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RSS2022 Vol. 43, No. 9
2022, 43(9): 1-6.
doi: 10.12259/j.issn.2095-610X.S20220915
Abstract:
Objective To investigate the effects of miR-125a-3p inhibitors on the atherosclerotic plaque formation, M1/M2 macrophages, MMP-9 and VEGF. Methods Fifteen healthy adult male Japanese big-eared rabbits were randomly divided into 3 groups with 5 rabbits in each group. Those in the control group were fed with the normal diet,, those in the atherosclerosis model group were injected with bovine serum albumin and fed with the high cholesterol diet, and those in the miR-125a-3p inhibitor intervention group were injected with miR-125a-3p to interfere with lentivirus vector. The plaque area was determined by image analysis after oil red O staining, MMP-9 and VEGF were determined by immunohistochemistry, and M1 marker CD11c and M2 marker CD206 in plaque tissues were detected by immunofluorescence. Results Compared with the atherosclerosis group, the percentage of plaque area in miR-125a-3p inhibitor group decreased significantly （P < 0.0001）. Compared with the control group, the levels of MMP-9 （P < 0.001）, VEGF （P < 0.01） and CD11c （P < 0.001） increased significantly, and the level of cd206 decreased significantly in the atherosclerosis group （P < 0.001）; Compared with the atherosclerosis group, the levels of MMP-9 （P < 0.01）, VEGF （P < 0.01） and CD11c （P < 0.001） decreased, and the level of cd206 increased in miR-125a-3p inhibitor intervention group （P < 0.001）. Conclusion Inhibition of miR-125a-3p can reduce the formation of atherosclerotic plaques, balance M1/M2 macrophages, and reduce the expression of MMP-9 and VEGF in plaque tissues.miR-125a-3p may be a new target for the treatment of unstable plaques.
2022, 43(9): 7-12.
doi: 10.12259/j.issn.2095-610X.S20220928
Abstract:
Objective To investigate the effects of dose-response and time-dependent of endotoxin on the proliferation of human umbilical cord mesenchymal stem cells（hUC-MSCs）. Methods The hUC-MSCs were cultured in stem cell culture medium containing different concentrations of endotoxin（0.098, 0.195, 0.390, 0.780, 1.5600, 3.12, 6.250, 12.500, 25.000 and 50.000 EU/mL）. CCK-8 proliferation assay was used to detect the cell proliferation at 24, 48 and 72 hours. The low concentration（0.098 EU/mL）, medium concentration（1.56 EU/mL）and high concentration（25 EU/mL） of LPS were determined to promote the proliferation of hUC-MSCs, and the action time was selected for 72 hours. The effect of LPS on the proliferation of hUC-MSCs was further determined by flow cytometry. Results After 24, 48 hours of the treatment, it was mainly manifested by inhibiting the proliferation of hUC-MSCs. After 72 hours of the treatment, it showed a trend of promoting cell proliferation, and the promotion effect was most significant in the low concentration area, and the promotion effect was relatively weakened when the concentration increased. Further flow cytometry results suggested that the proportion of G0/G1 phase decreased, S phase and G2/M phase increased in LPS group of low concentration. Conclusion The dose-response and time-dependent of endotoxin have different effects on the proliferation of hUC-MSCs , and the appropriate concentration and duration of action of endotoxin are beneficial to the proliferation of hUC-MSCs.
2022, 43(9): 13-18.
doi: 10.12259/j.issn.2095-610X.S20220923
Abstract:
Objective To analyze the significance of PD-L1, BRAFV600E, CD68 protein expressions and tumor infiltrating lymphocytes （TIL） in the diagnosis of malignant melanoma. Methods High-throughput tissue microarray technology and immunohistochemical methods were used to detect the expressions of PD-L1, BRAFV600E and CD68 in 60 primary malignant melanoma tissues. The relationship between PD-L1, BRAFV600E, CD68 expressions, TIL and the clinicopathological characteristics and prognosis of patients was analyzed. Results （1） There was a statistically significant difference between CD68 expression in malignant melanoma tissue and tumor T stage （P = 0.018）, but no statistical difference between tumor size, tumor invasion depth, lymph node metastasis and ulceration （P > 0.05）. （2） There was no significant difference between PD-L1, BRAFV600E, TIL and tumor T stage, tumor size, tumor invasion depth, lymph node metastasis and ulceration （P > 0.05）. （3） The mutation rate of BRAFV600E in cutaneous melanoma was about 36.67% （22/60）. The mutation rate of BRAFV600E in cutaneous acral melanoma was about 68.18%. （15/22）. The mutation rate of BRAFV600E in mucosal melanoma was about 23.33% （14/60）. （4） Cox regression analysis showed that lymph node metastasis was the prognostic factor of malignant melanoma patients. Conclusion （1） The expression of CD68 protein may play a role in determining the prognosis of patients. （2） BRAFV600E immunohistochemical detection is recommended for melanoma in the skin. （3） The presence of lymph node metastasis in patients can be used as a reference index for the prognosis of malignant melanoma.
2022, 43(9): 19-23.
doi: 10.12259/j.issn.2095-610X.S20220913
Abstract:
Objective To provide the guidance for the management of patients with Alzheimer’s disease （AD） and mild cognitive impairment （MCI） by analyzing the similarities and differences between them. Methods The Neuropsychiatric Inventory （NPI） was used to assess the prevalence and severity of behavioral and psychological symptoms of dementia in 71 patients with AD and 31 patients with MCI from Yunnan Province compared with 70 normal controls. Results The incidence and severity of depression, anxiety, and irritability were not significantly different between the AD and MCI groups （P > 0.05）, whereas they were higher in the MCI group than in the normal control group （P < 0.05）. There was no significant difference in the incidence of apathy between AD and MCI groups （P > 0.05）, and the severity of apathy was higher in the AD group than that in the MCI group （P < 0.05）. However, the incidence and severity of apathy in the MCI group were higher than those in normal controls （P < 0.05）. The NPI total score and the incidence or severity of the remaining symptoms were higher in the AD group than in the MCI group （P < 0.05）, whereas there were no significant differences in the incidence or severity between the MCI group and normal controls （P > 0.05）. Conclusion The overall BPSD of AD patients is more severe than that of MCI patients, while the symptoms of depression, anxiety, and irritability are not different between AD and MCI patients. MCI is at the transition stage of cognitive changes between normal aging and AD, and MCI patients with these symptoms need to be paid attention to and intervened early.
