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2024 Vol. 30, No. 4 Published: 2024-04-30 529 Study on the Effect and Mechanism of Sitagliptin on Chemotherapy Sensitivity of Lung Cancer Cells by Regulating the FOXO3-FOXM1 Signal Pathway HA Tu, XILIN Tonggalaga, LIANG Xiuping, et al DOI: 10.3969/j.issn.1006-6233.2024.04.01 Objective: To investigate the effect and mechanism of sitagliptin (SIT) on the chemosensitivity of lung cancer cells by regulating the forkhead box protein O3 (FOXO3) - forkhead protein M1 (FOXM1) signaling pathway. Methods: Human lung cancer cell line A549 and cisplatin (DDP) resistant cell line A549/DDP were cultured in vitro and treated with 0, 0.5, 1, 2, 3, and 4 mmol/L of SIT. CCK-8 method was applied to determine the A549 and of A549/DDP cells viability in each group to screen the optimal concentration of SIT. A549/DDP cells were randomly separated into control group, SIT (2mmoL/L) group, an si-NC group (transfected with si-NC plasmid), a SIT (2mmol/L)+si-FOXO3 (transfected with FOXO3 siRNA plasmid) group, and were treated with 0, 2, 4, 8, 16, and 32 mg/L DDP while treating with SIT and plasmid, then the CCK-8 method was applied to determine the chemotherapy resistance index of cells in each group. A549/DDP cells were randomly separated into control group, SIT (2mmol/L) group, DDP (4mg/L) group, DDP (4mg/L)+si-NC group, DDP (4mg/L)+SIT (2mmol/L) group, and a DDP (4mg/L)+SIT (2mmol/L)+si-FOXO3 group, after grouping, the CCK-8 method, clone formation assay, and flow cytometry assay were applied to determine the proliferation and apoptosis of A549/DDP cells in each group; Western blot was applied to detect the expression of A549/DDP cell proliferation (C-myc, PCNA), apoptosis {Bax, cleaved poly ADP ribose polymerase (PARP)}, drug resistance {P-glycoprotein (P-gp), multidrug resistance associated protein (MRP1), MRP2, breast cancer drug resistance protein (BCRP)} and FOXO3-FOXM1 pathway related proteins in each group. Results: Compared with the control group, the chemotherapy resistance index of cells in the SIT group decreased (P<0.05), while there was no significant change in the chemotherapy resistance index of cells in the si-NC group (P>0.05); compared with the SIT group, the SIT+si-FOXO3 group showed an increase in cell chemotherapy resistance index (P<0.05). Compared with the control group, the A549/DDP cell viability, clone formation rate, C-myc, and PCNA protein expression in the DDP group and DDP+si-NC group reduced (P<0.05), the apoptosis rate, Bax and cleaved PARP protein expression was up-regulated (P<0.05); the A549/DDP cell viability, clone formation rate, C-myc and PCNA, P-gp, MRP1, MRP2, BCRP, and FOXM1 protein expression in the DDP+SIT group reduced (P<0.05), the apoptosis rate, Bax and cleaved PARP, FOXO3 protein expression was up-regulated (P<0.05); the P-gp, MRP1, MRP2, BCRP, and FOXM1 protein expression in A549/DDP cells in the SIT group decreased (P<0.05), the FOXO3 protein expression was up-regulated (P<0.05). Compared with the DDP group, the A549/DDP cell viability, clone formation rate, C-myc and PCNA, P-gp, MRP1, MRP2, BCRP, and FOXM1 protein expression in the DDP+SIT group reduced (P<0.05), the apoptosis rate, Bax and cleaved PARP, FOXO3 protein expression was up-regulated (P<0.05); there was no significant change in all indicators of A549/DDP cells in the DDP+si-NC group (P>0.05). Compared with the DDP+SIT group, the A549/DDP cell viability, clone formation rate, C-myc and PCNA, P-gp, MRP1, MRP2, BCRP, and FOXM1 protein expression in the DDP+SIT+si-FOXO3 group increased (P<0.05), the apoptosis rate, Bax and cleaved PARP, FOXO3 protein expression decreased (P<0.05). Conclusion: SIT can down-regulate the expression of drug resistant proteins, and enhance the chemotherapy sensitivity of lung cancer cells by promoting FOXO3-FOXM1 signaling, and thereby enhance the killing effect of DDP on DDP resistant lung cancer cells. 2024 Vol. 30 (4): 529-536 [Abstract] ( 77 ) HTML (1 KB)  PDF (2331 KB)  ( 40 ) 536 Impacts of Evodiamine on Rituximab Resistance in Diffuse Large B-Cell Lymphoma Cells by Regulating the Shh/Gli1 Signaling Pathway CHEN Jiaomin, XU Weixing, ZHANG Wei, et al DOI: 10.3969/j.issn.1006-6233.2024.04.02 Objective: To investigate the impacts of evodiamine on rituximab (RIT) resistance in diffuse large B-cell lymphoma (DLBCL) cells by regulating the Shh/Gli family zinc finger protein 1 (Gli1) signal pathway. Methods: OCI-LY10 cells were cultured in vitro and their RIT resistant cell line OCI-LY10/RIT was constructed using gradient drug addition method. All cells were treated with 0, 1, 5, 10, 20 and 30 μmoL/L of evodiamine, CCK-8 method was applied to determine the activity of OCI-LY10 and OCI-LY10/RIT cells in each group and to screen the optimal concentration of evodiamine. OCI-LY10/RIT cells were randomly grouped into control group, RIT group, RIT+evodiamine group, RIT+empty group, and RIT+evodiamine+Shh overexpression group, after grouping and processing, real-time fluorescence quantitative PCR and immunoblotting experiments were applied to detect the expression of Shh/Gli1 pathway related mRNA and protein of cells in each group; CCK-8 method and Edu staining were applied to detect cell proliferation in each group; flow cytometry was applied to detect cell apoptosis in each group; Western blot was applied to detect the expression of apoptotic proteins (Cleaved Caspase-3, Bax) and drug resistance proteins [multiple drug resistance related protein 5 (MRP5), P-glycoprotein (P-gp)] in each group. OCI-LY10/RIT cells were cultured in vitro and randomly grouped into a control group, a evodiamine group, an empty group, and a evodiamine+Shh overexpression group, after grouping and processing, the CCK-8 method was applied to detect the survival rate of OCI-LY10/RIT cells in each group under 0, 16, 32, 64, 128, 256 and 384 μg/mL RIT treatment, and calculate their drug resistance index. Results: Compared with the control group, the apoptosis rate, the expression of Cleaved Caspase-3 and Bax proteins in the RIT+evodiamine group increased (P<0.05), the expression of Shh, Gli1 mRNAs and proteins, survival rate, Edu positive rate, and the expression of MRP5 and P-gp proteins decreased (P<0.05); there was no obvious change in all cell indicators in the RIT group and the RIT+empty group (P>0.05). Compared with the RIT group, the apoptosis rate, the expression of Cleaved Caspase-3 and Bax proteins in the RIT group and the RIT+empty group increased (P<0.05), the expression of Shh, Gli1 mRNAs and proteins, survival rate, Edu positive rate, and the expression of MRP5 and P-gp proteins decreased (P<0.05); there was no obvious change in all indicators of cells in the RIT+empty group (P>0.05). Compared with the RIT+evodiamine group, the apoptosis rate, the expression of Cleaved Caspase-3 and Bax proteins in the RIT+evodiamine+Shh overexpression group decreased (P<0.05), the expression of Shh, Gli1 mRNAs and proteins, survival rate, Edu positive rate, and the expression of MRP5 and P-gp proteins increased (P<0.05). Compared with the control group, the cell resistance index in the evodiamine group decreased (P<0.05), the drug resistance index of cells in the empty group showed no obvious change (P>0.05); compared with the Evodiamine group, the evodiamine+Shh overexpression group showed an increase in cell resistance index (P<0.05). Conclusion: Evodiamine can down-regulate the expression of Shh/Gli1 pathway related proteins, thereby reducing RIT resistance in DLBCL cells, inducing apoptosis and inhibiting proliferation of RIT resistant DLBCL cells under RIT treatment. 2024 Vol. 30 (4): 536-543 [Abstract] ( 63 ) HTML (1 KB)  PDF (2370 KB)  ( 38 ) 544 Effect of Atractylenolide I on Myocardial Injury in Rats with AMI through Adjusting HIF-1α/VEGF Signaling Pathway MA Weiqian, et al DOI: 10.3969/j.issn.1006-6233.2024.04.03 Objective: To investigate the effect of atractylenolide I (Atr-I) on myocardial injury in acute myocardial infarction (AMI) rats by regulating hypoxia inducible factor-1 alpha (HIF-1α)/vascular endothelial growth factor (VEGF) signaling pathway. Methods: Rats were separated into control group, AMI group, Atr-I group, aspirin group, BAY87-2243 group, and Atr-I+BAY87-2243 group, with 18 rats in each group. Except for the control group, rats in all other groups were used to construct AMI models through ligating the root of the left anterior descending branch of the coronary artery. After 1 hour of modeling, treatment began, and the drug was administered once a day for 7 days. Echocardiography was applied to detect changes in left ventricular short axis shortening rate (FS) and left ventricular ejection fraction (LVEF); the percentage of myocardial infarction area in rats was detected by 2,3,5-triphenyl tetrazolium chloride (TTC) staining; HE staining was applied to detect pathological changes in left ventricular myocardial tissue; TUNEL staining was applied to detect myocardial cell apoptosis; ELISA was applied to detect the levels of myoglobin (Mb), lactate dehydrogenase (LDH), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) in left ventricular myocardial tissue; Western blot was applied to detect the expression of HIF-1α and VEGF proteins in myocardial tissue homogenate. Results: Compared with the control group, the myocardial injury was obvious in the AMI group, the FS, LVEF, the expression of HIF-1α and VEGF proteins decreased, the percentage of myocardial infarction area, the contents of Mb, LDH, TNF-α, and IL-1β increased (P<0.05); compared with the AMI group, the myocardial damage in rats in Atr-I group and aspirin group improved, the FS, LVEF, the expression of HIF-1α and VEGF proteins increased, the percentage of myocardial infarction area, the contents of Mb, LDH, TNF-α and IL-1β decreased; the corresponding indexes of BAY87-2243 group showed the opposite trend (P<0.05); compared with the Atr-I group, the myocardial injury in the Atr-I+BAY87-2243 group was exacerbated, the FS, LVEF, the expression of HIF-1α and VEGF proteins decreased, the percentage of myocardial infarction area, the contents of Mb, LDH, TNF-α, and IL-1β increased (P<0.05). Conclusion: Atr-I reduces myocardial injury in AMI rats, which may be related to the activation of the HIF-1α/VEGF signaling pathway. 