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2024 Vol. 45, No. 8
2024, 45(8): 1-6.
doi: 10.12259/j.issn.2095-610X.S20240801
Abstract:
With the rapid development of artificial intelligence, digital technology has been widely used in the field of dentistry, especially playing a crucial role in the context of multidisciplinary diagnosis and treatment in dentistry. The introduction of digital technology has provided new insights and methods for interdisciplinary treatment with orthodontics as the main focus in dentistry. Doctors can more accurately assess patients' oral conditions, collaborate across multiple disciplines to develop personalized treatment plans, and conduct real-time monitoring and adjustments during treatment, thereby enhancing the precision and efficiency of treatment. Meanwhile, the application of digital technology brings patients a more refined and personalized treatment experience, providing reliable technical support and guidance for clinical practice. This paper provides a review of the clinical application of digital technology in multi-disciplinary diagnosis and treatment with orthodontics as the main focus in dentistry.
With the rapid development of artificial intelligence, digital technology has been widely used in the field of dentistry, especially playing a crucial role in the context of multidisciplinary diagnosis and treatment in dentistry. The introduction of digital technology has provided new insights and methods for interdisciplinary treatment with orthodontics as the main focus in dentistry. Doctors can more accurately assess patients' oral conditions, collaborate across multiple disciplines to develop personalized treatment plans, and conduct real-time monitoring and adjustments during treatment, thereby enhancing the precision and efficiency of treatment. Meanwhile, the application of digital technology brings patients a more refined and personalized treatment experience, providing reliable technical support and guidance for clinical practice. This paper provides a review of the clinical application of digital technology in multi-disciplinary diagnosis and treatment with orthodontics as the main focus in dentistry.
2024, 45(8): 7-16.
doi: 10.12259/j.issn.2095-610X.S20240802
Abstract:
Objective To investigate the clinicopathologic and other molecular markers features of oligodendrogliomas in adults with non-codeletion of 1p/19q. Methods 326 cases of oligodendrogliomas, anaplastic oligodendrogliomas, oligoastrocytomas, and anaplastic oligoastrocytomas diagnosed by histopathology after surgical resection were collected. The polymorphism of chromosome 1p and 19q were analyzed by fluorescence in situ hybridization （FISH）. Isocitrate dehydrogenase （IDH） 1/2 mutation, TP53 and promoter of telomerase reverse transcriptase （TERTp） were detected by Sanger sequencing. The expression levels of ATRX, PDGFRA, EGFR, CIC, FUBP1, INA, and PTEN were detected by immunohistochemical staining, and methylation specific PCR （MSP） was used to detect the methylation of MGMT promotor. Results The 1p/19q status of 326 adult oligodendrogliomas showed that 37.6% of the tumors were 1p/19q non-codeletion, and more than half of the 1p/19q non-codeleted oligodendrogliomas showed lack of expression of p53 and ATRX, the defining astrocytic markers. In the cohort of 1p/19q non-codeleted "oligodendrogliomas", patients with younger age （<45 years）, WHO grade 2, and typical oligodendroglioma histomorphology had a better prognosis（P < 0.01）, and the typical histomorphology of oligodendrogliomas was associated with TERTp mutation status, p53 expression, EFGR expression, PDGFRA expression（P < 0.05）. The expression of FUBP1, TERT, MGMT, PDGFRA, EGFR, PTEN, INA, and CIC was not found to have significant prognostic value（P > 0.05）. Conclusion According to the 5th edition of the 2021 WHO Classification of Tumors of the Central Nervous System, astrocytomas do not account for all 1p/19q non-codeleted oligodendrogliomas, and 1p/19q non-codeleted oligodendrogliomas may represent a distinct subgroup of diffuse gliomas.
2024, 45(8): 17-23.
doi: 10.12259/j.issn.2095-610X.S20240803
Abstract:
Objective To explore the expression characteristics, prognostic effect, functional activation and immune infiltration of HPRT1 gene in lung adenocarcinoma. Methods The data of adenocarcinoma of the lung from TCGA and multiple GEO databases were collected and analyzed. The relationship between HPRT1 expression level and overall survival （OS） was compared and validated, and the functional enrichment of upregulated genes in the HPRT1 high-expression group was analyzed using ClusterProfiler. Furthermore, the infiltration levels of immune cells in lung adenocarcinoma were calculated using TIMER and CIBERSORT algorithms and compared between the HPRT1 high- and low-expression groups. Results The expression of HPRT1 was significantly upregulated in lung adenocarcinoma tissues, and TCGA dataset analysis showed the patients with high expression of HPRT1 gene had a poorer overall survival （OS） prognosis （P < 0.01）. Validation through two GEO datasets also shows that high expression of the HPRT1 gene is associated with a worse OS prognosis （GSE13213, P < 0.01, GSE67639, P < 0.001）. Differential analysis indicates that among patients with high expression, the expression levels of 683 genes are significantly upregulated, with these upregulated genes primarily enriched in signaling pathways related to cancer, such as p53 and the cell cycle. Analysis of immune cell infiltration levels using TIMER and CIBERSORT algorithms reveals that in the group with high expression and poor prognosis, the levels of B cells and CD4 T cells are lower （P < 0.05）. Conclusion The higher the expression level of the HPRT1 gene, the significantly worse the overall survival of patients with lung adenocarcinoma, and in patients with high expression levels, the p53 signaling pathway is upregulated, and the infiltration level of B cells and CD4T cells is significantly decreased.