2022, 43(9): 24-28.
doi: 10.12259/j.issn.2095-610X.S20220901
Abstract:
Objective To find simple and reliable clinical quantitative indicators for the early diagnosis of SAE. Methods Seventy-two septic patients who were admitted to ICU from April 2020 to April 2022, including 31 with sepsis encephalopathy （SAE） and 41 without sepsis encephalopathy （Ne-SAE）, were collected. APACHE Ⅱ, SOFA and general data of Patients were recorded, and CLI, HCT-ALB were calculated based on the clinical assays. Plasma was collected using ELISA to detect NT-proCNP, S100A 8, Tau protein and C5a. Results APACHEⅡscore and SOFA score in SAE group were significantly higher compared with the patients in Ne-SAE group （P < 0.05）. Plasma NT-proCNP and S100A8 levels were significantly higher in the patients with SAE than that of the Ne-SAE group （P < 0.05）. There was no significant difference in CLI between SAE group and NE-SAE group. （P = 0.823）. But , the hct-alb was statistically significant between the two groups （P = 0.035）. The roc curve analysis showed: A cutoff value CLI of 11.04 （AUC = 0.478,95% CI 0.340-0.616, P = 0.746） had 46.34% sensitivity and 80.65% specificity in diagnosing SAE. A cutoff value HCT-ALB of 14.85 （AUC = 0.627,95% CI 0.491-0.762, P = 0.017） had 68.27% sensitivity and 67.74% specificity in diagnosing SAE. Conclusion The HCT-ALB level can be useful in the early diagnosis of SAE in patients with sepsis.
2022, 43(9): 29-33.
doi: 10.12259/j.issn.2095-610X.S20220905
Abstract:
Objective To investigate the relationships of matrix metalloproteinase-1 （MMP-1）, matrix metalloproteinase-3 （MMP-3）, matrix metalloproteinase-9 （MMP-9） and serum amyloid A （SAA） with the premature rupture of membranes. Methods Thirty cases of premature rupture of fetal membranes, 30 cases of full-term premature rupture of fetal membranes and 30 cases of full-term pregnancies were chosen as controls. The levels of MMP-1, MMP-3, MMP-9 and SAA in the peripheral blood of the three groups of pregnant women were measured by ELISA. The placental tissues of the three groups of pregnant women were examined pathologically to determine the presence of histological chorioamnionitis. Results （1） The levels of MMP-1 and SAA of PPROM and PROM groups were significantly higher than those of the control group （P < 0.05）. After the comparison, MMP-1 and SAA of the PPROM group were significantly more than those of the PROM group （P < 0.05）. However, the content of MMP-3 in PPROM group was significantly higher than that in PROM group and the control group （P < 0.05）, but there was no significant difference in the concentration between PROM group and the control group （P＞0.05）. There was no significant difference in the concentration of MMP-9 among the three groups （P > 0.05）. （2） 70% （21/30） in the PROM group, 33.3% （10/30） in the PROM group and 33.3% （10/30） in the control group. The histological positivity rate of placenta in the PPROM group was elevated compaired with that in the PROM and control groups, and the difference was statistically significant （ χ2 = 10.841, P < 0.05）. There was no significant difference between the PROM and control groups （P > 0.05）. Conclusion Serum MMP-1, MMP-3 and SAA are closely associated with the premature rupture of membranes complicated by early chorioamnionitis.
Study on the Correlation between Late-onset Breast Milk Jaundice and Defecation Frequency in Infants
2022, 43(9): 34-37.
doi: 10.12259/j.issn.2095-610X.S20220925
Abstract:
Objective To analyze the correlation factors of late-onset breast-feeding jaundice （LBMJ）, and provide the reference for the study of LBMJ etiology. Methods 102 full-term breast-fed infants aged 0-6 months from the First Affiliated Hospital of Kunming Medical University were selected as the participants of this study and according to their defecation frequency they were divided respectively into defecation frequency increased group or group A, i.e. defecation > 3 times / D （ n = 37）, decreased defecation frequency group or group B, i.e. one defecation in more than 4 days （n = 34） and the normal group or group C, i.e. defecating once within 3 days or 3 times a day （n = 31）. All the infants with jaundice were LBMJ and the correlation between LBMJ and defecation frequency, age and feeding frequency was analyzed. Results 1. There was a statistical difference between the age of exclusively breast-fed infants and their different defecation frequency （Hc =7.8007, P = 0.0202）. There was no significant difference between the change of defecation frequency and the absence of LBMJ （χ2 = 5.8649, P = 0.0533）, but the incidence of LBMJ increased with the increase of defecation frequency （χ2 =5.7593, P = 0.0164）. 2. LBMJ was positively correlated with the defecation frequency and feeding frequency in infants, and the above factors were negatively correlated with the age of infants. Conclusion The younger the infants aged from 0 to 6 months, the more frequent the breastfeeding, the more frequent the defecation and the higher the incidence of LBMJ. In addition, the enhancement of bilirubin enterohepatic circulation pathway in LBMJ has little correlation with the increased defecation frequency in infants.
