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RSS2024 Vol. 45, No. 7
2024, 45(7): 1-5.
doi: 10.12259/j.issn.2095-610X.S20240701
Abstract:
Temporomandibular joint osteoarthritis （TMJOA） is a chronic degenerative condition affecting the structures of the temporomandibular joint. Despite ongoing research efforts, the pathogenesis of TMJOA is not yet fully understood. Recent advancements in research techniques have allowed for a deeper exploration of the genetic factors underlying TMJOA. This article will provide an overview of the most recent developments in molecular biology research related to the pathogenesis of temporomandibular joint osteoarthritis.
Temporomandibular joint osteoarthritis （TMJOA） is a chronic degenerative condition affecting the structures of the temporomandibular joint. Despite ongoing research efforts, the pathogenesis of TMJOA is not yet fully understood. Recent advancements in research techniques have allowed for a deeper exploration of the genetic factors underlying TMJOA. This article will provide an overview of the most recent developments in molecular biology research related to the pathogenesis of temporomandibular joint osteoarthritis.
2024, 45(7): 6-13.
doi: 10.12259/j.issn.2095-610X.S20240702
Abstract:
Objective To explore the impact of herpes simplex virus type 1 （HSV-1） mutant strain M6 on macrophage-mediated immune responses after infecting human bronchial epithelial cells （16HBE cells）. Methods HSV-1 infection of 16HBE cells was conducted to assess cytokine alterations in the culture medium; Macrophages were co-cultured with supernatants from HSV-1-infected 16HBE cells and subsequently reintroduced into mice via tail vein infusion. Cytokine expression levels in mouse lymph nodes, changes in spleen T cell proportions, mouse neutralizing antibody levels, and specific T cell responses were measured on days 1, 3, 7, 28, 56, and 90. Results Following infection of 16HBE cells with the HSV-1 mutant strain, cytokine expression in the supernatant, associated with macrophage recruitment and activation, was elevated, albeit slightly lower than that observed in the wild-type strain group. Following the tail vein infusion experiment, the mutant strain group exhibited temporal changes in the proportions of inflammatory factors, chemokines, and T cells within the mouse lymph nodes, resulting in weaker humoral immunity compared to the wild-type strain group, yet eliciting stronger specific T cell responses, with only a few parameters showing significant differences from the wild-type strain group （P < 0.05）. Conclusion 16HBE cells infected with the HSV-1 mutant strain M6 can release cytokines that recruit and activate macrophages, allowing macrophages to carry specific activation information of the HSV-1 mutant strain, activating the host's immune system and inducing the host's Humoral immunity and cellular immunity.
2024, 45(7): 14-22.
doi: 10.12259/j.issn.2095-610X.S20240703
Abstract:
Objective To observe whether rosiglitazone, a peroxisome proliferator-activated receptor （PPAR-γ） agonist, can attenuate hepatic ischemia-reperfusion injury （IRI） in rats by modulating heme oxygenase 1 （HO-1） activity. Methods A rat 70% hepatic thermal ischemia/reperfusion （I/R） model and hypoxia-glucose deprivation/reperfusion （OGD/R）-induced liver sinusoidal endothelial cells （LSECs） injury model in rats were established. The rats were randomly divided into sham operation group, model group, rosiglitazone pretreatment group and zinc protoporphyrin （ZnPP） group （n = 6/group）. The serum ALT and AST levels of rats were detected by fully automatic biochemical analyzer. HE staining was used to assess liver histopathological injury. PPAR-γ and HO-1 protein expression levels were detected by Western Blot. The cell viability of LSECs was determined by CCK8 method, and reactive oxygen species （ROS） content in LSECs was determined by flow cytometry. Results Compared with the I/R model group, rosiglitazone pretreatment significantly decreased ALT and AST levels, reduced liver cell apoptosis, and alleviated liver tissue IRI （P < 0.01）. WB results showed that rosiglitazone upregulated the expression of PPAR-γ and HO-1protein （P < 0.01）. In addition, compared with the OGD/R model group, rosiglitazone pretreatment （10, 30 μmol/L） improved the survival rate of OGD/ R-induced LSECs and significantly reduced the ROS content in cells in a dose-responsive manner （P < 0.01）. When ZnPP blocked HO-1 activity, the protective effect of rosiglitazone on hepatic IRI in rats disappeared. Conclusion Rosiglitazone can mediate antioxidant and anti-inflammatory effects through up-regulation of HO-1 activity and reduce hepatic IRI in rats.
2024, 45(7): 23-29.
doi: 10.12259/j.issn.2095-610X.S20240704
Abstract:
Objective To evaluate differentially expressed genes with correlation of gene body methylation . Methods The lingual carcinogenesis was induced through the delivery of drinking water of 4-nitroquinoline-1-oxide（4NQO） with a density of 50 mg/L. The lingual mucosae specimens were harvested at 0, 12, 28 weeks, which represented normal, pre-cancer, and cancer individually. The microarray and methylated DNA immunoprecipitation sequencing （MeDIP-Seq） were used for the evaluation of gene expression and global DNA methylation in these specimens. The mRNA expression of Ubiquitin carboxyl-terminal hydrolase CYLD was tested with qRT-PCR in human normal and dysplasia mucosa. Results There were no statistical differences in gene body methylation among normal（C）, pre-cancer（M）, and cancer（E）（mean±sofMeDIP-score were 5.58±14.80, 5.79±13.35, 5.83±17.25 individually, H = 100.75, P > 0.05）There presented 145 differentially expressed genes with positive correlation to gene body methylation changes.The expression of CYLD mRNA was decreased in human dysplasia compared to normal mucosa with downregulation of gene body methylation. Conclusions There are many differentially expressed genes with a positive correlation to gene body methylations. The expression of CYLD is downregulated with the downregulation of gene body methylation in earlier stage during tongue carcinogenesis.