2024, 45(8): 24-29.
doi: 10.12259/j.issn.2095-610X.S20240804
Abstract:
Objective To explore the causal relationship between Alzheimer’ s disease and sarcopenia. Methods This study is based on three related phenotypes of Alzheimer's disease and sarcopenia in the public genome-wide association analysis （GWAS） database, namely, appendicular lean mass, walking speed, and low grip strength. Two-sample Mendelian randomization analysis was conducted using inverse variance weighting method, median weighting method, MR-Egger regression, etc., and sensitivity analysis was performed, including heterogeneity testing and multiple effect analysis. Results The MR analyses demonstrated that Alzheimer’ s disease may increase the risk of reduced appendicular lean mass （β = 0.010 , 95% confidence interval （CI） = 0.001～0.018, P = 0.021）, while Alzheimer’ s disease was a significantly correlated with low walking speed （β = 0.009, 95% confidence interval （CI） = 0.003～0.016, P = 0.005）. Conclusion Alzheimer’ s disease may increases the risk of sarcopenia.
2024, 45(8): 30-37.
doi: 10.12259/j.issn.2095-610X.S20240805
Abstract:
Objective To investigate caries status of children aged 3-6 in Anning City, evaluate the activity index of caries, and analyze the factors related to caries occurrence in children aged 3～6. Methods A stratified random cluster sampling method was employed to select 3-to-6-year-old children in Anning City for oral health examination and caries activity detection （Cariostat） from May 2023 to June 2023. Questionnaires were filled by parents. Logistic regression analysis was used to analyze the factors associated with caries in primary dentition. Results A total of 3070 children aged between 3 to 6 years old participated in the study. The caries rate of children aged 3～6 in Anning City was 65.8%, with an average dmft of 2.0 （0.0, 7.0）. There were statistical differences in caries rate and dmft scores （χ2 = 227.134, P < 0. 001; χ2 = 331.844, P < 0.001） among different caries activity groups. Multivariate regression analysis showed that the location where children reside, gender, brushing method, age of starting brushing, experience of toothache and dental visits, frequency of eating candy, grouping of caries test values, and differences in the occurrence of deciduous tooth caries have statistical significance. Conclusion The situation of dental caries in children aged 3～6 in Anning City, Yunnan Province, is serious. The caries rate of primary teeth is high and needs to be taken seriously. Cariostat testing can effectively assess the risk of dental caries in children, identify high-risk groups early, and carry out prevention and treatment work promptly. The occurrence of dental caries is related to family socioeconomic status and oral health-related behaviors, so it is necessary to strengthen relevant policies and support measures to reduce the caries rate in children and prevent the occurrence of dental caries.
2024, 45(8): 38-43.
doi: 10.12259/j.issn.2095-610X.S20240806
Abstract:
Objective To understand the current the status of sexual knowledge, attitude and behavior in university students from three non-medical colleges and universities in Yunnan Province. Methods From September, 2022 to June, 2023, 1170 college students from three non-medical universities in Yunnan Province were selected by multistage stratified cluster random sampling methods to conduct a questionnaire survey on their sexual knowledge, attitudes and behaviors, and descriptive methods were used to analyze their sexual knowledge, attitudes and behaviors. Results The awareness rate of emergency contraception within 72 hours was 22.2%, and the awareness rate of condoms for disease prevention and contraception was 65.6%. The awareness rates of PrEP and PEP were 49.2% and 39.3%, and the overall awareness rate of AIDS prevention knowledge was less than 90.0%. The overall awareness rate of sexual health and AIDS prevention knowledge among girls was higher than boys （P < 0.05）. 72.8% of the sampled population did not oppose premarital sex, and boys have a more open attitude towards sex than girls （P < 0.05）. 18.9% of respondents have had sexual activity. Among those with a history of sexual behavior, 60.5% can correctly use condoms consistently, and 35.1% have more than two sexual partners. The sexual behavior of boys is higher than that of girls （P < 0.05）. Among college students, 42.6% received sex education in junior high school, and 41.4% obtained sexual knowledge through the Internet. Conclusion College students lack sexual health knowledge, and their sexual attitudes and behaviors are relatively open. It is imperative for non-medical colleges in Yunnan Province to carry out comprehensive sex education.
2024, 45(8): 44-51.
doi: 10.12259/j.issn.2095-610X.S20240807
Abstract:
Objective To investigate the risk factors of type 2 diabetic peripheral neuropathy （DPN） complicated with microangiopathy. Methods A total of 197 DPN patients hospitalized in the Department of Endocrinology of the First People's Hospital of Yunnan Province from November 1, 2021 to December 31, 2022 were retrospectively reviewed. Patients were divided into groups based on whether they had concurrent microvascular complications: 66 cases in the pure DPN group, 45 cases in the DPN combined with type 2 diabetic retinopathy （DR） group, 50 cases in the DPN combined with type 2 diabetic kidney disease （DKD） group, and 36 cases in the DPN combined with DR and DKD group. General conditions and relevant clinical indicators of the patients were collected to analyze the factors influencing the combination of DPN with microvascular complications. Results The prevalence of DPN alone was 33.50%, DPN combined with DR Was 22.84%, DPN combined with DKD was 25.38%, and DPN combined with DR and DKD was 18.27%. In the four groups, age, disease duration, history of hypertension, systolic blood pressure （SBP）, estimated glomerular filtration rate （eGFR）, creatinine （Cr）, blood urea nitrogen （BUN）, albumin （ALB）, albumin/globulin ratio （A/G）, free triiodothyronine （FT3）, fasting C-peptide （C-P）, two hours of C-peptide （C-P2）, fasting insulin （INS）, insulin 2 hours after a meal （INS2h）, time in range （TIR） for glucose, visceral fat area （VFA）, and standard deviation of NN intervals （SDNN） for sinus rhythm all show statistically significant differences （P < 0.05）. The results of logistic regression analysis show that compared to DPN patients, age （OR = 0.882, 95%CI: 0.814～0.956, P = 0.002） and eGFR （OR=0.934, 95%CI: 0.886～0.985, P = 0.011） are protective factors for those with DPN and DR, while SBP （OR = 1.030, 95%CI: 1.003～1.058, P = 0.028） is an independent risk factor. When comparing DPN patients with those who have DPN and DKD, SBP （OR = 1.026, 95%CI: 1.001～1.052, P = 0.042） is an independent risk factor. Comparing DPN patients with those who have DPN and both DR and DKD, FT3 （OR = 0.468, 95%CI: 0.224～0.976, P = 0.43） is a protective factor, while SBP （OR = 1.029, 95%CI: 1.000～1.059, P = 0.047） and VFA （OR = 1.027, 95%CI: 1.006～1.049, P = 0.013） are independent risk factors. Conclusion Elevated systolic blood pressure and visceral fat are high-risk factors for the development of microvascular complications in diabetic peripheral neuropathy （DPN）, contributing to the occurrence and progression of microvascular complications in DPN.
