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2023 Vol. 29, No. 7 Published: 2023-07-31 1057 The Effect of Exposure to Chronic Intermittent Hypoxia on Hepatic Iron Metabolism in Rats SONG Jixian, CHEN Qi, JIA Cuiling, et al DOI: 10.3969/j.issn.1006-6233.2023.07.01 Objective: To establish a rat model of chronic intermittent hypoxia (CIH) to explore the effect of CIH exposure on hepatic iron metabolism and the specific mechanism. Methods: The CIH rat model was established (the rats were placed in the animal intermittent hypoxia chamber,and the O2 concentration was reduced to 5% by 100% N2 in the first 1.5 min,and the O2 concentration was increased to 21% by 100% O2 in the last 1.5 min.Each cycle lasted for 3min,8h/d,35d).The normoxia control group rats were placed in the same chamber filled with normal air).HE staining was used to observe liver injury.Serum iron and total iron binding capacity (TIBC) were detected by colorimetric method.Iron content in liver was observed by Perls’ staining.The protein expressions of divalent metal-ion transporter-1 [(DMT1(+ire),DMT1(-ire)],Ferroportin 1(FPN1),transferrin receptor 1(TfR1),ferritin light chain (FTL),phosphorylation signal transduction and activator of transcription-3 (p-STAT3) and signal transduction and activator of transcription-3 (STAT3) in liver were detected by Western blot.The mRNA expressions of hepcidin,DMT1(+ire),DMT1(-ire),FPN1,TfR1 and interleukin 6 (IL-6) in liver were detected by Q-PCR. Results: Compared with the control group,the structure of liver cells in CIH group was disordered,with fat vacuoles and nuclear atrophy.Compared with the control group,the mRNA and protein expressions of TfR1 and DMT1 (+ire) in CIH group were significantly increased (P<0.05),and protein expressions of membrane FPN1 were significantly decreased (P<0.05).Compared with the control group,the iron deposition in CIH group was significantly increased,the serum iron content and transferrin saturation were significantly decreased (P<0.01),and the expression of FTL protein was significantly increased (P<0.05).Compared with the control group,the mRNA expression of hepcidin and IL-6 in the liver of rats in CIH group was significantly increased (P<0.05),and the ratio of p-STAT3 / STAT3 was increased (P<0.05). Conclusion: CIH exposure may regulate hepcidin-FPN1 system by affecting IL-6/STAT3 pathway,which may cause iron deposition in liver and further aggravate liver injury. 2023 Vol. 29 (7): 1057-1061 [Abstract] ( 93 ) HTML (1 KB)  PDF (2240 KB)  ( 129 ) 1062 Regulation of Endoplasmic Reticulum Stress by Adenosine A2a Receptor Agonists in Septic Acute Kidney Injury WANG Jingjing, BAYINCHAHAN Boranyi, GUO Junchuan DOI: 10.3969/j.issn.1006-6233.2023.07.02 Objective: To investigate the effects of adenosine A2a receptor agonist on ER stress (ERS) pathway and monocyte chemotactic protein 1 (MCP-1) expression in sepsis acute kidney injury (AKI) model rats. Methods: The experiment was divided into 4 groups,including control group,adenosine A2a receptor agonist (CGS21680) group,model group (AKI) group,and adenosine A2a receptor agonist intervention group (CGS21680+AKI) group,with 10 SD rats in each group.CGS21680 group and CGS21680+AKI group were intrapitoneal injected with CGS21680,then the other three groups of rats except the control group were prepared with AKI model.One week later,serum creatinine (SCr) and urea nitrogen (BUN) levels were detected by automatic biochemical analyzer,and serum renal injury molecule-1 (KIM-1) and neutrophil-gelatinase-associated lipid carrier protein (NGAL) levels were detected by enzyme-linked immunosorbent assay (ELISA),Hematoxylin-eosin (HE) staining and PAS staining were used to observe the pathological changes of renal tissue,TDT-mediated dUTP Notch end labeling (TUNEL) staining was used to observe the apoptosis of cells in renal tissue.Immunohistochemical staining was used to detect CCAAT/enhancer binding protein homologous protein (CHOP) and glucose regulatory protein 78 (GRP78) in renal tissue,Western blot was used to determine the protein expression level of X-box-bound protein-1 (XBP1),protein kinase R-like endoplasmic reticulum kinase (PERK),eukaryotic initiation transcription factor 2α subunit (eIF2α) and phosphorylated eukaryotic initiation factor 2α (p-eIF2α) in renal tissue,immunohistochemical staining was used to detect the positive expression of MCP-1 in renal tissue,and Western blot was used to determine the protein expression level of MCP-1 in renal tissue. Results: Compared with the control group,the levels of SCr,BUN,KIM-1 and NGAL in AKI group were increased (P<0.05),the renal tubule dilatation,degeneration and glomerular edema were observed in renal tissue,the positive rate of TUNEL was increased (P<0.05),the positive expressions of GRP78 and CHOP were increased (P<0.05),the relative protein expression levels of XBP1 and PERK and the ratio of eIF2α/P-EIF2α in renal tissue were up-regulated (P<0.05),and the proportion of MCP-1 positive expression and the relative expression level of protein were also increased and up-regulated (P<0.05).Compared with AKI group,the levels of SCr,BUN,KIM-1 and NGAL in CGS21680+AKI group were decreased (P<0.05),the pathological damage of renal tissue was significantly improved,the positive rate of TUNEL was decreased (P<0.05),and the positive expressions of GRP78 and CHOP were decreased (P<0.05).The relative protein expression levels of XBP1 and PERK and the ratio of eIF2α/P-EIF2α in renal tissues were down-regulated (P<0.05), meanwhile,the positive expression ratio of MCP-1 and the relative expression level of MCP-1 were also down-regulated (P<0.05). Conclusion: Adenosine A2a receptor agonist can alleviate acute kidney injury in AKI rats,which may be related to its alleviation of endoplasmic reticulum stress and inhibition of MCP-1 level. 2023 Vol. 29 (7): 1062-1067 [Abstract] ( 91 ) HTML (1 KB)  PDF (2885 KB)  ( 75 ) 1068 The Mechanism of miR-543 on Radiosensitivity in Lung Cancer Cells Based on AMPK-ACC Signaling Pathway CHU Xiangjian, CAO Haiyan, DAI Meiyun DOI: 10.3969/j.issn.1006-6233.2023.07.03 Objective: To explore the potential role of miR-543 in regulating the radiosensitivity of NSCLC cells. Methods: The expression of miR-543 was detected by qRT-PCR; CCK8,colony formation assay and flow cytometry were used to explore the effect of miR-543 on the biological function of NSCLC cells.The expression of proteins related to AMPK-ACC signaling pathway was detected by WB.Reversion experiments and radiation treatment experiments were used to further verify the effect of miR-543 on the malignant progression and radiotherapy resistance of NSCLC cells through the AMPK-ACC signaling pathway. Results: miR-53 was up-regulated in NSCLC tissues and cells.Silencing miR-53 can inhibit the proliferation ability of NSCLC cells,promote cell cycle arrest and apoptosis,and weaken radiotherapy resistance.In addition,miR-53 is involved in the regulation of AMPK-ACC signaling pathway,and the use of compound C (an inhibitor of AMPK-ACC signaling pathway) can attenuate the effect of miR-53 silencing on NSCLC cell behavior and radiosensitivity. Conclusion: The results of this study suggest that miR-53 can enhance the radiotherapy resistance mechanism in NSCLC cells by regulating the AMPK-ACC signaling pathway,suggesting that targeting miR-53 may be a potential therapeutic target to improve the radiotherapy sensitivity in NSCLC. 2023 Vol. 29 (7): 1068-1073 [Abstract] ( 82 ) HTML (1 KB)  PDF (2936 KB)  ( 258 ) 1074 Influences of Genistein on the Migration and Invasion of Non-Small Cell Lung Cancer by Inhibiting OPN-FAK Signaling Pathway ZHANG Tian, REN Dan, et al DOI: 10.3969/j.issn.1006-6233.2023.07.04 Objective: To investigate the influences of genistein (GS) on the migration and invasion of non-small cell lung cancer (NSCLC) by inhibiting osteopontin (OPN)/focal adhesion kinase (FAK) signaling pathway. Methods: The expression levels of OPN and FAK mRNA in four NSCLC cell lines (H596,H520,A549,H1703) and normal human lung epithelial cells (BEAS-2B) were detected by qRT-PCR; taking A549 cells as the research target,the control group,the GS low concentration (GS-L) group (10μmoL/L),the GS medium concentration (GS-M) group (20μmoL/L),and the GS high concentration (GS- H) group (40μmoL/L),recombinant osteopontin (rOPN) group (15ng/mL),and GS-H+rOPN group (40μmoL/L GS+15ng/mL rOPN) were set.The proliferation rate and apoptosis rate of the cells in the above groups were detected by MTT method and flow cytometry respectively; scratch test and Transwell test were applied to detect changes in cell migration and invasion; Western blot and qRT-PCR were applied to detect the expression of OPN/FAK signaling pathway related genes and proteins. Results: Compared with BEAS-2B cells,the expression levels of OPN and FAK mRNA in A549 cells changed most obviously (P<0.05).Compared with the control group,the proliferation rate,migration rate,invasion and migration number,expression of OPN/FAK signaling pathway-related gene and protein,and apoptosis rate of A549 cells in GS-L,GS-M,and GS-H groups decreased obviously,and the apoptosis rate increased obviously (P<0.05); the proliferation rate,migration rate,invasion and migration number,expression of OPN/FAK signaling pathway-related gene and protein,and apoptosis rate of A549 cells in rOPN group increased obviously,and the apoptosis rate decreased obviously (P<0.05).Compared with the GS-H group,the proliferation rate,migration rate,invasion and migration number,expression of OPN/FAK signaling pathway-related gene and protein,and apoptosis rate of A549 cells in GS-H+rOPN group increased obviously,and the apoptosis rate decreased obviously (P<0.05).Compared with the rOPN group,the proliferation rate,migration rate,invasion and migration number,expression of OPN/FAK signaling pathway-related gene and protein,and apoptosis rate of A549 cells in GS-H+rOPN group decreased obviously,and the apoptosis rate increased obviously (P<0.05). Conclusion: GS can inhibit the migration,invasion and proliferation of NSCLC-A549 cells and promote their apoptosis,which may be related to the inhibition of OPN/FAK signaling pathway. 