2022, 43(9): 38-42.
doi: 10.12259/j.issn.2095-610X.S20220908
Abstract:
Objective To investigate the value of angle of progression progression （AOP）, fetal head descent distance （PD） and fetal head to pubic symphysis （HSD） in predicting the mode of delivery during the active phase of the first stage of labor. Methods The AOP, PD and HSD were measured at the active phase of the first stage of labor. The difference of these parameters was compared between the vaginal delivery group and the cesarean section group. Results The AOP and PD in vaginal delivery group were significantly higher than those in cesarean delivery group （141.09° ±9.87° vs 122.84° ±10.70° , 4.28 cm ± 0.48 cm vs 3.18 cm ± 0.83 cm）, while HSD in vaginal delivery group were significantly lower than that in cesarean delivery group （1.42 cm ± 0.40 cm vs 2.18 cm ± 0.64 cm） （P < 0.001）. The AUC of AOP, PD and HSD for predicting vaginal delivery was 0.892, 0.875 and 0.840, respectively, with statistical significance （P < 0.001）. Conclusion The measurement of AOP, PD and HSD in the active phase of the first stage of labor has the predictive value for the mode of delivery in nulliparous women.
2022, 43(9): 43-47.
doi: 10.12259/j.issn.2095-610X.S20220927
Abstract:
Objective To analyze and study the genotyping and drug resistance mutation sites of hepatitis B patients with low viral load in Kunming, so as to determine the difficulty of clinical antiviral treatment for low viral load hepatitis B patients and formulate individualized antiviral precision medicine programs. Methods A total of 1452 chronic hepatitis B patients with low viral load （HBV DNA < 2.0×10 3 IU/mL） were selected for hepatitis B typing and drug resistance gene loci detection. Results The proportion of HBeAg-negative patients in the low-load hepatitis B population in Kunming was higher （59.5%）, and the proportion of male patients （70.6%） was higher than that of female patients. The age distribution was mainly 30-60 years old （72.7%）. Genotyping The C genotype accounted for the highest proportion （61.8%）. Among the 1 452 low-load hepatitis B patients in Kunming area, a total of 37 patients were detected with drug-resistant mutation sites. The drug resistance rates of lamivudine and emtricitabine were consistent （1.6%）, and the drug resistance rate of telbivudine was the same 1.2%, adefovir resistance rate was 0.9%, entecavir resistance rate was 0.2%, and tenofovir resistance mutation sites were not detected. In addition to drug resistance mutation sites, 112 other mutation sites were also detected, among which S256G, S213T, N/H238T/D, Q215H had the highest detection rate, and the mutation site with the lowest detection rate was A194T. Conclusion The hepatitis B genotype in Kunming is mainly C type, which indicates that the distribution of HBV genotype in this area has independent characteristics. The resistance rate of entecavir in patients with hepatitis B with low viral load in Kunming area was the lowest, and TDF resistance was not found, but their sensitivity to tenofovir dipivoxil decreased. There is still some controversy whether the detected other mutation sites are related to drug resistance, but the detection rate also has a certain proportion.
2022, 43(9): 48-52.
doi: 10.12259/j.issn.2095-610X.S20220929
Abstract:
Objective To investigate the association between neonatal Hyperthyrotropinemia （HT） and perinatal risk factors. Methods A case-control study was conducted among 109 newborns with HT （case group） and 127 newborns without HT （control group） in the First Affiliated Hospital of Kunming Medical University from Jan. 2016 to Dec. 2020. Univariate and multivariate logistic regression analysis was conducted to identify the perinatal risk factors to neonatal HT. Results Univariate analysis indicated that the incidence of advanced maternal age and preterm delivery in the case group were significantly higher than those in the control group. The results of multivariate logistic regression analysis showed that advanced maternal age （OR = 2.320, 95%CI: 1.099～4.897）and preterm delivery （OR = 2.960, 95%CI: 1.354～6.473） increased the risk of neonatal HT. Conclusion Advanced maternal age and preterm delivery were the independent perinatal risk factors for neonatal HT. Efforts should be made to provide high quality pregnancy care, decrease the perinatal risk factors of neonatal HT, and to reduce the incidence of neonatal HT.
2022, 43(9): 53-58.
doi: 10.12259/j.issn.2095-610X.S20220924
Abstract:
Objective To explore the correlation of early serum uric acid fluctuations in patients after the bariatric surgery. Methods From January 2021 to June 2022, 80 patients with the metabolic syndrome who were admitted to Yan'an Hospital of Kunming and completed the follow-up one month after the surgery were selected as the objective of this research experiment.And according to the serum uric acid index one month after the surgery, they were divided into group A with the increase of serum uric acid after the operation and group B with the decrease of serum uric acid after the operation. The BMI value and the changes of various biochemical indexes were compared between the two groups before and after the bariatric surgery. Results Surgery method, postoperative protein intake, aerobic exercise and water intake were not the reasons for the fluctuation of serum uric acid in patients after weight loss（P > 0.05）, and the changes in liver function also could not explain the changes in patients 1 month after weight loss（P > 0.05）. The changes of blood sugar and triglyceride were the main reasons for the fluctuation of postoperative blood uric acid（P < 0.05）. The greater the decrease in triglycerides after the surgery, the less likely the increase in uric acid will occur.In addition, the increase of blood uric acid at 1 month after operation was greater than the decrease of blood uric acid after the operation, and the change of blood uric acid was correlated with the change of serum creatinine and monocyte/high-density lipoprotein（MHR）（P < 0.05）. The correlation coefficients were 0.204 and 0.511 respectively.respectively. Conclusion The changes of triglyceride and blood sugar in the early postoperative period are the reasons for the increase or decrease of blood uric acid in patients with weight loss after the surgery, and the changes of blood uric acid are mainly affected by creatinine and monocyte/high density.
