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RSS2023 Vol. 44, No. 8
2023, 44(8): 1-7.
doi: 10.12259/j.issn.2095-610X.S20230821
Abstract:
Objective To understand the distribution characteristics, transmission, and related influencing factors of Mycobacterium tuberculosis genotypes in Yunnan Province, and to provide policy basis for tuberculosis control. Methods Mycobacterium tuberculosis strains isolated from 32 drug-resistant monitoring counties districts in Yunnan Province from 2016 to 2019 were collected, and Spoligotyping and 15 MIRU-VNTR loci were used for genetic typing of Mycobacterium tuberculosis. Results A total of 846 Mycobacterium tuberculosis strains were collected, of which 539 strains were Beijing genotype （63.71%）, 307 strains were non-Beijing genotype, including 16 genotypes such as T1 （20.69%, 175/846）, T3 （4.49%, 38/846）, T2 （2.36%, 20/846）, and 42 strains （4.96%） were newly discovered or undefined strains. The clustering rate of 846 Mycobacterium tuberculosis strains was 25.89%, of which the clustering rate of Beijing genotype was 29.68%, and the clustering rate of non-Beijing genotype was 19.22%. There was a significant difference between the two （χ2 = 15.14, P < 0.001）. Beijing genotype and non-Beijing genotype Mycobacterium tuberculosis were not related to drug resistance. Logistic regression analysis showed that the clustering risk of Beijing genotype was 1.861 times that of non-Beijing genotype （P < 0.05, 95% CI 1.376-2.516）, and the risk of INH-sensitive strains was 1.869 times that of drug-resistant strains （P < 0.05, 95% CI 1.129-3.094）. Conclusion The Mycobacterium tuberculosis genotypes in Yunnan province are highly polymorphic, but the Beijing genotype is still the main epidemic strain. There is recent prevalence of tuberculosis in Yunnan Province, and Beijing genotype and INH sensitivity are influencing factors for recent transmission.
2023, 44(8): 8-13.
doi: 10.12259/j.issn.2095-610X.S20230809
Abstract:
Objective To study the genetic polymorphism of 19 STR loci in unrelated individuals of Achang and Deang ethnic groups in Yunnan Province, China, and to evaluate the forensic value of polymorphism data in ethnic groups. Methods 154 Achang and 405 Deang unrelated individuals were examined and amplified with Goldeneye™ 20A kit. ABI3130 capillary electrophoresis apparatus was used to isolate the amplified product fragments and genotype the alleles. Results A total of 184 alleles were detected in Achang population with allele frequencies ranging from 0.0032 to 0.5714 , and 212 alleles were detected in De’ang population with allele frequencies ranging from 0.0012 to 0.5568 , indicating poor polymorphism and identification ability of loci for TPOX, TH01, CSF1PO and D3S1358. The genotype distribution was consistent with the Hardy-Weinberg equilibrium, and both CDP and CPE showed good recognition. Conclusion The combined detection of 19 autosomal STR loci showed good genetic polymorphism and individual recognition ability in Achang and De’ang populations.
2023, 44(8): 14-26.
doi: 10.12259/j.issn.2095-610X.S20230808
Abstract:
Objective To screen and verify the potential prognostic markers of miRNA in cervical squamous cell carcinoma （CESC）, and to explore the molecular mechanism of CESC. Methods Using miRNA sequencing data of cervical squamous cell carcinoma tissues and adjacent tissues in the TCGA database, as well as patient clinical data, a risk model for predicting the prognosis of cervical squamous cell carcinoma patients was constructed using bioinformatics analysis. The model consists of four miRNAs （miR-505-5p, miR-142-3p, miR-532-5p, miR-218-1-3p）. The diagnostic performance of the model was evaluated. Reverse transcription-polymerase chain reaction （RT-PCR） was used to detect the expression levels of these four miRNAs in 21 pairs of cervical squamous cell carcinoma tissues and adjacent normal tissues. MiR-505-5p, which showed significant differential expression, was selected for further analysis to examine its relationship with various clinical pathological features of cervical squamous cell carcinoma patients. Transfection of miR-505-5p mimics into cervical squamous cell carcinoma cells was performed to investigate the impact of miR-505-5p on the cellular functions of cervical squamous cell carcinoma. Finally, potential target genes of miR-505-5p were predicted using bioinformatics methods and validated through RT-PCR and Western blot experiments. Results By analyzing the cervical squamous cell carcinoma （CESC） related data from the TCGA database, a prognostic risk model composed of 4 miRNAs （miR-505-5p, miR-142-3p, miR-532-5p, miR-218-1-3p） was constructed. The prognostic risk model effectively stratifies CESC patients into high-risk and low-risk groups for adverse prognosis. The expression of miR-505-5p in the collected 21 pairs of CESC tissues was lower than that in adjacent tissues （P < 0.05）, and its expression level was negatively correlated with the clinical stage and invasion degree of CESC patients. Overexpression of miR-505-5p inhibited the proliferation （P < 0.05） and migration of cervical squamous cell carcinoma SiHa cells, and promoted apoptosis （P < 0.05）. TBL1XR1 was identified as the best predicted target gene of miR-505-5p, and overexpression of miR-505-5p decreased the RNA and protein levels of TBL1XR1 （P < 0.05）. Conclusion miR-505-5p can be used as a potential prognostic marker in patients with CESC, and miR-505-5p may play a tumor suppressive role in CESC by targeting TBL1XR1.
