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RSS2022 Vol. 43, No. 11
2022, 43(11): 1-8.
doi: 10.12259/j.issn.2095-610X.S20221105
Abstract:
Objective To establish an animal model to investigate the relationship between cell division cycle 42 （CDC42） and cognitive deficits in hippocampal neurons. Methods Adenovirus with CDC42 mutant gene was packaged to infect excitatory neurons in the hippocampus of healthy mice by microinjection. The cognitive phenotypes of mice under various behavioral patterns were detected. Results Adenovirus specifically enhanced or decreased the expression activity of CDC42 protein in excitatory neurons in the hippocampus. After the inhibition of CDC42 protein in the hippocampus, the conditioned memory of the mice decreased ,significantly at 24 hours and 96 hours, and enhancing CDC42 activity in the hippocampus made mice show an obvious anxiety behavior. However, neither enhancement nor inhibition of the CDC42 activity in the hippocampus had a significant effect on social behavior （P > 0.05）. Conclusions The mice with altered CDC42 activity in hippocampal excitatory neurons may present a fear conditioning memory defect and significant anxiety behavior, this may suggest the relationship between cytoskeletal protein CDC42 and cognitive phenotypes. This regulatory model may provide new methods and ideas for the establishment of research models for mental disorders such as SZ and CDC42 is expected to become a new molecular target for the treatment of memory impairment or anxiety.
2022, 43(11): 9-16.
doi: 10.12259/j.issn.2095-610X.S20221101
Abstract:
Objective To study the effect of perindopril on body weight, blood lipids and intestinal flora of obese rats. Methods SPF Wistar rats were randomly divided into normal group, model group, perindopril low-dose and high-dose groups （0.4, 2 mg/（kg·d））. Changes in LDL-C, HDL-C, UA, GLU and intestinal flora in feces were compared. Results Compared with the normal group, the final body weight, body weight gain and Lee's index of the rats in the model group increased （P < 0.01）, indicating that the model was successfully established; compared with the model group, the body weight of the rats in the perindopril low and high dose groups significantly decreased （ P < 0.05, 0.01）. The results of 16S rRNA sequencing showed that perindopril could improve the level of intestinal flora diversity in rats, and the total number of OTUs in the perindopril low-dose group increased by 4.56%; at the phylum and genus levels, the perindopril low-dose group The species composition of Firmicutes was significantly decreased （P < 0.01）, and the species composition of Alloprevotella, NK4A214_group, no_rank_f__Erysipelotrichaceae, norank_f__Eubacterium_coprostanoligenes_group were significantly increased （P < 0.05, 0.01）, and The species compositions of Actinobacteriota, norank_f__Erysipelotrichaceae, Enterorhabdus and Staphylococcus were significantly increased in the perindopril high-dose group （P < 0.01）. Conclusion Perindopril can reduce the body weight of obese rats, and its effect may be related to the regulation of intestinal flora composition of rats.
2022, 43(11): 17-21.
doi: 10.12259/j.issn.2095-610X.S20221104
Abstract:
Objectives To analyze the prevalence trend and epidemic characteristics of hypertension among primary and middle school students in Kunming, and to provide scientific basis for the formulation of prevention and intervention strategies for hypertension among children and adolescents in Kunming. Methods A multi-stage stratified random cluster sampling was used to randomly select students aged 9 to 18 from 11 primary and secondary schools in 2 counties （districts） of Kunming, Yunnan. A total of 12,026 people were surveyed. Results The detection rate of hypertension in primary and secondary school students of Kunming was 8.15% and the standardized detection rate was 7.85%. The hypertension of primary and middle school students was increasing year by year （P < 0.01）. The prevalence of hypertension increased with age （P < 0.01）; Boys were higher than girls （P < 0.01）; The prevalence of hypertension in Han students increased faster than those of minority （P < 0.01）. Urban students were higher than suburban/county students, but the elevated blood pressure level of the suburban/county students increased faster than the urban students （P < 0.01）. Overweight （OR = 2.45） and obesity （OR = 4.78） were high-risk groups with hypertension （P < 0.05）. Conclusions The problem of hypertension among primary and secondary school students in Kunming cannot be ignored, and the risk factors of hypertension should be explored as soon as possible. In order to reduce the occurrence of unhealthy behaviors in primary and secondary school students, so as to reduce the occurrence of chronic diseases such as adult hypertension, coronary heart disease and stroke.
2022, 43(11): 22-29.
doi: 10.12259/j.issn.2095-610X.S20221128
Abstract:
Objective To study the relationship between the expression of receptor tyrosine kinase-like orphan receptor 1 （ROR1） and spread through air space （STAS） in lung adenocarcinoma tissues. Methods We collected 618 cases of lung adenocarcinoma from June 2017 to January 2, 2022, HE staining section was used to determine pathological subtypes and pathological characteristics, count STAS number and grade. The expression of ROR1 was detected by immunohistochemistry staining in different pathological subtypes of lung adenocarcinoma and the relationship with STAS quantity was analyzed. Results ROR1 expressions were higher in micropapillary and solid lung adenocarcinoma （poorly differentiated） （P < 0.001）; ROR1 expression rates were 88.0%, 94.1% in low STAS and high STAS groups, significantly higher than no STAS group （P < 0.001）. Conclusions ROR1 is highly expressed in poorly differentiated lung adenocarcinoma and suggests a higher incidence of STAS. ROR1 is expected to be a new diagnostic biomarker of lung adenocarcinoma for guiding clinical treatment and assisting prognostic judgment, and may be a potential therapeutic target for STAS-positive lung adenocarcinoma.