2022, 43(9): 59-65.
doi: 10.12259/j.issn.2095-610X.S20220910
Abstract:
Purpose To investigate whether a virtual reality game can reduce the chronic nonspecific low back pain and help patients recover. Methods In this randomized controlled trial, the patients with the chronic nonspecific low back pain were taken as the experimental group （n = 40） and underwent a period of exercise in an immersive virtual reality game, while those performed the same exercises without VR games were taken as the control group （n = 40） so as to investigate whether VR distraction had a hypoalgesia effect during and immediately after the exercises, and whether it reduced the time spent thinking of pain during the exercises. Thereafter, we further explored whether pain-related fear, pain catastrophizing and baseline pain intensity moderated the effects of VR distraction. Results The results of repeated measures analysis of variance showed that the pain intensity among the patients of the experimental group was the main effect, and time and pain intensity had an interactive effect. The time to think about pain during the exercise was significantly less than that of the control group （Experimental group M = 32.26, SD = 12.32; Control group M = 51.21, SD = 17.18; t80 = 5.80, P < 0.0001）, both had an analgesic effect during the exercise （Cohen’s d = 0.86） and after the exercise （Cohen’s d = 0.46）. The results of analysis of variance showed that fear of pain, catastrophic pain, and initial pain intensity all have the main effects, but there was no interaction on thinking time （all p values > 0.05）, and it was believed that it did not affect the distracting analgesic effect of virtual reality. Conclusion Virtual reality is effective in distracting attention and inducing pain reduction and it indicates that immersive virtual reality games can be used to relieve the pain of patients with chronic non-specific low back pain during the exercise and help them recover their health.
2022, 43(9): 66-69.
doi: 10.12259/j.issn.2095-610X.S20220926
Abstract:
Objective To study the clinical therapeutic effect of doxazosin mesylate on female patients with overactive bladder （OAB） complicated with micturition symptoms. Methods A retrospective analysis was made of 68 female patients who were diagnosed with OAB and complicated with micturition symptoms in the Outpatient Department of Urology of the Second Affiliated Hospital of Kunming Medical University from June to December 2021 due to lower urinary tract symptoms （LUTS）. Among them, 36 cases were treated with doxazosin mesylate combined with solinacin succinate tablets as the treatment group; 32 cases were treated with solinacin succinate tablets as the control group. After 12 weeks of the treatment, the symptoms before and after the treatment were compared using American Urological Association symptom score （AUAss）, overactive bladder symptom score （OABSS） and quality of life （QOL） score. Results After 12 weeks of the treatment, the scores of OABSS, AUAss and QOL in the treatment group and the control group were significantly improved compared with those before the treatment （P < 0.05）. There was significant difference in AUAss between the treatment group and the control group （P < 0.05）. Conclusion Doxazosin mesylate combined with sorinaxin succinate tablets can improve lower urinary tract symptoms and quality of life in female patients with OAB complicated with micturition symptoms.
2022, 43(9): 70-76.
doi: 10.12259/j.issn.2095-610X.S20220912
Abstract:
Objective To analyze PLA2G1B gene expression, prognosis, immunologic features and potential therapeutic effects in patients with lung adenocarcinoma, based on the data-mining of public databases. Methods Data from TCGA and GEO database of LUAD were collected, including gene expression matrix and clinical data. The overall survival （OS） rate was compared between these two groups of PLA2G1B high expressed and low expressed. CIBERSORT algorithm was introduced to calculate totally 22 immune cells infiltration level and their difference was also compared between PLA2G1B high and low groups. Finally, pRRophetic was used to find some drugs that were probably sensitive to the worse OS groups. Results PLA2G1B was down regulated in LUAD samples and the lower expression of PLA2G1B led to a worse OS in LUAD, this result was validated in two independent GEO cohorts. After adjusting three main clinical elements, PLA2G1B was proved to be an independent prognosis biomarker （P < 0.05）. For the worse OS group, we also found its immune infiltration level was lower than the better OS group, especially for B cell memory, T cell CD4+ memory resting, Monocyte, Myeloid dendritic cell and Mast activated cells. For the worse OS group, we found they might be more sensitive to several chemo drugs including Cisplatin, Docetaxel, Etoposide, Gemcitabine, Paclitaxeland Vinorelbine. Conclusion PLAG21B is an independent prognosis biomarker in LUAD and the ones low expressed showed worse OS and lower immune infiltration level.
2022, 43(9): 77-83.
doi: 10.12259/j.issn.2095-610X.S20220920
Abstract:
Objective To analyze the clinical effect of multimodality microsurgery on recurrent gliomas, and to explore the diagnosis and treatment of recurrent gliomas. Methods Data of 28 patients with recurrent GLIOMAS who underwent reoperation from September 2017 to December 2020 in the Department of Neurosurgery of a tertiary grade A hospital in Kunming were collected and analyzed retrospectively, After the reoperation, the Karnofsky neurological function score （KPS） was used to evaluate the clinical efficacy, and the imaging data was used to evaluate the degree of tumor resection, the postoperative comparison of pathological changes of recurrent glioma, postoperative adjuvant treatment, follow-up patient survival time and other overall effects. Graphpad Prism （V8.4.2.679） software was used to analyze the data and graph. The difference in KPS scores before and after the operation was tested in pairs. Results 28 patients were treated with reoperations to varying degrees. Postoperative imaging confirmed that 21 cases of tumors were totally resected, 5 cases were subtotal resected, and 2 cases had tumor biopsy. Postoperative complications occurred in 22 patients. The clinical symptoms before discharge were improved in 24 cases compared with that before the operation, with an improvement rate of 85.7%. The mean KPS score was 66.07 ± 7.37 before the operation and 72.14 ± 11.00 one month after the operation.The differences were statistically significant. Postoperative pathology showed the progression of Malignancy in 8 cases. The mean survival time of 28 patients were （7.98 ± 6.42） months and the longest survival time were 24 months. Conclusion The combined application of multi-modality and multi-technique microsurgery is a relatively minimally invasive and effective treatment for recurrent glioma. The surgical effect is good, and it can be used as an option for surgical resection of recurrent glioma.