2024, 45(7): 30-41.
doi: 10.12259/j.issn.2095-610X.S20240705
Abstract:
Objective To investigate the effects of Ganetespib and Pemetrexed on the proliferation, apoptosis and related signaling pathways of human lung adenocarcinoma cells in vitro. Methods Human lung adenocarcinoma cells HCC827, H1975, and A549 were divided into groups （Ganetespib group, pemetrexed group, combined treatment group）, and a control group （DMSO 0.2%） was set up. After culturing for 48 hours, the Cell Titer-Glo （CTG） method was used to detect the inhibitory effects of cell proliferation in vitro, and Western blot was used to detect the expression levels of Akt, p-Akt, and Bcl-2 proteins in cells. The apoptosis experiment was used to detect the apoptosis rate, and RNA-seq was used to detect the effects of the two drugs on the transcription level of the HCC827 cell line. Results The inhibitory effects of cell proliferation were as follows: Ganetespib > pemetrexed （P < 0.001）, and the inhibitory effect was enhanced when the two drugs were combined （P < 0.0001）; the apoptosis rate was as follows: Ganetespib > pemetrexed （P < 0.05）, and the apoptosis rate of HCC827 cells increased when the two drugs were combined; the phosphorylation level of Akt protein was lower in the Ganetespib group （P < 0.05）, and the phosphorylation level of Akt protein was higher in the pemetrexed group （P < 0.05）, and the results of the combined treatment group were similar to those of the Ganetespib group, and Bcl-2 protein was only downregulated in A549 cells （P < 0.01）; the two drugs had an effect on the gene transcription level of the HCC827 cell line, with 102 upregulated differentially expressed genes and 27 downregulated genes in the Ganetespib group, 53 upregulated differentially expressed genes and 8 downregulated genes in the pemetrexed group. Conclusion The combination of Ganetespib and pemetrexed can significantly inhibit the proliferation of lung adenocarcinoma cells HCC827, H1975, and A549, induce cell apoptosis. The molecular mechanism may be through the inhibition of lung adenocarcinoma cell proliferation by protein phosphorylation in the PI3K/AKT signaling pathway. The transcriptome of HCC827 cells was affected by the combination therapy. The combined treatment can enhance the inhibition of lung adenocarcinoma cell proliferation to some extent, and the specific mechanism needs further research.
2024, 45(7): 42-48.
doi: 10.12259/j.issn.2095-610X.S20240706
Abstract:
Objective To investigate the clinicopathological and molecular features of appendiceal mucinous neoplasms （AMNs）, compare the differences bewteen the LAMN and HAMN. Methods 32 cases of AMNs were collected between January 2015 and September 2021. They were hospitalized in the Affiliated Hospital of Southwest Medical University. 10 samples of them were selected for Next Generation Sequencing （NGS） analysis of 425 genes. Results The majority of AMNs were female （68.8%）. Most patients had positive tumor markers. The proportion of distant metastasis, recurrence and death in HAMN patients were higher than those in LAMN patients. KRAS, GNAS and BRAF gene mutations were common in AMNs patients. The SNP of MTHFR and NQO1 were common in AMNs patients. The TMB of LAMN and HAMN patients were both lower, and there was no statistical significance between them （P > 0.05）. Conclusion AMNs have special clinical pathological and molecular pathological changes, but there is no significant difference between HAMN and LAMN.
2024, 45(7): 49-55.
doi: 10.12259/j.issn.2095-610X.S20240707
Abstract:
Objective To investigate the incidence and identify risk factors associated with thyroid disease （TD） in patients diagnosed with acute leukemia （AL） following allogeneic hematopoietic stem cell transplantation （allo-HSCT）. Methods Clinical data of 98 AL patients who underwent allo-HSCT for the first time in the Department of Hematology of the First People's Hospital of Yunnan Province from January 2018 to June 2023 were collected and retrospectively analyzed. All AL patients were treated with anti-tumor drugs （excluding immune checkpoint inhibitors） and allo-HSCT, divided into non-TD group （n = 55） and TD group （n = 43） based on whether TD occurred. We collected the patients' general information and laboratory data, analyzed whether there were statistical differences between the two groups, and explored the related risk factors for TD after allo-HSCT treatment. Results Among the 98 AL patients who underwent allo-HSCT, 43 （43.8%） exhibited abnormal thyroid function, including 22 cases of hypothyroidism （comprising clinical and subclinical hypothyroidism）, 9 cases of hyperthyroidism （including clinical and subclinical hyperthyroidism）, and 12 cases of elevated thyroid antibodies. Univariate analysis of the non-TD group and TD group showed no statistical significance in age, gender, donor-recipient relationship, HLA matching, donor and recipient blood type, neutrophil implantation time and PLT implantation time （P > 0.05）. However, there were statistically significant differences in disease type and the presence of concurrent aGVHD （P < 0.05）. The binary logistic regression analysis revealed that aGVHD was identified as a significant risk factor for the development of thyroid disorders after transplantation （OR=3.693, 95%CI=1.166～11.699, P < 0.05）. Furthermore, when compared to the underlying disease ALL, AML and other AL exhibited a significantly higher susceptibility to thyroid disorders （P < 0.05）. Conclusion Hypothyroidism is the most common type of TD caused by allo-HSCT treatment in AL patients, and TD is more likely to occur in acute non-lymphocytic post-transplantation, and patients with aGVHD is a risk factor for TD.
2024, 45(7): 56-61.