2023 Vol. 29 (7): 1074-1079 [Abstract] ( 55 ) HTML (1 KB)  PDF (2089 KB)  ( 116 ) 1080 circRNA_MYLK Regulating the Proliferation and Apoptosis of Acute Lymphoblastic Leukemia Cells by Targeting MiR-92a-3p RAO Qi, WANG Dandan, LUO Ting DOI: 10.3969/j.issn.1006-6233.2023.07.05 Objective: To explore the effect of circRNA_MYLK on the proliferation and apoptosis of acute lymphoblastic leukemia cells and its possible mechanism. Methods: The 56 patients with acute lymphoblastic leukemia admitted to West China Hospital of Sichuan University were selected as the research group,and 45 healthy volunteers were selected as the control group.Mononuclear cells were isolated from bone marrow samples from two groups,and B lymphocytes were sorted by flow cytometry.The expression levels of circRNA_MYLK and microRNA-92a-3p (miR-92a-3p) in mononuclear cells were detected by qRT-PCR; the correlation between the expression of circRNA_MYLK and miR-92a-3p in the mononuclear cells of patients with acute lymphoblastic leukemia was analyzed by Pearson method.Human acute lymphoblastic leukemia cell lines (SUP-B15,NALM-6,BALL-1) and normal B lymphocytes were cultured in vitro and transfected into SUP-B15 cells with si-NC,si-circRNA_MYLK,anti-miR-NC,anti-miR-92a-3p,miR-NC,miR-92a-3pmimic,si-circRNA_MYLK and anti-miR-NC,si-circRNA_MYLK and anti-miR-92a-3p,respectively.CCK-8 experiment was used to detect cell proliferation ability; flow cytometry was used to detect the cell cycle and apoptosis; dual luciferase reporter assay verified the targeting effect of circRNA_MYLK and miR-92a-3p. Results: Compared with the control group and normal B lymphocytes,the expression of circRNA_MYLK in the mononuclear cells of the patients in the research group and human acute lymphoblastic leukemia cell lines (SUP-B15,NALM-6,BALL-1) was increased (P<0.05),while the expression of miR-92a-3p was decreased (P<0.05).circRNA_MYLK was negatively correlated with miR-92a-3p in mononuclear cells of patients with acute lymphoblastic leukemia (r=-0.9682).Interfering with circRNA_MYLK or overexpression of miR-92a-3p decreased the cell survival rate of SUP-B15 cells and the proportion of cells in S phase (P<0.05),and increased the proportion of cells in G0/G1 phase and apoptosis rate (P<0.05); circRNA_MYLK could target and regulate the expression of miR-92a-3p; inhibition of miR-92a-3p expression reversed the effect of interfering circRNA_MYLK expression on SUP-B15 cell proliferation,cell cycle and apoptosis (P<0.05). Conclusion: Interfering with the expression of circRNA_MYLK could induce apoptosis of acute lymphoblastic leukemia cells and inhibit cell proliferation,and its mechanism is related to targeted regulation of miR-92a-3p expression. 2023 Vol. 29 (7): 1080-1087 [Abstract] ( 90 ) HTML (1 KB)  PDF (2615 KB)  ( 627 ) 1088 Relationship and Significance of AFP IL-6 and FT3 Levels with Prognosis of Patients with Acute Liver Failure Supported by Artificial Liver LI Caixia, MENG Wenqin, HAO Yingnan, et al DOI: 10.3969/j.issn.1006-6233.2023.07.06 Objective: To investigate the relationship between serum alpha fetoprotein (AFP),interleukin-6 (IL-6),free triiodothyronine (FT3) and the prognosis of patients with acute liver failure treated with artificial liver. Methods: A retrospective study was conducted on 103 patients with acute liver failure who were treated with artificial liver support in our hospital from March 2019 to March 2021.According to the survival outcome within 90 days after treatment,they were divided into death group (35 patients) and survival group (68 patients).The serum AFP,FT3,IL-6 levels of the two groups of patients before artificial liver therapy were compared,the subject's work curve (ROC) was plotted to analyze the value of three indicators to predict the patient's outcome,the general clinical data and laboratory test results of the two groups of patients were collected,and it was analyzed whether the above three indicators are related to the prognosis of patients with acute liver failure treated with artificial liver therapy using logistic regression model. Results: Serum AFP and IL-6 were significantly higher than the survival group,and serum FT3 was significantly lower than the survival group,with a statistically significant difference (P<0.05); Serum AFP,IL-6 and FT3 were measured to plot ROC curves respectively.The results showed that AUC values of the area under the ROC curve that predicted the 90 day death of patients with acute liver failure after artificial liver treatment were 0.811,0.733 and 0.864,respectively; Logistic regression model showed that the increase of AFP,TBIL,PT,CTP score,MELD score,INR and hepatic encephalopathy would increase the risk of death 90 days after artificial liver therapy in patients with acute liver failure (P<0.05); the better level of PTA in patients with acute liver failure treated with artificial liver is a protective factor for good prognosis (P<0.05). Conclusion: The early AFP and IL-6 levels in patients with poor prognosis after artificial liver treatment of acute liver failure were significantly higher and FT3 was lower,which had a certain predictive value for the treatment outcome of patients.Higher serum AFP and lower FT3 would increase the risk of poor prognosis of patients. 2023 Vol. 29 (7): 1088-1093 [Abstract] ( 61 ) HTML (1 KB)  PDF (1344 KB)  ( 106 ) 1094 Study on the Diagnostic Value of PLGF HMGB1 and MPO Levels in Hypertensive Disorder in pregnancy LI Hui, MEI Xiaoqin, JIAO Shun, et al DOI: 10.3969/j.issn.1006-6233.2023.07.07 Objective: To explore the diagnostic value of placental growth factor (PLGF),high mobility group protein B1 (HMGB1) and myeloperoxidase (MPO) levels in hypertensive disorder complicating pregnancy. Methods: A total of 112 patients with hypertensive disorder in pregnancy who were treated in our hospital were selected as the observation group,112 healthy pregnant women were selected as the control group,and the differences of serum PLGF,HMGB1,and MPO levels were compared,and the differences of serum PLGF,HMGB1,and MPO levels in patients with different severity and pregnancy outcome in the observation group were analyzed,and the value of PLGF,HMGB1,and MPO in diagnosing severe preeclampsia and adverse pregnancy outcomes were analyzed. Results: Compared with the control group,the serum PLGF of the observation group was (46.63 ± 9.97) pg/mL,which was lower (P<0.05),while HMGB1 and MPO were (60.43±11.41) mmol/L and (14.46±1.38) ng/L,respectively,which was higher (P<0.05).The serum PLGF of patients with severe preeclampsia was (37.12±8.85) pg/mL,which was lower than that of patients with hypertensive disorder in pregnancy and mild preeclampsia (P<0.05),while HMGB1 and MPO were (72.78±9.83) mmoL/L and (16.09±1.40) ng/L,respectively,which were higher than those of patients with hypertensive disorder in pregnancy and mild preeclampsia (P<0.05).The serum PLGF of patients with adverse pregnancy outcome in the observation group was (40.41±8.21) pg/mL,which was lower than those without adverse pregnancy outcome (P<0.05),while HMGB1 and MPO were (69.56±8.97) mmoL/L and (16.12±1.97) ng/L,respectively,which were higher than those without adverse pregnancy outcome (P<0.05).The area under the ROC curve of serum PLGF,HMGB1,MPO diagnosis of severe preeclampsia were 0.723,0.805,0.869,respectively,P<0.05.The area under the ROC curve of serum PLGF,HMGB1,MPO prediction of adverse pregnancy outcomes were 0.797,0.829,0.751,respectively,P<0.05. Conclusion: The decrease of serum PLGF level and the increase of HMGB1 and MPO level in patients with hypertensive disorder in pregnancy have a certain relationship with the severity of the disease and adverse pregnancy outcomes,and have a certain value in predicting severe pre-eclampsia and adverse pregnancy outcomes. 2023 Vol. 29 (7): 1094-1098 [Abstract] ( 75 ) HTML (1 KB)  PDF (1547 KB)  ( 71 ) 1099 Correlation between Angptl2 YKL-40 and SII Levels and Patients with Hypertension Combined with Unstable Angina Pectoris WANG Ruixu, JIN Fengbiao, LI Bo, et al DOI: 10.3969/j.issn.1006-6233.2023.07.08 Objective: To investigate the diagnosis value of combined angiotensin-like protein 2 (Angptl2),chitinase protein 40 (YKL-40) and systemic immune inflammatory index (SII) levels for essential hypertension (EH) combined with unstable angina (UA) and to analyze their correlation with the degree of coronary artery lesions. Methods: The clinical data of 161 patients admitted with EH to the Affiliated Hospital of Chengde Medical University from December 2020 to December 2021 were collected.They were divided into EH group (n=76) and EH+UA group (n=85) according to whether they had UA.The serum Angptl2 and YKL-40 levels were measured separately in the two groups,and the SII levels were calculated according to the corresponding formula.General information and differences in Angptl2,YKL-40 and SII levels were compared between the groups.Multi-factor logistic regression was used to analyse independent influences on EH+UA,Spearman's rank correlation was used to analyse the correlation between Angptl2,YKL-40 and SII levels and the degree of coronary artery disease,and ROC curves were used to analyse the sensitivity and specificity of Angptl2,YKL-40 and SII levels in predicting EH+UA. Results: The levels of low-density lipoprotein cholesterol (LDL-C),supersensitive C-reactive protein (hsCRP),white blood cells (WBC),neutrophil count (Neutrophil),SII,Angptl2 and YKL-40 were higher in the EH+UA group than in the EH group (all P<0.05); the lymphocyte count (Lymphocyte) was lower in the EH+UA group than in the EH group (P<0.05).Angptl2,YKL-40 and SII levels may be independent predictors of EH+UA (P<0.05) and positively correlated with Angptl2,YKL-40 and SII levels and Gensini score (P<0.05).SII,Angptl2 and YKL-40 in the diagnosis of EH+UA.The area under the ROC curve (AUC) was 0.783 (95% CI:0.714-0.853 ),0.789 (95% CI:0.721-0.858 ) and 0.86 (95% CI:0.806-0.914),respectively,and the AUC of the three combined diagnoses was greater than that of SII,Angptl2 and YKL-40 alone or both AUC,and was