintained until 30 min before the end of the operation, and in the blank group, the same amount of 0.9% saline was pumped in the same way. The MAP and HR were recorded at room entry (T0), skin incision (T1), start of liver incision (T2), completion of liver incision (T3), and end of surgery (T4). Regional cerebral oxygen saturation (rSO2) was monitored continuously and the mean intraoperative rSO2 (rSO2), the minimum intraoperative rSO2 value (rSO2min), and the maximum percentage decrease of rSO2 from the basal value (rSO2%max) were calculated. The MMSE scoring were performed at 1 d before surgery, 1, 3 and 7 d after surgery, and the occurrence of postoperative cognition disorders (POCD) and the number of days of hospitalization were recorded in the two groups, respectively. The time of awakening, time of extubation and the incidence of adverse reactions during the recovery period were recorded. Results: The MAP of the experimental group was significantly greater than that of the blank group at T2 and T3, and the HR was significantly lower than that of the blank group, and the difference was statistically significant (P<0.05). At the time points from T2 to T4, the rSO2%max of the experimental group was significantly lower than that of the blank group, and the difference was statistically significant(P<0.05); there was no statistically significant difference in the rSO2min and rSO2 comparison between the 2 groups of patients (P>0.05). The incidence of POCD in the experimental group was significantly less than that in the blank group, and the difference was statistically significant (P<0.05). The hospitalization time of the experimental group was significantly shorter than that of the blank group and the difference was statistically significant (P<0.05). There was no statistic significance in revival time and the time for withdrawing the catheter between the 2 groups(P>0.05). The incidence of adverse reactions during the awakening period was significantly lower in the experimental group than in the blank group (P<0.05). Conclusion: Dexmedetomidine can maintain the stability of the patient's circulatory system, keep brain oxygen in a balanced state of supply and demand without affecting the recovery quality. It has few postoperative complications, has no effect on postoperative cognitive function, and it reduces the incidence of POCD. 2022 Vol. 28 (6): 1011-1015 [Abstract] ( 79 ) HTML (1 KB)  PDF (1259 KB)  ( 130 ) 1016 Effects of Creatine Phosphate Sodium Combined with Trimetazidine on Structural Changes and Cardiac Serological Parameters in Patients with Acute Cardiac Insufficiency ZHANG Huiwen, ZHOU Ming DOI: 10.3969/j.issn.1006-6233.2022.06.030 Objective: To investigate the effects of creatine phosphate and trimetazidine on cardiac structural changes and cardiac serological paremeters in patients with acute cardiac insufficiency. Methods: A total of 106 patients with acute cardiac insufficiency in our hospital were randomly divided into control group (conventional drug treatment) and experimental group (conventional drug treatment + creatine phosphate + trimetazidine), 53 cases in each group. Heart rate, cardiothoracic ratio, cardiac serological index, left ventricular structure index, oxidative stress index and adverse reactions were compared between the two groups before and after treatment. Results: Compared with the control group, the cardiothoracic ratio, interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), serum B-type natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-proBNP) and malondialdehyde in the experimental group were significantly lower than those in the control group, while the left ventricular ejection fraction (LVEF) and superoxide dismutase (SOD) were significantly increased (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Combined application of creatine phosphate and trimetazidine can effectively improve cardiac structural changes and cardiac serological parameters in patients with acute ardiac insufficiency, and achieve significant therapeutic effect, and the combination of them is safe and reliable. 