2022, 43(11): 30-35.
doi: 10.12259/j.issn.2095-610X.S20221112
Abstract:
Objective To assess the nutritional status of vitamin A among adults of ethnic minority groups native to Yunnan Province, and provide scientific evidence for healthy eating promotions. Methods Between 2016 and 2020, 841 adults were randomly sampled from seven ethnic minority groups according to the sex and age composition in the 6thnational census. The serum retinol level was determined using high-performance liquid chromatography （HLCP）, and judged by the WHO criteria. Vitamin A intake was calculated through a dietary survey and judged by reference to the dietary guidelines. Results The median serum vitamin A concentration was 0.55 mg/L （ranging from 0.44 to 0.68 mg/L） and significant differences were found in sex, race, education and income levels （all P < 0.05）. The prevalence of vitamin A deficiency and marginal deficiencies were 0.7% and 3.7%, respectively. The median of dietary vitamin A intake was 406.0 μg retinol equivalents （RE） and 67.0% of the subjects consumed less vitamin A than the Chinese Estimated Average Requirement （EAR）. The major food sources of vitamin A were dark vegetables, eggs, light vegetables and meat, accounting for 86.6% of total vitamin A intake. Conclusion The serum vitamin A concentration is relatively good in the population, whereas inadequate vitamin A intake remains a problem, especially for certain ethnic groups, older and poor adults.
2022, 43(11): 36-43.
doi: 10.12259/j.issn.2095-610X.S20221129
Abstract:
Objective To study the effects of puerarin on the immune homeostasis of T helper 17 （Th17）/regulatory T （Treg） cells and the expression of related transcription factors in rats with periodontitis. Methods A rat periodontitis model was established using gingival isolation, silk ligature application and subgingival injection of Escherichia coli endotoxin （E-LPS）. The rats were randomly divided into a normal control group （group A）, a periodontitis model group （group B）, and a 200 mg/（kg-d） puerarin group （group C）. HE staining was used to observe the changes of periodontal tissue. Micro-ct correlated bone indexes were also analyzed to quantify the resorption of alveolar bone. The percentages of Th17 and Treg cells and the expression of interleukin （IL）-17, retinoic acid-related orphan receptor gamma t （RORγt）, IL-10 and forkhead transcription factor-3 （Foxp3）in periodontal tissues were monitored by flow Cytometry and Western blot （WB）, respectively. Results In the study, the roots of the teeth in the puerarin group were significantly proliferated with new osteoblasts. Flow cytometry showed that the proportion of TH17 and Treg cells in the puerarin group decreased, and the proportion of TH17/Treg cells also decreased . The protein expressions of IL-10 and Foxp3 were up-regulated in puerarin, while the histone expressions of IL-17 and RORγt were down-regulated in puerarin （P < 0.05）. Conclusions Puerarin can alleviate the periodontal tissue inflammatory response and alveolar bone resorption in rats with periodontitis and favor periodontal tissue healing by regulating Th17/Treg cell immune homeostasis and the expression of related transcription factors. The mechanism of action may be related to effective regulation of Th17/Treg cell immune homeostasis by puerarin.
2022, 43(11): 44-51.
doi: 10.12259/j.issn.2095-610X.S20221102
Abstract:
Objective To explore the relevant risk factors for Refeeding Syndrome （RFS） in ICU patients with sepsis, and to establish a prediction model of RFS based on the selected risk factors. Methods The clinical data of sepsis patients admitted to the ICU of the First Affiliated Hospital of Kunming Medical University from November 2020 to January 2022 were studied retrospectively. Finally, 202 patients were selected according to the inclusion and exclusion criteria. According to the diagnosis criteria of ASPEN Consensus Recommendations （2020） for RFS, the patients were divided into two groups: RFS group （n = 141） and non-RFS group （n = 61） on the basis of whether occur of RFS. The differences of gender, body mass index （BMI）, nutrition risk screening, nutritional way, related critical score, intraabdominal pressure （IAP）, relevant laboratory tests, biochemical indexes and pharmacy were compared between the two groups. The independent risk factors of RFS in ICU patients with sepsis were screened by single factor and multivariate logistic regression analysis, and a prediction model was established according to the results of the analysis. The predictive value of the prediction model for RFS in ICU patients with sepsis was evaluated by drawing the receiver operating characteristic curve （ROC） of the subjects. Results After analyzing the relevant data of 202 sepsis patients, the results of monofactor logistic regression analysis showed: Body mass index （BMI）, albumin （ALB）, prealbumin （PA）, creatinine-height index （CHI）, serum sodium （Na+）, serum potassium （K+）, serum magnesium （Mg2+）, serum phosphorus （P- ）, interleukin-6 （IL-6）, fasting blood glucose （FBG）, vitamin B1 （VitB1）, glycosylated hemoglobin （HbA1c）, use of diuretics, use of insulin and other indicators were significantly different （P < 0.05）. And multivariate analysis showed that the use of diuretics, BMI, CHI, serum K+, FBG, and VitB1 were independent risk factors for RFS in ICU sepsis patients. Conclusions Based on the independent risk factors in the multivariate screening, the prediction model expression is established as: L = 1.39×diuretics + 0.15×BMI - 0.14×CHI + 0.75×K+-0.16×FBG+0.78×VitB1-2.94. The prediction model established by regression analysis has strong consistency, the joint prediction model has better predictive value.
2022, 43(11): 52-57.
doi: 10.12259/j.issn.2095-610X.S20221106
Abstract:
Objective To study the clinical effect of staged Island prepuce flap urethral plate reconstruction in the treatment of severe hypospadias. Methods Twenty-eight patients with severe hypospadias treated in our hospital from November 2013 to March 2022 were selected for the study. According to the different surgical methods, the patients were divided into two groups: staged island prepuce flap urethral plate reconstruction group （group A） and traditional staged operation （one-stage extension of penis and two-stage urethroplasty） group （group B）. The age, operation time, blood loss, postoperative complications of patients or relatives treatment confidence and cure rate were compared between the 2 groups. Results Thirteen patients were aged from 2 to 34 years at the time of first operation,and the urethral defect length was 3.5-6 cm. Fifteen patients, aged from 2 to 27 years at the time of the first operation, had a urethral defect of 3-6 cm in length. There were no significant differences in age, treatment time, intraoperative blood loss and treatment between the two groups. In the staged island foreskin flap urethral plate reconstruction operation group, 2 cases developed urethral fistula after the operation, and the other 1 case developed urethral rupture at the head of the penis. Re-repair of urethral fistula/urethroplasty. There were 4 cases of urethral fistula and 2 cases of urethral stricture and a urethral diverticulum in the traditional staged operation group. Need to re-operation urethral fistula repair/urethroplasty, urethral dilatation to cure. The surgical success rate of the staged island foreskin plate urethral plate reconstruction surgery group was 76.9%, and the surgical success rate of the traditional staged surgery group was 60.0%. Conclusions Staged Island prepuce flap urethral plate reconstruction has become an important method to cure hypospadias by stages. It has good safety, satisfactory appearance, low complication rate and clinical application value for moderate and severe hypospadias.
