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RSS2021 Vol. 42, No. 8
2021, 42(8): 11-16.
doi: 10.12259/j.issn.2095-610X.S20210803
Abstract:
Objective To screen the hypoglycemic activity of 4 extracts of Swertia Punicea Hemsl. Methods The ethanol extract of Swertia Punicea Hemsl was extracted by ethanol extraction, and the extracts were successively extracted with petroleum ether, chloroform, ethyl acetate and n-butanol to obtain 4 parts: chloroform, Ethyl Acetate, n-butanol and water, the 4 extracts were screened for hypoglycemic activity in Type I diabetic mice induced by alloxan. The diet and water of each group were measured daily starting from day 3; weight of all mice were measured every 2 days and blood glucose of each group was measured on the 7th and 14th day. Results The body weight of the diabetic mice was significantly increased （P < 0.05）, and the food intake, amount of drinking water, blood glucose were significantly decreased （ P < 0.05） in the diabetic mice fed with the water-soluble fraction and ethyl acetate extract fraction of Swertia Punicea Hemsl. Conclusion The water-soluble fraction and ethyl acetate extract fraction of Swertia Punicea Hemsl could significantly improve the symptoms of polydipsia, polyphagia, polyuria and weight loss in type I diabetic mice induced by alloxan, and significantly reduce the blood glucose of diabetic mice, showing a strong hypoglycemic activity.
2021, 42(8): 17-22.
doi: 10.12259/j.issn.2095-610X.S20210804
Abstract:
Objective To establish a rat model of nonalcoholic fatty liver disease （NAFLD） and to explore the therapeutic effect of peroxidase activator receptor （PPAR） agonist GW7647 on rat NAFLD. Methods After the experimental animals were grouped, GW7647 was administered daily for 6 consecutive weeks. After intragastric administration, blood samples were collected for the detection of insulin resistance, blood lipid levels and liver injury-related biochemical indexes, and pathological tests （HE and oil red O staining） were performed on the liver tissues of the rats. Results After 6 weeks of treatment, GW7647 significantly reduced body weight, improved glucose tolerance and restored insulin sensitivity in NAFLD rats. Liver staining showed improvement in liver pathology and decreased accumulation of lipid droplets; serum cholesterol and triglyceride levels decreased; and serum AST and ALT levels showed improved liver injury （P < 0.05）. Conclusion PPARα agonist GW7647 has a therapeutic effect on NAFLD rats by reducing body weight, reducing liver fat accumulation, restoring insulin sensitivity, improving liver injury and reducing blood lipids.
Effects and Mechanism of Anlotinib on Radiosensitivity of Non-small Cell Lung Cancer Cell Lines A549
2021, 42(8): 40-46.
doi: 10.12259/j.issn.2095-610X.S20210808
Abstract:
Objective To investigate the effect and mechanism of anlotinib on radiosensitization of human lung adenocarcinoma cell line A549. Methods Human lung adenocarcinom cell line A549 was treated with anlotinib and/or radiotherapy, then divided in to four groups, control group （Ctrl）, Anlotinib treatment group （A）, irradiation group （RT） and anlotinib combined with irradiation group （A + RT）. CCK8 method was used to determine cell proliferation; the clone formation experiment was used to determine the inhibitory effect on cell growth; flow cytometry was used to determine cell cycle and apoptosis; immunofluorescence of γ-H2AX was used to determine DNA damage; expression of DNA-PKcs were detected by Western blot. Results Anlotinib inhibited proliferation and clonogenic survival following irradiation. The dose （Dq）, the average lethal dose （D0） and the survival score （SF2） in the anlotinib combined radiotherapy group was significantly lower than those in the radiotherapy group. Anlotinib decreased G2/M phase arrest and promoted the cells apoptosis induced by in irradiation. The confocal microscopy results showed the average number of γ-H2AX foci in the A+RT group was more than that in RT group. The protein levels of DNA-PKcs were higher in A + RT group than that in RT group. Conclusion Anlotinib enhances the radiosensitivity of A549 cells, which may be attributed to the delay DNA damage repair. It provides a rationale strategy by Anlotinib combined with irradiation for NSCLC.
2021, 42(8): 54-59.
doi: 10.12259/j.issn.2095-610X.S20210810
Abstract:
Objective To explore the current status of hypertension in Dai and Jingpo groups in Dehong Prefecture, and to analyze the influencing factors of hypertension, provide informed intervention and treatment, and control the prevalence. Methods A total of 1607 Dai and Jingpo people aged 40 and above in Dehong prefecture were surveyed face-to-face by multi-stage stratified sampling method. Univariate analysis was performed by χ2 test, and multivariate analysis was performed by Logistic regression analysis. Results The prevalence of hypertension was 24.2%, with 27.8% in Dai people and 20.7% in Jingpo people. The proportion of respondents taking antihypertensive drugs was high （99.3%）. Multivariate analysis results showed that older age, lower education, and higher BMI were risk factors for hypertension （P < 0.05）. Conclusion The development of hypertension in Dai and Jingpo people is slightly lower, but there are still some recognized risk factors. Since the occurrence of hypertension is the result of a combination of many multiple factors. More attention should be paid to promoting the health of the elderly, those with less education, and those who are overweight or obese.
2021, 42(8): 1-6.
doi: 10.12259/j.issn.2095-610X.S20210801
Abstract:
Objective To investigate the therapeutic effect of transplanted Nurr1 gene-modified embryo midbrain neural stem cells in Parkinson’ s rats. Methods 1. Establishment of Parkinson’ s disease animal model in SD rats. 2. Primary culture of embryo midbrain neural stem cells （NCSs） and Nurr1 gene-modified neural stem cells. 3. Grouping: sham operation group （sham group）, Transplanted neural stem cell group （NCS group）, transplanted Nurr1 gene-modified neural stem cells group （NNCS group）. 4. At 3 weeks, 6 weeks, 9 weeks, and 12 weeks after the transplantation, the behavioral tests of rats in each group were performed to observe the improvement of symptoms in each group. 5. After 12 weeks of transplantation, the expression of Nurr1, TH protein and Nurr1 fluorescence were detected in each group. Results 1. Primary cultured neural stem cells, and successfully overexpressed Nurr1 in neural stem cells. 2. Overexpression of Nurr1 could promote the transformation of neural stem cells into dopaminergic neurons （P < 0.05）, which was confirmed by immunofluorescence and Western Blot. 3. Transplantation of NNCS can effectively improve the symptoms of rats with Parkinson’ s （P < 0.05）. 4. After transplantation, Nurr1 can promote the transformation of neural stem cells into dopaminergic neurons, greatly improve the survival of transplanted neural stem cells and achieve better therapeutic effect. Conclusion Nurr1 can promote the transformation of neural stem cells into dopaminergic neurons. Transplantation of overexpression of Nurr1 neural stem cells can effectively treat Parkinson’ s rats.
