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2022 Vol. 28, No. 12 Published: 2022-12-30 1937 The Role of Knockdown of CircCDR1as in Glucocorticoid-Induced Bone Microvascular Endothelial Cell Activity and Angiogenesis Aikeremujiang Aerken, Rixiati Paerhati, ZHANG Zheng DOI: 10.3969/j.issn.1006-6233.2022.12.001 Objective: To investigate the effect of knockdown of Circular RNAantisense to the cerebellar degeneration related protein 1 transcript (circCDR1as) on glucocorticoid-induced activity of human femoral head bone microvascular endothelial cells (BMECs) and angiogenesis. Methods: Femoral head tissue was collected from patients with glucocorticoid-induced osteonecrosis of the femoral head (ONFH), Histopathological features were observed by HE staining, the expression changes of CircCDR1as were detected by real-time quantitative polymerase chain reaction (qRT-PCR); the femoral heads of patients with total hip replacement were obtained, BMECs were isolated and cultured, and BMECs were identified by flow cytometry to detect the expression of cell surface markers CD31, CD34, CD45, CD54, CD144 and CD117, immunofluorescence staining was used to detect the expression of CD31 and vWF; the experimental groups included the control group, the GC group, the shNC+GC group and the shCDR1as+GC group, the glucocorticoid hydrocortisone-treated cells and the shCDR1as and shNC-transfected cells were treated accordingly, qRT-PCR to detect changes in the expression of CircCDR1as, the level of cell proliferation was detected by MTT method and EdU staining, in vitro tube formation experiments were performed to observe the formation of cell lumen, Western blot was used to determine the protein expressions of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-2 (VEGFR-2). Results: Bone marrow necrosis and empty bone cavity appeared in the femoral head tissue of ONFH patients, and the relative expression of CircCDR1as was significantly higher than that of the control group (P<0. 05). It was observed that the isolated cells grew in good condition, with positive expression of CD31, CD54 and CD144, negative expression of CD34, CD45 and CD117, and obvious immunofluorescence expression of CD31 and vWF in the cells, indicating that BMECs were successfully isolated. Compared with the control group, the relative expression of CircCDR1as in the GC group was up-regulated, the cell proliferation activity was decreased, the EdUpositive cell rate was decreased, the number of lumens formed by the cells was decreased, and the relative expressions of VEGF and VEGFR-2 proteins were down-regulated, the differences were statistically significant (P<0. 05); compared with the shNC+GC group, the relative expression of CircCDR1as in the shCDR1as+GC group was down-regulated, the cell proliferation activity and EdUpositive cell rate were increased, and the number of lumens formed by cells increased, at the same time, the relative expression of VEGF and VEGFR-2 proteins was up-regulated, the differences were all statistically significant (P<0. 05). Conclusion: CircCDR1as is highly expressed in the necrosis of femoral head tissue of patients. Knockdown of CircCDR1as can inhibit the activity of BMECs induced by glucocorticoids and promote angiogenesis in vitro, thereby protecting BMECs. 2022 Vol. 28 (12): 1937-1942 [Abstract] ( 87 ) HTML (1 KB)  PDF (2213 KB)  ( 221 ) 1943 Effect of miR-383-3p Targeting PTEN/PI3K/Akt/mTOR Signaling Pathway on Endothelial Cell Apoptosis in Rats with Coronary Atherosclerotic Heart Disease CAI Guidong, JIN Mengni, WANG Xiaojun, et al DOI: 10.3969/j.issn.1006-6233.2022.12.002 Objective: To explore the effect of microRNA-383-3p (miR-383-3p) on endothelial cell apoptosis in rats with coronary atherosclerotic heart disease (CHD) by targeting the gene of phosphate and tension homology deleted on chromsome ten/Phosphoinositide 3-kinases/protein kinase B/mammalian target of rapamycin (PTEN/PI3K/AKT/mTOR) signaling pathway. Methods: The SD rats were divided into control group, CHD group, mimic NC group, miR-383-3p mimic group, miR-383-3p mimic+pcDNA3. 1 group, and miR-383-3p mimic+pcDNA3. 1-PTEN group, with 15 rats in each group; except for the control group, rats in the other groups were fed with high-fat diet and injected with pituitrin to construct a CHD model, and the lentivirus solution or plasmid vector was injected into the corresponding group of rats at 24 hours before modeling; quantitative Real-time (qRT-PCR) was used to detect the expression of miR-383-3p in coronary arteries; automatic biochemical analyzer was used to determine the level of blood lipid in rats; enzyme linked immunosorbent assay(ELISA) was used to detect the levels of serum endothelin-1 (ET-1), angiotensin Ⅱ (AngⅡ), vascular endothelial growth factor (VEGF) and nitric oxide (NO); HE staining and TUNEL method were used to observe the pathological changes of coronary artery tissues and endothelial cell apoptosis; dual luciferase reporter gene experiment was used to verify the targeting relationship between miR-383-3p and PTEN; Western blot was used to detect the expression of Bcl-2, Bax and PTEN/PI3K/Akt/mTOR pathway protein in coronary artery tissue. Results: Compared with the control group, the miR-383-3p, high-density lipoprotein cholesterol (HDL-C), VEGF, NO, Bcl-2, p-PI3K/PI3K, p-Akt/Akt and p-mTOR/mTOR levels were significantly reduced in the CHD group, the triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), ET-1, AngⅡ levels, coronary artery tissue pathological damage, endothelial apoptosis index (AI), Bax, PTEN expression were significantly increased (P<0. 05); compared with the CHD group, the miR-383-3p, HDL-C, VEGF, NO, Bcl-2, p-PI3K/PI3K, p-Akt/Akt, p-mTOR/mTOR levels were significantly increased in the miR-383-3p mimic group, the TG, LDL-C, TC, ET-1, AngⅡ levels, coronary artery tissue pathological damage, endothelial cell AI, Bax, PTEN expression were significantly reduced (P<0. 05); overexpression of PTEN can reverse the improvement of miR-383-3p overexpression on endothelial cell apoptosis and functional damage in CHD rats; PTEN was the target gene of miR-383-3p. Conclusion: MiR-383-3p can targetingly inhibit the expression of PTEN to activate the PI3K/Akt/mTOR signaling pathway, thereby inhibiting the apoptosis of endothelial cells in CHD rats. 2022 Vol. 28 (12): 1943-1948 [Abstract] ( 63 ) HTML (1 KB)  PDF (2385 KB)  ( 94 ) 1949 Effects of miR-141 on Activity of Bone Marrow Mesenchymal Stem Cells and VEGF/TGF-β2 Protein in Femoral Head Necrosis TIAN Nannan, FENG Miya, et al DOI: 10.3969/j.issn.1006-6233.2022.12.003 Objective: To investigate the effects of Mir-141 on the activity of bone marrow mesenchymal stem cells and VEGF/TGF-β2 protein in femoral head necrosis. Methods: Patients with femoral fracture and steroid-induced femoral head necrosis admitted to our hospital were randomly divided into 4 groups after bone marrow extraction, culture and identification of MSCs during surgery,including group A (hMSCs cells from patients with femoral neck fracture), group B (hMSCs cells from patients with steroid-induced femoral head necrosis), group C (group B + Mir-141-sirNA-NC), and group D (group B + Mir-141-SiRNA). MTT was used to detect cell activity. The apoptosis rate was detected by flow cytometry. The protein and mRNA levels of VEGF and TGF-β2 were detected by western blot and RT-PCR, respectively. Luciferase assay demonstrated the regulatory effect of Mir-141 on VEGF and TGF-β2. Results: Compared with group A, the activity of hMSCs cells in group B was decreased at 24h, 48h and 72h (P<0. 05), while the OD values of hMSCs cells in groups B and C were insignificant at 24h, 48h and 72h (P>0. 05). Compared with group C, the activity of MSCs cells in group D was increased at 24h, 48h and 72h. There was significant difference between groups (P<0. 05). The apoptosis rates of group A, B, C and D were (4. 23±0. 33), (20. 73±1. 20), (19. 43±1. 16) and (14. 76±0. 80), respectively, and there were differences among groups (F=381. 00, P<0. 001). Compared with group A, the expressions of VEGF and TGF-β2 in group B were decreased (P<0. 05), and the expressions of VEGF and TGF-β2 in groups B and C were insignificant (P>0. 05). Compared with group C, the expressions of VEGF and TGF-β2 in group D were increased, and there were differences among groups (P<0. 05). Luciferase assay confirmed that VEGF and TGF-β2 were the target genes of Mir-141, and the expressions of VEGF and TGF-β2 increased when Mir-141 was inhibited. Conclusion: The silencing of Mir-141 can play a protective role of mesenchymal stem cells by improving the activity of bone marrow mesenchymal stem cells in femur head necrosis and inhibiting apoptosis. The mechanism may be related to the activation of VEGF and TGF-β2 activities. 2022 Vol. 28 (12): 1949-1955 [Abstract] ( 59 ) HTML (1 KB)  PDF (2182 KB)  ( 166 ) 1956 Study on the Mechanism of Cartilaginous Cell Pyroptosis Mediated by Diacerein in Repairing Cartilage Injury in Osteoarthritis YUAN Lei, LIU Zhiyuan, XUE Tao, et al DOI: 10.3969/j.issn.1006-6233.2022.12.004 Objective: To explore the mechanism of diacetylruiyin affecting cartilage injury in osteoarthritis. Methods: Cartilage cell lines were purchased for induction of osteoarthritic cartilage injury model by LPS, and the expression levels of miR-107 and SMAD2 were detected by qRT-PCR. Western blot was used to detect the expression level of SMAD2 and pyroptosis related protein Caspase-1; ELISA was used to detect the expression of inflammatory cytokines IL-1β and IL-18; starbase database and the dual luciferase assay was used to predict and verify the target binding sites of miR-107 and SMAD2. Results: Compared with the Blank group, the miR-107 level in the LPS group was obviously decreased, and the SMAD2 level was significantly increased. At the same time, LPS decreased the Caspase-1 level, and increased the expressions of inflammatory factors IL-1β and IL-18 dramatically. However, transfecting miR-107 mimic partially reversed results which LPS-induced. After the cell model was treated with diacerein, the level of miR-107 and Caspase-1 protein were increased, the level of SMAD2 and inflammatory factors were significantly decreased. Conclusion: Diacetin can repair osteoarthritis cartilage injury by miR-107/SMAD2. 