2023, 44(8): 27-36.
doi: 10.12259/j.issn.2095-610X.S20230819
Abstract:
Objective To investigate the mechanisms of Astragalus membranaceus in the treatment of hypertensive ventricular remodeling （VR） based on the principles of network pharmacology and molecular docking. Method The effective components of Astragalus membranaceus, drug targets and disease targets of hypertensive ventricular remodeling were obtained from the online database. The mRNA data were downloaded to screen the key modules and genes related to hypertensive ventricular remodeling, and then the disease targets of hypertensive ventricular remodeling were predicted, followed by GO functional/KEGG pathway enrichment analysis. PPI network were constructed and visualized. LASSO and Random Forest were used to construct the diagnostic model of hypertensive ventricular remodeling. After analyzing the biomarkers, the pharmacological regulatory network of traditional Chinese medicine was drawn and visualized for biomarkers and active components. Finally, the component structures were obtained through the database for molecular docking. Results 87 active ingredients of Astragalus membranaceus, 390 drug targets, 3281 hypertensive ventricular remodeling disease targets and 2103 differentially expressed key module genes were obtained, and 24 key targets were obtained by taking the intersection. There were 288, 15 and 29 targets in terms of key target genes and biological processes, molecular functions and cell components, respectively. A total of 54 related signaling pathways were obtained, and the interaction network relationships of 21 proteins were obtained. Four biomarkers （MAPK1, IL2, CSNK2B, SELE） were obtained, and the molecular docking results showed the existence of binding hydrogen bonds between the proteins and small molecules of all four markers. Conclusion Screening to obtain markers of ventricular remodeling in hypertension by Astragalus membranaceus validated the effect of Astragalus membranaceus in the treatment of hypertensive ventricular remodeling and may become a molecular biomarker for the diagnosis and treatment of hypertensive ventricular remodeling.
2023, 44(8): 37-43.
doi: 10.12259/j.issn.2095-610X.S20230829
Abstract:
Objective To explore the effect and regulatory mechanism of Shen-ling-bai-zhu-san （SLBZS）, a traditional Chinese medicine, on methamphetamine （METH）-induced gut microbiota change in mice. Methods SPF C57BL/6J mice were divided into three groups: saline group, METH group, and SLBZS+METH group, the latter two groups of mice were intraperitoneal injected METH for three weeks and intragastric administration of SLBZS for one week after METH injection, the immunological and biochemical indexes of mice peripheral blood were examined, and intestinal fecal samples of mice were collected for 16S rRNA sequencing, and then subjected to bioinformatic analysis. Results Compared to METH group, the percentage and number of white blood cells and lymphocytes were significantly increased （ P < 0.05）, while the number of neutrophils decreased in SLBZS+METH group （P < 0.05）, which indicated that SLBZS can enhance immunity and reduce the inflammatory response of METH-treated mice. The data of 16S rRNA sequencing indicated that the number of Operational Taxonomic Unit （OTU） of gut microbiota decreased in the METH group, which was characterized by the presence of pathogenic bacteria including Proteus mirabilis, Bittarella_massiliensis, Acinetobacter calcoacetate, etc. SLBZS administration increased the OTU number of gut microbiota, functional abundance of metabolism related to carbohydrates, cofactors, vitamins, amino acids, cell activity, and environmental adaptation. Conclusion SLBZS improves the immune response and the composition and function of gut microbiota in METH-treated mice.
2023, 44(8): 44-52.
doi: 10.12259/j.issn.2095-610X.S20230805
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Objective To investigate the effect of miR-216b-5p on ferroptosis in glioblastoma cells by targeting NCOA3, with a view to providing new targets for the clinical treatment of glioblastoma. Methods U251 cells were divided into DMSO-treated group, Erastin-treated group, Erastin + mimic NC group, Erastin + miR-216b-5p mimic group, Erastin + pcDNA 3.1 group, Erastin + pcDNA-NCOA3 group, pcDNA + miR-216b-5p mimic+ pcDNA-NCOA3 group. The expression of miR-216b-5p and NCOA3 and the expression of ferroptosis -related proteins PTGS2, NOX1, ACSL4, GPX4, FTH1 were detected by real-time fluorescence quantitative PCR assay and Western blot, and cell proliferation and apoptosis were detected by CCK-8 and flow cytometry, and MDA, Fe2+, glutamine, glutamic acid and α-ketoglutarate by kit. Results miR-216b-5p was highly expressed in human glioblastoma cell lines LN229 and U251, and the viability of Erastin-stimulated U25 cells increased and the apoptosis rate decreased. After transfection with miR-216b-5p mimics, MDA, Fe2+, glutamine, glutamic acid and α-ketoglutarate were all decreased significantly, and the expression of ferroptosis-related proteins PTGS2, NOX1, and ACSL4 increased significantly upon Erastin stimulation, while the protein amount of GPX4 and FTH1 decreased significant. 9 genes associated with ferroptosis in glioblastoma and directly targeted to miR-261b-5p were obtained, namely FOXO4, NCOA3, PARP8, PARP11, LIG3, MAPK9, TLR4, RB1, PTEN, miR-216b-5p, which directly bind to and negatively regulate NCOA3. Transfection with NCOA3 decreased cell viability, MDA, Fe2+, glutamine, glutamic acid, α-ketoglutarate levels, the protein expression of PTGS2, NOX1 and ACSL4 increased and that of GPX4 and FTH1 decreased; however, transfection of miR-216b-5p mimic reversed these results. Conclusion This study found that miR-216b-5p directly targets NCOA3 and regulates ferroptosis in glioblastoma cells through NCOA3, thereby promoting apoptosis. This study suggests new therapeutic targets for glioblastoma as well as new possibilities for subsequent research, in order to provide new ideas for the treatment of glioblastoma.
2023, 44(8): 53-58.
doi: 10.12259/j.issn.2095-610X.S20230807
Abstract:
objective To investigate the effect of H2O2 on lumbar nucleus pulposus cells and the regulatory mechanism of miR-153-3p on lumbar degeneration. Methods CCK8 was used to detect cell viability in control group and H2O2 group, and flow cytometry was used to detect reactive oxygen species and mitochondrial membrane potential in the two groups, and qPCR was used to detect the expression levels of matrix metalloproteinase 3 （MMP3）, Nrf2, miR-153-3p and type II collagen （COL-Ⅱ） in the above two groups. Results Compared with the control group, the H2O2-treated lumbar nucleus pulposus cells showed reduced viability and mitochondrial membrane potential. The expression levels of miR-153-3p, COL-Ⅱ, MMP3 and Nrf2 in the control group and the H2O2 group were detected by qPCR, and the results showed that there was no significant difference in Nrf2 expression levels in the control group and the H2O2 group （P < 0.05）. The expression levels of miR-153-3p and MMP3 in the H2O2 group were lower than those in the control group, while the expression of COL-Ⅱ was lower than that in the control group and there was a statistical difference （P < 0.05）. Western blot showed that the expression of Nrf2 in the control group, inhibitor-NC group and the inhibitor group was significantly higher than that in the control group and inhibitor-NC group （P < 0.05）. The expression of Nrf2 in the cytoplasm and nucleus of inhibitor-NC group was not significantly different from that of control group （P > 0.05）. Conclusion Inhibition of miR-153-3p expression can up-regulate the expression level of Nrf2 in lumbar nucleus pulposus cells, suggesting that miR-153-3p's involvement in the process of LDD may be related to its regulation of Nrf2 expression and mitochondrial autophagy.
