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RSS2022 Vol. 43, No. 7
2022, 43(7): 1-8.
doi: 10.12259/j.issn.2095-610X.S20220712
Abstract:
Objective To investigate the role of guanylate cyclase C （GC-C） signaling pathway in the intestinal inflammatory injury of mice induced by sodium dextran sulfate （DSS）. Methods The colitis models were constructed using DSS in the GC-C gene knockout （GC-C-/-） mice and wild-type （WT） mice. The mice were divided into the colitis groups which were given drinking 3% DSS solution for one week, and the control groups which were given normal diet. The expressions of GC-C mRNA and protein in colon tissues were detected by the methods of qRT-PCR and western blot. The inflammatory damage of colon tissues was observed by the HE staining and the histopathological score was performed by the light microscope. The levels of inflammatory factors （IL-8 and TNF-α） in the peripheral blood as well as intestinal mucus of mice were determined by ELISA. Results 1. Compared with the WT mice, the disease activity index （DAI） scores of the GC-C-/- mice induced by DSS increased significantly （P < 0.05）, and the shortening of colon, intestinal thickening, hyperemia and edema were more obvious; 2. The inflammatory damage of colon tissues was more serious and the histopathological score was higher in the GC-C-/-+DSS group than that of the WT+DSS group significantly （P < 0.05）; 3. The levels of IL-8 and TNF-αin the peripheral blood and intestinal mucus were higher in the GC-C-/-+DSS group than that of the WT+DSS group significantly （P < 0.05, respectively）. Conclusions The intestinal inflammatory injury is more serious in the GC-C-/- mice induced by chemical substances. GC-C signaling pathway may be involved in the occurrence and development of ulcerative colitis （UC）.
2022, 43(7): 9-17.
doi: 10.12259/j.issn.2095-610X.S20220717
Abstract:
Objective To investigate the expression and clinical significance of LEA and CDw75 in human colorectal adenocarcinoma. Methods The expressions of LEA and CDw75 were detected by immunohistochemistry staining in 11 cases of normal colorectal normal mucosa, 43 cases of colorectal adenomas, 51 cases of colorectal adenocarcinoma without lymph node metastasis, and 21 cases of colorectal adenocarcinoma with lymph node metastasis. Forty-five patients with colorectal adenocarcinoma were followed up, and the results of immunohistochemistry and follow-up were used for statistical analysis and prognosis analysis. Results 1. The expression of LEA and CDw75 in normal colon mucosa, colorectal adenoma and colorectal adenocarcinoma was gradually increased （P < 0.05）. It is related to the differentiation degree of colorectal adenocarcinoma （P < 0.05）. It was not related with lymph node metastasis （P > 0.05）. 2. The expression of LEA and CDw75 was higher in villous adenomas than in tubular adenomas （P < 0.05）. 3. Cox regression survival analysis showed that patient gender, age, clinical stage, LEA and CDw75 expression were the prognostic factors of colorectal adenocarcinoma. Conclusions 1. LEA and CDw75 may play a role during the development of colorectal adenocarcinoma. 2. Patient gender, age, clinical stage, LEA and CDw75 expression intensity can be used as prognostic indicators of colorectal adenocarcinoma.
2022, 43(7): 18-24.
doi: 10.12259/j.issn.2095-610X.S20220724
Abstract:
Objective To investigate the effect and mechanism of miR-208a on myocardial injury induced by myocardial ischemia reperfusion by regulating the expression of QKI5 in rats. Methods Thirty-two male SD rats were randomly divided into sham group, I/R group, I/R+anta-miR-NC group and I/R+anta-miR-208a group. The rat model of myocardial I/R was established, and the LVEF, LVFS and SV were detected in each group. The levels of CK-MB, cTnI, IL-1β, IL-6, TNF-αwere measured by ELISA. HE staining was used to observe the pathological changes of myocardial tissue in each group, and TUNEL staining was used to detect myocardial cell apoptosis.RT-PCR was used to detect the expression of miR-208a and QKI5 mRNA in myocardial tissue, and Western blot was used to detect the realative expression levels of QKI5 protein and Caspase-3 in myocardial tissue. Results Compared with the Sham group, the levels of LVEF, LVFS, SV in the I/R group were decreased, while the apoptosis rate of cardiomyocytes was increased, and the levels of CK-MB, cTnI, IL-1β, IL-6, TNF-α in serum and the expressions of miR-208a and Caspase-3 in the myocardial tissue were increased, and the expressions of QKI5 were decreased （P < 0.05）. Compared with the I/R+anta-miR-NC group, the levels of LVEF, LVFS, SV in the I/R+anta-miR-208a group were increased, while the apoptosis rate of cardiomyocytes was decreased, and the levels of CK-MB, cTnI, IL-1β, IL-6, TNF-α in serum and the expressions of miR-208a and Caspase-3 in the myocardial tissue were decreased, and the expressions of QKI5 were increased （P < 0.05）. Correlation analysis found that the expression of miR-208a and QKI5 had negative correlation in the I/R rats. Conclusion Inhibition of miR-208a may alleviate the inflammatory response to exert myocardial protective function in myocardial ischemia-reperfusion injury by regulating the expression of QKI5.