2022 Vol. 28 (12): 1956-1960 [Abstract] ( 65 ) HTML (1 KB)  PDF (1663 KB)  ( 141 ) 1961 Effects of Xinjiashenyuan Formula Regulation of RIPK1/RIPK3/MLKL Pathway on Diabetic Nephropathy Glomerular Podocyte Injury Induced by High Glucose ZHENG Ling, CHEN Li, WANG Yue DOI: 10.3969/j.issn.1006-6233.2022.12.005 Objective: To investigate the effects of Xinjiashenyuan formula on glomerular podocyte injury and RIPK1/RIPK3/MLKL pathway in diabetic nephropathy rats induced by high glucose, and to analyze its possible mechanism. Methods: A total of 70 SD rats were selected, and 12 were randomly selected as normal control group, and the remaining 58 rats were fed with high-sugar and high-fat diet for 8 weeks. Then, the DN rat model was established by intraderitoneal injection of 35 mg/kg streptozotocin, and 48 rats were successfully established. They were randomly divided into model group, positive control group, low-dose and high-dose Xinjiashenyuan Formula groups, with 12 rats in each group. Irbesartan solution was 0. 017g/kg in positive control group, 0. 72g/kg and 1. 44g/kg in Xinjiashenyuan formula group, and an equal volume of normal saline was the gavage for normal control group and model group. Renal function: urea nitrogen, serum creatinine, proteinuria; HE staining was used to observe the pathological morphology of renal tissue. Ultrastructural changes of glomerular podocyte were observed by transmission electron microscopy. TUNEL staining was used to detect the apoptosis of renal cells. The levels of TNF-α and IL-6 in renal tissue were detected by ELISA. The expression of RIPK1/RIPK3/MLKL pathway related proteins in renal tissues was detected by WB. The active ingredients contained in Xinjiashenyuan formula were collected and screened, and molecular docking was performed on the active ingredients with high degree values obtained from topological analysis of "active ingredient target". Results: Compared with normal control group, proteinuria, serum creatinine, urea nitrogen levels, apoptosis index, TNF-α, IL-6 levels, RIPK1, RIPK3 and MLKL protein expressions in model group were increased, while WT-1 protein expression was decreased (P<0. 05). Proteinuria, serum creatinine, urea nitrogen levels, apoptosis index, TNF-α, IL-6 levels, RIPK1, RIPK3 and MLKL protein expressions in positive control group, low and high dose groups were decreased compared with normal control group, while WT-1 protein expression was increased compared with normal control group (P<0. 05). In model group, the glomerular basement membrane was thickened, mesangial cells were hyperplasia, renal tubule turbidness and renal interstitial fibrosis were observed. The pathological morphological changes of renal tissues in positive control group, low dose group and high dose group were reduced in different degrees compared with model group. In model group, podocyte processes fused or disappeared and basement membrane was thickened. The pathological changes of renal ultrastructure in positive control group, low dose group and high dose group were improved in different degrees compared with model group. There are 22 active components of Panax ginseng in Xinjiashenyuanfang and 20 active components of zhihuangqi. Molecular docking results showed that Celabenzine in Ginseng and Mairin in prepared astragalus had better docking with key targets. The binding energies of Celabenzine in Ginseng and Mairin in prepared astragalus were -5. 3, -6. 42, -5. 48 and -5. 39, -7. 71, -5. 41 with RIPK1, RIPK3 and MLKL respectively. Conclusion: Xinjiashenyuan formula regulates RIPK1/RIPK3/MLKL signaling pathway through multiple components and multiple targets, reduces the levels of inflammatory factors TNF-α and IL-6, alleviates inflammatory response, and improves glomerular podocytic injury in diabetic nephropathy rats. 2022 Vol. 28 (12): 1961-1968 [Abstract] ( 79 ) HTML (1 KB)  PDF (2624 KB)  ( 468 ) 1969 CircBIRC6 Promotes PD-L1-Mediated Immune Escape in Non-Small Cell Lung Cancer through miR-944/CD44 Axis ZHANG Tian, REN Dan, et al DOI: 10.3969/j.issn.1006-6233.2022.12.006 Objective: To observe the expression of circular RNA (circRNA) BIRC6 (circBIRC6) in non-small cell lung cancer (NSCLC) and to explore its role and molecular mechanism in tumor cell immune escape. Methods: Human NSCLC cell lines (H1975, HCC827, H1650, H1299, and A549) and human normal lung epithelial cell lines (BEAS-2B) were cultured in vitro. The expressions of circBIRC6, miR-944, cluster of differentiation 44 (CD44) and programmed cell death ligand 1 (PD-L1) were detected by qRT-PCR. A549 cells were collected and separated into normal control (NC) group, si-NC group, si-circBIRC6 group, si-circBIRC6+anti-NC group, and si-circBIRC6+anti-miR-944 group. 48h after transfection, qRT-PCR and Western blot were applied to detect the mRNA and protein expression levels of circBIRC6, miR-944, CD44 and PD-L1 in cells; MTT assay was applied to detect cell proliferation activity; Transwell chambers were used to detect cell migration and invasion ability; A549 cells were co-cultured with CD8+ T cells; Trypan blue staining was applied to determine CD8+T cell viability in co-culture systems; flow cytometry was applied to detect CD8+T cell apoptosis in co-culture systems; ELISA was applied to detect the levels of soluble PD-L1 (sPD-L1), interferon-γ (INF-γ), tumor necrosis factor alpha (TNF-α), granzyme B, and perforin in culture supernatants of co-cultured cells; the role of knockdown of circBIRC6 in NSCLC immune escape was validated. Dual-luciferase reporter (DLRA), RNA immunoprecipitation (RIP) and RNA pull-down experiments were applied to validate the regulatory mechanisms of circBIRC6, miR-944 and CD44 in A549 cells. Results: CircBIRC6, CD44 and PD-L1 were highly expressed in NSCLC, while miR-944 was lowly expressed in NSCLC. Knockdown of circBIRC6 (0. 36±0. 05 vs 1. 01±0. 12) could up-regulate miR-944 (3. 45±0. 38 vs 0. 99±0. 10), inhibit the expression of CD44 mRNA (0. 39±0. 05 vs 1. 00±0. 10), CD44 protein (0. 25±0. 05 vs 0. 64±0. 07)and PD-L1 mRNA (0. 31±0. 04 vs 1. 00±0. 13), PD-L1 protein (0. 17±0. 03 vs 0. 52±0. 06), and greatly reduce the proliferation, migration and invasion abilities of A549 cells (all P<0. 05). In the co-culture system, knockdown of circBIRC6 in A549 cells could activate CD8+T cells [(68. 35±7. 20) % vs (35. 82±4. 14) %], inhibit the apoptosis of CD8+T cells [(23. 85±3. 76) % vs (56. 01±6. 22) %], reduce the level of sPD-L1 in the supernatant, increase the levels of IFN-γ, TNF-α, granzyme B and perforin (all P<0. 05). Down-regulation of miR-944 increased the expressions of CD44 and PD-L1, and attenuated the effects of circBIRC6 knockdown on the proliferation, migration and invasion of A549 cells and activation of CD8+ T cells (all P<0. 05). DLRA, RIP and RNA pull-down experiments confirmed that circBIRC6 could target and bind to miR-944 in A549 cells, and CD44 was the target of miR-944. Conclusion: Knockdown of circBIRC6 in A549 cells can activate CD8+ T cells in the tumor microenvironment by down-regulating the expression and secretion of PD-L1, thereby inhibiting the immune escape of NSCLC. The molecular mechanism may be related to the regulatory effect of miR-944/CD44 axis on PD-L1. 2022 Vol. 28 (12): 1969-1977 [Abstract] ( 60 ) HTML (1 KB)  PDF (2002 KB)  ( 258 ) 1978 The Effect of Hypoxia Exercise on Energy Metabolism in Obese Rats Based on PPAR-α/PGC-1α Pathway GAO Kun, YANG Lixin, WANG Ye, et al DOI: 10.3969/j.issn.1006-6233.2022.12.007 Objective: To study the mechanism of hypoxic exercise energy metabolism in obese rats . Methods: Eighty male SD rats were randomly divided into normal diet control group (10 rats) and high-fat diet model group (70 rats), and the model group rats were induced with high-fat diet for 7 weeks to construct an obese rat model. 60 obese rats with successful modeling were randomly divided into normoxic quiet group (group A), normoxic exercise group (group AE), 16. 3% hypoxic quiet group (group B), 16. 3% hypoxic exercise group (group BE), 13. 3% hypoxic quiet group (group C), and 13. 3% hypoxic exercise group (group CE). group), 13. 3% hypoxic quiet group (group C), 13. 3% hypoxic exercise group (group CE), 10 rats in each group, continued to be fed with high-fat diet, and the rats in the exercise group were trained with running platform endurance, and body length and body weight were measured, and Lee's index was calculated. Blood glucose (BG) and lipid quadruple (BG, TC, LDL-C, TG) were detected; oxygen consumption and energy expenditure after exercise were detected using rat metabolic system; PPAR-α and PGC-1α protein expression in skeletal muscle tissue were detected. Results: After 7 weeks of high-fat dietary feeding, the rats' body weight increased significantly and exceeded 20% of the body weight of the control rats, and blood glucose, TC, TG, and LDL-C contents increased significantly (P<0. 01, P<0. 05), suggesting that the nutritional obesity rat model was successfully established. After 8 weeks of intervention with hypoxia and endurance exercise, the body weight gain, TC, TG, LDL-C, and blood glucose of rats in AE, BE, C, and CE groups were significantly decreased (P<0. 05, P<0. 01), and HDL-C of rats in BE and CE groups were significantly increased (P<0. 01) compared with group A. Compared with group AE, the body weight gain, TC, TG, LDL-C and blood glucose of rats in groups BE and CE were significantly lower (P<0. 01), and the HDL-C of rats in groups BE and CE was significantly higher (P<0. 01); compared with group A, the immediate oxygen consumption and energy consumption of rats in the AE, B, BE, C and CE groups showed an increasing trend (P<0. 01, P<0. 05); compared with group AE, groups BE and CE showed an increase in oxygen consumption and energy consumption immediately after exercise (P<0. 05); compared with group A, the expression of PPAR-α and PGC-1α protein in groups BE, C and CE was significantly increased (P<0. 05, P<0. 01); compared with group AE, the expression of PPAR-α and PGC-1α protein in the BE, C and CE rats was significantly increased (P<0. 05, P<0. 01). Protein expression was significantly increased in BE, C and CE rats compared with group AE (P<0. 05, P<0. 01). Conclusion: Hypoxic exercise may enhance the expression of PGC-1α and PPAR-α proteins in skeletal muscle and thus improve the energy metabolism level in obese rats. 2022 Vol. 28 (12): 1978-1984 [Abstract] ( 62 ) HTML (1 KB)  PDF (1705 KB)  ( 102 ) 1985 Common Differential Genes in the Brodman9 Region of Brain Tissues in Patients with Parkinson's Disease and Major Depression Disease: A Bioinformatics-Based Study BAI Xue, ZHAO Shumin, CHEN Ranran, et al DOI: 10.3969/j.issn.1006-6233.2022.12.008 Objective: To provide common clues for the research on the mechanism between Parkinson Disease (PD) and major depression disease (MDD) by analyzing the common differential genes (DEGs), the common pathways and hub genes between PD and MDD in the Brodman9 (BA9) region of brain. Methods: GSE20168, GSE54567, GSE54568 and GSE54570 microarray data were downloaded from GEO database, and bioinformatics analysis packages such as limma, clusterProfiler and ggplot2 were called using R language to analyze PD and MDD co-expression with P<0. 