2022, 43(11): 58-62.
doi: 10.12259/j.issn.2095-610X.S20221107
Abstract:
Objective To establish an automatic review system for blood coagulation test report and evaluate its application effect. Methods The rules for the examination of coagulation test reports were written into Lis Procedure. A total of 6281 reports that were automatically audited during the commissioning period were selected for manual verification, to evaluate the feasibility of the rules. Results The passing rate of automatic verification was 71.34%, False positive rate （4.49%）, False negative rate （0.032%）, Positive coincidence rate （24.14%）, Negative coincidence rate （71.34%）, Consistent rate （95.48%） and correct passing rate （99.96%）. Conclusion There are 23 intercepting rules, the Delta Check rule of APTT needs to be improved, and the rest of 22 intercepting rules’ correct passing rate is 100%.
2022, 43(11): 63-70.
doi: 10.12259/j.issn.2095-610X.S20221127
Abstract:
Objective To analyse the effect of time interval on the outcome of microwave ablation （MWA）treatment of hepatocellular carcinoma （HCC） after transarterial chemoembolization （TACE）. Methods A retrospective analysis of recurrent 71 HCC patients after receiving TACE and MWA at the 3rd People’s Hospital of Kunming from February 2016 to December 2018; with 32 patients received sequential MWA treatment within 4 weeks after TACE （sequential Treatment group）, and 39 patients received delayed MWA treatment （delayed Treatment group） 4 weeks after the completion of TACE, the overall survival （OS） and progression-free survival （PFS） of two groups were observed. Survival curve was plotted using Kaplan-Meier, the multiple Cox proportional hazard regression was used to analyze prognostic factors, compare adverse reactions between the two groups. Results The median OS of the sequential group and the delayed group were 35.3 months and 29.1 months, respectively. PFS in the sequential group was 27 months, and 13.8 months in the delayed group. The sequential group had better overall survival OS （HR, 0.601; 95%CI, 0.378-0.796; P = 0.037） and longer PFS （HR, 0.779; 95%CI, 0.415-0.821; P = 0.004）. Maximum tumor diameter, number of tumors, and time interval are factors that affect OS and PFS. Child-Pugh classification is a factor that affects OS but does not affect PFS. Conclusion TACE plus sequential MWA within 4 weeks was more effective for treatment HCC than delayed MWA, and does not increase adverse reactions.
2022, 43(11): 71-76.
doi: 10.12259/j.issn.2095-610X.S20221109
Abstract:
Objective To explore the greater palatine foramen anatomical position and its relationship with the morphology of palatal vault in adults, so as to provide theoretical basis for the clinic operation related to palate. Methods We collected CBCT images of 180 adult patients, marked both 360 sides greater palatine foramen location, analyzed the relative position of greater palatine foramen to maxillary molar and the distance between the longitudinal suture of palate and longitudinal suture of palate and checked the relationship between different morphology of palatal vault and the distribution of greater palatine foramen. Results The distribution rates of the greater palatine foramen at the palatal side of second molar, third molar mesial side and palatal side of third molar were 21.39%, 21.11% and 57.50% respectively. The （GPF-MMS） distances of male and female were （16.31±1.18） mm and （15.82±1.32） mm, and the distance from the palatal foramen to the corresponding enamel cementum boundary （GPF-M） was （17.11±2.50） mm and （15.79±2.57） mm, All showed that male was larger than female （P < 0.05）. The distance of GPF-MMS in high palate group was lower than that in low palate group; On the contrary （P < 0.05）, GPF-M in high palate group was significantly higher than that in low palate group （P < 0.05）. Conclusion The position of the greater palatine foramen in adults patients is related to gender and the palatal vault arch.
2022, 43(11): 77-84.
doi: 10.12259/j.issn.2095-610X.S20221108
Abstract:
Objective To analyze the long non coding RNA （lncRNA） differentially expressed between nasopharyngeal carcinoma cell lines resistant to concurrent radiotherapy and chemotherapy and their parent cell lines, and explore the possible role of lncRNA in nasopharyngeal carcinoma resistance to concurrent radiotherapy and chemotherapy. Methods The concurrent chemoradiotherapy resistance model of nasopharyngeal carcinoma CEN1 and CNE2 cells was constructed in vitro, and the concurrent chemoradiotherapy resistance cell lines CEN1CRR and CNE2CRR of nasopharyngeal carcinoma cells were induced. The differentially expressed lncRNAs between the two groups of cell lines were screened by high-throughput sequencing, and the target genes of the differentially expressed lncRNAs were analyzed by GO and KEGG. Results With Log2FC > 1 or < - 1 and FDR < 0.05 as the differential expression criteria, 2746 lncRNAs （358 up-regulated and 2063 down-regulated） were differentially expressed in CNE1 CRR compared with CNE1. Compared with CNE2, CNE2CRR differentially expressed 3475 lncRNAs （265 up-regulated, 520 down-regulated）. In addition, 387 lncRNAs were downregulated in CNE1CRR and CNE2CRR, and 49 lncRNAs were upregulated in CNE1CRR and CNE2CRR. GO analysis showed that the target genes differentially expressing lncRNAs in the two groups of cells were involved in biological process （BP）, molecular function （MF）, and cell component （CC）. In the KEGG analysis results, it was found that in CNE1 group cells, the main signal pathways for the enrichment of target genes of differential lncRNAs were apoptosis, viral carcinogenesis, metabolic pathways, etc. In CNE2 group, the target genes of differential lncRNAs were mainly enriched through metabolic pathways （lipoic acid, pentose phosphate, arachidonic acid, ether lipid）, T cell receptor signaling pathways, nucleotide excision repair, etc. （P < 0.05）. Conclusions There are significant differences in lncRNA expression profiles between concurrent chemoradiotherapy-resistant cell lines and parental cell lines. These differentially expressed lncRNAs may participate in concurrent chemoradiotherapy resistance of nasopharyngeal carcinoma, and lay a foundation for its mechanism research.