2022, 43(7): 25-32.
doi: 10.12259/j.issn.2095-610X.S20220731
Abstract:
Objective To investigate the effect and related mechanism of circRNA EZH2 on proliferation and migration of prostate cancer cells through miR-30c-5p. Methods The expression difference and survival probability of EZH2 in prostate cancer were analyzed according to TCGA database. SiRNA were transfected to silence EZH2 in prostate cancer LNCaP cells, and proliferation and migration of LNCaP cells were detected by CCK-8 assay and wound healing assay, and the expression of miR-30c-5p, JAK1 and PI3K proteins were determined by RT-qPCR and western blot. Results The expression of EZH2 was up-regulated in prostate cancer tissues, and the survival rate of patients with high expression of EZH2 decreased. Compare with normal LNCaP cells, the proliferation and migration of EZH2-silenced LNCaP cells were decreased, miR-30c-5p expression was increased, JAK1 expression was decreased, and PI3K signal was inhibited. Conclusion EZH2 is highly expressed in prostate cancer and can promote the proliferation and migration of LNCaP cells by regulating miR-30c-5p/JAK1 axis and acting on PI3K signaling pathway.
2022, 43(7): 33-37.
doi: 10.12259/j.issn.2095-610X.S20220730
Abstract:
Objective To observe the effect of Saccharomyces cerevisiae （S. cerevisiae） YLR358C deletion on cell wall integrity. Methods The growth of YLR358CΔ yeast was observed by spot assay; the effect of YLR358C on yeast cell wall was analyzed by Calcofluor White （CFW） staining and transmission electron microscopy （TEM）; the signal pathway regulated by YLR358C was detected by transcriptome analysis and qRT-PCR. Results The growth of S. cerevisiae knockout with YLR358C was significantly inhibited on medium containing CFW, congored （CR） and sodium dodecyl sulfate （SDS） at different concentrations. The cell wall chitin was down-regulated by CFW staining and the cell wall thickness was reduced by TEM. Transcriptome sequencing and analysis indicated that YLR358C gene may be involved in the regulation of CWI signaling pathway. qRT-PCR showed that WSC3, SWI4 and HSP12 were differentially expressed after YLR358C knockout （P < 0.05）. Conclusion YLR358C may regulate the integrity of yeast cell wall, and has certain application potential in fermentation.
2022, 43(7): 38-45.
doi: 10.12259/j.issn.2095-610X.S20220721
Abstract:
Objective To investigate the effect of scutellarin （SCU） on the expression of NOX （NOX2, NOX4） and the degree of liver fibrosis induced by high fat and high sugar in non-alcoholic fatty liver disease （NAFLD）. Methods Sixty rats were randomly divided into normal group, model group, SCU-25 lower dose treatment group［25 mg/（kg·d）, SCU-50 dose in the treatment group［50 mg/（kg·d）］, SCU-100 high dose treatment group ［100 mg/（kg·d） and curcumin positive drug treatment group［200 mg/（kg·d）］, 10 in each group. The normal group was fed with ordinary diet for 24+8 weeks, and the other groups were fed with high-fat and high- sugar diet for 24 weeks to establish NAFLD animal model, and then given Different concentrations of SCU and curcumin intragastric treatment for 8 weeks. After the treatment, the weight of the rats was measured, and the serum samples and liver tissues of the rats were collected under anesthesia. The weight of theliver was measured and the liver index was calculated. ROS content in serum and tissues was detected by ELISA. Using oil red "O" Dyeing, detection of liver lipid deposition and Masson staining to detect the degree of fibrosis of liver tissue; Western blot and immunohistochemistry were used to detect the expression of NOX2 and NOX4 proteins in liver tissues. Results Body weight, liver weight and liver index increased in model group （ P < 0.01）, body weight, liver weight and liver index decreased after different doses of SCU and curcumin treatment group, while body weight and liver weight were significantly decreased in SCU-100 high-dose treatment group and curcumin positive drug treatment group （ P < 0.01）. ROS content in serum and liver tissues of model group was significantly increased （ P < 0.01）, and ROS content was decreased after treatment with different doses of SCU and curcumin （ P < 0.05）. In the liver tissue, the model group showed a large amount of lipid deposition and tissue fibrosis. After treatment with different doses of SCU and curcumin, the lipid deposition was reduced and the degree of liver fibrosis wasimproved. In liver tissue cells, the protein expressions of NOX2 and NOX4 were up-regulated in the model group （ P < 0.05）, but down-regulated in differentdoses of SCU and curcumin （ P < 0.05）, but not dose-dependent. Conclusion SCU may reduce ROS production by inhibiting the expression of NOX2 and NOX4 proteins in liver, thus alleviating the degree of liver fibrosis in NAFLD.
2022, 43(7): 46-54.
doi: 10.12259/j.issn.2095-610X.S20220714
Abstract:
Objective To explore the effect of HLA-G expression on NK cell surface activation receptor in cervical cancer cells. Methods Real-time PCR （RT-PCR） and Western Blot （WB） methods were used to examine the expression of HLA-G in cervical cancer cells and normal cervical cells, respectively. The cervical cancer cell lines transfected with lentivirus to silence the expression of HLA-G were co-cultured with NK cells. The proliferation ability of co-cultured cervical cancer cells was measured by the method of CCK8, and the level of apoptosis in cervical cancer cells was measured by the flow cytometry method, as well as the expression of NKG2D and NKP30, Granzyme and Perforin. Results The results of RT-PCR and WB showed that compared with H8 cells, the expressions of HLA-G in C33a and SiHa cells were significantly increased （P < 0.05）. Results of CCK8 showed that the proliferation of C33a and SiHa cells was significantly decreased （P < 0.05） when C33a and SiHa cells were co-cultured with NK cells after transfection. The levels of apoptosis in C33a and SiHa cells were significantly increased （P < 0.05）.The results of Flow cytometry showed that the expression of NKG2D on NK surface was significantly increased after C33a and SiHa were transfected （P < 0.05）. Of C33a, The expression of NKP30 on the surface of NK cells and Granzyme, Perforin were significantly increased （P < 0.05）. However, of C33a, the expression of NKP30 on the surface of NK cells and Granzyme, Perforin were increased, but the difference was not statistically significant （P > 0.05）. Conclusion The high expression of HLA-G is in cervical cancer cells, and it may enhance the killing effect of NK cells on cervical cancer cells by promoting the expression of activated receptor.
