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RSS2021 Vol. 42, No. 9
2021, 42(9): 13-19.
doi: 10.12259/j.issn.2095-610X.S20210939
Abstract:
Objective To explore the effects of 1800 MHz radio frequency electromagnetic fields on the body weight and expression of Glial fibrillary acidic protein （GFAP）, Neural Cell Adhesion Molecule （NCAM） and Gamma-Amino Butyric Acid （GABA） receptors in hippocampus of rats. Methods 14 SD rats were divided into the exposure group and the control group and the ratio of male to female was 3∶4 in the exposure group and 4∶3 in the control group. Exposure frequency 1800 MHz, intensity of 0.5 mW/cm2 RF field. Systemic exposure to three weeks, 12 hours a day （20:00-08:00）. After the exposure, the rats in the two groups were weighed respectively. Immunohistochemical techniques hippocampus GFAP stained sections, and GFAP NCAM and GABA receptors expression was measured in the hippocampus CA1, CA3 and DG （dentate gyrus）regions. Results The exposure group and the control group showed no significant difference in the body weight （P > 0.05）; the expression of GFAP in the CA1 and DG areas of the hippocampus decreased （ P < 0.05）, and there was no statistical significance in the other groups （ P > 0.05）. Conclusion At a frequency of 1800 MHz, an intensity of 0.5 mW/cm2 RF electromagnetic field SD rats are exposed for 3 weeks in rat hippocampal CA1 region and DG GFAP expression decreased, which may affect certain brain diseases.
2021, 42(9): 32-39.
doi: 10.12259/j.issn.2095-610X.S20210910
Abstract:
Objective To analyze the factors related to the different dietary behavior problems and parenting status of children aged 1 ～ 6 with “feeding problems”. Methods From January 2018 to October 2019, 700 children who were treated in the Department of Pediatrics of the Children’s Hospital of Kunming City for “feeding problems” were selected as the survey objects. Surveys were distributed to parents and 625 valid questionnaires were recovered. Parenting status was investigated in children aged 1-6 in Kunming with their poor appetite, food preference, bad habits, over-concern, fear of eating and potential illness. Results Among 625 children, 78.1% of them had 2 or more eating problems. The highest incidence of children’ s eating behavior problems were poor appetite （52.0%） and food preference （46.7%）. The factors affecting children’ s eating behavior problems were mainly parents’ education level, father’ s occupation, average monthly family income, main caregivers, family members’ eating behavior problems, the number of common meals and the knowledge of child rearing. Conclusion It is recommended that the aggravation of children in Kunming should increase the food diversity, fathers should increase children’ s participation in eating behaviors, the main adopters should increase the accumulation of parenting knowledge, and family members should lead by example when teaching children’ s eating habits.
2021, 42(9): 40-45.
doi: 10.12259/j.issn.2095-610X.S20210922
Abstract:
Objective To investigate the prevalence of hypertension and explore the influencing factors in the elderly of Nu ethnic group. Methods From July to September 2018, 1 080 Nu ethnic people aged ≥60 years old were selected by multi-stage stratified cluster sampling for the on-site questionnaire survey and physical examination. Results The detection rate of hypertension was 29.5% （95% CI: 26.8%-32.3%）, the detection rate of prehypertension was 29.3% （95% CI: 26.5%-32.0%）. The detection rate of hypertension increased with age, while the detection rate of normal prehypertension decreased with age （P < 0.05）. Hypertension detection rate of divorced or widowed elderly Nu was higher than that of married population; in overweight population was higher than that in normal BMI population; employees of enterprises and public institutions was higher than that farmers; moderate medical population was higher than mild population; drinkers were higher than non-drinkers; moderate and mild depression group was higher than normal population; the middle level of economic development was higher than the lower level of economic development（ P < 0.05）. The analysis of the multi-logistic regression model showed that the cross-layer interaction between the economic development level and alcohol consumption was statistically significant （ P < 0.05）, and the individual level covariate BMI （ OR = 1.057, 95% CI: 1.007-1.111）, divorce OR death had a positive effect on hypertension （OR = 1.901, 95% CI: 1.296-2.788）. Conclusion The detection rate of hypertension in the elderly patients of the Nu ethnic group is lower than the national level. The major risk factors are the economic development, alcohol consumption, BMI, divorces or widowes, overweight, employment in enterprises and public institutions, and moderate medical burden.