2022, 43(11): 85-89.
doi: 10.12259/j.issn.2095-610X.S20221110
Abstract:
Objective To compare the efficacy of biliary 125I seed stent and bare metal stent in the treatment of Bismuth Corlette Ⅲ cholangiocarcinoma complicated with obstructive jaundice. Methods A total of 51 patients with malignant biliary obstruction caused by Bismuth Corlette Ⅲ cholangiocarcinoma who were treated in our department from January 2010 to June 2018 were systematically retrospectively collected, of whom 25 were in the 125I seed stent implantation group （observation group）. There were 26 cases in the bare metal stent implantation group （control group）, and the preoperative and postoperative liver function, complication rate, stent patency time and survival time were compared between the two groups. Results The liver function and jaundice degree of patients in the 125I seed stent implantation group （observation group） and bare metal stent implantation group （control group） were significantly improved at 1 month after surgery. Compared with the control group, the observation group did not increase the incidence of postoperative complications. The average stent patency time in the observation group was （369.20±231.64） d, and the stent patency time was 310.05 d in the control group, the average stent patency time in the control group was （194.57±118.09） d, and the median stent patency time was 142.52 d. The stent patency time in the observation group was significantly longer than that in the control group （P＜0.05）. The median survival period was （334.24 ± 193.38） d, and the median survival period was 385.21 d. The average survival period of the control group was （251.23 ± 182.51） d, and the median survival period was 274.43 d. The survival period of patients in the observation group was significantly longer than that in the control group （P＜0.05）. Conclusion Compared with bare metal stent, biliary 125I seed stent can significantly reduce stent restenosis rate, prolong stent patency time, and improve patient survival without increasing postoperative complications.
2022, 43(11): 90-98.
doi: 10.12259/j.issn.2095-610X.S20221111
Abstract:
Objective To observe the effect of comprehensive rehabilitation combined with soft and hard occlusion therapy for disc anchor surgery of anterior disc displacement with reduction. Methods A total of 60 patients with anterior disc displacement with reduction who underwent unilateral disc anchor surgery from January 2017 to April 2021 were treated in The Affiliated Hospital of Yunnan University. The position of the postoperative condyle was maintained by assisted occlusion therapy. The subjects were randomly divided into two groups: the experimental group was the soft occlusion therapy group （n = 30 cases）, and the control group was the hard occlusion therapy group （n = 30 cases）. Comprehensive physical therapy and open-mouth training were performed 3 months after the operation, followed up 1, 3 and 6 months after the operation, and MRI was performed immediately, 3 and 6 months after the operation. Fricton index and MRI evaluation criteria were used to evaluate the reduction effect of joint disc, improvement degree of mouth opening, the comfort of patients wearing occlusion and visual analog scales. To study the efficacy of two occlusion therapy. Results Postoperative malocclusion occurred in all patients. The use of occlusion therapy for 3-6 months may decrease the proportion of malocclusion. The postoperative Friction index in both groups was significantly decreased compared with that before surgery. 1 month after surgery, CMI of the soft occlusion therapy group （0.149±0.054） was significantly lower than that of the hard occlusion therapy group （0.221±0.052）. Immediate postoperative MRI evaluation showed that the effective rate of soft and hard occlusion was 100% （30/30）. MRI evaluation results at 3 and 6 months after surgery were the same, and the effective rate of soft and hard occlusion treatment was 97% （29/30）. One month after surgery, the mouth opening degree in the soft occlusion therapy group was （2.73±0.27） mm better than that in the hard occlusion therapy group （2.07±0.39） mm, with statistical significance （P < 0.05）. One month after surgery, the VAS of the soft occlusion therapy group （2.18±0.54） was significantly lower than that of the hard occlusion therapy group （3.03±0.29）, with statistical significance （P < 0.05）. The wear comfort survey of patients in the two groups one month after surgery showed that the comfort rate of 86.7% in the soft occlusion therapy group was significantly higher than that in the hard occlusion therapy group （73.3%）, and the difference was statistically significant. Conclusions Soft occlusion and hard occlusion have similar effects, but the treatment effect of soft occlusion is significantly better than hard occlusion 1 month after surgery, and the patient’s comfort level is also significantly better than hard occlusion. Combined with the advantages and disadvantages of soft occlusion and hard occlusion, soft occlusion can be used immediately to 1 month after the operation, and hard occlusion can be used for treatment after 1-3 months after the patient's mouth opening significantly improves, or fixed orthodontics can be used for treatment according to specific malocclusion.
2022, 43(11): 99-106.
doi: 10.12259/j.issn.2095-610X.S20221113
Abstract:
Objective To evaluate the efficacy of a bedaquiline-containing regimen in the treatment of multidrug-resistant/extensively drug-resistant tuberculosis, and to explore the adverse reactions, so as to provide a reference for safe and rational drug use in clinical practice. Methods The clinical data of 62 patients with multi-drug resistant/extensively drug-resistant tuberculosis treated with a bedaquiline-containing regimen from October 2019 to October 2021 in the Third People’s Hospital of Kunming were retrospectively analyzed to evaluate the efficacy and safety of bedaquiline-containing regimen. Background Drug composition, number and days of sputum negative conversion, lesion absorption, cavity closure, and distribution of adverse events were counted, and their correlation was analyzed. QTcF values （corrected for heart rate, QT interval values calculated using the Fridericia formula） were recorded before and after medication, and changes from baseline at each monitoring point were compared and analyzed. Results All 62 patients were followed up for 24 weeks, and there were no deaths, lost to follow-up or withdrawal cases; At the end of 24 weeks of treatment, the sputum smear-negative conversion rate was 93.5% （58/62）, the sputum culture negative conversion rate was 85.4% （53/62）, the lesion absorption rate was 87.1% （54/62）, and the cavity closure rate was 92.3% （36/39） in 39 patients with cavities. There were a total of 217 adverse events, 203 （93.5%） were mild to moderate （grade 1 to 2） adverse events and 14 （6.5%） were serious （grade 3 to 5） adverse events. A total of 22 discontinuations were performed during treatment. Bedaquiline-related adverse events were 11 discontinuations, mainly manifested as QTc prolongation in 9 （41.0%） and hepatotoxicity in 2 （9.1%）. Statistical calculation results showed that abnormal liver function was negatively correlated with sputum negative conversion time （z = -0.293, P < 0.01）; QTc interval prolongation was negatively correlated with sputum negative conversion time （ z = -0.544, P < 0.01）. Sixty-two patients were compared between the mean QTcF value at each monitoring site and the baseline QTcF value, and the QTcF value gradually increased with the extension of the course of treatment, and the differences at weeks 4, 8, 12, 16, and 24 were statistically significant. Conclusions Bedaquiline-containing regimens achieve a high rate of sputum negative conversion at 24 weeks in the treatment of multidrug-resistant/extensively drug-resistant tuberculosis and can promote the absorption of imaging lesions in patients. Although the incidence of adverse drug reactions is high, they are generally controllable and tolerable to most patients. Special attention should be paid to QTc prolongation and liver injury during medication.