05 and logFC absolute value ≥ 0. 3 as criteria. Differential genes were further analyzed by GO and KEGG enrichment for common pathways, and protein-protein interaction (PPI) networks and key genes were identified using String database and cytoscape software. Results: There were 34 common DEGs in the BA9 region of PD and MDD patients, and 21 were up-regulated: SLC35E1,ATP8B1,TSR1, ZNF721, RIOK3,FBXW12, ZNF160, POLR1B, CACNA1I, MZT2B, PGF, RP11-403P17. 4, RPL23AP32, DBT, PRR11, USP34, LRRFIP1, DSERG1, DIP2A, AEBP1 and DNAJB2, 13 genes were down-regulated, namely NPTX2, PCSK1, SST, PPP1CB, SEC22B, ENPP4, NME5, CAPZA2, GLRB, ITFG1, GLIPR1, TM6SF1 and DUSP6. The functional enrichment analysis of DEGs showed that there were 5 common GO_BP terms between PD and MDD, namely: GO:0007611 (learning or memory), GO:0050890 (cognition), GO:0007612 (learning), GO:0051384 (response to glucocorticoids), GO:0008306 (associative learning), suggesting that both PD and MDD have cognitive, learning, memory and glucocorticoid response pathway dysfunctions (P<0. 05). PPI network mapping and hub genes analysis indicated that NPTX2, PCSK1, DUSP6, SST, and PPP1CB genes may be the common hub genes among PD and MDD, and their levels were significantly decreased in both PD and MDD (P<0. 05). Conclusion: Cognitive pathway dysfunction and decreased expression of genes such as NPTX2 in BA9 region may be the common molecular pathology between PD and MDD. 2022 Vol. 28 (12): 1985-1989 [Abstract] ( 74 ) HTML (1 KB)  PDF (2512 KB)  ( 387 ) 1990 Effect of Different ESD Surgical Procedures in the Treatment of Esophageal Cancer in the Early Stage and Its Influence on Perioperative Indicators Recurrence Risk and Safety Analysis YAO Chengyun, XIE Juan, WU Ping, et al DOI: 10.3969/j.issn.1006-6233.2022.12.009 Objective: To investigate the effect of different endoscopic submucosal dissection (ESD) surgical procedures in the treatment of esophageal cancer in the early stage and its effect on perioperative indicators, recurrence risk and safety. Methods: Sixty patients with early-stage esophageal cancer from January 2019 to January 2021 in our hospital were selected and grouped according to the random number table method, 30 cases each. The control group adopted conventional ESD and the observation group adopted Q method self-traction technique assisted ESD (Q-ESD). The surgical efficacy, surgical condition, pre- and post-operative traumatic stress indicators [tumour necrosis factor-α (TNF-α), C-reactive protein (CRP), cortisol (Cor), norepinephrine (NE)], quality of survival [Health Promoting Lifestyle-II (HPLP-II) score], and complication rate were compared between the two groups and followed up for 1 year to compare the recurrence rates of the two groups at 6 months and 1 year post-operatively. Results: There was no statistically significant difference between the whole resection rate of 96. 67% (29/30) and curative resection rate of 93. 33% (28/30) in the observation group and 93. 33% (28/30) and 86. 67% (26/30) in the control group (P>0. 05); the intraoperative blood loss in the observation group was less than that in the control group, the speed of dissection was greater than that in the control group, and the dissection time, operation time and hospital stay were shorter than control group. Serum TNF-α, CRP, Cor and NE levels in the two groups tended to increase before surgery and 1d, 3d and 5d after surgery, and then decreased, while serum TNF-α, CRP, Cor and NE levels in the observation group were lower than those in the control group at 1d, 3d and 5d after surgery (P<0. 05). The HPLP-II scores of physical activity, health responsibility, stress management, nutrition, interpersonal relationship, and spiritual growth were higher in both groups 1 month after surgery compared to the preoperative period, and were higher in the observation group than in the control group (P<0. 05); the complication rate in the observation group was 16. 67% (5/30) lower than that in the control group 40. 00% (12/30) (P<0. 05); 6 months and 1 year after surgery in the observation group. The recurrence rates of 0. 00% (0/30) and 7. 14% (2/28) in the observation group were not statistically significant (P>0. 05) compared with 3. 45% (1/29) and 11. 11% (3/27) in the control group. Conclusion: Q Method self-traction technique with ESD for early-stage oesophageal cancer significantly optimises the surgical situation, reduces surgical traumatic stress and facilitates post-operative recovery, and also improves the quality of survival and reduces complication rates without increasing the risk of recurrence. 2022 Vol. 28 (12): 1990-1995 [Abstract] ( 103 ) HTML (1 KB)  PDF (1339 KB)  ( 181 ) 1996 The Use of Digital Technology with Model-Made Implant Guides in the Restoration of Oral Implants in Patients with Missing Teeth ZHENG Yuanzhang, BI Wei, CAI Ruolin, et al DOI: 10.3969/j.issn.1006-6233.2022.12.010 Objective: To explore the application effect of digital technology combined with model-made implant guide in dental implant restoration for patients with missing dentition. Methods: A total of 80 patients with missing teeth in our hospital from August 2020 to August 2021 were selected and divided into a control group (n=40) and a study group (n=40) using the random number table method. The control group was treated with traditional implant restoration, and the study group was treated with digital technology with model-made implant guide implant restoration. The treatment results, implant position deviation, pre- and post-operative masticatory efficiency, quality of life (OHIP-14 score), oral implant satisfaction and complication rate were compared between the two groups. Results: The excellent treatment rate of the study group (97. 50%) was higher than that of the control group (80. 00%) (P<0. 05); the top deviation, root deviation, angle deviation, and depth deviation of the study group implants were smaller than those of the control group (P<0. 05); the masticatory efficiency of the study group at 3 months and 6 months after surgery was higher than that of the control group, and the OHIP-14 score was lower than that of the control group (P<0. 05); the restoration effect of the study group self-assessment, complication satisfaction, and quality of life satisfaction scores were higher in the study group than in the control group (P<0. 05); the difference was not statistically significant (P>0. 05) when comparing the complication rate in the study group (7. 50%) with that in the control group (20. 00%). Conclusion: The application of digital technology and model to make implant guides in dental implant restoration for patients with missing dentition can significantly reduce implant deviation and achieve better restoration treatment effect and satisfaction, which is worthy of popularization and application. 2022 Vol. 28 (12): 1996-2001 [Abstract] ( 92 ) HTML (1 KB)  PDF (2595 KB)  ( 211 ) 2002 Effect of Modified Ginseng Yangrong Decoction on the Expression of Tumor Markers and Th1/Th2 Cytokines in Pelvic Recurrent Cervical Cancer during Concurrent Radiotherapy and Chemotherapy PENG Lei, QIN Hongen, HUANG Huabin, et al DOI: 10.3969/j.issn.1006-6233.2022.12.011 Objective: To investigate the effect of modified Ginseng Yangrong Decoction on the expression of tumor markers and Th1Th2 cytokines in pelvic recurrent cervical cancer during concurrent radiotherapy and chemotherapy. Methods: 102 patients with recurrent pelvic cervical cancer admitted to our hospital from December 2018 to December 2021 were selected, and divided into the observation group (n=51) and the control group (n=51) in the ratio of 1:1 according to the order of admission single and double numbers. The control group was treated with synchronous radiotherapy, while the observation group was treated with synchronous radiotherapy combined with addition of Ginseng Yangrong Decoction. 21d was set as a cycle for both groups, and 2 cycles of continuous treatment were evaluated. The recent efficacy, KPS score, immune function, tumour markers, Th1/Th2 cytokine changes and toxic side effects of the two groups were compared before and after treatment. Results: The objective remission rate was higher in the observation group than in the control group (70. 95% vs 50. 98%, P<0. 05). The KPS score after treatment was higher in the observation group than in the control group (89. 80±2. 44 vs 73. 92±4. 93, P<0. 05). CD3+, CD4+ and CD4+/CD8+ were higher in the observation group than in the control group after treatment (58. 79±3. 01 vs 50. 81±3. 15, 38. 95±2. 65 vs 31. 29±3. 07, 1. 62±0. 21 vs 1. 04±0. 13, P<0. 05). CEA, CA19-9 and CYFRA21-1 levels were lower in the observation group than in the control group after treatment (83. 42±12. 25 vs 115. 26±20. 39, 18. 94±5. 46 vs 29. 46±6. 28, 4. 67±1. 08 vs 6. 58±1. 25, P<0. 05). The post-treatment levels of IL-2, IL-10, TNF-α and IFN-γ were lower in the observation group than in the control group (12. 26±2. 87 vs 16. 79±2. 54, 18. 29±3. 87 vs 25. 46±3. 34, 15. 47±4. 12 vs 21. 74±2. 95, 19. 98±5. 45 vs 32. 24±6. 65, P< (0. 05). The incidence of toxic side effects in the observation group was lower than that in the control group (11. 76% vs 29. 41%, P<0. 05). Conclusion: Modified Ginseng Yangrong Decoction has obvious curative effect on pelvic recurrent cervical cancer during concurrent radiotherapy and chemotherapy, improves the immune function of patients, reduces the levels of tumor markers CEA, CA19-9 and CYFRA21-1, and regulates the balance of Th1/Th2 cytokines. 2022 Vol. 28 (12): 2002-2006 [Abstract] ( 64 ) HTML (1 KB)  PDF (1222 KB)  ( 152 ) 2007 Bilobalide Regulates SOCS2 to Inhibit the Expression of Inflammatory Fibrotic Components in High Glucose-Induced Glomerular Mesangial Cells LI Xiaoyan, MO Liwen, CHENG Ying, et al DOI: 10.3969/j.issn.1006-6233.2022.12.012 Objective: To investigate whether bilobalide affects the expression of inflammatory and fibrotic components in high glucose-induced glomerular mesangial cells by regulating suppressor of cytokine signaling 2 (SOCS2). Methods: Human mesangial cells (HMC) were divided into the following groups:NG group (normal culture),HG group (30 mmoL/L glucose),HG+ low,medium and high bilobalide groups (6μmoL/L,12μmoL/L,24μmoL/L bilobalide and 30 mmoL/L glucose),HG+high bilobalide+NC group (transfected small interfering RNA negative control,24μmoL/L bilobalide and 30 mmoL/L glucose) and HG+high bilobalide+interfering SOCS2 group (transfected with small interfering RNA against SOCS2,24μmoL/L bilobalide and 30 mmoL/L glucose). Western blotting was used to detect the protein expressions of SOCS2 and fibrotic components transforming growth factor-β1 (TGF-β1),connective tissue growth factor (CTGF),and fibronectin (FN). Enzyme-linked immunosorbent assay (ELISA) was used to detect inflammation factors tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) expression. Results: Compared with the NG group,the protein expressions of TGF-β1[(0. 