2022 Vol. 28 (6): 1016-1019 [Abstract] ( 83 ) HTML (1 KB)  PDF (1234 KB)  ( 110 ) 1020 Effects of Sequential Butylphthalide Combined with Intravenous Thrombolysis on sdLDL-C Annexin A2, Hcy and Prognosis in Patients with Acute Cerebral Infarction WU Yunhong, ZHOU Hui, CHEN Wei, et al DOI: 10.3969/j.issn.1006-6233.2022.06.031 Objective: To analyze the effect of sequential butylphthalide combined with intravenous thrombolysis on small dense low density lipoprotein cholesterol (sdLDL-C), annexin A2, homocysteine (Hcy) and prognosis in patients with acute cerebral infarction. Methods: Totally 148 patients with acute cerebral infarction admitted to our hospital from June 2016 to June 2021 were randomly divided into butylphthalide group and control group, 74 cases in each group, all of which were treated with conventional comprehensive treatment and intravenous thrombolysis, while butylphthalide group was treated with butylphthalide sequentially. The levels of serum sdLDL-C, Annexin A2 and Hcy in the two groups were detected before and 4 weeks after treatment, and the prognosis was evaluated according to the changes of NIHSS neurological deficit score and Barthel index (BI) before and after treatment. Results: 4 weeks after treatment, serum sdLDL-C and Hcy in both groups were lower than before treatment, and Annexin A2 was higher than before treatment; the changes of serum sdLDL-C, Hcy and Annexin A2 in phthalide group were larger than those in control group (P<0.05). 12 weeks after treatment, the NIHSS score of both groups decreased and BI index increased; NIHSS score and BI index in phthalide group changed more than those in control group (P<0.05). The incidence of adverse reactions in butylphthalide group and control group during treatment was 9.46% and 10.81% respectively, and there was no statistical difference between the two groups (P>0.05). Conclusion: Sequential treatment with butylphthalide on the basis of intravenous thrombolysis can not only regulate the levels of sdLDL-C, Annexin A2 and Hcy in patients with acute cerebral infarction, but also improve the prognosis quality of patients by promoting the recovery of neurological function and living ability, with good safety. 2022 Vol. 28 (6): 1020-1023 [Abstract] ( 75 ) HTML (1 KB)  PDF (1240 KB)  ( 136 ) 1024 Effects of Reduced Glutathione Combined with Ganciclovir on Liver Function, CMV DNA and T Cell Subsets in Children with Cytomegalovirus Hepatitis TAN Ximei, YANG Bin, QI Yun, et al DOI: 10.3969/j.issn.1006-6233.2022.06.032 Objective: To analyze the effects of reduced glutathione combined with ganciclovir on liver function, CMV DNA and T cell subsets in children with cytomegalovirus (CMV) hepatitis. Methods: Totally 86 children with CMV hepatitis admitted to our hospital from January 2019 to May 2021 were divided into control group (n = 43) and combined group (n = 43). The control group was treated with reduced glutathione and the combined group was treated with reduced glutathione combined with ganciclovir. The differences of liver function, CMV DNA and T cell subsets between the two groups were compared. Results: Changes of liver function indexes: One month after treatment, the levels of TBil, GGT, AST, ALT in the two groups were significantly decreased compared with before treatment, and levels of TBil and GGT in the combined group was significantly decreased compared with the control group (P<0.05). Urine CMV DNA negative conversion: The negative time of urine CMV DNA in the combined group was significantly shorter than that in the control group (P<0.05). Changes of T lymphocyte subsets in peripheral blood: One month after treatment, the levels of CD3+, CD4+, and CD4+/CD8+ in the two groups were significantly higher than those before treatment, and the level of CD8+ in the combined group was significantly decreased compared with the control group (P<0.05). Conclusion: Reduced glutathione combined with ganciclovir can effectively alleviate liver function damage and promote liver function recovery in children with CMV hepatitis, which is worthy of clinical application. 2022 Vol. 28 (6): 1024-1027 [Abstract] ( 77 ) HTML (1 KB)  PDF (1245 KB)  ( 159 ) 1028 Clinical Efficacy of Levosimendan on Children with Low Cardiac Output Syndrome after Congenital Heart Disease and Its Influence on Renal Function ZHANG Jian, DONG Yuan, GAO Jinxia, et al DOI: 10.3969/j.issn.1006-6233.2022.06.033 Objective: To analyze the clinical effect of levosimendan on children with low cardiac output syndrome (LCOS) after congenital heart disease (CHD) operation, and to observe its effect on renal function. Methods: A total of 42 children with LCOS complicated within 24h after CHD surgery in Shijiazhuang Maternal and Child Health Hospital from January 2019 to August 2020 and whose condition was not improved by conventional vasoactive drugs after surgery were selected, and they were