2021, 42(8): 7-10.
doi: 10.12259/j.issn.2095-610X.S20210802
Abstract:
Objective To determine the volatile components of the dried Blaps rhynchoptera Fairmaire. Methods Headspace solid phase microextraction （HS-SPME） combined with gas chromatography-mass spectrometry （GC-MS） were used to analysis and identify the volatile components, and the relative content of each compound was calculated using the area normalization method. Results Through mass spectrum scanning combined with mass standard library, 40 components were identified, accounting for 92.80% of the total peak area. Sixteen hydrocarbons were represented by straight-chain and branched alkanes, accounting for 35.73%. Eight fatty acids were represented by short-chain fatty acids, accounted for 35.87%. In addition, it also contained amines, alcohols, esters, aldehydes, phenols, ketones, and ethers. Tridecane, 3-methylbutyric acid, 2-methylbutyric acid, trimethylamine and acetic acid were identified as the major components, accounting for 21.47%, 16.88%, 7.67%, 6.59% and 5.47%, respectively. Conclusion Hydrocarbons and short-chain fatty acids are main volatile components in the dried B. rhynchoptera, which have a variety of pharmacological activities. The results could provide a theoretical basis for the further development and utilization of the medicinal insect resources.
2021, 42(8): 23-30.
doi: 10.12259/j.issn.2095-610X.S20210805
Abstract:
Objective To investigate the effect of PTEN gene expression on the apoptosis of BCPAP cells and FTC133 thyroid cancer cells and on the expression of signal pathway proteins ERK and AKT. Methods BCPAP cells and FTC133 cells were transfected with PTEN-pCMV6 and silenced si-PTEN RNA, before the cell microscopic morphology changes were observed. Cell viability was measured by MTT, and apoptosis rate was measured by Annexin V-FITC and PI double staining flow cytometer, respectively. Furthermore, the protein expression levels of ERK, AKT, Bax, Bcl-2, caspase 8, 9, 12 and 3 were detected by Western blot. The association between different expression of PTEN gene and the apoptosis of BCPAP and FTC133 thyroid cancer cells and the expression of signal pathway proteins were analyzed. Results Compared with control group, when the PTEN gene was overexpressed, BCPAP and FTC133 thyroid cancer cells showed microscopic apoptotic changes such as deformation, volume reduction and nuclear pyknosis. The cell viability was decreased （P < 0.01）, and the cell apoptosis rate was increased （P < 0.01）. The expression levels of the apoptotic proteins caspase 8, 9, 12, 3, and proapoptotic protein Bax were significantly increased （P < 0.01）, and the expression of anti-apoptotic protein Bcl-2 was significantly decreased （P < 0.01）, the expression of ERK and AKT were decreased （P < 0.05）. The reduction degree of ERK relative expression in FTC133 cells was significantly higher than that in BCPAP cells （P < 0.01）, while the reduction degree of AKT relative expression in BCPAP and FTC133 cells was not statistically significant （P > 0.05）. After PTEN gene silencing, compared with the control group, the number, cell morphology, volume and nuclear morphology of BCPAP and FTC133 were not significantly different （P > 0.05）. The change of cell viability and apoptosis rate were not significantly different （P > 0.05）. The expression levels of apoptotic proteins caspase 8, 9, 12, 3, and proapoptotic protein Bax was significantly decreased （P < 0.01）, and the expression level of anti-apoptotic protein Bcl-2 were significantly increased （P < 0.01）. The expression levels of ERK and AKT in FTC133 cells were higher than those in the control group （P < 0.01）, and the expression levels of ERK in BCPAP cells were higher than those in the control group （P < 0.01）. Compared with the control group, there was no statistically significant difference in the expression level of AKT （P > 0.05）. The relative expression level of ERK increased in BCPAP and FTC133, but there was no statistically significant difference （P > 0.05）. The relative expression level of AKT increased in FTC133 cells than that in BCPAP cells （P < 0.05）. Conclusion PTEN gene promotes the apoptosis of BCPAP and FTC133 cells. Mitochondrial pathway, death receptor pathway and endoplasmic reticulum activation pathway are all involved in the process of BCPAP and FTC133 cell apoptosis. ERK plays an important role in PTEN gene regulation of BCPAP cell apoptosis, while AKT and ERK both are involved in the process of PTEN gene promoting FTC133 apoptosis.
2021, 42(8): 31-34.
doi: 10.12259/j.issn.2095-610X.S20210806
Abstract:
Objective To extract and identify the chemical constituents from ethyl acetate layer of the Buddleja officinalis Maxim. Methods The chemical constituents were isolated by silica gel column chromatography, Spehadex LH-20、HPLC and other methods, and MS、1H-NMR and 13C-NMR were used to identify its structure. Results 10 chemical compounds isolated and identified were α-amyrin （Ⅰ）, stigmasterol （Ⅱ）, lupeol （Ⅲ）, cycloeucalenone （Ⅳ）, ethylparaben （Ⅴ）, lupeol acetate （Ⅵ）, luteolin （Ⅶ）, ursolic acid （Ⅷ）, α-spinasterol （Ⅸ）, linarin （Ⅹ）. Conclusion Ⅰ, Ⅱ, Ⅲ, Ⅴ, Ⅷ are the first isolates from the Buddleja officinalis.
2021, 42(8): 35-39.
doi: 10.12259/j.issn.2095-610X.S20210807
Abstract:
Objective To establish a method for determination of norfloxacin glucose injection in compound EDTA injection. Methods The chromatographic column was Shiseido C18-MGⅡ5 μm 4.6×250 mm, with the mobile phase of acetonitrile: 0.05 mol/L ammonium acetate: water, mobile phase ratio of 70∶15∶15, flow rate of 1.0 mL/min, injection volume of 20 L, column temperature of 35 ℃, detection wavelength of 254 nm. The chelate from ferric chloride and EDTA disodium reaction were determined. Results EDTA-2Na was detected without any interference. In the range and peak area of 2.0326 µg/mL-200.3260 µg/mL, EDTA-2Na showed a good linear relation （R2 = 0.9997）, the average recovery was 98.11% （n = 9）. Conclusion The method is rapid, simple, specific, reproducible, accurate and reliable, and is suitable for determination of EDTA in norfloxacin glucose injection.