2023, 44(8): 59-70.
doi: 10.12259/j.issn.2095-610X.S20230823
Abstract:
Objective To explore the mechanism of miR-149-5p regulating the malignant biological behavior of glioma cells through MSH5/Wnt signaling pathway. Methods RT-qPCR was used to detected the expression of miR-149-5p in glioma tissues and cell lines A172, U251, HS683 and H4. CCK-8 was used to detected cell viability, and EDU staining was performed to measure cell proliferation, Transwell assay was used to detected cell migration and invasion, and flow cytometry examined cell cycle and apoptosis. The dual luciferase reporter gene experiment verified the targeting relationship between miR-149-5p and MSH5. The protein expressions of MSH5, GAPDH, GSK3β, β-catenin and AXIN2 were detected by Western blot. Results The expression of miR-149-5p was decreased in glioma tissues （P < 0.0001） and cell lines （P < 0.0001）. Overexpression of miR-149-5p significantly inhibited the proliferation （P < 0.01）, migration （P < 0.05）, invasion （P < 0.01）, and cell cycle （P < 0.01） of A172 cells, and induced cell apoptosis （P < 0.01）. However, knocking down miR-149-5p had the opposite effect. Dual luciferase assay verified that miR-149-5p targeted MSH5. Knockdown of miR-149-5p reversed the effect of knocking down MSH5 on the malignant biological behavior of A172 cells. Overexpression of MSH5 promoted the proliferation, migration and invasion of A172 cells, cell cycle, and inhibited apoptosis by inhibiting GSK3β and activating β-catenin/AXIN2 pathway. Conclusions miR-149-5p inhibited the AXIN2 expression and activated the β-catenin/AXIN2 pathway by targeting up-regulation of MSH5, thereby inhibited the malignant biological behavior of stromal tumor cells.
2023, 44(8): 71-76.
doi: 10.12259/j.issn.2095-610X.S20230820
Abstract:
Objective To investigate the current situation of CPR knowledge, attitude and practice of college students, analyze the influencing factors, and provide suggestions for CPR health education in colleges and universities. Methods Based on the questionnaire on the current situation of airport staff’s knowledge, attitudes, and practices in emergency first aid designed by Zhang Xinxin et al, a CPR questionnaire for college students was designed. A total of 1476 college students from various universities in Yunnan Province were randomly selected for the survey. Single-factor analysis and multiple stepwise regression analysis were used to identify influencing factors. Results The score of CPR knowledge was （4.64±2.43）, the score of CPR attitude was （13.99±3.23）, and the score of CPR behavior was （10.80±6.24）. Multiple stepwise regression analysis showed that major was the common factors affecting students’ CPR knowledge, attitude and practice.Gender and education influence knowledge and attitude scores, grade influence knowledge and practice scores, and nationality only influence behavior scores, with statistical significance （P < 0.05）. Conclusion College students have a positive attitude towards learning and implementing CPR, but their knowledge and mastery of CPR are not ideal. Colleges and universities need to pay attention to the differences brought by major, gender, grade, educational background and nationality. The key to improve college students’ CPR first aid literacy is to make training plans for different groups, provide professional education resources and strengthen the education of non-medical students.
2023, 44(8): 77-84.
doi: 10.12259/j.issn.2095-610X.S20230822
Abstract:
Objective To investigate the status quo of drug therapy and the factors affecting the standardized drug therapy in patients with heart failure with chronic ejection fraction reduction （HFrEF） in Yunnan province. Methods This is a single-center, prospective, and observational study. A total of 110 patients who were hospitalized in the Department of Cardiology in the First Affiliated Hospital of Kunming Medical University during July 2019 to September 2020 were enrolled.The utilization rate and dose of ACEI/ARB/ARNI, β-blocker and MRA were collected during hospitalization, 3 and 6 months after discharge. According to the drug dose at discharge, patients were divided into 100% target dose group, 50% ～ 99% target dose group and < 50% target dose group, and the factors affecting the standardized drug treatment were analyzed. Results The average age of 110 HFrEF patients was （57.9±14.1） years old, among which 65 （58.6%） were males. The utilization rates of ACEI/ARB/ARNI, β-blocker and MRA at discharge （73.6% , 82.1% , 89.6% , respectively） were higher than that at 3 months （69.8% , 79.2% , 84.4% , respectively） and 6 months （69.0% , 78.6% , 78.6% , respectively） after discharge. Both of 100% target dose of ACEI/ARB/ARNI and β-blocker were lower at the time of discharge, 3 and 6 months after discharge, among which the 100% target dose rate of β-blocker was the lowest. ACEI/ARB/ARNI and β-blocker usage at 100% target dose was lower at discharge, 3 months after discharge, and 6 months after discharge, with rates of 12.8% and 1.1%, 14.9% and 0%, and 15.5% and 1.5% respectively. Among them, the rate of reaching the target dose was the lowest for β-blockers. When comparing the three groups of 100% target dose, 50-99% target dose, and < 50% target dose, patients in the ACEI/ARB/ARNI 50-99% target dose group had higher body mass index （25.5±3.4 vs. 23.2±4.1, P = 0.038） and systolic blood pressure （131.1±21.6 vs 109.7±14.9, P < 0.001） than those in the < 50% target dose group. There were no significant differences in NYHA functional classification, BNP, and serum creatinine among the three groups （P > 0.05）. The age of patients in the β-blocker 50-99% target dose group was significantly lower than that in the < 50% target dose group （46.9±10.0 vs. 64.4±13.2, P = 0.005）, and there were no significant differences in NYHA functional classification, heart rate, and systolic blood pressure among the three groups （P > 0.05）. During hospitalization, the main reasons for the underuse or suboptimal dose of heart failure medications were lack of prescription by doctors, drug intolerance, and contraindications. After discharge, apart from contraindications, the main reasons for non-compliance with medication guidelines were patient self-discontinuation and lack of prescription by doctors. Conclusions In HFrEF patients in some areas of Yunnan Province, the utilization rate and dosage of ACEI/ARB/ARNI and β-blockers were low. With the extension of discharge time, the utilization rate of drugs continued to decline, and the dosage did not increase significantly. Drug contraindications or intolerances in patients, self-withdrawal after discharge and non-prescription by doctors are the important reasons for non-standardized drug use.
