Email
RSS2023 Vol. 44, No. 4
2023, 44(4): 1-8.
doi: 10.12259/j.issn.2095-610X.S20230403
Abstract:
Objective To explore the underlying mechnisms and effect of LINC00341 on the proliferation of lung adenocarcinoma cells. Methods The expression of LINC00341 mRNA in lung adenocarcinoma was analyzed in public data set SEO and TCGA, and its diagnostic value was analyzed by ROC curve. Survival analysis was performed on RMA and OKAYAMA data, and RNA-seq validation and ROC curve analysis were performed on lung cancer samples from Hospital of University of Michigan, USA. The biological function of LINC00341 gene was analyzed by gene otology （GO）. The expression of LINC00341 was silenced by siRNA and cells were divided into control group （NT） and silenced group （siLINC00341） according to different treatments, and the transfection efficiency was verified. Cell proliferation was detected by WST-1 and plate cloning assay. RNA subcellular localization was detected for LINC00341 localization, and Western blot was used to detect the effect of LINC00341 on the expression level of proteins related to MAPK signaling pathway. Results Low expression of LINC00341 was found in lung adenocarcinoma tissues （P < 0.0001 for 3 data sets）. ROC curve analysis indicated that LINC00341 could be used as a biomarker for lung adenocarcinoma , and low expression of LINC00341 was associated with better prognosis in patients （ P = 0.004）. GO enrichment analysis showed that LINC00341 was mainly related to transcriptional regulation of RNA polymerase II promoter and protein binding. Silencing LINC00341 could promote the proliferation of lung adenocarcinoma cells （P < 0.05） and clone formation （ P < 0.05） , and the MAPK signaling pathway proteins STAT3 and ERK were activated （ P < 0.05）. RNA localization showed that LINC00341 was mainly distributed in the nuclear. Conclusion LINC00341 may regulate MAPK pathway at transcriptional level, thus inhibiting the development of lung adenocarcinoma, and can be used as an important diagnostic and prognostic marker for lung adenocarcinoma.
2023, 44(4): 9-15.
doi: 10.12259/j.issn.2095-610X.S20230408
Abstract:
Objective To investigate the effect of scutellarin （SCU） on liver fibrosis in obese rats with chronic liver injury induced by high-fat and high-sugar diet, and to explore the possibility of SCU to ameliorate the degree of liver fibrosis by promoting the expression of MMP2 and MMP9 and inhibiting the expression of TIMP-1. Methods The model of chronic liver injury and liver fibrosis was induced by high-fat and high-sugar diet. After 8 weeks of intragastric administration of SCU and curcumin （CUR）, HE staining was used to observe the pathology of liver tissue; Masson staining was used to detect the deposition of collagen fibers in liver tissue; and western blot and immunohistochemical staining were used to observe the expression of TIMP-1, MMP2 and MMP9 in liver tissue. Results In the model group, hepatocytes were swollen with irregular hepatocyte morphology, a large number of fat vacuoles, and blue collagen fibers were deposited in the confluent area. After different doses of SCU and CUR intervention, the fat vacuoles were reduced, the swelling of hepatocytes was decreased, and the degree of fibrosis was improved. In liver tissue cells, the protein expressions of MMP2 and MMP9 were down-regulated in the model group （P < 0.01）, and up-regulated after treatment with different doses of SCU and CUR （P < 0.01）. The expression of TIMP-1 protein was up-regulated in the model group （P < 0.01）, and down-regulated after treatment with different doses of SCU and CUR （P < 0.01）, and the dose dependence was not significant. Conclusion SCU may improve liver fibrosis caused by obesity by promoting MMP2 and MMP9, inhibiting the expression of TIMP-1 protein and reducing the accumulation of ECM.
2023, 44(4): 16-22.
doi: 10.12259/j.issn.2095-610X.S20230423
Abstract:
Objective To investigate the effect of calcium store-operated calcium channel Orai3 on the proliferation of coronary artery smooth muscle cells （CASMC）. Methods Coronary artery smooth muscle cells （CASMC） were cultured, and Orai3 molecule in CASMC was interfered and over-expressed. QPCR and Western Blot were used to detect the expression of Orai3, and CCK8 and cell counts were used to detect the CASMC proliferation. Results CCK8 assay and cell counts showed that the proliferation rate of CASMC in serum-free group was lower than that in 10% serum group （P < 0.05）, and also the expression of Orai3 in CASMC was decreased （P < 0.05）. Compared with the control group, the proliferation rate of CASMC decreased after interference with Orai3 （P < 0.05）, and the proliferation rate of CASMC increased compared with the control group after over-expression of Orai3 （P < 0.05）. Conclusion The store-operated calcium channel constituent molecule Orai3 plays an important role in CASMC proliferation.
2023, 44(4): 23-30.
doi: 10.12259/j.issn.2095-610X.S20230402
Abstract:
Objective To investigate the influence of intestinal flora metabolites secondary bile acid DCA at different concentration and reaction time on the proliferation and cell cycle of human umbilical cord mesenchymal stem cells （hUC-MSCs） in vitro. Methods CCK8 and flow cytometry were used to detect the changes in cell proliferation and cell cycle of hUC-MSCs cultured in stem cell medium containing different concentrations of DCA （0.00 μmol/L, 1.56 μmol/L, 3.13 μmol/L, 6.25 μmol/L, 12.50 μmol/L, 25.00 μmol/L, 50.00 μmol/L, 100.00 μmol/L, 200.00 μmol/L, 400.00 μmol/L, 800.00 μmol/L） at 24h, 48h and 72h. Results The effect of deoxycholic acid on the proliferation of hUC-MSCs was both dose- and time-dependent （interaction, F = 6.622, P < 0.001）．When the concentration was constant, cell proliferation increases with time; When the treatment time was fixed, the cell proliferation decreased with the increase of concentration. When the concentration was constant, the proportion of cell was arrested in G0/G1 phase increased with time （P < 0.001）．The cell cycle of hUC-MSCs treated by DCA was blocked in G0/G1 and S phase in low concentration group, while S and G2/M phase in high concentration group （P < 0.001）． Conclusion The effects of DCA on the proliferation and cell cycle of hUC-MSCs were both dose and time in vitro.