2024 Vol. 30 (4): 544-549 [Abstract] ( 45 ) HTML (1 KB)  PDF (2407 KB)  ( 21 ) 549 Regulatory Mechanism of Mesalazine on Let-7i-5p/TLR4/MyD88 Signaling Pathway in a Mouse Model of Ulcerative Colitis MAO Zhenzhen, LIU Jing, ZHANG Chenhua, et al DOI: 10.3969/j.issn.1006-6233.2024.04.04 Objective: To investigate the regulatory mechanism of mesalazine (MSLZ) on Let-7i-5p and TLR4/MyD88 signaling pathway in a mouse model of 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced ulcerative colitis (UC). Methods: A UC model was established using the TNBS/ethanol method. Forty-four male mice were randomly divided into four groups: control group, model group, MSLZ group, and Let-7i-5p inhibitor group, with 11 mice in each group. Mice were gavaged or intraperitoneally injected with corresponding drugs or saline for 14 consecutive days. The expression levels of Let-7i-5p in colon tissues and serum of mice were detected by real-time quantitative polymerase chain reaction (qRT-PCR). The pathological changes of colon tissues were observed by hematoxylin and eosin (HE) staining under a microscope. The mRNA and protein levels of TLR4/MyD88 signaling pathway-related genes in colon tissues of mice were detected by qRT-PCR, Western blot, and immunohistochemistry, respectively. The expression levels of TNF-α and IL-1β in mouse serum were detected by ELISA. Results: According to the disease activity index (DAI), colon damage score, and pathological lesion score, the mouse UC model was successfully established. The expression levels of Let-7i-5p in colon tissues and serum of mice in the model group were significantly higher than those in the control group (P<0.0001). Compared with the model group, both MSLZ and Let-7i-5p inhibitor treatment could significantly inhibit the expression of Let-7i-5p (P<0.0001). Compared with the control group, the mRNA and protein levels of TLR4/MyD88 signaling pathway-related genes (including TLR4, MyD88, TRAF-6, and NF-κB) in colon tissues of mice in the model group were significantly upregulated. MSLZ and Let-7i-5p inhibitor treatment could significantly inhibit the expression of these genes, and the inhibitory effect of MSLZ was slightly stronger than that of Let-7i-5p inhibitor. Compared with the control group, the mRNA levels of IL-1β and TNF-α in colon tissues and the protein levels in serum of mice in the model group were significantly upregulated. MSLZ and Let-7i-5p inhibitor treatment could inhibit the expression levels of IL-1β and TNF-α. Conclusion: In the TNBS/ethanol-induced UC mouse model, MSLZ can inhibit the expression of Let-7i-5p in colon tissues and serum. In addition, MSLZ can also inhibit the release of inflammatory factors by inhibiting the TLR4/MyD88-dependent pathway in UC mice. 2024 Vol. 30 (4): 549-555 [Abstract] ( 38 ) HTML (1 KB)  PDF (2225 KB)  ( 19 ) 555 Signaling Pathway by DT-3 a Inhibitor of the PKGIα Pathway on Proliferation and Migration of Gastric Cancer Cells ZHANG Xiufen, et al DOI: 10.3969/j.issn.1006-6233.2024.04.05 Objective: To investigate the effect of DT-3, a specific inhibitor of the PKGIα signaling pathway, on the proliferation and migration of gastric cancer cells. Methods: Bioinformatics analysis was used to analyze the differential expression of PKGI in tissues and explore the prognosis of PKGI and PKGIα in gastric cancer patients based on the GEO, TCGA, HPA, Kaplan-Meier plotter databases and GEPIA online analysis website. CCK-8 and colony formation assays were used to detect the effect of DT-3 on cell proliferation, and wound healing assay was used to observe the effect of DT-3 on cell migration. Western blotting was used to verify the protein expression of PKGIα and correlation analysis was performed. Results: The expression of PKGI mRNA was increased in gastric adenocarcinoma tissues, and 27 out of 42 gastric cancer cell lines expressed PKGI mRNA. Gastric cancer tissues with high expression of PKGIα mRNA were more aggressive. Immunohistochemical (IHC) results showed that 6 out of 12 gastric cancer tissues showed moderate to strong cytoplasmic positive staining reaction. The expression of PKGI was negatively correlated with CDH1 (r=-0.74, P<0.05). Survival analysis showed that high expression of PKGI and PKGIα mRNA was significantly associated with overall survival (OS) of gastric adenocarcinoma patients (HR>1, logrank P<0.05). The experimental results showed that the expression of PKGIα protein was increased in human gastric cancer cell line AGS. DT-3 inhibited cell proliferation and migration (P<0.05), decreased the expression of phosphorylated p65 of NF-κB, and the expression of PKGI and NF-κB p-p65 was extremely positively correlated (r=0.957, P<0.05). Conclusion: Inhibition of the PKGIα signaling pathway by DT-3 can effectively inhibit the proliferation and migration of gastric cancer cells. 2024 Vol. 30 (4): 555-560 [Abstract] ( 54 ) HTML (1 KB)  PDF (2854 KB)  ( 37 ) 560 The Role of STAT3 Polymorphism in the Development of Cervical Cancer Caused by HPV16 ZHANG Hemin, YU Yan, LIU Yanyun DOI: 10.3969/j.issn.1006-6233.2024.04.06 Objective: To investigate the role of signal transducer and activator of transcription 3 (STAT3) polymorphism in the development of cervical cancer caused by human papillomavirus 16 (HPV16). Methods: A retrospective study was conducted on 34 patients with cervical cancer who were admitted to the hospital from 2019 to 2023. They were assigned to Group A. Another 54 patients with cervical intraepithelial neoplasia and 80 patients with chronic cervicitis admitted to the hospital during the same period were assigned to Groups B and C, respectively. The expression of HPV16 E6 protein was detected by immunohistochemistry and polymerase chain reaction (PCR)-reverse dot blot hybridization. The expression of STAT3 protein was detected by PCR, and the polymorphism of STAT3 gene C1697G was detected by PCR-restriction fragment length polymorphism (RFLP). The expression rates of E6 and STAT3 proteins and the genotypes of STAT3 gene polymorphism in the three groups were compared and analyzed. Results: The positive expression rates of E6 and STAT3 proteins in Group A were significantly higher than those in Groups B and C (P<0.0167). The positive expression rates of E6 and STAT3 proteins in Group B were significantly higher than those in Group C (P<0.0167). The frequency of the G/G genotype in Groups A and B was significantly lower than that in Group C, and the frequency of the C/C genotype was significantly higher than that in Group C (P<0.0167). The frequency of the G/G genotype in Group A was significantly lower than that in Group B, and the frequency of the C/C genotype was significantly higher than that in Group B (P<0.0167). There was no significant difference in the frequency of the G/C genotype among the three groups (P>0.0167). Conclusion: STAT3 and its polymorphism may play an important role in the development and progression of cervical cancer caused by HPV16. 2024 Vol. 30 (4): 560-564 [Abstract] ( 54 ) HTML (1 KB)  PDF (1225 KB)  ( 19 ) 564 Pulmonary Infection Airway Inflammatory Injury Changes Significance of Serum SAA and CRP in Elderly Patients with COPD and Obstructive Sleep Apnea Syndrome FU Xiaopei, SHI Jingfeng, TENG Xiaobao, et al DOI: 10.3969/j.issn.1006-6233.2024.04.07 Objective: To explore pulmonary infection, airway inflammatory injury, changes significance of serum amyloid A (SAA) and C-reactive protein (CRP) in elderly patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSAS). Methods: A total of 120 elderly patients with COPD and OSAS and 120 elderly patients only with COPD in the hospital were enrolled as COPD combined OSAS group and simple COPD group between January 2021and June 2023. The detection rate of pulmonary infection and levels of serum IL-6, IL-10, IL-1β, COX-2, CRP and SAA were compared between the two groups. The levels of serum indexes in patients with pulmonary infection and those without infection were compared. The evaluation efficiency of serum CRP and SAA for pulmonary infection was analyzed by ROC curves. Results: The detection rate of pulmonary infection in COPD combined OSAS group was higher than that in simple COPD group (28.33% vs 17.50%, P<0.05), and levels of serum IL-6, IL-10, IL-1β, COX-2, CRP and SAA were also higher than those in simple COPD group (P<0.05). The levels of serum CRP and SAA in patients with pulmonary infection were significantly higher than those in patients without infection (P<0.05). ROC curves analysis showed that AUC values of serum CRP, SAA and combined detection for evaluating pulmonary infection were 0.834, 0.894 and 0.929, respectively (P<0.05). Conclusion: The levels of serum CRP, SAA and airway inflammatory injury indexes are abnormally increased in elderly patients with COPD and OSAS. The combined detection of serum CRP and SAA has the best evaluation efficiency for pulmonary infection. 2024 Vol. 30 (4): 564-569 [Abstract] ( 44 ) HTML (1 KB)  PDF (1281 KB)  ( 17 ) 570 Relationship between the Expression of Serum miR-33 ABCA1 in Patients with Gestational Diabetes and the Condition and Pregnancy Outcome LI Hongxia, ZENG Huan DOI: 10.3969/j.issn.1006-6233.2024.04.08 Objective: To investigate the relationship between the expression of serum miR-33 and ABCA1 in patients with gestational diabetes and the condition and pregnancy outcome. Methods: Retrospective analysis was made on 75 pregnant women (diabetes group) who were diagnosed with gestational diabetes during obstetric examination in our hospital from April 2022 to April 2023, and 64 pregnant women with normal pregnancy as the control group, fasting blood samples were taken and insulin resistance was calculated; reverse transcription quantitative real-time PCR method was applied to measure the expression level of serum miR-33; enzyme linked immunosorbent assay (ELISA) was applied to measure serum ABCA1 level; the serum levels of miR-33 and ABCA1 were compared between two groups and among patients with different Priscilla WHITE grades; Pearson method was applied to analyze the correlation between serum miR-33 and ABCA1 levels, and their correlation with insulin resistance; the adverse outcomes of subjects and newborns in two groups were compared; according to the adverse pregnancy outcome, the patients with gestational diabetes were separated into good pregnancy group (42 cases) and poor pregnancy group (33 cases), the serum levels of ABCA1 and miR-33 were compared between the two groups; Logistic regression was applied to analyze the factors affecting the outcome of gestational diabetes. Results: The serum ABCA1 level in the diabetes group was obviously lower than that in the control group (t=9.839, P=0.000), and the expression of miR-33 and insulin resistance were obviously increased (t=9.256, P=0.000), there was no statistical difference in the gestational week, first pregnancy, body mass and age (P>0.05), as the condition worsened, the expression level of miR-33 increased (t=5.231, P=0.000) and the level of ABCA1 decreased (t=9.421, P=0.000). Serum ABCA1 was negatively correlated with miR-33 and insulin resistance in patients with gestational diabetes (r=-0.685, -0.510, P=0.000), but miR-33 was positively correlated with insulin resistance (r=0.535, P=0.000); the incidences of macrosomia, neonatal hypoglycemia and premature rupture of membranes in the diabetes group were obviously higher than those in the control group (P<0.05); the serum miR-33 level in the poor pregnancy group were obviously increased compared to the good pregnancy group (P<0.05), but the ABCA1 level was obviously reduced (P<0.05); serum miR-33 and ABCA1 levels and insulin resistance were independent influencing factors for adverse pregnancy in patients with gestational diabetes (P<0.05). Conclusion: Serum miR-33 is obviously increased and ABCA1 expression is decreased in patients with gestational diabetes, both of which are related to insulin resistance. The pregnancy outcome is affected by the levels of serum miR-33, ABCA1 and insulin resistance. 