2022, 43(9): 84-89.
doi: 10.12259/j.issn.2095-610X.S20220904
Abstract:
Objective To explore the risk factors of hypoparathyroidism （HypoPT） after thyroidec-tomy and analyze the relationship between the number of coexisting risk factors and the incidence of HypoPT, so as to guide the clinical treatment. Methods A total of 266 patients with the complete data after the thyroidectomy in Yunnan Cancer Hospital from July 2021 to March 2022 were retrospectively analyzed. Univariate analysis and multivariate Logistic regression were used to analyze the risk factors of HypoPT and the relationship between the number of co-existing risk factors and the incidence of HypoPT. Results （1） Univariate analysis results: There were statistically significant differences in age, body mass index （BMI）, hypertension, metabolic syndrome （MS）, mass nature, T stage, central lymph node dissection （CLND） , lymph node metastasis, surrounding invasion, gland lobectomy method （unilateral total resection, bilateral total resection） （P < 0.05）; （2） Logistic multivariate analysis results: MS, CLND, tumor nature, Lymph node metastasis were the independent risk factors for the incidence of HypoPT （ P < 0.05）; （3） After adjusting for age and other clinical factors, there was a positive correlation between the number of risk factors and the incidence of HypoPT. Conclusion （1） Age, BMI, hypertension, MS, mass nature, T stage, CLND, lymph node metastasis, peripheral invasion, and gland lobectomy method will affect the incidence of HypoPT; （2） MS, CLND, mass nature, lymph node metastasis are independent risk factor for HypoPT; （3） There is a positive correlation between the number of risk factor and the incidence of HypoPT.
2022, 43(9): 90-95.
doi: 10.12259/j.issn.2095-610X.S20220917
Abstract:
Objective To explore the application value of multi-mode ultrasound in post-liver transplantation monitoring by combining two-dimensional gray scale ultrasound, CDFI, Spectral Doppler and CEUS in gray scale, blood flow and microperfusion examination after the liver transplantation. Methods In this study, 57 patients with liver transplants donated by those after brain death （DBD） in our hospital from January 2018 to December 2021 were selected. All the patients underwent the real-time, dynamic and continuous monitoring by conventional ultrasound after the liver transplantation. Results There were 7 cases of vascular complications, including 2 cases of hepatic artery stenosis （3.5%）, 2 cases of portal vein thrombosis （3.5%）, 1 case of inferior vena cava thrombosis （1.2%）, and 2 cases of inferior vena cava stenosis （3.5%）. There were 4 biliary complications （7.0%）, including 3 biliary stenosis （5.2%） and 1 choleoma （1.2%）, which were clinically confirmed. The common complications were pleural and abdominal effusion in 57 cases （100%）, intrahepatic and perihepatic hematoma in 31 cases （54.3%）. False aneurysm of hepatic artery was missed by multimodal ultrasound in 1 case （1.2%）. Conclusion As the first choice after the liver transplantation, multimodal ultrasound can accurately diagnose the complications after the liver transplantation.
2022, 43(9): 96-100.
doi: 10.12259/j.issn.2095-610X.S20220919
Abstract:
Objective To investigate the curative effect of sinus enlargement and opening partial middle turbinate resection combined with nerve branch block in patients with refractory sinusitis. Methods A total of 60 patients with refractory sinusitis admitted to the Otolaryngology Department of The Second People’ s Hospital of Qujing city from May 2019 to May 2021 were selected and divided into 2 groups by random number table method. The control group （n = 30 cases） was treated with sinus enlargement and middle turbinate resection, while in the study group （n = 30 cases）, sinus enlargement, middle turbinectomy and nerve branch occlusion were performed. The effective rate, recurrence rate, visual analogue scale （VAS）, clinical symptom score and clinical level indexes of the two groups were observed and analyzed. Results The effective rate of operation in the study group was higher than that in the control group, and the recurrence rate was lower than that in the control group. The differences were statistically significant （P = 0.021, 0.007）. VAS scores of 3 months, 6 months and 1 year after the operation in the study group were lower than those in the control group and the differences were statistically significant （P = 0.041, 0.039, 0.017）. The clinical symptom score of the study group was lower than that of the control group and the differences were statistically significant （P = 0.028, 0.037, 0.010, 0.022）. EOS, IFN-γ and basophils in the study group were better than those in the control group, and the differences were statistically significant （P = 0.029, 0.003, 0.045）. Conclusion The treatment of refractory sinusitis with sinus enlargement, middle turbinate resection and nerve branch block can relieve the clinical symptoms and reduce the recurrence rate, which is worthy of application.
2022, 43(9): 101-106.
doi: 10.12259/j.issn.2095-610X.S20220909
Abstract:
Objective To explore the influence and relationship of prepregnancy weight and pregnancy weight gain on pregnancy complications and adverse pregnancy outcomes, and to provide the evidence for the pregnancy health care, reducing pregnancy complications and improving maternal and infant outcomes. Methods According to the retrospective study method, 603 singleton live pregnancies who were hospitalized and delivered in People’s Hospital of Xishuangbanna Dai Autonomous Prefecture with gestational diabetes mellitus （GDM）, hypertension and other diseases and fetal macrosomia during January 2020 to January 2022 were collected. According to the prepregnancy body mass index （BMI） and gestational weight gain （GWG） criteria, they were divided into the low weight group （n = 31）, normal weight group （n = 365）, super weight group （n = 146）, obesity group （n = 61）, underweight gain group （n = 163）, normal weight gain group （n = 230） and excessive weight gain group （n = 210）: The pregnancy complications and adverse pregnancy outcomes, such as cesarean section rate, shoulder dystocia, birth rate of macrosomia, low birth weight infants, and admission rate to NICU were compared and analyzed. Results Prepregnancy maternal obesity was the influencing factor of preeclampsia. The incidence of preeclampsia, cesarean section, preterm delivery, low birth weight and NICU transfer increased with the increase of BMI before the pregnancy, and the difference was statistically significant （P < 0.05）. The incidence of macrosomia, shoulder dystocia, preeclampsia and cesarean section increased with the increase of GWG, and the difference was statistically significant （P < 0.05）. Conclusion High BMI before the pregnancy and excessive weight gain during the pregnancy can increase the incidence of pregnancy complications and lead to the increase in the incidence of adverse pregnancy outcomes. We should further strengthen the management and education of pregnant women’s weight during the pregnancy, and carry out whole-process intervention on weight during the pregnancy.