2022, 43(11): 107-111.
doi: 10.12259/j.issn.2095-610X.S20221126
Abstract:
Objective To analyze the difference in cardiac function between intracranial and extracranial atherosclerotic stroke and aortic arch atherosclerotic stroke, so as to investigate the effect of cardiac function on the prognosis of large artery atherosclerotic stroke. Methods A total of 846 patients with first-ever acute ischemic stroke from January 2014 to October 2017 in 920th Hospital of People’s Liberation Army, Logistics Support Force were selected. A total of 552 large artery atherosclerotic stroke patients who met the Chinese Ischemic Stroke Subclassification. Among these 507 were diagnosed with intracranial and extracranial atherosclerotic stroke and 45 were diagnosed with aortic arch atherosclerotic stroke. To analyze the difference in cardiac function between intracranial and extracranial atherosclerotic stroke and aortic arch atherosclerotic stroke. The multivariate regression analysis was used to analyze the effect of cardiac function on the 30-day prognosis of stroke. Results The LVEF and LVFS in the aortic arch atherosclerosis group were lower than those in the intracranial and extracranial atherosclerosis group. The ESV in patients with aortic arch atherosclerosis was greater than that in the intracranial and extracranial atherosclerosis groups. In patients with large artery atherosclerotic stroke, decreased SV and coronary atherosclerotic heart disease increased the risk of 30-day disability; increased CO, hyperuricemia and age increased the risk of 30-day death. Conclusions The cardiac systolic function of patients with aortic arch atherosclerotic stroke is worse than that of patients with intracranial and extracranial atherosclerotic stroke. In patients with large artery atherosclerotic stroke, the decrease of SV and coronary atherosclerotic heart disease is independently associated with the 30-day disability, the increase of CO, age and hyperuricemia are independently associated with the 30-day death.
2022, 43(11): 112-117.
doi: 10.12259/j.issn.2095-610X.S20221103
Abstract:
Objective To investigate the effects of hemoglobin level during pregnancy, pre-pregnancy body mass index and weight gain during pregnancy on pregnancy outcomes. Methods Retrospective research was used to analyze the medical records of delivery women in Yunnan Third People’s Hospital from August 2021 to December 2021. According to the hemoglobin level during pregnancy, they were divided into low hemoglobin group, middle hemoglobin group and high hemoglobin group. According to pre-pregnancy body mass index, they were divided into 3 groups: low pre-pregnancy BMI group, normal BMI group, and pre-pregnancy high BMI group. According to weight gains, they were divided into three groups: insufficient weight gain, normal weight gain, and excessive weight gain. The pregnancy outcomes of each group were compared. Results There were statistical differences in the incidence of preterm birth among the low hemoglobin group, the middle hemoglobin group and the high hemoglobin group （P < 0.05）. There were statistical differences in the incidences of uterine birth, macrosomia, and fetal growth restriction （P < 0.05）. There was a statistical difference in the incidence of macrosomia （P < 0.05）. Conclusion Pregnancy hemoglobin, pre-pregnancy BMI and gestational weight gain all have an impact on pregnancy outcomes, and reasonable control of them can reduce the occurrence of adverse pregnancy outcomes and promote maternal and infant health.
2022, 43(11): 118-123.
doi: 10.12259/j.issn.2095-610X.S20221114
Abstract:
Objective To explore the application value of CBCT imaging in the diagnosis of salivary gland disease by sialography. Methods After sialography,51 patients performed traditional pantomography and CBCT scans, Multi-planar images（MPR）, synthetic pantographs（SPAN） and 3D images were reconstructed from CBCT volume data and compared with TPAN. Results 51 salivary glands after sialography can display the full picture of salivary glands in 360 degrees on CBCT 3D images, and the lesion characteristics such as duct dilation, stenosis and distal catheter “punctate dilation” were obviously better than those of TPAN. Its MPR image showed the filling defect formed by salivary gland space-occupying lesions such as negative--“punctate dilation” was obviously better than that of TPAN. Its MPR image showed the filling defect formed by salivary gland space-occupying lesions such as negative sialolith and tumors more clearly and accurately. Conclusion CBCT imaging can stereoscopically display the ductal system and glandular morphological changes of the salivary glands with a variety of reconstruction techniques （MPR, SPAN and 3D） in sialography, which is more conducive to the diagnosis of salivary gland diseases, In addition, the advantages of a comfortable position, simple operation, low radiation dose, and so on, it has unique application value in the diagnosis of salivary gland diseases.