2021, 42(8): 47-53.
doi: 10.12259/j.issn.2095-610X.S20210809
Abstract:
Objective To investigate the role of Stargazin-nitroso modification in synaptic plasticity after cerebral ischemia and reperfusion, and to investigate the molecular mechanism of NO regulating AMPAR “trafficking”. Methods The rat model of focal cerebral ischemia-reperfusion injury was replicated by the middle cerebral artery occlusion （MCAO） method, and the animal model was interfered with NMDAR inhibitor MK801 and oxidative reductant DTT, respectively. mNSS score was used to detect the neurological function of rats. TTC staining and Western Blot were used to detect the ischemic injury of the brain; TUNEL staining was used to detect the apoptosis of hippocampal neurons in the ischemic side; Griess staining was used to detect the content of NO in the ischemic side of hippocampal tissue, and Western Blot was used to detect the stargazin-nitrogenization modification level and AMPAR protein expression and activation in the hippocampal tissue. Results After treatment with MK801 and DTT, the Stargazin-nitroso modification level （P < 0.01） and NO content （P < 0.01） in MCAO/R model were decreased. Phosphorylation of GluR2 in AMPAR subunit was decreased （P < 0.0001）; Inhibition of Stargazin’ s nitrosylation modification improved MCAO/ R-induced nerve damage and apoptosis （P < 0.001）. Conclusion Inhibition of endogenous NO and Stargazin nitrosylation levels promotes synaptic remodeling in the MCAO/R model, possibly by interfering with the GluR2 affinity between Stargazin helper proteins and AMPAR subunit.
2021, 42(8): 60-64.
doi: 10.12259/j.issn.2095-610X.S20210811
Abstract:
Objective To investigate the recognition and satisfaction of medical institutions on public health service in the poor mountainous areas of western Yunnan, to explore issues and solutions, and to provide countermeasures and suggestions for the capacity building of public health service in western Yunnan. Methods Using multi-stage sampling method, three sample counties in the poor mountainous area of western Yunnan were selected, and the health personnel in the county and village level medical and health institutions were taken as the research subjects. Qualitative and quantitative research were conducted through literature analysis and questionnaire survey. Results The majority of health professionals at the county and township levels are college graduates, and only 30% have bachelor’ s degrees. The education level of health professionals at the village level was mainly secondary vocational school, and only 1.8% have bachelor’ s degree. There were differences in the degree of public health care at the county and village levels, and County L had higher degree of public health care at the county and township levels （all P < 0.05）. County-level personnel in County L and County C were more satisfied with the guidance and management of superior medical institutions （P = 0.004）, and township personnel were more satisfied with the standard of public health service subsidy （P = 0.006）. Conclusion The recognition and satisfaction of public health services in the poor mountainous areas of western Yunnan is generally high, the recognition in County C is low, and the degree of satisfaction in City S is low. At the same time, there are problems such as lack of public health talents and low educational level. Therefore, the construction of public health talents should be continued to be strengthened to promote the equality of public health services in the poor mountainous areas of western Yunnan.
2021, 42(8): 71-77.
doi: 10.12259/j.issn.2095-610X.S20210813
Abstract:
Objective To investigate the correlation between serum soluble oncogenic inhibitor 2 （sST2） level and cardiac function and remodeling in patients with heart failure （HFrEF） with reduced ejection fraction. Methods A total of 110 patients with HFrEF admitted to the Department of Cardiology, the First Affiliated Hospital of Kunming Medical University from July 2019 to September 2020 were enrolled. Serum sST2 levels were detected by immunofluorescence dry quantitative method, and parameters reflecting cardiac function and structure in echocardiography were collected. Left ventricular ejection fraction （LVEF）, interventricular septal thickness, left atrial inner diameter, right atrial length diameter, left ventricular posterior wall, right ventricular length diameter, left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV） and other indicators were calculated. LVEDVI and LVESVI were calculated. The subjects were divided into low level group （sST2 < 20.0 ng/mL, n = 55） and high level group （sST2 ≥20.0 ng/mL, n = 55） according to the median serum sST2 level of 20.0 ng/mL. The correlation between serum sST2 level and cardiac function and cardiac remodeling indexes was analyzed. Results Among 110 HFrEF patients, the median serum sST2 level was 20.0 ng/mL. Patients with higher serum sST2 level were more likely to have chronic kidney disease and thyroid dysfunction than patients with lower serum sST2 level. Patients with higher serum sST2 level had higher D-dimer, B-type natriuretic peptide, creatinine, uric acid, aspartate aminotransferase level, and larger right atrial diameter, higher pulmonary artery systolic pressure than patients with lower serum sST2 level （P < 0.05）. Serum sST2 level was positively correlated with pulmonary artery systolic pressure （ r = 0.284, P = 0.003） and right atrial diameter （r = 0.356, P = 0.000）. Conclusion In HFrEF patients, serum sST2 level was positively correlated with pulmonary artery systolic pressure and right atrial diameter. The higher sST2 level was, the larger right atrial diameter and pulmonary artery systolic pressure were. In other words, serum sST2 level in patients with HFrEF is correlated with right heart function. Serum sST2 may play an important role in cardiac remodeling in patients with HFrEF.
2021, 42(8): 65-70.
doi: 10.12259/j.issn.2095-610X.S20210812
Abstract:
Objective To analyze and evaluate the application value of dry fluorescent luminescence in the diagnosis and treatment of HBV infection. Methods A total of 397 serum samples were collected from patients attending Liver Diseases Department of the Third People’ s Hospital of Kunming from June 1, 2020 to December 31, 2020. Among these samples, 360 were detected for HBsAg, HBsAb, HBeAg, HBeAb and HBcAb by dry fluorescent luminescence method and ELISA, and 37 HBsAg positive samples in HBeAg seroconversion period detected by electrochemiluminescence method were tested for HBsAg, HBeAg and HBeAb by three methods: dry fluorescent luminescence method, enzyme-linked immunosorbent assay and colloidal gold method. The positive coincidence rate, negative coincidence rate and total coincidence rate of each test item by dry fluorescent luminescence method in diagnosis and treatment of HBV infection were compared and analyzed. Results The S/C value of ELISA was consistent with the trend of S/C value of dry fluorescent luminescence method, showing a certain positive correlation （r = 0.819, 0.913, 0.906, 0.732, 0.842, P < 0.001）. The positive coincidence rate, negative coincidence rate and total coincidence rate of the five items of HBV by the two detection techniques were more than 90%, with high consistency （Kappa = 0.949, 0.944, 0.955, 0.842, 0.949）. The results of 37 serum samples from HBsAg positive HBeAg seroconversion period showed that the coincidence rate between dry fluorescent luminescence method and Roche electrochemiluminescence HBeAb was 100% （37/37）, much higher than that of ELISA 18.92% （7/37） and colloidal gold 5.40% （2/37）. Conclusion Dry fluorescent luminescence method can effectively reflect the serological conversion period of HBeAg. Conventional HBV screening test and enzyme-linked immunosorbent assay have a high consistency. At the same time, it has the advantages of short detection time, no frequent manual operation and simple operation, so it has a good application prospect.