2021, 42(9): 1-6.
doi: 10.12259/j.issn.2095-610X.S20210918
Abstract:
Objective To investigate the therapeutic effect and mechanism of hydrogen water on paraquat induced pulmonary fibrosis in rats through autophagy. Methods 6-8 week=old SD rats were randomly divided into the control group, the paraquat exposure group, the hydrogen-water treatment group, the rapamycin treatment group and the comprehensive treatment group （10 rats in each group）. All rats were sacrificed after 28 days and their lung tissues were taken and stained with hematoxylin & eosin as well as Masson for histological examination. The expressions of Col-I and COL-III mRNA were detected by RT-PCR, and the expressions of P62 and LC3 were detected by Western Blot method. Results Compared with the control group, lung tissue of rats exposed to paraquat showed pathological changes of fibrosis, increased Col-ImRNA and Col-IIImRNA expression （P < 0.01）, increased P62 expression （P < 0.001）, and decreased LC3II/I value （P < 0.05）. Compared with the paraquat exposure group, the degree of pulmonary fibrosis in hydrogen water treatment group was reduced, and the expressions of Col-ImRNA and Col-IIImRNA were decreased （P < 0.05）, the expression of P62 was decreased （P < 0.05）, and the LC3II/I value was increased （P < 0.05）. Compared with the paraquat exposure group, the degree of pulmonary fibrosis in rapamycin treatment group was reduced, the expression of Col-ImRNA and Col-IIImRNA were decreased （P < 0.05）, the expression of P62 was decreased （P < 0.01）, and the LC3II/I value was increased （P < 0.01）. Compared with the paraquat poisoning group, the degree of pulmonary fibrosis in the comprehensive treatment group was significantly reduced, the expressions of Col-ImRNA and Col-IIImRNA were significantly decreased （P < 0.01）, the expression of P62 was significantly decreased （P < 0.01）, and the LC3II/I value was significantly increased （P < 0.001）. Conclusion Paraquat induces the pulmonary fibrosis and inhibites the autophagy in rats; while Rapamycin activates the autophagy and alleviates the paraquat-induced pulmonary fibrosis in rats. Hydrogen water alleviates the paraquat-induced pulmonary fibrosis and promotes the autophagy in rats. Hydrogen water combined with rapamycin is better than hydrogen water combined with rapamycin alone in the treatment of paraquat induced pulmonary fibrosis.
2021, 42(9): 7-12.
doi: 10.12259/j.issn.2095-610X.S20210914
Abstract:
Objective To investigate the mechanism of galanin receptor 2 （GalR2） in nucleus accumbens （NAc） mediated needle knife intervention in neuralgia. Methods A mononeuropathy model was duplicated by chronic constriction injury （CCI） of the left sciatic nerve of rat. The hind paw withdraw latency （HWL） to noxious thermal stimulation and the hind paw withdraw threshold （HWT） to noxious mechanical stimulation were tested. Western blot was used to detect the effect of needle knife therapy on the expression of GalR2 in NAc of CCI rats. Finally, the HWL and HWT were tested by intra-NAc injection of galanin receptor blockers after the needle knife therapy in CCI rats. Results The increases of HWL （left: P < 0.001; right: P < 0.05）and HWT （left: P < 0.01; right: P < 0.05）induced by the needle knife therapy were reduced by intra-NAc injection of 2 nmol galanin receptors blocker galantide in CCI rats, but not 1 nmol galantide （P > 0.05）. The expression of GalR2 in NAc of CCI rats was upregulated by the needle knife therapy （P < 0.01）, and intra-NAc injections of 2 nmol of GalR2 specific blocker M871 weakened the increase of HWL （left: P < 0.001; right: P < 0.001）and HWT （left: P < 0.001; right: P < 0.01）induced by the needle knife therapy in CCI rats. Conclusion GalR2 may mediate the analgesic effect of the needle knife therapy in NAc of CCI rats.