2022, 43(7): 55-61.
doi: 10.12259/j.issn.2095-610X.S20220711
Abstract:
Objective To investigate the potential of CXCL10 as a noninvasive biomarker of liver cirrhosis and its mechanism in the progression of liver fibrosis. Methods Peripheral blood samples of EDTA-K2 anticoagulant tubes were collected from cirrhotic patients （n = 64） and healthy subjects （n = 64） in the Second Affiliated Hospital of Kunming Medical University from March to August 2021, and the basic information and laboratory examination results of the patients were strictly recorded. CXCL10 concentration in plasma was determined by ELISA. The relationship between CXCL10 expression level and biochemical test results was analyzed. ROC curve was used to analyze the predictive value of plasma CXCL10 levels for cirrhosis. Results The plasma CXCL10 concentration in patients with cirrhosis was significantly higher than that in healthy subjects, and the difference was statistically significant （P < 0.0001）. Plasma CXCL10 levels were positively correlated with ALT, AST, PT, APTT and DD in patients with cirrhosis （P < 0.05）. The area under ROC curve of CXCL10 is 0.8264, which has good diagnostic performance. Conclusion CXCL10 can be used as a non-invasive biomarker and a potential therapeutic target for liver cirrhosis.
2022, 43(7): 62-67.
doi: 10.12259/j.issn.2095-610X.S20220708
Abstract:
Objective To analyze the effects of different frequency intense pulsed light （IPL）treatment on tear film stability and meibomian gland function in patients with MEibomian gland dysfunction （MGD）. Methods One hundred and forty eyes of 70 MGD patients admitted to Yuxi People’s Hospital from March 2021 to December 2021 were selected as the research objects. Patients were randomly divided into group A and group B according to the number table method, with 35 cases in each group. Group A received one IPL treatment at week 0, week 1, week 3 and week 7 （A total of 4 treatments）, and group B received one IPL treatment at week 0 and week 1 （A total of 2 treatments）.Fluorescein sodium ophthalmic dipstick was used to detect tear film rupture time. Mean non-invasive tear film rupture time （NIBUTav）, first non-invasive tear film rupture time （NIBUTf）, tear river height and corneal luciferin staining were measured by ocular surface analyzer. The tear film rupture time, OSDI scale score, NIBUTav, NIBUTf, lacrimal river height, meibomian gland secretion capacity score, meibomian gland secretion score and corneal fluorescein staining score were compared before and after IPL treatment at different frequencies. Results Compared with before treatment, the tear film rupture time and OSDI score in group A and GROUP B were significantly decreased, with statistical significance （P < 0.05）.The time of tear film rupture in group A was lower than that in group B, and the difference was statistically significant （ P < 0.05）, while the OSDI score between group A and GROUP B showed no significant difference （ P > 0.05）. After treatment, NIBUTav, NIBUTf and lacrimal river height were significantly increased in group A and group B, and NIBUTav and NIBUTf in group A were higher than those in group B, while the lacrimal river height was lower than those in group B, with statistical significance （ P < 0.05）.After treatment, meibomian gland secretion status score and secretory ability score of group A and GROUP B were decreased, and the score of group A was lower than that of group B, the difference was statistically significant （ P < 0.05）. After treatment, the corneal fluorescein staining score of group A and group B decreased, and the score of group A was higher than that of group B, the difference was statistically significant （ P < 0.05）. Conclusion IPL treatment at week 0, week 1, week 3 and week 7 for MGD patients can effectively improve the symptoms and signs of dry eye, and the efficacy and safety can be well balanced during the treatment.
2022, 43(7): 68-73.
doi: 10.12259/j.issn.2095-610X.S20220722
Abstract:
Objective To focus on the difference between solution focused group therapy （SFGT） combined with Escitalopram and only use Escitalopram in the treatment of depression group, and evaluate the efficacy of focus resolution short-course group psychotherapy （SFGT） combined with Escitalopram in the treatment of depressive disorders. Methods Eithty-four patients who met the diagnostic criteria of ICD-10 depression in Yunnan Psychiatric Hospital were randomly divided into combined treatment group （42 patients） and simple drug group （42 patients）. The period of this treatment was 8 weeks. A total of 84 patients who met the diagnostic criteria of ICD-10 depressive disorder in our hospital were randomly divided into combination therapy group and single drug group for 8 weeks of treatment. The effect was evaluated by Social Disability Screening Schedule （SDSS） and Genera Self-efficacy Scale （GSES）, and SPSS22.0 was used for statistical analysis. Results After 8 weeks of treatment, 18 cases fell from the two groups, including 8 cases from the combined treatment group and 10 cases from the control group. There was no difference in the subscales and total scores of SDSS and GSES between the two groups before treatment. The total scores and subscales scores of SDSS were lower than those in the control group at the 4th and 8th weeks of treatment （P < 0.05） . Compared with the control group, the GSES scores of the combined treatment group were higher than those of the control group at the 4th and 8th week in the course of treatment, and the difference was statistically significant （P < 0.05）. Conclusions Solution focused group therapy （SFGT） combined with Escitalopram is better than drug therapy alone in the treatment of depression. Solution focused group therapy （SFGT） combined with Ecitalopram is more effective than monotherapy for depressive disorders.