2023, 44(8): 85-90.
doi: 10.12259/j.issn.2095-610X.S20230804
Abstract:
Objective To investigate the effect of estrogen application duration on pregnancy outcomes in women of childbearing age during hormone replacement therapy frozen-thawed embryo transfer （HRT-FET）. Methods A case-control study was conducted to retrospectively analyze the clinical data of 1, 348 patients who underwent HRT-FET at the Reproductive Medicine Department of the Second Affiliated Hospital of Kunming Medical University from January 2017 to December 2020. The patients were divided into four groups based on the number of days of estrogen application before endometrial transformation: Group A （≤12 days）, Group B （13-16 days）, Group C （17-20 days）, and Group D （> 20 days）. The general clinical characteristics and pregnancy outcomes of the four groups of patients were compared. Statistical analysis included one-way analysis of variance for continuous variables and chi-square test for categorical variables. Results The endometrial thickness and estradiol （E2） levels on the day of endometrial transformation were compared among four groups of patients. Group A had the highest endometrial thickness, while the other groups showed a decreasing trend. Group A had the lowest E2 level, while the other groups showed an increasing trend. The differences were statistically significant （P < 0.05）. General clinical characteristics, including infertility duration, age at oocyte retrieval, anti-Mullerian hormone （AMH） levels, body mass index （BMI）, and progesterone （P） levels on the day of endometrial transformation, showed no significant differences among the four groups （P > 0.05）. Comparison of pregnancy outcomes among the four groups of patients, including HCG positive rate, clinical pregnancy rate, ectopic pregnancy rate, early miscarriage rate, live birth rate, singleton preterm birth rate, and singleton low birth weight rate, showed no statistically significant differences （P > 0.05）. Conclusion For patients with HRT-FET cycles, extending the duration of estrogen application may improve the endometrial thickness of patients with inadequate endometrial growth. Although there are still differences in endometrial thickness compared to normal patients, similar pregnancy outcomes as normal endometrial patients can be achieved.
2023, 44(8): 91-94.
doi: 10.12259/j.issn.2095-610X.S20230814
Abstract:
Objective To evaluate the efficacy of neuroendoscopic surgery in the treatment of intraventricular hemorrhage. Methods The clinical data of 60 cases of intraventricular hemorrhage were analyzed, including 30 cases of endoscopic intracranial hematoma removal combined with intracranial pressure monitoring external drainage operation group （endoscope + drainage group） and 30 cases of intracranial pressure monitoring external drainage operation group （drainage group）. The hematoma clearance rate, operation time, intraoperative blood loss, retention time of drainage tube, hospitalization days and GCS score 1 week after operation were compared between the two groups. Results There was no significant difference in preoperative clinical data between the two groups （P > 0.05）. The hematoma clearance rate was （98.4±1.1） % in the endoscopic + drainage group and （50.1±5.4） % in the drainage group （P < 0.05）. The operation time was （51.1±6.5） min in the endoscopic plus drainage group and （39.7±8.4） min in the drainage group （P < 0.05）. The intraoperative blood loss was （35.1±5.5） mL in the endoscopic plus drainage group and （31.1±4.4） mL in the drainage group （P > 0.05）. The indwelling time of drainage tube was （2.5±1.3） days in the endoscopic plus drainage group and （7.1±2.3） days in the drainage group （P < 0.01）. The length of hospital stay was （7.5±2.1） days in the endoscopic plus drainage group and （14.2±1.3） days in the drainage group （P < 0.01）. The 1-week postoperative GCS score was 12.1±1.5 in the endoscope-plus-drainage group and 9.2±1.4 in the drainage group （P < 0.01）. Conclusion Neuroendoscopic surgery can effectively remove intraventricular hemorrhage and significantly improve the prognosis of patients.
2023, 44(8): 95-99.
doi: 10.12259/j.issn.2095-610X.S20230816
Abstract:
Objective To explore inferior vena cava respiratory variation assessing volume responsiveness in patients with septic shock. Methods A total of 60 patients with septic shock in the Emergency Department of the First Affiliated hospital of a medical university from August 2018 to May 2019 were selected. According to the different guidance methods of fluid resuscitation, they were divided into the Variance of Inferior Vena Cava （VIVC） guided fluid resuscitation group A and Central Venous Pressure （CVP） guided fluid resuscitation in group B. Stroke volume （SV） was evaluated by ultrasound before and 30min, 1h, 3h and 6h after fluid infusion. Lactate （Lac）, brain natriuretic peptide （BNP）, base excess （BE） and heart rate （HR） , respiratory rate （RR）, central venous oxygen saturation （SCVO2）, mean arterial pressure （ MAP） and urine volume were recorded at the above time points in both groups and were compared. Results MAP, SCVO2, and urine volume increased, while RR decreased in the same group at different time points with the progress of fluid infusion （P < 0.05）. However, there was no significant difference in MAP, RR, SCVO2 and urine volume between the two groups （P > 0.05）. After stopping resuscitation, BNP increased and HR decreased in the two groups, and BNP and HR in group B were higher than those in group A （P < 0.05）. Lac decreased and BE increased in the two groups, but there was no significant difference between the two groups （P > 0.05）. Conclusion Compared with CVP, IVC variability is equally valuable in evaluating fluid responsiveness in patients with septic shock, and it is safer because it causes less BNP elevation and avoids fluid overload.