82±0. 04) vs (0. 23±0. 02)],CTGF[(0. 69±0. 05) vs (0. 12±0. 01)],FN[(0. 81±0. 06) vs (0. 19±0. 03)],TNF-α [(580. 58±41. 78) vs (148. 46±11. 47)] pg/mL and IL-6 [(427. 82±31. 51) vs (60. 72±6. 24)] pg/mL in the glomerular HMC cells of the HG group were increased,while the protein expression of SOCS2 [(0. 22±0. 02) vs (0. 79±0. 06)] was decreased (P<0. 05); compared with the HG group,the protein expressions of TGF-β1,CTGF and FN,and the expression levels of TNF-α and IL-6 in the glomerular mesangial HMC cells of the HG+ low,medium and high bilobalide groups gradually decreased,but the protein expression of SOCS2 gradually increased (P<0. 05),and all in a concentration-dependent manner. Compared with HG+high bilobalide+NC group,the expression of SOCS2 protein in glomerular mesangial HMC cells in HG+high bilobalide+interfering SOCS2 group decreased,the expression of TGF-β1,CTGF,FN and TNF-α,IL-6 was increased (P<0. 05). Conclusion: Bilobalide can inhibit the expression of inflammatory and fibrotic components in mesangial cells induced by high glucose by up-regulating the expression of SOCS2. 2022 Vol. 28 (12): 2007-2012 [Abstract] ( 44 ) HTML (1 KB)  PDF (1626 KB)  ( 208 ) 2013 Transnasal Intermittent Positive Pressure Ventilation Combined with Pulmonary Surfactant in the Treatment of Respiratory Distress Syndrome in Low Weight Neonates LI Ye, GAO Zhibo , LIU Yushen, et al DOI: 10.3969/j.issn.1006-6233.2022.12.013 Objective: To analyze the influence of transnasal intermittent positive pressure ventilation with pulmonary surfactant on low weight neonates with respiratory distress syndrome. Methods: The clinical data of 116 low weight neonates with respiratory distress syndrome who were delivered in obstetrics department of our hospital from November 2019 to October 2021 were retrospectively analyzed. They were divided into two groups, the observation group and the control group according to different treatment methods. The neonates in the control group were treated with routine transnasal intermittent positive pressure ventilation, while the neonates in the observation group were given pulmonary surfactant combined with transnasal intermittent positive pressure ventilation. The blood gas analysis, treatment effect, ventilator assisted treatment time, hospital stay and other related conditions and the incidence of ramification were compared between the two groups before and after treatment. Results: After treatment with different methods, the pH value, PaO2 and blood oxygen saturation of the two groups were significantly higher than those before treatment, while PaCO2 was significantly lower than those before treatment, and the differences were statistically significant (P<0. 05). The difference of pH value, PaO2, PaCO2 and blood oxygen saturation before and after treatment in the observation group was significantly greater than that in the control group (P<0. 05). The total effective rate of neonatal respiratory distress syndrome in the observation group was significantly higher than that in the control group (P<0. 05). The time of ventilator-assisted treatment, hospitalization and invasive mechanical ventilation in the observation group were shorter than those in the control group (P<0. 05). The total incidence of related complications in the observation group was lower than that in the control group (P<0. 05). Conclusion: Pulmonary surfactant combined with transnasal intermittent positive pressure ventilation is effective for low weight neonates with respiratory distress syndrome, and the time of ventilator assisted treatment and hospitalization is short, and the incidence of treatment-related complications is low, which is worthy of clinical application. 2022 Vol. 28 (12): 2013-2016 [Abstract] ( 54 ) HTML (1 KB)  PDF (1204 KB)  ( 110 ) 2017 Effect of Local Application of Bone Wax and Tranexamic Acid on Postoperative Bleeding and Short-Term Knee Function during Unicondylar Arthroplasty SUN Shaosong, LU Wenhai, SHI Sifeng DOI: 10.3969/j.issn.1006-6233.2022.12.014 Objective: The effect of bone wax and tranexamic acid on postoperative bleeding and short-term knee function during unicondylar arthroplasty was analyzed. Methods: A total of 84 patients who underwent unicondylar joint replacement in our hospital from April 2020 to October 2021 were selected as the research subjects. The patients were divided into 4 groups by lottery technique with simple random method, with 21 cases in each group. Group A received compression dressing, group B received bone wax, group C received tranexamic acid, and group D received bone wax combined tranexamic acid. The amount of blood loss, hemoglobin and coagulation function before and 1 week after operation, and knee function before and 1 week and 1 month after operation were compared in 4 groups. Results: The intraoperative blood loss, postoperative blood loss and perioperative total blood loss in groups B, C and D were lower than those in group A (P<0. 05), while the blood loss in groups C and D was lower than that in group B (P<0. 05), and there was no statistical significance between group C and group D (P>0. 05). One week after operation, hemoglobin (HB) and fibrinogen (FIB) in groups B, C and D were higher than those in group A (P<0. 05), and those in groups C and D were higher than those in group B (P<0. 05), but there was no statistical significance between group C and group D (P>0. 05). 1 week and 1 month after surgery, there was no significant difference in HSS scores of knee joints among the 4 groups (P>0. 05). Conclusion: Topical application of bone wax or tranexamic acid in monondylar joint replacement can reduce the amount of blood loss in patients, but tranexamic acid and bone wax combined with tranexamic acid has better hemostatic effect than bone wax alone, and does not affect the recovery of knee function. 2022 Vol. 28 (12): 2017-2021 [Abstract] ( 64 ) HTML (1 KB)  PDF (1234 KB)  ( 126 ) 2022 Relationship between Serum SHBG, β-HCG, HIF-1α and Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes DING Yuanyuan, CHEN Xiuping, HAO Dongya, et al DOI: 10.3969/j.issn.1006-6233.2022.12.015 Objective: To explore the relationship between serum sex hormone binding globulin (SHBG), β-human chorionic gonadotropin (β-HCG), hypoxia-inducible factor-1α (HIF-1α) and gestational diabetes mellitus (GDM) and adverse pregnancy outcomes. Methods: A total of 112 pregnant women with GDM who were admitted to our hospital from October 2019 to October 2021 were selected as the observation group, and another 50 healthy pregnant women who underwent pregnancy tests during the same period were selected as the control group. The serum levels of SHBG, β-HCG and HIF-1α and the occurrence of adverse pregnancy outcomes were detected and compared between the two groups of research subjects, and the levels of serum SHBG, β-HCG and HIF-1α in pregnant women with different pregnancy outcomes were analyzed. Results: Compared with the healthy control group, the serum SHBG levels of pregnant women in the GDM group were significantly decreased, while the levels of β-HCG and HIF-1α were significantly increased (P<0. 05). The total incidence of adverse pregnancy outcomes in the observation group (42. 86%) was significantly higher than that in the control group (14. 00%) (P<0. 05). The serum SHBG level in the adverse pregnancy group was lower than that in the normal pregnancy group, and the levels of β-HCG and HIF-1α were higher than those in the normal pregnancy group (P<0. 05). Conclusion: Serum SHBG, β-hCG and HIF-1α are related to the occurrence of GDM, and may affect the outcome of pregnancy, which should be paid attention to in early pregnancy examination. 2022 Vol. 28 (12): 2022-2025 [Abstract] ( 50 ) HTML (1 KB)  PDF (1221 KB)  ( 75 ) 2026 Expression and Clinical Significance of Serum IGF-1 IL-6 and IL-10 in Patients with Acute Respiratory Distress Syndrome after Valve Replacement under Extracorporeal Circulation CHEN Yongliang, et al DOI: 10.3969/j.issn.1006-6233.2022.12.016 Objective: To investigate the levels of serum IGF-1, IL-6, IL-10 in patients with acute respiratory distress syndrome after valve replacement under extracorporeal circulation and their correlation with prognosis. Methods: 211 patients who underwent valve replacement under extracorporeal circulation in our hospital from December 2016 to December 2020 were divided into ARDA group and non-ARDS group according to whether they developed acute respiratory distress syndrome after operation. Arterial blood gas analysis was collected after anesthesia induction and before extracorporeal circulation, 2h, 6h, 12h and 24h after extracorporeal circulation (recorded as T1~T5), and oxygenation index (OI) was calculated; the venous blood of patients was collected at T1-T5. The levels of IGF-1, IL-6 and IL-10 in serum were measured by ELISA. The change trends of IGF-1, IL-6 and IL-10 in serum and their effects on postoperative acute respiratory distress syndrome were analyzed. Results: The serum concentrations of IGF-1, IL-6 and IL-10 in patients with ARDS after valve replacement under extracorporeal circulation were significantly higher than those before operation, and showed an upward trend within 24 hours after operation; the serum concentrations of IGF-1, IL-6 and IL-10 in ARDS group were significantly higher than those in non ARDS group at 12 and 24 hours after operation (P<0. 05). In ARDS group, the concentration of cytokines at 24h after valve replacement under CPB and OI at 24h after operation were analyzed by Pearson correlation. The results showed that the concentration of IGF-1 at 24h after CPB was correlated with OI at 24h after operation (r=0. 808, P<0. 001); IL-6 at 24h after CPB was correlated with OI at 24h after CPB (r=0. 737, P=0. 