2022, 43(9): 107-113.
doi: 10.12259/j.issn.2095-610X.S20220906
Abstract:
Objective To investigate the effect of double row suture fixation on avulsion fracture of anterior cruciate ligament （ACL） tibial insertion under arthroscopy. Methods A total of 35 patients with avulsion fracture of anterior cruciate ligament tibial insertion and meeting the inclusion and exclusion criteria were selected from the Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University from January 2017 to December 2020. All patients were treated with double row sutures under arthroscopy. Lysholm score and International Committee for Knee Literature score were compared between the patients before and 12 months after the surgery. All the enrolled patients signed the relevant informed consent, and the trial plan was approved by the Ethics Committee of the First Affiliated Hospital of Kunming Medical University. Results Lysholm score and IKDC score at 12 months of review were higher than those before the surgery, and the differences were statistically significant （Lysholm score: （91.14±3.22） vs （39.34±4.72）, t = 60.53, P < 0.001; IKDC score: （89.17±3.51） vs （39.14±4.04）, t = 69.37, P < 0.001. Conclusion The Versalok anchor double-row suture fixation method under arthroscopy is simple and can ensure the stable fixation of avulsed bone and restore the tension of ACL and stability of knee joint.
2022, 43(9): 114-117.
doi: 10.12259/j.issn.2095-610X.S20220921
Abstract:
Objective The purpose of this study is to analyze whether mild thrombocytopenia is associated with an increased risk of postpartum hemorrhage in women undergoing cesarean section. Methods All women who underwent cesarean section in the department of gynecology in our hospital from September 2018 to June 2021 were included in the study for retrospective analysis. The study subjects were divided into normal platelet count group （≥150000/μL） and mild thrombocytopenia group （100000～149000/μL） according to the platelet concentration. The maternal postpartum hemorrhage, blood transfusion, wound complications （infection, dehiscence or hematoma at the operation site） and postpartum emergency visits were observed. Results Among 918 women, 832 （90.6%） had the normal platelet counts, and 86 （9.4%） had mild thrombocytopenia. Compared with the women with mild thrombocytopenia, there was no difference in risks of postpartum hemorrhage （13.5% vs 14.0%, OR = 1.16, 95% CI 0.88-1.54, P = 0.801） , need for blood transfusions （6.5% vs 6.7%, OR = 1.34, 95%CI 0.80-2.24, P = 0.622）, wound complications （4.5% vs 5.4%, OR = 1.53, 95%CI 0.88-2.64, P = 0.494） or emergency postpartum visits （9.0% vs 10.7%, OR = 1.37; 95%CI 0.92–2.03, P = 0.346） for the women with the normal platelet counts. Conclusion The preoperative mild thrombocytopenia of cesarean section women has nothing to do with the postpartum hemorrhage, blood transfusion, wound complications or postpartum emergency visits.
2022, 43(9): 118-124.
doi: 10.12259/j.issn.2095-610X.S20220914
Abstract:
Objective To investigate the diagnosistic efficiency of digital breast tomosynthesis （DBT） in breast diseases. Methods 151 women with a clinically suspicious breast disease during Sept. 2017 to Sept. 2019 were enrolled into the study and all of them received full-field digital mammography （FFDM） and DBT examinations in Yan'an Hospital of Kunming. Results The specificity, sensitivity, positive predictive value, negative predictive value and accuracy of DBT in diagnosing benign and malignant breast lesions were significantly higher than those of FFDM, while the sensitivity, positive predictive value, negative predictive value and accuracy were slightly lower than those of FFDM + DBT （P < 0.05）; The specificity, sensitivity, positive predictive value, negative predictive value and accuracy of DBT in diagnosing breast lesions were higher than those of FFDM alone （ P < 0.05）. The diagnostic efficacy of DBT and DBT + FFDM was comparable; For dense intraglandular lesions, the specificity, sensitivity, positive predictive value, negative predictive value and accuracy of DBT in diagnosing breast lesions were significantly higher than those of FFDM alone （ P < 0.05）. The sensitivity, positive predictive value, negative predictive value and accuracy of DBT in diagnosing breast lesions were lower than those of DBT + FFDM （ P < 0.05） Conclusion As compared with FFDM, DBT + FFDM and DBT significantly can improve the accuracy of breast disease diagnosis, especially for dense breast; FFDM + DBT has some advantages over DBT.
2022, 43(9): 125-129.
doi: 10.12259/j.issn.2095-610X.S20220931
Abstract:
Objective To understand the vitamin D nutritional status of pregnant women and infants in Kunming by analyzing the serum level of 25 hydroxyvitamin D（25OHD）, and to explore the relationship between vitamin D and the risk of gestational diabetes so as to provide reasonable suggestions for vitamin D supplementation. Methods The serum 25OHD and blood glucose levels of normal pregnant women and infants were collected and analyzed by SPSS19.0. Results The overall levels of serum 25OHD in pregnant women and infants in Kunming were （20.41±8.08）ng/mL, （29.14±8.89）ng/mL and （31.67±9.77）ng/mL. From 2018 to 2020, the deficiency rate of serum 25OHD decreased from 7.31% to 0.09%, and the deficiency rate decreased from 66.7% to 7.95%. There was a negative correlation between serum 25OHD and blood glucose level in pregnant women. Conclusion The overall level of serum 25OHD in pregnant women and infants in Kunming has been increasing year by year, and the level of serum 25OHD in all ages shows a slightly higher level in infants. Vitamin D level has an impact on blood glucose level to some extent. Pregnant women should take vitamin D supplements, mainly with food and sunshine, appropriate light, supplemented by vitamin D preparation.It is not only beneficial to the prevention and treatment of which can not only prevent the calcium deficiency and other related diseases, but also helps to stabilize the blood sugar level of women during pregnancy.