2022, 43(7): 74-79.
doi: 10.12259/j.issn.2095-610X.S20220701
Abstract:
Objective To analyze the maternal and systemic factors that affect the endometrial implantation window in women with repeated implantation failure in assisted reproductive therapy. Methods Retrospective analysis was made on the data of cases diagnosed as repeated implantation failure and endometrial receptivity test （ERT） in the Department of Reproductive Medicine, First People's Hospital of Yunnan Province from December 2020 to January 2022. According to ERT results, they were divided into tolerance group and non-tolerance group. Insulin resistance, vitamin D deficiency, prethrombotic state, incidence of thyroid autoimmunity and positive rates of antinuclear antibody and antiphospholipid antibody were compared between the two groups. Logistic regression analysis was carried out on the results of the above single factor analysis, and the independent risk factors affecting the endometrial implant window were obtained. Results There was no significant difference in general information between the two groups （P > 0.05）, but there were significant differences in the incidence of insulin resistance and the positive rate of antiphospholipid antibody between the two groups （P < 0.05）. Multivariate logistic regression analysis showed that insulin resistance, prethrombotic state and thyroid autoimmunity were independent risk factors for endometrial implantation window （P < 0.05）. Conclusion Among the maternal factors, insulin resistance, prethrombotic state, and thyroid autoimmunity are the risk factors for the displacement of endometrial implant window in the population with repeated implant failure.
2022, 43(7): 80-85.
doi: 10.12259/j.issn.2095-610X.S20220710
Abstract:
Objective To analyze the clinical characteristics of squamous cell carcinoma with cervical lymph node metastasis of unknown primary （CCUP） focus, explore the prognostic factors, and provide the basis for clinical diagnosis and treatment. Methods The clinical data of 23 patients with CCUP who were admitted to our hospital from September 2018 to December 2020 were reviewed. Lymph node metastasis area, tumor stage, P16+, etc. were used as analysis indicators. Univariate analysis was used to establish Cox risk model to analyze prognostic factors. Results As of the end of follow-up, 19 patients survived and 4 died. There was no correlation between the survival prognosis of patients and the gender, course of disease, history of smoking and alcohol, EBV+, lymph node metastasis area, P16+, and whether the primary tumor was clear, and the difference was not statistically significant （all P > 0.05）, but it was related to the age of the patient. Correlation （P = 0.024 < 0.05）. In the N stage, the later the N stage, the lower the survival rate. The survival rate of patients with unknown primary tumor was lower and clinically significant, but the difference was not statistically significant. Conclusion The patients with CCUP have a short course of disease, and the level Ⅱ, Ⅲ neck lymph nodes are the most involved. EBV detection, P16 and other immunohistochemical staining are helpful for finding the primary site. The best diagnosis and treatment plan should be selected according to the patient’s condition to reduce tumor recurrence and improve the quality of life.
2022, 43(7): 86-91.
doi: 10.12259/j.issn.2095-610X.S20220732
Abstract:
Objective To analyze the change law of the color information of maxillary anterior teeth in Kunming, Yunnan Province, so as to provide a reference basis for clinical aesthetic prosthesis colorimetry. Methods Vita easyshade advanced 4.0 wireless computer colorimeter was used to measure the L * a * b * values in 1 / 3 of 1800 upper anterior teeth （left and right symmetrical central incisors, lateral incisors and canines）aged 20～89 in Kunming, Yunnan. They were grouped according to age and tooth position, and statistical analysis was carried out by spss24.0 software. Results 1.There was no significant difference between left and right symmetrical homonymous teeth （P > 0.05）. 2.There was no significant difference in color between male and female homonymous teeth （P > 0.05）. 3.There were significant differences in L * a * b * values in different tooth positions （P < 0.05）; 4.There was statistical difference in L * a * b * with age （P < 0.05）. Conclusions 1.the color of the crowns of the maxillary anterior teeth in Kunming area of Yunnan Province is related to tooth position, age and age, but not to gender. 2.From central incisor to lateral incisor and canine, the brightness gradually decreases, the hue gradually changes to red and yellow. 3.With the increase of age, the brightness of the upper anterior teeth gradually decreases, and the color phase transits to green and yellow. It is suggested that the teeth with the same name on the opposite side of the same jaw are preferred in clinical color comparison of maxillary anterior teeth. If the teeth with the same name on both sides are missing, the tooth position with the highest saturation, and not easy to fall off in the mouth, namely the canine, is selected as the reference color comparison.
2022, 43(7): 92-96.
doi: 10.12259/j.issn.2095-610X.S20220719
Abstract:
Objective To explore the influence of different thyroid surgery methods on the function of parathyroid glands. Methods We analyzed the clinical data of 60 patients undergoing thyroid surgery, including 30 cases in the subtotal thyroidectomy group and 30 cases in the total thyroidectomy group. Then we compared the preoperative PTH, the level of PTH and the degree of decrease in PTH in one week after the operation, as well as the preoperative blood calcium content, the level of blood calcium content and the decrease in blood calcium content one week after the operation. Results No difference was found in preoperative clinical data between the two groups （P > 0.05）. There was no significant difference in PTH [（46.71±11.52） ng/L vs（46.23±11.74） ng/L, P > 0.05] and blood calcium levels [（1.85±0.47） mmol/L vs（1.88±0.39） mmol/L, P > 0.05] between the two groups before surgery. One week after the operation, the PTH and blood calcium of the two groups were lower than before the operation. The PTH [（23.35±6.42） ng/L vs （32.18±9.51） ng/L, P < 0.05] and blood calcium levels [（1.42±0.31） mmol/L vs （1.75±0.21）mmol/L, P < 0.05] in the total thyroidectomy group were significantly lower than those in the subtotal thyroidectomy group. The degree of decrease in PTH [（49.5±5.1%） vs （31.1±3.5%）, P < 0.05] and blood calcium levels [（24.5±2.31%） vs （5.4±0.5%）, P < 0.05] were significantly higher than the subtotal thyroidectomy group. Total thyroidectomy group parathyroid detection rate was significantly higher than the subtotal thyroidectomy group （26.67%比3.33%, P < 0.05）. Conclusion Different thyroid surgery methods will lead to different degrees of postoperative hypoparathyroidism, and total thyroidectomy has a more significant impact than subtotal thyroidectomy.