2024, 45(8): 52-57.
doi: 10.12259/j.issn.2095-610X.S20240808
Abstract:
Objective To detect the expression level of ESAT-6 combined with IL-6, IL-10, IFN-γ, CK-18, MMP-7, MMP-9 in the serum of patients with anti-tuberculosis drug induced liver injury （ATB-DILI）, to analyze the correlation between the above indicators and the severity of liver injury, and to explore the evaluation value of 7 factors for ATB-DILI. Methods From January 2019 to January 2023, pulmonary tuberculosis patients treated at the Third People's Hospital of Kunming were included. Using the ELISA method, the levels of ESAT-6, IL-6, IL-10, IFN-γ, CK-18, MMP-7, and MMP-9 in the serum of 210 ATB-DILI tuberculosis patients （Group A）, 120 tuberculosis patients without liver damage during anti-tuberculosis treatment （Group B）, and 50 healthy individuals undergoing physical examinations （Group C） were tested. The correlation between the above indicators and the severity of liver damage was analyzed, as well as the accuracy of assessing the severity of liver damage. Results The age of patients in group A was higher than that in group B and C （P < 0.05）. Compared with the control group, the expression of serum ESAT-6, IL-10, CK-18, MMP-7 and MMP-9 was significantly up-regulated in group A, and the expression of ESAT-6 and MMP-7 was significantly up-regulated in group B （P < 0.05）. The expression levels of CK-18, IL-10, and MMP-9 in Group A were higher than in Group B （P < 0.05）. In Group A, age, ESAT-6, CK-18, and MMP-9 were positively correlated with the severity of liver injury （P < 0.05）. Logistic regression analysis indicated that age >65 years, ESAT-6 >31.3 pg/mL, and CK-18 >45.5 ng/mL in Group A patients were independent risk factors for ATB-DILI. Conclusion Elderly patients are more prone to ATB-DILI. Elevated levels of ESAT-6, CK-18, and MMP-9 are related to the severity of ATB-DILI. Age over 65, ESAT-6 > 31.3 pg/mL, and CK-18 > 45.5 ng/mL are independent risk factors for ATB-DILI. The combined detection of ESAT-6 and CK-18 expression levels in elderly patients holds significant clinical value for predicting and assessing the severity of ATB-DILI.
2024, 45(8): 58-66.
doi: 10.12259/j.issn.2095-610X.S20240809
Abstract:
Objective This study aims to evaluate the left ventricular myocardial function in HCM patients with or without subendocardial LGE by cardiac magnetic resonance （CMR） layer-specific strain technology and to explore the factors for predicting subendocardial LGE in HCM patients. Methods A retrospective study was conducted on 61 patients with HCM who underwent CMR imaging at the First Affiliated Hospital of Kunming Medical University from January 2017 to September 2020, with 49 healthy controls matched for age and gender. The HCM patients were divided into a group without subendocardial LGE （G1 group, n = 40） and a group with subendocardial LGE （G2 group, n = 21）. CMR-based feature tracking was used to obtain global longitudinal strain （GLS） and endocardial longitudinal strain （endoLS） of the left ventricular myocardium. Differences in cardiac structure, function, and strain parameters among the three groups were compared. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for subendocardial LGE in HCM patients, and the predictive performance was assessed using receiver operating characteristic （ROC） curve. Results GLS and endoLS were significantly lower in G2 than those in G1 and control group （GLS: -10.57%±2.56%（G2）Vs. -12.53%±2.49%（G1）Vs. -17.35%±1.77%（controls）, endoLS: -10.35%±2.47%（G2）Vs. -13.60%±2.52%（G1）Vs. -18.58%±1.86% （controls）, all P < 0.001）. Multivariate Logistic regression analysis showed that endoLS was an independent risk factor for subendocardial LGE in HCM patients （OR = 1.696, P = 0.001）. The area under the curve （AUC） for predicting subendocardial LGE was 0.852, the cutoff value was -11.87%, the sensitivity was 81.0% and the specificity was 85.0%. Conclusion CMR-layered strain index endoLS can identify early dysfunction of the endocardium in HCM patients, and may be an ideal predictor for the occurrence of endocardial LGE in HCM patients.
2024, 45(8): 67-73.
doi: 10.12259/j.issn.2095-610X.S20240810
Abstract:
Objective To investigate the survival and prognosis of 1635 patients with esophageal cancer. Methods Data of 1635 hospitalized patients with esophageal cancer treated at Yunnan Cancer Hospital from January 1st, 2012, to December 31st, 2017, were collected. The survival status of the patients was assessed using a combination of active and passive methods, and Kaplan-Meier method was employed to analyze the 1-year, 3-year, and 5-year survival rates as well as median survival time. Results The median survival time of the 1635 patients with esophageal cancer was 11.60 months, with 1-year, 3-year, and 5-year survival rates of 48.80%, 20.58%, and 15.11% respectively. Single-factor analysis showed that the 5-year survival rate of female patients is higher than that of male patients. As the age at diagnosis increases, the 5-year survival rate showed a decreasing trend（P = 0.008）, and the 5-year survival rate in the esophageal abdominal segment was higher than that in the esophageal cervical segment and thoracic segment （P < 0.001）. Conclusion Gender, age at diagnosis, anatomical location, clinical stage, and differentiation degree are closely related to the prognosis of esophageal cancer patients. Early screening and standardized treatment of esophageal cancer, as well as promoting coordinated development of medical care and prevention, are important measures to reduce the burden of esophageal cancer in China.