doi: 10.12259/j.issn.2095-610X.S20240708
Abstract:
Objective To compare the effect of different approaches of microscopic surgery in the treatment of severe hypertensivebasal ganglia hemorrhage （HBGH） in young patients. Methods A retrospective analysis was performed on young patients with severe HBGH admitted to the department of Neurosurgery of Ankang Central Hospital from July 2017 to June 2023. According to the different surgical approaches, the patients were divided into a lateral fissure group （microscopic hematoma removal via lateral fissure approach） and a middle temporal gyrus group （microscopic hematoma removal via middle temporal gyrus approach）. According to the propensity matching score method （caliper=0.02）, the confounding factors were excluded, and 40 patients were obtained in each group. The hematoma clearance rate, perioperative indicators （surgical time, intraoperative blood loss, hospital stay, re-hemorrhage rate）, incidence rates of complications, preoperative and postoperative serum indicators at 3 months [neuron specific enolase （NSE）, S-100 protein], prognosis status （GOS）at 3 months after surgery and symptom improvement [modified Rankin scale （mRS）, activity of daily living （ADL）] at 3 and 6 months after surgery were compared between the two groups. Results Within 24 hours after surgery, the hematoma clearance rate in lateral fissure group was significantly better than that in the middle temporal gyrus group （P < 0.05）. There were no significant differences in the surgical time and re-hemorrhage rate between both groups （P > 0.05）, but the intraoperative blood loss and hospital stay in the lateral fissure group were significantly less or shorter than those in the middle temporal gyrus group （P < 0.05）. There was no statistically significant difference in the incidence of complications between the two groups （P > 0.05）. At 3 months after surgery, NSE and S100 in both groups of patients significantly decreased （P < 0.05）, and the lateral fissure group was significantly lower than the middle temporal gyrus group （P < 0.05）. After 3 months of surgery, the GOS grading of the lateral fissure group was significantly better than that of the middle temporal gyrus group （P < 0.05）. At 3 and 6 months after surgery, the mRS in the two groups decreased gradually （P < 0.05） while the ADL increased gradually （P < 0.05）. The mRS in the lateral fissure group was significantly lower （P < 0.05） while the ADL was significantly higher than that in the middle temporal gyrus group （P < 0.05）. Conclusion Compared with the middle temporal gyrus approach, the lateral fissure approach in the treatment of severe HBGH has a higher hematoma removal rate, shorter surgical time, less blood loss and better prognosis of patients.
2024, 45(7): 62-68.
doi: 10.12259/j.issn.2095-610X.S20240709
Abstract:
Objective This study employs bioinformatics analysis to evaluate the expression, immune correlation, and diagnostic value of EMC6 gene in pan-cancer and cervical cancer, and investigate the associations of EMC6, C-myc, and BCL-2 proteins with cervical cancer and patient prognosis. Methods This study analyzed the expression of EMC6 across pan-cancer and cervical cancer datasets from TCGA and GTEx, utilizing SangerBox and Timer databases to assess its correlation with immune response and employing ROC analysis to evaluate its diagnostic potential. EMC6, C-myc, and BCL-2 protein expressions were detected in 68 cases of cervical cancer and adjacent tissues using immunohistochemistry, and their associations with clinicopathological characteristics were analyzed. The Phi coefficient method was employed to assess correlations, and the Kaplan-Meier method was used to evaluate the impact of these proteins on prognosis. Results In cervical cancer, the expression of EMC6 decreased, which significantly affected immune infiltration and had a high diagnostic accuracy （AUC = 0.819）. Immunohistochemistry revealed that compared to the adjacent tissues of cervical cancer, the expression of EMC6 protein decreased, while the expressions of C-myc and BCL-2 proteins were upregulated, with statistically significant differences （P < 0.05）. EMC6 expression showed no correlation with clinicopathological features （P > 0.05）, while C-myc was associated with pathological type （P < 0.05）, and BCL-2 was associated with age, pathological type, tumor size, and degree of differentiation （ P < 0.05）. In cervical cancer, the expression of EMC6 was negatively correlated with C-myc and BCL-2 （Phi = -0.367, P = 0.002; Phi = -0.284, P = 0.019）, and all three were significantly associated with overall patient survival （ P < 0.05）. Conclusions The expression of EMC6 protein decreases in cervical cancer and is negatively correlated with the expression of C-myc and BCL-2 proteins. There is a significant correlation between the expression levels of these proteins and the overall survival of patients, suggesting that they may be used as treatments for cervical cancer and Potential biomarkers for prognostic assessment.
2024, 45(7): 69-72.
doi: 10.12259/j.issn.2095-610X.S20240710
Abstract:
Objective To analyze the operation of the influenza monitoring system in Yunnan Province from 2021 to 2022 and conduct quality evaluation, identify weak links and take targeted measures to improve the level of influenza monitoring works. Methods We download related data of all national-level network laboratories and sentinel hospitals from China Influenza Monitoring Information System in 2021-2022, and used descriptive epidemiological methods to analyze the monitoring results, evaluated the quality of influenza monitoring work according to the National Quality Assessment Plan for Influenza Monitoring （2017 Edition）. Results The average ILI% （percentage of ILI in the total number of outpatient and emergency cases） of sentinel hospitals in the province is 1.49%, which is the same as the previous two years. The positive rate of ILI nucleic acid was 9.74%, and the Popular dominant strain was BV, accounting for 89.63%. 49 influenza outbreaks have been reported in 2021-2022 monitoring year, mainly concentrated in December and Mainly occurring in primary and middle schools.94.74% of sentinel hospitals can report all ILI data, and 78.95% of sentinel hospital specimens can meet the requirements of the plan. 70.59% of network labs can test 90% of samples timely, 69.09 of virus strains can send to national lab within 30 days. 100% of network laboratories have influenza nucleic acid testing capabilities and can ensure the accuracy of testing results. Conclusions The influenza monitoring work continues to advance, but some sentinel hospitals have problems such as missing data or untimely reporting, and insufficient sample collection. The timely detection rate of some laboratories is not high, the number of tested strains does not meet the national requirements, and the ability of using chicken embryos to isolate influenza viruses needs further improvement. Some states have not strictly followed national requirements in their response to influenza outbreaks. Effective measures should be taken by various regions to address the existing problems, further improving the quality of influenza monitoring work, and striving to meet or exceed the requirements of all monitoring indicators.