2023, 44(4): 31-39.
doi: 10.12259/j.issn.2095-610X.S20230419
Abstract:
Objective This study aims to explore the role and mechanism of voluntary exercise training in the development and progression of breast cancer. Methods Primary human Breast Cancer gene 1-mutation （BRCA-1 mutation） cancer cells were cultured in vitro, before treated with the serum of wheel running rats and sedentary rats for 14 consecutive days. The cells cultured in above conditions were injected subcutaneously into BALB/c nude mice to observe the in vitro and in vivo breast cancer cells with BRCA-1 mutation and tumor transplantation after different interventions. Results In vitro, compared with sedentary rat serum group, the activity and growth of BRCA-1 mutant breast cancer cells were inhibited and apoptosis was promoted after in the wheel running group. In vivo, the grafts of BRCA-1 mutated breast cancer cells cultured from in the wheel running group decreased in volume and grew slower compared with the sedentary group, and the wheel running group showed enhanced Caspase-3 activity both in vivo and in vitro. Conclusion Voluntary wheel running may attenuate the growth of BRCA1 mutant breast cancer cells and their proliferation and apoptosis in BALB/c nude mice by enhancing the activity of Caspase3, thus inhibiting the growth of breast cancer cells in vitro and in vivo.
2023, 44(4): 40-47.
doi: 10.12259/j.issn.2095-610X.S20230409
Abstract:
Objective To explore the association between gene single nucleotide polymorphisms of SLC2A9 and susceptibility to pyrazinamide induced hyperuricemia （PIHU） in Yunnan Han population. Methods The polymorphisms of SLC2A9 gene rs2280205, rs3733591, rs3775948 and rs10939650 were detected by Mass ARRAY method. Genotype and allele frequency distribution were compared between the test group （n = 294） and the control group （n = 220） and analyzing the association between the polymorphisms of SLC2A9 with susceptibility to PIHU in different genetic models. Results There were significant differences in genotype frequency and allele frequency distribution of rs2280205 between the two groups （P < 0.05）. Patients carrying allele A had an increased risk of PIHU; rs2280205 polymorphism was significantly correlated with PIHU in co-dominant, dominant and recessive models （all P < 0.05）. rs3733591 genotype frequency and allele frequency distribution between the two groups, the difference was statistically significant （P < 0.05）, the patients with allele T increased the risk of PIHU. rs3733591 polymorphism was significantly correlated with PIHU in co-dominant, dominant and recessive models （all P < 0.05）. rs3775948 genotype frequency and allele frequency distribution between the two groups, the difference was statistically significant （all P < 0.001）, the patients with allele C of PIHU increased risk; rs3775948 polymorphism was significantly associated with PIHU in both co-dominant and dominant models （P < 0.05）. rs10939650 genotype frequency and allele frequency distribution between the two groups, the difference was statistically significant （all P < 0.001）, the patients with allele C of PIHU increased risk; rs10939650 polymorphism was significantly associated with PIHU in both co-dominant and recessive models （P < 0.05）. Conclusion SLC2A9 gene polymorphisms rs2280205, rs3733591, rs3775948 and rs10939650 may be associated with the susceptibility to PIHU in Yunnan Han population, and allele A of rs2280205, allele T of rs3733591, allele C of rs3775948 and allele T of rs10939650 may be risk factors for PIHU.
2023, 44(4): 48-52.
doi: 10.12259/j.issn.2095-610X.S20230427
Abstract:
Objctive To investigate the association between glucose time in range and carotid artery intima-media thickness in type-2 diabetes mellitus. Methods A total of 232 patients with type 2 diabetes were selected and divided into two groups based on the thickness of the common carotid artery intima-media, ie CIMT ≥ 0.8 cm in the abnormal group and < 0.8 cm in the normal group. Height and weight were measured, biochemical indexes and dynamic blood glucose parameters were detected, and glucose TIR values were calculated to compare the differences of indexes and TIR values between the two groups. Pearson correlation was used to analyze the correlation between CIMT and CGM indexes. Binary Logistic regression analysis examined the relationship between CIMT and CGM indexes. Results The TIR value of CIMT < 0.8 cm group was significantly higher than that of CIMT ≥ 0.8 cm group [ （77.22±23.26） nmol/L vs （69.47±22.03） nmol/L], and CIMT was negatively correlated with TIR. TIR was positively correlated with SDBG, MBG and TAR. Binary logistic regression suggested that the decrease of TIR （P = 0.016） and the increase of SDBG （P = 0.025）, MBG （P = 0.006） and TAR （P = 0.014） were risk factors for CIMT thickening. Conclusion In patients with type 2 diabetes, there was a negative correlation between TIR and CIMT, and decreased TIR values may be an independent risk factor for thickening of the common carotid artery intima-media.