2022, 43(9): 130-134.
doi: 10.12259/j.issn.2095-610X.S20220918
Abstract:
Objective To explore the efficacy and safety of white noise on improving the subjective sleep quality of soldiers in plateaus. Methods At a garrison of 3,800 meters, the Pittsburgh Sleep Assessment Scale （PSQI scale）, anxiety self-assessment scale （SAS）, and Epworth sleepiness scale （ESS scale） were used. Subjects meeting the inclusion criteria were randomized by 1∶1 into the trial and control groups for an open control trial.The trial group had a 30-min white noise intervention twice daily, while no intervention was used in the control group. The PSQI, SAS, and ESS scores were performed again after 3 consecutive months. Results A total of 423 valid screening questionnaires were obtained, with 59.21% of dyssomnia （PSQI≥5）, anxiety （SAS≥50） detected at 43.97%, and 68.88% of drowsiness （ESS≥7） detected. A total of 40 participants participated in the controlled trial. After the completion of the 3-month white noise intervention, the PSQI scores （P = 0.001） and SAS scores （P = 0.026） were significantly different, but there was no significant difference in the ESS scores. Conclusion White noise intervention has a positive effect on improving the subjective sleep quality and relieving the anxiety of soldiers in plateaus.
2022, 43(9): 135-140.
doi: 10.12259/j.issn.2095-610X.S20220907
Abstract:
Objective To investigate the effects of vitamin D supplementation on thyroid function, autoimmune antibody and serum 25 （OH） D levels in female patients with autoimmune thyroiditis （AT） in the reproductive age. Methods 94 childbearing age females with AT and admitted to the department of endocrinology of our hospital from January 2019 to August 2021 were enrolled as subjects. According to random number table method, they were randomly assigned to two groups, the control group （n = 47） and the study group （n = 47）, and the parallel control were conducted. All the subjects received the instruction of life style and diet style, the study group received the oral Thyroid hormone and Vitamin D therapy, while the control group only received the oral Thyroid hormone therapy. Thereafter, serum Thyroid hormone levels （FT3, TSH and FT4）, thyroid autoantibodies （TRAb, TPO-Ab） and 25 （OH） D were measured and compared between the two groups at different stages. Results （1）Thyroid function: Compared with the situation before the treatment, serum FT3, TSH and FT4 were improved to varying degrees in 2 groups after 6 months of treatment （P < 0.01）, the serum TSH content in the study group was apparently higher than that in the control group [（2.34±0.33） μIU/mL VS （2.19±0.36） μIU/mL], and the results were statistically significant （P < 0.05）. （2） Thyroid autoimmune antibody: After 6 months of treatment, serum TRAb and TPO-Ab levels in the study group were evidently better, compared to the control group [（0.56±0.38） U/L VS （4.35±1.71） U/L; （35.71±8.85） U/mL VS （77.41±19.91） U/mL] （P < 0.01）, lower than TRAb and TPO-Ab levels before treatment and 3 months after the treatment （P < 0.01）. （3） Serum 25 （OH）D level: Compared with the situation before the treatment, the serum 25 （OH）D level of the study group increased significantly after 6 months of treatment （P < 0.05）, evidently better than that in the control group [（61.91±8.73） ng/mL VS （10.79±3.16） ng/mL] （P < 0.05）. Conclusion Vitamin D supplementation can significantly improve serum 25 （OH） D level and autoimmune antibody titer in patients with autoimmune thyroiditis in the short term （6 months）, but the effect on Thyroid hormone levels is not obvious and it can be used as an adjunctive treatment for autoimmune thyroiditis patientswith low vitamin D level.
2022, 43(9): 141-146.
doi: 10.12259/j.issn.2095-610X.S20220930
Abstract:
Objective To investigate the effect of ranibizumab and odix on the microvascular structure of the macular region in patients with retinal vein occlusion-macular edema （RVO-ME）. Methods All patients with RVO-ME admitted and diagnosed in the ophthalmology department of our hospital were included in the screening scope, and 101 of them were selected as the research subjects. The inclusion time was from January 2020 to December 2021, and they were divided into the observation group and the control group according to the differences in treatment methods, with 51 cases and 50 cases in each group. The observation group was given intravitreal injection of ranibizumab, and the control group was given intravitreal injection of AODEX. The age, gender, best corrected visual acuity （BCVA）, macular fovea thickness （CMT）, shallow retinal capillary layer （SCP）, deep capillary layer blood flow density （DCP） and other effective rates of the two groups before and after the treatment were included in spss21.0 software to compare the treatment differences. Results （1） There was no significant difference in BCVA, CMT, SCP, and DCP between the two groups before the treatment （P > 0.05）. With the delay of treatment time, BCVA, CMT, SCP and DCP of the two groups were significantly improved ,the control group was better than the observation group and the difference was statistically significant （P < 0.05） and （2） The total effective rates of the observation group were 94.12% and 98.04% at 3 and 6 months after the treatment while the total effective rates of the control group were 84.00% and 88.00%, showing that the control group was better than the observation group and the difference was statistically significant （P < 0.05）. Conclusion Autodix treatment can effectively improve the macular microvascular structure in RVO-ME patients.
2022, 43(9): 147-154.
doi: 10.12259/j.issn.2095-610X.S20220916
Abstract:
Objective To develop a LC-MS/MS method for the determination of scopolamine and atropine in human blood and urine after Datura stramonium poisoning. Methods Shim-pack GISR-HP C18 column was used for gradient elution with acetonitrile formic acid （0.1%） as the mobile phase. The electrospray ionization ion source multiple reaction monitoring mode mass spectrometry was used to analyze the scopolamine and atropine by two characteristic ion pairs and the external standard curve method. Results The quantitative ion pairs of scopolamine and atropine were m/z 304.25 [M+H]+→138.15 and m/z 290.2 [M+H]+→124.15, respectively. The linear range of scopolamine and atropine were 1～100 ng/mL （R≥0.999）. The limits of detection （LOD） were 0.45 ng/ml and 0.19 ng/ml in blood, 0.38 ng/ml and 0.16 ng/ml in urine; The limits of quantitation （LOQ） were 1.01 ng/ml and 0.63 ng/ml in blood, 1.07 ng/ml and 0.38 ng/ml in urine; The extraction recoveries were 94.38% and 94.49% in blood, 94.96% and 96.52% in urine; The average recoveries of the substances were 94.38% and 94.49% in matrixs. The matrix effects effect was -3.51%～0.84%. The accuracy of substances were 89.38%～102.86%, and the intra day and inter day precisions were less than 6%. Conclusions The method can be used to determine the concentration of scopolamine and atropine in biological samples quickly and accurately.
