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2023 Vol. 29, No. 5 Published: 2023-05-31 705 Mechanisms by which MTMR14 Ameliorates Hypoxia/Reoxygenation-Induced Cardiomyocyte Injury via PTEN/Akt Signaling Pathway ZHONG Ni'er, YANG Guang, et al DOI: 10.3969/j.issn.1006-6233.2023.05.01 Objective: To investigate the role and mechanism of myotubularin-related protein 14 (MTMR14) in regulating hypoxia/reoxygenation (H/R)-induced cardiomyocyte injury. Methods: The mouse cardiomyocytes were cultured under hypoxia for 6 hours followed by reoxygenation of 12 hours to establish the H/R model. Adeno-associated virus mediated gene delivery was used to overexpress MTMR14. Experiments were divided into normoxic group, H/R group, H/R + control AAV group, and H/R + AAV-MTMR14 group, H/R + AAV-MTMR14 + AAV-PTEN group and H/R + AAV-MTMR14 + MK-2206 group. The mRNA expression of MTMR14 was measured by real-time quantitative PCR (RT-qPCR). The protein levels of MTMR14, Bax, Bcl2, Caspase-3, PTEN and Akt were examined by Western blotting. The survival rate of cardiomyocytes was assessed by cell counting kit-8 (CCK-8) assay. Cell injury of cardiomyocytes was determined by lactate dehydrogenase (LDH) cytotoxicity assay. The apoptosis of cardiomyocytes was examined by terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) assay. Results: MTMR14 expression levels were significantly lower in the H/R group compared with the normoxia group (P<0.05). MTMR14 expression levels were significantly increased in the H/R + AAV-MTMR14 group compared with the H/R + control AAV group (P<0.01). The survival rate of cardiomyocytes was significantly higher and apoptosis rate was significantly lower in the H/R + AAV-MTMR14 group compared with the H/R group and the H/R + control AAV group (P<0.01). PTEN protein levels were significantly lower and Akt protein phosphorylation levels were significantly higher in the H/R + AAV-MTMR14 group compared with the H/R group and the H/R + control AAV group (P<0.01). Compared with the H/R + AAV-MTMR14 group, the H/R + AAV-MTMR14 + AAV-PTEN group had significantly higher PTEN protein levels, significantly lower Akt protein phosphorylation levels, and significantly increased apoptosis rate in cardiomyocytes (P<0.01). Compared with the H/R + AAV-MTMR14 group, the H/R + AAV-MTMR14 + MK-2206 group had significantly lower Akt protein phosphorylation levels and significantly increased cardiomyocyte apoptosis rate (P<0.01). Conclusion: MTMR14 ameliorates H/R-induced cardiomyocyte injury through regulation of the PTEN/Akt pathway. 2023 Vol. 29 (5): 705-710 [Abstract] ( 93 ) HTML (1 KB)  PDF (2107 KB)  ( 108 ) 710 Effects of Esketamine on Neuronal Damage Inflammation and AMPK/NF-κB Signaling Pathway in Rats with Traumatic Brain Injury LIU Xuan, TENG Jinliang, YUAN Li, et al DOI: 10.3969/j.issn.1006-6233.2023.05.02 Objective: To investigate the effects of esketamine on neuronal injury, inflammation and adenosine monophosphate activated protein kinase (AMPK)/nuclear factor-κB (NF-κB) signaling pathway in rats with traumatic brain injury (TBI). Methods: According to the random number table, the rats were divided into sham operation group, model group, esketamine group (50 mg/kg), AMPK inhibitor group (20 mg/kg), and esketamine+AMPK inhibitor group (50 mg/kg+20 mg/kg). TBI rat models were established in groups except the sham operation group, and each group was given corresponding intervention for 7 days. Modified neurological severity score (mNSS) was used to evaluate the neural function of rats; serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay; HE staining was used to observe the pathological changes of the brain tissue around the lesion; Nissner staining was used to observe the damage of neurons in the brain surrounding the lesion; TUNEL was used to detect the apoptosis of neurons in the brain surrounding the lesion; detection of AMPK/NF-κB pathway protein expression in the brain tissue around the injured focus of rats by Western blot. Results: Compared with the sham group, rats in the model group showed severe lesions and neuronal damage around the foci of injury. mNSS score, serum IL-6, TNF-α, neuronal apoptosis number, phosphorylated NF-κB p65 (p-NF-κB p65)/NF-κB p65 protein expression were significantly increased, and phosphorylated AMPK (p-AMPK)/AMPK protein expression was significantly decreased (P<0.05). Compared with the model group, the brain tissue pathological condition and neuronal damage around the injury foci were improved in the esketamine group. mNSS score, serum IL-6, TNF-α, neuronal apoptosis number, p-NF-κB p65/NF-κB p65 protein expression was significantly reduced and p-AMPK/AMPK protein expression was significantly increased in the AMPK inhibitor group (P<0.05). In rats, brain tissue lesions and neuronal damage around the injury foci were aggravated, and mNSS score, serum IL-6, TNF-α, neuronal apoptosis number, p-NF-κB p65/NF-κB p65 protein expression were significantly increased and p-AMPK/AMPK protein expression were significantly decreased (P<0.05). The changes in each of these indices in the esketamine + AMPK inhibitor group were between the esketamine and AMPK inhibitor groups. Conclusion: Esketamine can alleviate the neuronal injury and inflammatory reaction in TBI rats, which may be related to the regulation of AMPK/NF-κB pathway. 2023 Vol. 29 (5): 710-716 [Abstract] ( 79 ) HTML (1 KB)  PDF (2181 KB)  ( 199 ) 716 Impact of Trigonelline on OGD/R-Induced Neuronal Apoptosis Mediated by Mitophagy via Pink1/Parkin Signaling Pathway HUANG Qi, ZHAI Haicheng DOI: 10.3969/j.issn.1006-6233.2023.05.03 Objective: To investigate the impact of trigonelline on oxygen-glucose deprivation/reoxygenation (OGD/R)-induced neuronal apoptosis mediated by mitophagy via PTEN-inducible kinase protein 1 (Pink1)/E3 ubiquitin ligase (Parkin) signaling pathway. Methods: Primary cultured rat hippocampal neurons were induced neuronal damage through OGD/R after pretreatment with down-regulation of Pink1 or trigonelline. There were control group, OGD/R group, trigonelline group, pLKO empty vector group (transfected with pLKO empty vector), pLKO-Pink1 group (transfected with pLKO vector connected with Pink1 shRNA interference plasmid), and trigonelline + pLKO-Pink1 group in the experiment. Annexin V-FITC/PI double staining method was used to determine the apoptosis rate of neurons; the mitochondrial membrane potential (MMP) was measured by JC-1 method; Calcein-AM method was used to measure the opening degree of mitochondrial membrane permeability transition pore (MPTP); the number of autophagosomes was observed by transmission electron microscope; Western Blot was used to determine the expression of mitophagy-related proteins [microtubule-associated protein 1 light chain 3 II (LC3 II), Pink1, Parkin]. Results: Compared with the control group, the neuron apoptosis rate and MPTP opening degree in the OGD/R group increased, MMP decreased, the number of autophagosomes and the expression of LC3-II, Pink1 and Parkin proteins increased (P<0.05); compared with the OGD/R group, the neuron apoptosis rate and MPTP opening degree of trigonelline group decreased, MMP increased, the number of autophagosomes and the expression of LC3-II, Pink1 and Parkin proteins increased (P<0.05), the trends of pLKO-Pink1 group were opposite to those of trigonelline group; compared with the trigonelline group, the neuron apoptosis rate and MPTP opening degree in the trigonelline+pLKO-Pink1 group increased, MMP decreased, the number of autophagosomes and the protein expressions of LC3-II, Pink1 and Parkin decreased (P<0.05). Conclusion: Trigonelline can inhibit OGD/R-induced neuronal apoptosis, which may be achieved by activating Pink1/Parkin signaling pathway and up-regulating mitophagy. 2023 Vol. 29 (5): 716-721 [Abstract] ( 47 ) HTML (1 KB)  PDF (2874 KB)  ( 112 ) 721 Influence of Scutellarin on Renal Tissue Damage in Rats with Diabetic Nephropathy by Regulating RhoA/ROCK Signaling Pathway WANG Jing, LI Min, HE Liming, et al DOI: 10.3969/j.issn.1006-6233.2023.05.04 Objective: To investigate the influence of scutellarin (Scu) on renal tissue damage in diabetic nephropathy (DN) rats by regulating RhoA/ROCK signaling pathway. Methods: Ten SD rats were randomly selected as the control group, and the rest of the 60 rats were constructed as DN models, the rats with successful modeling were grouped into 5 subgroups according to random number table method: DN group, Scu-L group (25mg/kg, 8 weeks), Scu-M group (50mg/kg, 8 weeks), Scu-H group (100mg/kg, 8 weeks), Scu-H+LPA group (100mg/kg Scu, 8 weeks+50μmol/L RhoA/ROCK signaling pathway activator LPA, 2 weeks). ELISA kit was used to detect 24h urine microalbumin (MAU) and serum biochemical indexes; HE staining and Masson staining were applied to observe kidney tissue damage; RT-qPCR and Western blot were applied to detect TGF-β1, VEGF, PTEN levels; Western blot was applied to detect RhoA/ROCK pathway protein levels. Results: The morphology and structure of the glomeruli in the Control group were normal; in the DN group, the glomerular morphology and structure were abnormal, the renal tubules appeared edema and necrosis, and the Bowman's capsule showed adhesion and large blue-stained collagen fiber deposits; after Scu treatment, renal tubular edema and necrosis were reduced, the morphology and structure of glomeruli became more regular, Bowman's cysts were reduced, and the deposition of blue-stained collagen fibers was decreased. Compared with the Con group, FBG, BUN, Scr, MAU, IL-6, TNF-α, TGF-β1, VEGF mRNA and protein levels, RhoA, p-ROCK/ROCK protein levels in the DN group were obviously increased (P<0.05), PTEN mRNA and protein levels were obviously decreased (P<0.05); after Scu treatment, FBG, BUN, Scr, MAU, IL-6, TNF-α, TGF-β1, VEGF mRNA and protein levels, RhoA, p-ROCK/ROCK protein levels were obviously decreased (P<0.05), PTEN mRNA and protein levels were obviously increased (P<0.05), and the higher the Scu additive dose, the more obvious the effect; LPA abolished the ameliorating effect of Scu-H group on DN rats. Conclusion: Scu may alleviate renal tissue damage in DN rats by down-regulating RhoA/ROCK signaling pathway. 