2024 Vol. 30 (4): 570-575 [Abstract] ( 50 ) HTML (1 KB)  PDF (1269 KB)  ( 21 ) 575 Effect of Reflux Disease on the Expression Levels and Clinical Manifestations of Serum IL-10 TGF-β1 sPD-1 and sPD-L1 in Patients with Chronic Obstructive Pulmonary Disease XU Teng, HAO Lijun, LIU Hongchun, et al DOI: 10.3969/j.issn.1006-6233.2024.04.09 Objective: To analyze the influence of gastroesophageal reflux disease (GRED) on the expression levels and clinical manifestations of serum interleukin -10(IL-10), transforming growth factor -β1(TGF-β1), soluble programmed death receptor -1(sPD-1) and sPD-1 ligand (sPD-L1) in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 104 COPD patients admitted to our hospital from January 2022 to September 2023 were divided into combined group and non-combined group according to whether the patients were complicated with reflux disease. The lung function, IL-10, TGF-β1, sPD-L1 and sPD-1 expression levels and clinical manifestations were compared between the two groups. Results: Among 104 COPD patients, 32 cases were complicated with GERD, accounting for 30.77%. IL-10 in the combined group was lower than that in the non-combined group, and its TGF-β1, sPD-1 and sPD-L1 were higher than those in the non-combined group, with statistical significance (P<0.05). FEV1, FEV1/FVC and FEV1% in the combined group were lower than those in the non-combined group, and the difference was statistically significant (P<0.05). The combined group had higher cough symptoms, cough effects, expectoration symptoms, expectoration effects scores, mMRC scores, SGRQ scores and total scores than the non-combined group, and the difference was statistically significant (P<0.05). Conclusion: Nearly one third of COPD patients are complicated with GERD, and GERD is related to the stronger inflammatory reaction and the high expression of sPD-1 and sPD-L1, accompanied by worse lung function and more serious clinical manifestations. 2024 Vol. 30 (4): 575-579 [Abstract] ( 36 ) HTML (1 KB)  PDF (1219 KB)  ( 18 ) 580 Effect of Platelet-Rich Fibrin on Inflammatory Response in Refractory Wounds YANG Jingzhe, XIAO Changshuan, BAO Haiyang, et al DOI: 10.3969/j.issn.1006-6233.2024.04.010 Objective: To investigate the effect of platelet-rich fibrin (PRF) on inflammatory response in refractory wounds. Methods: From September 2020 to December 2022, 40 patients with refractory wounds diagnosed in the Department of Burns and Plastic Surgery of the Affiliated Hospital of Chengde Medical University were randomly divided into the PRF group and the control group, with 20 cases in each group. After admission, all patients underwent wound debridement and iodine disinfection. The PRF group was treated with PRF on the wound surface, and the dressing was changed every other day. The control group was treated with sterile dressing change. Wound tissue was collected before treatment, on the 7th and 14th day after treatment for HE staining to observe the pathological changes of the wound. Venous blood was drawn to detect the changes of white blood cell (WBC), C-reactive protein (CRP), and procalcitonin (PCT) levels. Immunohistochemical staining of CD34 was performed on the wound tissue to observe the vascularization of the wound before and after treatment. Flow cytometry was used to compare the changes of CD4+T cells and CD8+T cells in the blood of patients before and on the 7th day after treatment, as well as the CD4+T/CD8+T ratio. Results: There was no statistically significant difference in gender, age and course of disease before admission between the two groups (P>0.05). HE staining showed that before treatment, there was a large number of inflammatory cell infiltration and a small number of vessels in the wounds of both groups. On the 7th day after treatment, the inflammatory cell infiltration in the PRF group was reduced, and new vessels were formed. On the 14th day after treatment, the inflammatory cells in the PRF group were significantly reduced, the epithelium proliferated, and new skin appendages appeared. There was no statistically significant difference in WBC, CRP, and PCT levels before treatment (P>0.05). On the 7th and 14th day after treatment, the inflammatory indicators all decreased, and the differences between the two groups were statistically significant (P<0.05). On the 7th and 14th day after treatment, the number of CD34 positive cells in the PRF group was more than that in the control group, and the number of new vessels was more. The epithelialization of the wound also appeared earlier than that in the control group. There was no statistically significant difference in CD4+T cells, CD8+T cells, and CD4+/CD8+ ratio between the two groups before treatment (P>0.05). On the 7th day after treatment, the CD4+T and CD4+/CD8+ ratio cells in both groups increased, and the CD8+T cells decreased. There were statistically significant differences in CD4+T cells, CD8+T cells, and CD4+/CD8+ ratio between the two groups (P<0.05). Conclusion: PRF can reduce inflammatory response, improve blood circulation and immune function in refractory wounds. 2024 Vol. 30 (4): 580-586 [Abstract] ( 42 ) HTML (1 KB)  PDF (1914 KB)  ( 34 ) 586 Effects of Ticagrelor Combined with PCI on Oxidative Stress Injury Cardiac Function and Adverse Cardiovascular Events in Elderly Patients with Acute Myocardial Infarction WU Lulu, SHI Shengjin, LI Jiawei, et al DOI: 10.3969/j.issn.1006-6233.2024.04.011 Objective: To observe the effects of Ticagrelor combined with percutaneous coronary intervention (PCI) on oxidative stress injury, cardiac function and adverse cardiovascular events in elderly patients with acute myocardial infarction. Methods: A total of 160 elderly patients with acute myocardial infarction who underwent PCI treatment in our hospital from January 2020 to June 2021 were selected as the study subjects. They were randomly divided into two groups using a random number table method, with a single group of 80 patients. Both groups received PCI treatment, the control group received dual antiplatelet therapy of aspirin combined with clopidogrel, and the observation group received antiplatelet therapy of aspirin combined with tigrel. Compare the differences in cardiac function, oxidative stress injury, high sensitivity C-reactive protein (hs CRP), soluble CD40 ligand (sCD40L), N-terminal proBNP precursor (NT-proBNP), and activated platelet glycosylation complex (PAC-1) between the two groups, and analyze the occurrence of major adverse cardiovascular events (MACE) between the two groups. Results: Before treatment, there was no statistically significant difference in cardiac function between the two groups (P>0.05). Compared with before treatment, the left ventricular ejection fraction (LVEF), stroke volume (SV), and cardiac index (CI) of the two groups increased at 4 and 24 weeks of treatment. There was no statistically significant difference in cardiac function between the two groups (P>0.05). Before treatment, there was no statistically significant difference in the indicators of oxidative stress damage, hs CRP, NT-proBNP, sCD40L, and PAC-1 between the two groups (P>0.05). Compared with before treatment, hs CRP, NT-proBNP, malondialdehyde (MDA), sCD40L, and PAC-1 in both groups decreased at 4 and 24 weeks of treatment. The observation group was lower than the control group at 4 and 24 weeks of treatment (P<0.05), and the levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in both groups increased at 4 and 24 weeks of treatment. The observation group was higher than the control group at 4 and 24 weeks of treatment (P<0.05). The incidence of MACE in the observation group was 7.50% (6/80), lower than the control group's 18.75% (15/80) (P<0.05), and the cumulative incidence of adverse reactions was 13.75% (11/80). There was no statistically significant difference (P>0.05) compared to the control group's 11.25% (9/80). Conclusion: Tiagrelor combined with PCI in the treatment of elderly patients with acute myocardial infarction can reduce oxidative stress injury, reduce the expression levels of hs-CRP and NT-proBNP, and reduce the occurrence of MACE. 2024 Vol. 30 (4): 586-592 [Abstract] ( 32 ) HTML (1 KB)  PDF (1250 KB)  ( 16 ) 593 Clinical Efficacy of Noninvasive Mechanical Ventilation in the Treatment of AECOPD Combined with Hypercapnia and Its Effect on Blood Gas Analysis and Inflammatory Factors GUAN Wenxia, JIN Jianfeng, MA Xiaojun DOI: 10.3969/j.issn.1006-6233.2024.04.012 Objective: To analyze the clinical efficacy of non-invasive mechanical ventilation (NIV) in the treatment of AECOPD combined with hypercapnia and its effect on blood gas analysis, inflammation factors. Methods: A retrospective analysis was conducted on 118 patients with AECOPD combined with hypercapnia treated in our hospital from April 2022 to April 2023, 58 cases were divided into control group (oxygen therapy and conventional drug treatment) and 60 cases were divided into observation group (NIV treatment). The clinical efficacy, blood gas analysis (pH, PaO2, PaCO2), Inflammatory factors (IL-6, IL-10,TNF-α) and T lymphocyte subsets (CD3+, CD4+, CD4+/CD8+). Results: The total effective rate of the control group (63.79%) was lower than that of the observation group (81.67%) (P<0.05); the differences in PaO2, pH, and PaCO2 before treatment between the two groups were not statistically significant (P > 0.05). Comparison of the differences in PaO2, pH, PaCO2 before and after treatment between the two groups (P>0.05); Comparison of the levels of IL-6, IL-10, TNF-α before treatment between the two groups (P>0.05); The difference in IL-6, IL-10, TNF-α before and after treatment in the observation group was greater than that in the control group (P<0.05); Comparison of the levels of CD3+, CD4+, CD4+/CD8+ before treatment between the two groups (P<0.05); Comparison of the levels of CD3+, CD4+, CD4+/CD8+ before treatment between the two groups (P<0.05). levels were compared (P>0.05); the difference between CD3+, CD4+, CD4+/CD8+ before and after treatment in the observation group was greater than that in the control group (P<0.05). Conclusion: NIV treatment improves the clinical therapeutic effect of AECOPD patients with hypercapnia, effectively improves inflammatory factor indexes and T lymphocyte subsets, and contributes to the comprehensive recovery of patients. 