more sensitive. Conclusion: Abnormal up-regulation of Angptl2,YKL-40 and SII levels may be a risk predictor for EH+UA,and high levels of Angptl2,YKL-40 and SII may also be a predictor for assessing the severity of coronary artery lesions,and the combined test is more valuable for the diagnosis of EH+UA. 2023 Vol. 29 (7): 1099-1104 [Abstract] ( 54 ) HTML (1 KB)  PDF (1568 KB)  ( 84 ) 1105 Relationship between Tumor Budding and Clinicopathological Features and Prognosis of Prostate Cancer ZHANG Fan, et al DOI: 10.3969/j.issn.1006-6233.2023.07.09 Objective: To analyze the relationship between tumor budding and clinicopathological features and prognosis of prostate cancer (PCa). Methods: The clinical data of 101 patients with PCa who underwent radical resection in the hospital were collected between January 2018 and December 2021.Two pathologists used the tumor budding count and grading method proposed by Ueno et al.to determine the tumor budding of PCa tissue,and Kappa consistency test was used to evaluate the consistency.The relationship between clinicopathological features and tumor budding grading was analyzed among patients with PCa.The survival rate of patients with different tumor budding grades was compared among patients with follow-up time≥2 years. Results: The minimum and maximum tumor budding counts of 101 patients with PCa were 0 and 31,with the median of 4.There were 45 cases of high-grade tumor budding,56 cases of low-grade tumor budding,and 21 cases without budding.The two pathologists had good consistency in judging the tumor budding grading (Kappa coefficient=0.880,P<0.05).Among patients with PCa,the high-grade rate of tumor budding was higher among patients with high TNM stage,high Gleason score,lymph node metastasis,capsular invasion,seminal vesicle invasion and negative E-cadherin expression (P<0.05).62 cases were followed up for ≥2 years,including 26 cases of high-grade tumor budding and 36 cases of low-grade tumor budding.Log-rank test showed that the survival rate of patients with high-grade tumor budding was significantly lower than that of patients with low-grade tumor budding (P<0.05). Conclusion: Tumor budding is closely related to the clinicopathological feature of PCa,and can predict the prognosis of patients with PCa. 2023 Vol. 29 (7): 1105-1109 [Abstract] ( 58 ) HTML (1 KB)  PDF (1390 KB)  ( 101 ) 1110 Application of Serum Lipase and SAA Expression in the Early Assessment of Severe Acute Pancreatitis HUANG Lili, HAN Neng, LI Shujin DOI: 10.3969/j.issn.1006-6233.2023.07.010 Objective: To observe the serum lipase (LPS) and serum amyloid (SAA) expression in patients with acute pancreatitis of different severity,and analyze the application of the above serum indicators in the early assessment of patients with severe acute pancreatitis,with the aim of guiding the early treatment of patients with clinical severe acute pancreatitis and promoting benign patient outcomes. Methods: Retrospectively,baseline data of 50 patients with mild acute pancreatitis admitted to our hospital between January 2018 and January 2022 were collected and included in the mild disease group (APACHE II score <8),and baseline data of 55 patients with severe acute pancreatitis during the same period were collected and included in the severe disease group (APACHE II score ≥8),and the baseline data of the two groups were compared with serum SAA and LPS expression,and the application of the above serum indicators in the early assessment of patients with severe acute pancreatitis was analyzed. Results: There was no statistically significant difference between the age,combined hypertension,combined diabetes mellitus,combined hyperlipidemia,and gender data of the two groups (P>0.05); compared with the mild disease group,the patients in the severe disease group showed high expression of serum SAA and LPS and higher APACHE II score,and the differences were statistically significant (P<0.05); multiple logistic regression model was established,and the results showed that the expression of serum SAA and LPS before treatment was related to the severity of acute pancreatitis patients,and overexpression of serum SAA and LPS might be a risk factor for aggravation of acute pancreatitis patients (OR>1,P<0.05); the ROC curve was plotted,and the results showed that the AUC of serum SAA and LPS expression before treatment to predict heavy disease in acute pancreatitis patients were all >0.80,and the predictive value were good.The results of bivariate Spearman linear correlation analysis showed that there was a positive correlation between the pre-treatment serum SAA and LPS expression and APACHE II score in patients with acute pancreatitis. Conclusion: Serum SAA and LPS can be used for the early assessment of patients with heavy acute pancreatitis,and patients with acute pancreatitis with high serum SAA and LPS expression should be considered as heavy,and the corresponding clinical treatment should be carried out immediately to promote a favorable prognosis of patients in the future. 2023 Vol. 29 (7): 1110-1113 [Abstract] ( 59 ) HTML (1 KB)  PDF (1511 KB)  ( 81 ) 1114 Analysis of Changes in Myocardial Enzyme Indexes and miR-26b and miR-19b Expression in Peripheral Blood of Patients with Toxic Myocarditis and the Relationship with Prognosis WANG Xiaofang, LIN Lin, LEI Lei, et al DOI: 10.3969/j.issn.1006-6233.2023.07.011 Objective: To investigate the changes of myocardial enzymology indexes in peripheral blood,serum micrornA-26b (miR-26b),micrornA-19b (miR-19b) and their relationship with prognosis in patients with viral myocarditis. Methods: A total of 116 patients with viral myocarditis admitted to our hospital from November 2020 to August 2022 were selected as the myocarditis group,and 60 cases non-myocarditis volunteers who underwent physical examinations during the same period were selected as the control group.The myocardial enzyme indicators,serum miR-26b,and miR-19b levels of the two groups were compared,and the patients were grouped based on the 6-month follow-up prognosis.The general information and research indicators of the two groups were compared.Logistic regression analysis was used to identify relevant indicators that affected the prognosis of patients with viral myocarditis. Results: The expression levels of ALT,AST,LDH,cTnI,CK-MB,CK,and miR-19b in patients with myocarditis were higher than those in the control group,and the difference was statistically significant (P<0.05); the relative expression intensity of miR-26b in patients with myocarditis was lower than that in the control group,and the difference was statistically significant (P<0.05); according to a 6-month follow-up,there were 36 patients with poor prognosis,including 2 deaths,18 hospitalizations for recurrent heart failure,9 hospitalizations for arrhythmia,and 7 relapses of myocarditis; there was no statistically significant difference in age,BMI,gender and chest pain between the group with good prognosis and the group with poor prognosis (P>0.05); the systolic blood pressure and diastolic blood pressure in the poor prognosis group were lower than those in the good prognosis group,and the heart rate,chest tightness,myocardium,fatigue,respiratory rate,atrial flutter/atrial fibrillation,atrioventricular block and bundle branch block in the poor prognosis group were higher than those in the good prognosis group,with a statistically significant difference (P<0.05); the expression levels of ALT,AST,LDH,cTnI,CK-MB,CK and miR-19b in patients with poor prognosis were higher than those in patients with good prognosis,and the difference was statistically significant (P<0.05); the relative expression intensity of miR-26b in patients with poor prognosis was lower than that in patients with good prognosis,and the difference was statistically significant (P<0.05); the results of logistic regression analysis showed that atrial flutter/atrial fibrillation,atrioventricular block,bundle branch block,increased ALT,AST,LDH,cTnI,CK-MB,CK,miR-19b and miR-26b were independent risk factors for poor prognosis in patients with myocarditis (P<0.05). Conclusion: In patients with viral myocarditis,peripheral blood myocardial enzymology indexes and miR-19b expression were significantly increased,and miR-26b expression was significantly decreased,which was closely related to poor prognosis of patients. 2023 Vol. 29 (7): 1114-1119 [Abstract] ( 63 ) HTML (1 KB)  PDF (1215 KB)  ( 95 ) 1120 Characteristics and Differential Diagnosis of Conventional Ultrasound and Contrast-enhanced Ultrasound in CCRCC WANG Lei, HE Nianan, YE Xianjun, et al DOI: 10.3969/j.issn.1006-6233.2023.07.012 Objective: To investigate the characteristics and differential diagnostic value of conventional ultrasound and contrast-enhanced ultrasound in renal clear cell carcinoma (CCRCC). Methods: A total of 76 patients (CCRCC group) with CCRCC who were treated in our hospital from September 2020 to August 2022 were selected,including Fuhrman classification:48 cases of grade Ⅰ~Ⅱ and 28 cases of grade Ⅲ-Ⅳ.,and 50 patients with renal angiomyolipoma (RAML) who were treated at the same time were selected as the control group (RAML group).The differences between conventional ultrasound and contrast-enhanced ultrasound images of the two groups were compared,and the differences between conventional ultrasound and contrast- enhanced ultrasound images of CCRCC lesions with different Fuhrman grades were analyzed,as well as the diagnostic value of conventional ultrasound combined with contrast-enhanced ultrasound. Results: The diameter of lesions in CCRCC group was (35.54 ± 11.02) mm,which was significantly higher than that in RAML group (P<0.05).The proportion of hypoechoic,rich blood flow,"fast forward" perfusion,high perfusion intensity,uneven perfusion and peripheral annular enhancement in CCRCC group was 81.58%,57.89%,94.74%,93.42%,73.68% and 42.11% respectively,which was significantly higher than that in RAML group (P<0.05).Compared with grade Ⅰ~Ⅱ lesions,the diameter of grade Ⅲ ~Ⅳ lesions in CCRCC group was (41.25±10.03) mm,which was significantly higher (P<0.05).Compared with in grade Ⅰ~Ⅱ lesions,the percentage of peripheral annular enhancement in grade Ⅲ ~ Ⅳ lesions in CCRCC group was 56.25%,which was significantly higher (P<0.05).Compared with conventional ultrasound and contrast-enhanced ultrasound,the sensitivity of conventional ultrasound+ contrast-enhanced ultrasound in the diagnosis of CCRCC was 94.74%,which was significantly higher (P<0.05).The accuracy and negative predictive value of conventional ultrasound+ contrast- enhanced ultrasound in the diagnosis of CCRCC were 86.51% and 90.24%,respectively,which were significantly higher than those of conventional ultrasound (P<0.05).The accuracy of contrast-enhanced ultrasound in the diagnosis of CCRCC was 83.33%,which was significantly higher than that of conventional ultrasound (P<0.05). Conclusion: Compared with RAML,the image features of conventional ultrasound and contrast-enhanced ultrasound of CCRCC are different to some extent,the combination of conventional ultrasound and contrast-enhanced ultrasound has better application value in differential diagnosis of CCRCC. 