001). Conclusion: The serum concentrations of IGF-1, IL-6 and IL-10 in patients with acute respiratory distress syndrome after valve replacement under extracorporeal circulation are significantly higher than those without extracorporeal circulation. The serum concentrations of IGF-1, IL-6 and IL-10 are closely related to the occurrence and development of acute respiratory distress syndrome after valve replacement under extracorporeal circulation, which has certain guiding significance for predicting the complication of acute respiratory distress syndrome after valve replacement under extracorporeal circulation. 2022 Vol. 28 (12): 2026-2030 [Abstract] ( 52 ) HTML (1 KB)  PDF (1364 KB)  ( 123 ) 2031 Changes and Clinical Significance of Serum Troponin and Myocardial Enzymes in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Hypoxemia WANG Xi, DONG Lin, YANG Wanchun DOI: 10.3969/j.issn.1006-6233.2022.12.017 Objective: To investigate the changes and clinical significance of serum troponin and myocardial enzymes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and hypoxemia. Methods: A total of 123 patients with AECOPD admitted to the hospital from January 2020 to January 2022 were selected. Patients with arterial partial pressure of oxygen (PaO2) ≥ 60 mmHg were included in the control group (n=62), and patients with PaO2 <60 mmHg were included in the observation group (n=61). The levels of serum troponin I (cTnI), creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) were compared between the groups, and between patients with different severity of hypoxemia. Spearman correlation analysis was performed to analyze the relationship between the severity of hypoxemia and serum cTnI, CK and CK-MB. Results: The levels of serum cTnI, CK and CK-MB in the observation group were significantly higher than those in the control group (P<0. 05). The levels of serum cTnI, CK and CK-MB increased with the aggravation of hypoxemia (P<0. 05). Spearman correlation analysis showed that the severity of hypoxemia was significantly positively correlated with serum CTnI, CK and CK-MB (r=0. 916, 0. 665, 0. 805, P<0. 05). Conclusion: The levels of serum cTnI, CK and CK-MB in patients with AECOPD and hypoxemia are higher than those in patients with simple AECOPD. The levels of serum cTnI, CK and CK-MB are positively correlated with the severity of hypoxemia, which deserves clinical attention. 2022 Vol. 28 (12): 2031-2033 [Abstract] ( 60 ) HTML (1 KB)  PDF (1204 KB)  ( 179 ) 2034 Effect of Different Therapeutic Doses of Platelet Transfusion on Serum Ferritin Level and Short-Term Prognosis in Children with Acute Lymphoblastic Leukemia HUANG Bin, DENG Zhihua, WU Junjun, et al DOI: 10.3969/j.issn.1006-6233.2022.12.018 Objective: To compare the effects of different doses of platelet transfusion on serum ferritin level and short-term prognosis in children with acute lymphocytic leukemia (ALL). Methods: 109 children with ALL who received platelet transfusion from March 2019 to March 2021 in our hospital were selected. According to the actual platelet transfusion dose per unit body surface area of the children, the transfusion doses of < 2. 2×1011/m2, 2. 2~4. 4×1011/m2 and > 4. 4× 1011/m2 were respectively included in the low dose group (n=37). The effects of platelet transfusion, 24-hour platelet count increase index (CCI), 24-hour platelet recovery rate (PPR) and serum ferritin levels before and after platelet transfusion were compared among the three groups, and the 1 year survival of the three groups was compared. Results: The platelet /BSA and PPI of low dose group were lower than those of middle dose group, and the platelet /BSA and PPI of middle dose group were lower than those of high dose group (P<0. 05). There was no significant difference in CCI and infusion efficiency among the three groups (P>0. 05). There were no obvious adverse events in the three groups during platelet transfusion. 24 hours after infusion, the platelet counts of both groups were higher than those before infusion, and the serum ferritin levels were lower than those before infusion. The difference of platelet counts before and after infusion in the middle dose group was higher than that in the low dose group, and the difference of platelet counts before and after infusion in the high dose group was higher than that in the high dose group, with statistical significance (P<0. 05). There was no significant difference in the event-free survival rate among the three groups after treatment (P>0. 05). Conclusion: Different therapeutic doses of platelet transfusion have no significant difference on serum ferritin level and short-term prognosis of children with ALL. Middle and high dose platelet transfusion can't improve CCI, so low dose platelet transfusion can be considered in clinical practice. 2022 Vol. 28 (12): 2034-2037 [Abstract] ( 62 ) HTML (1 KB)  PDF (1222 KB)  ( 200 ) 2038 Characteristics of Lymph Node Metastasis in the Lateral Cervical Region of Papillary Thyroid Cancer and Analysis of Related Risk Factors DU Zhenhong, et al DOI: 10.3969/j.issn.1006-6233.2022.12.019 Objective: To explore the clinical characteristics of cervical lateral lymph node metastasis in patients with papillary thyroid carcinoma (PTC), and to perform the analysis on its related risk factors. Methods: The clinical data of 114 PTC patients with suspected lateral cervical lymph node metastasis who were admitted to the hospital between February 2019 and February 2022 were retrospectively selected. The lateral cervical lymph node quantity distribution, metastasis distribution and skip metastasis involving lateral cervical region were statistically analyzed, and the relationship between the clinical characteristics of patients with PTC and the lymph node metastasis in lateral cervical region was analyzed. Results: Among the 114 patients, there were 95 cases of cervical lateral lymph node metastasis and 11 cases of skip metastasis. 1,983 lymph nodes were detected among 95 patients with positive lateral cervical lymph nodes. The lymph node distribution in region Ⅲ was the highest (73. 68%), followed by region Ⅳ (64. 21%) and region Ⅱ (54. 74%) and the lowest in region Ⅴ (12. 63%). Among the 95 patients with PTC, there were 32 cases (33. 68%) of single-region involvement, 41 cases (43. 16%) of double-region involvement, 13 cases (13. 69%) of three-region involvement and 9 cases (9. 47%) of four-region involvement. When PTC lesions were situated in the upper pole, there were 3 cases of single-region involvement, 1 case of double-region involvement and 0 cases of three-region involvement. When PTC lesions were located in the middle pole, there were 2 cases of single-region involvement, 2 cases of double-region involvement and 3 cases of three-region involvement. Univariate analysis showed that the patients with multiple lesions, bilateral lesions, invasive capsule, large tumor diameter and positive central lymph node had higher PTC cervical lateral lymph node metastasis rate (P<0. 05). Multivariate analysis revealed that the risk factor for cervical lateral lymph node metastasis was positive central lymph node metastasis (P<0. 05). Conclusion: The region of cervical lateral lymph node metastasis is in descending order of region Ⅲ, region Ⅳ, region Ⅱ and region Ⅴ. Cervical lateral lymph node metastasis is mainly with multi-regional involvement and with low skip metastasis. Positive central lymph node metastasis is an independent risk factor for cervical lateral lymph node metastasis. 2022 Vol. 28 (12): 2038-2043 [Abstract] ( 53 ) HTML (1 KB)  PDF (1516 KB)  ( 93 ) 2044 Clinical Effect of Focused Ultrasound in the Treatment of vulvar sclerosing moss WANG Xiaowei, et al DOI: 10.3969/j.issn.1006-6233.2022.12.020 Objective: To analyze the clinical effect of focused ultrasound in patients with vulvar sclerosing moss. Methods: 76 patients with vulvar sclerosing moss who were admitted and treated from July 2019 to June 2020 were randomly divided into the study group and the control group, 38 patients in each group. The control group received testosterone propionate injection, and the study group received focused ultrasound treatment (once every 7-10 days, 6 consecutive times). The efficacy, pruritus degree and recurrence rate of the two groups were compared, and the SF-36 quality of life questionnaire was selected to evaluate the health status of the two groups. Results: Comparing the two groups, the total effective rate of treatment in the research group is higher, with statistical significance (97. 37% vs 78. 95% χ2=6. 176 P=0. 013); the recurrence rate was decreased, with statistical significance (2. 63% vs 18. 42%) χ2=5. 029 P=0. 025). The itching degree score and SF-36 score of the research group before treatment had no statistical significance (2. 72±0. 25 points vs 2. 70±0. 24 points t=0. 356 P=0. 723, 650. 33±26. 71 points vs 651. 71± 27. 42 points t=0. 222 P=0. 825); the pruritus degree scores of the research group after 1 month, 3 months and 6 months of treatment were all decreased, with statistical significance (2. 26±0. 26 points vs 2. 51±0. 25 points t=4. 273 P =0. 001, 1. 69±0. 28 points vs 2. 18±0. 35 points t=6. 739 P=0. 001, 1. 07±0. 31 points vs 1. 82±0. 35 points t=9. 888 P=0. 001), 1 month, 3 months, 6 months of treatment The SF-36 scores of the research group were all increased, with statistical significance (675. 62±24. 46 points vs 662. 51±25. 22 points t=2. 300 P=0. 024, 692. 65±22. 68 points vs 678. 41±22. 53 points t=2. 746 P=0. 008, 727. 91±21. 52 vs 701. 45±20. 49 points t=5. 489 P=0. 001). Conclusion: Focused ultrasound therapy for patients with vulvar sclerosing moss can significantly relieve itching symptoms, and the recurrence rate after treatment is low, which is conducive to improving the quality of life of patients. 2022 Vol. 28 (12): 2044-2046 [Abstract] ( 71 ) HTML (1 KB)  PDF (1197 KB)  ( 174 ) 2047 Effects of Fluid Resuscitation on Hematocrit, Serum Lactic Acid and Prognosis of Patients with Traumatic Hemorrhagic Shock WANG Ping, LI Le, SHU Nengyuan, et al DOI: 10.3969/j.issn.1006-6233.2022.12.021 Objective: To study the effects of different fluid resuscitation modes on hematocrit (HCT), serum lactic acid (BLA) and prognosis of patients with traumatic hemorrhagic shock. Methods: The clinical data of 184 patients with traumatic hemorrhagic shock admitted to the hospital between January 2017 ~ November 2021 were retrospectively analyzed. According to the fluid resuscitation mode, they were divided into observation group and control group, with 92 cases in each group. Patients in the control group were treated with conventional limited fluid resuscitation, and patients in the observation group were treated with B-ultrasound monitored inferior vena cava variability guided fluid resuscitation. The fluid infusion volume, blood transfusion volume, length of intensive care unit (ICU) stay, prothrombin time (PT), activated partial thromboplastin time (APTT), HCT and BLA level were compared between the 2 groups, and prognosis of the 2 groups was analyzed. Results: The fluid infusion volume, blood transfusion volume and ICU stay of the observation group were significantly smaller/shorter than those of the control group (P<0. 