2021, 42(8): 78-82.
doi: 10.12259/j.issn.2095-610X.S20210814
Abstract:
Objective To investigate the detection rate of musculoskeletal ultrasonography in patients with rheumatic knee arthritis and its correlation with knee function. Methods A total of 118 patients with rheumatic knee arthritis （all patients with one knee affected） from May 1, 2019 to March 1, 2020 were selected as the subjects. All patients were confirmed by clinical manifestations combined with X-ray examination. Before diagnosis, all patients were planned to undergo musculoskeletal ultrasound examination, and the results of musculoskeletal ultrasound examination and X-ray examination were compared to analyze the detection rate of musculoskeletal ultrasound in patients with rheumatic knee arthritis. Lysholm score was used to evaluate the knee function of the affected and unaffected limbs. Pearson correlation analysis was used to analyze the correlation between musculoskeletal ultrasound results and knee function. Results The detection rate of synovium thickening, articular cartilage degeneration, suprapatellar sac effusion, medial meniscus injury and degeneration, popliteal cyst, ligament injury and subchondral bone destruction in musculoskeletal ultrasound was higher than that in X-ray （P < 0.05）. The detection rates of subchondral bone destruction, joint space narrowing, osteoporosis and bone hyperplasia in musculoskeletal ultrasound were lower than those of X-ray （P < 0.05）. The claudication, supporting, stair-climbing, squatting and standing up, pain, joint swelling and pain and total scores of the affected side of rheumatoid knee arthritis patients were lower than those of the healthy side （P < 0.05）. Pearson correlation analysis results showed that knee function in patients with rheumatic knee arthritis was negatively correlated with synovial thickening, articular cartilage degeneration, suprapatellar sac effusion, medial meniscus injury and degeneration, popliteal fossa cyst, ligament injury, subchondral bone destruction and osteogenesis, and articular space narrowing （P < 0.05）. Conclusion Musculoskeletal ultrasound has a high detection rate in patients with rheumatic knee arthritis, and there is correlation between the detection results and knee function.
2021, 42(8): 83-89.
doi: 10.12259/j.issn.2095-610X.S20210815
Abstract:
Objective To investigate the prevalence of and risk factors for type 2 diabetes mellitus in patients with chronic viral hepatitis C. Methods A total of 294 patients with chronic hepatitis C in Yunnan First People’ s Hospital from January 2018 to May 2020 were divided into two groups: 70 patients with diabetes and 224 patients without diabetes. After deletion of incomplete data, 56 patients with hepatitis C complicated with diabetes and 59 patients without diabetes were selected, then another 52 patients with type 2 diabetes mellitus who were treated in Endocrinology and Metabolism Department of Yunnan First People’ s Hospital in October 2020 were randomly selected for the study. General clinical data （gender, age, Place of residence, alcohol consumption） and laboratory tests （HCV RNA, hepatitis C antibody, LDH, AST, ALP, GGT, TBIL, DBIL, TBA, TP, ALB, GLB, BUN, CR, UA, TC, TG, HDL-C, LDL, blood sugar） were collected, and SPSS26.0 statistical software was used to establish a database and analyze whether there are statistical differences in blood biochemical indexes among the three groups of patients, and use disordered multivariate logistic regression to analyze risk factors. Results The detection rate of type 2 diabetes mellitus in patients with Chronic hepatitis C was 23.8%. There were significant differences in sex, age, region, alcohol consumption, UA, GLB, LDL-C, TC, LDH, GLB, AST, ALP, GGT, TBiL, DBiL, TBA and TG among the three groups （P < 0.05）, but there were no significant differences in TP, HDL-C, BUN and CR（P > 0.05）. Disordered multivariate Logistic regression analysis showed that age and TBA were the risk factors of type 2 diabetes in patients with chronic hepatitis C （P < 0.05）. Conclusion Hepatitis C virus infection can aggravate liver injury, and elderly patients with hepatitis C with high TBA level are more likely to develop type 2 diabetes.
2021, 42(8): 90-94.
doi: 10.12259/j.issn.2095-610X.S20210816
Abstract:
Objective To evaluate the effect of tracheotomy at different time in patient with severe cerebrovascular disease. Methods A retrospective analysis was conducted on 56 patients with severe cerebrovascular disease who underwent tracheotomy in Qingdao Central Hospital Affiliated to Qingdao University from January 2018 to December 2020. All patients were divided into Early tracheotomy group [≤ 10 d Early tracheotomy （ET） group] and Late tracheotomy group [> 10 d Late tracheotomy （LT） group] based on the time of endotracheal intubation. Among them, 38 were male and 18 were female, aged 44-86 years. The basic characteristics, length of stay in intensive care unit （ICU） after tracheotomy, total length of stay in ICU, and the incidence of ventilator-associated pneumonia （VAP）, the duration of antibiotic use in patients with pulmonary infection, the incidence of multidrug resistance （MDR） in sputum culture and the distribution of bacterial flora in bacterial culture in the 2 groups were compared. Results There were no differences between the two groups in general characteristics, such as age, gender, acute physiology and chronic health evaluation Ⅱ（APACHEII）score and Glasgow coma scale （GCS） score （P > 0.05）. The incidence of VAP and the length of post-PDT ICU stay also showed no different between the two groups （P > 0.05）. However, in the early tracheotomy group, total ICU stay （median 15.5 and 22 d, respectively, P < 0.001）, duration of antibiotic use [（11.8±3.2） d and （17.1±4.1） d, respectively, P < 0.001] and the incidence of multiple drug resistance was significantly reduced compared with the late tracheotomy group （39% and 79%, respectively, P = 0.003）. The incidence of Klebsiella pneumoniae infection was lower in the early tracheotomy group （P = 0.029, respectively）. Conclusion ET in patients with severe cerebrovascular disease might contribute to a shorter duration of ICU length of stay, lower incidence of MDR, and shorter duration of antibiotic use. But ET does not reduce the incidence of VAP. Further assessment through effective methods is necessary for tracheotomy indication and timing.