2022, 43(11): 124-129.
doi: 10.12259/j.issn.2095-610X.S20221115
Abstract:
Objective To study the efficacy and safety of real-world sofosbuvir/velpatasvir （SOF/VEL） in combination with or without ribavirin （RBV） in the treatment of patients with chronic hepatitis C （CHC） genotype 3 in Yunnan. Methods A total of 219 patients with genotype 3 CHC between January 2018 and March 2022 were selected and treated with SOF/VEL in combination with or without RBV for 12 weeks or 24 weeks with a 12-week follow-up after discontinuation of the drug. General demographic data, HCV RNA quantification, liver function, and liver stiffness measurements were collected from patients. Results Among 219 patients with genotype 3 CHC, abnormal biochemical parameters and liver hardness values were significantly lower than baseline at 12 weeks of discontinuation, with a sustained viral response rate of 95.4% （209/219）. 60 cases reported mild adverse effects, mainly anemia, malaise and headache, and no serious adverse effects were observed. Conclusions SOF/VEL in combination with or without RBV regimen can result in high response rates in patients with hepatitis C genotype 3 without cirrhosis or combined with compensated cirrhosis, but lower response rates in patients with hepatitis C genotype 3 in combination with chronic liver failure. Patients may have mild adverse effects and an acceptable safety profile with this regimen.
2022, 43(11): 130-135.
doi: 10.12259/j.issn.2095-610X.S20221116
Abstract:
Objective To study the effect and safety of linaclotide combined with compound polyethylene glycol electrolyte （PEG） in bowel preparation in patients with chronic constipation. Methods A total of 174 patients with chronic constipation who underwent colonoscopy in Qingdao Eighth People’s Hospital from March 2021 to February 2022 were selected as the research subjects, and they were divided into group A, group B, and group C by random number table method, with 58 cases in each group. Patients in group A were treated with 3LPEG fractionated bowel cleansing, patients in group B were treated with 3 capsules of linaclotide combined with 3LPEG fractional bowel cleansing, and group C patients were given 4LPEG fractional bowel cleansing. The quality of bowel preparation, colonoscopy time and incidence of adverse reactions were compared among the three groups. Results The scores of the left semicolon, transverse colon, right semicolon and Boston bowel preparation scale （BBPS） total score in groups B and C were higher than those in group A （P < 0.05）. There was no significant difference in the scores of the left semicolon, transverse colon, right semicolon and total BBPS score between group B and group C （P > 0.05）. Among the elderly patients with constipation, the scores of the left semicolon, transverse colon, right semicolon and BBPS total score in group B were higher than those in group C （P < 0.05）. The entry time, exit time and total colonoscopy time of groups B and C were all shorter than those of group A （P < 0.05）. Compared with group C, the entry time, exit time and total colonoscopy time of group B were shorter than those of group C （P < 0.05）. Compared with group C, the incidence of each adverse reaction in groups A and B was lower than that in group C （P < 0.05）. Conclusions Linaclotide combined with fractional oral 3LPEG improves the quality of bowel preparation and shortens the time of colonoscopy compared with single fractional oral 3LPEG. Compared with fractional oral 4LPEG alone, it can achieve the same bowel preparation effect and can reduce the incidence of adverse reactions, with high safety. For elderly patients with chronic constipation, linaclotide combined with fractional oral 3LPEG has a better bowel preparation effect than fractional oral 4LPEG alone.
2022, 43(11): 136-140.
doi: 10.12259/j.issn.2095-610X.S20221117
Abstract:
Objective To observe the clinical efficacy and safety of sacubitril-valsartan in patients with reduced ejection fraction and hypotensive heart failure. Methods A total of 100 patients with decreased ejection fraction combined with hypotension and heart failure who were admitted to the Department of Cardiology of Kunming First People’s Hospital from January 2020 to December 2021 were included in the study. The patients were randomly divided into an observation group and a control group, with 50 cases in each group. The patients in the two groups were given standard treatment for heart failure including diuresis and β -receptor blockers. The patients were given sacubatril valsartan at a small dose of 25–50 mg twice a day. According to the patient’s tolerance, the dose was doubled and increased once every 2–4 weeks until the maintenance dose was reached. After 12 months of treatment, the LVEF, LVDd and LVDs of cardiac function in two groups were compared before and after treatment, and the SBP, DBP, blood K+, blood Na+, CTNT, NT-proBNP were observed. Results After treatment, the LVEF of patients in the two groups was increased, while the LVDd and LVDs were decreased. There was statistical difference in LVEF and LVDs between the two groups （P < 0.05）, but no statistical difference in LVDd （P > 0.05）. After treatment, the levels of blood K+, blood Na+, and CTNT increased in the two groups , there was no significant difference between the two groups after treatment （P > 0.05）; NT proBNP decreased significantly after treatment （P < 0.05）. After treatment, the systolic blood pressure in the experimental group increased compared with that before treatment, while there was no significant change in the control group （P > 0.05）, and there was no significant difference in diastolic blood pressure between the two groups （P > 0.05）. Conclusion The treatment of HFrEF combined with hypotension in patients taking sacubatril valsartan can improve heart function, it has no effect on blood pressure, and is safe.
2022, 43(11): 141-145.
doi: 10.12259/j.issn.2095-610X.S20221118
Abstract:
Objective To analyze the positive test results of respiratory tract virus pathogens in hospitalized children in Anning area. Methods A total of 1766 hospitalized children in Anning District from September 2019 to February 2022 were selected as subjects, and they were divided into < 6 months old group, 6 months to 4 years old group, and 4 to 14 years old group according to their age. According to the prevention and control of COVID-19, the period from September 2019 to February 2020 shall be before public protection, and the period after February 2020 shall be after public protection. All children’s nasopharyngeal swab samples were tested by using direct immunofluorescence method for determination of antigen of influenza a virus, hepatitis b antigen of influenza virus, respiratory syncytial virus antigen and antigen of adenovirus, vice antigen of influenza virus type Ⅰ, parainfluenza Ⅱ antigen and deputy antigen of influenza virus type Ⅲ seven respiratory pathogens, and the data of children with respiratory tract pathogen examination were statistically analyzed. Results Among 1766 children, 584 （33.07%）were positive for respiratory virus pathogens. The main pathogens were respiratory syncytial virus （316 cases/17.89%）, adenovirus （90 cases/5.10%） and parainfluenza virus TYPE Ⅲ （82 cases/4.64%）. The positive rate of respiratory tract infection pathogen in children was mainly concentrated in < 6 months old group and 6 months to 4 years old group, with 111 （34.69%） and 327 （34.31%） cases, respectively. There was statistical significance in the positive rate of respiratory tract infection pathogens in different age groups （χ2 = 8.392, P = 0.031）. The positive rate of influenza A virus detected after public protection （0.29%） was lower than that before public protection （5.94%）, the difference was statistically significant （P < 0.05）. There was no statistical significance in the detection rate of influenza B virus antigen, adenovirus antigen, parainfluenza virus Ⅰ, parainfluenza virus Ⅱ and parainfluenza virus Ⅱ before and after public protection （P > 0.05）. Conclusion The detection rate of virus etiology of respiratory tract infection in hospitalized children in Anning area is high, respiratory syncytial virus is the main pathogen, and the positive rate of influenza A virus detection decreases obviously after public protection, so it is important to continue to do public protection to prevent influenza A.