05). 1h after resuscitation, PT, APTT and BLA level of the observation group were significantly shorter/lower than those of the control group (P<0. 05), and HCT was significantly higher than that of the control group (P<0. 05). In the observation group, 7 patients developed multiple organ dysfunction syndrome (MODS), 6 patients developed acute respiratory distress syndrome (ARDS), and 3 patients died during hospitalization. In the control group, 10 patients developed MODS, 9 patients developed ARDS, and 7 patients died during hospitalization. There were no significant differences in the incidence rates of MODS, ARDS and death between the 2 groups (P>0. 05). Conclusion: B-ultrasound monitored inferior vena cava variability guided fluid resuscitation is simple to operate, and the monitoring indicators are more accurate. Compared with conventional limited fluid resuscitation, it can reduce the risks of coagulation dysfunction and other complications. 2022 Vol. 28 (12): 2047-2051 [Abstract] ( 40 ) HTML (1 KB)  PDF (1235 KB)  ( 126 ) 2052 Correlation between CT Perfusion Imaging and Recurrence and Cognitive Function before and after Thrombectomy in Acute Ischemic Stroke CHEN Hua, ZHANG Ji, ZHANG Bo, et al DOI: 10.3969/j.issn.1006-6233.2022.12.022 Objective: To investigate the correlation between CT perfusion imaging findings before and after embolization in acute ischemic stroke and patients' disease recurrence and cognitive impairment. Methods: 97 patients with acute ischemic stroke treated in neurosurgery of our hospital from July 2019 to October 2021 were selected. All patients were treated with mechanical thrombectomy, and all patients were examined by 64 row spiral CT before and after thrombectomy. The cognitive function of patients with and without cognitive impairment was evaluated at discharge. The baseline data of patients with and without cognitive impairment and the levels of rCBF, rCBV and rmtt before and after thrombectomy were compared. All patients were followed up for at least 6 months to compare the baseline data of recurrent and non recurrent patients and the levels of rCBF, rCBV and rmtt before and after thrombectomy. The correlation between rCBF, rCBV, rmtt and recurrence and cognitive impairment was analyzed. Results: The rCBF and rCBV of 97 patients after thrombectomy were significantly higher than those before thrombectomy, while the rmtt was significantly lower. Among them, 28 patients had cognitive impairment and 19 patients had recurrence. The rCBF and rCBV of patients with cognitive impairment and normal cognitive function increased significantly after thrombectomy, and the rMTT of patients with normal cognitive function decreased significantly (P<0. 05). At the same time, the rCBF and rCBV of patients with normal cognitive function before and after thrombectomy were significantly higher than those of patients with cognitive impairment, and the rMTT was significantly lower than those of patients with cognitive impairment (P<0. 05); the rCBF and rCBV in the recurrent group and the non recurrent group were significantly higher and the rMTT was significantly lower after thrombectomy. At the same time, the rCBF and rCBV in the recurrent group were significantly higher than those in the non recurrent group, and the rMTT was significantly lower than that in the non recurrent group (P<0. 05). After multivariate logistic regression analysis, it was found that the low level of rCBF and rCBV before and after thrombectomy and the high level of rMTT before and after thrombectomy were risk factors affecting cognitive dysfunction of patients, while the low level of rCBF and rCBV after thrombectomy and the high level of rMTT after thrombectomy were risk factors affecting disease recurrence of patients, and the difference was statistically significant (P<0. 05). Conclusion: For patients with acute ischemic stroke, the levels of rCBF, rCBV and rMTT can be determined by CTP before and after thrombectomy, so as to provide a reliable reference basis for the evaluation of patients' prognosis. 2022 Vol. 28 (12): 2052-2057 [Abstract] ( 50 ) HTML (1 KB)  PDF (1978 KB)  ( 74 ) 2058 Efficacy of Stage I Three-dDimensional External Fixator System Combined with Stage Ⅱ Internal Fixation in the Treatment of Gustilo Type Ⅲ Open Tibiofibular Fractures and the Influence on Functional Recovery YANG Haidong, CHEN Qiming DOI: 10.3969/j.issn.1006-6233.2022.12.023 Objective: To investigate the efficacy of stage I three-dimensional external fixator system combined with stage Ⅱ internal fixation in the treatment of Gustilo type Ⅲ open tibiofibular fractures, and the influence on lower limb function recovery. Methods: From April 2017 to April 2021, 93 patients with Gustilo type Ⅲ open tibiofibular fractures underwent surgical treatment in the hospital. The patients were randomly divided into conventional group (45 cases) and combined group (48 cases) using the method of random number table. The operation-related indicators, clinical effect, lower limb function recovery and postoperative complications were compared between the two groups. Results: The total operation time, postoperative hospital stay and fracture healing time of the combined group were shorter than those of the conventional group (P<0. 05), and the clinical effect was better than that of the conventional group (P<0. 05). The American Orthopedics Foot and Ankle Society (AOFAS) score and American Hospital for Special Surgery Knee Score (HSS) showed no statistically significant difference between the two groups before operation (P>0. 05). At 6 months after operation, the AOFAS scores and HSS scores were increased in the two groups, and the combined group had higher score difference than the conventional group (P<0. 05). The incidence of total complications in the combined group was lower than that in the conventional group (P<0. 05). Conclusion: Stage I three-dimensional external fixator system combined with stage Ⅱ internal fixation for treating Gustilo type Ⅲ open tibiofibular fractures can reduce time cost, improve clinical effect, and better restore the patients' lower limb function, with fewer postoperative complications. 2022 Vol. 28 (12): 2058-2062 [Abstract] ( 49 ) HTML (1 KB)  PDF (1476 KB)  ( 109 ) 2063 Multi-Layer Spiral CT Multiplanar Reconstruction Post-Processing Technique Applied to the Diagnosis of Appendiceal Mucinous Neoplasm Disease HUANG Yabo, WANG Jinjun, XI Yongqiang DOI: 10.3969/j.issn.1006-6233.2022.12.024 Objective: To study the clinical value of multislice spiral CT multiplane reconstruction in the diagnosis of appendicitis mucinous tumor. Methods: A retrospective analysis was conducted, and 60 patients with mucinous tumor of the appendix admitted from January 2017 to January 2022 were selected as the observation subjects. All patients received multislice spiral CT multiplane reconstruction examination and abdominal CT plain scan examination. The diagnostic accuracy of the two examination methods was compared, and the manifestations of multislice spiral CT multiplane reconstruction were analyzed. Results: The accuracy of multislice spiral CT multiplane reconstruction was 98. 33% in 60 patients with mucinous tumor of the appendix. The accuracy of abdominal CT plain scan in 60 patients with appendiceal mucinous tumor was 85. 00%. The accuracy of multislice spiral CT in the diagnosis of appendiceal mucinous tumor was significantly higher than that of abdominal CT, and the difference was statistically significant (P<0. 05). Multislice spiral CT multi-plane reconstruction showed that the tumor lesions in 25 patients were oval, small at the bottom and mouth, and enlarged in the middle. In 13 patients, the tumor lesions were aubergine-like, enlarged at the bottom and middle, and small at the mouth. In 13 patients, the tumor lesions were peanut-shaped, the cystic mass was overall enlarged, and the expansion at the bottom and mouth was more significant than that in the middle, and the tumor showed bunched waist sign. The tumor lesions of 9 patients were irregular and long tubular. After multi-plane reconstruction, not only the shape of the tumor can be clearly displayed, but also the three directions (upper and lower diameters, left and right diameters, front and rear diameters) can be measured, so as to measure the stenosis and enlargement of different shapes of the tumor, thus improving the accuracy of the measurement of the tumor size. Conclusion: The application of multi-slice spiral CT multi-plane reconstruction post-processing technology in the diagnosis of mucinous tumors of the appendix has significant effects, which can effectively improve the diagnostic accuracy. Moreover, this technology has certain characteristics in the morphologic manifestations of tumors, and can provide reference for the formulation of clinical treatment plan. 2022 Vol. 28 (12): 2063-2066 [Abstract] ( 40 ) HTML (1 KB)  PDF (2714 KB)  ( 98 ) 2067 Correlation of Balthazar CT Grading and CECT Necrotic Volume and Attenuation Values with Prognosis of Patients with Acute Necrotizing Pancreatitis GAO Mingsheng, FENG Lei,YAO Yong DOI: 10.3969/j.issn.1006-6233.2022.12.025 Objective: To analyze the correlation between Balthazar CT grading and contrast-enhanced CT (CECT) necrosis volume and attenuation value and prognosis of patients with acute necrotizing pancreatitis. Methods: 92 patients with acute necrotizing pancreatitis who were treated in the hospital were selected between June 2019 and June 2021, and they were divided into the poor prognosis group and the good prognosis group according to the clinical prognosis at 6 months of follow-up. The general data of the two groups of patients were collected, and Balthazar CT, CECT necrosis volume and attenuation value were compared between the two groups. Multivariate logistic regression analysis was used to analyze the influencing factors of prognosis in patients with acute necrotizing pancreatitis. Receiver operating characteristic curve (ROC) was adopted to analyze the predictive value of Balthazar CT grading, CECT necrosis volume and attenuation value on prognosis in patients with acute necrotizing pancreatitis. Results: At 6 months of follow-up, there were 64 cases of poor prognosis and 28 cases of good prognosis among 92 patients with acute necrotizing pancreatitis. There were no significant differences in age, gender, body mass index, onset time, etiology, comorbidities, amylase (AMS) and albumin (ALB) between the two groups (P>0. 