2021, 42(8): 95-100.
doi: 10.12259/j.issn.2095-610X.S20210817
Abstract:
Objective To analyze the drug resistance of Escherichia coli and Klebsiella pneumoniae causing bloodstream infection in our hospital from 2017 to 2020, so as to provide reference for clinical treatment of children with bloodstream infection. Methods The blood culture results of outpatients and inpatient children with clinical diagnosis of bacteremia in our hospital from January, 2017 to April, 2020 were collected, and data were analyzed by WHONET 5.6 software. Results A total of 193 strains of Escherichia coli were isolated from blood culture positive samples, including 100 strains （51.8%） producing extended spectrum β-lactamases （ESBLs）, 8 strains （3.3%） of carbapenem resistant Escherichia coli （CR-ECO）. There were 46 strains of Klebsiella pneumoniae, including 18 strains （39.1%） producing extended spectrum beta lactamases （ESBLs）, and 14 strains （30.4%） of carbapenem resistant Klebsiella pneumoniae （CR-KPN）. The resistance rate of ESBLs producing strains of Escherichia coli and Klebsiella pneumoniae was higher than that of non-ESBLs producing strains. The resistance rate of CR-ECO to aztreonam was 85.7%, and the resistance rates to ciprofloxacin, levofloxacin and cotrimoxazole were 100%; The resistance rate of CR-KPN to aztreonam was 61.1%, the resistance rates to ciprofloxacin, levofloxacin was 44.4%, and the resistance rate to cotrimoxazole was 5.6%. The MIC value of imipenem in 12 CR- KPN strains were greater than 16 µg/mL, accounting for 85.7% （12/14）. The MIC value of imipenem in 7 CR-ECO strains were greater than 16 µg/mL, accounting for 87.5% （7/8）. The highest distribution of isolated strains in clinical departments was in neonatology department, followed by hematology tumor and intensive care unit; most of the newborns aged < 28 days, followed by > 28 days to 1 year old. Conclusion The neonatal ward, hematological oncology and intensive care unit of our hospital have higher prevelance of bloodstream infection of multiple drug resistant Escherichia coli and Klebsiella pneumoniae. These infections are difficult to treat, which is an issure we should address. It is particularly important to control infection effectively and reduce the emergence of drug-resistant strains.
2021, 42(8): 101-105.
doi: 10.12259/j.issn.2095-610X.S20210818
Abstract:
Objective To explore the expression and significance of microRNA-21 and its regulatory gene EGFR in non-small cell lung cancer, lung adenocarcinoma and squamous cell carcinoma. Methods Lung tissue samples of 30 patients with pathologically confirmed non-small cell lung cancer from October 2020 to December 2020 in The 1st Affiliated Hospital of Kunming Medical University were taken as the research objects, including 24 cases of lung adenocarcinoma and 6 cases of lung squamous cell carcinoma, and the lung tissue adjacent to cancer was taken as the control. The expression of microRNA-21 was detected by real-time quantitative PCR, and the protein expression and localization of EGFR were detected by immunohistochemistry. Results The expression levels of microRNA-21 and EGFR in lung tissue adjacent to cancer were lower. Compared with lung tissue adjacent to cancer, the expression levels of microRNA-21 and EGFR in lung adenocarcinoma and lung squamous cell carcinoma were significantly increased （P < 0.01）; compared with lung adenocarcinoma, the expression levels of microRNA-21 and EGFR in lung squamous cell carcinoma were significantly increased （P < 0.05）. Conclusion MicroRNA-21 and its regulatory gene EGFR are highly expressed in NSCLC lung adenocarcinoma and squamous cell carcinoma, and the expression trend is consistent, which can be used to predict the progress and prognosis of NSCLC.
2021, 42(8): 106-110.
doi: 10.12259/j.issn.2095-610X.S20210819
Abstract:
Objective To investigate the clinical characteristics of newly diagnosed type 2 diabetes mellitus （T2DM） patients among Tibetans in Deqin, analyze the influencing factors of HbA1c, and explore the correlation between HbA1c and hemoglobin （Hb） in Tibetan population at high altitude. Methods Clinical data of 120 tibetan patients with medical examination or receiving diagnosis and treatment in People’ s Hospital of Deqinfrom May 2018 to June 2020 were collected, and they were divided into three groups according to blood glucose level: newly diagnosed type 2 diabetes group, pre-diabetes group and normal glucose tolerance group. General data and laboratory indexes among the three groups were compared. According to hemoglobin level, the subjects were divided into high hemoglobin group and normal hemoglobin group. Fasting plasma glucose （FPG）, two-hour postprandial plasma glucose （2 hPG） and glycosylated hemoglobin （HbA1c） levels between the two groups were compared. The relationship between HbA1c and FPG, 2 hPG and Hb was analyzed by multiple linear regression. Results Comparedwith the normal glucose tolerance group, the diabetes group had higher body mass index （BMI）, triglyceride （TG）, cholesterol （TC）, low density lipoprotein （LDL） and fatty liver ratio （P < 0.05）. There were no significant differences in gender, age, hypertension, high density lipoprotein （HDL）, uric acid （UA）, red blood cell （RBC） and Hb among the three groups. There was no significant difference in FPG, 2 hPG and HbA1c between the high hemoglobin group and the normal hemoglobin group （P > 0.05）. Multiple linear regression analysis showed that both FPG and 2 hPG affected HbA1c, but Hb did not. The regression equation was y = 2.422 + 0.217 × FPG + 0.227 × 2 hPG （R2 = 0.73, P < 0.05）. Conclusion BMI, TG, TC and fatty liver in patients with newly diagnosed type 2 diabetes mellitus in Deqin Tibetan nationality is higher, which is a clue for early recognition of diabetes. The main influencing factors of HbA1c were FPG and 2 hPG. Hb was not the influencing factor of HbA1c.