2024 Vol. 30 (4): 593-597 [Abstract] ( 35 ) HTML (1 KB)  PDF (1217 KB)  ( 19 ) 597 Clinical Value of High Frequency Ultrasound and Real Time Shear Wave Elastography in Diagnosis of Acute Anterior Talofibular Ligament Injury MAO Ji, HU Zeying, ZHU Xiansheng DOI: 10.3969/j.issn.1006-6233.2024.04.013 Objective: To compare the diagnostic efficacy of high-frequency ultrasound (HFUS) and real-time shear wave elastography (SWE) in diagnosing acute anterior talofibular ligament (ATFL) injury and to explore the advantages of diagnostic methods for clinical diagnosis of the disease. Methods: A total of 80 patients with suspected acute ATFL injury of the ankle joint were collected from March 2021 to April 2023. All patients underwent HFUS and SWE ultrasound elastography examination before surgery. The arthroscopy examination results were used as the gold standard for diagnosis. The diagnostic value of HFUS and SWE in acute ATFL injury was compared, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of HFUS and SWE for acute ATFL injury. The detection rates of joint effusion, talar cartilage injury, tendon injury, and fracture were also compared. Results: ①All 80 patients were confirmed to have injuries by arthroscopy, including 42 cases of complete tear, 35 cases of partial tear, and 3 cases of ligament injury. In the HFUS examination, there were 47 cases of complete tear, 30 cases of partial tear, and 3 cases of ligament injury. In the HFUS combined with SWE examination, there were 43 cases of complete tear, 35 cases of partial tear, and 2 cases of ligament injury. ②Taking the arthroscopy examination results as the gold standard, the consistency analysis was performed using SPSS software. The consistency test results showed that the kappa coefficient of consistency between HFUS and arthroscopy diagnosis was 0.644 (P < 0.001), and there was no statistical difference between the two in I degree injury (χ2 = 0.000, P = 1.000), II degree injury (χ2 = 0.648, P = 0.421), and III degree injury (χ2 = 0.633, P = 0.426). The Kappa coefficient of consistency between HFUS combined with SWE and arthroscopy diagnosis was 0.857 (P < 0.001), and there was no statistical difference between the two in I degree injury (χ2 = 0.206, P = 1.000), II degree injury (χ2 = 0.000, P = 1.000), and III degree injury (χ2 = 0.025, P = 0.874). ③The area under the curve (AUC) of HFUS for I degree injury was 0.827, and the AUC of HFUS combined with SWE for I degree injury was 0.833, with no statistical difference (P > 0.05); the AUC of HFUS for II degree injury was 0.802, and the AUC of HFUS combined with SWE for II degree injury was 0.938, with statistical difference (P < 0.05); the AUC of HFUS for III degree injury was 0.831, and the AUC of HFUS combined with SWE for III degree injury was 0.949, with statistical difference (P < 0.05). ④There was no statistical difference in the detection rates of joint effusion, talar cartilage injury, and tendon injury between HFUS and HFUS combined with SWE (P > 0.05); the detection rate of fracture was statistically different (P < 0.05). Conclusion: HFUS combined with SWE has high clinical value in diagnosing acute ATFL injury, and it has high judgment ability for injury grading, and it can also be used to judge the combined injury of the ankle joint. 2024 Vol. 30 (4): 597-603 [Abstract] ( 34 ) HTML (1 KB)  PDF (1507 KB)  ( 19 ) 603 Comparison of Short-Term Efficacy of Mediastinal Tumor Resection via Subcostal Incision and Intercostal Approach under Thoracoscope LIANG Guanbiao, YANG Nuo, LI Changqian, et al DOI: 10.3969/j.issn.1006-6233.2024.04.014 Objective: To compare the short-term efficacy of video-assisted thoracoscopic (VATS) trans-xiphoid subcostal and intercostal approaches for mediastinal tumor resection. Methods: A total of 157 patients who underwent thoracoscopic mediastinal tumor resection via the xiphoid process or intercostal approach in the Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangxi Medical University from January 2019 to January 2022 were selected. They were divided into the xiphoid process group (n=56) or intercostal group (n=102) according to the surgical approach. After propensity score matching, 52 patients were included in each group. The two groups were compared for surgery-related indicators [postoperative chest drainage volume, intraoperative blood loss, drainage tube indwelling time, operation time, bed rest time, number of self-pressing analgesia pumps, and hospitalization costs], postoperative complication rate, and pain level. Serum myoglobin (Mb), nerve growth factor (NGF), creatine phosphokinase (CPK), and prostaglandin E2 (PGE2) levels were measured using electrochemiluminescence and enzyme-linked immunosorbent assay before surgery, and on days 1, 3, and 5 after surgery. Results: The indwelling time of drainage tube (2.37±1.05) days, bed rest time (1.37±0.65) days, hospitalization time (6.07±1.82) days, intraoperative blood loss (72.26±9.41) ml, chest drainage volume (248.74±80.41) ml, the number of times of self-pressing the analgesia pump (3.72±0.98) times, and hospitalization costs (3.10±0.84) million yuan in the xiphoid group were less than those in the intercostal group (3.02±1.31) days, (1.92±0.70) days, (7.31±2.13) days, (85.33±12.69) ml, (325.96±95.22) ml, (8.41±2.17) times, and (3.76±1.22) million yuan (t=2.792, 4.152, 3.192, 5.966, 4.468, 14.204, 3.213, P<0.05); at 1 d, 3 d and 5 d after surgery, Mb, CPK, NGF and PGE2 in the xiphoid group were lower than those in the intercostal group (P<0.05); at 1 d, 7 d and 1 month, 3 months after surgery, the pain VAS scores in the xiphoid group were lower than those in the intercostal group (P<0.05); the incidence of complications in the xiphoid group was 1.92% (1/52), which was lower than that in the intercostal group (17.31%) (χ2=7.081, P<0.05). Conclusion: Compared with thoracoscopic transcostal approach, transxiphoid subcostal approach for mediastinal mass resection can significantly reduce the degree of muscle injury and pain in patients, and the operation is safe and reliable, conducive to postoperative recovery of patients, and the hospitalization cost is relatively low. 2024 Vol. 30 (4): 603-608 [Abstract] ( 38 ) HTML (1 KB)  PDF (1228 KB)  ( 11 ) 609 Relationship between Serum IL-6 PCT and CRP Levels and Prognosis of Neonatal Sepsis XU Aihua, GU Tao, LI Yun, et al DOI: 10.3969/j.issn.1006-6233.2024.04.015 Objective: To investigate the relationship between serum interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) levels and the prognosis of neonatal sepsis. Methods: A total of 86 neonates with sepsis admitted to our hospital from August 2020 to March 2023 were enrolled as the study subjects. The general data of the cured/improved group and the death group were analyzed. The serum IL-6, PCT, and CRP levels of the neonates in the two groups at different time points were compared, and the factors affecting the prognosis of neonates with sepsis were analyzed. Results: Among the 86 neonates with sepsis, there were 77 neonates in the cured/improved group and 9 neonates in the death group (4 neonates died within 12 hours, 2 died within 2 days, 2 died within 3 days, and 1 died within 5 days). The percentages of IL-6 > 7 pg/mL, PCT > 0.5 ng/mL, and CRP > 10 mg/mL in the death group were higher than those in the cured/improved group at 12 hours, 12-36 hours, and 7 days after onset (P < 0.05). There were no statistically significant differences in gender, premature rupture of membranes, preterm birth, jaundice, and delivery method between the two groups (P > 0.05). The gestational age, birth weight, and Ages & Stages Questionnaires (ASQ) at 0-6 years old were significantly different between the two groups (P < 0.05). Multivariate logistic regression analysis showed that ASQ at 0-6 years old, IL-6, PCT, and CRP were independent risk factors for the prognosis of neonatal sepsis (P < 0.001). Conclusion: Serum IL-6, PCT, and CRP levels are related factors affecting the prognosis of neonates with sepsis. Monitoring serum IL-6, PCT, and CRP levels may provide reliable references for clinical adjustment of treatment strategies for neonatal sepsis. 