2023 Vol. 29 (7): 1120-1125 [Abstract] ( 132 ) HTML (1 KB)  PDF (1549 KB)  ( 89 ) 1126 The Value of ADC of DWI Sequence in Differentiating Benign and Malignant Focal Lesions of Prostate WANG Kai, ZHANG Qianwen, ZHANG Peng DOI: 10.3969/j.issn.1006-6233.2023.07.013 Objective: To investigate the value of apparent diffusion coefficient (ADC) of diffusion weighted imaging (DWI) sequence in differentiating benign and malignant focal lesions of the prostate. Methods: A total of 105 patients with peripheral zone lesions of prostate treated in our hospital from January 2019 to November 2022 were selected,including 59 patients with malignant lesions and 46 patients with benign lesions.The difference of ADC values between benign and malignant lesions was analyzed,and the relationship between ADC values and clinicopathology of malignant lesions was analyzed. Results: The ADC value of malignant lesions was (0.81±0.13) × 10-3 mm2/s,which was lower than that of benign lesions (P<0.05).The ADC value of middle and high risk lesions was (0.75±0.16)×10-3 mm2/s,which was lower than low-risk lesions (P<0.05).The ADC values of the lesions in clinical stage C and D were (0.76± 0.15) ×10-3 mm2/s and (0.72±0.14)×10-3 mm2/s,which was lower than that of stage B lesions (P<0.05).There was no significant difference in ADC values among different age,body mass index,lesion diameter and pathological type groups (P>0.05).The ADC value of malignant lesions was negatively correlated with Gleason score (r=-0.343,P<0.05).The area under the ROC curve of malignant lesions judged by ADC value was 0.912 (95% CI:0.839~0.986),P<0.05,and the cut-off value was 0.99×10-3 mm2/s,the sensitivity and specificity were 86.10% and 92.80%,respectively. Conclusion: The ADC value of DWI sequence has a high diagnostic value in differentiating benign and malignant focal lesions around the prostate,and the ADC value is related to the severity and clinical stage. 2023 Vol. 29 (7): 1126-1129 [Abstract] ( 102 ) HTML (1 KB)  PDF (1389 KB)  ( 389 ) 1130 Efficacy of Revised Endoscopic Sinus Surgery Combined with Middle Turbinectomy in the Treatment of Patients with Refractory Rhinosinusitis and the Influence on Perioperative Indicators and the Prognosis CHEN Xingrong, XIE Yunping, ZHANG Zhibin DOI: 10.3969/j.issn.1006-6233.2023.07.014 Objective: To investigate the effects of revised endoscopic nasal sinus surgery combined with middle turbinectomy in the treatment of patients with refractory rhinosinusitis and the influence on perioperative condition and the prognosis. Methods: A total of 91 patients with refractory rhinosinusitis were admitted to the hospital from January 2019 to January 2022.They were divided into the control group (n=45) and the observation group (n=46) by random number table method.The control group underwent conventional endoscopic open surgery,while the observation group underwent revised endoscopic sinus surgery combined with middle turbinectomy.Surgical effects of the 2 groups were compared.T & T olfactometry was used to assess changes in olfactory function before and after surgery.The Visual Analogue Scale (VAS) was used to assess changes in subjective symptoms such as nasal congestion,nasal secretions,nasal discharge,head and face swelling pain,hyposmia,and general malaise before and after surgery.The Lund-Kennedy scoring system was used to evaluate changes in objective condition (polyps,edema,scars,scabs,rhinorrhea,etc.),and the Sino-Nasal Outcome Test-20 (SNOT-20) was used to evaluate quality of life.The occurrence of surgical complications was recorded,and 1-year recurrence rate was counted. Results: The curative effect classification and olfactory function classification at 6 months after surgery in the observation group were better than those in the control group (P<0.05).Compared with the control group,the observation group had lower VAS scores for nasal congestion,nasal secretions,nasal discharge,head and face swelling pain,hyposmia and general malaise,lower scores for polyps,edema,scars and scabs,and lower SNOT-20 score at 6 months after surgery (all P<0.05).The incidence rates of nasal adhesion,periorbital bruising,intraocular rectus injury and follow-up recurrence rate in the observation group were slightly lower than those in the control group,but the differences were not statistically significant (P>0.05). Conclusion: Revised endoscopic sinus surgery combined with middle turbinectomy is effective in the treatment of patients with refractory rhinosinusitis,which can improve olfactory function,subjective and objective symptoms as well as quality of life,and reduce the risk of recurrence. 2023 Vol. 29 (7): 1130-1136 [Abstract] ( 85 ) HTML (1 KB)  PDF (1236 KB)  ( 346 ) 1137 Parameter Characteristics of Breast Cancer Detection Using RTE Technique and Its Diagnostic Value CHEN Chen, GONG Wenliang, ZHOU Jian, et al DOI: 10.3969/j.issn.1006-6233.2023.07.015 Objective: To explore the value of real-time tissue ultrasound elastography (RTE) in the diagnosis of breast cancer. Methods: From July 2019 to July 2022,105 patients with breast masses in our hospital with 170 lesions were examined by RTE to compare the differences of RTE parameters between benign and malignant lesions,and RTE parameters of malignant lesions with different clinicopathological characteristics,the values of elasticity score,entirety strain rate ratio (ESR),local strain rate ratio (LSR) and blue area ratio (AREA%) in diagnosing benign and malignant lesions were also analyzed. Results: 170 lesions were diagnosed by pathology,including 70 benign lesions and 100malignant lesions.Compared with benign lesions,the ESR,LSR and AREA% of malignant lesions were (3.05 ± 0.88),(46.69 ± 20.28) and (74.30 ± 28.31)%,which were significantly higher(P<0.05); compared with benign lesions,the proportion of elasticity score ≥ 3 in malignant lesions was 67.86%,which was higher than that in benign lesions (P<0.05); there was no significant difference in elastic score,ESR,LSR and AREA% between breast fibroma and other benign lesions (P>0.05); there was no significant difference in elastic score,ESR,LSR and AREA% among patients with different age,lesion size and pathological type (P>0.05); ESR,LSR and AREA% in TNM stage Ⅲ~Ⅳ were significantly higher than those in stage Ⅰ~Ⅱ (P<0.05); the area under the ROC curve of elasticity score,ESR,LSR,and AREA%to judge benign and malignant lesions were 0.676(95%CI:0.593~0.759),0.746 (95%CI:0.652~0.804),0.905 (95%CI:0.753~0.901) and 0.794 (95%CI:0.705~0.883),P<0.05. Conclusion: RTE parameters have a certain application value in the diagnosis of breast cancer,which can provide objective diagnostic indicators and is worth clinical application. 2023 Vol. 29 (7): 1137-1141 [Abstract] ( 84 ) HTML (1 KB)  PDF (1519 KB)  ( 98 ) 1142 Influence of Individual Factors on the Efficacy of Percutaneous Balloon Compression in the Treatment of Primary Trigeminal Neuralgia LI Chuansheng, WANG Kunpeng, YANG Jie, et al DOI: 10.3969/j.issn.1006-6233.2023.07.016 Objective: To explore the influence of individual factors on the efficacy of percutaneous balloon compression in the treatment of primary trigeminal neuralgia. Methods: The clinical data of 89 PTN patients treated with PBC from November 2018 to February 2022 were analyzed retrospectively. The pain score of Barrow Neurological Institute was used to grade facial pain. The pain recurrence (BNI pain score) was followed up and recorded at 3, 6, 9 and 12 months after surgery, and patients were divided into the cure group (BNI pain score Ⅰ to Ⅱ) and recurrence group (BNI pain score Ⅲ to Ⅴ) based on the results of the follow-up at month 12, and the gender, age, body mass index (BMI), underlying disease (hypertensive disease) were analyzed between the two groups of patients, diabetes mellitus), side, disease duration, involved branches, surgical history, preoperative BNI pain score, size of the external orifice of the foramen ovale (FO) (including longitudinal diameter, transverse diameter, longitudinal diameter ratio, and transverse diameter ratio), and other individual factors and recurrence after PBC were analyzed between the two groups. Results: During the follow-up period, 18 patients experienced pain recurrence. Univariate analysis showed that there was no significant difference in sex, age, hypertension, diabetes, side, involved branches, preoperative BNI pain score, transverse diameter and transverse diameter ratio of FO between the cure group and the relapse group (P>0.05); BMI, disease duration, operation history, length to diameter and length to diameter ratio of FO were related to the postoperative effect (P<0.05). Multivariate logistic regression analysis of significant individual factors showed that BMI≥24kg/m2, disease duration≥5 years, and previous surgical history were independent risk factors for postoperative pain recurrence (P<0.05), and FO length was a protective factor for postoperative recurrence (P<0.05). ROC curve analysis showed that FO length had a predictive effect on pain recurrence after PBC (P<0.05), with a predictive effect of 68.9%. The