2021, 42(8): 111-117.
doi: 10.12259/j.issn.2095-610X.S20210820
Abstract:
Objective To explore the correlation between adipose tissue around the heart （pericardial adipose tissue, PAT; epicardial adipose tissue, EAT） and severity of coronary artery atherosclerosis with the Dual-source CT. Methods 223 patients suspected with coronary artery disease underwent Dual-source CT coronary angiography were enrolled in this study. The severity of coronary artery atherosclerosis were evaluated by using Circulation software. The correlation between PAT volume, EAT volume, EAT/PAT ratio and gender, with or without coronary atherosclerosis and the degree of coronary atherosclerosis were analyzed. Results There was no gender difference in PAT volume and EAT volume between the two groups （P > 0.05）, and there was gender difference in EAT/PAT ratio between the two groups （P < 0.05）. PAT volume, EAT volume and EAT/PAT ratio were positively correlated with coronary atherosclerosis in males and females （P < 0.05）. PAT volume, EAT volume and EAT/PAT ratio were positively correlated with the presence and absence of coronary atherosclerosis in all patients （P < 0.05）. Conclusion The correlation between EAT volume and CAS is higher than PAT volume, while the ratio of EAT/PAT has higher correlation with CAS than PAT volume and EAT volume, which should be able to predict CHD more accurately.
2021, 42(8): 118-122.
doi: 10.12259/j.issn.2095-610X.S20210821
Abstract:
Objective To investigate the characteristics of vaginal microecology in patients with cervical intraepithelial neoplasia and cervical cancer, and provide information for the prevention and treatment of cervical diseases. Methods From July 2018 to October 2018, patients with cervical intraepithelial neoplasia （n = 65）, patients with cervical cancer （n = 51） and healthy control （n = 88） in Yunnan Cancer Hospital were selected. Vaginal swabs were collected and microecological assessment were performed by microscopic examination. Results Compared with healthy group, there was a significant difference in the composition of bacterial density in the cervical intraepithelial neoplasia group （P < 0.05）, despite there was no significant difference in flora diversity, dominant bacteria, pH and Nugent score （P > 0.05）. There were significant differences in flora density, dominant bacteria, pH and Nugent score composition between the cervical cancer group and the healthy group （P < 0.05） and there was no significance in the composition of bacterial diversity （P > 0.05）. Conclusion Patients with cervical intraepithelial neoplasia and cervical cancer have microecological imbalance, especially in cervical cancer patients. Early detection and restoration of female vaginal microecological imbalance are beneficial for the prevention and treatment of cervical cancer.
2021, 42(8): 123-127.
doi: 10.12259/j.issn.2095-610X.S20210822
Abstract:
Objective To investigate the value of colposcopic cervix tube scraping （ECC） in the detection of low grade squamous intraepithelial lesions （LSIL） and above. Methods The clinical data of 1104 women who underwent cervical thin-thickness liquid-based cytology （TCT）, human papillomavirus （HPV）, colpopcopy, cervical biopsy and ECC in the gynecological outpatient department of the First Affiliated Hospital of Kunming Medical University from June 2018 to June 2020 were statistically analyzed. Results 18.75% （207/1104） women with LSIL+ were diagnosed by ECC, and additional detection was 8.82% （60/680）. Univariate analysis showed that women’ s age （P < 0.001）, cytology abnormality （P < 0.001）, HPV16/18 infection （P < 0.001）, colposcopy satisfaction （P < 0.001）, cervical biopsy pathology（P < 0.001）were statistically different for LSIL+ detection ECC. Multivariate regression analysis also showed that LSIL + detection of ECC was related to women’ s age （P = 0.017）, cytology abnormality （P < 0.001）, HPV16/18 infection （P < 0.001）, colposcopy satisfaction （P < 0.001）, cervical biopsy pathology （P < 0.001）. Conclusion Multi-point cervical biopsy and ECC under full colposcopy can improve the detection rate of cervical LSIL+ lesions, which is very important for early diagnosis and early treatment of cervical intraepithelial lesions and cervical cancer, but the value of ECC is still limited. It is recommended that ECC should be performed for cytological abnormalities, especially those with high-grade abnormalities, HPV16/18 type infection, those with unsatisfactory colposcopy, those with high-grade cervical lesions and older people, so as to increase the detection of cervical lesions.
2021, 42(8): 128-131.
doi: 10.12259/j.issn.2095-610X.S20210823
Abstract:
Objective To investigate the effects of different concentrations of Tiger17 on the proliferation and migration of human oral mucosa fibroblast cells （hOMF） for different periods of time. Methods The cells were cultured and migration of hOMF cells treated with different concentrations of Tiger17 for different time were detected by CCK8 and scratch test. The expression levels of TGF-β1, ERK1/2 and p-ERK1/2 in HOMF cells were detected by Western Blot. Results The proliferative activity of hOMF was significantly higher than that of the control group at 48 h （P < 0.05） in 100 μg/mL and 200 μg/mL Tiger17; the migration rate of hOMF was significantly higher than that of the control group at 24 h and 48 h （P < 0.01） in 100 μg/mL Tiger17; different concentrations of Tiger17 acted on hOMF for 24 h and 48 h, the expression of TGF-β1 and p-Erk1/2 protein increased, and the difference was statistically significant （P < 0.05）. Conclusion Tiger17 increases the expression of TGF-β1 and p-Erk1/2 in hOMF cells, and promotes the proliferation and migration of hOMF cells.
2021, 42(8): 132-139.
doi: 10.12259/j.issn.2095-610X.S20210824
Abstract:
Objective To investigate the correlation between Vitamin D receptor gene Bg1I, Cdx-2 polymorphism with Hashimoto’ s thyroiditis （HT）. Methods The SNP of VDR gene Bg1I and CDX-2 in 178 HT patients were detected by TaqMan fluorescent probe, including 56 patients with normal thyroid function （H0 group）, 80 patients with subclinical hypothyroidism （H1 group）, 42 patients with hypothyroidism （H2 group） and 64 healthy controls （NT group）. The genotype frequency, allele frequency and related clinical data were compared and analyzed. Results Bg1I GG, GT and TT genotypes frequencies were 0.500, 0.405 and 0.095, respectively; alleles G and T were 0.7025 and 0.2975, respectively. CDX-2 GG, GA and AA genotypes frequencies were 0.2934, 0.5289 and 0.1777, respectively; alleles G and A frequencies were 0.5579 and 0.4421, respectively. The genotype frequency and allele frequency in two groups were not significantly different （P > 0.05）. Logistic regression analysis indicated 25 （OH） D deficiency might be an independent risk factor for HT （OR = 1.573, P = 0.046）; male （OR = 0.158, P < 0.001） and CDX-2 G genotype （OR = 0.301, P = 0.035） may be protective factors for hypothyroidism in HT patients. High titrate TPO-Ab （OR = 1.639, P = 0.045） and TG-Ab （OR = 1.779, P = 0.035） may be risk factors for hypothyroidism in HT patients. Conclusion （1）Single nucleotide polymorphisms （SNPs） were found at VDR BG1I and CDX-2 sites. （2）CDX-2 G genotype may be a protective factor of hypothyroidism in HT. （3）Bg1I single nucleotide polymorphism was not related to the occurrence and progression of HT.