2022, 43(7): 97-104.
doi: 10.12259/j.issn.2095-610X.S20220727
Abstract:
Objective To analyze the differences in overall survival （OS） among people died of cancer in Yunnan from the perspective of social determinants of health, and provide evidence to the strategic plan for cancer prevention and control. Methods Death registry data on cancer in Yunnan from 2015 to 2019 were analyzed using Stata 15.1. Adjusted OS was predicted by multivariate linear regression after controlling the confounding variables. The impacts of social determinants of health （such as age, sex, residential area, ethnicity, educational level, occupation, and marital status） on OS among people died of cancer were estimated, and subgroup analyses were conducted for 17 kinds of malignant tumors. Results Totally 128,356 people with the information OS after a cancer diagnosis were recorded in Yunnan from 2015 to 2019, with an average OS of （17.28±23.33） months. The average OS due to cancer was shorter among people under 65 years old, male, living in rural area, belonging an ethnic minority group, with junior high school education or below, being peasant, or unmarried, compared with their counterparts （P < 0.001）. However, people living in severely impoverished counties and belonging to an “Zhiguo ethnicity” separately have longer OS after a cancer diagnosis than those living in other poor counties and belonging other ethnic minority groups （P < 0.001）. The effects of age, sex, residential area, ethnicity, educational level, occupation, or marital status on OS remained after controlling the confounding factors （P < 0.001）, but varied among different cancers. Conclusions The cancer survivals in the most vulnerable areas and people have been improved in Yunnan. However large differences exist in the OS among different people with cancer. Strategic plan for cancer prevention and control is needed in future to promote health equity.
2022, 43(7): 105-109.
doi: 10.12259/j.issn.2095-610X.S20220728
Abstract:
Objective To explore the anti-platelet efficacy of national bulk collection and original clopidogrel bisulfate after stent implantation in patients with acute coronary syndrome （ACS） in the real world. Methods We established a real-world database of patients with acute coronary syndrome （ACS） after stent implantation. After stent implantation, the patients were divided into the group with dose collection and the control group, and the baseline variables and outcome variables were constructed, and the two groups were matched according to the propensity score of 1∶1. The antiplatelet effects and adverse drug reactions were compared between the two groups after oral administration of double doses of clopidogrel （75 mg, BID） for one month and then adjusted to the general maintenance dose （75 mg, QD） for one year. Results 1. There was no significant difference in the ADP inhibition rate between the two groups on the 5th day after oral intensive dose （P > 0.05）, but the ADP inhibition rate on the 5th day after oral maintenance dose was increased after one month, and there was significant difference between the two groups before and after oral intensive dose （ P < 0.05）. There was no significant difference in the increase of ADP inhibition rate between the maintenance dose and the intensive dose on the 5th day （ P > 0.05）. 2. There was no significant difference in MA-ADP between the two groups on the fifth day of oral intensive dose （ P > 0.05）, and there was no significant difference in MA-ADP between the two groups on the fifth day of oral maintenance dose after one month （ P > 0.05）, but there was significant difference within the group （ P < 0.05）; There was no significant difference in whether MA-ADP fell within the normal therapeutic window at two different time points between the two groups （ P > 0.05）. 3. Compared with the original clopidogrel （ C/E = 2.124）, the pooled clopidogrel （C/E = 0.840） had a better average cost-effectiveness pharmacoeconomic effect. Conclusion There is no significant difference in antiplatelet efficacy and safety between pooled clopidogrel and original clopidogrel in the intensive dose period or maintenance dose period of antiplatelet after PCI.
2022, 43(7): 110-115.
doi: 10.12259/j.issn.2095-610X.S20220709
Abstract:
Objective To evaluate the difference of Pressure Support vs T-Piece vs Automatic Tube Compensation Ventilation Strategies during Spontaneous Breathing Trials on lung aeration. Methods Sixty-nine cases of mechanically ventilated patients who were prepared to undergo the first spontaneous breathing trial （SBT） in EICU of an affiliated Hospital of Medical University from June 2020 to January 2021 were included. They were randomly divided into T-Piece group, Pressure Support Ventilation （PSV） group and Automatic Tube Compensation （ATC） group for 30 minutes of SBT. After successful SBT, the tracheal intubation was removed within 24 hours. We observed the patients’ Lung Ultrasound Scores （LUS） with ultrasound before the beginning of SBT （T0）, at the end of SBT （T1） and 30 minutes after extubation （T2） in all patients. Results At the end of SBT, the LUS of the three groups were not significantly different （P > 0.05）. The LUS of patients in T-Piece , there was no significant difference in the changes from T1 to T2 （P > 0.05）. The LUS of patients in the PSV group and ATC group increased from T1 to T2 （P < 0.05）. Conclusion SBT strategy with pressure support is helpful for patients to pass SBT and ensure lung ventilation during SBT, however, T-tube SBT seems to be a better predictor of lung ventilation after extubation.