2023 Vol. 29 (5): 721-726 [Abstract] ( 54 ) HTML (1 KB)  PDF (2968 KB)  ( 169 ) 726 Mechanism of Astragaloside Regulating p38 MAPK/NF-κB Signaling Pathway to Improve Apoptosis in Hyperthyroidism Rats GAO Yuecai, WANG Xu, LIU Rongge, et al DOI: 10.3969/j.issn.1006-6233.2023.05.05 Objective: To investigate the effect of Astragaloside on the cellular damage of thyroid tissue in hyperthyroidism model rats by intervening p38MAPK/NF-κBp65 signaling pathway. Methods: A total of 60 SPF grade Wistar rats were randomly divided into blank group, model group, methimazole group and Astragaloside low and high dose groups, with 12 rats in each group. The blank group was left untreated, and the other groups were treated with intervention after preparation of hyperthyroidism rat models. The basal metabolism of the rats in the five groups was compared before and after the intervention. The expression levels of NF-κBp65, p38MAPK protein and mRNA in thyroid tissues were detected by Western Blot and real-time fluorescence quantitative PCR. Results: After modeling, compared with the blank group, rats in the model group had increased food and water intake, decreased body mass, increased levels of T3, T4, TSH and IL-1β, IL-6, TNF-α, VEGF content (all P<0.05), increased histopathological damage, increased levels of apoptosis, and increased NF-κBp65, p38MAPK protein and mRNA expression in thyroid tissue were elevated (P<0.05). Compared with the model group, rats in the methimazole and astragaloside intervention groups showed decreased food and water intake, significantly increased body mass, decreased levels of T3, T4, TSH and IL-1β, IL-6, TNF-α and VEGF (all P<0.05), significantly improved histopathological damage, decreased levels of apoptosis, and increased levels of NF-κBp65, p38MAPK protein and mRNA in thyroid tissues (P<0.05), p38MAPK protein and mRNA expression in thyroid tissues were significantly reduced (P<0.05), in which the improvement in the high-dose group of astragaloside was significantly better than that in the low-dose group of astragaloside (P<0.01).Conclusion: Astragaloside can effectively improve the apoptosis and reduce the inflammatory factor expression in the thyroid tissue, which may be related to the regulation of the p38MAPK/NF- κB signaling pathway. 2023 Vol. 29 (5): 726-732 [Abstract] ( 59 ) HTML (1 KB)  PDF (2062 KB)  ( 124 ) 732 Proliferation and Osteogenic Differentiation of Rat BMSCs by Different Tension Stress DENG Haiyan, GULIZAINU Yibulayin, SUN Jiangwei, et al DOI: 10.3969/j.issn.1006-6233.2023.05.06 Objective: To examine the effects of the magnitude and duration of drafting stress on the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Methods: Ten SPF-grade SD rats were isolated and cultured and BMSCs were identified by osteogenic and lipogenic differentiation methods. Cell grouping was set for the magnitude of drafting stress loading (0.5% stretch, 5% stretch, 10% stretch, 15% stretch) and duration of action (0.5h, 6h, 12h, 24h, 48h, 72h). Proliferation of BMSCs was measured by CCK-8 method. The BCIP/NBT method was used to determine cellular alkaline phosphatase activity. Cellular osteogenic and lipogenic differentiation was detected by alizarin red and oil red O staining.Results: Tensile stress at 10% stretch for 12h maximally increased the proliferation rate of BMSCs by 1.53-fold, which was higher than that of the 5% and 15% stretch groups, with statistically significant differences (P<0.01). tensile stress at 5% stretch for 48h maximally increased alkaline phosphatase expression of BMSCs by 4.2-fold, increased mineralized nodule formation of BMSCs by 65%, and decreased BMSCs formation of lipid droplets by 32%, which was higher than the 10% and 15% stretch amplitude groups, with statistically significant differences (P<0.05 or P<0.01).Conclusion: The best effect of tensile stress stretching at 10% for 12h was observed in promoting the proliferation of BMSCs. Draft stress of 5% for 48h had the most significant effect on the formation of alkaline phosphatase and mineralized nodules in BMSCs, which in turn promoted osteogenic differentiation of BMSCs. The magnitude and duration of tension stress required to promote the proliferation and osteogenic differentiation of BMSCs varied. 2023 Vol. 29 (5): 732-736 [Abstract] ( 49 ) HTML (1 KB)  PDF (1557 KB)  ( 144 ) 737 Engeletin Down-Regulates the PERK-ATF4 Signaling Pathway to Improve the Liver of Hepatocirrhosis Rats DAI Ying, DENG Jiong, LU Yijun, et al DOI: 10.3969/j.issn.1006-6233.2023.05.07 Objective: To investigate the liver protective effect of engeletin (Eng) on rats with hepatocirrhosis by regulating protein kinase R-like endoplasmic reticulum kinase (PERK) - activating transcription factor 4 (ATF4) signaling pathway. Methods: 10 rats were randomly selected as the control group (NC group), and the rest of the rats were induced into the HC rat model. After successful modeling, they were randomly divided into HC group, L-Eng group (10mg·kg-1·d-1), M-Eng group (20mg·kg-1·d-1), H-Eng group (40mg·kg-1·d-1), and H-Eng+CCT group (40mg·kg-1·d-1 Eng+2 mg·kg-1·d-1 CCT020312), 10 rats in each group, lasting for 3 weeks. Detection of liver function indicators, liver histopathological changes α- Expression of SMA, Collagen, EMT marker protein, PERK-ATF4 pathway protein. Results: The NC group had normal liver tissue structure, clear staining and no fibrosis; the HC group showed extensive necrosis, massive lymphocyte infiltration, disorganized liver cords, fibrous hyperplasia and pseudobullet formation; after Eng treatment, lymphocyte infiltration was reduced, cells were more neatly arranged and fibrous hyperplasia improved; compared with the NC group, the HC group showed significantly higher Ishak score, Ishak stage, liver index , alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels, α-SMA, Collagen levels, Vimentin, PERK, ATF4 protein levels were significantly increased (P<0.05), and albumin (ALB), total protein (TP) levels, E-cadherin protein levels were significantly downregulated in the HC group compared with the NC group (P<0.05); the above indexes were improved after Eng treatment, and the effect of Eng showed a dose-dependent effect; CCT020312 reversed the favorable effect of H-Eng on HC rats.Conclusion: Engeletin may play a liver protective role in HC rats by regulating PERK-ATF4 signaling pathway. 2023 Vol. 29 (5): 737-742 [Abstract] ( 59 ) HTML (1 KB)  PDF (2676 KB)  ( 121 ) 742 Vasodilator-Stimulated Phosphoprotein Alleviates Cardiomyocyte Damage in Septic Mice ZHANG Jilong, SHAN Ping, HAN Yang, et al DOI: 10.3969/j.issn.1006-6233.2023.05.08 Objective: Validation of dibutyryl cyclic adenosine (Bucladesine)-mediated changes in vasodilator-stimulated phosphoprotein (VASP) in relation to cardiomyocyte action in septic mice. Methods: A mouse model of sepsis was constructed by cecum ligation perforation, and the experiment was divided into: control (Con), sham-operated (Sham), model (Mod) and Bucladesine (Buc) groups. Biochemical assays were performed to detect tissue malondialdehyde (MDA) and superoxide dismutase (SOD) levels in serum and myocardium. Flow cytometry was performed to detect reactive oxygen species (ROS) levels in myocardial tissue and mitochondrial membrane potential in cells. TUNEL staining was performed to detect myocardial tissue apoptosis. Hematoxylin-eosin (HE) staining was performed to observe myocardial lesions. p-VASP expression levels in myocardial tissues were measured by Western blot. Results: Compared with the control and sham groups, the model group showed significantly higher MDA levels (P<0.05), lower SOD levels (P<0.05), higher ROS levels (P<0.05), higher p-VASP and VASP protein expression levels (P<0.05) in serum and myocardial tissue, myocardial fiber breakage, laxity, increased gap, and increased TUNEL brown area coloring. Compared with the model group, the serum and myocardial tissue in the Buc group showed significantly lower MDA content (P<0.05), higher SOD content (P<0.05), lower ROS content (P<0.05), lower p-VASP and VASP protein expression levels (P<0.05), tighter myocardial fibers, and reduced TUNEL brown area coloration. Conclusion: Inhibition of p-VASP by Bucladesine can alleviate the myocardial dysfunction caused by sepsis, which mechanism of action is associated with modulation of cardiomyocyte mitochondrial activity and enhancement of cellular antioxidant capacity. 2023 Vol. 29 (5): 742-747 [Abstract] ( 54 ) HTML (1 KB)  PDF (2567 KB)  ( 162 ) 747 Expressions of COX-2 Protein, C-erbB-2, P53 and VEGF-C Protein in Breast Cancer Tissues and Their Relationships with Clinicopathological Parameters and Prognosis LI Ruiqing, ZHANG Jie DOI: 10.3969/j.issn.1006-6233.2023.05.09 Objective: To analyze the expressions of cyclooxygenase-2 (COX-2) protein, human epidermal growth factor receptor 2 (c-erbB-2), mutant P53 protein, and vascular endothelial growth factor c (VEGF-C) protein in breast cancer tissues and their relationships with clinicopathological parameters and prognosis. Methods: The surgical resection specimens of 103 patients with breast cancer who were treated in the hospital from March 2017 to May 2019 were selected. The protein positive rates of COX-2, c-erbB-2, P53 and VEGF-C were determined by immunohistochemistry. The relationships of levels of the above indicators with pathological parameters such as TNM staging and differentiation degree were compared. The survival data of patients at 3 years after surgery were followed up, and Kaplan-Meier method was used to analyze the effects of protein levels of COX-2, c-erbB-2, P53 and VEGF-C on the prognosis survival. Results: TNM staging and differentiation degree were correlated with positive COX-2 (P<0.05). Tumor diameter ≥3cm and lymph node metastasis were associated with positive c-erbB-2 (P<0.05). TNM staging, differentiation degree and lymph node metastasis were correlated with positive P53 (P<0.05). Lymph node metastasis was related to positive VEGF-C (P<0.05). 103 patients were followed up for 3 years, with a follow-up rate of 100%; 20 patients died (19.42%) and 83 patients survived (80.58%) as of May 2022; positive patients were divided into survival and death subgroups according to the death status, and the histochemical scores of patients in the death subgroup were significantly higher than those in the survival subgroup at enrollment (P<0.05). Log-rank χ2 test showed that there were statistical differences in the cumulative survival rates between patients with positive and negative P53 and VEGF-C after 3 years of follow-up (χ2=14.000, 5.206, all P<0.05). There were no statistically significant differences in the cumulative survival rates between patients with positive and negative COX-2 and c-erbB-2 (χ2=1.761, 2.830, P=0.184, 0.093). Conclusion: The protein positive rates of COX-2, c-erbB-2, P53 and VEGF-C in breast cancer tissues are related to TNM staging, lymph node metastasis, differentiation degree and other pathological parameters, and they have certain guiding significance on the evaluation of prognosis of patients. 