2024 Vol. 30 (4): 609-613 [Abstract] ( 38 ) HTML (1 KB)  PDF (1201 KB)  ( 30 ) 613 Analysis of Factors Influencing Early Neurological Deterioration after Emergency Interventional Thrombolysis in Patients with Acute Cerebral Infarction ZHANG Feng, JI Liu, GE Chunyang, et al DOI: 10.3969/j.issn.1006-6233.2024.04.016 Objective: To investigate the factors influencing early neurological deterioration (END) after emergency interventional thrombolysis in patients with acute cerebral infarction. Methods: A total of 105 patients with acute cerebral infarction who underwent emergency interventional thrombolysis in our hospital from March 2020 to March 2023 were enrolled in this study. According to whether END occurred within 24 hours after thrombolysis, the patients were divided into the END group (n=34) and the non-END group (n=71). Univariate analysis was used to analyze the factors related to END, and multivariate logistic regression analysis was used to analyze the independent risk factors for END. Results: Univariate analysis showed no significant differences between the END and non-END groups in terms of gender, age, BMI, smoking history, drinking history, hypertension history, diabetes history, coronary heart disease history, and distribution of the responsible large vessel (P>0.05). However, the degree of stenosis of the responsible large vessel was significantly different between the END and non-END groups (P<0.05). Univariate analysis of the quantitative data showed that the National Institutes of Health Stroke Scale (NIHSS) score, thrombolysis time, white blood cell count, neutrophil count, Lp-PLA2 level, and lipoprotein a level were significantly different between the END and non-END groups (P<0.05). However, there were no significant differences between the END and non-END groups in terms of time from onset to thrombolysis, D-dimer level, and Hcy level (P>0.05). Multivariate logistic regression analysis showed that the degree of stenosis of the responsible large vessel, NIHSS score on admission, thrombolysis time, white blood cell count, neutrophil count, Lp-PLA2, and lipoprotein a were independent risk factors for END. Conclusion: The incidence of END after emergency interventional thrombolysis in patients with acute cerebral infarction is high and is influenced by multiple factors. The degree of stenosis of the responsible large vessel, NIHSS score on admission, thrombolysis time, white blood cell count, neutrophil count, Lp-PLA2, and lipoprotein a are independent risk factors for END. 2024 Vol. 30 (4): 613-618 [Abstract] ( 48 ) HTML (1 KB)  PDF (1223 KB)  ( 22 ) 618 A Comparative Study of Arthroscopic Treatment of Acromion Impingement Syndrome with Tendinitis of Biceps Brachii Long Head (LHBT) in High Joint and Low Intertrochanteric Groove with Small Incision WU Fengchun, LIAO Mingxin, HUANG Jiexin, et al DOI: 10.3969/j.issn.1006-6233.2024.04.017 Objective: To investigate the comparative study of arthroscopic high intra-articular and small incision low extra-articular LHBT amputation and fixation for SIS patients with long head tendinitis of biceps brachii. Methods: From December 2019 to December 2022, 92 patients with ASES accompanied with tendinitis of biceps brachii long head were selected in our hospital. Among them, 45 patients were treated with high intra-articular LHBT amputation and fixation under arthroscopy (observation group A), and 47 patients were treated with low intra-articular LHBT amputation and fixation under intertrochanteric groove (observation group B). The scores of each dimension, total score and Constant of the University of California (UCLA) shoulder joint scoring system before and after treatment were compared. Results: After treatment, both UCLA scores of each dimension, patient satisfaction, and total scores were increased (P<0.05), but the differences in UCLA scores, patient satisfaction, and total scores before and after treatment in Group A were significantly lower (P<0.05). After treatment, Constant and ASES scores increased in both groups compared to before treatment (P<0.05), but the difference between the Constant and ASES scores of Group A before and after treatment is significantly lower (P<0.05). Compared with 95.74%, 80.00% was significantly less effective (P<0.05). Conclusion: Compared with arthroscopic treatment of high-level intra-articular LHBT amputation and fixation, small-incision low-level intra-articular LHBT amputation and fixation for SIS patients with long head tendinitis of biceps brachii can effectively promote the recovery of shoulder joint function and improve the clinical curative effect. 2024 Vol. 30 (4): 618-623 [Abstract] ( 21 ) HTML (1 KB)  PDF (2170 KB)  ( 17 ) 623 The Relationship Between EEG Abnormalities and Serum BDNF GFAP miR-7-5p Expression Characteristics and Cognitive Function in Epilepsy Patients BAI Yang, YANG Yue, QI Huizhen DOI: 10.3969/j.issn.1006-6233.2024.04.018 Objective: To explore the relationship between EEG abnormalities, serum levels of Brain-Derived Neurotrophic Factor (BDNF), Glial Fibrillary Acidic Protein (GFAP), and miR-7-5p expression characteristics, and cognitive function in epilepsy patients. Methods: The study included 294 epilepsy patients treated at our hospital from April 2017 to April 2021. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. Patients were divided into two groups based on their MoCA scores: 198 patients with scores ≥26 were included in the cognitively normal group, while 96 patients with scores <26 were included in the cognitive impairment group. All patients underwent EEG examinations. The study compared EEG abnormalities and serum levels of BDNF, GFAP, and miR-7-5p between the groups and investigated their association with cognitive impairment. Results: Analysis of the MoCA scores showed that patients in the cognitive impairment group had significantly lower scores than those in the cognitively normal group (P<0.05). Compared to the cognitively normal group, patients in the cognitive impairment group had a lower proportion of normal EEGs and higher rates of epileptiform discharges and slow-wave activity (P<0.05). Serum levels of BDNF and miR-7-5p were lower, while GFAP levels were higher in the cognitive impairment group (P<0.05). Pearson correlation analysis indicated that cognitive function in epilepsy patients was positively correlated with BDNF and miR-7-5p levels and negatively correlated with GFAP levels (P<0.05). ROC curve analysis demonstrated that BDNF, miR-7-5p, and GFAP levels have diagnostic value for cognitive impairment in epilepsy patients, with AUC values of 0.836, 0.845, and 0.957, respectively. Conclusion: The abnormal characteristics of EEG in patients with cognitive impairment are mainly EEG discharge and slow wave distribution of EEG. The expression of serum BDNF and miR-7-5p is lower than that of patients with normal epilepsy, and the expression of GFAP is higher than that of patients with normal epilepsy, and serum BDNF, miR-7-5p and GFAP have certain diagnostic value for the occurrence of cognitive impairment in patients with epilepsy. 2024 Vol. 30 (4): 623-629 [Abstract] ( 23 ) HTML (1 KB)  PDF (1472 KB)  ( 27 ) 629 Effect of Three Fixation Methods of Sengstaken-Blakemore Tube on Compression Hemostasis in Patients with Esophageal and Gastric Varices Bleeding GUO Lei, ZHAO Lifang, LU Wei DOI: 10.3969/j.issn.1006-6233.2024.04.019 Objective: To explore the application efficacy of three fixation methods of Sengstaken-Blakemore tube on compression hemostasis in patients with esophageal and gastric varices bleeding. Methods: A total of 210 patients with esophageal and gastric varices bleeding admitted to our hospital from January 2021 to October 2022 were selected as the study subjects. The patients were randomly divided into traditional fixation group, rhinobyon fixation group and table tennis fixation group by means of the randomization method, with 70 cases in each group. The traditional fixation group was fixed with Sengstaken-Blakemore tube by traditional method, and the rhinobyon fixation group was fixed by rhinobyon method, and the table tennis fixation group was fixed by table tennis method. The clinical efficacy (hemostasis effective rate, bleeding control time, blood transfusion volume, rebleeding rate), incidence rates of complications (nasal mucosa damage, asphyxia, chest tightness, retrosternal pain, throat injury), airbag breakage rate and catheterization success rate were compared among the three groups of patients. The differences in bleeding-related biochemical indicators (hemoglobin, urea nitrogen, platelet count) and coagulation function indicators (fibrinogen content, prothrombin time, thromboplastin time) were recorded before treatment and at 6 months after treatment. Results: The hemostasis effective rate and success rate of catheterization were shown as table tennis fixation group (97.44%, 100%) >rhinobyon fixation group (94.87%, 97.14%) >traditional fixation group (87.50%, 78.57%) (P<0.05). The clinical efficacy indexes (bleeding control time, blood transfusion volume) were manifested as table tennis fixation group<thromboplastin fixation group<traditional fixation group (P<0.05). Compared with before treatment, the hemoglobin content and platelet count in the three groups were significantly increased at 6 months after treatment (P<0.05), and the increases revealed table tennis fixation group>thromboplastin fixation group>traditional fixation group. The concentration of urea nitrogen was significantly decreased (P<0.05), and the decrease was expressed as table tennis fixation group>thromboplastin fixation group>traditional fixation group. There were no obvious differences in rebleeding rate, airbag breakage rate and coagulation function indicators among the three groups (P>0.05). Conclusion: Compared with rhinobyon fixation method and traditional fixation method, table tennis fixation method with Sengstaken-Blakemore tube can more effectively improve the clinical hemostatic efficacy and reduce the probability of complications to the greatest extent, and it has a higher success rate. 2024 Vol. 30 (4): 629-634 [Abstract] ( 35 ) HTML (1 KB)  PDF (1224 KB)  ( 14 ) 635 Clinical Efficacy of Calcaneal Fracture Treatment with Tarsal Sinus Small Incision Internal Fixation Combined with Traditional Chinese Medicine Orthopaedic Manipulation WU Jingwen, et al DOI: 10.3969/j.issn.1006-6233.2024.04.020 Objective: To investigate the clinical efficacy of calcaneal fracture treatment with tarsal sinus small incision internal fixation combined with traditional Chinese medicine orthopaedic manipulation. Methods: A retrospective analysis was conducted on 80 patients with calcaneal fracture in Qingyuan Traditional Chinese Medicine Hospital from January 2018 to June 2022. According to different treatment plans, they were divided into two groups. The observation group was treated with tarsal sinus small incision internal fixation combined with traditional Chinese medicine orthopaedic manipulation, and the control group was treated with tarsal sinus small incision internal fixation. The general data and imaging parameters of the patients in the