2021, 42(9): 20-24.
doi: 10.12259/j.issn.2095-610X.S20210905
Abstract:
Objective To construct the self-assembled nanoparticle influenza vaccine with the M2e-HA2 epitopes, and detect the immunological serology. Methods The M2e and HA2 antigen epitopes of influenza viruses were expressed in tandem with Ferritin protein, and the nanometer self-assembled particles were extracted under the condition of non-denatured and purified by affinity chromatography. The mice were immunized for two times, after the two immunizations, serum of mice was collected, western blot was used for antigenicity detection, and ELISA was used for antibody level detection. Results M2e-HA2self-assembled nanoparticles were successfully prepared, and high levels of M2e and HA2 specific antibodies were produced in the serum of immunized mice. Conclusion M2e-HA2 self-assembled nanoparticles can stimulate the production of high levels of M2e and HA2 specific antibodies in mice, laying the foundation for the development of a universal influenza vaccine.
2021, 42(9): 25-31.
doi: 10.12259/j.issn.2095-610X.S20210904
Abstract:
Objective To establish a rapid detection method for the nucleic acid of severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） based on the reverse transcription loop mediated isothermal amplification （RT-LAMP）. Method The RT-LAMP primers were designed according to the conservative region of N and ORF1ab gene of SARS-CoV-2. And the specificity, the minimum detection limit, the anti-interference ability and the best reaction time of the system were evaluated. Result Artificial synthesized SARS-CoV-2 nucleic acid samples were tested, and the results were consistent with the expected results.It confirmed the feasibility of the detection system. Conclusion The reaction system using RT-LAMP for the rapid detection of SARS-CoV-2 nucleic acid has the high specificity and sensitivity, and is suitable for the border areas with limited conditions.
2021, 42(9): 71-75.
doi: 10.12259/j.issn.2095-610X.S20210912
Abstract:
Objective To study the role of atropine in spontaneous breathing painless fiberoptic bronchoscopy. Methods Forty cases of patients scheduled for receivepainless fiberoptic bronchoscopy were randomly divided into 2 groups, with 20 cases in each group.The patients in the control group （group C） were gven the intravenous anesthesia with sufentanil 0.1 μg/kg, dexmedetomidine 0.2 μg/kg, propofol 1 mg/kg, remifentanil 0.2 μg/kg, propofol 1 mg/kg, then endotracheal fiberoptic bronchoscopy were conducted cooperating with the endotracheal surface anesthesia.An extra propofol 0.4 mg/kg was given when choking cough or body moving occurred.The patients in the observation group （group S） were given atropine 0.006 mg/kg intravenous injection, the subsequent processing was the same as for group C. The changes of vital signs at different points during the perioperative period, the time of operation, anesthesia recovery and leaving operation room, the excellent and good rate for anesthesia, the number of cases of propofol supplementation and use of vasoactive drugs, the incidence of intraoperative respiratory adverse events and postoperative adverse events were observed and compared between the two groups. Results The levels of HR, MAP and SpO2 had no significant different between the two groups on T1 （P > 0.05）, those of group S were significantly higher than group C on T 2 （P < 0.05）, the levels of HR and MAP on T 2 were significantly lower than those on T1 in group C （P < 0.05）, the rate of excellent and good of anesthesia of group S was significantly higher than that of group C （ P < 0.05）, the time of anesthesia recovery and leaving the operation room of group S were significantly lower than that of group C （ P < 0.01）, the number of cases of intraoperative propofol supplementation and use of vasoactive drugs of group S were significantly lower than those of group C （ P < 0.05）, the incidence of intraoperative respiratory adverse events of group S was significantly lower than that of group C （ P < 0.05）. Conclusion Atropine can improve the safety of the anesthesia of preserving spontaneous breathing for painless fiberoptic bronchoscopy.