2023 Vol. 29 (5): 747-751 [Abstract] ( 41 ) HTML (1 KB)  PDF (1198 KB)  ( 70 ) 752 Analysis of the Efficacy and Factors Influencing Flucocorticoid Shock Therapy in Patients with Moderate to Severe Thyroid-Related Ophthalmopathy in the Active Phase LIANG Jian, ZHANG Zhen, ZENG Yi DOI: 10.3969/j.issn.1006-6233.2023.05.010 Objective: To explore possible factors affecting the effect of glucocorticoid shock therapy for active thyroid associated ophthalmopathy (TAO) in moderate to severe ophthalmopathy. Methods: In this retrospective study, 103 patients with moderate to severe TAO during active period who received standardized pulse glucocorticoid therapy who were admitted to the Department of Endocrinology of the fifth people's hospital of zhuhai from June 2018 to March 2020 were enrolled in this study. According to the changes of eyelid retraction, exophthalmos, eye movement, and clinical activity score (CAS) after treatment, the patients were assigned into two groups: 80 cases in the significant effectiveness group and 23 cases in the ineffectiveness group. The age, gender, smoking history, exophthalmos, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), neutrophil count (NEU), lymphocyte count (LYM), neutrophil-lymphocyte ratio (NLR), thyroid stimulating hormone receptor antibodies (TRAb), anti-thyroglobulin antibodies (TGAb), thyroid peroxidase antibody (TPOAb) were collected and the related factors affecting the curative effect were analyzed. Results: There were no statistical differences in age, sex and LYM between the two groups (P>0.05). Smoking history, degree of exophthalmos, CRP, NEU, NLR ESR, TRAb, TGAb, TPOAb were statistically different between the two groups (P<0.05). Logistic regression analysis also showed that smoking history, degree of exophthalmos, CRP, ESR, NEU, NLR, TRAb, TGAb, TPOAb were associated with the effectiveness (P<0.05). Conclusion: For patients with moderate to severe TAO, age, gender, LYM were not associated with prognosis, while smoking history, exophthalmia, CRP, ESR, NEU, NLR, TRAb, TGAb, TPOAb were associated with the effectiveness. Smoking cessation and active treatment of thyroid disease can help improve the curative effect. 2023 Vol. 29 (5): 752-756 [Abstract] ( 57 ) HTML (1 KB)  PDF (1160 KB)  ( 102 ) 756 Changes and Significance of Breg Treg Composition and Related Cytokine Concentration in ITP Patients before and after Treatment HAO Lijun, XU Teng, CUI Yanjie, et al DOI: 10.3969/j.issn.1006-6233.2023.05.011 Objective: To investigate the levels and significance of regulatory B cells (Breg), regulatory T cells (Treg) and their related cytokines in patients with immune thrombocytopenia (ITP) before and after treatment. Methods: A total of 103 ITP patients treated in our hospital from December 2018 to January 2022 were selected as the observation group, while 103 healthy volunteers were selected as the control group, and the two groups were examined for Breg cells, Treg cells, transforming growth factor-β (TGF-β), interleukin-10 (IL-10), interleukin-4 (IL-4), interleukin-17 ( IL-17), soluble programmed death 1 (sPD-1) and soluble programmed death ligand 1 (sPD-L1) differences, and also analyze the differences of Breg cells and Treg cells before and after treatment in the observation group. Results: Breg cells, Treg cells, TGF-β, IL-10 and IL-4 in the observation group were (4.46±1.01)%, (5.11±1.03)%, (2203.19±225.51)pg/ml, (4.06±0.93)pg/ml and (298.32±55.62)pg/ml, respectively, which were significantly lower than those in the control group (P<0.05), IL-17 and sPD-1 were (12.01±2.28) pg/ml and (110.32±19.20) pg/ml, respectively, significantly higher than the control group (P<0.05). There was no statistically significant difference between the observation group and the control group comparing sPD-L1 (P>0.05). Breg cells, Treg cells, TGF-β, IL-10 and IL-4 were higher in the observation group 3 months after treatment compared with before treatment (P<0.05), while IL-17 and sPD-1 were lower than before treatment (P<0.05). The pre-treatment Breg cells and Treg cells were (3.88±0.97)% and (4.72±0.98)% in the observation group of treatment-ineffective patients, respectively, which were significantly lower than those of treatment-effective patients (P<0.05); the differences between the comparison of pre-treatment TGF-β, IL-10, IL-4, IL-17, sPD-1 and sPD-L1 in the observation group of treatment-ineffective and effective patients were not statistically (P>0.05). The post-treatment Breg cells, Treg cells and TGF-β were (5.68±1.01)%, (6.65±1.02)% and (2606.82±203.14)pg/ml, respectively, in the observation group of treatment-naive patients, which were significantly lower than those of treatment-effective patients (P<0.05), while IL-17 and sPD-1 were (10.11±1.60)pg/ml and (102.21±14.04) pg/ml, which were significantly higher than those in treatment effective patients (P<0.05). The area under the ROC curve for pre-treatment Breg cells and Treg cells predicting treatment effective was 0.694 and 0.725, respectively, P<0.05.Conclusion: Breg cells and Treg cells were significantly lower before treatment in ITP patients, and the levels of related cytokines were significantly abnormal. After treatment, the indices of Breg cells and Treg cells in patients improved significantly, while the pre-treatment Breg cells and Treg cells have some application value in predicting the efficacy of treatment. 2023 Vol. 29 (5): 756-761 [Abstract] ( 48 ) HTML (1 KB)  PDF (1216 KB)  ( 153 ) 762 Expression Levels and Significance of Serum hs-CRP PCT RDW and NRBC in Patients with Severe Acute Pancreatitis LI Ge, TIAN Xia DOI: 10.3969/j.issn.1006-6233.2023.05.012 Objective: To investigate the expression levels and clinical significance of serum hypersensitive C-reactive protein (hs-CRP), procalcitonin (PCT), red blood cell distribution width (RDW) and nucleated red blood cells (NRBC) in patients with severe acute pancreatitis (SAP). Methods: The clinical data of 409 patients with acute pancreatitis (AP) treated in our hospital from January 2021 to December 2022 were analyzed retrospectively. According to disease severity, the patients were divided into mild AP (MAP) group (213 cases), moderate AP (MSAP) group (88 cases) and severe AP (SAP) group (108 cases). Serum hs-CRP, PCT, RDW and NRBC levels, the Acute Physiological and Chronic Health Evaluation II (APACHE-II) scores and CT Severity Index (CTSI) scores were compared among the three groups. The receiver operating characteristic (ROC) curves of hs-CRP, PCT, RDW and NRBC for diagnosing SAP were plotted, and the area under the curve (AUC) was analyzed. According to clinical outcomes, patients in SAP group were divided into survival group and death group, serum hs-CRP, PCT, RDW and NRBC levels, and APACHE-II scores were compared between the two groups. The correlation between serum hs-CRP, PCT, RDW and NRBC levels and APACHE-II score was analyzed by Preason correlation analysis. Results: Compared with MAP group and MSAP group, serum hs-CRP, PCT, RDW and NRBC levels, APACHE-II scores and CTSI scores were higher in SAP group (P<0.05). The ROC curve analysis results showed that hs-CRP, PCT, RDW and NRBC were helpful for diagnosing SAP. Among them, the diagnostic efficiency of PCT was the highest (AUC=0.994), and the diagnostic efficiency of RDW was the lowest (AUC=0.772). Serum hs-CRP, PCT, RDW and NRBC levels, and APACHE-II scores in the survival group were lower than those in the death group (P<0.05). Pearson correlation analysis showed that serum hs-CRP, PCT, RDW and NRBC levels were positively correlated with APACHE-II score. Conclusion: Serum hs-CRP, PCT, RDW and NRBC levels are higher in patients with SAP, and are closely related to disease severity. The detection of serum hs-CRP, PCT, RDW and NRBC is beneficial to diagnose SAP, which indicates that these indicators can be used as real-time monitoring indicators for patients with SAP. 2023 Vol. 29 (5): 762-767 [Abstract] ( 64 ) HTML (1 KB)  PDF (1387 KB)  ( 149 ) 767 Relationship between Serum LncRNA-MSC-AS1 Level and Clinicopathological Features and Prognosis in Patients with Ovarian Cancer LI Cui'e, HE Xiaoli, HE Jieli, et al DOI: 10.3969/j.issn.1006-6233.2023.05.013 Objective: To explore the relationship between serum long-stranded non-coding RNA myoprotein antisense RNA 1 (LncRNA-MSC-AS1) level and clinicopathological features and prognosis in patients with ovarian cancer (OC). Methods: A total of 106 OC patients admitted to our hospital from November 2016 to November 2018 were taken as the OC group, and 106 normal healthy subjects were taken as the control group. The expression level of LncRNA-MSC-AS1 in serum was detected by quantitative real-time PCR (qRT-PCR); Kaplan-Meier survival curve was used to analyze the relationship between LncRNA-MSC-AS1 expression level and 3-year survival in OC patients; Cox regression analysis of risk factors affecting adverse prognosis of OC patients at 3 years after surgery. Results: The expression of LncRNA-MSC-AS1 in OC group (0.75±0.08) was lower than that in control group (1.01±0.11) (t=19.681, P<0.05); the expression level of LncRNA-MSC-AS1 in OC patients was correlated with TNM stage, lymph node metastasis, tumor diameter, and CA125 (P<0.05); Kaplan-Meier survival curve analysis showed that the 3-year survival rate of the high expression group of LncRNA-MSC-AS1 was 71.15% (37/52), which was significantly higher than that of the low expression group (37.04% (20/54). (Log rank χ2=12.404, P<0.001); COX regression analysis showed that TNM stage, tumor diameter, low expression of CA125 and LncRNA-MSC-AS1 were risk factors for poor prognosis of OC patients at 3 years after operation (P<0.05). Conclusion: LncRNA-MSC-AS1 is under-expressed in OC patients, which is related to the clinicopathological characteristics and prognosis of OC patients, and is expected to be a potential biomarker for OC prognosis assessment. 2023 Vol. 29 (5): 767-772 [Abstract] ( 58 ) HTML (1 KB)  PDF (1251 KB)  ( 81 ) 772 Effectiveness of SGLT2 Inhibitor for Type 2 Diabetic Nephropathy and Its Correlation with SUA Smad1 Protein and Lipoprotein HAO Limei, SONG Wei, WANG Pei, et al DOI: 10.3969/j.issn.1006-6233.2023.05.014 Objective: To observe the effectiveness of SGLT2 inhibitor on type 2 diabetic nephropathy (T2DN) and analyze the correlation between T2DN and serum uric acid (SUA), Smad1 protein and lipoprotein.Methods: The clinical data of 72 patients with T2DN admitted in our hospital from April 2020 to March 2022 (study group) were analyzed retrospectively. Based on the urinary albumin excretion rate (UAER), the number of patients with early stage diabetic nephropathy (UAER 30-300mg/24h) and clinical diabetic nephropathy (UAER >300mg/24h) were counted, and the treatment effect and adverse effects were evaluated after receiving SGLT2 inhibitor treatment (10mg/dose, 1d/dose) for 3 consecutive months.Another 54 healthy individuals who underwent health checkups at our hospital during the same period were selected as the control group. The levels of SUA, Smad1 protein and lipoprotein were compared in different populations, and the correlation between the above factors and UAER was analyzed by Spearman.Results: The SUA, Smad1 protein, and lipoprotein levels in the study group were higher than those in the control group (P<0.05). 72 patients with T2DN had an overall effectiveness of 87.50% (63/72) after treatment, and the overall incidence of adverse effects was 9.72% (7/72). After treatment, SUA, Smad1 protein, and lipoprotein levels were reduced in T2DN patients compared with those before treatment (P<0.05). Statistically, there were 45 cases in the early diabetic nephropathy group and 27 cases in the clinical diabetic nephropathy group. Before treatment, SUA, Smad1 protein and lipoprotein levels in the early diabetic nephropathy group were lower than those in the clinical diabetic nephropathy group (P<0.05). After treatment, the levels of SUA, Smad1 protein and lipoprotein decreased in both groups compared with those before treatment, with the early diabetic nephropathy group being lower than the clinical diabetic nephropathy group (P<0.05). Spearman analysis showed that the expression of SUA, Smad1 protein and lipoprotein were positively correlated with UAER (P<0.001).Conclusion: SUA, Smad1 protein and lipoprotein were highly expressed in T2DN patients. SGLT2 inhibitor treatment could reduce the levels of SUA, Smad1 protein and lipoprotein, with low adverse reactions. The clinical detection of SUA, Smad1 protein and lipoprotein levels can reflect the degree of renal injury in patients, and has certain guiding value for formulating treatment plans. 