2024, 45(7): 73-78.
doi: 10.12259/j.issn.2095-610X.S20240711
Abstract:
Objective To analyze the molecular characteristics of the whole VP1 gene region of coxsackievirus A16 （CVA16） isolated from children with hand, foot and mouth disease （HFMD） in 2022 from a hospital in Kunming, Yunnan. Methods Two hundreds fecal specimens of HFMD clinical samples from 2022 in a hospital in kunming, were processed and isolated by RD cells and Vero cells, respectively, and viral nucleic acids were extracted from the cell cultures that still produced cytopathogenic effect （CPE） after three times of incubation, then amplified and sequenced by RT- PCR using universal primers 222/224, and sequenced, and the sequences were compared by BLAST to determine the serotypes, and then the full VP1 region of CVA16 was amplified with specific primers CA16VP1F/CA16VP1R , then sequenced and spliced. The standard sequences of CVA16 virus were downloaded, and the nucleotide and amino acid sequences of the whole VP1 region of CVA16 in this study were analyzed using software such as Geneious 5.4.1 and Mega 6.05. Results 22 strains of CVA16 isolated from Vero cells and 6 strains isolated from RD cells were detected by RT-PCR using universal primers, and the available sequences of 21 strains of full-length CVA16 VP1 region were further amplified by the specific primers of CVA16, and the nucleotide and amino acid sequences of the 21 strains of full-length CVA16 VP1 genes were highly homologous to each other, with 91.9%～99.6% and 89.2%～99.3%, respectively. The nucleotide and amino acid sequence homology with other strains of the chinese B1a genotype ranged from 89.7%～96.3% and 94.6%～99.0%, respectively; and nucleotide and amino acid sequence homology was in the range of 84.3%～87.2% and 89.2%～97.0%, respectively, when compared with the other reference strains of B1b. The phylogenetic analysis showed that all 21 CVA16 strains belonged to the B1a genotype. The 21 mutations were found by compared with that of other B1a strains. Conclusions The CVA16 strain that caused HFMD in a hospital in Kunming, Yunnan Province, China in 2022 belongs to the B1a genotype. Surveillance should be continued to clarify its epidemiological characteristics.
2024, 45(7): 79-86.
doi: 10.12259/j.issn.2095-610X.S20240712
Abstract:
Objective To analyze the serum typing, PFGE molecular typing, and drug-resistance of Shigella strains isolated from the active surveillance for foodborne diseases in Yunnan province from 2016 to 2022, the aim is to understand the pathogen characteristics of Shigella in this period and provide the data support for the control and treatment of Shigella infection. Methods Shigella strains were isolated from the feces of patients between January 2016 and December 2022. Serological typing of the strains was performed using the slide agglutination. Pulsed field gel electrophoresis （PFGE） was employed to detect the molecular typing of the strains. Drug resistance test was achieved by the broth microdilution method. Results A total of 89 Shigella strains were isolated, of which Shigella flexneri accounted for 52.81% and Shigella sonnei 47.19%. Both Shigella flexneri and Shigella sonnei were divided into A and B clusters in PFGE analysis, with B as the predominant cluster. The PFGE bands of 47 Shigella flexneri strains were categorized as 30 types with 3 dominant classes, while 42 Shigella sonnei strains contained 22 types PFGE bands with 4 dominant classes. Two suspected outbreaks were distinguished. Shigella displayed varying degrees of drug resistance to 13 antibiotics, with a 78.65% of multiple resistant strains. Conclusion The dominant PFGE bands of Shigella in Yunnan province were clear, partial of which appeared the clustering distribution. The drug resistance of Shigella was severe and the phenomena of multiple drug resistance were very serious. Drug resistance prototypes between Shigella flexneri and Shigella sonnei were different.
2024, 45(7): 87-91.
doi: 10.12259/j.issn.2095-610X.S20240713
Abstract:
Objective To analyze the clinical effectiveness of neuroendoscopy and microscopy in the treatment of hypophysectomy. Methods The clinical data of 150 patients with pituitary adenoma treated in the Department of Neurosurgery, the First Affiliated Hospital of Kunming Medical University from January 2019 to December 2023 were retrospectively analyzed. According to the surgical methods, they were divided into the microscope group （ n = 100 ） and the neuroendoscopy group （ n = 50 ）. The clinical efficacy of the two surgical methods on pituitary adenoma was compared. Results In the two groups of surgical patients, there was no significant difference between the total incision rate of Knosp grade 0-II in the neuroendoscopy group （97.6%） and the microscopy group （95.1%）, the total incision rate of Knosp grade III-IV in the neuroendoscopy group （66.7%） was significantly higher than that of the microscopy group （10.5%）, The postoperative hospital stay and the rate of improvement of primary symptoms were better in the neuroendoscopic group than in the microscopic group, and the difference was highly significant （P < 0.05）. There was no significant difference in rates of CSF leak, hemorrhage, hormonal changes, or complications between these two groups （ P > 0.05）. Conclusion Both surgical methods have good therapeutic effects on patients with pituitary adenomas. For Knosp grade III to IV pituitary adenomas, the total resection rate is higher with neuroendoscopy than with microscopy. The clinical decision to use either technique depends on the type of tumor and the patient's general condition.
2024, 45(7): 92-98.
doi: 10.12259/j.issn.2095-610X.S20240714
Abstract:
Objective To explore the effect of exoskeleton robot-assisted rehabilitation training on lower limb motor and walking function in patients with hemiplegia after stroke. Methods We recruited 36 patients with lower limb hemiplegia after stroke in the Department of Rehabilitation Medicine of the Third People's Hospital of Yunnan Province, from January 2023 to February 2024. All patients received conventional rehabilitation, observation group received lower limb exoskeleton robot-assisted training. We assessed lower-extremity motor and walking function by following items: muscle strength （iliopsoas, quadriceps, hamstring, triceps, tibialis anterior）, functional ambulation category Scale （FAC）, 10-meter walk test （10MWT）, gait analysis （Tinetti score）, ADL score. These measurements were performed before and after the intervention. In addition, we observed the brain network connectivity of 2 patients and 2 normal volunteers during the walking state by functional near-infrared spectroscopy （fNIRS）. Results After two weeks of intervention, all patients in the observation group and control group showed improvement in lower extremity function, and the improvement in the observation group was significant. The muscle strength of all patients was significantly improved in the observation group, iliopsoas muscle （P < 0.01）, quadriceps muscle （P < 0.01）, hamstring muscle （P < 0.01）; Triceps calf （P < 0.005）, anterior tibialis （P < 0.005）. The motor ability of the lower limb was improved in both the observation group and control group, FAC score increased （P < 0.01）, 10MWT time was shortened than before （P < 0.01）, and Tinetti score was increased （P < 0.01）. The ADL score was improved significantly in the observation group （P < 0.01）. To compare with normal volunteers, the patients' brain map of fNIRS showed decreased inter-hemispheric connections. Conclusion Exoskeleton robot-assisted rehabilitation training on the lower limb can effectively improve the motor and walking function of patients with hemiplegia after stroke, and improve the quality of life. Enhancing brain network connectivity between interhemispheres might be a potential way to promote functional recovery of stroke patients’ hemiplegic limbs.