calculated maximum Joden index is 0.359, the corresponding FO length diameter is 6.74mm, the sensitivity is 0.803, and the specificity is 0.556. Conclusion: PBC is an effective surgical treatment for PTN, and individual factors have an important impact on the recurrence of pain after PBC. 2023 Vol. 29 (7): 1142-1148 [Abstract] ( 79 ) HTML (1 KB)  PDF (1996 KB)  ( 197 ) 1149 Correlation Analysis of Stone and Urine Composition and Stone Recurrence in Patients with Urinary Calculi HU Xiaojian, ZHENG Liang, ZHANG Zhigang, et al DOI: 10.3969/j.issn.1006-6233.2023.07.017 Objective: To investigate the correlation between stone and urine composition and stone recurrence in patients with urinary calculi. Methods: A total of 120 patients with urinary calculi were treated in the hospital from March 2019 to May 2021.They were selected as the research subjects,and followed up for 1 year.The postoperative stone recurrence rate was recorded.The patients were grouped according to the presence or absence of stone recurrence.General clinical data of the patients were analyzed to screen the risk factors for stone recurrence.The correlation between stone and urine composition and stone recurrence was analyzed. Results: Among the 120 patients,27 patients had stone recurrence,and the 1-year recurrence rate was 22.50%.The proportion of patients aged 70 or older in the recurrence group (62.96%) was higher than that in the non-recurrence group (40.86%).The proportion of surgical stone removal rate ≥80% in the recurrence group (66.67%) was lower than that in the non-recurrence group (90.32%).The proportion of patients with history of endocrine diseases in the recurrence group (55.56%) was higher than that in the non-recurrence group (21.50%) (P<0.05).The pH value of urine components in the recurrence group (5.36±0.58) was lower than that in the non-recurrence group (6.89±0.71).The levels of uric acid,oxalic acid and phosphorus[(2.67±0.26) mmoL/L,(0.52±0.05) mmoL/L and (15.49±2.47) mmoL/L] were higher than those in the non-recurrence group[(2.15±0.28) mmoL/L,(0.41±0.06) mmoL/L and (12.36±2.38) mmoL/L] (P<0.05).The proportion of magnesium ammonium phosphate in the recurrence group (66.67%) was higher than that in the non-recurrence group (23.66%) (P<0.05).Logistic regression analysis showed that age ≥ 70,history of endocrine disease,magnesium ammonium phosphate in stone composition,surgical stone clearance rate <80%,urine pH value,uric acid,oxalic acid,and phosphorus were risk factors for stone recurrence in patients with urinary calculi.Correlation analysis showed that magnesium ammonium phosphate in the stone components was positively correlated with the recurrence of stones (r=0.536,P<0.05),pH in urine components was negatively correlated with the recurrence of stones (r=-0.417,P<0.05),and uric acid,oxalic acid and phosphorus were positively correlated with the recurrence of stones (r=0.387,0.425,0.439,P<0.05). Conclusion: Patients with urinary calculi have a relatively high rate of postoperative stone recurrence,especially those aged ≥ 70,with history of endocrine disease,with magnesium ammonium phosphate in stone composition,with surgical stone clearance rate < 80%,lower urine pH,lower urine uric acid,oxalic acid and phosphorus.Clinically,treatment for the above patients should be strengthened to reduce the risk of stone recurrence. 2023 Vol. 29 (7): 1149-1153 [Abstract] ( 56 ) HTML (1 KB)  PDF (1187 KB)  ( 86 ) 1154 Laparoscopic Combined with Bianchi Operation for Inguinal Cryptorchidism HAN Nuan, FENG Lin, SUN Jinsong, et al DOI: 10.3969/j.issn.1006-6233.2023.07.018 Objective: To investigate the effect and safety of laparoscopic Bianchi operation in the treatment of inguinal cryptorchidism in children. Methods: Totally 120 children with cryptorchidism in inguinal area admitted to our hospital from June 2019 to June 2022 were selected as the research subjects.They were randomly divided into study group and control group,with 60 cases in each group.The study group was treated with Bianchi operation under laparoscope,and the control group was treated with a small testicular descending transverse inguinal incision.The operation indexes,serum sex hormones,interleukin-6 (IL-6),IL-8 The changes of high sensitivity C-reactive protein (hs CRP),serum anti Mullerian hormone (AMH),inhibin B (INHB) levels and the occurrence of surgical complications. Results: The average operation time of the study group was longer than that of the control group,and the amount of intraoperative bleeding,incision length,and hospital stay were all smaller than those of the control group,with significant differences (P<0.05).Before operation,there was no significant difference in the baseline serum T,E2,FSH,AMH,INHB levels between the study group and the control group (P>0.05).Three months after operation,the above serum hormone indexes were checked again.The serum AMH,INHB levels in the two groups were significantly higher than those before operation,and the serum E2,FSH levels were significantly lower than those before operation,with statistically significant differences (P<0.05).There was no significant difference in the above indicators between the two groups 3 months after operation (P>0.05).Before operation,there was no significant difference in the baseline serum IL-6,IL-8,hs CRP levels between the study group and the control group (P>0.05).On the first day after operation,the serum IL-6,IL-8 and hs CRP in the study group were lower than those in the control group,with significant differences (P<0.05).The measured values of IL-6,IL-8 and hs CRP in the two groups on the first day after operation were significantly higher than those before operation (P<0.05).The incidence of complications in the study group was 8.33%,which was lower than that in the control group (28.33%,P<0.05). Conclusion: The effect of Bianchi operation under laparoscope in the treatment of children with inguinal cryptorchidism is positive,with few complications,which is worthy of clinical application. 2023 Vol. 29 (7): 1154-1158 [Abstract] ( 80 ) HTML (1 KB)  PDF (1201 KB)  ( 89 ) 1159 Application of Early High Protein Nutrition Combined with Rehabilitation Exercise in Invasive Mechanical Ventilation in AECOPD LI Shutie, ZHU Xiaobo, ZUO Luguang, et al DOI: 10.3969/j.issn.1006-6233.2023.07.019 Objective: To observe the clinical effect of early high protein nutrition combined with rehabilitation exercise on patients with invasive mechanical ventilation (AECOPD). Methods: A total of 60 patients with AECOPD admitted to our hospital was divided into research group and control group,30 cases in each group.The control group was given invasive mechanical ventilation,conventional Western medical treatment and conventional nutritional support,while the study group was given early high protein nutrition combined with active and passive exercise rehabilitation equipment for rehabilitation exercise on top of the above.On days 2~3,10 minutes in the morning,15 minutes at noon and 15 minutes in the evening; on day 4,20 minutes in the morning,20 minutes at noon and 20 minutes in the evening; from the start of mechanical ventilation to deconditioning in both groups; comparison of serum nutritional parameters (albumin,transferrin,prealbumin and haemoglobin),serum inflammatory parameters (IL-6,TNF-α,CRP),and changes in SOFA score and muscle strength recovery before and after treatment in both groups were compared. Results: Before treatment,there was no significant difference between the study group and the control group in terms of albumin,transferrin,prealbumin and haemoglobin.There was no significant difference between the serum nutritional indicators in the study group and the control group (P>0.05); compared with the pre-treatment group,the serum nutritional indicators improved significantly in both groups after treatment,with statistical differences (P<0.05); compared with the control group,the serum nutritional indicators (hemoglobin,albumin,transferrin and prealbumin) improved more significantly in the study group,with statistical differences (134.61±5.11) vs 119.47±5.58,46.79±1.68 vs42.01±2.06,1.82±0.95 vs 1.42±0.09,237.82±10.81 vs 143.20±9.78,P<0.05); before treatment,there was no significant difference in all serum inflammatory indexes between the study group and the control group (all P>0.05); after treatment,the serum inflammation indexes in the study group were significantly improved compared with those before treatment (all P<0.05),and the serum IL-6,TNF-α and CRP in the study group were (30.52 ± 6.34) pg/mL,(60.13 ± 4.76) pg/mL and (5.38 ± 1.95) mg/L,respectively,while the serum IL-6,TNF-α and CRP in the control group were (36.75 ± 10.35) pg/mL,respectively.(36.75±10.35) pg/mL,(66.34±6.57) pg/mL,(7.31±2.34) mg/L respectively in the control group,with significant differences in the above indexes between the two groups (all P<0.05); the efficiency of muscle strength recovery was 93.33% (28/30) and 83.33% (25/30) in the study group and control group respectively after treatment,with significant differences between the groups ( P<0.05). Conclusion: Early high protein nutrition combined with rehabilitation exercises can improve the nutritional and infectious status of patients with invasive mechanical ventilation in AECOPD and improve muscle strength,which is beneficial to patients' recovery and prognosis. 