2023 Vol. 29 (5): 772-776 [Abstract] ( 56 ) HTML (1 KB)  PDF (1248 KB)  ( 91 ) 776 Analysis of the Current Situation of Patients with Nephrotic Syndrome Complicated by Acute Kidney Injury and Its Factors CHEN Qingmiao, CHEN Yueyao, ZHOU Shiqun, et al DOI: 10.3969/j.issn.1006-6233.2023.05.015 Objective: To observe the occurrence of acute kidney injury in patients with nephrotic syndrome and analyze the factors that may lead to the occurrence of acute kidney injury in patients, and to guide the development of clinical intervention countermeasures in order to reduce the risk of acute kidney injury. Methods: One hundred and twenty patients with nephrotic syndrome admitted to our hospital between January 2020 and January 2022 were included in the study, and the patients were divided into the occurrence group and the non-occurrence group based on the presence or absence of acute kidney injury, and the baseline data of the two groups were compared to analyze the factors that may lead to the occurrence of acute kidney injury in patients.Results: Among the 120 patients with nephrotic syndrome enrolled, 32 patients had acute kidney injury, including 15 patients of grade 1, 12 patients of grade 2, and 5 patients of grade 3; 88 patients did not have acute kidney injury; compared with the non-occurrence group, the occurrence group had higher age (≥60 years), use of low molecular dextrose (yes), co-infection (yes), irrational use of diuretics (yes), use of glucocorticoids (yes), creatinine ( ≥353.6 umol/L), and urea nitrogen (≥8.0 mmol/L) accounted for a higher proportion, and serum NGAL, IL-18, and neutrophil count were highly expressed (P<0.05); other data were compared between groups (P>0.05); the results of binomial logistic regression analysis showed that age (≥60 years), use of low-molecular dextro-anhydride (yes), co-infection (yes), irrational use of diuretics (yes), use of glucocorticoids (yes), creatinine (≥353.6 umol/L), and urea nitrogen (≥8.0 mmol/L) were all higher, and high expression of serum NGAL, IL-18, and neutrophil count were all influential factors in the development of acute kidney injury in patients with nephrotic syndrome (OR>1, P<0.05). Conclusion: Age, use of low molecular dextran, co-infection, irrational use of diuretics, use of glucocorticoids, creatinine, urea nitrogen, serum NGAL, IL-18, and neutrophil count are all important factors contributing to the increased risk of acute kidney injury in patients with nephrotic syndrome. 2023 Vol. 29 (5): 776-782 [Abstract] ( 46 ) HTML (1 KB)  PDF (1167 KB)  ( 120 ) 782 Diagnostic Value of Fine Needle Aspiration Biopsy of Thyroid Nodules Guided by Conventional Ultrasound and Elastography for C-TI-RADS4 Nodules DING Huajie, NA Lei, GONG Xue, et al DOI: 10.3969/j.issn.1006-6233.2023.05.016 Objective: To investigate the diagnostic value of fine needle aspiration biopsy of thyroid nodules guided by conventional ultrasound and elastography for C-TI-RADS4 nodules.Methods:A total of 141 patients with 141 nodules who had undergone surgical resection of thyroid nodules from June 2019 to December 2021 at our hospital were retrospectively analyzed, and all nodules were classified as C-TI-RADS4. All nodules were subjected to conventional ultrasound and elastography strain-rate ratio-guided fine needle aspiration biopsy of the thyroid gland (US-FNAB, E-US-FNAB) to obtain cytopathological results, which were eventually compared with postoperative histopathological results to analyze the diagnostic value of conventional ultrasound and elastography-guided fine needle aspiration biopsy of thyroid nodules for C-TI-RADS4 category nodules.Results: For 141 C-TI-RADS4 category thyroid nodules, the sensitivity, specificity, accuracy, positive and negative predictive values of conventional ultrasound-guided fine-needle aspiration biopsy of thyroid nodules were 86.5%, 86.7%, 86.5%, 96%, and 63.4%, respectively; the sensitivity, specificity, accuracy, positive and negative predictive values of elastography-guided fine-needle aspiration biopsy of thyroid nodules were 96.4%, 86.7%, 94.3%, 96.4%, and 86.7%, respectively. The differences between the sensitivity, accuracy and negative predictive values were statistically significant (χ2=6.964, χ2=4.956, χ2=4.779, P<0.05); the differences between the specificity and positive predictive values of the two diagnoses were not statistically significant (χ2=0.000, χ2=0.000, P>0.05).Conclusion: Ultrasound elastography guided fine needle aspiration biopsy of thyroid nodule has certain clinical value in the diagnosis of C-TI-RADS4 nodule. 2023 Vol. 29 (5): 782-785 [Abstract] ( 55 ) HTML (1 KB)  PDF (1142 KB)  ( 130 ) 785 Comparison of the Clinical Application of Titanium Nail Intermaxillary Fixation Combined with Elastic Cap-Assisted Fixation Method and Titanium Plate Internal Fixation Combined with Titanium Nail Intermaxillary Traction Method in the Treatment of Mandible Fracture LIU Xiaowen, LIU Zhaogang, TIAN Hongwei, et al DOI: 10.3969/j.issn.1006-6233.2023.05.017 Objective:To compare the effect of titanium nail intermaxillary fixation combined with elastic cap assisted fixation and micro titanium plate internal fixation combined with titanium nail intermaxillary traction on mandibular fracture. Methods: A total of 102 patients with mandibular fracture admitted to our hospital from January 2020 to October 2022 were included in the study. All patients were divided into observation group and control group according to the computer randomization method. The observation group patients (n=51) were treated with titanium nail intermaxillary fixation combined with elastic cap assisted fixation treatment, and the control group patient(n=51) was treated with titanium plate internal fixation combined with titanium nail intermaxillary traction method. The postoperative efficacy of patients was evaluated, and the oral hygiene of patients before and after treatment was compared, including the Community Periodontal Treatment Scale Index (CPI), Gingival Index (GI), and Soft Dirt Index (DI). The patients' chewing and oral functions was analyzed, the patients' maxillofacial conditions was evaluated, the patients' adverse reactions after surgery was counted, and their incidence was calculated. Results: After treatment, there was no significant difference in the response rate (90.38%) and the control group (94.23%) (P>0.05). CPITN, GI and DI indexes increased in both treated groups, and increased more in the observation group than in the control group (P<0.05). After treatment, the lower scores of chewing, opening function and maxillofacial condition in the observation group were greater than in the control group (P<0.05). The incidence of adverse reactions in the observation group was 9.62%, lower than that in the control group (25.49%), with a statistically significant difference (P<0.05). Conclusion: The titanium nail intermaxillary fixation combined with elastic cap assisted fixation can shorten the treatment time of patients with mandibular fracture, improve the oral hygiene of patients after surgery, promote the recovery of patients' maxillofacial region, and reduce the occurrence of adverse reactions. 2023 Vol. 29 (5): 785-789 [Abstract] ( 55 ) HTML (1 KB)  PDF (1435 KB)  ( 149 ) 790 Application of Methotrexate Combined with UACE in the Removal of Pregnancy Substances in CSP Patients SHI Ping, GENG JiaoJiao, et al DOI: 10.3969/j.issn.1006-6233.2023.05.018 Objective: To investigate the application effect of methotrexate combined with uterine arterial chemoembolization (UACE) in the removal of pregnancy substances in patients with cesarean scar pregnancy (CSP). Methods: A total of 84 CSP patients admitted to our hospital from May 2020 to December 2021 were selected and divided into an observation group and a control group according to the random number table method, with 42 cases in each. The control group was given methotrexate, and the observation group was given methotrexate combined with UACE. The data were compared including clinical efficacy, general operation, disappearance time of pregnancy substance, time to return to normal blood β-HCG, ovarian function indexes [follicle-stimulating hormone]. (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (PROG)], and occurrence of complications. Results: The total effective rates of the observation group and the control group were 97.62% and 83.33%, respectively. The observation group had higher effective rate than the control group (P<0.05). The intraoperative blood loss in the observation group was significantly less than that in the control group, and the hospital stay was significantly shorter than that in the control group (P<0.05), while there was no significant difference in operation time between the two groups (P>0.05). The time to disappearance of pregnancy material and the time to normalization of blood β-HCG in the observation group were significantly earlier than those in the control group (P<0.05). There was no significant difference in the effect of different treatment methods on ovarian function indexes between the two groups at 3 and 6 months after operation (P>0.05). The incidence of complications in the observation group and the control group were 7.14% and 11.90%, respectively, and the difference was not statistically significant (P>0.05). Conclusion: Methotrexate combined with UACE has good curative effect on CSP patients, can effectively improve the symptoms of patients, reduce intraoperative blood loss and shorten the hospitalization time, and at the same time effectively remove pregnancy substance, and has less impact on ovarian function and fewer complications. 