treated with levosimendan injection. The basic conditions of the children during the perioperative period and the changes of hemodynamics indicators [heart rate (HR), systolic blood pressure (SBP), central venous pressure (CVP)], blood metabolic indicators [B-type brain natriuretic peptide level (NT-proBNP), cardiac troponin (cTnI), blood lactate (Lac )], vasoactivity indicators [cardiac output index (CI) level, vasoactive drug score (VIS)], renal function indicators [serum creatinine (Scr), cumulative fluid load] before (T0) and 24h (T1), 48h (T2), 72h (T3) after the application of levosimendan were observed and recorded. Results: The median time of cardiopulmonary bypass was 95.3 (69, 133) min; the median time of aortic occlusion was 63.8 (47, 143) min; the median time of auxiliary circulation was 48.9 (33, 115) min; the median time of tracheal intubation was 99.8 (60.9 , 164.6) h; the median time of PICU stay was 10.5 (6.0, 15.7) d; the median total hospitalization time was 32.3 (22.2, 47.1) d; 1 case (2.4%) died. Compared with time T0, HR showed a decreasing trend, SBP showed a rising trend at T1~T3 time (P<0.05), and there was no significant difference in CVP (P>0.05). The level of NT-proBNP in children at T1 was significantly higher than that at T0 (P<0.05), and gradually decreased to the level at T0 at T2~T3 (P>0.05); the levels of cTnI and Lac at T1~T3 were lower than those at T0 time (P<0.05). The VIS of children at T1 was significantly higher than that at T0 (P<0.05), and gradually decreased to the level at T0 at T2~T3 (P>0.05). The blood Scr of the children at T1~T2 first showed an upward trend, and then gradually decreased at T3, which was higher than that at T0 (P<0.05); the cumulative fluid load level of children at T1~T3 was lower than that at T0 (P<0.05).Conclusion: Levosimendan improved the systemic tissue perfusion level and enhanced myocardial contractility in children with LCOS without adverse effects such as cardiac arrhythmias, and had a protective effect on renal function, which was beneficial to the children's recovery. 2022 Vol. 28 (6): 1028-1031 [Abstract] ( 71 ) HTML (1 KB)  PDF (1245 KB)  ( 178 ) 1032 Efficacy of Gamma Globulin Combined with Ribavirin in the Treatment of Children with Infectious Mononucleosis and Its Influence on TLR2, TLR9 and T Lymphocyte Subsets LI Mingyue, WANG Yan, YUE Jingwei DOI: 10.3969/j.issn.1006-6233.2022.06.034 Objective: To investigate the efficacy of gamma globulin combined with ribavirin in the treatment of children with infectious mononucleosis (IM), and the influence on Toll-like receptor 2 (TLR2), Toll-like receptor 9 (TLR9) and T lymphocyte subsets. Methods: 226 children with IM admitted to the hospital were selected between March 2019 and March 2021. They were randomly divided into control group (111 cases) and study group (115 cases) by the random number table method. Children in the control group were treated with ribavirin, and children in the study group were treated with gamma globulin combined with ribavirin. Efficacy and clinical signs of the two groups were observed. The mRNA expression of TLR2 and TLR9, and the levels of T lymphocyte subsets (CD3+, CD4+, CD8+) in the two groups were compared before and after treatment. Results: The total effective rate of treatment in the study group was 92.17%, higher than 81.08% in the control group (P<0.05). The time for lymph node shrinking, time for liver and spleen shrinking, angina relief time, and fever abatement time in the study group were shorter than those in the control group (P<0.05). The difference of TLR2 and TLR9 mRNA levels in the study group before and after treatment was higher than that in the control group (P<0.05). The difference of CD3+, CD4+ and CD8+in the study group before and after treatment were higher than those in the control group (P<0.05). Conclusion: Gamma globulin combined with ribavirin is effective in the treatment of children with IM, which can significantly reduce the expression of TLR2 and TLR9 and improve immunity. 