2022, 43(9): 155-159.
doi: 10.12259/j.issn.2095-610X.S20220911
Abstract:
S-nitrosylation modification is a selective and reversible post-translational modification of protein by high concentration of nitric oxide （NO）, which is related to a variety of cellular processes and tissue homeostasis. Most digestive system tumors interact with the development of inflammation. The body induces a great deal of NO in an inflammatory state and NO can modify the substrate protein S-nitrosylation. At present, it has been found that the expression of S-nitrosylation of proteins in a variety of cancer tissues is abnormal. Relevant studies at home and abroad show that the relationship between S-nitrosylation and tumor occurrence and development has become a current research focus. By briefly describing the mechanism of protein S-nitrosylation imbalance in the occurrence and development of different digestive system tumors and treatments,this review concludes that S-nitrosylation imbalance in different digestive system tumors can promote or inhibit the development of tumors through the S-nitrosylation of different proteins and aims to tap the therapeutic potential of S-nitrosylation level in digestive system tumors.
S-nitrosylation modification is a selective and reversible post-translational modification of protein by high concentration of nitric oxide （NO）, which is related to a variety of cellular processes and tissue homeostasis. Most digestive system tumors interact with the development of inflammation. The body induces a great deal of NO in an inflammatory state and NO can modify the substrate protein S-nitrosylation. At present, it has been found that the expression of S-nitrosylation of proteins in a variety of cancer tissues is abnormal. Relevant studies at home and abroad show that the relationship between S-nitrosylation and tumor occurrence and development has become a current research focus. By briefly describing the mechanism of protein S-nitrosylation imbalance in the occurrence and development of different digestive system tumors and treatments,this review concludes that S-nitrosylation imbalance in different digestive system tumors can promote or inhibit the development of tumors through the S-nitrosylation of different proteins and aims to tap the therapeutic potential of S-nitrosylation level in digestive system tumors.
2022, 43(9): 160-165.
doi: 10.12259/j.issn.2095-610X.S20220903
Abstract:
Placenta plays an important role in the process of glucose transfer from maternal to fetus. The normal structure and function of the placenta guarantee the fetus to take up glucose effectively from maternal side over the gestation. Glucose transplacental transfer mainly depends on the glucose transporters （GLUTs）. And the placenta and other factors such as placental glucose metabolic activity could also affect the glucose transplacental transfer. Gestational diabetes mellitus （GDM） is a main complication of pregnancy. Fetal adverse outcomes from GDM patients may be caused by the abnormality of glucose transport in the placenta. This review aims to discuss the glucose transplacental transfer on the normal placenta and summarize some changes and molecular mechanism that have been reported about glucose transplacental transfer in the GDM.
Placenta plays an important role in the process of glucose transfer from maternal to fetus. The normal structure and function of the placenta guarantee the fetus to take up glucose effectively from maternal side over the gestation. Glucose transplacental transfer mainly depends on the glucose transporters （GLUTs）. And the placenta and other factors such as placental glucose metabolic activity could also affect the glucose transplacental transfer. Gestational diabetes mellitus （GDM） is a main complication of pregnancy. Fetal adverse outcomes from GDM patients may be caused by the abnormality of glucose transport in the placenta. This review aims to discuss the glucose transplacental transfer on the normal placenta and summarize some changes and molecular mechanism that have been reported about glucose transplacental transfer in the GDM.
2022, 43(9): 166-171.
doi: 10.12259/j.issn.2095-610X.S20220902
Abstract:
Objective To explore the effect of TBL-PBL-CBL combined teaching mode in the clinical practice of cardiology, and provide a new training direction for high-quality doctors. Methods 80 students participating in the clinical practice in the Cardiology Department of The Second Affiliated Hospital of Kunming Medical University were selected from July 2021 to March 2022 and were randomly divided into the control group （n = 40） and the experimental group （n = 40）. Those in the control group were taught with the traditional lecture-based mode, while those in the experimental group were given the teaching method of TBL combined with PBL and CBL. Finally, the teaching effect was evaluated by questionnaire survey and test result. Results Compared with the control group, the test results of theory, electrocardiogram and cardiac physical examination in the experimental group were higher （P < 0.001）. Furthermore, students in the experimental group thought that the teaching method of TBL combined with PBL and CBL had improved their ability in autonomic learning, logical thinking, clinical thinking and team cooperation. Conclusion The teaching method of TBL combined with PBL and CBL has a positive effect on promoting the clinical ability of students.
2022, 43(9): 172-176.
doi: 10.12259/j.issn.2095-610X.S20220922
Abstract:
Objective To explore the effect of continuous nursing intervention for discharged stroke patients based on FOCUS-PDCA procedure. Methods 100 patients with cerebral apoplexy who were about to be discharged from our hospital from May 2020 to February 2021 were selected as the research objects and randomly divided into the control group （n = 50） and the observation group （n = 50）. The control group adopted the traditional continuous nursing mode, while the observation group of patients received FOCUS-PDCA program intervention mode on the basis of routine nursing. MBI, FMA and satisfaction were compared between the two groups. Results After the intervention, scores of MBI, FMA and satisfaction in the observation group were significantly higher than those in the control group （P < 0.05）, and the differences were statistically significant. Conclusion FOCUS-PDCA program intervention of continuous care for stroke discharged patients can significantly improve the quality of life and satisfaction, promote the rehabilitation effect and it is worthy of clinical application.