2023 Vol. 29 (5): 790-794 [Abstract] ( 43 ) HTML (1 KB)  PDF (1159 KB)  ( 62 ) 794 Relationship between Left Ventricular Dysfunction and Serum Levels of 25 Hydroxyvitamin D D-Dimer and APTT in Patients with Hyperthyroidism SONG Huijie, LI Yang, XIAO Fangxi, et al DOI: 10.3969/j.issn.1006-6233.2023.05.019 Objective: To investigate the occurrence of left ventricular dysfunction in patients with hyperthyroidism and its relationship with serum levels of 25 hydroxyvitamin D [25 (OH) D], brain natriuretic peptide (BNP). Methods: 71 patients with hyperthyroidism combined with left ventricular dysfunction treated in our hospital from January 2021 to June 2022 (observation group) were selected, including 41 patients with left ventricular systolic dysfunction and 30 patients with left ventricular diastolic dysfunction. At the same time, 71 patients with simple hyperthyroidism (control group) were selected. The differences in clinical data of each group were compared, and the differences in echocardiographic parameters of patients with left ventricular systolic dysfunction and left ventricular diastolic dysfunction were analyzed. Results: The course of hyperthyroidism in the observation group was (21.32 ± 3.48) months, which was significantly higher than that in the control group (P<0.05). BNP in the observation group was (2.81± 0.72) ng/L, which was significantly higher than that in the control group (P<0.05), while 25 (OH) D was (15.12 ± 4.22) ng/ml, respectively, which were significantly lower than that in the control group (P<0.05). BNP of patients with left ventricular systolic dysfunction was (2.98 ± 0.60) ng/L, which was significantly higher than that of patients with diastolic dysfunction (P<0.05), while 25 (OH) D were (13.83 ± 3.11) ng/ml, which were significantly lower than those of patients with left ventricular diastolic dysfunction (P<0.05). 25 (OH) D was positively correlated with LVEF (r=0.665, P<0.05); BNP was negatively correlated with LVEF (r=-0.759, P<0.05), but positively correlated with E/A (r=0.787, P<0.05). The ROC area under the curve diagnosised by 25 (OH) D, BNP for left ventricular dysfunction were 0.837 and 0.951, respectively, P<0.05. Conclusion: In patients with hyperthyroidism and left ventricular dysfunction, the BNP level increase significantly, and 25 (OH) D decrease significantly, which has certain application value in diagnosis left ventricular dysfunction. 2023 Vol. 29 (5): 794-799 [Abstract] ( 53 ) HTML (1 KB)  PDF (1270 KB)  ( 100 ) 799 Analysis of the Application of Bridging Combined System for Femoral Shaft Fractures in School-Age Children NIAN Zhenghao, et al DOI: 10.3969/j.issn.1006-6233.2023.05.020 Objective: To investigate the effect of bridging combination system on femoral shaft fractures in school-age children. Methods: A total of 85 pediatric patients with femoral shaft fracture admitted to our hospital from January 2019 to January 2022 were selected for study. By random number table, they were divided into study group (43 cases) and control group (42 cases) by simple random method. The control group was treated with locking compression plate fixation and the study group was treated with a bridging combination system. The surgical data, fracture healing time and complications of the two groups were compared. The Johner-Wruh functional evaluation criteria were used to evaluate the limb function of the two groups 6 months after surgery. Results: There was no significant difference in incision length between the two groups (P>0.05), but the operation time, blood loss and postoperative drainage volume of the study group were significantly less than that of the control group (P<0.05), the fracture healing time of the study group was shorter than that of the control group, and the incidence of complications was lower than that of the control group (P<0.05). The optimal rate of Johner-Wruh function in the study group was 88.37%, which was higher than 47.62% in the control group (P<0.05). Conclusion: The bridging combination fixation system has obvious effect in the treatment of femoral shaft fractures in school-age children, with short healing time and rare complications. It also has a positive effect on postoperative limb function recovery and has high application value. 2023 Vol. 29 (5): 799-802 [Abstract] ( 40 ) HTML (1 KB)  PDF (1132 KB)  ( 83 ) 802 The Value of Two-Dimensional Imaging Features and CDFI Blood Flow Characteristics in the Diagnosis of the Nature of Thyroid Nodules and the Relationship with Invasiveness LIU Huiming, CUI Jingjing, LI Hongyu, et al DOI: 10.3969/j.issn.1006-6233.2023.05.021 Objective: To explore the value of two-dimensional ultrasonography and color Doppler flow imaging (CDFI) flow characteristics in diagnosing the nature of thyroid nodules (TNS) and their correlation with invasiveness.Methods: From February 2021 to February 2022, 146 patients with TNS in our hospital were selected and examined by 2D ultrasound and CDFI, and the pathological findings were used as the "gold standard" to compare the general data, 2D ultrasound characteristics, CDFI flow abundance, flow parameters [resistance index (RI), peak systolic flow velocity (PSV)] between malignant and benign TNS patients. The study compared CDFI flow parameters and expression of invasive genes [metalloproteinase dissociin 9 (ADAM9) and chemokine receptor 4 (CXCR4)] in patients with malignant TNS with those without cervical lymph node metastasis, and analyzed the relationship between CDFI flow parameters and malignant TNS lesions.The relationship between the expression of invasion genes in tissues and the value of diagnosing cervical lymph node metastasis.Results: Among the 146 TNS patients in this study, 52 were confirmed to be malignant TNS by pathological examination, and 94 were benign TNS; the 2D ultrasonic features of microcalcified foci, hypoechogenicity, proportion of peripheral anechoic halo, CDFI flow abundance, RI, and PSV were higher in patients with malignant TNS than in patients with benign TNS (P<0.05);the sensitivity, specificity and accuracy of 2D ultrasonography and CDFI in the differential diagnosis of benign and malignant TNS were 73.08%, 78.72%, and 76.71%, respectively; the expression of RI, PSV and ADAM9 and CXCR4 genes in focal tissues was higher in patients with malignant TNS with cervical lymph node metastasis than in those without cervical lymph node metastasis (P<0.05); there was a positive correlation between RI, PSV and ADAM9 and CXCR4 gene expression in focal tissues in patients with malignant TNS (P<0.05);The area under the curve (AUC) of combined RI and PSV for the diagnosis of cervical lymph node metastasis in patients with malignant TNS was 0.906, with diagnostic sensitivity and specificity of 94.74% and 93.94%, respectively.Conclusion: 2D ultrasonography and CDFI have good value in the differential diagnosis of benign and malignant TNS, and CDFI blood flow parameters are closely related to the invasiveness of malignant TNS, which can provide a reliable reference for clinical diagnosis of cervical lymph node metastasis in patients with malignant TNS. 2023 Vol. 29 (5): 802-808 [Abstract] ( 64 ) HTML (1 KB)  PDF (2253 KB)  ( 164 ) 808 Maximum Standardized Uptake Value of SPECT/CT and Serum ALP N-MID TPINP Levels in Patients with Lung Cancer Bone Metastasis and Their Significance TAN Guowei, et al DOI: 10.3969/j.issn.1006-6233.2023.05.022 Objective: To investigate the significance of the maximum standardized uptake value (SUVmax) of single photon emission computed tomography(SPECT)/computed tomography(CT), serum alkaline phosphatase (ALP), N-terminal intermediate molecular fragment of osteocalcin (N-MID), and total type I procollagen N-terminal prepreptide (TPINP) in patients with bone metastasis from lung cancer. Methods: A total of 107 lung cancer patients treated in our hospital from January 2021 to June 2022 were selected, including 37 patients with bone metastasis and 70 patients without bone metastasis, the differences of SUVmax, ALP, N-MID and TPINP between patients with bone metastasis and patients without bone metastasis were compared, and the relationship between SUVmax, ALP, N-MID and TPINP and clinicopathological characteristics was analyzed, as well as the value of ALP, N-MID and TPINP in diagnosing bone metastasis. Results: The ALP, N-MID and TPINP of patients with bone metastasis were (120.30 ± 33.32) U/L, (19.03 ± 3.54) μg/L and (82.21 ± 26.65) μg/L, respectively, which were significantly higher than those of patients without bone metastasis (P<0.05), while the lumbar bone mineral density (BMD) was (0.82 ± 0.12), (0.74 ± 0.11) and (0.66 ± 0.14), respectively, which was significantly lower than that of patients without bone metastasis (P<0.05). SUVmax in patients with adenocarcinoma was (11.45 ± 1.98), which was significantly lower than that in patients with squamous cell carcinoma and other types (P<0.05). The SUVmax of tumor diameter>5cm and TNM stage Ⅲ~Ⅳ were (13.38 ± 1.95) and (12.99 ± 2.00) respectively, which were significantly higher than those of patients with treatment diameter ≤ 5cm and TNM stage Ⅰ~Ⅱ (P<0.05). ALP, N-MID and TPINP in TNM stage Ⅲ~Ⅳ were (110.39 ± 21.12) U/L, (18.62 ± 2.22) μg/L and (70.31 ± 17.02) μg/L respectively, which were significantly higher than those in TNM stage Ⅰ~Ⅱ patients (P<0.05). The area under ROC curve of ALP, N-MID and TPINP in diagnosing bone metastasis was 0.695, 0.734 and 0.837 respectively (P<0.05). Conclusion: Compared with lung cancer patients with without bone metastasis, the levels of ALP, N-MID and TPINP in lung cancer patients with bone metastasis are significantly higher, while SUVmax has no significant difference; SUVmax, ALP, N-MID and TPINP have a certain relationship with the clinicopathological characteristics of lung cancer patients. Among them, ALP, N-MID and TPINP have a certain application value in the diagnosis of bone metastasis of lung cancer. 2023 Vol. 29 (5): 808-814 [Abstract] ( 80 ) HTML (1 KB)  PDF (1224 KB)  ( 139 ) 814 Effect of Inhaled Coricosteroids on Serum TNF-α HDAC2 and PTX3 Levels in Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease LIU Ting, LI Yang, SHI Zhihong, et al DOI: 10.3969/j.issn.1006-6233.2023.05.023 Objective: To observe the effects of inhaled coricosteroids on the levels of serum tumor necrosis factor-α (TNF-α), histone deacetylase 2 (HDAC2) and pentraxin 3 (PTX3) in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: One hundred and thirty patients with AECOPD admitted to our hospital from January 2020 to December 2021 were selected and divided into two groups using the coin toss grouping method. Both groups were given conventional symptomatic treatment, the control group was additionally given terbutaline nebulizer inhalation treatment, and the observation group was treated with combined inhaled corticosteroids on the basis of the control group. The differences of symptom and sign scores, pulmonary function, blood routine, TNF-α, HDAC2 and PTX3 were compared between the two groups, and the adverse effects were counted in both groups. Results: Before treatment, there was no statistically significant difference between the two groups in terms of symptom and sign scores and pulmonary function (P>0.05). Compared with before treatment, the scores of cough, sputum, shortness of breath, and lung auscultation decreased after treatment in both groups, and the decrease values were greater in the observation group before and after treatment than in the control group (P<0.05). The first second force expiratory volume (FEV1) and FEV1/forced vital capacity (FVC) increased after treatment in both groups, and the increased values were greater in the observation group before and after treatment than in the control group (P<0.05).Before treatment, there were no statistically significant differences in TNF-α, HDAC2, PTX3, and routine blood indices between the two groups (P>0.05). Compared with before treatment, neutrophil percentage (NE%), TNF-α, neutrophil-to-lymphocyte ratio (NLR), HDAC2, white blood cell count (WBC), and PTX3 decreased after treatment in both groups, and the decrease value was greater in the observation group before and after treatment than in the control group (P<0.05). Lymphocyte percentage (LY%) increased in both groups after treatment, and the increase was greater in the observation group before and after treatment than in the control group (P<0.05). Two cases of hoarseness and one case of hoarseness occurred in the control group and the observation group, respectively, and no adverse reactions such as pharyngeal discomfort and blood glucose elevation occurred.Conclusion: Inhaled coricosteroids for AECOPD can reduce symptoms such as cough and sputum and improve lung function, which may be related to reducing the expression of TNF-α, HDAC2 and PTX3. 