2023, 44(4): 53-61.
doi: 10.12259/j.issn.2095-610X.S20230401
Abstract:
Objective To investigate the influencing factors of colorectal polyp canceration, to improve the early diagnosis and treatment of colorectal cancer, and to reduce the incidence. Methods Patients diagnosed with intestinal polyps during hospitalization in the Department of Gastroenterology, the First Affiliated Hospital of Kunming Medical University from January 2020 to December 2022 were retrospectively selected. Clinical data including gender, age, height, weight, history of smoking, drinking, diabetes and hypertension, family and personal history of bowel cancer, the position, shape, size, number and pathological type of polyps were collected and analyzed. Results A total of 4700 patients were investigated and cancer occurred in 665 cases, with a cancer rate of 14.1%. There was no significant difference in the rate of intestinal polyp canceration in gender, BMI, diabetes mellitus, alcohol consumption or family history of bowel cancer groups （P > 0.05）. There were significant differences in intestinal polyp canceration rate among patients in different age groups, hypertension, smoking, history of bowel cancer, different polyp sites, different polyp morphology, different polyp surface conditions, different number of polyps （single or multiple）, and different polyp diameters （P < 0.05）. The results of unconditioned binary Logistic regression analysis showed that age, hypertension, smoking, polyp location, morphology, surface and size were the factors affecting the carcinogenesis of intestinal polyps （P < 0.05）. When analyzing the relationship between pathological types and canceration, 5 cases of villous adenoma among 4700 patients investigated were too few to be included in the analysis, but the number of cases was too small to be included in the analysis. 69 cases were found to be “adenocarcinoma”, and the pathological types before canceration could not be identified, so they were not included in the analysis. Finally, 4, 626 patients were included in the analysis. The cancer rate of different pathological types was statistically significant （P < 0.05）. Pair-wise comparison showed that there were differences between the following groups （P < 0.001） : the cancer rate of tubulovillous adenoma was the highest （42.0%）, followed by tubulovillous adenoma （6.1%）, and the lowest non-neoplastic polyps （0%）. Conclusion The most common pathological type of large intestine polyp is tubular adenoma, and the risk of polyp canceration increases with the increase of villi. The endoscopic characteristics of high-risk polyps include locating at rectal and sigmoid colon, lobed surface, type Ⅱ and Ⅲ of Polyp field classification, large diameter polyps. The risk of colorectal polyp canceration was positively correlated with age, and the risk of polyp canceration increased with age, especially over 60 years old. Smoking and high blood pressure are the risk factors for intestinal polyp canceration.
2023, 44(4): 62-68.
doi: 10.12259/j.issn.2095-610X.S20230407
Abstract:
Objective To investigate the value of urine AD7c-NTP level test combined with ERP P300 in the diagnosis of AD-derived mild cognitive impairment （MCI）. Methods 78 healthy subjects in control group, 72 in MCI group and 108 in AD group were selected and assessed by MMSE and ADL scale. AD7c-NTP levels in urine of each group were determined by enzyme-linked immunosoradsorption method （ELLSA） and event-related potential （ERP） P300 tests were performed in each group. Results Urine AD7c-NTP and latent time of ERP P300 were siginificantly different among healthy control group, MCI group and AD group （P < 0.05）. Pair-wise comparison showed that urine AD7c-NTP and latent time of ERP P300 were different among healthy control and MCI group, MCI group and AD group, and healthy control and AD group （P < 0.05）. Conclusion The elevated AD7c-NTP in urine in this study indicated the neuronal damage from mild cognitive impairment （MCI） to AD. The abnormal P300 indicates the impaired brain function, and the two have the same pathophysiological process. These results showed that the detection rate of early AD can be effectively improved through the combination of laboratory and functional examination, which can be used as an important reference index for early diagnosis and treatment of AD, as well as a reference basis for screening MCI and early AD.
2023, 44(4): 69-74.
doi: 10.12259/j.issn.2095-610X.S20230413
Abstract:
Objective The purpose of this study was to investigate the care burden and influencing factors of the primary caregivers for patients with adolescent idiopathic scoliosis （AIS） treated conservatively, and to explore the correlation between care burden and various factors. The results were expected to provide evidence to clinicians for taking targeted measures to reduce the burden of caregivers and improve the quality of medical care. Methods A total of 56 eligible AIS patients and their primary caregivers were enrolled from West China Hospital of Sichuan University from December 2021 to July 2022. The demographic characteristics of patients and their caregivers were surveyed by self-designed questionnaires; the caregiver burden was assessed by the Caregiver Burden Scale （CBI）; the self-efficacy of the caregivers was assessed by the General Self-Efficacy Scale （GSES）. The Sobernheim Stress Level Questionnaire-Brace （BSSQ-Brace） and Stress Level Questionnaire-Deformity （BSSQ-Deformity） were used to investigate the patients’ feelings about wearing the brace and their body image. The Cobb angles of the patient’s main curve were measured and collected. SPSS 23.0 was used for statistics analysis. Descriptive statistics were used for analysing the general information and questionnaire results, and multiple linear regression was used to explore the main influencing factors of caregiver burden. Results After conservative treatment, the mean correction of the patient’s main curve was 7.13±5.64°; the CBI score of the primary caregiver was 26.52±10.79, and the multiple linear regression results showed that the influencing factors were GSES score and BSSQ-Brace score （R2 = 0.194, F = 7.602, P < 0.01）. Conclusions AIS patients have different degrees of increased burden on their primary caregivers during conservative treatment, and the influencing factors significantly related to self-efficacy of the caregivers and patients’ feelings about wearing the brace.