2024, 45(7): 99-104.
doi: 10.12259/j.issn.2095-610X.S20240715
Abstract:
Objective To investigate the changes of serum hepatitis B virus surface antigen （HBsAg）, hepatitis B virus ribonucleic acid （HBV RNA）, γ-glutamyl transpeptidase （GGT）, γ-glutamyl transpeptidase to platelet ratio （GPR） levels in patients with different stages of natural history of chronic hepatitis B virus （HBV） infection and the diagnostic value of combined detection in the staging of natural history of chronic HBV infection. Methods A total of 172 patients with chronic HBV infection who were not treated with antiviral therapy in the Third People’ s Hospital of Kunming from November 2020 to December 2023 were selected as the research objects. According to the process of HBV infection, they were divided into HBeAg-positive chronic HBV infection （EPI） group （n = 77）, HBeAg-positive CHB （EPH） group （n = 42）, HBeAg-negative chronic HBV infection （ENI） group （n = 26）, HBeAg-negative CHB （ENH） group （n = 27）. The differences of serum HBsAg, HBV RNA, GGT and GPR levels in each group were compared, and the receiver operating characteristic （ROC） curve was drawn to explore the diagnostic value of combined detection of serum HBsAg, HBV RNA, GGT and GPR in EPH and ENH stages in the natural history of chronic HBV infection. Results There were significant differences in serum HBsAg, HBV RNA, GGT and GPR levels among the four groups （P < 0.05）. The area under the ROC curve （AUC） of combined detection of serum HBsAg, HBV RNA, GGT and GPR in the diagnosis of EPH and ENH was 0.869 and 0.836, respectively, and the sensitivity and specificity were 76.19%, 59.26% and 84.42%, 96.15%, respectively. Conclusion The combined detection of serum HBsAg, HBV RNA, GGT and GPR has high accuracy and low misdiagnosis rate in the diagnosis of natural history of chronic HBV infection, which is expected to replace the traditional invasive examination. It plays an important clinical significance in the accurate diagnosis and individualized treatment strategy of patients with a natural history of chronic HBV infection.
2024, 45(7): 105-112.
doi: 10.12259/j.issn.2095-610X.S20240716
Abstract:
Objective To investigate the clinical features and prognostic factors of pediatric acute lymphoblastic leukemia with hyperleukocytosis （HL-ALL）. Methods The clinical data of 427 newly diagnosed ALL children admitted to the Department of Hematology and Oncology of Kunming Children’ s Hospital from January 2019 to July 2022 were retrospectively analyzed. According to the initial white blood cell count （WBC） of 100×109/L, the children were divided into the hyperleukocytosis group and the non-hyperleukocytosis group. The clinical characteristics, major laboratory tests, overall survival （OS） and event-free survival （EFS） were compared between the two groups. Results There were 250 males and 177 females, with a male-to-female ratio of 1.41∶1. There were 92 cases （21.5%） in the hyperleukocytosis group and 335 cases （78.5%） in the non-hyperleukocytosis group. Compared with the non-hyperleukocytosis group, the hyperleukocytosis group had significantly higher proportions of children aged < 1 year and > 10 years, T lymphoblastic leukemia （T-ALL）, moderate to severe hepatosplenomegaly, and high-risk risk （P < 0.05）, as well as significantly higher percentage of immature cells at initial diagnosis, serum uric acid （UA） level, and lactate dehydrogenase （LDH） level （P < 0.05）. The platelet count （PLT） and the proportion of hyperdiploidy at diagnosis were lower （P <0.05）. The 3-year EFS and OS of the hyperleukocytosis group were lower than those of the non-hyperleukocytosis group. WBC ≥100×109/L at diagnosis, age >10 years, age < 1 year, T-ALL, high-risk, D15 MRD positive, D33 MRD positive, CNSL, MLL rearrangement, and MEF2D rearrangement were independent risk factors for EFS and OS rates in children with ALL （P < 0.05）. Conclusion The children with HL-ALL usually have a higher percentage of peripheral blood immature cells, elevated serum UA and LDH, and are often accompanied by age of onset <1 or > 10 years old, T-ALL, hepatosplenomegaly, and high risk. The early treatment response and prognosis of the children with HL-ALL are poor.
2024, 45(7): 113-118.
doi: 10.12259/j.issn.2095-610X.S20240717
Abstract:
Objective To explore the mechanism of acetylcysteine aerosol inhalation combined with non-invasive ventilator pressure supported ventilation （NIPSV） in the treatment of acute stage of chronic obstructive pulmonary disease （AECOPD） complicated with respiratory failure by regulating the immune inflammatory response. Methods A total of 80 patients with AECOPD combined with respiratory failure who were treated in Tongcheng People's Hospital of Anhui Province from February 2020 to December 2022 were selected and divided into experimental group （n = 42） and control group （n = 38） according to different treatment plans. The experimental group was treated with NIPSV mode combined with acetyl cysteine atomization inhalation. The control group was treated with non-invasive ventilator NIPSV mode. The pulmonary function of the two groups before and after treatment was compared, including forced expiratory volume （FEV1）, forced vital capacity （FVC） and FEV1/FVC. Blood gas index: arterial partial pressure of oxygen （PaO2）, arterial carbon dioxide （PaCO2）, and blood oxygen saturation （SaO2）; Serum indicators: Interleukin-6 （IL-6）, amyloid A （SAA）, C-reactive protein （CRP）, T lymphocyte subsets （CD3+, CD4+, CD8+） levels, and the incidence of adverse reactions during treatment were compared. Results After treatment, the levels of FEV1, FVC and FEV1/FVC in experimental group were significantly higher than those in control group and before treatment （P < 0.05）. After treatment, PaO2, PaCO2 and SaO2 levels in the experimental group were higher than those in the control group and before treatment （P < 0.05）. The levels of IL-6, SAA and CRP in the experimental group after treatment were lower than those in the control group and before treatment （P < 0.05）. After treatment, the levels of CD3+ and CD4+ were increased in both groups, the experimental group was higher than the control group, the CD8+ level was lower in the experimental group than the control group （P < 0.05）. The incidence of adverse reactions in experimental group was significantly lower than that in control group （P < 0.05）. Conclusion AECOPD combined with non-invasive ventilator NIPSV and acetylcysteine inhalation can effectively reduce the inflammatory response, improve lung function and immune function, and improve blood gas indexes in patients with respiratory failure.