2023 Vol. 29 (5): 814-819 [Abstract] ( 54 ) HTML (1 KB)  PDF (1179 KB)  ( 84 ) 819 Association of VILIP-1 Annexin A2 and sEPCR with Outcomes of Acute Emergency Department Cerebral Infarction Patients after Intravenous Thrombolysis WANG Gang, GONG Bo, YU Zhiguo, et al DOI: 10.3969/j.issn.1006-6233.2023.05.024 Objective: To investigate the relationship between visinin-like protein-1 (VILIP-1), Annexin A2, soluble vascular endothelial cell protein C receptor (sEPCR) and outcomes of patients with acute cerebral infarction (ACI) after intravenous thrombolysis. Methods: A total of 203 ACI patients treated in the emergency department of our hospital from January 2020 to January 2022 were retrospectively selected as the ACI group, and divided into good outcome group (n=158) and poor outcome group (n=45) according to the outcomes of patients after intravenous thrombolysis, and 100 healthy people who underwent physical examination in our hospital during the same period were selected as the healthy group. The levels of VILIP-1, Annexin A2, sEPCR were detected, and the relationship between VILIP-1, Annexin A2 and sEPCR and the condition of ACI patients was analyzed. The general data of the good outcome group and the poor outcome group, as well as the dynamic change trend of the levels of VILIP-1, Annexin A2 and sEPCR before, immediately after and 2h after intravenous thrombolysis were compared. The difference between VILIP-1, Annexin A2, and sEPCR before thrombolysis and 2h after thrombolysis (△VILIP-1, △Annexin A2, △sEPCR) was calculated to clarify the value of △VILIP-1, △Annexin A2, and △sEPCR in diagnosing the outcome of ACI patients. Results: VILIP-1[8.12±1.09 (μg/mL) vs 8.12±1.09 (μg/mL)] and sEPCR[145.63±20.93 (μg/L) vs 100.32±10.54 (μg/L)] in ACI group were higher than those in healthy group. Annexin A2[17.14±1.63 (ng/mL) vs 34.34±2.76 (ng/mL)] was lower than that in the healthy group (t=64.740, 20.400, 67.980, all P<0.05). As the condition of ACI patients worsened, VILIP-1 [6.54±0.78 (μg/mL) vs 10.98±1.44 (μg/mL) vs 13.42±1.56 (μg/mL)], sEPCR [119.98±20.93 (μg/L) vs 135.32±15.64 (μg/L) vs 156.82± 16.74 (μg/L)] were elevated and Annexin A2 [25.63±2.31 (ng/mL) vs 19.08±1.88 (ng/mL) vs 13.42±1.09 (ng/mL)] were decreased (F=45.517, 15.633, 53.977, all P<0.05). Conclusion: VILIP-1 and sEPCR decreased and Annexin A2 increased during intravenous thrombolytic therapy for acute cerebral infarction, which can dynamically monitor the changes of the above indicators to early diagnose and predict the outcomes of patients and improve the prognosis of patients. 2023 Vol. 29 (5): 819-826 [Abstract] ( 57 ) HTML (1 KB)  PDF (1568 KB)  ( 228 ) 826 Correlation between Partial Indicators and Ratios of Blood Lipid Profiles and Severity of Coronary Artery Lesion in Elderly Patients with Hypertension and Coronary Artery Disease LIN Xiu, YANG Yuanrui, WU Jie, et al DOI: 10.3969/j.issn.1006-6233.2023.05.025 Objective: To explore the correlation between partial indicators and ratios of blood lipid profiles and severity of coronary artery lesion in elderly patients with hypertension and coronary artery disease. Methods: A total of 125 elderly patients with hypertension and coronary artery disease during the period from January 2019 to January 2022 were enrolled as the research subjects. Coronary angiography (CAG) was performed and fasting blood lipids [triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C)] were detected among all patients. Gensini (GS) score was performed according to the CAG detection results, and the patients were divided into high score group (n=38), medium score group (n=45), and low score group (n=42). The blood lipids indicators and blood lipids ratios (TG, TC, HDL-C, LDL-C, VLDL-C, TC/TG, TG/HDL-C, TG/LDL-C, LDL-C/HDL-C) were compared among the three groups of patients, and the correlation between blood lipids indicators, blood lipids ratios and GS score was analyzed. Taking GS score as the dependent variable and blood lipids indicators and blood lipids ratios as the independent variables, multivariate linear regression analysis was carried out, and the indicators with correlation with GS score after multivariate adjustment were screened out. Results: The TC and LDL-C in low score group, medium score group and high score group were all increased in turn (P<0.05), and the differences between groups were statistically significant (P<0.05), while there were no statistically significant differences in the levels of TG, HDL-C and VLDL-C among the three groups (P>0.05). TC/TG and LDL-C/HDL-C were increased in sequence (P<0.05) while TG/LDL-C was reduced in sequence (P<0.05) in low score group, medium score group, and high score group and the differences between the groups were statistically significant (P<0.05). Pearson correlation analysis showed that TC, LDL-C, TC/TG and LDL-C/HDL-C were positively correlated with GS score (P<0.05), while TG/LDL-C was negatively correlated with GS score (P<0.05). Multivariate linear regression analysis showed that LDL-C/HDL-C was an independent influencing factor of GS score (P<0.05). Conclusion: TC, LDL-C, TC/TG, LDL-C/HDL-C and TG/LDL-C have certain correlation with the severity of coronary artery lesion in elderly patients with hypertension and coronary artery disease. LDL-C/HDL-C can be used as an ideal indicator to assess the severity of coronary artery lesion. 2023 Vol. 29 (5): 826-831 [Abstract] ( 52 ) HTML (1 KB)  PDF (1186 KB)  ( 126 ) 831 Significance of S100A6 Protein Expression in Thyroid Carcinoma JIANG Yansong, ZHANG Bingxin, BAI Jiming, et al DOI: 10.3969/j.issn.1006-6233.2023.05.026 Objective: To investigate the expression and clinical significance of S100A6 protein in thyroid carcinoma tissue, and to provide a favorable basis for clinical evaluation of the disease. Methods: One hundred and twenty patients with thyroid carcinoma admitted to our hospital from August 2016 to August 2021 were selected as the study group, and 120 patients with benign thyroid nodules in the same period were selected as the control group, and paraffin sections were taken for immunohistochemical staining to detect the expression level of S100A6 protein. Results: The positive rates of S100A6 protein expression were 12.50%, 81.25%, 30.00% and 13.46% in benign thyroid nodular, papillary thyroid carcinoma, medullary thyroid carcinoma and follicular carcinoma thyroid, respectively. As seen from Table 2, pairwise comparison showed that the positive rate of benign thyroid nodules and papillary thyroid carcinoma was statistically significant (P<0.05). The positive rate of benign thyroid nodules and medullary carcinoma was statistically significant (P<0.05). The comparison of the positive rate of benign thyroid nodules with follicular thyroid carcinoma was not statistically significant by statistical analysis (P>0.05). In contrast, the positive rate of papillary and medullary thyroid carcinoma compared with follicular thyroid carcinoma was statistically significant by statistical analysis (P<0.05). Conclusion: S100A6 protein is highly expressed in papillary thyroid carcinoma tissue, which can be used as an important biological indicator. At the same time, S100A6 protein can also be used as a predictor of thyroid carcinoma metastasis. 2023 Vol. 29 (5): 831-834 [Abstract] ( 42 ) HTML (1 KB)  PDF (2604 KB)  ( 81 ) 834 Effects of Budesonide Nebulization Combined with PCV Lung Recruitment Maneuver on Hemodynamics Oxygenation Status and Inflammatory Response in Patients with ARDS LIU Qiuyu, WANG Simei, ZHANG Dan, et al DOI: 10.3969/j.issn.1006-6233.2023.05.027 Objective: To observe the effect of budesonide nebulization combined with pressure controlled ventilation (PCV) lung recruitment method on hemodynamics, oxygenation status and inflammatory response in patients with acute respiratory distress syndrome (ARDS). Methods: A total of 103 patients with ARDS admitted in our hospital from February 2019 to May 2022 were selected and divided into control group (51 cases) and observation group (52 cases) by simple randomization method. Both groups were intervened with PCV lung recruitment maneuver. The observation group was given budesonide nebulization treatment, and the control group was given 0.9% sodium chloride solution nebulization treatment. The oxygenation status, hemodynamics and inflammatory reaction levels were compared between the two groups, and the duration of mechanical ventilation, length of stay in ICU and mortality were recorded. Results: Before treatment, there were no significant statistical differences in oxygenation-related indexes and hemodynamics between the two groups (P>0.05). After treatment, the arterial oxygen partial pressure (PaO2), oxygenation index (PaO2/FiO2) and central venous pressure (CVP) in both groups were significantly higher than before treatment, while the mean arterial pressure (MAP) and heart rate (HR) were significantly lower than before treatment. The comparison between groups suggested that the oxygenation status index in the observation group was higher than that in the control group after treatment. The difference was statistically significant (P<0.05), while there was no significant statistical difference in hemodynamics between the observation group and the control group after treatment (P>0.05). The differences of oxygenation status index, MAP and CVP in the observation group before and after treatment were greater than that in the control group, and the difference was statistically significant (P<0.05), while the difference of HR before and after treatment was not statistically significant (P>0.05). Before treatment, there was no significant statistical difference in inflammatory reaction between the two groups (P>0.05). After treatment, the neutrophil to lymphocyte ratio (NLR), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and procalcitonin (PCT) in both groups were significantly decreased compared with that before treatment, and the comparison between the two groups suggested that the inflammatory indexes in the observation group was significantly lower than those in the control group after treatment, while the difference before and after treatment was larger than that in the control group (P<0.05). The mechanical ventilation time and ICU stay time in the observation group were shorter than those in the control group, and there was no significant statistical difference in mortality between the observation group and the control group (P>0.05). Conclusion:Budesonide nebulization combined with PCV lung recruitment maneuver in the treatment of ARDS can improve the hemodynamics and oxygenation status of patients, reduce the inflammatory response, and promote the recovery of patients. 