2023, 44(4): 75-81.
doi: 10.12259/j.issn.2095-610X.S20230411
Abstract:
Objective To analyze the clinical data of patients with PHPT in Yunnan Cancer Hospital, to explore the clinical characteristics, and improve the understanding, diagnosis and treatment of this disease. Methods The clinical data of 108 PHPT patients admitted to Yunnan Cancer Hospital from January 2012 to December 2021 were retrospectively analyzed, and the clinical differences between symptomatic PHPT and asymptomatic PHPT were compared. Results Among 108 patients with PHPT, 58 （53.7%） were in the symptomatic group and 50 （46.3%） were in the asymptomatic group. The age of onset was earlier in males than in females, the difference was statistically significant （P = 0.001）. The proportion of men in the symptom group was higher than that of women, the difference was statistically significant （P = 0.002）. Patients of sPHPT had an earlier onset age （P = 0.001） and longer disease duration than those of aPHPT （P < 0.001）. PHPT visits were increasing, and the increasing trend was more pronounced in aPHPT after 2018 than in sPHPT. Impairment of the skeletal system （84.5%）was the most common patient in the symptomatic group, while patients in the asymptomatic group often had unexpected findings of blood calcium elevation or suspicious lesions found by neck ultrasound.The accuracy of 99mTc-MIBI lesion localization （94.44%）is higher than neck ultrasound （78.7%）or neck contrast-enhanced CT, but 99mTc-MIBI combined with neck ultrasound examination may improve the accuracy of preoperative localization （97.22%）. Skeletal system damage was the most common in sPHPT （84.5%）, while in aPHPT group, patients were more likely to seek medical treatment due to accidental discovery of elevated blood calcium or suspicious lesions found by cervical ultrasound. The accuracy of 99mTc-MIBI lesion localization （94.44%） was higher than that of cervical ultrasound （78.7%） or cervical contrast CT （78.7%）, but 99mTc-MIBI combined with cervical ultrasound could improve the accuracy of preoperative localization （97.22%）. Conclusion There is an increasing trend for PHPT visits. In recent years, the increase trend of aPHPT patients is more obvious than that of sPHPT; Male patients were more severely ill than female patients and had an earlier onset in PHPT. The localization accuracy of 99mTc-MIBI is the highest, and the combination of neck ultrasound can improve the localization accuracy.
2023, 44(4): 82-87.
doi: 10.12259/j.issn.2095-610X.S20230412
Abstract:
Objective To investigate the correlation between delivery factors and early postpartum pelvic organ prolapse （POP） in primipara. Methods From January 2021 to June 2022, primiparas who underwent routine ultrasound examination at the Affiliated Hospital of Yunnan University were retrospectively analysed. The case group included 141 primiparas diagnosed as POP by ultrasound, and the control group included 119 primiparas without POP randomly selected during the same period. The correlation between primiparas’ delivery factors and postpartum POP was analyzed by combining the indexes of fetal weight, labor process and lateral episiotomy. Results Age, birth weight, second stage of labor, vaginal delivery and episiotomy were significantly correlated with the occurrence of POP in primiparas （P < 0.05） . Conclusion Age, birth weight, second stage of labor, vaginal delivery, episiotomy are significantly correlated with early postpartum POP. These findings provide reference significance for clinical prediction of postpartum POP, and crucial for appropriate interventions during pregnancy and delivery, so as to reduce the incidence of postpartum POP.
2023, 44(4): 88-92.
doi: 10.12259/j.issn.2095-610X.S20230426
Abstract:
Objective To evaluate the analgesic effect of ultrasound-guided transmuscular quadratus lumborum block in pediatric patients for hip surgery. Methods 60 children with elective hip operation, aged 1-3 years, ASAⅠ～Ⅱ, were randomly divided into 2 groups after anesthesia induction tracheal intubation. The patients of TQL group （n = 30） received ultrasound-guided transmuscular quadratus lumborum block, while the patients of group C （n = 30） did not receive TQL block. The primary outcome was the number of patients who require rescue analgesia in the first 24 h. The secondary outcome were the FLACC pain scale, heart rate, and blood pressure at 1 h, 4 h, 6 h, 12 h and 24 h postoperatively, and postoperative adverse event （e.g., local hematoma, and organ injuries）. Results 24 h after surgery, the need for rescue analgesia was statistically significantly higher in group C when compared to the TQL group [21/30 （70%） vs 5/30 （16.7%）, P < 0.001]. The FLACC score, heart rate, and blood pressure were lower in the TQL group than the C group at various points during 24 h postoperatively （P < 0.05）. No postoperative adverse event occurred in the TQL group. Conclusion Ultrasound-guided quadratus lumborum block reduces pain scores and analgesic needs following hip surgery in pediatric patients.
2023, 44(4): 93-99.
doi: 10.12259/j.issn.2095-610X.S20230410
Abstract:
Objective To investigate the interaction between the level of unmet needs and dyadic coping of breast cancer patients and their spouses after radical mastectomy, and to provide reference for health care workers to develop intervention programs to help breast cancer patients and their spouses improve their quality of life. Methods 110 patients who were hospitalized in Yunnan Cancer Hospital from June 2021 to January 2022 after radical mastectomy and their spouses were selected by convenience sampling method. The Chinese Version of Need for Breast Cancer Patients and Spouse Scale, and Dyadic Coping Inventory were used to measure the level of unmet needs and dyadic coping of participants respectively. The relationship between the level of unmet needs and dyadic coping of breast cancer patients and their spouses was analyzed by the Actor-Partner Interdependence Model （APIM）. Results In this study, a total of 110 questionnaires were distributed, and 104 valid questionnaires were recovered, with an effective recovery rate of 94.5%. The unmet needs and dyadic coping levels of patients and their spouses were generally above the medium level. The stress communication score of patients was higher than that of spouses （P < 0.001）, and the negative coping score of spouses was higher than that of patients （P < 0.05）. The level of dyadic coping of breast cancer patients was positively correlated with the level of unmet needs of their spouses （r = 0.239, P < 0.05）, and positively correlated with the level of dyadic coping of their spouses （r = 0.542, P < 0.001）. The level of dyadic coping of spouses was positively correlated with their unmet needs （r = 0.378, P < 0.001）. The level of unmet needs of breast cancer patients was positively correlated with that of their spouses （r = 0.197, P < 0.05）. The results of the Actor-Partner Interdependence Model showed that in the subjective effect, the level of unmet needs of spouses could positively predict their own level of dyadic coping （β = 0.350, P < 0.05）. In the object effect, the level of unmet needs of spouses could positively predict the level of dyadic coping of breast cancer patients （β = 0.464, P < 0.001）. Conclusion The level of dyadic coping of breast cancer patients is influenced by the level of unmet needs of their spouses, and is closely related to the level of the dyadic coping of their spouses. The level of dyadic coping of spouses is influenced by their own unmet needs, and the level of unmet needs of breast cancer patients are closely related to the level of unmet needs of their spouses.