2024, 45(7): 119-125.
doi: 10.12259/j.issn.2095-610X.S20240718
Abstract:
Objective To explore the application value of high-sensitivity C-reactive protein （hs-CRP）, chemokine CC motif ligand （CCL）, and CCL3 in the treatment of neonatal bacterial infections. Methods A total of 70 cases of neonatal bacterial infection admitted to the People's Hospital of Langfang City from January 2021 to January 2023 were selected as the bacterial infection group. In addition, 70 cases of neonatal viral infection and 70 cases of non-infected newborns were selected as the viral infection group and control group, respectively, at a ratio of 1∶1. The serum hs-CRP, CCL2, and CCL3 levels of the three groups and the bacterial infection group were compared at admission, the serum levels of each index were compared among the bacterial infection group with different therapeutic effects, and a receiver operating characteristic curve （ROC） was drawn to analyze the predictive efficacy of each serum index on therapeutic effects. The relative risk （RR） was used to analyze the impact of different expression of each serum index on the therapeutic effect of neonatal bacterial infection. Results The expressions of hs-CRP, CCL2 and CCL3 in the bacterial infection group and viral infection group at admission were higher than those in the control group （P < 0.05）. The expressions of hs-CRP, CCL2 and CCL3 in severe children with bacterial infection at admission were higher than those in mild children （P < 0.05）. The levels of hs-CRP, CCL2 and CCL3 in the ineffective subgroup were higher than those in the effective subgroup at admission, 24 h, 3rd day and 5th day （P < 0.05）. The combined effect of serum hs-CRP, CCL2 and CCL3 on neonatal bacterial infection at admission, 24 h, 3 d and 5 d was better than that of single index at each time point, and the combined prediction of AUC at 24 h was the largest. According to the cut-off value of each index 24 hours after admission, the risk of treatment failure in children with high expression of hs-CRP, CCL2 and CCL3 was 3.577 times, 3.357 times and 2.630 times higher than that in children with low expression. Conclusions hs-CRP, CCL2 and CCL3 are highly expressed in the serum of neonatal bacterial infection, and they are closely related to the severity of the disease and the therapeutic effect of the children. The combination of the three serum indicators has good reference value in predicting the therapeutic effect of the children.
2024, 45(7): 126-131.
doi: 10.12259/j.issn.2095-610X.S20240719
Abstract:
Objective To observe the levels of serum 25-hydroxyvitamin D, calcium and zinc in children, and explore the relationship between the three indexes and the growth and development of children. Methods From January 2021 to December 2022, 98 children with growth retardation treated in Zigong Maternal and Child Health Hospital were included in the growth retardation group, and 80 children with normal growth and development were taken as the normal growth and development group. The serum 25-hydroxyvitamin D, calcium , zinc level and other clinical data of the two groups were compared, and the relationship between serum 25-hydroxyvitamin D, calcium , zinc level and growth and development was analyzed. Results The levels of body length/height, weight, calcium, zinc and 25- hydroxyvitamin D in the growth retardation group were lower than those in the normal growth development group （P < 0.05）. The results of point-and-column correlation analysis showed that the levels of calcium, zinc and 25- hydroxyvitamin D were negatively correlated with children's growth retardation （r < 0, P < 0.05）. Logistic regression model was established. The results showed that the levels of Size / height （95%CI:0.673～0.824）, weight （95%CI:0.477～0.717）, calcium （95%CI: 0.127～0.467）, zinc （95%CI: 0.140～0.571） and 25- hydroxyvitamin D （95%CI: 0.130～0.461） were the protective factors for children's growth and development （or < 1 The ROC curve was drawn. The results showed that the levels of calcium, zinc and 25-hydroxyvitamin D had certain predictive value for children's growth and development （AUC = 0.601, 0.627 and 0.667）, and the predictive value of The three indicators are parallel was higher （AUC = 0.808）. Conclusion The growth and development of children is closely related to the level of serum 25-hydroxyvitamin D, calcium and zinc. Clinical monitoring of the level of serum 25-hydroxyvitamin D, calcium and zinc is helpful for early prediction of children's growth and development.
2024, 45(7): 132-139.
doi: 10.12259/j.issn.2095-610X.S20240720
Abstract:
Objective To explore the application value of Bobath therapy combined with the suspension technique in the rehabilitation treatment of children with cerebral palsy from the aspects of skeletal muscle development, gross motor function and limb balance. Methods A total of 98 children with cerebral palsy in Zigong Maternal and Child Health Hospital were selected from March 2021 to March 2023. According to the 1∶1 control principle, they were randomly divided into a control group and a study group using a computer random number table method, with 49 cases in each group. The control group was treated with Bobath therapy, and the study group was treated with Bobath therapy combined with suspension technology for 3 months. The therapeutic effects of the two groups were compared, as well as the gross motor function measurement scale （GMFM-88）, leg skeletal muscle development [thickness of the anterior tibial muscle, medial gastrocnemius muscle, and soleus muscle （MT）, muscle bundle length （FL）], Berg balance scale （BBS）, cerebral artery blood flow [Mean blood flow velocity （Vm） in the anterior cerebral artery （ACA）, middle cerebral artery （MCA） and posterior cerebral artery （PCA）], F-wave amplitude and stimulation threshold, daily living ability evaluation scale for children with cerebral palsy （ADL）, and modified Ashworth spasticity scale （MAS） before treatment, at 1 month and 3 months after treatment. Results The total effective rate of the study group was 89.80% higher than that of the control group 73.47% （P < 0.05）. At the 1st and 3rd month of treatment, MT and FL of the anterior tibial muscle, medial gastrocnemius muscle and soleus muscle in 2 groups were higher than before treatment, and the study group was higher than the control group （P < 0.05）. At the 1st and 3rd month of treatment, GMFM-88, BBS and ADL scores in 2 groups were higher than before treatment, and those in study group were higher than those in control group （P < 0.05）. At the first and third month of treatment, Vm of ACA, MCA and PCA in 2 groups was higher than before treatment, and that in study group was higher than that in control group （P < 0.05）. At the first and third months of treatment, the F wave amplitude of the study group was lower than that of the control group, and the F wave stimulation threshold was higher than that of the control group （P < 0.05）. At the first and third month of treatment, MAS scores in the 2 groups were lower than before treatment, and those in the study group were lower than those in the control group （P < 0.05）. Conclusion The Bobath therapy combined with suspension technique has a definite effect on children with cerebral palsy, which can promote the development of skeletal muscle in the lower leg, restore gross motor function, improve balance ability, and improve cerebral artery blood flow.