2023 Vol. 29 (7): 1159-1163 [Abstract] ( 58 ) HTML (1 KB)  PDF (1209 KB)  ( 90 ) 1164 Comparison of Effects of Supracricoid Partial Laryngectomy and Total Laryngectomy on Serum let-7a and CK18 Levels and Tumor-Free Survival in Patients with Advanced Laryngeal Ccancer LI Zhiyong, YANG Quanquan, MA Peng, et al DOI: 10.3969/j.issn.1006-6233.2023.07.020 Objective: To compare the effects of supracricoid partial laryngectomy and total laryngectomy on patients with advanced laryngeal cancer. Methods: A total of 105 patients with advanced laryngeal cancer in the hospital from February 2016 to June 2019 were selected as the research subjects,and they were classified into control group (n=50) and observation group (n=55) by means of different surgical regimens.The control group underwent total laryngectomy while the observation group received supracricoid partial laryngectomy.The patients were followed up for 3 years after surgery.The perioperative indicators[postoperative drainage volume,nasal feeding time,trial eating start time,hospital stay],postoperative complications,levels of serum let-7a and CK18 before and after surgery,swallowing function and tumor-free survival were compared between groups of patients. Results: The various perioperative indicators in observation group were better than those in control group (P<0.05).The total incidence rate of complications in observation group at 7 days after surgery was lower compared with that in control group (P<0.05).The swallowing function grading in observation group was better compared to control group (P<0.05).After surgery,the level of serum let-7a in observation group was higher (P<0.05) while the CK18 was lower than that in control group (P<0.05).There was no statistical difference in the 3-year overall survival rate between both groups (P>0.05). Conclusion: Supracricoid partial laryngectomy in the treatment of patients with advanced laryngeal cancer can significantly improve the perioperative indicators,serum indicators and swallowing function.In addition,it has few complications and its long-term prognosis is comparable to that of total laryngectomy. 2023 Vol. 29 (7): 1164-1168 [Abstract] ( 56 ) HTML (1 KB)  PDF (2336 KB)  ( 97 ) 1169 Clinical Effects of High-Intensity Focused Ultrasound Combined with GnRH-a in Treating Adenomyosis and Analysis of Prognosis and Recurrence XU Xiaoping, WU Han, YIN Yan, et al DOI: 10.3969/j.issn.1006-6233.2023.07.021 Objective: To analyze the clinical effects of high-intensity focused ultrasound (HIFU) combined with gonadotropin-releasing hormone agonist (GnRH-a) in the treatment of adenomyosis and evaluate the prognosis and recurrence. Methods: The clinical data of 122 patients with adenomyosis treated in the hospital were retrospectively analyzed between June 2018 and December 2020.56 patients were treated with single GnRH-a (GnRH-a group),and 66 patients performed HIFU combined with GnRH-a (HIFU+GnRH-a group).The uterine volume,dysmenorrhea degree[Visual Analogue Scale (VAS)],menstrual volume,endometrial receptivity (the quantity and maturity of endometrial pinoplasts) and ovarian function[follicle-stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2)] were compared between the two groups before treatment and at 6 months after the treatment.The adverse reactions of treatment and recurrence-free survival rate at 12 months after the end of treatment were recorded in the two groups. Results: At 6 months after the treatment,the uterine volume,dysmenorrhea VAS score,and menstrual flow score in the two groups were significantly reduced compared with those before treatment (P<0.05),and the above indicators in HIFU+GnRH-a group were lower than those in GnRH-a group (P<0.05).The quantity and maturity of endometrial pinoplasts in both groups were enhanced compared to before treatment (P<0.05),and the two indicators were higher in HIFU+GnRH-a group than those in GnRH-a group (P<0.05).At 6 months after the treatment,there were no significant changes in serum FSH,LH and E2 levels in the two groups compared with those before treatment (P>0.05),and there were no significant differences between the two groups (P>0.05).The difference in incidence rate of adverse reactions was not statistically significant (12.12% vs 5.36%) (P>0.05).The recurrence-free survival rate at 12 months after the end of treatment in HIFU+GnRH-a group was higher than that in GnRH-a group (P<0.05). Conclusion: The combined treatment of HIFU and GnRH-a is more significant in relieving the clinical symptoms of adenomyosis,more beneficial to improving endometrial receptivity and more effective in reducing the recurrence rate,with good safety. 2023 Vol. 29 (7): 1169-1173 [Abstract] ( 66 ) HTML (1 KB)  PDF (1363 KB)  ( 132 ) 1174 Effect of CO2 Laser Vocal Cord Resection Combined with Low Temperature Plasma on Voice and Vocal Cord Adhesion in Patients with Early Glottic Carcinoma WEI Xing, DUAN Lifu, YAN Bincheng, et al DOI: 10.3969/j.issn.1006-6233.2023.07.022 Objective: To investigate the effect of CO2 laser vocal cord resection combined with low temperature plasma on voice and vocal cord adhesion in patients with early glottic carcinoma ( EGC ). Methods: The clinical data of 72 patients with EGC who underwent surgical treatment in our hospital from March 2019 to June 2022 were retrospectively collected.According to different treatment methods,they were divided into observation group ( n=42 ) and control group ( n=30 ).The control group was treated with CO2 laser vocal cord resection,and the observation group was treated with CO2 laser vocal cord resection combined with low temperature plasma.The voice index,short-term efficacy,quality of life score and complication rate before and after operation were compared between the two groups. Results: Six months after operation,the fundamental frequency perturbation and amplitude perturbation of the two groups were lower than those before operation,and the longest phonation time ( MPT ) was longer than that before operation.Compared with the control group,the fundamental frequency perturbation,amplitude perturbation and MPT of the observation group were significantly better than those of the control group.The difference was statistically significant (1.15±0.49% vs1.36±0.31%,t= 2.068,P= 0.042,2.69±0.85 % vs3.32±0.54 %,t=3.573,P=0.001,15.69±1.84vs13.17±1.69,t= 5.924,P=0.000).Compared with the control group,the total effective rate of the observation group was significantly higher,the difference was statistically significant (95.24vs76.67,χ2=5.518,P<0.05).Six months after operation,the scores and total scores of the quality of life scale in the two groups were lower than those before operation,and the scores and total scores of the quality of life scale in the observation group were significantly lower than those in the control group.The difference was statistically significant ( 4.31±1.28vs6.39±0.54,t= 8.371,P=0.000,10.25± 1.32vs11.39 ±1.07,t= 3.901,P= 0.000,7.11±0.94vs7.56±0.53,t= 2.364,P= 0.021,17.83±2.34vs20.62±1.71,t= 5.552,P=0.000).There was no significant difference in the incidence of vocal cord adhesion,granuloma and total incidence of complications between the two groups (P>0.05 ). Conclusion: CO2 laser combined with low temperature plasma therapy for EGC can further improve the clinical efficacy,voice quality,and quality of life. 2023 Vol. 29 (7): 1174-1177 [Abstract] ( 52 ) HTML (1 KB)  PDF (1188 KB)  ( 56 ) 1178 Correlation Analysis between Metabolic Syndrome and Early Poor Prognosis in Patients with Severe Trauma WANG Yang, FANG Jianbo, ZHU Guanneng, et al DOI: 10.3969/j.issn.1006-6233.2023.07.023 Objective: To investigate the correlation between metabolic syndrome and early poor prognosis in severe trauma patients. Methods: The medical records of 107 severe trauma patients admitted to Huangshan People's Hospital from January 2020 to August 2022 were retrospectively analyzed,and the patients were divided into observation group (n=30,combined metabolic syndrome) and control group (n=77,no metabolic syndrome) according to their metabolic syndrome prevalence status,and relevant clinical data were collected from both groups.All patients received conventional treatment for severe trauma.The general conditions of the two groups were compared,the occurrence of complications in the two groups was compared,1-month survival was counted and the effect of MS on patient survival was analysed. Results: The duration of ICU stay and ventilator time were significantly longer in the observation group than in the control group (P<0.05),and the incidence of acute kidney injury,MODS,ARDS,cardiac arrest,decubitus ulcer and surgical site infection was significantly higher in the observation group than in the control group (P<0.05).When comparing the incidence of other complications in the two groups,the difference was not statistically significant (P>0.05).multi-factor logistic regression analysis showed that diabetes mellitus was the only MS component contributing to death in severe trauma patients. Conclusion: Metabolic syndrome is closely related to the poor early prognosis of severe trauma patients,among which the diabetes component is closely related to the early survival rate of patients,and clinical attention should be paid to patients with combined metabolic syndrome to improve their early prognosis. 2023 Vol. 29 (7): 1178-1182 [Abstract] ( 67 ) HTML (1 KB)  PDF (1183 KB)  ( 52 ) 1183 Effectiveness of Transarterial Chemoembolization with Drug-Laden Microspheres in the Preoperative Descending Phase of Liver Transplantation for Hepatocellular Carcinoma LIU Baowang, DOU Jian, WANG Yang, et al DOI: 10.3969/j.issn.1006-6233.2023.07.024 Objective: To investigate the value of drug-laden microsphere transarterial chemoembolization (DEB-TACE) versus conventional transarterial chemoembolization (cTACE) in the preoperative descending treatment of liver cancer liver transplantation. Methods: The clinical data of 74 patients who underwent classical in situ liver transplantation for hepatocellular carcinoma (HCC) in our hospital from January 2015 to January 2022 were collected for a retrospective study.Among them,36 cases underwent DEB-TACE downstaging treatment before liver transplantation as the DTACE group and 38 cases underwent cTACE downstaging treatment before liver transplantation as the cTACE group.The efficacy of the step-down treatment,serum tumor markers[alpha-fetoprotein (AFP),glycoantigen 199 (CA199),E-calcine mucin (EC)],liver function indexes[aspartate aminotransferase (AST),total bilirubin (TBIL),alanine aminotransferase (ALT)],prognosis-related markers[vascular endothelial growth factor (VEGF),secretory protein Dickkopf-1 (DKK1),CD24],incidence of adverse events,and recurrent metastases 1 year after liver transplantation. Results: There was no statistically significant difference (P>0.05) between the remission rate of the DTACE group on descending treatment (83.33%) and the cTACE group (71.05%); serum AFP,CA199 and EC levels were lower in the DTACE group than in the cTACE group after treatment (P<0.05).Serum AST,TBIL and ALT levels were lower in the DTACE group than in the cTACE group after treatment (P<0.05); serum VEGF,DKK1 and CD24 levels were lower in the DTACE group than in the cTACE group after treatment (P<0.05).There was no statistically significant difference in the incidence of nausea/vomiting,abdominal pain,fever,and liver abscess in the DTACE group (11.11%,16.67%,69.44%,2.78%) compared with the cTACE group (18.42%,21.05%,76.32%,7.89%) (P>0.05); the recurrence rate and metastasis rate 1 year after liver transplantation in the DTACE group ( 5.56%,10.53%) compared with the cTACE group (11.11%,18.42%) were not statistically significant (P>0.05). Conclusion: Both DEB-TACE and cTACE can achieve good therapeutic effects in the preoperative descending treatment of liver cancer liver transplantation,among which DEB-TACE can more significantly downregulate serum tumor markers and prognosis-related markers levels,and has obvious advantages in protecting liver function. 