2023 Vol. 29 (5): 834-839 [Abstract] ( 45 ) HTML (1 KB)  PDF (1179 KB)  ( 57 ) 839 The Study of Cone Beam CT Image Registration Based on Different Anatomical Markers in Lung Cancer Radiotherapy YUAN Yajie, et al DOI: 10.3969/j.issn.1006-6233.2023.05.028 Objective: To explore the effect of image registration with different anatomical structures on the results of lung cancer patients in radiotherapy, and to provide a basis for the optimal selection of anatomical structures in image registration of image guided radiotherapy for lung cancer. Methods: From June 2021 to August 2022, 43 lung cancer patients who received chest radiation therapy in Chengde Central Hospital were selected. All patients received image guided intensity-modulated radiation therapy. In 29 patients with central lung cancer, the thoracic vertebrae, sternum, trachea, tracheal ramus, and tumor were used as the anatomical structures, and in the other 14 patients with peripheral lung cancer, the thoracic vertebrae, tumor, affected ribs, and ribs near the tumor union were used as the anatomical structures. (The error values in X (left and right), Y (head and foot) and Z (front and back) directions were recorded, and the error values obtained from the registration of the tumor group as the control group were compared with those of the other groups to analyze the causes of the errors. Results:In the central type of lung cancer, the error value of each anatomical structure is the smallest in the tumor group, followed by the trachea carina group, thoracic vertebrae group, trachea group, and the sternum group, and the sternum group had the largest error values. The results of one-way ANOVA showed that the differences were mainly reflected on the Y and Z axes (F=3.329, P=0.012; F=0.033, P=0.022). Further statistical analysis showed that the difference between Y axis and Z axis was mainly between sternum group and tumor group. In peripheral lung cancer, the error values in ascending order are: the rib near the tumor joint, the rib at the affected side, the thoracic spine, and the tumor. The error value is statistically significant on the X and Z axes (F=3.63, P=0.019; F=2.889, P=0.044). In addition, the error values of the affected rib group and the rib group near the tumor union were statistically significant compared with the error values of the tumor group. Conclusion:Anatomical structure selection during image registration of lung cancer image-guided radiotherapy: tumor combined with adjacent ribs as the registration structure of peripheral lung cancer is preferred; trachea carina, thoracic vertebra and trachea can be used as the registration structure of central lung cancer; trachea carina and thoracic vertebra are preferred. 2023 Vol. 29 (5): 839-843 [Abstract] ( 76 ) HTML (1 KB)  PDF (1165 KB)  ( 100 ) 844 Curative Effect of INFIX and External Fixator Combined with Sacroiliac Screw on Tile Type B Fracture CHEN Lin, LIU Dong, WANG Zhiqiang, et al DOI: 10.3969/j.issn.1006-6233.2023.05.029 Objective: To explore the curative effect of internal fixation (INFIX) and external fixator combined with sacroiliac screw on Tile type B fracture. Methods: A total of 88 patients with Tile type B fracture admitted to Orthopedics Department of the hospital were retrospectively analyzed between March 2019 and March 2022, including 47 cases treated with INFIX and sacroiliac screws in INFIX group and 41 cases treated with external fixator and sacroiliac screws in external fixator group. The operation time, intraoperative blood loss, hospitalization time, postoperative weight-bearing time, healing time, incidence of complications, scores of Matta and Majeed, and scores of EQ-5D and VAS at 1, 3 and 6 months after surgery were compared between the two groups. Results: The hospitalization time and healing time in INFIX group were shorter than those in external fixator group, and the incidence of complications was lower than that in external fixator group (P<0.05). At 6 months after surgery, good rate of Matta score in INFIX group was higher than that in external fixator group (95.74% vs 80.49%, P<0.05), and sex life score was higher than that in external fixator group (P<0.05). The differences in EQ-5D and VAS scores were statistically significant in different groups at different time points (P<0.0001). At 1 month and 3 months after surgery, EQ-5D score in INFIX group was higher than that in external fixator group, and VAS score was lower than that in external fixator group (P<0.05). Conclusion: The clinical curative effect of INFIX combined with sacroiliac screw is better on Tile type B fracture, with shorter recovery period. It is more conducive to early functional exercise, with low incidence of complications. 2023 Vol. 29 (5): 844-849 [Abstract] ( 76 ) HTML (1 KB)  PDF (1512 KB)  ( 231 ) 849 Study on the Diagnosis and Prognosis of AECOPD Combined with Respiratory Failure by Serum Pro-BNP hs-CRP and FIB Levels LIU Jiamin, et al DOI: 10.3969/j.issn.1006-6233.2023.05.030 Objective: To explore the levels of serum pro-brain natriuretic peptide (pro-BNP), high-sensitivity C-reactive protein (hs-CRP), and plasma fibrinogen (FIB) in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure and the evaluation of prognosis. Methods: A total of 72 patients with AECOPD complicated with respiratory failure who were admitted to the hospital from January 2017 to December 2021 were selected as group A, 71 patients with AECOPD without respiratory failure were selected as group B, and 71 patients with stable COPD who underwent reexamination were included in group C. The first second expiratory volume (FEV1) and peak expiratory flow rate (PEF) before treatment in the three groups of patients were detected, blood and separate serum for pro-BNP, hs-CRP and FIB were collected, the differences of the above indexes in patients with AECOPD combined with respiratory failure, simple AECOPD and stable COPD patients were analyzed, and the relationship between pro-BNP, hs-CRP and FIB and FEV1 and PEF in patients with AECOPD combined with respiratory failure were studied. The relationship between pro-BNP, hs-CRP and FIB with FEV1 and PEF was investigated among patients with AECOPD and respiratory failure, and the value of pro-BNP, hs-CRP and FIB in guiding the diagnosis of AECOPD with respiratory failure was explored. According to the survival status, the patients were divided into survival group and death group, and the laboratory indicators detected after admission were classified and recorded to explore the value of pro-BNP, hs-CRP and FIB on guiding the prognosis prediction of AECOPD with respiratory failure. Results: FEV1/FVC and PEF were lower in groups A and B than those in group C (P<0.05), and were lower in group A than in group B (P<0.05). The levels of pro-BNP, hs-CRP and FIB were higher in group A and group B than in group C (P<0.05), and higher in group A than in group B (P<0.05). The maximum pro-BNP Yordon index corresponds to a cut-off of 299.95 ng/L and an AUC of 0.878 for the diagnosis of AECOPD combined with respiratory failure, with diagnostic sensitivity and specificity of 86.36% and 86.21%; the maximum hs-CRP Yordon index corresponds to a cut-off of 12.01 mg/L and an AUC of 0.838, with predictive sensitivity and specificity of 70.00% and 88.89%, respectively; the maximum FIB Yordon index corresponds to a cut-off of 4.89 g/L and an AUC of 0.772. The sensitivity and specificity were 70.00% and 88.89%, respectively; the maximum FIB Yordon index corresponded to a cut-off of 4.89 g/L and an AUC of 0.772, with a diagnostic sensitivity and specificity of 75.21% and 75.93%. Predictive prognostic efficacy: pro-BNP, hs-CRP and FIB were higher in the death group than in the survival group (P<0.05), and pro-BNP predicted poor prognosis of AECOPD combined with respiratory failure with a maximum Yordon index corresponding to a cut-off of 367.03 ng/L and an AUC of 0.854, with diagnostic sensitivity and specificity of 88.24% and The maximum hs-CRP Yordon index corresponded to a cut-off of 17.69 mg/L and an AUC of 0.795, with a predictive sensitivity and specificity of 76.47% and 86.67%, respectively; the maximum FIB Yordon index corresponded to a cut-off of 5.99 g/L and an AUC of 0.781, with a diagnostic sensitivity and specificity of 82.35% and 82.22%, respectively.Conclusion: The abnormally elevated levels of serum pro-BNP, hs-CRP and FIB in patients with AECOPD complicated with respiratory failure are related to the pulmonary function indicators of FEV1/FVC and PEF, and serum pro-BNP, hs-CRP and FIB have high value in the diagnosis and prognosis evaluation of AECOPD with respiratory failure. 2023 Vol. 29 (5): 849-855 [Abstract] ( 46 ) HTML (1 KB)  PDF (1313 KB)  ( 67 ) 855 Neuroelectrophysiological Characteristics of Peripheral Neuropathy with Impaired Glucose Regulation GE Jing, ZOU Li, FU Chunyan, et al DOI: 10.3969/j.issn.1006-6233.2023.05.031 Objective: To investigate the characteristic neurophysiological analysis of peripheral neuropathy with impaired glucose regulation and the diagnostic value of the Toronto Clinical Scoring System for the combination of peripheral neuropathy with impaired glucose regulation, and to provide clinicians with information for the early detection of peripheral neuropathy in patients with impaired glucose regulation.Methods: The data of 200 subjects admitted to our hospital from January 2021 to December 2022 were selected as the study group, and all subjects had a score of no less than 6 on the Toronto Clinical Scoring System. There were 68 patients with impaired fasting glucose, 66 patients with abnormal glucose tolerance and 66 patients with type 2 diabetes mellitus. They were divided into three groups, namely impaired fasting glucose + peripheral neuropathy - group A, abnormal glucose tolerance + peripheral neuropathy - group B and diabetic peripheral neuropathy - group C. Meanwhile, 200 cases of healthy physical examiners were selected as the control group during the same period.Results: As seen in the sensory nerve conduction test, the SCV and SNAP wave amplitudes of the median nerve in the study group were significantly lower than those of the control group, and the difference was statistically significant by statistical analysis (P<0.05); the SCV and SNAP wave amplitudes of the median nerve in group C were significantly lower than those of groups A, B and the control group; the SNAP wave amplitudes of the gastrocnemius and superficial peroneal nerve in the study group were significantly lower, and the difference was statistically significant when compared with the control group ( P<0.05); superficial peroneal nerve and peroneal nerve SCV were reduced in both groups B and C, which were statistically