2022, 43(11): 146-150.
doi: 10.12259/j.issn.2095-610X.S20221119
Abstract:
Objective To investigate the combination of recombinant human thrombopoietin （rhTPO） combined with high-dose short-cycle dexamethasone （hexadecadrol, HDD） regimen in the treatment of anti-nuclear antibody （ANA） positive adults with immune thrombocytopenia （immune thrombocytopenia, ITP） efficacy and safety. Methods A total of 66 adult patients with ANA-positive immune thrombocytopenia diagnosed in Qujing First People's Hospital from August 2020 to December 2021 were selected and divided into HDD alone group （n = 22）, rhTPO alone group （n = 22） and combination group （n = 22） by random number table method. The HDD alone group was treated with high-dose short-cycle dexamethasone （HDD）, the rhTPO alone group was treated with rhTPO, and the combination group was treated with HDD and rhTPO. The liver and kidney-related indexes, platelet count, clinical efficacy including total effective rate, recurrence rate, time to effective standard of platelet count and adverse reactions were compared between the three groups before and after treatment. Results The total effective rate of the combination group was significantly higher than that of HDD alone group and rhTPO alone group （P < 0.05）. The platelet count of combination group was higher than that of HDD alone group and rhTPO alone group, and the effective time of platelet count was shorter than that of HDD alone group and rhTPO alone group （P < 0.05）. There was no significant difference in platelet transfusion rate among the three groups （P > 0.05）. There was no significant difference in the incidence of total adverse reactions among the three groups （P > 0.05）. There were no significant differences in ALT, AST, BUM and Scr levels among the three groups before and after treatment （P > 0.05）. Compared with before treatment, there were no significant differences in ALT, AST, BUM and Scr levels among the three groups after treatment （P > 0.05）. After the course of treatment, there was no significant difference in the recurrence rate among the three groups （P > 0.05）. Conclusion The use of rhTPO combined with high-dose short-cycle HDD therapy can significantly improve the clinical efficacy of ANA-positive adult ITP, increase the number of platelets, and has good safety.
2022, 43(11): 151-155.
doi: 10.12259/j.issn.2095-610X.S20221120
Abstract:
Objective To explore the effect of early interventional therapy with bronchoscopic alveolar lavage on AIDS patients complicated with severe pneumonia. Methods Adult AIDS patients complicated with severe pneumonia （44 cases） who were hospitalized in the Department of Intensive Care Unit of the Third People’s Hospital of Kunming from January 2018 to June 2021 and needed invasive mechanical ventilation support were selected. They were divided into observation group and control group , with 22 cases in each group. The observation group was treated with bronchoscopic alveolar lavage on the basis of conventional treatment, the control group received conventional treatment. We compared the efficacy of the two groups before and after treatment such as infectivity index, arterial oxygen saturation, arterial oxygen partial pressure and oxygenation index, APACHE II, hospitalization days in the intensive care unit, 28-day mortality, mechanical ventilation time and the time of body temperature returns to normal. Results （1）After one-week treatment, the procalcitonin and c-reactive protein levels in the observation group were significantly lower than those in the control group （P < 0.05）. （2）The levels of SaO2, PaO2, PaO2/FiO2 in the observation group were higher than those in the control group after one-week treatment, the difference was statistically significant （P < 0.05）. （3）After one-week treatment, the score of APACHE II in the observation group is decrease than the control group, the difference was statistically significant （P < 0.05）. In the observation group, the data about mechanical ventilation time and the time of body temperature returns to normal all lower than those in the control group, the difference was statistically significant （P < 0.05）. The 28-day mortality of the observation group was significantly lower than that of the control group, but the difference was not statistically significant （P > 0.05）. There was no statistically significant difference in Hospitalization days between the two groups （P > 0.05）. Conclusions Early interventional therapy with bronchoscopic alveolar lavage can effectively reduce the infection index, reduce the inflammatory reaction of the body, improve oxygenation, and reduce the time of invasive mechanical ventilation in the treatment of AIDS patients complicated with severe pneumonia. Bronchofiberscope alveolar lavage is of great significance to reduce mortality and improve clinical rescue efficiency, and is worthy of clinical application and popularization.
2022, 43(11): 156-164.
doi: 10.12259/j.issn.2095-610X.S20221121
Abstract:
The incidence of adolescent idiopathic scoliosis （AIS） worldwide is 1%～3%, the base of the diseased population is large, and it causes both physical and psychological pains to patients. Numerous studies have shown that genetic factors may play an important role in the occurrence and development of AIS. The correlation between single nucleotide polymorphisms （SNPs） and AIS is the focus of medical molecular research in recent years. In-depth research on the SNPs of susceptibility genes will help to explore new strategies for the prevention, diagnosis and treatment of AIS. This article reviews the research advances concerning gene SNPs and AIS susceptibility.
The incidence of adolescent idiopathic scoliosis （AIS） worldwide is 1%～3%, the base of the diseased population is large, and it causes both physical and psychological pains to patients. Numerous studies have shown that genetic factors may play an important role in the occurrence and development of AIS. The correlation between single nucleotide polymorphisms （SNPs） and AIS is the focus of medical molecular research in recent years. In-depth research on the SNPs of susceptibility genes will help to explore new strategies for the prevention, diagnosis and treatment of AIS. This article reviews the research advances concerning gene SNPs and AIS susceptibility.