2024, 45(8): 74-78.
doi: 10.12259/j.issn.2095-610X.S20240811
Abstract:
Objective To investigate the influencing factors of serum HCG levels on the next day of human chorionic gonadotropin （HCG） trigger during in vitro fertilization-embryo transfer （IVF-ET） and its relationship with clinical outcomes. Methods A retrospective analysis was conducted on the data of 253 infertile patients who underwent IVF-ET fertility assistance at the Reproductive Genetics Center of the First People's Hospital in Kunming from January 2020 to December 2022. Patients were divided into 4 groups based on the serum HCG levels on the trigger day: Group A: HCG <50 IU/L with 8 cases; Group B: 50 IU/L ≤ HCG <100 IU/L with 73 cases; Group C: 100 IU/L ≤ HCG <150 IU/L with 90 cases; Group D: HCG ≥150 IU/L with 82 cases. The analysis included the impact of body mass index （BMI）, estradiol level on the trigger day, effect of number of follicles with a diameter ≥14 mm on the trigger day on the serum HCG level on the trigger day, and the relationship between the high and low levels of serum HCG on the trigger day and the clinical outcomes. Results There were statistically significant differences in BMI among the groups（P < 0.05）. The linear regression coefficient between BMI and serum HCG levels on the next day of trigger was-11.896（P < 0.05）, showing a significant negative correlation. There were statistically significant differences in oocyte retrieval rate, Meiosis II （MII） oocyte rate and normal fertilization rate among the four groups（P < 0.05）. There was no significant difference in other observed indicators（P > 0.05）, but there was an increasing trend in the rates of high-quality embryos, embryo implantation, and clinical pregnancy with increasing HCG levels. Conclusion The serum HCG levels of the day after trigger have a significant effect on the oocyte retrieval rate, MII oocyte rate and normal fertilization rate potentially affecting the high-quality embryo rate, clinical pregnancy rate and embryo implantation rate. BMI is an important factor affecting the serum HCG levels on the day after trigger, and the dosage of HCG trigger should be personalized based on BMI levels.
2024, 45(8): 79-85.
doi: 10.12259/j.issn.2095-610X.S20240812
Abstract:
Objective To collect color data of tetracycline staining in upper anterior teeth in Kunming, Yunnan area, study their color characteristics and distribution patterns. Methods A total of 100 tetracycline dental patients with an average age of 48 were randomly selected from Yan’ an Hospital in Kunming City from January 2023 to December 2023. The VITA Easyshade Advance 4.0 wireless spectrophotometer was used for color comparison. The L*a*b* values of the upper central incisors, lateral incisors, and canines were measured at the cervical 1/3, middle 1/3, and incisal 1/3 positions of each tooth. The teeth were grouped by gender, age, location, and degree of discoloration for statistical analysis. Results The overall distribution of the middle 1/3 L*a*b* values of the anterior teeth with different staining degrees of tetracycline is as follows: mild degree: L*: 64.1～75.7, a*:1.4～5.1, b*:12.5～24.2; medium degree: L*: 51.8～70, a*: 1.5～8, b*: 13.8～34.3; severe degree: L*:44.9～65, a*:3.3～11.6, b*:11.4～29.5. There was no significant difference in the chromaticity value of the anterior teeth of tetracycline in different genders（P > 0.05）. The L* value of tetracycline in anterior teeth at different ages was significantly different（P < 0.05）.The difference of a*b* values in different parts was statistically significant （P < 0.05）. The difference of L*a* values in different coloring degree was statistically significant （P < 0.05）. Conclusion The color changes of tetracycline-stained anterior teeth in the Kunming area of Yunnan are not related to gender, but rather to age, location, and degree of staining; compared to normal teeth, the color range of tetracycline-stained teeth is more diverse, with an overall hue leaning towards red, yellow, and gray. The brightness of severely tetracycline-stained teeth is generally darker, suggesting that when clinically performing aesthetic restoration or making shade guides for tetracycline-stained teeth, shade tabs with slightly lower brightness and hues leaning towards red, yellow, and gray can be used as references.
2024, 45(8): 86-92.
doi: 10.12259/j.issn.2095-610X.S20240813
Abstract:
Objective To evaluate the therapeutic effect of Zhuang medicine liquid aroma moxibustion combined with celecoxib on Xiangbi （cervical spondylosis）. Methods 90 patients who met the inclusion criteria for cervical spondylosis from the Pain Clinic of Guangxi International Zhuang Medicine Hospital from January to December 2023 were selected as the research subjects. They were divided into 3 groups: the oral celecoxib control group （Group A, n = 30）, the Zhuang Medicine liquid moxibustion control group （Group B, n = 30）, and the Zhuang Medicine liquid moxibustion combined with celecoxib experimental group （Group C, n = 30）. During the treatment process, the Visual Analog Scale （VAS）, Neck Pain Questionnaire （NPQ）, Neck Disability Index （NDI）, and Erythrocyte Sedimentation Rate （ESR） were used to evaluate the patients before and after treatment to understand the improvement in pain and neck function among the 3 groups of patients, ultimately summarizing the clinical efficacy of the 3 groups of patients. Results The total effective rate of group C was 93.33% （28/30）, while the total effective rate of group A was 86.67% （26/30）, and the total effective rate of group B was 83.33% （25/30）. Group C's overall effectiveness rate is significantly higher than that of Groups A and B （P < 0.05）. Patients in all three groups showed a significant decrease in retested VAS, NPQ, NDI scales, and Erythrocyte Sedimentation Rate （ESR） indicators after treatment compared to before, with Group C showing a greater decrease than the other 2 groups （P < 0.05）. Conclusion The combination of Zhuang medicine liquid moxibustion and Celecoxib has good efficacy in treating cervical spondylosis. Clinical evidence indicates a significant and lasting improvement in neck pain symptoms and neck mobility, enabling a rapid recovery of patients' daily self-care abilities, with no apparent adverse reactions. It is worth promoting its clinical application.