05). The APACHE Ⅱ score, C-reactive protein (CRP), blood urea nitrogen, Balthazar CT, necrosis volume and average attenuation value in the poor prognosis group were significantly higher than those in the good prognosis group (P<0. 05). Logistics analysis showed that Balthazar CT grading, necrosis volume and average attenuation value were independent risk factors for poor prognosis in patients with acute necrotizing pancreatitis (P<0. 05). The areas under the curves (AUCs) of Balthazar CT grading, necrosis volume and average attenuation value on predicting the prognosis of patients with acute necrotizing pancreatitis were 0. 765, 0. 624, 0. 764 and 0. 861 respectively. Conclusion: The Balthazar CT grading, necrosis volume and average attenuation value are significantly higher among patients with acute necrotizing pancreatitis complicated with poor prognosis, and they are also independent risk factors for poor prognosis , and can help clinically predict the prognosis of patients with acute necrotizing pancreatitis, and the combined detection has better application effects. 2022 Vol. 28 (12): 2067-2071 [Abstract] ( 61 ) HTML (1 KB)  PDF (2878 KB)  ( 100 ) 2072 The Efficacy of Shock Wave Combined with Lower Limb Weight-Bearing Vibration Training in the Treatment of Lower Limb Muscle Spasm after Stroke WANG Teng, MENG Haichao, WANG Zhengtian, et al DOI: 10.3969/j.issn.1006-6233.2022.12.026 Objective: To study the effect and function of extracorporeal shock wave combined with lower limb weight-bearing vibration training in the treatment of lower limb muscle spasm after stroke. Methods: 120 patients with lower limb spasm after stroke treated in our hospital from January 2019 to January 2020 were selected as the research subjects. They were randomly divided into observation group and control group, with 60 cases in each group. All patients were treated with routine antispasmodic rehabilitation therapy. On this basis, the patients in the observation group were given extracorporeal shock wave combined with lower limb weight-bearing vibration training. The patients in both groups were treated for 4 weeks. Before and at the end of treatment, the patients in the two groups were examined with modified Ashworth Scale (MAS), activities of daily living (ADL), Fugl Meyer assessment (FMA), modified Barthel index, functional ambulation category scale (FAC) Joint mobility (ROM), and ultrasonic muscle structural parameters such as pinnate angle of muscle (PA), muscle fiber length (FL) and muscle fiber thickness (MT) were measured. Results: After treatment, the MAS grade of the two groups was significantly improved (P<0. 05). After treatment, the proportion of MAS grade I in the observation group was significantly higher than that in the control group (70. 00% vs 50. 00%), and the proportion of grade Ⅲ in the observation group was significantly lower than that in the control group (0. 00% vs 15. 00%) (P<0. 05). After treatment, the MAS score of the two groups was significantly lower than that before treatment, and the FMA score, FAC score and modified Barthel index were significantly higher than those before treatment (P<0. 05). The a-rom score and p-rom score of the observation group after treatment were significantly lower than those before treatment (P<0. 05). After treatment, the MAS score of the observation group was significantly lower than that of the control group, and the FMA score, FAC score, modified Barthel index, a-rom score and p-rom score of the observation group were significantly higher than those of the control group (P<0. 05). After treatment, PA and MT decreased significantly and FL increased significantly in the two groups (P<0. 05). After treatment, PA and MT of the affected limbs in the observation group were significantly lower than those in the control group, and FL was significantly higher than that in the control group (P<0. 05). Conclusion: On the basis of routine antispasmodic rehabilitation, the combined application of extracorporeal shock wave and lower limb weight-bearing wave vibration therapy can significantly alleviate the spasticity of lower limbs, improve the muscle strength of lower limbs, and improve the trunk stability, posture control ability and muscle structure parameters of patients. The clinical effect is accurate and worthy of popularization. 2022 Vol. 28 (12): 2072-2076 [Abstract] ( 56 ) HTML (1 KB)  PDF (1239 KB)  ( 290 ) 2077 Effects of Maintenance Hemodialysis Combined with Hemoperfusion on Toxin Clearance and Neuroendocrine Hormone in Uremic Patients with Hypertension WANG Ting, LI Yufang, ZHANG Li, et al DOI: 10.3969/j.issn.1006-6233.2022.12.027 Objective: To analyze the effects of maintenance hemodialysis (MHD) combined with hemoperfusion (HP) on toxin clearance and neuroendocrine hormones in patients with uremia and hypertension. Methods: A total of 92 uremic patients with hypertension who were admitted to our hospital from June 2018 to June 2020 were selected and divided into the control group (MHD group, n=46) and the observation group (HP+MHD group, n=46) by random table method. Clinical data of patients were collected to compare the changes in the levels of toxin level factors C-reactive protein (CRP), homocysteine (Hcy), macronutrient toxin (β2-MG), horse uric acid (HA), parathyroid hormone (PTH) levels, changes in the levels of neuroendocrine hormones angiotensin Ⅱ (Ang Ⅱ), renin (PRA), aldosterone (Ald), and the occurrence of adverse reactions in both groups before and after treatment. Results: After treatment, the levels of CRP, Hcy, β2-MG, HA and PTH in patients of the observation group decreased compared with those before treatment, while the levels of β2-MG in patients of the control group decreased, but the levels of CRP, Hcy, HA and PTH increased compared with those before treatment, and the levels of endotoxin in the observation group after treatment were compared with those in the control group (P<0. 05), the improvement effect of neuroendocrine hormones Ang Ⅱ, PRA and Ald in the observation group patients after treatment was significantly different compared with the control group (P<0. 05), and the adverse reactions in the observation group patients were significantly lower than those in the control group (P<0. 05). Conclusion: Maintenance hemodialysis combined with hemoperfusion in the treatment of uremic patients with hypertension can effectively remove toxins from the patient's body and reduce the secretion of neuroendocrine hormones, and the clinical effect is significant. 2022 Vol. 28 (12): 2077-2080 [Abstract] ( 44 ) HTML (1 KB)  PDF (1218 KB)  ( 166 ) 2081 Efficacy of LEEP Combined with Recombinant Human Interferon a2b on Patients with Cervical Intraepithelial Neoplasia and Its Effects on Vaginal Microecology WU Wanru, DENG Qing, ZHANG Cuiwen DOI: 10.3969/j.issn.1006-6233.2022.12.028 Objective: To observe the efficacy of loop electrosurgical excision procedure (LEEP) combined with recombinant human interferon a2b gel on patients with cervical intraepithelial neoplasia (CIN) and its effects on vaginal microecology. Methods: 106 patients with CIN who were treated in the hospital between June 2019 and December 2021 were selected as the observation subjects, and they were simply divided into the observation group (n=53, LEEP+recombinant human interferon a2b gel) and the control group (n=53, LEEP) using the random number table method. Both groups were continuously treated for 4 weeks. The HPV negative conversion and vaginal microecology recovery at 3 months after treatment, and inflammatory factors and immune function before treatment and at 3 months after treatment were compared between the two groups. Results: At 3 months after treatment, the HPV negative conversion rate and effective rate were 66. 04% and 96. 23% in the observation group, which were higher than 26. 42% and 64. 15% in the control group (P<0. 05). The proportion of normal or recovered vaginal microecology (92. 45% vs 30. 38%) in the observation group was higher while the vaginal secretion pH [(4. 19±0. 52) vs (4. 46±0. 50)] and Nugent score [(2. 31±0. 45) points vs (2. 93±0. 52) points] were lower (P<0. 05) compared to the control group. The levels of INF-γ, IL-12, serum CD4+ and CD4+/CD8+ in the local cervical microecological environment of the two groups were higher than those before treatment, and the differences before and after treatment in the two groups were statistically significant (P<0. 05). The levels of IL-4, TNF-α and serum CD8+ in the local cervical microecological environment of both groups were lower than those before treatment, and the differences in the two groups before and after treatment were statistically significant (P<0. 05). Conclusion: LEEP+recombinant human interferon a2b is beneficial to increasing the negative conversion rate of HPV, reducing the inflammatory response, enhancing the immune function, and changing the prognosis of patients. 2022 Vol. 28 (12): 2081-2085 [Abstract] ( 50 ) HTML (1 KB)  PDF (1236 KB)  ( 104 ) 2086 Correlation of the Deepest S Wave and QT Interval Dispersion of the Electrocardiogram with Blood Pressure Variability and NT-proBNP in Patients with Essential Hypertension Combined with Left Ventricular Hypertrophy WANG Yanyan, Dili Nur Maimaitijiang, Nurbiya Aihemaiti, et al DOI: 10.3969/j.issn.1006-6233.2022.12.029 Objective: To analyze the correlation of the deepest S wave (SD) and QT (QTcd) interval dispersion of the electrocardiogram with blood pressure variability and NT-proBNP in patients with essential hypertension combined with left ventricular hypertrophy (LVH). Methods: A total of 304 patients with essential hypertension who were treated in the hospital from January 2021 to June 2022 were selected as the research subjects. According to whether the patients were accompanied by LVH or not, they were divided into LVH group (n=173) and non-LVH group (n=131). The SD, QTcd, blood pressure variability and serum NT-proBNP level were compared between the two groups, and the correlation between SD, QTcd and blood pressure variability and NT-proBNP in patients with essential hypertension and LVH was analyzed using Pearson correlation analysis. Results: SD and QTcd in LVH group were significantly higher than those in non-LVH group (P<0. 