2021, 42(9): 127-133.
doi: 10.12259/j.issn.2095-610X.S20210906
Abstract:
Objective To investigate the effects of sedation and analgesia induced tracheal intubation on reducing hemodynamic fluctuation and conscious tracheal intubation on postoperative adverse memory, negative emotion, psychological or mental effects. Methods 116 patients who were treated in our hospital from June 2017 to October 2020 were divided into the study group and the control group, with 58 cases in each group. The control group was given routine rapid induction of general anesthesia rapid induction of general anesthesia tracheal intubation, the medical staff completed posture placement, the study group was given sedation, analgesia, tracheal surface anesthesia slowly induced to lethargy and retained spontaneous breathing tracheal intubation. The hemodynamic indexes, postoperative memory and psychological status of the two groups were compared. Results There was no significant difference in the hemodynamic stability between the two groups T1 time points （P > 0.05）; the systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） hemodynamic stability of the study group was better than those of the control group （ P < 0.05）. Of the two groups, the T3 time point systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） of the study group were better than those of the control group （0.05）, the systolic blood pressure （SBP）, diastolic blood pressure （DBP）, and heart rate （HR） of the study group were better than those of the control group （ P < 0.05）. From the beginning of administration to the completion of tracheal intubation in the study group （ P < 0.05）, At the end of operation, there was no significant difference between the two groups （ P > 0.05）. There was no significant difference in memory and mental state between the two groups 1 d after operation （ P > 0.05）. Conclusion Sedation, analgesia and slow induction of tracheal intubation in patients undergoing general anesthesia will not increase the probability of postoperative adverse memory, negative emotional, psychological or mental effects. The clinical operation time of slow induction is slightly longer than that of fast induction, but it will not cause the delay of awakening and extubation. Although the hemodynamic changes are caused by intubation, the effect is slight. Extubation can reduce the adverse reactions caused by extubation stimulation, and the hemodynamic effect is better than that of fast induced tracheal intubation.
2021, 42(9): 46-50.
doi: 10.12259/j.issn.2095-610X.S20210935
Abstract:
Objective To explore the clinical value of peripheral blood T lymphocyte subsets and NK cell levels measured at multi-time points in patients with esophageal cancer. Methods A total of 39 cases of esophageal cancer patients were enrolled. Flow cytometry was used to detect the T lymphocyte subsets and NK cells in peripheral blood before and after the surgery and chemotherapy. Another 39 cases of healthy adults in the clinic during the same period were included as the control group, and the level of T lymphocyte subsets and NK cells were detected in the same way. Results The proportions of lymphocytes subsets and the levels of NK cells in patients with esophageal cancer were significantly lower compared with the control group before the surgery and chemotherapy （P < 0.05）, and decreased significantly after the surgery （P < 0.05）, the lowest value was found on the 3rd day after the surgery, then increased gradually, the ratio of CD4+/CD8+ didn’ t show the obvious difference in this period. After the chemotherapy, the proportion of CD3+、CD4+ and the ratio of CD4+/CD8+ increased significantly, while the proportion of CD8+ decreased significantly （P < 0.05）. 3 weeks after the chemotherapy, the proportions of T lymphocyte subsets were similar to that before the chemotherapy. There was no significant difference in NK cells though it showed a similar trend as T lymphocyte subsets before and after the chemotherapy （P > 0.05）. Conclusion The immune function of patients with esophageal cancer is in a suppressed state. After the surgery, their immune function reduced temporarily. Chemotherapy can improve this situation but it actually useful in the long term, which may support the idea of effective combinations of chemotherapy and T cell-dependent immunotherapy in a simultaneous or sequential regimen.