2024, 45(8): 93-100.
doi: 10.12259/j.issn.2095-610X.S20240814
Abstract:
Objective To compare the effectiveness of V-shaped double-channel spine endoscope technology （VBE） in treating lumbar disc herniation （LDH） with lumbar instability with traditional transforaminal lumbar interbody fusion （TLIF）. Methods From January 2021 to March 2023, 102 patients with LDH and lumbar instability admitted to the People's Hospital of Guandu District, Kunming City, and the Tenth People's Hospital of Shanghai were selected. They were randomly divided into two groups using random grouping software: the TLIF group （undergoing TLIF surgery, n = 51） and the VBE group （undergoing VBE surgery, n = 51）. The two groups were compared in terms of general surgical conditions, perioperative pain levels （VAS scores）, pre- and postoperative levels of back and leg pain （VAS scores）, lumbar spine stability （intervertebral height, lumbar lordosis angle）, decompression effect （cross-sectional area of the dural sac, intervertebral foramina area）, functional prognosis, and complication status. Results In the VBE group, the amount of bleeding during the surgery was less than in the TLIF group, with shorter incision length, bed rest time, and hospital stay compared to the TLIF group （P < 0.05）. VAS scores at 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours post-operation were lower in the VBE group compared to the TLIF group （P < 0.05）. VAS scores for lower back pain and leg pain at 3 and 6 months post-operation, as well as intervertebral height, lumbar lordosis angle, dural sac cross-sectional area, and intervertebral foramen area at 6 months post-operation were higher than pre-operation levels in both groups, but the inter-group differences were not statistically significant （P > 0.05）. Comparison of the excellent-to-good functional prognosis rates between the two groups （98.04%, 94.12%） showed no statistically significant difference （P > 0.05）. no complications occurred in the VBE group, while one case of incision exudation occurred in the TLIF group. Conclusion VBE and TLIF treatment for LDH with lumbar instability patients can enhance lumbar stability, improve patients' lumbar function, ensure safety, while VBE with a small incision can reduce intraoperative bleeding, decrease early postoperative pain, and speed up early recovery.
2024, 45(8): 101-108.
doi: 10.12259/j.issn.2095-610X.S20240815
Abstract:
Objective To investigate the expression of ANXA8, PGRMC1, and miR-92a in cervical cancer tissues and their relationship with clinicopathological features. Methods A total of 69 cervical cancer patients treated at the Second People’ s Hospital of Yibin City from January 2020 to March 2022 were included in this study. Cervical cancer tissues and adjacent normal tissues from these patients were collected for analysis. Immunohistochemistry was used to detect the positivity of ANXA8 and PGRMC1. Western blot was performed to analyze the protein expression of ANXA8 and PGRMC1. RT-PCR was used to measure the mRNA levels of ANXA8 and PGRMC1, as well as the expression level of miR-92a.The linear correlation among ANXA8, PGRMC1, and miR-92a expression levels, as well as their relationships with the clinical pathological features of cervical cancer patients, were analyzed. Results The positive rates of ANXA8 and PGRMC1 in cervical cancer tissues （76.81%, 72.46%） were significantly higher than adjacent tissues （4.35% and 7.25%）, and the expression level of miR-92a was significantly higher than adjacent tissues （P < 0.05）. With higher FIGO stage, lower differentiation degree, lymph node metastasis, and parametrial infiltration, the positivity rates of ANXA8 and PGRMC1 as well as the expression level of miR-92a were higher（P < 0.05）. Conclusion ANXA8, PGRMC1, and miR-92a are highly expressed in cervical cancer tissues, and are related to the pathological characteristics such as tumor staging, differentiation degree, metastasis, and invasion. They can provide a reliable basis for the pathological evaluation of cervical cancer patients.
2024, 45(8): 109-116.
doi: 10.12259/j.issn.2095-610X.S20240816
Abstract:
Objective To establish a diabetic kidney disease （DKD） progression prediction scale based on the decision tree classification model. Methods A retrospective analysis was conducted on 308 patients with diabetic kidney disease admitted to Department of Endocrinology, the Second People's Hospital of Liupanshui from July 2020 to July 2021. The patients were divided into two groups: microalbuminuria group （n = 224） and macroalbuminuria group （n = 84）. Univariate and multivariate Logistic regression analysis were performed on demographic data, past medical history and other indicators of the two groups of patients, and a DKD progression prediction scale was established using the decision tree classification model. Results Among the 308 subjects, 84 （27.27%） had macroalbuminuria and 224 （72.73%） had microalbuminuria. Multivariate Logistic regression analysis showed that systolic blood pressure （OR = 1.022, P = 0.003） and serum creatinine （OR = 1.012, P < 0.001） and total protein levels （OR = 0.953, P = 0.003） were risk factors for macroalbuminuria. The decision tree classification model was used to establish a prediction scale with a total score of 60 points and a diagnostic threshold of 33 points. The area under the ROC curve of the decision tree model （0.781） was greater than that of the multivariate logistic regression model （0.769）. The sensitivity was 95.2% and the specificity was 78.9%. Conclusion DKD progression prediction scale can accurately assess the progression of DKD and has good clinical value for the early prediction of DKD progression.