2024, 45(7): 140-147.
doi: 10.12259/j.issn.2095-610X.S20240721
Abstract:
Objective To observe the effect of comprehensive treatment on reproductive hormones, MicroRNA（miRNA） and prognosis of infertile women with polycystic ovary syndrome （PCOS）. Methods A total of 120 infertile PCOS patients admitted to Jiangmen Central Hospital hospital from July 2020 to July 2022 were randomly divided into 3 groups, 40 cases in each group. The control A group took medication （estrogen + clomiphene + metformin）, the control B group took physical and mental interventions （diet + exercise + psychology）, and the composite treatment group took a comprehensive treatment program （medication + physical and mental interventions）, the intervention lasted for 6 consecutive courses. The prognosis of the three groups was statistically analyzed, as well as their psychological status before and after intervention [The Positive and Negative Affect Scale （PANAS）], miR-320 expression, miR-27a expression, body mass index （BMI）, inhibin B （IHNB）, hip circumference, anti-Mullerian hormone （AMH）, waist circumference, luteinizing hormone/follicle stimulating hormone （LH/FSH）. Results Comparison of positive emotion scores in the PANAS scale of three groups after three and six courses of intervention: composite treatment group>control group B>control group A; comparison of negative emotion scores: composite treatment group<control group B<control group A（P < 0.05）; comparison of miR-320 levels among three groups after three and six courses of intervention: composite treatment group>control group A>control group B, comparison of miR-27a, LH/FSH, IHNB, and AMH levels: composite treatment group<control group A<control group B （P < 0.05）; after 3 and 6 courses of intervention, the waist circumference, BMI, and hip circumference of the combined treatment group were all smaller than those of the control group A and control group B, and the clinical pregnancy rate was 55.00%, which was higher than the 32.50% of the control group A and the 27.50% of the control group B （P < 0.05）, however, there was no statistically significant difference between the control groups A and B （P > 0.05）. Conclusion The comprehensive treatment program applied to PCOS infertility patients has a precise effect, which can promote the balance of hormone metabolism, regulate microRNA expression, reduce obesity, improve menstruation, enhance the pregnancy rate, and also improve the patient’ s emotional state.
2024, 45(7): 148-153.
doi: 10.12259/j.issn.2095-610X.S20240722
Abstract:
Objective To assess the potential value of high-field MRI T1 perfusion imaging combined with diffusion-weighted imaging （DWI） in evaluating neoadjuvant chemotherapy efficacy in breast cancer. Methods The clinical and radiological data, including pre-and post-chemotherapy T1 perfusion imaging and DWI imaging data, were retrospectively collected from 126 breast cancer patients. Multifactorial logistic regression analysis was used to investigate the relationship between different imaging parameters and neoadjuvant chemotherapy efficacy, and a predictive model was established. Results T1 perfusion parameters and DWI imaging parameters （area under the curve, time to peak, washing, maxenh, ADC value） were all related factors in evaluating the efficacy of neoadjuvant chemotherapy for breast cancer （P < 0.05）. The multifactorial logistic regression model based on these correlated parameters achieved an accuracy of 91.3% in predicting chemotherapy efficacy. Conclusions MRI T1 perfusion imaging combined with DWI imaging holds potential clinical application prospects in assessing neoadjuvant chemotherapy efficacy in breast cancer. Comprehensive analysis of MRI T1 perfusion imaging combined with DWI imaging parameters allows for a more accurate prediction of breast cancer patients' response to treatment, providing robust support for treatment decisions.
2024, 45(7): 154-159.
doi: 10.12259/j.issn.2095-610X.S20240723
Abstract:
Objective To obtain the distribution of allele frequency and population genetic data of 23 autosomal STR loci contained in the MicroreaderTM 23HS Plex ID System kit in the Han population of northern China, and explore its application value in forensic medicine. Methods The MicroreaderTM 23HS Plex ID System kit was used to detect the DNA of 548 unrelated samples which from the Han population in northern China. Then, the allele frequencies, heterozygosity（H） in the samples, polymorphism information content（PIC）, power of discrimination（DP）, and probability of paternity exclusion（PE） were calculated and Hardy-Weinberg equilibrium was tested on each locus based on the genotyping data of 548 samples we collected. The cumulative individual identification ability （CDP） and cumulative non-paternity exclusion rate （CPE）of the MicroreaderTM 23HS Plex ID System were also calculated. Results A total of 260 alleles were detected in 548 unrelated samples from 23 STR loci which conformed to Hardy-Weinberg equilibrium. And the alleles frequencies ranged from 0.0009 to 0.5902, H ranged from 0.611 to 0.885, PIC ranged from 0.577 to 0.864, DP ranged from 0.815 to 0.973 （mean DP was 0.922） and PE ranged from 0.089 to 0.406. At the same time, the CDP of MicroreaderTM 23HS Plex ID System was 1-3.663×10-27 and CPE was 1-2.668×10-16. Conclusion The 23 loci of MicroreaderTM 23HS Plex ID System have a good polymorphism in the north Chinese Han population, and have high application value in population genetics research, forensic personal identification, paternity testing and complex kinship identification.