Prenatal Ultrasound Observation of Persistent Left Superior Vena Cava with Intracardiac Malformation
2023, 44(8): 100-104.
doi: 10.12259/j.issn.2095-610X.S20230827
Abstract:
Objective To investigate the type and pregnancy evolution of persistent fetal left superior vena cava（PLSVC） complicated with intracardiac malformations. Methods The data of 90 fetal cases with persistent left superior vena cava were collected via imaging and patients’ case system of the Affiliated Hospital of Yunnan University. The types of congenital and external malformations and pregnancy outcomes of the fetus were retrospectively analyzed. Result PLSVC was diagnosed in 76（84.4%） fetuses at 22-24 weeks of systemic ultrasonography, and 14（15.6%） fetuses were found in late pregnancy. Among the 90 fetuses, 26（28.9%） had combined intracardiac anomalies, 21（23.3%） had combined extracardiac anomalies, and 50（55.5%） had uncomplicated anomalies. The most common intracardiac anomaly was aortic arch narrowing or arch dysplasia（34.6%）, followed by ventricular septal defect（26.9%）, and the most common extracardiac anomaly was single umbilical artery. Conclusion The persistent left superior vena cava is closely related to congenital heart disease. For fetuses with PLSVC, observation of cardiac function should be strengthened during pregnancy. In prenatal ultrasound screening, the section of innominate vein should be added to the section of four cavities and three vessels to improve the detection rate of PLSVC.
2023, 44(8): 105-109.
doi: 10.12259/j.issn.2095-610X.S20230802
Abstract:
Objective To observe the clinical efficacy of using acupuncture combined with swallowing therapy device guided by the “central-peripheral-central” closed-loop rehabilitation theory in the treatment of post-stroke dysphagia. Methods 60 patients with post-stroke dysphagia were randomly divided into treatment group （n = 30） and control group （n = 30）. Both groups received secondary prevention of cerebrovascular disease and swallowing rehabilitation training. In addition, the control group received treatment with a swallowing therapy device, while the treatment group received treatment with acupuncture combined with the swallowing therapy device. Each treatment session lasted for 20 minutes, once a day, 5 times per week, for a total of 3 weeks. The patients were evaluated using the Standard Swallowing Assessment （SSA） and the Swallowing Quality of Life Questionnaire （SWAL-QOL） before and after the treatment. the cases in both groups whose gastric tubes were removed were calculated. Results After treatment, SAA score in 2 groups significantly decreased （P < 0.01）, and SWAL-QOL scores significantly increased （P < 0.05）. After treatment, the SSA score of the treatment group was significantly lower than that of the control group （P < 0.05）, and the SWAL-QOL score was significantly higher than that of the control group （P < 0.01）. There were more patients whose gastric tubes were removed in treatment group than that of control group （P < 0.05）. Conclusion Under the guidance of “central-peripheral-central” closed-loop rehabilitation theory, head acupuncture combined with swallowing apparatus can improve the swallowing function and quality of life of stroke patients.
2023, 44(8): 110-116.
doi: 10.12259/j.issn.2095-610X.S20230817
Abstract:
Objective To retrospectively analyze the risk factors of deep vein thrombosis （DVT） in patients with soft tissue trauma of the lower extremities, and to provide reference for the prevention and treatment of DVT. Methods The general clinical data, trauma status, laboratory tests data, imaging data, clinical management information, complications, and other factors of patients with lower limb soft tissue trauma admitted to a single center from January 2020 to December 2021 were collected and statistically analyzed. The risk factors of lower limb soft tissue trauma complicated with DVT were analyzed. Results The incidence of deep vein thrombosis （DVT） in 363 patients with lower limb soft tissue trauma was 8.8%. DVT involved the iliac vein in 1 case, the femoral vein in 1 case, the popliteal vein in 3 cases, the posterior tibial vein in 3 cases, the peroneal vein in 3 cases, and the muscular veins in 31 cases. There were significant differences between the DVT group and the non-DVT group in terms of age, gender, smoking, alcohol consumption, heart disease, type and severity of trauma, hemoglobin, fibrin degradation products （FDP）, D-dimer, waiting time for admission, lack of prophylactic anticoagulation, post-traumatic local infection, and soft tissue defects （P < 0.05）. Multivariate logistic regression analysis showed that age, smoking, post-traumatic local infection, waiting time for admission, lack of prophylactic anticoagulation, severity of trauma, and elevated D-dimer （ > 0.5 μg/mL） were independent risk factors for DVT after lower limb soft tissue trauma （P < 0.05）. Conclusion DVT following soft tissue trauma of the lower limb mainly involves the intermuscular veins. Age, smoking history, local infection after trauma, waiting time for admission, unprotected anticoagulation, severity of trauma, and elevated D-dimer （ > 0.5 μg/mL） is closely related to the occurrence of DVT.
2023, 44(8): 117-122.
doi: 10.12259/j.issn.2095-610X.S20230806
Abstract:
Objective To investigate the effect of cognitive behavioural therapy for insomnia （CBT-I） intervention on sleep quality and mood in Parkinson’s disease patients with insomnia. Methods Parkinson’s disease patients with insomnia who were hospitalized in a tertiary hospital in Hebei from January 2021 to March 2022 were selected as the study subjects. A random number table method was used for randomization. The control group was given conventional care, while the experimental group was given cognitive behavioural therapy of CBT-I insomnia for 8 weeks on top of this. All patients were routinely given anti-Parkinson’s disease medication. The Pittsburgh Sleep Quality Index （PSQI） scale, Insomnia Severity Index （ISI） scale, sleep log, Hamilton Depression Inventory （HAMD17） and Hamilton Anxiety Inventory （HAMA14） were used for outcome assessment before and after the intervention. Results The differences in PSQI scale, ISI scale, sleep latency （SOL）, total sleep time （TST）, HAMD17 and HAMA14 scores between the test group and the control group after the intervention were statistically significant （P < 0.05）, while the differences in sleep efficiency （SE） between the two groups were not statistically significant （ P > 0.05）. Conclusion Cognitive behavioural therapy for insomnia is effective in improving sleep quality and improving anxiety and depression in patients with Parkinson’s disease with insomnia.