2024, 45(8): 117-124.
doi: 10.12259/j.issn.2095-610X.S20240817
Abstract:
Objective To investigate the relationship between peripheral blood blast clearance （PBBC） time during induction chemotherapy and albumin （ALB） level at diagnosis and genetic mutation and prognosis in acute myeloid leukemia patients （AML）. Methods Clinical data of 175 AML patients initially diagnosed from January 2017 to May 2023 at the Second Affiliated Hospital of Kunming Medical University were collected for a retrospective analysis. ROC curve was used to determine the optimal cut-off value of PBBC as 6.5 days. PBBC ≤ 6.5 days were classified as the Peripheral Blood Primitive Blood Cell Short-Term Clearance Group （EBC）, and PBBC > 6.5 days were classified as the Peripheral Blood Primitive Blood Cell Long-Term Clearance Group （DBC）. A simple prognostic model was established based on PBBC and ALB at initial diagnosis, dividing patients into groups a, b, and c: group A （PBBC ≤ 6.5 d, ALB > 34.45 g/L, no risk factors）, group b （PBBC > 6.5 d, ALB > 34.45 g/L or PBBC ≤ 6.5 d, ALB ≤ 34.45 g/L, 1 risk factor）, group c （PBBC > 6.5 d, ALB ≤ 34.45 g/L, 2 risk factors）. Genetic mutations and OS were compared among the three groups of patients; differences in various parameters were evaluated using t-test and chi-squared test or rank sum test, and survival analysis was performed using the Kaplan-Meier method. Results COX regression analysis showed that PBBC and ALB were independent factors affecting prognosis, with statistical significance （P < 0.05）. Comparison of OS among groups revealed median OS values of not reached, 1.86 a, and 0.93 a, respectively （a vs. b group, P < 0.001; a vs. c group, P < 0.001; b vs. c group, P = 0.001）, with statistically significant differences indicating that the OS and PFS of the no-risk group were better than those with 1 to 2 risk factors.It was found that CEBPA double mutation and NPM1 gene mutation among the three groups were not statistically significant （P > 0.05）, but C-KIT gene mutation was statistically significant （P < 0.05）. Conclusion PBBC and ALB are independent risk factors for the prognosis of AML patients. A simple prognostic model composed of PBBC and ALB can provide a basis for the selection of precise and personalized induction chemotherapy regimens, and provide reference for determining gene mutations and prognosis in newly diagnosed AML patients.
2024, 45(8): 125-132.
doi: 10.12259/j.issn.2095-610X.S20240818
Abstract:
Objective To explore the application of hybrid blood purification in patients with end-stage renal disease （ESRD） with inadequate peritoneal dialysis, and its effects on dialysis adequacy, chronic inflammation status, and safety improvement. Methods 80 patients with inadequate peritoneal dialysis （ESRD） in Foshan Nanhai District People's Hospital from September 2020 to August 2022 were selected and randomly divided into two groups, with 40 cases in each group. The control group received simple hemodialysis, while the observation group received hybrid blood purification continuously for 3 months. A comparison was made between the general data of the two groups, serum indicators before and after treatment [intact parathyroid hormone （iPTH）, β2-microglobulin （β2-MG）, cystatin C （CysC）], renal function indicators [blood urea nitrogen （BUN）, serum creatinine （Scr）, residual renal function （RRF）], nutritional status [hemoglobin （Hb）, albumin （Alb）, transferrin （TRF）], chronic inflammatory status [interleukin-6 （IL-6）, high-sensitivity C-reactive protein （hs-CRP）, tumor necrosis factor-alpha （TNF-α）], red blood cell immune function [red blood cell immune complex ring rate （RBC-ICR）, red blood cell C3b receptor （RBC-C3bR）, CD35-positive red blood cell percentage] and urea clearance index （KT/V）, as well as the incidence of complications. Results After 1 and 3 months of treatment, the levels of iPTH, β2-MG and CysC in the observation group were lower than those in the control group, and KT/V was higher than that in the control group （P < 0.05）; after 1 and 3 months of treatment, BUN, Scr, RRF levels were lower than those in the control group （P < 0.05）; after 1 and 3 months of treatment, the levels of Hb, Alb, and TRF in the observation group were higher than those in the control group, and the levels of IL-6, hs-CRP, and TNF-α were lower than those in the control group （ P < 0.05）; after 1 and 3 months of treatment, the percentage of CD35-positive red blood cells and RBC-C3bR level in the observation group were higher than those in the control group, and the RBC-ICR level was lower than that in the control group （P < 0.05）; the incidence of complications in the observation group was 7.50% Compared with 20.00% in the control group, the difference was not statistically significant （P > 0.05）. Conclusion Hybrid blood purification utilizes the principles of diffusion, convection, and adsorption to maximize the removal of inflammatory mediators, improve dialysis adequacy and red blood cell immune adhesion activity, enhance body nutritional status and renal function. This approach has shown significant effectiveness in ESRD patients with inadequate dialysis.
2024, 45(8): 133-138.
doi: 10.12259/j.issn.2095-610X.S20240819
Abstract:
Objective To analyze and summarize case data of patients with X-linked sideroblastic anemia secondary to hematological diseases. Methods The clinical data of a case of X-linked sideroblastic anemia with secondary hemochromatosis admitted to the Department of Endocrinology of the First Affiliated Hospital of Kunming Medical University were retrospectively analyzed, and the related literatures were reviewed. Results The patient presented with persistent fatigue and sought medical attention at multiple hospitals, yet the underlying cause remained elusive. Subsequently, the patient was admitted to the Department of Endocrinology of the First Affiliated Hospital of Kunming Medical University due to hyperglycemia and cutaneous pigmentation. Following comprehensive diagnostic procedures including bone marrow aspiration, genetic testing, liver CT scan, and MRI examination, a definitive diagnosis was established. The patient’ s clinical symptoms exhibited improvement subsequent to iron chelation therapy. Later, the patient died of heart failure due to irregular iron treatment. Conclusion Diabetes caused by hemochromatosis is a special type of diabetes. Diagnosing this disease not only relies on serological and imaging examinations, but genetic testing is also very important. In clinical practice, when skin pigmentation combined with diabetes and liver function abnormalities are found, hemochromatosis should be considered. Genetic testing can not only assist in diagnosing hemochromatosis, but also help distinguish between primary and secondary hemochromatosis
2024, 45(8): 139-144.