2023, 44(4): 100-105.
doi: 10.12259/j.issn.2095-610X.S20230404
Abstract:
Objective To explore the effect of rehabilitation therapy on the psychological and medical coping styles of patients with reversible anterior disc displacement of temporomandibular joint, so as to provide some theoretical support for clinical treatment and research. Methods From April 2022 to August 2022, 185 patients with reversible anterior disc displacement of the temporomandibular joint diagnosed at the stomatology center of the Affiliated Hospital of Yunnan University were randomly divided into two groups: the experimental group received rehabilitation therapy combined with basic infrared polarized light physiotherapy and psychotherapy （n = 93cases）, and the control group received basic infrared polarized light physiotherapy and psychotherapy （n = 92 cases）. The subjects were treated for 1 month, and the generalized Anxiety Scale, depressive Symptom Group Scale, patient health questionnaire Somatic Symptom Group Scale and medical Coping questionnaire were used to investigate and analyze the two groups of patients before and after treatment. Result The mean values of anxiety, depression, physical symptoms and medical coping styles in the experimental group were significantly lower than those in the control group （P < 0.05）. Conclusion Compared with the use of conventional infrared polarized light physiotherapy and psychotherapy alone, rehabilitation therapy combined with conventional infrared polarized light physiotherapy and psychotherapy has a more significant effect on reducing anxiety, depression, physical symptoms and improving the positive way of medical response.
2023, 44(4): 106-111.
doi: 10.12259/j.issn.2095-610X.S20230424
Abstract:
Objective To investigate the blood lead level and its distribution in non-occupational adults, and to analyze the association of excessive blood lead with hypertension. Methods The concentration of lead in blood was detected by GFAAS, and the potential factors affecting blood lead level and the prevalence of hypertension were collected by questionnaire. Rank sum test, chi-square test, Logistic regression, and the restrictive Cubic Spline （RCS） of Logistic regression were used to analyze the influencing factors of excess lead in blood and its association with hypertension. Results The median and quartile spacing （M±Q） of blood lead levels in non-occupational adults was （0.031±0.020） mg/L, and the blood lead exceedance rate was 13.07%. The results of univariate logistic regression analysis showed that the probability of excessive blood lead in non-occupational adults aged > 60 years was 88% lower than that in those aged ≤60 years （P < 0.05）; the probability of excessive blood lead in alcohol consumption was 3.014 times higher than that in non-alcohol consumption （P < 0.05）; and excessive blood lead would lead to 2.87 times higher prevalence of hypertension （P < 0.05）. Restricted cubic spline model combined with the multi-factor logistic regression analysis results show that the incidence of blood lead levels will increase the probability of hypertension by 7.66 times. When the blood lead level was ≥0.031 mg/L, there was a significant nonlinear dose-response relationship between the common logarithm of blood lead （lgpb） and hypertension （global correlation test χ2 = 10.26, P = 0.001, nonlinear test χ2 = 8.87, P = 0.012）, and the prevalence of hypertension showed a significant increase with the increase of blood lead content. Conclusion Excessive blood lead level in non-occupational adults will increase the prevalence of hypertension. High risk groups should have regular physical examination, strengthen the understanding of high risk factors of excessive lead, reduce exposure, and reduce the damage of excessive blood lead.
2023, 44(4): 112-116.
doi: 10.12259/j.issn.2095-610X.S20230405
Abstract:
Objective To investigate the efficacy of dapagliflozin in elderly heart failure patients with preserved ejection fraction （HFpEF） complicated with type 2 diabetes mellitus （T2DM） and its effect on inflammatory factors. Methods From March 2021 to September 2022, 64 patients with HFpEF and type 2 diabetes in the Second People’s Hospital of Kunming were randomly divided into two groups. The control group was treated with metformin, and the study group was treated with dapagliflozin. The indexes of cardiac ultrasound, changes in exercise endurance, inflammatory factors, N-terminal pro-brain natriuretic peptide levels, and adverse reactions were studied. Results After 3 months and 6 months of treatment, the LVEF and 6 min walking distance indexes of the two groups were significantly higher than those before treatment （P < 0.05）, and the LVEDD and E/e′ indexes were significantly lower than those before treatment （P < 0.05）. After 3 months and 6 months of treatment, LVEF and 6 min walking distance indexes of the study group were significantly higher than those of the control group （P < 0.05）, LVEDD and E/e′ indexes were significantly lower than those of the control group, and the differences were statistically significant （P < 0.05）. The hs-CRP, TNF-α and NT-proBNP of the two groups at 3 months and 6 months after treatment significantly were lower than those before treatment （P < 0.05）. The hs-CRP, TNF-α and NT-proBNP in the study group were significantly lower than those in the control group at 3 months and 6 months after treatment （P < 0.05）. There were no adverse reactions such as allergic rash, hypotension, acute renal injury, and hyperkalemia in two groups during treatment, and there were no statistically significant differences in the incidence of adverse reactions such as gastrointestinal reaction, urinary system infection, and hypoglycemia between the two groups （P > 0.05）. Conclusion In the treatment of elderly HFpEF patients with type 2 diabetes mellitus, compared with metformin dapagliflozin can improve cardiac function and exercise endurance , without significant adverse reactions.