2023, 44(8): 123-127.
doi: 10.12259/j.issn.2095-610X.S20230815
Abstract:
Objective To evaluate the incidence of nutritional risk in hospitalized elderly patients with chronic obstructive pulmonary disease complicated with dysphagia with the Nutritional Risk Screening 2002 scale, and to explore the clinical application value of NRS 2002. Methods A total of 124 elderly patients with COPD complicated with swallowing disorder admitted to the Department of General Medicine of the Third People’s Hospital of Yunnan Province from November 2021 to October 2022 were selected. The patients were divided into NRS≥3 group （n = 69 cases） and NRS < 3 group （n = 55 cases）. The general data and nutrition-related biochemical indexes （total protein, albumin, and prealbumin） of the two groups were compared, and a correlation analysis was performed. Results The incidence of nutritional risk in elderly COPD patients with dysphagia was 55.6%. Among the patients with nutritional risk, 84.0% were over 80 years old （P < 0.05）. The levels of total protein, albumin, prealbumin and BMI of nutritional risk score ≥3 group were lower than those of group with < 3 （P < 0.05）. Spearman correlation analysis showed that the nutritional risk score was positively correlated with age, length of stay, and hospitalization cost （P < 0.05）, and negatively correlated with the levels of nutrition-related indicators （total protein, albumin, prealbumin and BMI） （P < 0.05）. The results of one-way ANOVA showed that there were statistically significant differences （P < 0.05） in the mean values of NRS 2002 score, total protein, albumin, and BMI among patients with different levels of swallowing disorders. However, there was no statistically significant difference （P > 0.05） in the levels of pre-albumin among the groups. Conclusion Elderly COPD patients with swallowing disorders have a high incidence of nutritional risk （55.6%）. NRS 2002 can be used as an early nutritional risk screening tool for elderly COPD patients with swallowing disorders. Early identification of nutritional risk in patients and taking proactive intervention measures can prevent the occurrence of swallowing disorders in elderly COPD patients.
2023, 44(8): 128-132.
doi: 10.12259/j.issn.2095-610X.S20230825
Abstract:
Objective To explore the application effect of whole-process management combined with injury control based on rapid rehabilitation in multiple injuries. Methods 43 patients with multiple injuries treated with the traditional specialized treatment mode at the Affiliated Honghe Hospital of Kunming Medical University from January 2019 to December 2020 were selected as the control group. 43 patients with multiple injuries treated with the whole-process management and injury control surgery mode based on rapid rehabilitation at the Affiliated Honghe Hospital of Kunming Medical University from January 2021 to December 2022 were selected as the observation group. The rescue response time, on-site treatment time, warning time, ICU admission time, fluid volume, blood transfusion volume, length of hospital stay, hospitalization costs, treatment success rate, and occurrence of adverse reactions were compared between the two groups. Results The observation group had significantly shorter rescue response time, on-site treatment time, warning time, ICU admission time, and hospital stay compared to the control group （P < 0.05）. The observation group had significantly less fluid and blood transfusion volume than the control group （P < 0.05）, but had significantly higher hospitalization costs than the control group （P < 0.05）. The observation group had a significantly higher treatment success rate （95.35% vs 81.40%） compared to the control group （P < 0.05）. There was no statistically significant difference in the incidence of thrombosis （9.30% vs 13.95%）, disseminated intravascular coagulation （0.00% vs 4.65%）, pulmonary infection （4.65% vs 9.30%）, and pulmonary atelectasis （0.00% vs 4.65%） between the observation group and the control group （P > 0.05）. The incidence of complications in the observation group （13.95% vs 32.56%） was significantly lower than that in the control group （P < 0.05）. Conclusion The application of whole-process management based on rapid rehabilitation combined with injury control in multiple injuries can effectively improve the rescue efficiency and the success rate of treatment, reduce adverse reactions and accelerate the recovery of patients.
2023, 44(8): 133-138.
doi: 10.12259/j.issn.2095-610X.S20230801
Abstract:
Objective To compare the clinical efficacy of using erythritol air-polishing and silica particle polishing for treating extrinsic black tooth stain （EBS） in children. Methods 48 children aged 3-12 years who met the inclusion criteria were selected. The Lobene stain index was used to record the pigment level, and a self-half-mouth control was used to randomly divide the left and right sides into the experimental group or control group. The experimental group was treated with erythritol air-polishing, and the control group was treated with silica particle air-abrasion to remove EBS on the labial and buccal surfaces of the teeth. The operation time, treatment experience score, and safety were recorded, and the cleaning efficiency （S/s） was calculated using the “pigment score divided by operation time” formula. The pigment reattachment level was followed up at 3 and 6 months after treatment using SPSS 23.0 software for analysis. Results There was no significant difference in pigment scores between the left and right sides before treatment, but the pigment score on the lingual and palatal surfaces was higher than that on the labial and buccal surfaces, and there was a statistically significant difference in pigment scores among different areas of the teeth. The efficiency of the experimental group was higher than that of the control group [（0.06±0.05） S/s vs （0.04±0.02） S/s, P < 0.001]. 8 （16.7%） of the study subjects felt nervous during air-polishing treatment, and 7 （14.6%） had gum bleeding during the process. There was no difference in pigment levels between the experimental and control groups before treatment, at 3 months, or at 6 months after treatment. Conclusion Although erythritol air-polishing may cause more gum bleeding and nervousness in children, its pigment removal efficiency is higher and it is worth promoting clinically.