doi: 10.12259/j.issn.2095-610X.S20240820
Abstract:
Objective To study the clinical efficacy and safety of Roxadustat in the maintenance hemodialysis of HIV/AIDS patients with EPO resistance. Methods 60 cases of HIV/AIDS patients with EPO resistance undergoing maintenance hemodialysis treatment at the Blood Purification Center of the Third People's Hospital of Kunming from July 2022 to December 2023 were divided based on patient preference into a control group of 30 cases continuing Erythropoietin （EPO） treatment and an observation group of 30 cases treated with Roxadustat for 8 weeks. Changes in patients' hemoglobin （HGB）, serum ferritin （SF）, serum iron （SI）, total iron binding capacity （TIBC）, high-sensitivity C-reactive protein （hs-CRP）, cytokines （IL-1β, IL-6, IL-8, IL-10, TNF-α, IFN-γ, IFN-α） were recorded and compared before and after treatment in the two groups, along with monitoring the occurrence of adverse drug reactions. Results After 8 weeks of treatment, the levels of hemoglobin （HGB）, serum iron （SI） and total iron binding capacity （TIBC） in observation group were significantly increased, and the differences were statistically significant （all P < 0.05）, while the levels of serum ferritin （SF）, IL-1β, IL-6, IL-10 and TNF-α were significantly decreased, with statistically significant （all P < 0.05）. In the comparison between the two groups, the levels of hemoglobin （HGB） and total iron binding capacity （TIBC） in the observation group were higher than those in the control group, with statistically significant differences （all P < 0.05）. The levels of serum iron （SF）, IL-1β, IL-6, IL-10, and TNF-α in the observation group were lower than those in the control group, with statistically significant differences （P < 0.05）. There were no serious adverse reactions in either group. Conclusion The use of Roxadustat in maintenance hemodialysis patients resistant to EPO and living with HIV/AIDS is safe and effective, significantly improving the patients' hemoglobin and iron metabolism levels, and can improve the patients' state of micro-inflammation.
2024, 45(8): 145-153.
doi: 10.12259/j.issn.2095-610X.S20240821
Abstract:
Objective Compare the toxic effects of Amanita Manginiana from seven different regions in Yunnan Province on the livers and kidneys of mice. Methods The Kunming mice were randomly divided into 7 groups, each subgrouped into 6 h, 3 d, 7 d, and 14 d time points, with 5 mice in each time group. The experiment involved gastric lavage using Yunnan's Amanita Manginiana from 7 villages from different counties, with the control group （0 h） receiving an equivalent amount of saline lavage. Blood samples were taken from the eyes at different time points after each lavage to measure levels of alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, and uric acid （UA） in the serum. The mice's liver and kidney weights were measured, their liver and kidney indices determined, and liver and kidney tissues were observed using HE staining. Results The Amanita Manginiana from Yuding Village, Mouding County （MDYD）, and Yongcui Village, Luquan County （LQYC）, caused acute damage to the livers and kidneys of mice. Within 6 hours of gavage, the mice's serum biochemical indicators began to rise, peaking on the 7th day, and started to decline by the 14th day, indicating a trend towards recovery of the damage （P < 0.05）. However, the Amanita Manginiana from Donghua Village, Tengchong City （TCDH）, and Yongcui Village, Luquan County （LQYC）, only damaged the livers of mice. Even after the 14th day, the levels of AST, ALT, and UA in the serum continued to rise, indicating a longer-lasting impact of the local Amanita Manginiana on the liver （P < 0.05）. The Amanita Manginiana from Moguang Village, Heqing County （HQMG）, Dean Village, Nanjian County （NJDA）, and Gaoping Village, Mouding County （MDGP）, caused damage to both the livers and kidneys of mice. After the 14th day, the levels of AST, ALT, and UA in the serum continued to increase （P < 0.05）, showing that the damage to the mice's liver and kidneys did not improve. Conclusion Amanita Manginiana from different villages in Yunnan Province contains varying levels of liver and kidney toxicity, posing a potential risk to the liver and kidneys. It is advisable to exercise caution when consuming Amanita Manginiana.
2024, 45(8): 154-160.
doi: 10.12259/j.issn.2095-610X.S20240822
Abstract:
Immune function is an important physiological function in the human body that plays a crucial role in maintaining human health. Pyrethroid pesticides （PYRs） and their metabolites can have immunotoxic effects on the body, increasing the risk of immune-related diseases. This review summarizes the effects of PYRs exposure on the body’ s immune organs, immune cells, and immune molecules, as well as the immunotoxic mechanisms, and provides a summary and outlook on the immunotoxicity caused by early-life PYRs exposure, offering new ideas and recommendations for human studies on the immunotoxicity of PYRs exposure.
Immune function is an important physiological function in the human body that plays a crucial role in maintaining human health. Pyrethroid pesticides （PYRs） and their metabolites can have immunotoxic effects on the body, increasing the risk of immune-related diseases. This review summarizes the effects of PYRs exposure on the body’ s immune organs, immune cells, and immune molecules, as well as the immunotoxic mechanisms, and provides a summary and outlook on the immunotoxicity caused by early-life PYRs exposure, offering new ideas and recommendations for human studies on the immunotoxicity of PYRs exposure.
2024, 45(8): 161-165.
doi: 10.12259/j.issn.2095-610X.S20240823
Abstract:
In recent years, computer-aided design and manufacturing （CAD/CAM） have been driving the development and reform of the dental field. Prosthodontics is an essential part of oral medicine, and CAD/CAM is increasingly being used in prosthodontics, leading to rapid advancements in this field. This paper summarizes a number of domestic and international literatures to provide an overview of the progress of CAD/CAM in prosthodontics.
In recent years, computer-aided design and manufacturing （CAD/CAM） have been driving the development and reform of the dental field. Prosthodontics is an essential part of oral medicine, and CAD/CAM is increasingly being used in prosthodontics, leading to rapid advancements in this field. This paper summarizes a number of domestic and international literatures to provide an overview of the progress of CAD/CAM in prosthodontics.