2021, 42(9): 51-56.
doi: 10.12259/j.issn.2095-610X.S20210917
Abstract:
Objective To detect the expression of caspase-1、IL-1β and IL-18 in endometrial polyps so as to explore the relationship between pyroptosis and endometrial polyps and provide the basis for exploring the pathogenesis of endometrial polyps. Methods In total 30 endometrial polyps specimens （from the observation group） and 30 normal endometrial specimens （from the control group） were collected from the patients visiting the Obstetrics and Gynecology Department of the First Affiliated Hospital of Kunming Medical University from January 2020 to January 2021. The expression of caspase-1, IL-1β and IL-18 in both groups were detected by immunohistochemical method. Results Caspase-1 was mainly expressed in the cytoplasm, the IRS score in the observation group and control group was 4.88±1.82 points and 1.37±1.13 points respectly, caspase-1 express was higher in the observation group （t = 8.95, P < 0.05）. IL-1β was not expressed in both groups. IL-18 was mainly expressed in cytoplasm and nucleus, the IRS score in the observation group and control group was 6.84±2.41 points and 1.73±0.90 points respectly, IL-18 express was higher in observation group （t = 10.87, P < 0.05）. Conclusion Caspase-1 and IL-18 in endometrial polyps is increased, and these two pyroptosis related factors may be involved in the occurrence of endometrial polyps.
2021, 42(9): 57-64.
doi: 10.12259/j.issn.2095-610X.S20210913
Abstract:
Objective To investigate the expression of C/EBPδ in colorectal cancer and its effect on the proliferation of colorectal cancer cells. Methods The expression of C/EBPδ protein in 40 patients undergoing the radical resection of colon cancer in the Second People’ s Hospital of Yunnan province from 2017 to 2018 was detected by immunohistochemistry. The interaction between C/EBPδ and Siah2 in colorectal cancer tissues was detected by immunoprecipitation. Viral vectors with C/EBPδ overexpression and interference were constructed to infect colorectal cancer caco-2 cells, respectively. The effects of C/EBPδ expression and interference on cell proliferation, apoptosis and cycle were observed through CCK8, flow cytometry detection and plate cloning formation experiments. Chi-square test was used to analyze the correlation factors of positive expression rate. Results Ⅰ The expression of C/EBPδ increased successively from the normal intestinal tissues to paracellular tissues and then to colorectal cancer tissues, and the differences were statistically significant （all P < 0.05）. The expression of C/EBPδ protein was more significant in colorectal cancer patients with liver metastasis; Ⅱ The C/EBPδ increased colorectal cancer tissues were accompanied by the increase of Saih2, and there was an interaction between the two; Ⅲ C/EBPδ overexpression significantly increased the proliferation of caco-2 cells, while the shRNA interference of C/EBP significantly reduced the proliferation of colorectal cancer cells; Ⅳ Compared with the control group, the shRNA interference of C/EBPδ significantly inhibited the in vitro migration and invasion of colorectal cancer cells caco-2. Conclusion C/EBPδ is abnormal in colorectal cancer tissues, and the overexpressed C/EBPδ promotes the invasion and rotation of colorectal cancer cells by interacting with Saih2, which may be related to the poor prognosis of colorectal cancer.
2021, 42(9): 65-70.