two groups were collected, and the operation time, intraoperative blood loss, length of hospital stay, pain score, calcaneal parameters, ankle function, and complications were analyzed. Results: There was no statistically significant difference in gender, age, and other data between the two groups (P>0.05). The intraoperative blood loss and length of hospital stay in the observation group were significantly lower than those in the control group (P<0.05). There was no statistically significant difference in the operation time between the two groups (P>0.05). With the extension of the postoperative time, the VAS pain scores of the patients in both groups decreased, and the observation group had a greater decrease, with a statistically significant difference (P<0.05). There was no statistically significant difference in the Gissane angle, Bohler angle, Pitch angle, and ankle score between the two groups before surgery (P>0.05). Compared with the preoperative values, the Gissane angle, Bohler angle, and Pitch angle increased, and the ankle score increased in both groups after surgery, with a statistically significant difference (P<0.05). There was a statistically significant difference in the changes of Gissane angle, Bohler angle, Pitch angle, and ankle score before and after surgery between the two groups (P<0.05). The incidence of complications in the observation group was 2.38%, which was lower than that in the control group (5.26%), but the difference was not statistically significant (χ2=1.065, P>0.05). Conclusion: The clinical efficacy of calcaneal fracture treatment with tarsal sinus small incision internal fixation combined with traditional Chinese medicine orthopaedic manipulation is better. It can cooperate with the surgical process, make up for the defect of insufficient exposure, achieve the purpose of good reduction, and shorten the hospital stay, reduce the intraoperative blood loss, and reduce the pain degree. It can promote the recovery of foot function and fracture end anatomical structure, and has a high safety. 2024 Vol. 30 (4): 635-640 [Abstract] ( 30 ) HTML (1 KB)  PDF (1228 KB)  ( 21 ) 640 Relationship Between Expression of Ferroptosis-Related Indicators and Clinical Prognosis of Patients with Severe Acute Pancreatitis YU Lu, LAN Zhixin, et al DOI: 10.3969/j.issn.1006-6233.2024.04.021 Objective: To analyze the relationship between serum ferritin (SF) level, an indicator of ferroptosis, and the clinical prognosis of patients with severe acute pancreatitis (SAP). Methods: This study retrospectively analyzed 76 patients with SAP who were admitted to our hospital from January to December 2022. Serum SF levels were obtained on days 1, 3, and 7 after admission, and patients were divided into two groups according to whether the serum SF level on day 1 was greater than 275 ng/mL: the elevated SF level group (n=36) and the normal SF level group (n=40). The correlation between SF level and CRP level, APACHE II score, and CTSI score was analyzed, as well as its ability to predict SAP patients. Results: Compared with the normal SF level group, the elevated SF level group had significantly increased APACHE II scores on days 1 and 7, CTSI score on day 7, SF levels on days 1, 3, and 7, and mortality rate (P<0.05). The SF level on day 1 was significantly positively correlated with the APACHE II scores on days 1 and 7, CTSI scores on days 1 and 7, and CRP level on day 7 (r=0.236, 0.495, 0.269, 0.582, 0.362, respectively; all P<0.05). In Cox survival analysis, etiology, SF level on day 1, CTSI score on day 7, and persistent organ failure were independent risk factors for death in SAP patients (all P<0.05). ROC analysis showed that the SF level on day 1 of admission had the highest predictive ability for death in SAP patients (AUC=0.851), which was significantly higher than the APACHE II score (AUC=0.630) and CTSI score (AUC=0.693) at the same time. Conclusion: Early elevated SF level is associated with poor prognosis of SAP and can be used as a potential predictor of death in patients. 2024 Vol. 30 (4): 640-646 [Abstract] ( 49 ) HTML (1 KB)  PDF (1708 KB)  ( 24 ) 646 Analysis of Influencing Factors and Predictive Value of Vaginal Delivery in Scarred Uterus Re-Pregnancy MA Xiaodan, LIU Yang, WU Yun, et al DOI: 10.3969/j.issn.1006-6233.2024.04.022 Objective: To investigate the influencing factors and predictive value of vaginal delivery in scarred uterus re-pregnancy. Methods: A retrospective study was conducted on 109 pregnant women with scarred uterus re-pregnancy who were admitted to the First People's Hospital of Bengbu from January 2021 to June 2023. According to the delivery outcome, they were divided into two groups: vaginal delivery success group (n=78) and failure group (n=31). The baseline data and late pregnancy myometrial thickness of the pregnant women in the two groups were compared. Logistic regression analysis was used to analyze the influencing factors of vaginal delivery in scarred uterus re-pregnancy, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of the influencing factors for vaginal delivery in scarred uterus re-pregnancy. Results: There was no significant difference in age, gestational week, parity, interval from previous cesarean section, estimated fetal weight before delivery, admission in labor, and education level between the two groups (P>0.05). The pre-pregnancy body mass index (BMI), cervical Bishop score, and myometrial thickness were significantly different between the two groups (P<0.05). Logistic regression analysis showed that pre-pregnancy BMI, cervical Bishop score, and myometrial thickness were the influencing factors of delivery outcome in scarred uterus re-pregnancy (P<0.05). The ROC curve analysis showed that the areas under the curve (AUC) of pre-pregnancy BMI, cervical Bishop score, and myometrial thickness for predicting vaginal delivery in scarred uterus re-pregnancy were 0.669, 0.691, and 0.670, respectively. The AUC of the combined prediction of the three indicators was 0.806, which was significantly higher than that of the single indicators (Z=2.885, 3.604, 3.296, P=0.004, <0.001, 0.001). The sensitivity was 90.32%, and the specificity was 61.54%. Conclusion: Pre-pregnancy BMI, cervical Bishop score, and myometrial thickness are the influencing factors of vaginal delivery outcome in scarred uterus re-pregnancy and can be used as predictive indicators of vaginal delivery outcome. 2024 Vol. 30 (4): 646-650 [Abstract] ( 31 ) HTML (1 KB)  PDF (1277 KB)  ( 15 ) 651 Feasibility and Safety of Apical Inward Cut during Bipolar Transurethral Plasma Kinetic Prostatectomy on Patients with Benign Prostatic Hyperplasia with Volume>80 mL PENG Qiang, WANG Dingyong, TIAN Feng, et al DOI: 10.3969/j.issn.1006-6233.2024.04.023 Objective: To analyze the feasibility and safety of apical inward cut during transurethral plasma kinetic prostatectomy (TUPKP) on patients with benign prostatic hyperplasia (BPH) with volume>80mL. Methods: A total of 196 BPH patients with volume >80 mL and elective surgery in our hospital were selected from October 2019 to October 2022, and were randomly divided into two groups, the study group (n=98, with the application of apical retractive dissection during TUPKP) and the conventional group (n=98, with conventional TUPKP). The operation time, bleeding volume, weight of the resected gland, hospitalization time, forced urethral muscle pressure, initial urinary volume, residual urine volume after voiding, maximum urinary volume, International Prostate Symptom Score, Quality of Life Rating Scale, and complication rate were compared between the two groups. Results: The surgery-related indicators revealed no statistical differences between the two groups (P>0.05). At 3 months after surgery, the detrusor pressure, initial urine volume, residual urine volume after urination and maximum urine volume were improved in both groups compared with those before surgery (P<0.05), but the differences of above indicators between both groups were not statistically significant (P>0.05). The international prostate symptom score grading in study group at 3 months after surgery was better in comparison with conventional group (P<0.05), and the interaction term between time and prostate symptom grading was significant (P<0.05). At 3 months after surgery, the scores of dimensions of quality of life scale were enhanced in both groups compared to before surgery (P<0.05), and the differences of scores of dimensions of quality of life scale were higher in study group compared to conventional group (P<0.05). The total incidence rate of complications in study group at 3 months after surgery was 2.04%, which was lower than 9.18% in conventional group (P<0.05). Conclusion: Apical inward cut during TUPKP can relieve the symptoms and enhance the quality of life in the treatment of patients with BPH with volume>80mL, and it has few complications and is safe and reliable. 2024 Vol. 30 (4): 651-656 [Abstract] ( 33 ) HTML (1 KB)  PDF (1220 KB)  ( 30 ) 656 Clinical Study of Two Kinds of Laser Treatment for Spider Angioma with Central Point Protrusion in Children YANG Yifan, et al DOI: 10.3969/j.issn.1006-6233.2024.04.024 Objective: To investigate the efficacy, side effects and complications of two laser methods in the treatment of spider angioma with central point. Methods: Sixty children with central point spider navi diagnosed by the orthopedic Department of Hebei Children's Hospital from October 2020 to October 2022 were selected as the study objects. They were randomly divided into 595nm pulsed dye laser group and super-pulsed CO2 dot matrix laser group by digital table method, with 30 cases in each group. The frequency, efficacy, adverse reactions and complications of treatment were evaluated. Results: After follow-up, 595nm group was treated more times than CO2 group, the difference was statistically significant (P<0.05). The cure rate of the two groups after one treatment was 80% and 95%, respectively, the difference was statistically significant (P<0.05). There was no significant difference in the cure rate between the two groups after multiple treatments (P>0.05). The adverse reaction of 595nm group was higher than that of CO2 group, and the difference was statistically significant (P<0.05). After 12 weeks of follow-up, there was no significant difference in complications (P>0.05). Conclusion: Both 595nm pulsed dye laser and super-pulsed CO2 dot matrix laser are effective in the treatment of spider angioma in children, and each has its own advantages and disadvantages. Appropriate treatment methods can be selected according to the characteristics of the lesions and the requirements of the children. 