2021, 42(8): 140-147.
doi: 10.12259/j.issn.2095-610X.S20210825
Abstract:
Objective To investigate condylar morphology, position and mandibular symmetry in transverse discrepancy patients with temporomandibular joint disorders compared to those with normal occlusion. Methods 18 transverse discrepancy patients with temporomandibular joint disorders and 18 normal occlusion participants were selected .CBCT （Cone Beam CT） was taken before treatment, and the condylar morphology, position and mandibular symmetry of the two groups were compared and analyzed. Results （1） There was no significant difference in the height of bilateral ascending ramus between the experimental group and the control group （P > 0.05）. The difference of mandibular symmetry index between experimental group and control group was statistically significant （P < 0.05）. Mandibular symmetry in control group was better than that in the experimental group （P < 0.05）; （2） There was no significant difference in anterior, superior and posterior joint space between the experimental group and the control group （P > 0.05）. The condylar position on both sides of the control group was correlated （P < 0.05）, while the condylar position on both sides of the test group was not（P > 0.05）.（3）The axial condylar angles on the left side and right side of the experimental group were （25.56 ± 8.69）° and （25.88 ± 10.19）°, respectively, which are significantly higher than those in the control group, and the differences were statistically significant（ P < 0.05）. There was a correlation between the axial condylar angles in the two groups（P < 0.05）. （4） Anteroposterior diameter of condyle in the experimental group was （16.47 ± 2.03） mm on the left side and （16.62 ± 2.16） mm on the right side.The left side of the control group was （17.76 ± 1.93） mm, and the right side was （17.84 ± 2.09） mm, and there was no significant difference between the two groups （P > 0.05）. The medio-lateral diameter of condyle in the experimental group was （7.12 ± 1.3） mm on the left, （6.78 ± 1.47） mm on the right, and that in the control group was （8 ± 0.88） mm on the left, and（7.76 ± 0.92）mm on the right, the difference between the two groups was statistically significant （P < 0.05）. （5） There was no significant difference in the distance between the condylar center and the median sagittal plane between the two sides in both group （P > 0.05）. There was no significant difference between the experimental group and the control group in the anteroposterior orientation of the condylar center on both sides （P > 0.05）. There was no correlation between the condylar and the median sagittal plane distance on both sides in the experimental group （P > 0.05）, but there was correlation between the condylar and the median sagittal plane distance on both sides in the control group （P < 0.05）. Conclusion In the patients with transverse discrepancy and TMD, the mandibular symmetry, disc-process relationship and bilateral condylar position had poor correlation, and the condylar was smaller than the normal occlusal patients. For patients with transverse discrepancy, TMJ should be actively evaluated to reduce the risk of orthodontic treatment.
2021, 42(8): 148-151.
doi: 10.12259/j.issn.2095-610X.S20210826
Abstract:
Objective To explore the clinical efficacy of standardized exercise prescription on pain, immobility, depression and other related symptoms in patients with herniated lumbar disc. Methods 40 patients with lumbar intervertebral disc herniation were enrolled and randomly divided into observation group （conventional treatment plus standard exercise prescription rehabilitation training） and control group （conventional treatment plus routine exercise training）. Visual Analogue Scale （VAS）, self-rating depression scale （SDS） and straight leg elevation angle were measured before and after treatment in each group. Results After treatment, VAS, SDS and straight leg elevation angle of the experimental group were significantly improved. VAS, SDS in the experimental group changed significantly before and after treatment, and the difference was statistically significant （P < 0.001）. The VAS of patients in the control group changed before and after treatment, the difference was statistically significant （P = 0.001）, while difference of SDS before and after treatment was not statistically significant （P = 0.178）. The VAS, SDS and straight leg elevation angle of the experimental group were significantly different from those of the control group （P < 0.05）. The improvement degree of pain, depression and straight leg elevation angle of the experimental group was significantly higher than that of the control group （P < 0.001）. Conclusion The standardized exercise prescription rehabilitation training can alleviate the pain of lumbar disc herniation, improve the angle of straight leg raising, and improve the clinical effect of depression, so as to improve the quality of life of patients.
2021, 42(8): 152-157.
doi: 10.12259/j.issn.2095-610X.S20210827
Abstract:
Objective To investigate the incidence and trends of opportunistic infections in hospitalized patients with HIV/AIDS in Kunming. Methods The data of 7756 inpatients were retrospective analyzed in the third people’ s hospital of Kunming from 2012 to 2020. The number of inpatients and their demographic data of each year were compared. Chi-square test was used to analyze the trend of disease distribution and proportion in each year. From 2012 to 2020, the number of hospitalized patients with HIV/AIDS showed an upward trend. The average hospital stay decreased significantly in 2019 and 2020. The top five co-infections of HIV were bacterial pneumonia （39.01%）, tuberculosis （23.58%）, candidiasis （23.19%）, PCP （8.88%）, CMV （3.83%）. Bacterial pneumonia increased from 2012 to 2016, then decreased from 2017 to 2020. TB prevalence rose from 2012 to 2014 and gradually declined after 2015. Candidiasis showed an increase from 2012 to 2016, and a decrease from 2016 to 2020. PCP increased from 2012 to 2017, and decreased from2017 to 2020. Tuberculosis mainly affected the lungs, followed by lymph nodes, meningeal and pleura. The incidence of liver disease is the highest among non-HIV related diseases （34.39%）, including HCV （22.54%）, HBV （5%）, drug-induced liver injury （4.47%）, fatty liver （1.48%）, alcoholic hepatitis （0.67%）, autoimmune liver disease （0.16%）. Liver disease showed an upward trend from 2012 to 2014, and decreased significantly from 2015 to 2019, then increased in 2020 （P < 0.001）. The incidence of cardiovascular disease is increasing by year （P < 0.001）, other disease showed a slow rise. Conclusion Number of HIV/AIDS patients increases in hospital admissions, the common diseases are bacterial pheumonia, tuberculosis, candidiasis, PCP. Opportunistic infections are mostly on the decline, non-HIV related diseases are on the rise.