doi: 10.12259/j.issn.2095-610X.S20210932
Abstract:
Objective To explore the relationship between the different degrees of visceral fat area and obesity indexes and glycolipid metabolism indexes in type 2 diabetes patients. Methods From October 2017 to September 2018, 682 T2DM patients admitted to the Endocrinology Department of the 2nd Affiliated Hospital of Kunming Medical University were included in this study. The visceral fat area （VFA） was measured by the visceral fat detector （DUALSCAN HDS-2000） and divided into group A, B, C and D according to VFA 0～50 cm2, 50～100 cm2, 100～150 cm2 and ≥150 cm2. The differences of waist circumference, BMI, abdominal subcutaneous fat area, insulin （INS） and C-peptide （C-P） release test, uric acid （UA）, blood lipid, HCY, Cystatin C （Cysc） in the four groups were compared and the correlation was analyzed. Results There was a positive correlation between the visceral fat area and obesity-related indicators （r >, P < 0.05）. VFA was positively correlated with INS（0 h, 1 h, 2 h, 3 h）, C-P （0 h, 1 h）, TG, APOE, UA, CYSC （r > 0, P < 0.05）. Conclusion VFA is positively correlated with obesity, insulin resistance, triglyceride, uric acid and CYSC in patients with type 2 diabetes. The greater the VFA, the more severe the degree of obesity and insulin resistance, and the higher the blood uric acid and triglyceride.
2021, 42(9): 76-82.
doi: 10.12259/j.issn.2095-610X.S20210937
Abstract:
Objective To study the related risk factor of recurrence after the treatment of choledochojejunostomy in hepatolithiasis. Methods Retrospective analysis was performed on the clinical data of patients with hepatolithiasis who underwent biliary jejunostomy in the Second Affiliated Hospital of Kunming Medical University from June 2014 to June 2019.According to the criteria for recurrence of bile duct stones, the included patients were divided into the recurrence group and the non-recurrence group. Results A total of 77 patients with hepatolithiasis and undergoing the underwent choledochojejunostomy were included in this study, all of whom were followed up successfully, including 21 in the recurrence group and 56 in the non-recurrence group.Univariate analysis and multivariate analysis showed that stone size ≥10 mm, choledochal diameter < 20 mm, stone location, biliary inflammation, anastomotic anastomosis, no supporting tube, no biliary drainage and no hepatectomy were the risk factors for recurrence of hepatolithiasis after the biliary jejunectomy （P < 0.05）. Conclusion Stone size ≥10 mm, choledochal diameter < 20 mm, stone location, biliary inflammation, anastomotic anastomosis, no supporting tube, no biliary drainage and no hepatectomy are the risk factors for the recurrence of hepatolithiasis after the biliary jejunectomy.
2021, 42(9): 83-89.
doi: 10.12259/j.issn.2095-610X.S20210927
Abstract:
Objectives To analyze the correlation of blood lactate concentration in artery, central vein and peripheral vein of patients with septic shock, and to explore the value of blood lactate and lactate clearance rate in different periods of time in evaluating the prognosis of patients with septic shock. Methods A total of 60 patients with septic shock in ICU of building 3 of the First Affiliated Hospital of Kunming Medical University from June 2020 to February 2021 were selected as the research objects. The general data of the patients were collected, and the blood gas parameters of artery, peripheral vein and central vein at admission and 6 h, 12 h and 24 h after treatment, as well as arterial blood gas parameters at 48 h and 72 h after the treatment were monitored. First, according to the source of blood samples, they were divided into the artery group, the central vein group and the peripheral vein group. The correlation of blood lactic acid concentration in artery, central vein and peripheral vein was analyzed. Then, according to the 28 day survival of patients, they were divided into the death group and the survival group. The evaluation value of blood lactic acid and lactic acid clearance rate in different periods of early stage on the prognosis of patients was discussed. Results （1） According to Pearson correlation analysis, there was a correlation between arterial lactic acid and central venous lactic acid at ICU admission and 6 h, 12 h, 24 h after the treatment, with r value between 0.89-0.90 at each time period, P < 0.05; there was a correlation between arterial lactic acid and peripheral venous lactic acid at ICU admission and 6 h, 12 h, 24 h after treatment, with r value between 0.83-0.87 at each time period, P < 0.05. （2） By drawing ROC curve, the AUC of arterial lactic acid at the initial and 6 h, 12 h, 24 h, 48 h and 72 h after the treatment were 0.64, 0.62, 0.64, 0.72, 0.66, 0.63, respectively, P < 0.05. The AUC of arterial lactate was the highest at 24 h, with the best cutoff value of 2.42 mmol/L, sensitivity of 0.64 and specificity of 0.66. （3） By drawing the ROC curve, the AUC of arterial lactic acid clearance at 6 h, 12 h, 24 h, 48 h and 72 h were 0.66, 0.61, 0.74, 0.72 and 0.70, respectively, P < 0.05. The AUC of 24 h lactate clearance was the highest, with the best cutoff value of 19.57%, sensitivity of 0.64 and specificity of 0.68. Conclusions （1） There is a correlation between arterial and central venous blood lactic acid levels and between arterial and peripheral venous blood lactic acid levels in patients with septic shock. （2） The arterial lactate and lactate clearance rate 24 hours after the treatment have a good evaluation value for the prognosis of patients with septic shock.