2024 Vol. 30 (4): 656-660 [Abstract] ( 29 ) HTML (1 KB)  PDF (1211 KB)  ( 18 ) 660 A Study on the Correlation between Pathological Types of Lupus Nephritis and Laboratory Indicators and Clinical Features LI Juan, et al DOI: 10.3969/j.issn.1006-6233.2024.04.025 Objective: To investigate the correlation between pathological types of lupus nephritis (LN) and laboratory indicators and clinical features. Methods: A total of 406 patients with LN who were admitted to our hospital from January 2020 to February 2023 were selected as the research subjects. LN was divided into six types, including I, II, III, IV, V, and composite types, of which the composite type was II + V, III + V, and IV + V. The relationship between LN clinical classification and pathological type, LN clinical manifestations and pathological type, LN activity score and pathological type, and LN pathological activity index and clinical indicators were analyzed. Results: Among the 406 patients with LN, 273 cases (67.24%) were of renal onset type, which was the highest, and the incidence rates of types II, IV, V, and composite type were higher than that of type III (P<0.05). The incidence rate of asymptomatic type II was higher than that of types IV, V, and composite type (P<0.05). The incidence rate of nephritic syndrome in type III was higher than that in type IV (P<0.05). The incidence rates of nephrotic syndrome in types IV, V, and composite type were higher than that in type II (P<0.05). The incidence rate of renal insufficiency in type IV was higher than that in type II (P<0.05). The detection rates of hypertension in types IV and composite type were significantly higher than those in other types (P<0.05). The incidence rate of hematuria in type IV was higher than that in other types (P<0.05). The incidence rates of hypoproteinemia and massive proteinuria in types V, IV, and composite type were higher than those in types II and III (P<0.05). The level of serum creatinine in type IV was higher than that in other types (P<0.05). The incidence rate of anemia in type IV was higher than that in other types (P<0.05). The positive rates of anti-dsDNA antibody in different pathological types were statistically different (P<0.05), and the positive rate of anti-dsDNA antibody was the lowest in type V and the highest in type IV. The detection rate of low C3 was higher in type IV than in other types (P<0.05). The detection rates of low C3 and low C4 were lower in type V than in other types (P<0.05). Compared with other types, the AI and SLEDAI scores in type IV were the highest (P<0.05). Compared with other types, the CI score in the composite type was the highest (P<0.05). AI was negatively correlated with platelet count, C3, and C4, and positively correlated with 24Upro and SLEDAI (P<0.05). Serum creatinine was positively correlated with AI and CI (P<0.05). Conclusion: The proliferative type is the most common pathological type of LN, and the most common type is IV. The pathological type of LN is correlated with clinical features and laboratory indicators, which is worth considering in clinical practice. 2024 Vol. 30 (4): 660-664 [Abstract] ( 31 ) HTML (1 KB)  PDF (1216 KB)  ( 31 ) 665 A Study on the Value of Combined Mid-Pregnancy Serum Freeβ-hCG and uE3 Screening for Severe Congenital Heart Disease in Pregnant Women Using the "Four-Plane" Method of Ultrasound LI Bo, ZHANG Huanhuan, QU Donghui, et al DOI: 10.3969/j.issn.1006-6233.2024.04.026 Objective: To investigate the clinical application value of the "four-plane" method of ultrasound combined with mid-pregnancy maternal serum free human chorionic gonadotropin (Freeβ-hCG) and estriol (uE3) for screening severe congenital heart disease (CHD) in fetuses. Methods: A total of 97 pregnant women who underwent mid-pregnancy CHD screening in our hospital from January 2020 to June 2021 were selected. The maternal serum Freeβ-hCG and uE3 levels were detected, and the "four-plane" method of ultrasound was used to screen for CHD. The diagnostic value of the "four-plane" method of ultrasound combined with serum Freeβ-hCG and uE3 levels for CHD was analyzed. Results: A total of 9 cases (9/97, 9.28%) of severe CHD were confirmed by follow-up; 25 cases of high-risk fetuses were detected by the "four-plane" method of ultrasound, of which 4 cases were confirmed to have severe CHD (4/25, 16.00%); 36 cases of high-risk fetuses were detected by maternal serum biochemical test, of which 6 cases were finally confirmed to have severe CHD (6/36, 16.67%); and 9 cases of high-risk fetuses were detected by the combined "four-plane" method of ultrasound and maternal serum biochemical test, of which 5 cases were confirmed to have severe CHD (5/9, 55.56%). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the "four-plane" method of ultrasound for screening severe CHD were 16.00%, 93.51%, 74.51%, 44.44%, and 77.22%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of maternal serum Freeβ-hCG and uE3 levels for screening severe CHD were 55.56%, 95.31%, 92.08%, 66.67%, and 64.00%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the combined screening for severe CHD were 55.56%, 95.65%, 92.08%, 55.56%, and 91.09%, respectively. The diagnostic results of the combined detection were higher than those of the single detection method (P<0.05). Conclusion: The "four-plane" method of ultrasound has a high diagnostic value for screening severe CHD in pregnant women in mid-pregnancy. The combination of maternal serum Freeβ-hCG and uE3 levels can further improve the diagnostic accuracy and has good clinical application value. 2024 Vol. 30 (4): 665-669 [Abstract] ( 31 ) HTML (1 KB)  PDF (1217 KB)  ( 20 ) 669 Quality of Life and Influencing Factors of Female Fibromyalgia Syndrome with Different BMI ZHOU zhian, BIAN shuwei, LI yang, et al DOI: 10.3969/j.issn.1006-6233.2024.04.027 Objective: To investigate the differences in quality of life (QoL) of female fibromyalgia syndrome (FMS) patients with different body mass index (BMI) and the factors influencing their QoL, so as to provide a basis for more precise treatment and management of FMS patients and improve their QoL. Methods: A total of 120 female FMS patients admitted to our hospital were selected and divided into groups A and B according to BMI. Group A had BMI ≤ 24 (n=66) and Group B had BMI > 24 (n=54). The QoL, pain, fatigue, anxiety and depression of FMS patients in the two groups were compared. Multivariate linear regression analysis was used to analyze the risk factors affecting the QoL of FMS patients, and Pearson correlation analysis was used to analyze the correlation between the risk factors and the scores of each dimension of SF-36. Results: There were statistically significant differences in the scores of social function, physical function, physical pain, vitality, general health, emotional function, mental health and psychological health between the two groups (P<0.05), and the scores in Group A were significantly higher than those in Group B (P<0.05). There were statistically significant differences in VAS, FSS and HADS scores between the two groups (P<0.05), and VAS, FSS and HADS scores in Group A were significantly lower than those in Group B (P<0.05). Pearson correlation analysis showed that BMI was negatively correlated with social function, physical function, physical pain, vitality and general health (P<0.05), FSS score was negatively correlated with social function, general health and emotional function (P<0.05), and HADS was negatively correlated with social function, physical function, physical pain, mental health and psychological health (P<0.05). Multivariate linear regression analysis showed that BMI, FSS and HADS scores were risk factors affecting the QoL of FMS patients. Conclusion: There are significant differences in the QoL of female FMS patients with different BMI. High BMI can reduce the QoL of FMS patients, aggravate the pain, fatigue, anxiety and depression of FMS patients, and BMI, FSS and HADS scores are risk factors affecting the QoL of FMS patients. 2024 Vol. 30 (4): 669-674 [Abstract] ( 27 ) HTML (1 KB)  PDF (1230 KB)  ( 15 ) 674 Application Value of Anal Restitution Combined with Modified External Dissection and Internal Ligation in the Treatment of Multiple Mixed Hemorrhoids CHEN Xuyuan, LUO Shiyun, LI Wenzhong, et al DOI: 10.3969/j.issn.1006-6233.2024.04.028 Objective: To analyze the application value of anal restitution combined with modified external dissection and internal ligation in multiple mixed hemorrhoids. Methods: A total of 112 patients with multiple mixed hemorrhoids undergoing surgical treatment in the hospital were retrospectively enrolled between June 2020 and March 2023. According to different surgical methods, they were divided into modified group (modified external dissection and internal ligation, n=47) and combination group (anal restitution on basis of modified group, n=65). The perioperative indexes were compared between the two groups. The curative effect and postoperative anal pain in the two groups were evaluated. The anal smoothness, edema of anal margin and hemafecia were compared before and after surgery, and the occurrence of complications was recorded. Results: The hospitalization time in combination group was shorter than that in modified group (P<0.05). The total number of effective cases in combination group was more than that in modified group (P<0.05). With time, VAS scores were gradually decreased in both group. At 1d, 3d and 5d after surgery, VAS scores in combination group were lower than those in modified group (P<0.05). At 3d after surgery, scores of anal smoothness, anal margin edema and hemafecia in combination group were lower than those in modified group, and difference values were greater than those in improved group (P<0.05). Compared with the modified group, the combination group had a lower complication rate(P<0.05). Conclusion: The curative effect of anal restitution combined with modified external dissection and internal ligation is good on multiple mixed hemorrhoids, which can relieve postoperative pain, improve anal smoothness and anal margin edema, reduce the occurrence of hemafecia and complications. 