significant when compared with the control group (P<0.05); there was no statistically significant difference between the control group and group A in terms of peroneal nerve and superficial peroneal nerve SCV (P>0.05); median, superficial peroneal and peroneal nerve SNAP wave amplitude and SCV in group C were significantly lower than those in group A, which were statistically significant by sub-statistical analysis (P<0.05); the ulnar nerve SNAP and SCV wave amplitudes in group A, group B, group C and control group were not statistically significant by statistical analysis (P>0.05). In the motor nerve conduction test, it was seen that the MCV and CMAP wave amplitudes of the median nerve, tibial nerve and common peroneal nerve were significantly lower in group C compared with the control group, and the DML was seen to be prolonged compared with the control group (P<0.05); in group B compared with the control group, it was seen that the CMAP wave amplitudes of the median nerve, tibial nerve and common peroneal nerve were significantly lower, the DML was seen to be prolonged, and the MCV of the common peroneal nerve and median nerve were significantly lower (P<0.05); CMAP wave amplitude of median nerve and tibial nerve in group A was significantly lower than that in the control group, which was statistically significant (P<0.05); CMAP wave amplitude of median nerve and common peroneal nerve, MCV of tibial nerve and DML prolongation in group C were significantly slower compared with group A (P<0.05); CMAP wave amplitude of costal nerve in group B was significantly lower compared with group A, and DML had prolongation (P<0.05). The mean latency of F waves of ulnar nerve and tibial nerve in groups A, B and C was significantly higher than that in the control group, which was statistically significant by statistical analysis (P<0.05); the emergence rate of F waves of ulnar nerve and tibial nerve in groups A, B and C was significantly lower than that in the control group (P<0.05); the emergence rate of F waves of ulnar nerve and the mean latency of F waves of tibial nerve in group C were prolonged and all decreased significantly; the tibial nerve in group A was compared with group B There was statistical significance (P<0.05) when comparing the tibial nerve in group A with group B; there was statistical significance (P<0.05) when comparing the appearance rate of ulnar nerve, tibial nerve and F wave in group A with group C.Conclusion: In patients with impaired glucose regulation combined with peripheral neuropathy, the abnormalities of lipid metabolism and dyslipidemia are similar to those of patients with DPN, with elevated levels of triglycerides and low-density lipoproteins predominating. The early manifestations of peripheral neuropathy are not obvious, so neurophysiological examination should be performed early in conjunction with the clinical manifestations of the patient to facilitate early detection and treatment. 2023 Vol. 29 (5): 855-861 [Abstract] ( 50 ) HTML (1 KB)  PDF (1207 KB)  ( 84 ) 861 Effects of Sacubitril/Valsartan and Benazepril Hydrochloride on Serum NT-proBNP cTnT Levels and Cardiac Ultrasound Function Indicators in Patients with Acute Decompensated Heart Failure WANG Niuniu, LU Dasheng, YANG Qingqing, et al DOI: 10.3969/j.issn.1006-6233.2023.05.032 Objective: To analyze the intervention effects of sacubitril/valsartan and benazepril Hydrochloride on patients with acute decompensated heart failure (ADHF). Methods: A total of 126 patients with ADHF who were treated in Department of Emergency Medicine and Department of Cardiovascular Medicine of our hospital between December 2019 and February 2022 were selected and divided into observation group (conventional western medicine+sacubitril/valsartan, n=63) and control group (conventional western medicine+benazepril, n=63) by the non-randomized concurrent control trial and voluntary principle of patients. Both groups were treated for 8 weeks. The cardiac function grading, 6-minute walk test (6MWT), cardiac function ultrasound indicators and serological indicators before and after treatment and adverse drug reactions during treatment were compared between the two groups. The prognosis within 3 months after discharge was recorded in the two groups. Results: During treatment, 1 case was excluded from control group and the remaining 62 effective cases were obtained. The NYHA cardiac function grading and 6MWT distance in the two groups after treatment were significantly improved compared with those before treatment (P<0.05), and the improvement of 6MWT distance before and after treatment in observation group was significantly higher than that in control group [116.17±12.25) VS (99.95±10.64)] (P<0.05). After treatment, the increase of LVEF in observation group was significantly higher than that in control group [(7.73±1.03) VS (4.95±0.89)] while the decreases of LVIDd, LVIDs and LA were significantly lower than those in control group [(-7.74±1.05) VS (-3.60±0.42), (-8.91±1.89) VS (-6.74±1.15), (-4.62±0.51) VS (-1.81±0.20)] (P<0.05). The reductions of serum NT-proBNP, cTnT and CK-MB levels in observation group after treatment were significantly higher compared with those in control group [(1243.25±100.64) VS (1060.88±110.35), (0.07±0.02) VS (0.06±0.01), (14.57±3.27) VS (11.15±4.60)] (P<0.05). The incidence rate of adverse reactions during treatment in observation group was 6.35% (4/63) and was 4.84% (3/62) in control group (P>0.05). During follow-up, there were 6 cases of readmission and 2 cases of all-cause death in observation group, and 10 cases of readmission and 3 cases of all-cause death in control group, and there was no significant difference in the incidence rate of poor prognosis between the two groups (P>0.05). Conclusion: Compared with benazepril hydrochloride, sacubitril/valsartan in the treatment of ADHF can more significantly improve the cardiac function and reduce the levels of serum markers with a better efficacy. 2023 Vol. 29 (5): 861-866 [Abstract] ( 80 ) HTML (1 KB)  PDF (1181 KB)  ( 120 ) 867 Effects of Nifedipine Combined with Enalapril on Blood Lipid Metabolism Vascular Endothelial Function and Inflammatory Response in Elderly Patients with Coronary Artery Disease and Hypertension TIAN Fuxiao, WU Xiaoqin, WANG Jing, et al DOI: 10.3969/j.issn.1006-6233.2023.05.033 Objective: To observe the effect of nifedipine combined with enalapril on vascular endothelial function, lipid metabolism and inflammatory reaction in elderly patients with coronary artery disease and hypertension. Methods: A total of 168 elderly patients with coronary heart disease and hypertension admitted to Zhangye People's Hospital Affiliated to Hexi University from January 2020 to July 2021 were selected as subjects and divided into two groups by odd-even random method. Eighty-two patients in the control group received nifedipine treatment, and 86 patients in the combination group received enalapril treatment on the basis of the control group. The differences of lipid metabolism, vascular endothelial function and inflammatory response were compared between the two groups, and the efficacy and safety of the two groups were evaluated. Results: There was no significant difference in blood lipid metabolism, vascular endothelium-related factors and inflammatory factors between the two groups before treatment (P>0.05); Compared with before treatment, the levels of high-density lipoprotein cholesterol (HDL-C), nitric oxide (NO), apolipoprotein A1 (Apo-A1), C1q tumor necrosis factor associated protein 3 (CTRP3) and apolipoprotein B (Apo-B) in the two groups increased after treatment, and the combined group increased more significantly than the control group (P<0.05); Total cholesterol (TC), endothelin (ET), soluble vascular adhesion factor-1 (sVCAM-1), triglyceride (TG), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), low-density lipoprotein cholesterol (LDL-C), lipoprotein (a) [LP (a)] in the two groups decreased after treatment, and the decrease in the combined group was more significant than that in the control group (P<0.05). The total effective rate of the combined group was 96.51% (83/86), which was higher than 87.80% (72/82) of the control group, with a statistical difference (P<0.05). The adverse reaction rate of the combination group was 4.65% (4/86), compared with 3.66% (3/82) of the control group, there was no statistical difference (P>0.05). Conclusion: Nifedipine combined with enalapril in the treatment of elderly coronary artery disease with hypertension can regulate the metabolism of blood lipids and the expression of CTRP3, sVCAM-1, improve the endothelial function, and improve the efficacy. 2023 Vol. 29 (5): 867-872 [Abstract] ( 53 ) HTML (1 KB)  PDF (1180 KB)  ( 67 ) 872 Analysis of the Effect of Propofol Compounded with Sufentanil Anesthesia and Anesthetic Resuscitation in Patients Undergoing Painless Gastroenteroscopy LIU Wenliang, et al DOI: 10.3969/j.issn.1006-6233.2023.05.034 Objective: To investigate the effect of propofol compounded with sufentanil on anesthetic efficacy and anesthetic resuscitation in patients undergoing painless gastroenteroscopy. Methods: A total of 138 patients who were waiting to undergo painless gastroscopy in our hospital from March 2020 to November 2021 were selected and simply randomly divided into observation and control groups by random number table method, 69 patients in each group. The observation group was given propofol compounded with sufentanil and the control group was given propofol. The hemodynamics, drug dosage and cognitive function were compared between the two groups.Results: There was no significant difference in good rate of anesthesia between the two groups (P>0.05). After anesthesia, mean arterial pressure (MAP) and heart rate (HR) were lower than those before anesthesia in both groups. MAP and HR were increased during gastroscopy and endoscopy, still lower than those before anesthesia (P<0.05). During gastroscopy and endoscopy, MAP and HR were lower in observation group than control group (P<0.05). After anesthesia, there was no significant difference in blood oxygen saturation (SpO2) between the two groups (P>0.05). The dosage of propofol was smaller in observation group than control group, and recovery time after examination was shorter in observation group (P<0.05). At 30 min after examination, score of mini-mental state examination (MMSE) was lower in observation group than control group (P<0.05). There was no significant difference in MMSE scores between the two groups at 1h and 3h after after examination (P>0.05). The difference in incidence of adverse reactions between the two groups was not statistically significant (P>0.05). Conclusion: The application of propofol compounded with sufentanil in patients undergoing painless gastroenteroscopy resulted in stable blood circulation during the operation, reduced dosage of propofol drug, and rapid recovery from anesthesia after completion of the examination. 2023 Vol. 29 (5): 872-876 [Abstract] ( 58 ) HTML (1 KB)  PDF (1155 KB)  ( 318 )

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