2022, 43(7): 116-120.
doi: 10.12259/j.issn.2095-610X.S20220703
Abstract:
Objective To investigate the therapeutic effect of flunarizine combined with ginkgo-damole in elderly patients with vertigo. Methods A total of 76 elderly patients with vertigo from July 2019 to July 2020 in Kunming Second People's Hospital were selected as the subjects and divided into two groups by random number table method. The observation group （n = 38 cases） was given flunarizine combined treatment on the basis of the treatment in the control group. The effect of the patients was evaluated after 4 weeks of treatment, and the total effective rate, hemorheology level, and inflammatory factor levels were compared between the two groups, drug safety. Results After treatment, the total effective rate in the observation group was significantly higher than that in the control group, and the difference was statistically significant （P < 0.05）. There was no significant difference in hemorheology level between the two groups before treatment （P > 0.05）. The hemorheology level of the two groups was significantly decreased after 4 weeks of treatment （P < 0.05）. At 4 weeks after treatment, plasma viscosity, fibrinogen, whole blood low-cut viscosity and whole blood high-cut viscosity in the observation group were lower than those in the control group, and the differences were statistically significant （P < 0.05）. After 4 weeks of treatment, il-6 and Hs-CRP levels in the observation group were lower than those in the control group, and the differences were statistically significant （P < 0.05）. There was no significant difference in adverse drug reactions between the two groups during treatment （P > 0.05）. Conclusion The combined application of flunoperizine and ginkgo damo in elderly patients with posterior circulation ischemic vertigo is effective, the improvement of hemorheology index is obvious, and the level of inflammatory factors can be effectively improved, which is worthy of popularization and application.
2022, 43(7): 121-127.
doi: 10.12259/j.issn.2095-610X.S20220723
Abstract:
Objective To evaluate frailty of surgical elderly hospitalized patients by four kinds of frailty assessment tools, FP （frailty phenotype, FP）, FI-CD （frailty index of accumulative deficits, FI-CD）, Frail Scale, and TFI （tilburg frailty indicator, TFI）, and to compare their ability to predict postoperative complications. Methods A cohort study method was used to select elderly patients undergoing surgical operations in Guangzhou hospitals for data collection, including general information, FP, FI-CD, Frail Scale, TFI, operation time, blood loss, complications during hospitalization, and those occurring within 30 days of discharge Complication information, etc. We calculated the receiver operating characteristic curve （ROC） and area under the ROC curve （AUC）, and compared the ability of FP, FI-CD, Frail Scale, and TFI to predict postoperative complications. Results A total of 294 patients were included, 21 cases were lost to follow-up, and 273 patients with complete data were finally collected, aged 60-88 （69.49 ± 6.90） years old. The percentages of frailty detected by FP, FI-CD, Frail Scale, and TFI were 30.4%, 24.5%, 28.6%, and 26.4%, respectively. After chi-square test, the kappa values of FP, FI-CD and Frail Scale （FS） and TFI evaluation results were 0.52, 0.60, 0.47, 0.65, 0.54, 0.58, respectively （P < 0.001）, and the consistency was weak. The AUC of FP, FI-CD, Frail Scale, and TFI predicting postoperative complications were 0.896 [95% CI （0.784, 0.929）], 0.767 [95% CI （0.706, 0.829）], 0.799 [95% CI （0.742）, respectively , 0.857）], 0.745 [95%CI （0.683, 0.808）], （all P < 0.05）. Conclusions Different frailty assessment tools have great differences in the detection rate of frailty, and caution should be exercised when selecting frailty assessment methods in clinical work. AUC for FP, FI-CD, FS, and TFI for postoperative complications are 0.836, 0.767, 0.799, and 0.745, respectively. The ability of FP to predict postoperative complications is better than the other three assessment tools.
2022, 43(7): 128-133.
doi: 10.12259/j.issn.2095-610X.S20220713
Abstract:
Objective To explore the effect of enhanced recovery after surgery strategy on stress factors and postoperative rehabilitation of patients with ovarian cystectomy under single-port laparoscopy. Methods A total of 68 patients with ovarian cystectomy under single-port laparoscopy from September 1, 2020 to September 30, 2021 in the first people's hospital of Kunming were randomly selected. The control group was given perioperative traditional intervention, Observation group implements ERAS strategy. The levels of perioperative heat shock protein 70 and C-reactive protein, pain digital score, clinical observation indexes （operation time, blood loss, intraoperative infusion volume, ventilation time, indwelling catheter time and out of bed time） and postoperative complications were compared between the two groups. Results There was no significant difference at operation time, blood loss, intraoperative infusion volume. The clinical indexes of ERAS group were better than those of control group at ventilation time, indwelling catheter time and out of bed time. There were differences in NRS scores between the two groups at 4 h and 8 h after surgery（P < 0.05）, but there was no significant difference at 24 h after surgery（P > 0.05）. The stress factors （HSP70 and CRP） of the two groups at admission was no significant difference（P > 0.05）, but at the time of anesthesia induction and 24 hours after the operation, the stress factor value in the control group was higher than the observation group（P < 0.05）. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusions ERAS strategy is safe and effective in patients with ovarian cystectomy under single-port laparoscopic surgery, and can reduce perioperative stress response. The advantages of single-port laparoscopy combined with the ERAS strategy can make patients feel more secure and satisfied with the operation.