05). The 24h SCV, 24h DCV, dSCV, dDCV, nSCV and nDCV were significantly higher in LVH group than those in non-LVH group (P<0. 05). Serum NT-proBNP level in LVH group was significantly higher compared to non-LVH group (P<0. 05). SD and QTcd were significantly positively correlated with 24h SCV, 24h DCV, dSCV, dDCV, nSCV and nDCV in patients with essential hypertension and LVH (P<0. 05). SD and QTcd were significantly positively correlated with NT-proBNP in patients with essential hypertension complicated with LVH (P<0. 05). Conclusion: SD and QTcd in patients with essential hypertension complicated with LVH are significantly increased, which may be related to blood pressure variability and serum NT-proBNP level. 2022 Vol. 28 (12): 2086-2089 [Abstract] ( 57 ) HTML (1 KB)  PDF (1241 KB)  ( 122 ) 2090 Expression and Significance of VEGF and MVD in Patients with Placental Implantation Complicated by Infection JIN Fengmei, et al DOI: 10.3969/j.issn.1006-6233.2022.12.030 Objective: To explore the relationship between vascular endothelial growth factor (VEGF), placental microvessel density (MVD) and postpartum placental accretacomplicated with infection. Methods: Placental tissue and fasting venous blood were taken as samples of 535 pregnant women with placental accretain admitted to our hospital from September 2011 to February 2021. Real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR), enzyme-linked immunosorbent test (ELISA), western blotting (WB) test and immunohistochemistry were used to detect the expression of VEGF protein, VEGF mRNA and MVD in placental tissue and serum. Pearson correlation was used to analyze the relationship between VEGF and MVD. Results: Compared with the placenta accreta without complicated infection group, the proportion of patients over 35 years old, the proportion of cesarean section times ≥ 1 and the proportion of induced abortion times ≥ 2 patients in the placenta accreta complication group were higher (χ2=80. 558, 82. 320, 116. 681, P<0. 001), and the mRNA, protein expression and serum content of VEGF were significantly increased (t = 22. 834, 15. 575, 7. 862, P<0. 001), and the MVD value was also significantly increased (t = 10. 096, P<0. 001). Pearson correlation analysis showed that the content of VEGF in placenta was positively correlated with MVD value (r=0. 645, P<0. 001). Conclusion: The expression of VEGF and MVD increased in placenta accreta complicated with infection, which was positively correlated with placenta accreta complicated infection, and VEGF content was positively correlated with MVD value in infected placenta, which could be used as the basis for the treatment of placenta accreta complicated with infection. 2022 Vol. 28 (12): 2090-2094 [Abstract] ( 57 ) HTML (1 KB)  PDF (1316 KB)  ( 78 ) 2095 Correlation between Levels of Peripheral Blood NLR LMR and IL-17 and Prognosis in Patients with Breast Cancer QI Jing, et al DOI: 10.3969/j.issn.1006-6233.2022.12.031 Objective: To analyze the correlation between levels of peripheral blood neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and interleukin-17 (IL-17) and survival prognosis in patients with breast cancer. Methods: 120 patients with breast cancer who were treated in the hospital between January 2018 and February 2019 were selected as the research subjects and were included in the breast cancer group, and 106 subjects who underwent breast health examination in the hospital during the same period were selected as healthy controls. The levels of NLR, LMR and IL-17 in peripheral blood were compared between the breast cancer group and the healthy control group at enrollment. The relationship between levels of NLR, LMR and IL-17 and clinicopathological parameters of patients with breast cancer at enrollment was analyzed. The patients in the breast cancer group were followed up at discharge, and the prognosis was statistically analyzed and the predictive value of levels of peripheral blood NLR, LMR and IL-17 on the poor prognosis was analyzed. Results: The levels of NLR and IL-17 in peripheral blood of patients in the breast cancer group were significantly higher than those in the healthy control group (P<0. 05) while the level of peripheral blood LMR was significantly lower than that in the healthy control group (P<0. 05). The levels of peripheral blood NLR. LMR and IL-17 were not related to age, disease type, tumor size, presence or absence of triple-negative breast cancer, ki67 level and assessment of target lesions (P>0. 05), but were related to TNM stage (P<0. 05). The levels of NLR and IL-17 in peripheral blood in the poor prognosis group were significantly higher than those in the good prognosis group (P<0. 05) while the LMR level was significantly lower than that in the good prognosis group (P<0. 05). ROC curve results showed that the combined diagnosis of peripheral blood NLR+LMR+IL-17 had higher predictive efficiency than each indicator alone for poor prognosis of breast cancer, and the predictive value of LMR for poor prognosis of breast cancer had certain limitations (AUC=0. 652). Conclusion: The levels of NLR, LMR and IL-17 in peripheral blood of patients with breast cancer have certain reference value on evaluation of prognosis of patients. 2022 Vol. 28 (12): 2095-2099 [Abstract] ( 62 ) HTML (1 KB)  PDF (1286 KB)  ( 107 ) 2100 Risk Factors of Early Neurological Deterioration of Patients with Ischemic Stroke Undergoing Intravenous Thrombolysis:a Meta Analysis LIU Yanping, KANG Lingling, CUI Hui, et al DOI: 10.3969/j.issn.1006-6233.2022.12.032 Objective: To determine the risk factors of END after intravenous thrombolysis in patients with ischemic stroke based on the meta-analysis. Methods: The evaluation standard of END was that the NIHSS score increased by ≥ 4 points at any time point or the patient died of the disease within 24 hours after admission; the database was searched based on a unified data retrieval strategy from January 2016 to October 2021; Newcastle Ottawa scale and Review Manager 5. 3 were respectively used to assess the quality of the literrature and implement the meta-analysis. Results: 14 papers were included and there were 13 controversial risk factor indexes. TThe combined effect sizes of advanced age, atrial fibrillation, leukocytes, hypertension, and randomized glucose were analyzed to be statistically significant, and the combined effect sizes of stroke of unknown or other cause, stroke history, coronary artery disease, and dyslipidemia in TOAST typing were not statistically significant and the sensitivity analysis results of the above studies were more robust; the sensitivity analysis results of large artery atherosclerotic stroke, small artery occlusive stroke, cardiogenic cerebral infarction, and diabetes mellitus in TOAST typing were less robust. Conclusion: Old age, hypertension, atrial fibrillation, white blood cells and random blood glucose are the risk factors of END after intravenous thrombolysis in patients with ischemic stroke. The sensitivity analysis results of some indicators are poor, which need to be verified by the multi-center and large sample experiments. 2022 Vol. 28 (12): 2100-2104 [Abstract] ( 66 ) HTML (1 KB)  PDF (1268 KB)  ( 152 ) 2108 Effect of Esketamine on Analgesia and Stress Response to Nucleus Pulposus Removal in Patients with Lumbar Disc Herniation CHEN Tian, LIAO Xingzhi, QIAO Yan, et al DOI: 10.3969/j.issn.1006-6233.2022.12.034 Objective: To explore the effect of esketamine on analgesia and stress response in patients with lumbar discectomy. Methods: A total of 102 patients undergoing nucleotomy who were admitted to our hospital from January 2021 to December 2021 were prospectively selected as the research subjects. They were divided into groups A and B by simple random coin tossing method, and 58 patients in group A were finally included. 44 cases in group B and endotracheal intubation were given general anesthesia. Before induction of anesthesia, patients in group A were intramuscularly injected with 1 mg/kg esketamine injection, and group B was intramuscularly injected with an equal volume of normal saline. The heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels before and after anesthesia, as well as the number of analgesic pump compressions and visual analogue scale (VAS) at 3h and 6h after surgery were compared between the two groups. Visual analogue scale (VAS) was used to compare the oxidative stress (superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase) before and 3 days after surgery between the two groups of patients (Glutathione peroxidase, GSH-Px)) and inflammatory factors (hypersensitive C-reactive protein (hs-CRP), interleukin-6 (interleukin-6, IL-6)) level changes. Results: After anesthesia, the levels of SBP and DBP in both groups decreased, and group A was significantly higher than group B, P<0. 05; analgesia pump compression was performed in group A 3 hours and 6 hours after operation. The frequency and VAS score were significantly lower than those in group B. The number of analgesic pump pressings and VAS score in groups A and B at 6 hours after operation were significantly higher than those at 3 hours after operation, P<0. 05; on the 3d postoperative period, the SOD, MDA and GSH-Px levels of patients in both groups were significantly reduced, and the SOD and GSH-Px levels of patients in group A were significantly higher than those in group B, and the MDA levels were significantly lower than those in group B. The comparison of the SOD, MDA and GSH-Px levels of patients in both groups before and in the 3d postoperative period, and the comparison of the difference of the decrease in SOD, MDA and GSH-Px levels in both groups in the 3d postoperative period compared with those before surgery The differences were statistically significant, P<0. 05;on 3d postoperatively, IL-6 and hs-CRP levels increased significantly in both groups, and IL-6 and hs-CRP levels in group A were significantly lower than those in group B. The differences between preoperative and 3d postoperative IL-6 and hs-CRP levels in both groups, and the difference between the elevation of IL-6 and hs-CRP levels in both groups in 3 d postoperatively compared with preoperatively, were statistically significant, P<0. 05. Conclusion: Esketamine has an ideal analgesic effect on patients with lumbar discectomy, and can effectively relieve pain, improve stress response, and inhibit inflammatory factors, which is worthy of clinical reference. 2022 Vol. 28 (12): 2108-2112 [Abstract] ( 94 ) HTML (1 KB)  PDF (1224 KB)  ( 133 )

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