2023, 44(8): 139-144.
doi: 10.12259/j.issn.2095-610X.S20230812
Abstract:
With cancer becoming increasingly prevalent and affecting younger populations, there is growing concern about its development and progression. It is worth noting that the global population of obese individuals is also on the rise, and numerous studies have found that obesity increases the risk of developing cancer. Abnormal lipid metabolism is one of the prominent metabolic changes in cancer development. Therefore, it is crucial to pay attention to the role of lipid metabolism in cancer. In recent years, as researchers have delved deeper into the study of lipid metabolism, the perilipin family of lipid droplet surface proteins has been discovered. These proteins not only serve as structural proteins for lipid droplets, but they are also closely associated with cancer cell proliferation, invasion, and metastasis. Therefore, the perilipin family may represent a potential and promising target for cancer treatment. This review primarily focuses on the latest findings regarding the roles and mechanisms of the perilipin family members in cancer. These studies will deepen our understanding of the functions of the perilipin family in the progression of cancer and provide new insights for better cancer prevention and control.
With cancer becoming increasingly prevalent and affecting younger populations, there is growing concern about its development and progression. It is worth noting that the global population of obese individuals is also on the rise, and numerous studies have found that obesity increases the risk of developing cancer. Abnormal lipid metabolism is one of the prominent metabolic changes in cancer development. Therefore, it is crucial to pay attention to the role of lipid metabolism in cancer. In recent years, as researchers have delved deeper into the study of lipid metabolism, the perilipin family of lipid droplet surface proteins has been discovered. These proteins not only serve as structural proteins for lipid droplets, but they are also closely associated with cancer cell proliferation, invasion, and metastasis. Therefore, the perilipin family may represent a potential and promising target for cancer treatment. This review primarily focuses on the latest findings regarding the roles and mechanisms of the perilipin family members in cancer. These studies will deepen our understanding of the functions of the perilipin family in the progression of cancer and provide new insights for better cancer prevention and control.
2023, 44(8): 145-150.
doi: 10.12259/j.issn.2095-610X.S20230811
Abstract:
Schizophrenia is a mental disorder characterized by significant abnormalities in cognition, thinking, emotion, and behavior. It is one of the most common severe mental disorders and causes serious distress to individuals, families, and society. In recent years, epigenetic studies focusing on DNA methylation have been conducted to understand schizophrenia. This review summarizes the research progress on DNA methylation and schizophrenia in recent years, aiming to provide new insights and reference value for further research on schizophrenia.
Schizophrenia is a mental disorder characterized by significant abnormalities in cognition, thinking, emotion, and behavior. It is one of the most common severe mental disorders and causes serious distress to individuals, families, and society. In recent years, epigenetic studies focusing on DNA methylation have been conducted to understand schizophrenia. This review summarizes the research progress on DNA methylation and schizophrenia in recent years, aiming to provide new insights and reference value for further research on schizophrenia.
2023, 44(8): 151-155.
doi: 10.12259/j.issn.2095-610X.S20230803
Abstract:
Objective To construct a multi-dimensional evaluation system for teachers’ clinical teaching ability and explore its effectiveness in improving teachers’ clinical teaching ability. Methods From October 2019 to September 2022, 100 teachers for undergraduate interns of clinical medicine in our hospital were selected as the research subjects, and their teaching ability was evaluated by the multi-dimensional evaluation system of target-oriented clinical teaching ability. The peer evaluation scores of the teachers before and after the application of the evaluation system were compared. The undergraduate students of clinical medicine were selected as the teaching effect evaluers, among which 50 students before the application of the evaluation system were selected as the control group, and 50 students after the application of the evaluation system were selected as the experimental group. The internship assessment results （theoretical knowledge, operation level, clinical thinking ability, critical thinking ability, team cooperation ability） and satisfaction were compared between the two groups. Results After adopting the multi-dimensional evaluation system of target-oriented clinical teaching ability, teachers’ peer evaluation scores, students’ practice assessment scores and satisfaction scores were significantly improved （P < 0.05）. Conclusion The multi-dimensional evaluation system of teachers’ clinical teaching ability oriented by training goals is helpful to enhance teachers’ teaching ability and improve the quality of clinical teaching, and is worthy of further promotion and application.
2023, 44(8): 156-161.
doi: 10.12259/j.issn.2095-610X.S20230826
Abstract:
Objective This study aims to investigate the differences in satisfaction with online and offline teaching services among international medical students in China and to explore the influencing factors. The ultimate goal is to contribute to the high-quality development of education for international students in China’s universities and enhance the international influence of medical education in these universities. Methods Data were collected from MBBS students before the COVID-19 pandemic in 2019 （representing offline teaching） and during the pandemic in 2021 （representing online teaching）. Latent class analysis was employed to identify the 14 satisfaction items. Multi-group latent class analysis was conducted to compare the latent class patterns and influencing factors of satisfaction between online and offline teaching. Results The data from 174 and 112 international students in online and offline teaching, respectively, were classified into three latent class models （high, medium, and low satisfaction groups）. Multi-group latent class analysis revealed that the proportion of international students with high satisfaction was significantly higher in online teaching （55.6%） than in offline teaching （43.2% and 53.2% for the medium and low satisfaction groups, respectively）. Moreover, regardless of online or offline teaching, multinomial logistic Regression indicated that gender, grade, and nationality significantly influenced whether students belonged to the high satisfaction group （P < 0.05）, with OR values of 1.917, 0.591, and 0.413, respectively. Conclusion The findings of this study suggest that online teaching is generally more satisfactory for international medical students than offline teaching. Moreover, male students, lower grade levels, and non-Indian international students tend to have higher satisfaction with teaching. This study provides insights into the optimization of teaching methods for international medical students in China and contributes to the improvement of the quality of international education in Chinese universities.
2023, 44(8): 162-166.
doi: 10.12259/j.issn.2095-610X.S20230810
Abstract:
Objective To investigate the effects of the psychological distress and quality of life of patients with gastrointestinal malignant tumors, and provide reference for clinical care. Methods 80 patients with gastrointestinal malignancies were randomly assigned to control group and intervention group, with 40 subjects in each group. The control group routine nursing care, and the intervention group added received narrative nursing program on the basis of the control group The differences in psychological distress and quality of life between the two groups were compared. Results The psychological distress score in the intervention group decreased （3.15±1.27） significantly than that in the control group （P < 0.001）, and in terms of quality of life, the scores of social/family status（21.55±2.57） and functional status （16.75±4.54） were higher than those in the control group （P < 0.05）. Conclusion Narrative nursing plays an important role in improving the psychological pain and quality of life of patients with digestive tract malignant tumor.