2022, 43(7): 134-139.
doi: 10.12259/j.issn.2095-610X.S20220707
Abstract:
Objective To explore the value of triple mirror combination technique in patients with dilated choledocholithiasis. Methods A retrospective analysis of 81 patients with dilated common bile duct stones （common bile duct diameter 0.8cm） were admitted to the Second Affiliated Hospital of Kunming Medical University from December 2019 to October 2021.Depending on the surgical method, patients were divided into three-mirror group group A （n = 40）, sequential laparoscopic cholecystectomy LC + laparoscopic-choledotoscopy combined exploration lithotomy LCBDE + endoscopic nasal bile duct drainage ENBD + primary common biliary suture PS.Double-mirror Group B （n = 41）, sequential rows of LC + LCBDE + PS. The observation indexes included preoperative indexes （stone size, total bile duct diameter）, intraoperative indexes （bleeding amount, operation time） and postoperative indexes （near-term complication rate, residual stone rate） and statistical treatment. Results Both groups of preoperative indicators, and the intraoperative indicators had no statistically significant differences. Operation time and bleeding volume were better in group B than in group A. Postoperative residual rate had no significant difference between the two groups. In terms of recent complications, the incidence of bile leakage in group A was lower than that in group B, and the long-term complications were relatively insignificant. Conclusions Application of triple oscopy combined primary suture in patients with cholangiogenic cholelithiasis can reduce the incidence of bile leakage in the first-phase bile duct suture technique, reduce the pain of patients, improve the patient compliance, and does not increase the incidence of complications and tube wearing time. It is worthy of clinical promotion and use.
2022, 43(7): 140-144.
doi: 10.12259/j.issn.2095-610X.S20220718
Abstract:
Objective To compare the clinical characteristics and analyzing the risk factors for poor prognosis of Talaromyces Marneffei and disseminated Nontuberculosis Mycobacterium disease in AIDS patients . Methods We retrospectively collected the data of cases of Talaromyces Marneffei and disseminated Nontuberculosis Mycobacterium disease in Shanghai Public Health Clinical Center from 2015 to 2021. Then we compared the differences of clinical characteristics between the two groups, the risk factors for poor prognosis were also analyzed. Results The mean age in both groups were younger than 40 years and, the proportion of poor prognosis in NTM group was 24% while it was 17% in TM group. Compared to the NTM group, serum albumin was lower in group TM （P = 0.003）, Procalcitonin was higher （P = 0.002）, slower ESR （P = 0.011）, fungal D-glucan was higher （P < 0.001）. When CD8 less than 250/µL, the risk of poor prognosis was higher than patients with CD8 > 250/µL （P = 0.049） in the NTM group. Albumin < 30 g/L （P = 0.017） or endotoxin < 6 pg/ml （P = 0.022） were both independent risk factors for poor prognosis in the NTM group. The fungal D glucan less than 11pg/mL （P = 0.016） or CD8 < 250/µL （P = 0.012） were both independent risk factors for poor prognosis in the TM group. Conclusions In AIDS patients, people infected with Talaromyces Marneffei have lower albumin than disseminated Nontuberculous Mycobacterium and need to pay close attention to timely supplement. Cases in both TM and NTM groups have high mortality. Higher levels of CD8 indicate a better prognosis.
2022, 43(7): 145-151.
doi: 10.12259/j.issn.2095-610X.S20220733
Abstract:
Diabetic encephalopathy （DE） is one of the chronic complications associated with diabetes. It is affected by many risk factors. Its main clinical manifestations are cognitive impairment, decision making disorders and emotional disorders. At present, the possible pathogenesis is pancreatic amyloid polypeptide homeostasis imbalance, MicroRNAs, macrophage autophagy, lipoprotein Lipin1, advanced glycation end products （AGEs）, oxidative stress, overphosphorylation of Tau protein, calcium homeostasis, and other mechanisms, which affect the function of brain tissue cells and cause corresponding pathological changes of diabetic encephalopathy. Promote the development of diabetic encephalopathy.
Diabetic encephalopathy （DE） is one of the chronic complications associated with diabetes. It is affected by many risk factors. Its main clinical manifestations are cognitive impairment, decision making disorders and emotional disorders. At present, the possible pathogenesis is pancreatic amyloid polypeptide homeostasis imbalance, MicroRNAs, macrophage autophagy, lipoprotein Lipin1, advanced glycation end products （AGEs）, oxidative stress, overphosphorylation of Tau protein, calcium homeostasis, and other mechanisms, which affect the function of brain tissue cells and cause corresponding pathological changes of diabetic encephalopathy. Promote the development of diabetic encephalopathy.
2022, 43(7): 152-155.
doi: 10.12259/j.issn.2095-610X.S20220734
Abstract:
Enteric hyperoxaluria is a secondary hyperoxaluria characterized by excessive absorption of intestinal oxalate and increased urinary oxalate. Enteric hyperoxaluria is closely related to the occurrence of urinary calcium oxalate stones. It is of great significance to effectively reduce the absorption of intestinal oxalate and urinary oxalate to prevent the occurrence of urinary calcium oxalate stones. This article reviews the pathogenesis and treatment of enteric hyperoxaluria.
Enteric hyperoxaluria is a secondary hyperoxaluria characterized by excessive absorption of intestinal oxalate and increased urinary oxalate. Enteric hyperoxaluria is closely related to the occurrence of urinary calcium oxalate stones. It is of great significance to effectively reduce the absorption of intestinal oxalate and urinary oxalate to prevent the occurrence of urinary calcium oxalate stones. This article reviews the pathogenesis and treatment of enteric hyperoxaluria.