2022, 43(11): 165-171.
doi: 10.12259/j.issn.2095-610X.S20221122
Abstract:
Liver fibrosis （HF） is the result of abnormal deposition of various extracellular matrix （ECM） caused by the over-repair response of various chronic liver diseases, such as genetic-related diseases, chronic viral hepatitis, alcoholic hepatitis, cholestasis and drug-induced liver injury. The pathogenesis of hepatic fibrosis is related to hepatic stellate cell （HSC）, hepatic macrophage, endoplasmic reticulum stress （ERs） and autophagy. Liver fibrosis is a dynamic process that can progress to cirrhosis or even hepatocellular carcinoma without intervention. Therefore, delaying or reversing the occurrence of liver fibrosis has very important clinical significance. The purpose of this review is to summarize the etiology, occurrence and development mechanism of liver fibrosis and provide a reference for the research of anti-liver fibrosis drugs.
Liver fibrosis （HF） is the result of abnormal deposition of various extracellular matrix （ECM） caused by the over-repair response of various chronic liver diseases, such as genetic-related diseases, chronic viral hepatitis, alcoholic hepatitis, cholestasis and drug-induced liver injury. The pathogenesis of hepatic fibrosis is related to hepatic stellate cell （HSC）, hepatic macrophage, endoplasmic reticulum stress （ERs） and autophagy. Liver fibrosis is a dynamic process that can progress to cirrhosis or even hepatocellular carcinoma without intervention. Therefore, delaying or reversing the occurrence of liver fibrosis has very important clinical significance. The purpose of this review is to summarize the etiology, occurrence and development mechanism of liver fibrosis and provide a reference for the research of anti-liver fibrosis drugs.
2022, 43(11): 172-177.
doi: 10.12259/j.issn.2095-610X.S20221123
Abstract:
Objective To explore the application effect of rain classroom combined scenario simulation teaching method based on Bloom’s target teaching theory in the teaching of intern nursing students in the radiotherapy department. Methods 120 nursing students were divided into intervention group and control group, 60 in each group. The control group received routine clinical nursing instruction in the radiotherapy department. The intervention group took the rain classroom combined with the scenario simulation teaching method based on Bloom’s target teaching theory on the basis of routine clinical nursing teaching in the radiotherapy department. The practice period is one month, and questionnaires, theoretical scores and operational scores are used to evaluate the teaching effect when leaving the course. Results At the end of the practice, the nursing students in the intervention group had significantly higher scores of critical thinking, theory, operation and teaching satisfaction than the control group （P < 0.05）. Conclusion The rain classroom combined scenario simulation teaching method based on Bloom’s target teaching theory can significantly improve the critical thinking ability, theoretical and operational performance and satisfaction of practice teaching of nursing students.
2022, 43(11): 178-184.
doi: 10.12259/j.issn.2095-610X.S20221124
Abstract:
Objective To explore the effects of natural sleep and drug sedation on the degree of cooperation and image quality in children with epilepsy, and to guide nurses to master the advantages and disadvantages of the two methods. Methods A total of 72 children with epilepsy （45 males and 27 females, aged from 1 to 12 years old） in the PET/CT Center of the First People’s Hospital of Yunnan Province from May 2020 to January 2022 were enrolled retrospectively. all children were sedated by natural sleep and drug the sedation before examination. After resting for 1 hour, the anesthesiologist and nurse scored the cooperation degree （PSSS score 0-5） and performed PET/CT scan. After scanning, the image fusion was performed by the post-processing workstation, and the image offset distance was calculated automatically by the workstation. Two imaging doctors evaluated the overall image quality, lesion saliency and image background noise （Likert score 1-5）. T-test and rank sum test was used to analyze the differences between the two sedation methods; the natural sleep method was set to 0 and the drug sedation method was set to 1 for Pearson correlation analysis, and the correlation between the two sedation methods and other scores and indexes was observed. Results There was only significant difference in blood glucose between the two groups （P < 0.05）, but there was no significant difference in age, sex, body weight, body length and injection dose between the two groups （P > 0.05）. There were significant differences in PSSS score distribution, image offset distance and overall image quality Likert score distribution between the two groups （P < 0.05）, but there was no significant difference in lesion significance and image background noise Likert score distribution between the two groups. Correlation analysis showed that the overall Likert score of PET/CT image quality of children with drug sedation was higher （P < 0.05, r＞0） and the image offset distance was small （P < 0.05, r < 0）. Conclusions The quality of PET/CT images of children with drug sedation is better than that of natural sleep. Nurses need to master the advantages and disadvantages of the two methods in order to cooperate with guardians to flexibly prepare before PET/CT examination of epilepsy.
2022, 43(11): 185-192.
doi: 10.12259/j.issn.2095-610X.S20221125
Abstract:
Objective To improve effectively the quality of life outside the hospital for patients with Chronic Heart Failure （CHF） through the construction of a Multidisciplinary Teams （MDT）-driven “path-based” core symptom group management mode based on Symptom Management Education （SME）. Methods 72 patients with CHF hospitalized in the heart failure ward of our department were studied, and the patients were divided into control a group and an intervention group by randomized number table method. The control group was given routine care for CHF, and the intervention group built a path-based SME model driven by a MDT. Three months and six months after discharge from the hospital, the quality of life scores were compared and analyzed. Results Compared with the two groups of patients with CHF at 3 months and 6 months after discharge from the hospital, the difference in the total quality of life score of heart failure and the three-dimensional score was statistically significant （P < 0.05）, and the score of the intervention group in the same period was lower than the control group. Before and after the intervention, the quality of life of the two groups of patients with heart failure and the score of each dimension were analyzed repeatedly measured variance. The inter-group effect, time effect and interaction effect were statistically significant （P < 0.05）. The intra-group comparison between the two groups showed that the total quality of life score and the three-dimensional score in the intervention group showed a significant downward trend, and the overall decline and speed of each dimension were better than those in the control group. Conclusion The path-based SME model driven by MDT can effectively improve the self-symptom management ability of patients with CHF and maintain a good quality of life outside the hospital.