2023 Vol. 29 (7): 1183-1187 [Abstract] ( 65 ) HTML (1 KB)  PDF (1202 KB)  ( 303 ) 1188 Value of CT Three-Dimensional Reconstruction in Diagnosing Severe DDH Secondary to Osteoarthritis in Adults LI Xiangyang, WANG Haodong, CHEN Xinyi, et al DOI: 10.3969/j.issn.1006-6233.2023.07.025 Objective: To explore the diagnostic value of CT three-dimensional reconstruction for severe developmental dysplasia of the hip (DDH) secondary to osteoarthritis (OA) in adults. Methods: A total of 106 adult patients with severe DDH admitted to the hospital were enrolled as the research objects between January 2018 and January 2021.According to presence or absence of OA,they were divided into OA group (29 cases) and non-OA group (77 cases).The acetabular index,upper and medial space of hip joints,Sharp angle,CE angle,tangent angle of hip roof and coverage rate of femoral head were compared between the two groups.The imaging indexes with statistical significance were included into the diagnostic indexes to analyze the diagnostic efficiency of single index and their combination for OA in patients with severe DDH. Results: The upper hip space,CE angle,tangent angle of hip roof and coverage rate of femoral head in OA group were lower than those in non-OA group,while medial hip space was larger than that in non-OA group (P<0.05).There was no significant difference in acetabular index or Sharp angle between the two groups (P<0.05).ROC curves showed that AUC values of upper hip space,medial hip space,CE angle,tangent angle of hip roof and coverage rate of femoral head in the diagnosis of severe DDH combined with OA were 0.749,0.725,0.779,0.683 and 0.694,respectively,lower than that of combined diagnosis (0.881,P<0.05). Conclusion: CT three-dimensional reconstruction has high diagnostic value for severe DDH combined with OA in the adults. 2023 Vol. 29 (7): 1188-1191 [Abstract] ( 59 ) HTML (1 KB)  PDF (1549 KB)  ( 94 ) 1192 Analysis of the Effects of Complete Endoscopic Radical Thyroidectomy with Non-Pneumatic Axillary Approach on Parathyroid Function and Related Hormone Levels LING Yao, LAN Xuejun, et al DOI: 10.3969/j.issn.1006-6233.2023.07.026 Objective: To investigate the effect of complete endoscopic radical thyroidectomy (GUA) with non-pneumatic axillary approach on parathyroid function and related hormone levels. Methods: A total of 116 patients with thyroid cancer in our hospital from January 2020 to January 2022,and the enrolled patients were divided into a endoscopic group of 58 cases and an open group of 58 cases using a random number table method.The endoscopic group was treated with GUA surgery,and the open group was treated with radical neck anterior incision.The changes of perioperative indexes,postoperative complications,and VAS of patients in the two groups were recorded at 24h and 48h after operation; changes in thyroid hormone levels before and 3 days after surgery. Results: Intraoperative blood loss was less in the endoscopic group than in the open group,the duration of surgery was longer in the endoscopic group than in the open group,the postoperative drainage was higher in the endoscopic group than in the open group,and the postoperative hospital stay was shorter in the endoscopic group than in the open group (P<0.05).There was no significant difference in postoperative complications between the two groups (P>0.05).VAS scores were lower in the endoscopic group than in the open group at 24h and 48h.PTH,T3 and T4 levels were lower than preoperative levels,while TSH levels were higher in the two groups at 1 month postoperatively (P<0.05); the difference in PTH,T3,T4 and TSH levels before and after surgery was lower in the laparoscopic thyroid cancer patients than in the control group (P<0.05). Conclusion: The GUA procedure for patients with thyroid cancer has a low impact on parathyroid function and is worthy of clinical consideration. 2023 Vol. 29 (7): 1192-1195 [Abstract] ( 61 ) HTML (1 KB)  PDF (1179 KB)  ( 78 ) 1196 Pathogen Distribution,Imaging Characteristics,and Influencing Factors of Respiratory Failure in COPD Patients with Community-Acquired Pneumonia KANG Lin, WANG Yanxin, ZHU Ying, et al DOI: 10.3969/j.issn.1006-6233.2023.07.027 Objective: To investigate the pathogen distribution,imaging characteristics and related factors of respiratory failure in elderly patients with COPD complicated with community acquired pneumonia. Methods: A total of 154 patients with COPD complicated with community acquired pneumonia who were treated were selected as the observation group,while 154 patients with simple COPD were selected as the control group,the differences in pathogenic bacteria and imaging characteristics between the two groups were compared,and the differences in clinical data between the observation group and patients without respiratory failure were analyzed. Results: 93 strains of pathogenic bacteria were detected in the observation group,including Klebsiella pneumoniae,Escherichia coli,Streptococcus pneumoniae and atypical pathogens,accounting for 16.13%,13.98%,12.90% and 12.90% respectively.The proportion of lamellar infiltration shadow,consolidation shadow and cavity in the observation group was 86.36%,20.78% and 14.94% respectively,which was significantly higher than that in the control group (P<0.05).The proportion of ≥ 70 years old,APACHE Ⅱ score>15,serum albumin<30g/L,COPD course>10 years in patients with combined respiratory failure was 72.86%,65.71%,64.29% and 72.86%,(P<0.05).Logistic showed that age,APACHE Ⅱ,serum albumin and COPD course were the influencing factors of respiratory failure (P<0.05). Conclusion: Patients with COPD complicated by community-acquired pneumonia have a high rate of Klebsiella pneumoniae infection,with significant differences in imaging features between the two; the development of respiratory failure in patients with COPD complicated by community-acquired pneumonia is influenced by factors such as patient age and APACHE Ⅱ score. 2023 Vol. 29 (7): 1196-1200 [Abstract] ( 54 ) HTML (1 KB)  PDF (1344 KB)  ( 102 ) 1201 Analysis of the Effect of AR Navigation Combined with the Seven-Step Two-Shot Method for 3D Laparoscopic Reduction of the Right Hemicolectomy WU Yongrong, LIU Zhen, HAO Shuqing, et al DOI: 10.3969/j.issn.1006-6233.2023.07.028 Objective: To investigate the value of augmented reality (AR) navigation combined with the seven-step,two-shot method in 3D laparoscopic reduction of the right hemicolectomy. Methods: A simple randomization method was used to divide 104 patients with hepatocellular carcinoma admitted to our hospital from January 2019 to January 2022 into a standard group and a modified group,with 52 patients in each group.The standard group underwent 3D laparoscopic right hemicolectomy,and the modified group underwent 3D laparoscopic reduced right hemicolectomy using AR navigation combined with the seven-step two-shot method.The two groups were compared in terms of the general condition of surgery,postoperative recovery process,hemoglobin,albumin,liver function[total bilirubin (TBil),glutamic aminotransferase (AST),glutamic aminotransferase (ALT)],coagulation function[prothrombin time (PT),prothrombin activity (PA),activated partial thromboplastin time (APTT),fibrinogen (FIB)],immunoglobulin[immune globulin G (IgG),IgA,IgM],complications and recurrence rate at 1 year follow-up. Results: The operation time,recovery time of postoperative bowel sounds,postoperative exhaustion time,postoperative bed activity time,postoperative tube placement time,and hospital stay were shorter in the modified group than in the standard group,and the intraoperative bleeding and actual volume of liver resection were lower than in the standard group,and the remaining liver volume was higher than in the standard group (P<0.05); hemoglobin,albumin,PA,and FIB were higher in the modified group than in the standard group at 3d and 5d postoperatively,and TBil,AST,ALT,PT,APTT were lower than those in the standard group (P<0.05).The IgG,IgA,and IgM at 3d and 5d postoperatively were higher in the modified group than in the standard group (P<0.05); the overall complication rate and recurrence rate at 1 year follow-up in the modified group were 1.92% (1/52) and 3.92% (2/51),respectively,which were not significantly different from 5.77% (3/52) and 8.00% (4/50) in the standard group (P>0.05). Conclusion: AR navigation combined with the seven-step,two-shot method can optimize the path of 3D laparoscopic reduction of right hemicolectomy,reduce intraoperative bleeding and hepatic resection volume,mitigate liver function and immune function damage,improve patients' coagulation function,and shorten patients' recovery process,with better safety and near- to mid-term results. 