2022, 43(7): 156-161.
doi: 10.12259/j.issn.2095-610X.S20220702
Abstract:
Objective To evaluate the reliability of the Student Evaluation Scale for the Teaching Level of Teachers in Medical Universities （SESTLTMU） and determine the appropriate number of students in the teaching evaluation based on Multivariate Generalizability Theory （MGT） . Methods The data of 422 students from a medical university who were surveyed by this scale were collected and analyzed by using mGENOVA, a special software of multivariate generalizability theory. The variance components of various error sources were estimated in Generalizability Study （G-study）, and then several Decision Studies （D-studies） with varying numbers of items and numbers of students were analyzed to obtain reliability coefficients including generalizability coefficient （G） and the indexes of dependability （Ф） in order to evaluate the reliability of the scale. Results In the G-study, the most prominent variation in every domain was introduced by student nested in teacher effect. In the D-study, at the level of domain, the G coefficients and the Ф coefficients for three of the five domains were approximately equal to or greater than 0.80, except for the teaching organization domain and teaching method domain （> 0.70 but < 0.80）. For the overall scale, the compositeG and composite Ф coefficients were larger than 0.85. Under the premise that the Ф is 0.80 or above, the minimum number of students selected from each class should be 25. Under the premise that the G is 0.80 or above, the minimum number of students selected from each class should be 28. Conclusions The scale has good reliability as a whole based on the results of MGT. If this scale needs to be revised in the future, it can be considered to adjust the content in the teaching organization domain and the teaching method domain. It is the most appropriate to select 28 students from each class for investigation in the practice of teaching evaluation by university students.
2022, 43(7): 162-167.
doi: 10.12259/j.issn.2095-610X.S20220716
Abstract:
Objective To construct the family needs scale of critically ill tumor patients by using Delphi method, and to provide a basis for accurately evaluating and m-e eting the needs of the family members of critically ill tumor patients. Methods Based on the previous research foundation, through literature review, clinical observation, an initial pool of items for the family members of critically ill patients with cancer was formed. Using the Delphi expert consultation method, 19 experts were selected for two rounds of correspondence to form the final version of the tumor risk scale. Needs scale for family members of critically ill patients. Results The positive coefficients of the two rounds of expert correspondence were both 1.00. The authoritative coefficients of the two rounds of experts were 0.94 and 0.95. The coordination coefficients were 0.54 and 0.543, respectively. Through 2 rounds of Delphi expert consultation, the final formation includes 7 first-level items（maintaining one’s own health, obtaining support from medical staff, knowing the patient’s condition and disease-related knowledge, visiting patients, obtaining guidance on coping with migration stress, participating in patient care, and when necessary Obtained the support of the palliative care team）, 30 second- level items of the family needs scale of critically ill patients with cancer. Conclusion The family needs scale of critically ill tumor patients based on the Delphi method is scientific and reliable, and can be used as an evaluation tool for evaluating the needs of family members of critically ill tumor patients.
2022, 43(7): 168-171.
doi: 10.12259/j.issn.2095-610X.S20220706
Abstract:
Objective To explore the effect of health education implemented by nursing process on improving perioperative anxiety and treatment compliance of lung cancer patients. Methods Eighty-six lung cancer patients were randomly divided into experimental group and control group, 43 cases in each group. The experimental group carried out health education with nursing process, while the control group carried out routine health education. Anxiety was assessed by self-rating anxiety Scale （SAS） in perioperative lung cancer patients. The compliance level was evaluated by comparing the excellent and good treatment compliance rate. Results Before health education, there was no statistical difference in anxiety between the two groups （P < 0.05）. After health education, no matter 1 day before surgery or 3 days after surgery, the anxiety of the experimental group was lower than that of the control group （P < 0.05）. The excellent compliance rate of experimental group was significantly higher than that of control group （P < 0.05）. Conclusion Health education in programmed nursing can not only effectively relieve perioperative anxiety of lung cancer patients, but also effectively improve their treatment compliance.
2022, 43(7): 172-176.
doi: 10.12259/j.issn.2095-610X.S20220704
Abstract:
Objective To construct a recertification management system for orthopedic specialist nurses’ qualifications. Methods Through literature review and semi-structured interviews, a preliminarily orthopedic specialist nurse qualification recertification management system was developed. From June to August 2021, using the Delphi method, 20 experts were sent two rounds of letters to inquire about the recertification application time, recertification organization, recertification content, etc, and preliminarily orthopedic specialist nurse qualification recertification management system will be finally formulated. Results The enthusiasm of experts was 100%, the degree of authority was 0.93, and the coordination coefficients of the first and second rounds of experts were 0.46 and 0.49. Finally, the recertification evaluation index system for the orthopedic specialist nurses was constructed, including 9 first-level items, 18 second-level items, 9 third-level items, and 10 fourth-level items. Conclusion The recertification evaluation index system for the orthopedic specialist nurses is scientific and reliable, which can provide a reference for the management of orthopedic specialist nurse qualification recertification.
2022, 43(7): 177-180.
doi: 10.12259/j.issn.2095-610X.S20220729
Abstract:
Objective Based on the concept of ERAS and the rehabilitation needs of patients after laparoscopic hepatocellular carcinoma resection, to construct a rehabilitation log after laparoscopic hepatocellular carcinoma resection and study its application effect. Methods A total of 120 patients undergoing laparoscopic hepatocellular carcinoma resection from January to December 2021 were selected and randomly divided into control group and experimental group according to perioperative management methods （79 cases in ERAS group and 41 cases in non-ERAS group）. The control group adopted holistic nursing and routine perioperative health guidance, while the experimental group adopted the mode of medical, nursing and patient co-management, and applied the recovery log. The recovery and satisfaction of the two groups were compared. Results There was no significant difference in the number of complications between the experimental group and the control group （P > 0.05）, and other indicators of the experimental group were significantly better than the control group （P < 0.05）. Results: There was no statistically significant difference between the two groups in bleeding after ambulation, but other indexes were significantly better than the control group （P < 0.01）. Conclusion The construction and application of rehabilitation log can help patients master postoperative rehabilitation knowledge after laparoscopic hepatectomy, improve the initiative of patients, promote the active participation of family members, and accelerate the recovery of patients.