2021, 42(9): 90-94.
doi: 10.12259/j.issn.2095-610X.S20210930
Abstract:
Objective To investigate the effect of percutaneous coronary intervention （PCI） under the guidance of FFR on the guidance of patients with the acute coronary syndrome （ACS） with multi-vessel disease and the effect on adverse events. Methods A total of 320 patients with ACS complicated with multi-vessel disease admitted to the Department of Cardiology, of the First People’ s Hospital of Kunming city from April 2019 to April 2020 were divided into 2 groups by random number table method, with 160 patients in each group. PCI was guided by blood flow reserve fraction （FFR group） and PCI was guided by coronary angiography （CAG group）. The differences in the basic data, success rate of PCI and the number of stent implantation between the two groups were compared. The incidence of major adverse cardiovascular events （MACE） was compared between the two groups after 6 months of the follow-up. Results There was no significant difference in the basic data between the two groups （P > 0.05）; There was no statistical significance in the success rate of PCI, duration of PCI operation and length of hospital stay between 2 groups （P > 0.05）; The number of stent implanted and the amount of contrast agent used in FFR group were lower than those in CAG group （P < 0.05）; 6 months after the surgery, there was no significant difference in the total incidence of target vessel revascularization and adverse cardiovascular events between the two groups （P > 0.05）. Conclusion Downward PCI guided by FFR can reduce the unnecessary stent implantation, reduce the occurrence of major adverse cardiovascular events, and improve the prognosis of patients with ACS complicated with multi-vessel disease.
2021, 42(9): 95-100.
doi: 10.12259/j.issn.2095-610X.S20210909
Abstract:
Objective To investigate the expression and significance of TGF-β1, TIMP-1 and Collagen Ⅲ in the vaginal wall of patients with pelvic organ prolapse （POP）. Methods A total of 28 POP patients who underwent surgery in the Department of Gynecology of the First Affiliated Hospital of Kunming Medical University from March 2020 to December 2020 were selected as the POP group, which were divided into 7 cases of grade Ⅱ, 16 cases of grade Ⅲ, and 5 cases of grade Ⅳ according to POP-Q staging method. Thirty patients with complete hysterectomy and/or bilateral adnexectomy without POP due to gynecological benign lesions were selected as the control group. The expressions of TGF-β1, TIMP-1 and Collagen Ⅲ in vaginal wall tissue were identified by immunohistochemistry. Results The IRS score of TGF-β1, TIMP-1 and Collagen Ⅲ in the POP group were significantly lower than those in the control group, with the statistical significance （P < 0.05）. The IRS scores of TGF-β1, TIMP-1 and collagen Ⅲ in patients with grade Ⅱ, grade Ⅲ and grade Ⅳ in the POP group gradually decreased with the increase of degree, and the differences were statistically significant （P < 0.05）. There was a positive correlation between TIMP-1 and TGF-β1 expression in the vaginal wall tissue of the POP group （r = 0.381, 0.519, P < 0.05）. TGF-β1 expression was positively correlated with TIMP-1 expression （r = 0.270, P < 0.05）. Conclusion Collagen Ⅲ, TIMP-1 and TGF-β1 are low expressed in vaginal wall tissue of pop patients, which may be involved in the occurrence and development of pop, and may be correlated with the severity of the disease. Collagen Ⅲ, TIMP-1 and TGF-β1 in the vaginal wall tissue of pop patients are correlated to some extent, and they have a certain synergistic effect, jointly participating in the occurrence and development of the disease.