2023 Vol. 29 (7): 1201-1207 [Abstract] ( 62 ) HTML (1 KB)  PDF (1218 KB)  ( 75 ) 1208 Exploring and Analyzing the Efficacy of Modified Anal Fissure Resection Combined with Chinese Herbal Sitz Bath in the Treatment of Chronic Anal Fissure SUN Lijun DOI: 10.3969/j.issn.1006-6233.2023.07.029 Objective: To analyze the clinical value of modified anal fissure resection combined with traditional Chinese medicine sitz bath in patients with chronic anal fissure. Methods: A retrospective study was carried out on 120 patients with chronic anal fissure who underwent anal fissure resection in our hospital's anorectal department from March 2020 to September 2021,and the patients were divided into traditional operation group and modified operation group according to their surgical methods.In the traditional surgery group (n=57),the treatment method was traditional anal fissure excision + herbal sitz bath,and in the modified surgery group (n=63),the treatment method was modified anal fissure excision + herbal sitz bath.The time of operation,hospitalisation,post-operative wound healing time,pain scores,incidence of post-operative complications,cure rate,and post-operative recurrence rate were observed and recorded for both groups. Results: Before treatment,there was no statistically significant difference in the general clinical information (gender,age,duration of disease,blood in stool,pain level,staging,etc.) between the patients in the conventional surgery group and the modified surgery group (P>0.05).The duration of surgery was significantly greater in the conventional surgery group (24.13±3.04) min than in the modified surgery group (19.17±2.91) min,with a significant difference (P<0.001).The length of hospital stay was significantly greater in the conventional surgery group (9.21±1.89) than in the modified surgery group (6.23±1.27),with a significant difference (P<0.001).After 48 hours postoperatively,the mean difference (4.45±1.22) of VAS scores before and after operation in the modified operation group was significantly higher than that in the traditional operation group (2.71 ± 1.90),and the difference was statistically significant (P<0.001).The wound healing time was significantly greater in the conventional surgery group (21.60±3.53) days than in the modified surgery group (19.03±3.23) days (P=0.001).At 1 month after surgery,there was no significant difference between the incisional healing grade A rate of patients in the modified surgery group (92.06%) and the incisional healing grade A rate of patients in the conventional surgery group (87.72%),(P=0.626).The incidence of postoperative complications was much greater in the conventional surgery group (11 cases,19.30%) than in the modified surgery group (2 cases,3.17%),(χ2=6.471,P=0.011).The cure rate was 65.08% in the modified surgery group and 59.65% in the conventional surgery group.The cure rate was significantly higher in the modified surgery group than in the conventional surgery group,but the difference between the groups was not statistically significant (p=0.539).By the end of the 3-month follow-up period after surgery,no recurrence was observed in patients in both the conventional and modified surgery groups. Conclusion: Modified anal fissure excision combined with traditional Chinese medicine sitz bath can effectively shorten the operation time,recover faster after operation,relieve postoperative pain,shorten wound healing time,and effectively avoid complications. 2023 Vol. 29 (7): 1208-1212 [Abstract] ( 58 ) HTML (1 KB)  PDF (1186 KB)  ( 95 ) 1213 The Application of Roxadustat in Patients with Renal Anemia and Its Effects on Inflammatory Mediators and Myocardial Enzymes TIAN Lihui, LIU Fei, GUO Hongping, et al DOI: 10.3969/j.issn.1006-6233.2023.07.030 Objective: To investigate the effect of Roxadustat on inflammatory mediators and myocardial enzymes in patients with renal anemia. Methods: According to the principle of random number grouping,90 patients with renal anemia admitted from October 2020 to December 2021 were divided into an observation group and a control group,with 45 patients in each group..The patients in the control group were treated with routine anti anemia therapy,while the patients in the observation group were treated with Roxadustat on the basis of the treatment in the control group,and the therapeutic effects,iron metabolism indicators[serum ferritin (SF),transferrin (TRF),transferrin saturation (TSAT),and ferrimodulin (Hepc)],inflammatory mediators[interleukin-6 (IL-6) and C-reactive protein (CRP)] Myocardial zymogram indicators[phosphocreatine kinase (CK),phosphocreatine kinase isoenzyme (CK-MB),lactate dehydrogenase (LDH)] and adverse reactions were compared. Results: The therapeutic effect,SF,TRF and TSAT levels in the observation group were higher than those in the control group (P<0.05).After treatment,the levels of Hepc,IL-6,CRP,CK,CK-MB and LDH in the observation group were lower than those in the control group (P<0.05).There was no statistical difference between the two groups in the incidence of adverse reactions (P>0.05). Conclusion: Rosalrestat has a good effect on patients with renal anemia.It can effectively improve the level of iron metabolism and inflammatory state,and reduce the indexes of myocardial zymogram,but it has little effect on the occurrence of adverse reactions during treatment. 2023 Vol. 29 (7): 1213-1216 [Abstract] ( 58 ) HTML (1 KB)  PDF (1168 KB)  ( 121 ) 1217 Analysis of the Effect of Cyclosporine on Gallstone Formation in Patients with Aplastic Anemia JI Tongying, LI Gonghui, WANG Yingfen DOI: 10.3969/j.issn.1006-6233.2023.07.031 Objective: To analyze the effect of cyclosporine on cholelithiasis in a population of patients with aplastic anemia. Methods: Two hundred and sixty-three patients with aplastic anemia admitted to our hospital from January 2016 to May 2022 were selected and divided into 103 cases in the anti-thymocyte globulin group (ATG group) and 160 cases in the cyclosporine group (CsA group) according to the immunosuppressive treatment regimen.Liver function and lipids were measured in peripheral blood laboratory after admission and after receiving 6 months of treatment,and cholestasis and stone formation in the biliary system were examined by color Doppler ultrasound in all patients. Results: The incidence of cholestasis in the ATG group was 5.83% and the incidence of stones was 2.91%; the incidence of cholestasis in the CsA group was significantly higher in the CsA group than in the ATG group (P<0.05,P<0.05); there was no significant difference in liver function between the two groups (P>0.05); the incidence of dyslipidemia was 2.91% in the ATG group and 9.38% in the CsA group during the same treatment cycle.The incidence of dyslipidemia in patients in the CsA group was significantly higher than that in the ATG group (P<0.05). Conclusion: Cholelithiasis can be secondary to the treatment of aplastic anemia with cyclosporine,among which gallbladder sediment stones are common,and the generation of stones may be closely related to cholestasis caused by cyclosporine,and CsA can cause dyslipidemia in patients. 2023 Vol. 29 (7): 1217-1221 [Abstract] ( 48 ) HTML (1 KB)  PDF (1240 KB)  ( 115 ) 1222 Effect of Bronchoalveolar Lavage Combined with Immunoglobulin on the Prognosis and Imaging Performance of Children with Severe Mycoplasma Pneumonia LU Wei, et al DOI: 10.3969/j.issn.1006-6233.2023.07.032 Objective: To investigate the effect of bronchoalveolar lavage combined with immunoglobulin on the prognosis and imaging performance of children with severe mycoplasma pneumonia. Methods: One hundred and fifty children with SMPP admitted from January 2018 to December 2019 were selected as study subjects,and the children were divided into hormone group,propecia group,and combined treatment group according to the random number table method,with 50 cases in each group.In the hormone group,there were 28 males and 22 females,aged 5-12 years,mean age (8.62±1.03) years,duration of illness 7-14 days,mean (10.17±1.33) days; in the propecia group,there were 30 males and 20 females,aged 6-12 years,mean age (9.14±1.04) years,duration of illness 7-14 days,mean (10.22±1.28) days; in the combination therapy group,there were 26 males and 24 females,mean age (9.14±1.04) years,duration of illness 7-14 days,mean (10.22±1.28) days.group,26 males and 24 females,age 5-12 years,mean age (9.17±1.17) years,duration of disease 7-14 days,mean (9.44±1.19) days.In the hormone group,methylprednisolone 1~2mg/kg-d was administered intravenously for 5 days,and basic treatment such as anti-infection and appropriate rehydration was also given.The C-ball group was treated with immunoglobulin 400mg/kg-d intravenously for 5 days.In the combined treatment group,bronchoalveolar lavage was added on top of the treatment in the propofol group.The efficacy of the three groups and the imaging changes before and after treatment were observed. Results: The total effective rate of clinical treatment was 86.00% in the hormone group,84.00% in the propofol group,and 96.00% in the combined treatment group.The difference between the combined treatment group and the hormone and propofol groups was statistically significant (χ2=5.137,4.726,P=0.032,0.011).The results of the review of imaging after one week of treatment in the three groups showed that 16 cases (32.00%) of significant absorption in the hormone group and 18 cases (36.00%) of significant absorption in the propofol group were significantly lower than 22 cases (44.00%) in the combined treatment group,and the difference was statistically significant (P<0.05); 6 cases (12.00%) of bronchial occlusion in the hormone group and 8 cases (12.00%) of bronchial occlusion in the propofol group were statistically significant.The differences were statistically significant (P<0.05) when comparing 8 cases (16.00%) of bronchial occlusion in the hormone group (12.00%) and 8 cases (8.00%) in the propofol group with 4 cases (8.00%) in the combined treatment group. Conclusion: Bronchoalveolar lavage combined with immunoglobulin can effectively improve the treatment efficiency of children with severe mycoplasma pneumonia and promote the absorption of lung imaging lesions in children,which is worthy of clinical promotion. 2023 Vol. 29 (7): 1222-1225 [Abstract] ( 56 ) HTML (1 KB)  PDF (1180 KB)  ( 67 )

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