2023, 44(4): 117-122.
doi: 10.12259/j.issn.2095-610X.S20230415
Abstract:
Objective To investigate the clinical application of peripherally inserted central catheter （PICC） guided by ultrasound in neonates with vascular access difficulties. Methods From January 2019 to April 2021, 104 neonates with vascular access difficulties identified by the PICC management team in the Department of Neonatology of Kunming Children’s Hospital were selected as the research subjects. They were randomly divided into observation group and control group, 52 neonates in each group. The control group received traditional catheterization, while the observation group was treated with ultrasound-guided catheterization. The differences in inserting times, indwelling time, one-time insertion success rate, one-time catheterization success rate, and indwelling time between the two groups were compared. Results The average inserting times and catheterization time of the observation group were less than those of the control group. The success rate of one-time puncture and one-time catheterization in the observation group were higher than those in the control group. The indwelling time in the observation group was longer than that in the control group, and the differences were statistically significant （P < 0.05）. The incidence of peripheral tissue injury and percutaneous oxygen saturation decline during puncture in the observation group were lower than those in the control group. The total incidences of postoperative complications in the observation group were lower than that in the control group, the difference was statistically significant （P < 0.05）. Conclusion During PICC for neonates with difficult access, ultrasound guidance can effectively reduce the number of puncture and catheterization time, improve the success rate of one-time puncture and one-time catheterization, and increase the indwelling time, which is of clinical application value.
2023, 44(4): 123-127.
doi: 10.12259/j.issn.2095-610X.S20230428
Abstract:
Objective To investigate the efficacy of rituximab combined with methylprednisolone in the treatment of autoimmune encephalitis （AE） and its effect on programmed death factor-1 （PD-1） and programmed death factor ligand 1 （PD-L1） in peripheral blood. Methods A total of 60 patients with AE admitted to Kunming Children's hospital from February 2019 to July 2022 were selected as research subjects, and were divided into observation group （n = 30） and control group （n = 30） according to random number table. The control group was treated with methylprednisolone, and the observation group was treated with rituximab combined with methylprednisolone. Both groups were evaluated after 4 weeks of treatment. The curative effect, T lymphocyte subsets, peripheral blood PD-1, PD-L1 levels and immunoglobulin levels were compared between the two groups. Results The total effective rate of the observation group （90.00%） was higher than that of the control group （66.67%）, P < 0.05. After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group, and the level of CD8+ was lower than that in the control group （P < 0.05）. PD-1 and PD-L1 in peripheral blood were higher than those in control group （P < 0.05）, and the levels of IgA, IgG and IgM in the control group were obviously lower than those in the control group （P < 0.05）. Conclusion Rituximab combined with methylprednisolone has a definite therapeutic effect on AE; it can improve the immune function of the body and increase PD-1 and PD-L1 levels. Our findings can be used as a guide for clinical application.
2023, 44(4): 128-132.
doi: 10.12259/j.issn.2095-610X.S20230425
Abstract:
Objective To study the value of heart murmur auscultation （MUR） combined with pulse oximetry （POX） in the screening of congenital heart disease （CHD） at different time periods after birth in Anning area. Methods A total of 1833 newborns born in the obstetrics department and referred to the Department of Neonatology of Anning First People’s Hospital from June 2021 to November 2022 were selected as the study subjects. According to the age, the subjects were divided into 24-72 hours group （575 cases） and 2-4 weeks group （1258 cases）. The double-index method of heart murmur auscultation （MUR） combined with pulse oxygen saturation （POX） was used to screen CHD. The value of heart murmur auscultation combined with pulse oxygen saturation in screening CHD at different time points after birth was recorded. Results Among the 1833 neonates, 68 were diagnosed with CHD by echocardiography, with an incidence rate of 3.71%.The top three types of CHD were ventricular septal defect （23 cases, 33.82%）, atrial septal defect （22 cases, 32.35%）, and patent foramen ovale （16 cases, 23.53%）. The positive rate of heart murmur auscultation combined with pulse oxygen saturation detection in 24-72 hours group was 12.00%, and the missed diagnosis rate was 39.13%. The screening positive rate of 2-4 weeks group was 5.88%, and the missed diagnosis rate was 28.89%, Screening positive rate χ2 = 2.474, missed diagnosis rate χ2 = 3.441, P < 0.05. In 24-72 hours group, the sensitivity of heart murmur auscultation combined with pulse oxygen saturation detection was 60.87%, and the specificity was 90.04%, the accuracy was 88.87%, the false positive rate was 79.71%, the false negative rate was 1.78%, the positive predictive value was 20.29%, the negative predictive value was 98.22%, and the Youden index was 0.5089. The screening sensitivity, specificity, accuracy, false positive rate, false negative rate, positive predictive value, negative predictive value and Youden index of 2-4 weeks group were 71.11%, 96.54%, 95.63%, 56.76%, 1.10%, 43.24%, 98.90% and 0.6764, respectively;sensitivity χ2 = 8.325, specificity χ2 = 7.051, P < 0.05. Conclusion For CHD screening of newborns after birth, heart murmur auscultation （MUR） combined with pulse oxygen saturation （POX） has the highest accuracy and low rate of missed diagnosis at 2-4 weeks of screening time, which can improve the birth quality of newborns and play an important role in promoting neonatal eugenic and eugenic care in Anning area.