2024 Vol. 30 (4): 674-678 [Abstract] ( 29 ) HTML (1 KB)  PDF (1220 KB)  ( 17 ) 679 Relationship Analysis of Endoscopic Typing of Early Gastric Cancer with Infiltration Depth and Lymphatic Metastasis CHEN Zhuo, ZHANG Shuangshuang, GUO Renwei, et al DOI: 10.3969/j.issn.1006-6233.2024.04.029 Objective: To analyze the relationship between endoscopic typing of early gastric cancer and infiltration depth and lymph node metastasis. Methods: 103 patients with early gastric cancer admitted to the hospital from March 2020 to March 2023 were selected as the research subjects. General clinical data of patients were collected and the relationship between endoscopic typing, infiltration depth and lymph node metastasis was analyzed. Results: Among the 103 patients, 63.11% were males and 36.89% were females. The mean age was (52.36±10.73) years old and the mean maximum tumor diameter was (2.15±0.89) cm. The tumor locations were 20.39% in the upper part, 50.49% in the middle part and 29.13% in the lower part. The differentiation degree of gastric cancer showed that there were 37.86% of high differentiation, 43.69% of middle differentiation and 18.45% of low differentiation. Lauren typing revealed that interstitial type accounted for 49.51% and adenocarcinoma type accounted for 50.49% respectively. In terms of TNM staging, IA stage and IB stage accounted for 69.90% and 30.10%. According to endoscopic typing, there were 15 cases (14.56%) of type I, 64 cases (62.14%) of type II and 24 cases (23.30%) of type III among the 103 patients. The differences in tumor infiltration depth among different endoscopic types were statistically significant (P<0.05). In pairwise comparisons between groups, the differences between Type I and both Type II and Type III were statistically significant (P=0.025 and 0.032, respectively), and the difference between Type II and Type III was also statistically significant (P=0.047). The differences in lymph node metastasis detection rates among different endoscopic types were statistically significant (P<0.05). In pairwise comparisons, the rate for Type I was lower than that for Type II and Type III (P=0.028 and 0.015, respectively), and the rate for Type II was lower than that for Type III (P=0.036). Conclusion: Endoscopic typing of early gastric cancer is closely related to infiltration depth and lymph node metastasis. 2024 Vol. 30 (4): 679-682 [Abstract] ( 27 ) HTML (1 KB)  PDF (1202 KB)  ( 21 ) 682 Clinical Efficacy of Glutamine Combined with Erythropoietin in the Treatment of Necrotizing Enterocolitis in Premature Infants and Its Effect on Serum IL-6 TNF-α and i-FABP Levels SUN Shiqi, PIAO Qian DOI: 10.3969/j.issn.1006-6233.2024.04.030 Objective: To investigate the clinical efficacy of glutamine combined with erythropoietin in the treatment of necrotizing enterocolitis (NEC) in premature infants and its effect on serum IL-6, TNF-α, and i-FABP levels. Methods: A retrospective analysis was conducted on 100 premature infants diagnosed with NEC in the Department of Neonatology, The First Affiliated Hospital of China Medical University from January 2020 to January 2022. According to the treatment methods received by the infants, they were divided into the observation group (n=50) and the control group (n=50). The observation group was treated with glutamine combined with erythropoietin, and the control group was treated with glutamine alone. The total effective rate, inflammatory reaction, i-FABP, immunoglobulin level, intestinal flora change, and drug safety of the two groups were recorded and observed. Results: The total effective rate of the observation group (92.00%) was significantly higher than that of the control group (70.00%), and the difference was statistically significant (P<0.05). Before treatment, there was no statistically significant difference in the levels of serum inflammatory factors, i-FABP, IgA, IgM, IgG, and the total number of bacteria, cocci, and bacilli in the stool specimens between the two groups (P>0.05). Compared with before treatment, the levels of serum IL-6, TNF-α and i-FABP in both groups decreased after 7 days of treatment, and the levels of IgA, IgM, IgG, the total number of bacteria, cocci, and bacilli in the stool specimens increased. The differences were statistically significant (P<0.05). There was a statistically significant difference in the changes of serum IL-6, TNF-α, i-FABP, IgA, IgM, IgG levels, and the total number of bacteria, cocci, and bacilli in the stool specimens before and after treatment between the two groups (P<0.05). During the one-month follow-up, there was no statistically significant difference in the adverse reactions between the two groups (P>0.05). Conclusion: On the basis of glutamine, combined erythropoietin can effectively improve the clinical efficacy of NEC in premature infants, reduce the levels of serum inflammatory factors and i-FABP, promote the stability of intestinal flora in premature infants, enhance the immunity of infants, and has a high safety. 2024 Vol. 30 (4): 682-687 [Abstract] ( 24 ) HTML (1 KB)  PDF (1228 KB)  ( 18 ) 687 Value of Bioabsorbable Hemostatic Powder Combined with Budesonide Soaking in Postoperative Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Prospective Randomized Bilateral Study HU Zhiyong, CHENG Meihao DOI: 10.3969/j.issn.1006-6233.2024.04.031 Objective: To evaluate the value of bioabsorbable hemostatic powder combined with budesonide soaking in postoperative endoscopic sinus surgery for chronic rhinosinusitis (CRS) based on a prospective randomized controlled study of the bilateral sides of the patients. Methods: A prospective randomized controlled study was conducted on 102 patients with CRS who were admitted to our hospital from April 2021 to May 2023. After endoscopic sinus surgery, budesonide absorbable hemostatic cotton soaked was randomly assigned to fill one side of the nasal cavity (control side), and bioabsorbable hemostatic powder combined with budesonide absorbable hemostatic cotton soaked was filled on the other side (combined side). The bleeding, nasal symptoms, modified endoscopic Lund-Kennedy score, filling material degradation score, ciliary clearance rate, olfactory function, ciliary clearance speed, and safety of the two sides were compared. Results: The bleeding scores on the combined side were lower than those on the control side on the 1st day, 3rd day, 7th day, and 14th day after surgery (P<0.05). The scores of nasal congestion, purulent rhinorrhea, clear rhinorrhea, and facial swelling on the combined side were lower than those on the control side on the 14th day and 1 month after surgery (P<0.05). The modified endoscopic Lund-Kennedy scores on the combined side were lower than those on the control side on the 3rd day, 7th day, and 14th day after surgery (P<0.05). The distribution of filling material degradation scores on the combined side was better than that on the control side on the 7th day and 14th day after surgery (P<0.05). The ciliary clearance rate and ciliary clearance speed on the combined side were higher than those on the control side on the 7th day and 14th day after surgery, and the olfactory function score was lower than that on the control side (P<0.05). There was no significant difference in complications between the combined side and the control side (P>0.05). Conclusion: Bioabsorbable hemostatic powder combined with budesonide soaking does not affect the degradation of filling materials after endoscopic sinus surgery for CRS, and it can synergistically enhance the hemostatic effect, improve nasal symptoms, mucosal status, and olfactory function, and improve ciliary function. It is safe and reliable. 2024 Vol. 30 (4): 687-692 [Abstract] ( 21 ) HTML (1 KB)  PDF (1241 KB)  ( 21 ) 692 Application of Sevoflurane or Propofol in Craniocerebral Surgery and Analysis of Related Factors for Postoperative Outcome FAN Yong, LIAO Xingzhi, LIU Yufang, et al DOI: 10.3969/j.issn.1006-6233.2024.04.032 Objective: To explore the application of sevoflurane or propofol in craniocerebral surgery, and analyze the relevant factors affecting the prognosis of patients after craniocerebral surgery. Methods: A total of 144 patients undergoing craniocerebral surgery in our hospital from March 2020 to March 2022 were selected as the study subjects. They were divided into sevoflurane group and propofol group according to the randomized double-blind method, with 72 patients in each group. The sevoflurane group received sevoflurane inhalation anesthesia, while the propofol group received propofol intravenous anesthesia. The serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), neuron specific enolase (NSE), acute physiological and chronic health (APACHRE) II scores, and Glasgow coma score (GCS) were compared between the two groups.According to the GCS score, the patients were divided into a poor outcome group (GCS ≤ 11 points, 21 cases) and a good outcome group (GCS>11 points, 123 cases). Logistic regression analysis was used to analyze the factors affecting the postoperative outcome of the patients. Results: There was no significant difference in CRP, IL-6 and NSE levels and differences between sevoflurane group and propofol group before and 1 day after surgery (P>0.05). There was no significant difference in 3d APACHEⅡ and GCS scores and differences between sevoflurane group and propofol group before and after surgery (P>0.05). Compared with the group with good outcome, the group with poor outcome had a higher age, longer surgical time, lower admission GCS scores, and a higher proportion of admission pupil dilation, hypotension, gastrointestinal bleeding, and pulmonary infection (P<0.05). Logistic regression analysis showed that age, surgical time, and admission GCS score were the influencing factors for poor postoperative outcome in patients undergoing craniocerebral surgery (P<0.05). Conclusion: Compared with propofol, maintenance anesthesia with sevoflurane during craniocerebral surgery has no significant impact on poor postoperative outcome. Age, surgical time, and admission GCS score are the influencing factors for poor postoperative outcome in patients undergoing craniocerebral surgery. 2024 Vol. 30 (4): 692-697 [Abstract] ( 29 ) HTML (1 KB)  PDF (1245 KB)  ( 19 )

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