2023, 44(8): 167-171.
doi: 10.12259/j.issn.2095-610X.S20230818
Abstract:
Objective To explore the effect of narrative nursing on adverse psychological reactions and sleep quality of RSA patients, and to evaluate its clinical application effect and value. Methods 240 RSA patients in the Department of Reproductive Medicine of The Second Affiliated Hospital of Kunming Medical University from April 2021 to April 2023 were randomly divided into control group and experimental group with 120 patients in each group. The general data of all patients were collected at the first outpatient visit, and the negative emotion was evaluated by self-rating anxiety scale （SAS） and self-rating depression scale （SDS）, and the sleep quality was evaluated by Pittsburgh Sleep quality Index （PSQI）. During the outpatient treatment, the control group was given routine assisted reproductive care, while the experimental group was given narrative nursing on the basis of routine assisted reproductive care. The frequency of narrative nursing intervention was 30 minutes per session, once a week. SAS and SDS were used to evaluate the negative emotions of all patients after treatment, and PSQI scale was used to evaluate the sleep status of patients.The adverse psychological reactions, sleep scores, nursing satisfaction and doctor compliance of the two groups were compared. Results There was no significant difference in SAS score, SDS score and PSQI score between the two groups before intervention （P > 0.05）. After narrative nursing intervention, the scores of SAS, SDS and PSQI in the experimental group were significantly lower than those in the control group （P < 0.05）. The scores of SAS, SDS and PSQI in the experimental group were significantly lower than those in the control group. The satisfaction of patients in the experimental group was significantly higher than that in the control group, and the difference was statistically significant （P < 0.05）. The compliance of patients in the experimental group was significantly higher than that in the control group, and the difference was statistically significant （P < 0.05）. Conclusion Narrative nursing can effectively alleviate the negative emotions of female patients with RSA, improve the overall sleep quality of patients, and significantly improve the degree of cooperation in nursing work and satisfaction at the end of diagnosis and treatment.
2023, 44(8): 172-176.
doi: 10.12259/j.issn.2095-610X.S20230828
Abstract:
Objective To explore the effect of O2O health education based on propensity score matching method on moderate and severe acne vulgaris. Methods A retrospective analysis was conducted on the patients with moderate to severe acne vulgaris treated in the Western Theater Command General Hospital of the Chinese People’s Liberation Army from April 2018 to January 2023. According to whether O2O-style health education was conducted, the participants were divided into two groups: a conventional education group with 509 cases and an O2O group with 243 cases. Then, propensity score matching （PSM） was used to match the two groups in a 1∶1 ratio, resulting in 241 participants in each group. The conventional education group received routine health education using educational handbooks, while the O2O group received a combination of online and offline health education. During the treatment period, the O2O group primarily received offline education with online support, while after the treatment, the O2O group primarily received online education with offline support. The dropout rate, overall satisfaction rate, disease recurrence rate, as well as knowledge, attitude, and practice survey （KAP） were collected and analyzed for both groups. Results O2O group had a dropout rate of 7.88%, a satisfaction rate of 98.65%, and a disease recurrence rate of 19.09; while the conventional education group had a dropout rate of 17.01%, a satisfaction rate of 84.5%, and a disease recurrence rate of 65.56%. The O2O group performed better than the conventional education group, and the differences were statistically significant （P < 0.05）. In terms of KAP （Knowledge, Attitude, and Practice）, there were no statistically significant differences in knowledge scores, attitude scores, and practice scores between the two groups before treatment （P > 0.05）. At 3 months after treatment, the scores for all three aspects were higher in both groups compared to before implementation, and the differences were statistically significant （P < 0.05）. When comparing between the two groups, the O2O group had higher scores in all three aspects compared to the conventional education group, and the differences were statistically significant （P < 0.05）. Conclusion O2O health education can break through time and space limitations, improve the acceptance and satisfaction of patients with moderate to severe acne vulgaris towards health education knowledge, and reduce the recurrence rate and loss rate of acne.
2023, 44(8): 177-184.
doi: 10.12259/j.issn.2095-610X.S20230824
Abstract:
Objective To understand the mental health status and influencing factors of nurses participating in out-of-hospital emergency rescue in Yunnan province, and to provide reference for formulating targeted mental health intervention programs for emergency rescue nurses. Methods The purposive sampling method was used to select nurses from selected medical institutions in Yunnan Province who participated in out-of-hospital emergency rescue in 2022 as the research subjects. General demographic questionnaires, the Kessler Psychological Distress Scale-10 （K10）, the Generalized Anxiety Disorder Scale-7 （GAD-7）, and the Patient Health Questionnaire-9 （PHQ-9） were used for the investigation. Results 19.1% of the research subjects had poor psychological health. Univariate analysis showed that the factors of reproductive status and the number of out-of-hospital emergency rescue incidents were important factors affecting psychological health status, with statistically significant differences （P < 0.05）. Multivariate analysis showed that reproductive status and participating in out-of-hospital emergency rescue incidents ≥3 times were independent risk factors affecting psychological health status （both P < 0.05）. Furthermore, 25.4% of the research subjects had varying degrees of anxiety symptoms, and job position was an important factor influencing anxiety, with statistically significant differences （P < 0.05）. 27.3% of the research subjects had varying degrees of depression symptoms, and the investigated factors did not have a statistically significant impact on the depression status of the research subjects （P > 0.05）. Conclusion Reproductive status and the number of out-of-hospital emergency rescue incidents are important factors influencing the psychological health of emergency rescue nurses, while job position is a factor influencing their anxiety. Managers need to pay attention to the psychological status of emergency rescue nurses, develop rational and effective emergency rescue personnel allocation plans, and regularly conduct targeted psychological interventions to prevent more severe psychological problems among emergency rescue nurses.