Analysis of Serum G-17 and PG Levels in Ethnic Minority Patients with Gastric Cancer in Lijiang Area
2023, 44(4): 133-138.
doi: 10.12259/j.issn.2095-610X.S20230429
Abstract:
Objective This study aims to analyze the level of G-17 and PG in ethnic minority gastric cancer patients in Lijiang, and to investigate their value in gastric cancer screening. Methods Selected from July 2020 to August 2022, Lijiang people’s hospital of gastroscopy patients with gastric cancer and gastritis, the biopsy confirmed gastric cancer in 52 cases of minority patients as an observation group, further gastric cancer group for early gastric cancer group and advanced gastric cancer group, while the same gastroscopy diagnosis of chronic gastritis （atrophic gastritis, atrophic gastritis） in 105 cases of ethnic minority patients as a control group. Serum G-17, PGI, PGII, and PGR levels were collected for correlation analysis. Results The serum G-17 level in gastric cancer group and atrophic gastritis group was significantly higher than that in non-atrophic gastritis group （P < 0.05）. The serum PGⅡ level in gastric cancer group was significantly higher than that in atrophic gastritis group （P < 0.05）. The PGI level in early gastric cancer group was lower than that in advanced gastric cancer group, and the difference was statistically significant （P < 0.05）. The AUC values of serum G-17, PGI, PGII and PGR combined tests were higher than those of single test （P < 0.0001）. Conclusion Serum G-17 and PG can be used for the identification and screening of ethnic minority gastric cancer patients in Lijiang, as well as as non-invasive indicators of early and advanced gastric cancer.
2023, 44(4): 139-147.
doi: 10.12259/j.issn.2095-610X.S20230420
Abstract:
Objective To explore the correlation between 15 candidate gene single nucleotide polymorphisms with emotion problems in ADHD children. Methods A total of 139 children with ADHD who met the DSM-V diagnostic criteria were selected from Kunming Children’s Hospital from July 2022 to September 2022. Their caregivers were asked to fill in the Vanderbilt scale, Conners scale and CBCL scale, and the teachers were asked to fill in the Vanderbilt scale for the assessment of children’s emotional problems. The peripheral blood was tested for single nucleotide polymorphisms of 15 candidate gene loci （NET1-rs3785143, DBH-rs1611115, COMT-rs4680, MAOA-rs3788862, 5-HTTLPR-rs25531, OXTR-rs4686302, ACTR3B-rs4629772, LMOD2-rs7809453, FOXN3-79162905, LRRTM4-rs146855089, CUX1-rs10808119, NRL-rs61227778, PBX4-rs56159542, CALD1-rs79846815, ARHGEF12-rs77216358）, then analyzed the result. Results In ADHD children associated with emotion problems, The SNP of LRRTM4-rs146855089 and MAOA-rs3788862 showed significant difference in the component ratio of emotion subscale of VADTRS （P < 0.01）. The SNP of OXTR-rs4686302 in PSQ psychosomatic problem factor had statistical difference （P < 0.05）. The results indicated that GG genotype of LRRTM4-rs146855089 , G genotype of MAOA-rs3788862 and TT/CT genotype of OXTR-rs4686302 accounted for a higher proportion in ADHD children with emotional problems. In male children, the composition ratio of DBH-rs1611115 CC genotypes in the dyssociability scale of CBCL scale had significant statistical difference （P < 0.01）, suggesting that the proportion of CC genotypes in positive cases was higher. Conclusion GG genotype of LRRTM4-rs146855089 and TT/CT genotype of OXTR-rs4686302 in all children, G genotype of MAOA-rs3788862 and CC genotype of DBH-rs1611115 in male children were associated with comorbidities of emotional problems in ADHD children .
2023, 44(4): 148-153.
doi: 10.12259/j.issn.2095-610X.S20230422
Abstract:
Objective The influencing factors of abnormal echocardiography in HIV/AIDS patients were analyzed retrospectively. Methods A total of 386 patients with HIV/AIDS who received echocardiography in the Third People's Hospital of Kunming City from December 1, 2020 to November 30, 2021 were selected, Chi-square test and Logistic regression were used for univariate and multivariate analysis. Results Among the 386 study subjects, 54.1% （209/386） of the patients were smoker, 45.3% （175/386） regularly consumed alcohol, and 20.7% （80/386） complicated hypertension, 21.5% （83/386） complicated diabetes, and 25.1% （97/386）complicated hyperlipidemia. The abnormal rate of echocardiography in HIV/AIDS patients was 40.2% （155/386）. Multifactorial logistic regression analysis showed that age > 44 years （OR = 3.579, 95%CI 2.200 to 5.823）, hypertension （OR = 1.847, 95%CI 1.075 to 3.175）, hyperlipidemia （OR = 1.868, 95%CI 1.120 to 3.115）, and ART medication （OR = 1.855, 95%CI 1.029 to 3.345） were factors influencing the presence of abnormal echocardiograms in patients with HIV/AIDS. Conclusion Age > 44 years, hypertension, hyperlipidemia, and ART medication were factors influencing the presence of abnormal echocardiograms in HIV/AIDS patients.
2023, 44(4): 154-158.
doi: 10.12259/j.issn.2095-610X.S20230421
Abstract:
Overactive bladder （OAB） is a common condition in women. Current guidelines recommend the use of urodynamics （UDS） only in complex cases, but recent studies have shown that UDS plays a key role in the diagnosis and treatment of idiopathic OAB in female patients . This article reviews the progress of urodynamic testing in the management of women with OAB.
2023, 44(4): 159-164.
doi: 10.12259/j.issn.2095-610X.S20230416
Abstract:
Hepatocellular carcinoma（HCC）, characterized by high malignancy and rapid development, is one of the most common malignant tumors in the world. In most cases the tumor is inoperable when diagnois is made. Therefore, non-surgical treatment plays an increasingly important role. Although the curative effect of hepatocellular carcinoma has made great progress in recent years with the development of drugs and the innovation of radiotherapy technology, the prognosis of patients with hepatocellular carcinoma is still not ideal due to its high recurrence rate and frequent resistance to treatment. The development of hepatocellular carcinoma is the result of abnormal accumulation of multiple genes and cellular events. The autophagy dysregulation can cause the occurrence of hepatocellular carcinoma. Autophagy is closely related to the occurrence and development, metastasis and recurrence, and resistance to treatment of hepatocellular carcinoma. This paper aims to review the mechanisms of autophagy in hepatocellular carcinoma and provide reference for future anti-tumor studies on autophagy.