2024, 45(7): 160-167.
doi: 10.12259/j.issn.2095-610X.S20240724
Abstract:
Accurate assessment of embryo development is of paramount importance for the success of Assisted Reproductive Technologies （ART）. Traditional methods predominantly rely on subjective embryo morphological evaluations, lacking objectivity and real-time capabilities. Time-lapse Technology （TLT） offers a more stable incubation environment, facilitating dynamic monitoring of embryo development, analysis, and modeling of dynamic parameters during different developmental stages for predicting embryo implantation potential. However, dynamic parameters often require manual annotations, introducing subjective bias and exhibiting significant disparities in data modeling capabilities, deviating from real-world scenarios, especially in the analysis of chromosomal ploidy. With the continuous advancement of Artificial Intelligence （AI）, the integration of TLT and AI holds promise in reducing manual annotation time in TLT, enhancing embryo implantation rates, and chromosomal ploidy prediction. This review aims to explore the application of TLT combined with AI in morphological and dynamic parameters for assessing embryo implantation potential and chromosomal ploidy.
Accurate assessment of embryo development is of paramount importance for the success of Assisted Reproductive Technologies （ART）. Traditional methods predominantly rely on subjective embryo morphological evaluations, lacking objectivity and real-time capabilities. Time-lapse Technology （TLT） offers a more stable incubation environment, facilitating dynamic monitoring of embryo development, analysis, and modeling of dynamic parameters during different developmental stages for predicting embryo implantation potential. However, dynamic parameters often require manual annotations, introducing subjective bias and exhibiting significant disparities in data modeling capabilities, deviating from real-world scenarios, especially in the analysis of chromosomal ploidy. With the continuous advancement of Artificial Intelligence （AI）, the integration of TLT and AI holds promise in reducing manual annotation time in TLT, enhancing embryo implantation rates, and chromosomal ploidy prediction. This review aims to explore the application of TLT combined with AI in morphological and dynamic parameters for assessing embryo implantation potential and chromosomal ploidy.
2024, 45(7): 168-176.
doi: 10.12259/j.issn.2095-610X.S20240725
Abstract:
Compared with adult patients with depression, adolescents with depression have a higher incidence rate, poorer quality of life and poorer treatment effects. International guidelines generally recommend giving priority to psychological treatment for mild adolescent depression. For moderate to severe patients, antidepressant drugs combined with psychotherapy are a feasible option. How to choose suitable antidepressant drugs is still a problem to be solved. Antidepressant drugs have a series of side effects, including sleep disorders, extrapyramidal reactions, and gastrointestinal reactions. In order to reduce these side effects and improve clinical efficacy, individualized treatment plans are crucial. This article summarizes the pathogenesis of adolescent depression, the pharmacokinetics and side effects of antidepressant drugs, as well as the medication guidelines for adolescent patients with depression from 2013 to 2023, and provides scientific suggestions for drug treatment options for adolescent patients with depression.
Compared with adult patients with depression, adolescents with depression have a higher incidence rate, poorer quality of life and poorer treatment effects. International guidelines generally recommend giving priority to psychological treatment for mild adolescent depression. For moderate to severe patients, antidepressant drugs combined with psychotherapy are a feasible option. How to choose suitable antidepressant drugs is still a problem to be solved. Antidepressant drugs have a series of side effects, including sleep disorders, extrapyramidal reactions, and gastrointestinal reactions. In order to reduce these side effects and improve clinical efficacy, individualized treatment plans are crucial. This article summarizes the pathogenesis of adolescent depression, the pharmacokinetics and side effects of antidepressant drugs, as well as the medication guidelines for adolescent patients with depression from 2013 to 2023, and provides scientific suggestions for drug treatment options for adolescent patients with depression.
2024, 45(7): 177-182.
doi: 10.12259/j.issn.2095-610X.S20240726
Abstract:
Objective To construct breast imaging teaching software and case library based on the outcome-based education （OBE） concept, and explore the practical effects of teaching. Methods We randomly selected 81 undergraduate students who majored in medical imaging diagnostics and technology at Kunming Medical University in the first semester of the 2023-2024 academic year, including 42 in the control group, using the traditional breast imaging teaching model, and 39 in the experimental group, using breast imaging teaching software and case library based on the OBE concept. After 3 months of study, the knowledge level and clinical application ability of the two groups of students were evaluated, and their satisfaction and suggestions for the case library software were collected. Results The average score of the students in the experimental group was （88.9±9.1） points, and the average score of the students in the control group was （84.1±10.7） points. The difference was statistically significant （P < 0.05）. More than 90% of students believed that using the case library software was conducive to the mastery and application of breast imaging diagnostic knowledge, improved learning interest and independent learning ability, and could solve problems existing in the learning process. Conclusion The breast imaging teaching software and case library based on the OBE concept can effectively improve students' knowledge level and clinical application ability and provide new ideas for medical imaging teaching reform.
2024, 45(7): 183-190.
doi: 10.12259/j.issn.2095-610X.S20240727
Abstract:
Objective To develop a patient-reported outcome scale for bladder cancer suitable for Chinese culture and test its reliability and validity. Methods The initial scale was formed by literature review, semi-structured interview, cognitive test, and two rounds of Delphi expert consultation guided by Levin's conservation model. A total of 313 bladder cancer patients from the outpatient or inpatient departments of three tertiary care hospitals in Yunnan Province from July to November 2021 were selected by convenience sampling to investigate the scale for item analysis and reliability testing. Results The final patient-reported outcome scale for bladder cancer consisted of 4 domains, 11 dimensions, and 54 items. Exploratory factor analysis was performed on the four domains of the scale, and four, two, two, and three common factors were extracted, respectively, and the cumulative variance contribution rates were greater than 50%; the Cronbach’ s α coefficient of the total scale was 0.950 and the split-half reliability coefficient was 0.831; the content validity index of each item of the scale ranged from 0.833 to 1.000, the average content validity index of the scale was 0.996, and the content validity index of all consistent scales was 0.982. Conclusion The patient-reported outcome scale for bladder cancer has good reliability and can be used to evaluate the patient-reported outcome of bladder cancer in China, providing a reference for clinical medical staff to implement treatment decisions and precise nursing interventions to improve patient health outcomes.