2022 Vol. 28 (6): 1032-1036 [Abstract] ( 79 ) HTML (1 KB)  PDF (1231 KB)  ( 186 ) 1037 Curative Effect of Amiodarone Combined with Metoprolol in the Treatment of Acute Myocardial Infarction Complicated with Arrhythmia and Its Influence on Serum Inflammatory Factors Oxidative Stress and Vascular Endothelial Function HE Ruiying, LIAO Hui, LI Luna DOI: 10.3969/j.issn.1006-6233.2022.06.035 Objective: To investigate the clinical effects of amiodarone combined with metoprolol in the treatment of acute myocardial infarction complicated with arrhythmia, and its influence on serum inflammatory factors, oxidative stress and vascular endothelial function. Methods: Totally 116 patients with acute myocardial infarction complicated with arrhythmia who were admitted to the hospital between September 2017 and October 2020 were randomly divided into amiodarone group (n=38), metoprolol group (n=38), and combination group (amiodarone combined with metoprolol, n=40). Serum inflammatory factors, oxidative stress, vascular endothelial function and adverse reactions were compared between the groups. Results: The total clinical response rate in the combination group (92.50%) was higher than that in the amiodarone group (78.95%) or the metoprolol group (76.32%) (P<0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), endothelin-1 (ET-1), von Willebrand factor (vWF), and malondialdehyde (MDA) were significantly decreased, while the levels of serum nitric oxide (NO), superoxide dismutase (SOD), and glutathione peroxidase (GPX) were significantly increased in the three groups. The decreases or increases of the combination group were significantly greater than those of the other two groups (P<0.05). The incidence of adverse reactions was 12.50% in the study group, 15.79% in the amiodarone group, and 18.42% in the metoprolol group (P>0.05). Conclusion: Amiodarone combined with metoprolol is markedly effective in the treatment of acute myocardial infarction complicated with arrhythmia. It can effectively reduce the levels of serum inflammatory factors, and improve oxidative stress response and vascular endothelial function in the patients, with good safety. 2022 Vol. 28 (6): 1037-1040 [Abstract] ( 76 ) HTML (1 KB)  PDF (1239 KB)  ( 130 ) 1041 Effect of Alteplase Combined with Low-Dose Tirofiban on Serum Cytokines and NIHSS Score of Patients with Acute Ischemic Stroke FU Jindao, YANG Hui, WANG Yingxia, et al DOI: 10.3969/j.issn.1006-6233.2022.06.036 Objective: To explore the effect of alteplase (rt-PA) combined with low-dose tirofiban on serum cytokines and the National Institutes of Health Stroke Scale (NIHSS) score of patients with acute ischemic stroke (AIS). Methods: According to the order of admission, 145 patients with AIS were divided into combination group (n=49), positive control group (n=48), and negative control group (n=48). Patients in the negative control group were given conventional treatment, patients in the positive control group were treated with rt-PA on the basis of conventional treatment, and patients in the combination group were treated with rt-PA combined with low-dose tirofiban on the basis of conventional treatment. The carotid intima-media thickness ( C-IMT), carotid plaque score (Crouse score), serum levels of high-sensitivity C-reactive protein (hs-CRP), interleukin 17 (IL-17) and vascular endothelial growth factor (VEGF), and safety indexes were compared among the 3 groups. The NIHSS and Activity of Daily Living Scale (ADL) were used to evaluate nerve function and self-care ability on the day of admission and after the end of treatment. The prognosis was judged based on the modified Rankin Scale (mRS) score at 3 months after the end of the treatment, namely, the score≤1 indicated good prognosis, and the score≥2 indicated poor prognosis. The good prognosis rate was compared among the groups. Results: After treatment, C-IMT, Crouse score, serum levels of hs-CRP, IL-17 and VEGF, and NIHSS score were significantly decreased, while ADL score was significantly increased in the 3 groups (P<0.05). The difference values of above indexes on the day of admission and after treatment in combination group were greater than those in positive control group and negative control group(P<0.05). There was no significant difference in adverse reactions among the three groups (P>0.05). The mRS score of combination group was significantly lower than that of positive control group or negative control group at 3 months after treatment, and the good prognosis rate was significantly higher than that in positive control group and negative control group(P<0.05). Conclusion: The treatment of rt-PA combined with low-dose tirofiban for AIS can effectively reduce C-IMT, Crouse score, serum levels of hs-CRP, IL-1 and VEGF, and NIHSS score, and increase ADL score, thus improving the prognosis. 2022 Vol. 28 (6): 1041-1046 [Abstract] ( 83 ) HTML (1 KB)  PDF (1270 KB)  ( 136 )

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