Hepatocellular carcinoma（HCC）, characterized by high malignancy and rapid development, is one of the most common malignant tumors in the world. In most cases the tumor is inoperable when diagnois is made. Therefore, non-surgical treatment plays an increasingly important role. Although the curative effect of hepatocellular carcinoma has made great progress in recent years with the development of drugs and the innovation of radiotherapy technology, the prognosis of patients with hepatocellular carcinoma is still not ideal due to its high recurrence rate and frequent resistance to treatment. The development of hepatocellular carcinoma is the result of abnormal accumulation of multiple genes and cellular events. The autophagy dysregulation can cause the occurrence of hepatocellular carcinoma. Autophagy is closely related to the occurrence and development, metastasis and recurrence, and resistance to treatment of hepatocellular carcinoma. This paper aims to review the mechanisms of autophagy in hepatocellular carcinoma and provide reference for future anti-tumor studies on autophagy.
2023, 44(4): 165-169.
doi: 10.12259/j.issn.2095-610X.S20230417
Abstract:
Objective To explore the application effect of OBE （outcome-based education） concept on the nursing clinical practice education. Methods A total of 206 nursing interns form the First affiliated hospital of Kunming Medical University were selected as the research subjects, the number of experimental group and control group were both 103, respectively. The control group received the traditional teaching, and the experimental group received the OBE education. At the end of the internship, the clinical communication ability, internship satisfaction, daily performance, theoretical test and operational test of the two groups were evaluated. SPSS21.0 was used for independent-samples T test. Results The experimental group was significantly higher than control group in the total scores of clinical communication ability and its five dimensions including establishing rapport, confirming patient problem, active listening, participating, and verifying feelings （P < 0.05）. Besides, the total scores of the nursing student internship satisfaction and its four dimensions, the score of theory test and daily performance of experimental group was significantly higher than control group （P < 0.05）. Conclusion The OBE concept applied in nursing clinical practice education can improve the students’ clinical communication ability, internship satisfaction, and the score of theory test. It can provide innovative ideas and reform approaches for the clinical practice teaching of nursing students.
2023, 44(4): 170-175.
doi: 10.12259/j.issn.2095-610X.S20230406
Abstract:
Objective To establish the diversified clinical education model in physiotherapy for pediatric patients and to examine the effect in improving skills of students. Methods The undergraduate students majoring in physiotherapy who were admitted to Kunming Medical University in year 2018 and 2019 were selected as the research subjects, and were divided into experimental group （year 2019 students, n = 52） and control group （year 2018 students, n = 63）. The experiment group received diversified clinical education model and the control group received the traditional clinical education model during the COVID-19. The learning effect was evaluated by questionnaire of students’ learning confidence and scores of clinical education and final examination. Results The results showed that the students’ confidence in professional knowledge and clinical reasoning and professional behavior were improved significantly （P < 0.05）, but the difference of practice skills was not significant （P > 0.05）. The examination scores of clinical education in experimental group were significant higher than that of control group. But there were no significant difference in the final exanimation score between two groups. Conclusion The diversified clinical placement training improved the effectiveness of clinical education. The students could benefit from the program in professional knowledge and clinical reasoning.
2023, 44(4): 176-180.
doi: 10.12259/j.issn.2095-610X.S20230414
Abstract:
Objective To analyze the effect of oral exercise intervention on feeding, growth and development in low birth weight infants. Methods A total of 86 of low birth weight infants from December 2020 to December 2022 admitted in the neonatal ward of a hospital in Yunnan Province were randomly divided into experimental group and control group, 43 cases in each group. The control group received routine care, while the experimental group received oral exercise intervention and routine care. The incidence of feeding intolerance, oral infection, total oral feeding time, time of return to birth weight, body weight growth rate, daily increase in milk and hospital stay of low birth weight infants between the two groups were compared. Results The incidence of feeding intolerance and oral infection rate of low birth weight infants in the experimental group were significantly lower than those in the control group （P < 0.05）. The time of complete oral feeding, the time to recover to birth weight and the hospital stay of low birth weight infants in the experimental group were significantly shorter than those in the control group （P < 0.05）. The body weight increasing speed and daily milk increasing amount in the experimental group were significantly higher than those in the control group （P < 0.05）. Conclusion Oral exercise intervention can effectively reduce feeding intolerance and complications of low birth weight infants, shorten the time of complete oral feeding, and promote the growth and development of low birth weight infants. It is recommended to be applied to the feeding management of low birth weight infants.
2023, 44(4): 181-186.
doi: 10.12259/j.issn.2095-610X.S20230418
Abstract:
Objective To establish a scientific, effective and feasible list of robot-assisted thoracoscopic surgery perioperative nursing procedures, and provide reference for robot-assisted thoracoscopic surgery perioperative nursing work through Delphi expert consultation method. Methods On the basis of previous studies, the initial list of perioperative nursing procedures suitable for robot-assisted thoracoscopic surgery was developed after literature review, in reference to clinical practice guidelines, consensus and clinical observation. A total of 15 experts in thoracic surgery, anesthesia surgery and nursing in Yunnan Province were selected for two rounds of Delphi expert consultation to determine the list of perioperative nursing procedures for robot-assisted thoracoscopic surgery. Results The positive coefficient of experts in the two rounds was 100%, Ca was 0.85, Cs was 0.82, and Cr was 0.83. After the second round of correspondence, the coordination coefficients of the primary index and the secondary index were 0.267. Conclusion According to expert opinions, the list of perioperative nursing procedures for robot-assisted thoracoscopic surgery was established to provide a basis for the training, teaching and clinical work of thoracic nurses.