2024, 45(8): 166-173.
doi: 10.12259/j.issn.2095-610X.S20240824
Abstract:
Objective Based on constructivist theory, this study aims to combine case-based learning （CBL） with mind mapping to develop a "Clinical Case Mind Map Library based on System Organs" containing complete medical history clues and detailed diagnostic and treatment processes. Methods The present situation of CBL teaching in Kunming Medical University and the demand for constructing clinical case mind map database were investigated by questionnaire. A mind map library with typical medical records as the core was constructed by using the action research method and X-mind tool software. The students' learning effect was tested by the comparative study of equal groups. Results The survey shows that both teachers and students have an urgent need to build a clinical case mind map library; action research demonstrates that the development and application of a case-based mind map library can effectively stimulate students' interest in learning and improve their ability for independent study; comparison studies show that the average scores of the experimental group students are significantly higher than those of the control group （P < 0.05）, the proportion of failing students in the experimental group has decreased （P < 0.05）, and the proportion of passing （P < 0.05） and excellent students has increased, achieving good teaching results. Conclusion The development and application of a clinical case mind map library based on systemic organs can effectively solve the problem of insufficient case resources in CBL courses; the combination of reducing text and empowering logic can help improve the depth and efficiency of CBL course learning, and is worth promoting.
2024, 45(8): 174-181.
doi: 10.12259/j.issn.2095-610X.S20240825
Abstract:
Objective To analyze and discuss the safety and feasibility of ambulatory laparoscopic cholecystectomy （ALC） based on the surgical situation of gallbladder resection patients in Qujing, Yunnan. Methods A retrospective analysis was conducted on 77 patients who underwent laparoscopic cholecystectomy at the First People's Hospital of Qujing City from September 2019 to October 2020. Based on the different treatment methods, the 77 patients were divided into the ALC group （n = 38） and the traditional laparoscopic cholecystectomy （TLC） group （n = 39）, and comparisons were made on the general preoperative conditions, surgical safety, health economics, and satisfaction indicators of the two groups. Results There were no statistically significant differences between the two groups of patients in terms of medical history, gender, age, surgery time, intraoperative bleeding, postoperative complications, and postoperative satisfaction （P > 0.05）. The differences in preoperative waiting time, length of hospital stay, and hospital costs were statistically significant between the two groups （P < 0.05）, with the ALC group showing a significant reduction in preoperative waiting time and hospital stay compared to the TLC group, and a significant decrease in surgical costs compared to the TLC group. Conclusion Precise minimally invasive surgical procedures combined with continuous postoperative care services, multi-modal pain management concepts, and fast recovery concepts in perioperative management can significantly shorten the preoperative and hospital stay duration, reduce hospital costs, and avoid an increase in postoperative complications. Therefore, ALC is practical, safe, effective, and beneficial to patients and regional medical resources. It can be implemented in combination with the actual situation in different regions.
2024, 45(8): 182-187.
doi: 10.12259/j.issn.2095-610X.S20240826
Abstract:
Objective To investigate the quality of life of stroke patients with dysphagia and find the appropriate position for swallowing. Methods From January to September 2023, 90 patients with dysphagia caused by stroke were selected from the Department of Geriatrics and Rehabilitation Medicine at the Third People's Hospital of Yunnan Province as study subjects. After the water swallowing test categorization, patients were randomly divided into 3 groups based on different levels of the test - 30° , 60° , 90° examination positions, with each group containing 30 cases. The patients were given a "Stroke Dysphagia Patient Quality of Life Survey" questionnaire to analyze the impact of different positions on swallowing function and the patients' quality of life. Results The proportion of patients with abnormal self-care ability was 91.11%, the rate of mild anxiety was 6.67%, the rate of mild depression was 16.67%, the rate of moderate nutritional risk was 91.11%, and the rate of gastroesophageal reflux was 36.67%. There were differences in self-care ability and gastroesophageal reflux among patients with different levels of swallowing dysfunction （P < 0.05）. There were differences in the incidence of leakage and aspiration in the 30° , 60° and 90° positions respectively （P < 0.05）. Conclusion The health status of stroke patients with dysphagia is concerning. The use of the 30° and 60° positions can effectively reduce the leakage and aspiration of the patients' swallowing. By enhancing patient health education and management, actively providing nutritional guidance and psychological support, as well as comprehensive measures such as medication, care, and rehabilitation training, the quality of life of patients can be further improved.
2024, 45(8): 188-192.
doi: 10.12259/j.issn.2095-610X.S20240827
Abstract:
Objective To explore the interventional effect of olfactory soothing combined with maternal voice stimulation on the sleep of hospitalized preterm infants. Methods A total of 90 hospitalized premature infants in the neonatal intensive care unit of a tertiary hospital in Yunnan Province from August 2023 to March 2024 were selected. Using a random number table method, they were randomly divided into two groups: the olfactory comfort combined with mother's voice stimulation group and the control group, with 45 cases in each group. The control group received routine gentle pat comfort intervention, while the olfactory comfort combined with mother’ s voice stimulation group was wiped with 5 drops of breast milk on a sterile cotton swab 1～2 cm away from the nostrils of premature infants. At the same time, the mother's voice was played 15 cm away from the premature infants. During playback, a decibel testing instrument was used to adjust the volume of the mother's voice to about 35～40 decibels. The playback time period was from 08:00 to 08:20, 14:00 to 14:20, 20:00 to 20:20. Each playback period is 20 minutes, and the mother's voice is played while providing olfactory comfort once. Two groups of hospitalized premature babies were compared for 24-hour total sleep time, sleep onset time, daytime sleep time, nighttime sleep time, and number of nighttime awakenings. Results Compared with the control group, the olfactory comfort combined with mother's voice stimulation group had significantly longer daytime sleep time, nighttime sleep time, and 24-hour total sleep time, significantly shorter sleep latency time, and significantly fewer nighttime awakenings, with statistical significance （P < 0.05）. Conclusion The combination of olfactory comfort and maternal voice stimulation can effectively improve the sleep quality of hospitalized premature infants, providing a reference method for sleep intervention in premature infants.