2021, 42(8): 158-163.
doi: 10.12259/j.issn.2095-610X.S20210828
Abstract:
Cardiovascular diseases is a serious threat to human health, which is characterized by high morbidity, high lethality and disability. In recent years, studies have found that complement factor H （CFH） is a very important negative regulator in the complement system and inflammatory response. The decrease or absence of CFH can continuously activate the complement alternative pathway and enhance the mediated inflammatory response, leading to damage of endothelial cells and cardiomyocytes. CFH plays an important role in the pathogenesis of cardiovascular disease and is involved in the pathophysiology mechanism. This article reviewed the role and mechanism of CFH in the pathogenesis of cardiovascular disease.
Cardiovascular diseases is a serious threat to human health, which is characterized by high morbidity, high lethality and disability. In recent years, studies have found that complement factor H （CFH） is a very important negative regulator in the complement system and inflammatory response. The decrease or absence of CFH can continuously activate the complement alternative pathway and enhance the mediated inflammatory response, leading to damage of endothelial cells and cardiomyocytes. CFH plays an important role in the pathogenesis of cardiovascular disease and is involved in the pathophysiology mechanism. This article reviewed the role and mechanism of CFH in the pathogenesis of cardiovascular disease.
2021, 42(8): 164-169.
doi: 10.12259/j.issn.2095-610X.S20210829
Abstract:
Objective To explore the effect of mobile platform-based "flipped classroom" teaching mode on nursing students’ performance, autonomous learning ability and academic self-efficacy. Methods （1） Intern nursing students in the Blood Purification Center in 2018 were selected as the experimental group, in which the "flipped classroom" teaching mode based on the mobile platform was used. Nursing students who practiced in our department in 2017 were the control group, in which the traditional teaching mode was used. The nursing students’ autonomous learning ability and academic self-efficacy of the two groups were evaluated after the internship. Results The comparison of theory test and practice test showed that the experimental group have better performance than the control group （P < 0.01）. The autonomous learning ability in the experimental group was evaluated in four dimensions, and the 20 items were better than those in the control group, with statistical significance （P < 0.01）. The comparison of 22 items in the two groups showed that the two dimensions of academic self-efficacy of nursing students were better than the control group, and the difference was statistically significant （P < 0.01）. Conclusion The application of the "flipped classroom" teaching mode based on the mobile platform in the teaching of nursing students in blood purification center have better effect in promoting students’ learning motivation, improving their autonomous learning ability and self-efficacy. Utilizing the mobile platform helps improve the quality of nursing teaching and diversifies teaching mode in teaching hospitals.
2021, 42(8): 170-173.
doi: 10.12259/j.issn.2095-610X.S20210830
Abstract:
Objective To investigate the effect of Moist Exposed Burn Ointment on the retaining time of positive-pressure intravenous indwelling needle in patients with infusion of special medications. Methods A total of 200 patients in our department who received high-concentration and highly irritating drugs via positive pressure intravenous indwelling needles were randomly divided into experimental group and control group （100 cases in each group）. In experimental group, the Moist Exposed Burn Ointment was applied with a thickness of about 1～2 mm along the vein and wrapped with plastic wrap, twice a day. In control group routine nursing measures were used without any other drug intervention. The incidence of complications and the retaining time of indwelling needle were compared. Results 95% of the patients in the experimental group had an needle retention time of 72 h, while in the control group, only 76% of the patients had retention time of 72 h, and the difference was statistically significant （P < 0.05）. The incidence of complications was 4% in the experimental group and 34% in the control group, with statistically significant difference between the two groups （P < 0.05）. The satisfaction rate of the two groups was 96% in the control group and 78% in the observation group, and the difference was statistically significant （P < 0.05）. Conclusion MEBO is effective in prolonging the retention time of the indwelling needle and reducing complications for patients with high-concentration and highly irritating drugs infused with a positive pressure intravenous indwelling needle in tumor neurosurgery. It is economical and worthy of clinical application.
2021, 42(8): 174-176.
doi: 10.12259/j.issn.2095-610X.S20210831
Abstract:
objective To explore the post-operative quality of life in cardiac valve replacement patients. Method A total of 200 patients who had undergone the first mechanical heart valve replacement within 1 year （July 2018 to July 2019） in the Department of Cardiology of The First Affiliated Hospital of Kunming Medical University were selected, and the patients received anticoagulant therapy （warfarin）after surgery. The included cases were randomly divided into the control group （100 cases） and the experimental group （100 cases）. All patients in the experimental group received FCC; that is, all patients had an assigned full-time nurse who was fully responsible for their home care from admission to later stage. The control group received routine nursing care. The patients were evaluated for postoperative nursing effect at 3, 6 and 12 months after surgery, and the evaluation indicators included medication compliance and patients’ quality of life. Results There was no statistically significant difference （P > 0.05） between the two groups in medication compliance and postoperative survival quality at 3 months after surgery; but in 6 months and 12 months, compared with the control group, experimental group’ s medication adherence and postoperative quality of life, were significantly increased （P < 0.05）. Conclusion For patients undergoing heart valve replacement, FCC is associated with a higher postoperative medication compliance and a lower incidence of complications, leading to a higher quality of life.
2021, 42(8): 177-180.
doi: 10.12259/j.issn.2095-610X.S20210832
Abstract:
Objective To investigate the effect of the shared decision-making in patients with primary liver cancer during perioperative period. Methods A total of 120 patients with primary liver cancer who underwent laparoscopic hepatectomy from November 1, 2020 to April 30, 2021 were selected and randomly divided into control group （n = 60） and experimental group （n = 60）. The patients in the control group were treated with routine health intervention mode during perioperative period, while the patients in the experimental group were treated with the patient-nurse shared decision-making mode. The psychological pain degree （distress thermometer, DT）, the hospital anxiety and depression degree （HADS）, postoperative self-care ability (ADL), compliance behavior, length of hospital stay, patient satisfaction and follow-up visit rate were compared between the two groups. Results There was no significant difference in the psychological state and self-care ability between the experimental group and the control group （P > 0.05）; Postoperative self-care ability, patient compliance behavior, length of hospital stay, medical satisfaction, follow-up visit rate were significantly better than the control group, the difference was statistically significant （P < 0.05）. Conclusion Shared decision-making for primary liver cancer patients undergone laparoscopic hepatectomy is beneficial in reducing psychological distress, relieving patients’ anxiety depression, improving postoperative life self-care ability and improving the medical behavior, shortening the length of hospital stay, which is both safe and efficient for patients’ recovery, and is worthy of clinical promotion and reference.