2021, 42(9): 101-107.
doi: 10.12259/j.issn.2095-610X.S20210940
Abstract:
Objective To investigate the clinical value of expression levels of TNF- α、IL-6、IL-17 in the maternal serum and umbilical cord serum in the premature rupture of membranes （PROM） with chorioamnionitis （CS） and PROM with the neonatal infection during the perinatal period. Methods 51 patients with the premature rupture of membrane who had been admitted to the Obstetrics Department of the First Affiliated Hospital of Kunming Medical University were enrolled as PROM group. At the same time, 20 normal maternities delivered in this hospital were adopted to the control group. Double antibody sandwich ELISA was used to detect the expression levels of TNF-α, IL-6 and IL-17 in the maternal serum and umbilical cord serum. After that, the PROM group was regrouped into PROM with CS group and PROM without CS group, PROM without the neonatal infection during the perinatal （group A1） and PROM with the neonatal infection during perinatal （group A2）. Comparing the expression levels of these three indicators in the maternal serum and umbilical cord serum of different groups and using ROC curve to analyze the value of these indexes above in predicting the premature ruptured of membranes with adverse pregnancy outcomes associated with maternal and fetal infection. Result （1） The levels of TNF-α and IL-6 in the maternal serum and umbilical cord serum in PROM with CS group were statistically higher than those in PROM without CS group and the control group （P < 0.05）. The levels of TNF-α in the maternal serum and the levels of IL-6 in the umbilical cord serum in the PROM without CS group were statistically higher than those in the control group （P < 0.05）. （2） Expression levels of TNF-α, IL-6 and IL-17 in the maternal serum and umbilical cord serum of A2 group were statistically higher than those of A1 group and the control group （P < 0.05）. The levels of TNF-α in the maternal serum and the levels of IL-6 in the umbilical cord serum of A1 group were significantly higher than those of the control group （P < 0.05）. （3） The expression level of TNF-α、IL-6 and IL-17 in the maternal serum and in the umbilical cord serum were significantly positively correlated （P < 0.001）. （4） In the diagnosis of PROM with CS, TNF-α in the maternal serum was of the biggest area under the curve （AUC） among all single index （0.763）. The AUC of TNF-α in the maternal serum was bigger than that in the umbilical cord serum （0.614）（P < 0.05）. When four indexes were used in combination, the AUC of TNF-α+IL-6 in the maternal serum combined with TNF-α+IL-6 in the umbilical cord serum （0.820） was bigger than that of single detection of TNF-α in the umbilical cord serum （0.614）（P < 0.05）. （5） In the diagnosis of PROM with the neonatal infection during perinatal, IL-6 was of the biggest AUC among all single index in the maternal serum （0.800） and IL-17 was of the biggest AUC among all single index in the umbilical cord serum （0.829）. The AUC of IL-17 in the umbilical cord serum was bigger than that in the maternal serum （0.735）（P < 0.05）. Two indexes combined of IL-6+ IL-17 or Three indexes combined of TNF-α+ IL-6+ IL-17 in the umbilical cord serum was of great diagnostic value （AUC: 0.863、0.866）. Conclusion TNF-α, IL-6 and IL-17 in the maternal serum and umbilical cord serum are of great predictive value for predicting PROM with CS and PROM with the neonatal infection during the perinatal period. The diagnostic value of joint detection is better. In clinical work, detection of the three indexes in the maternal serum also has a good value of the clinical application when collecting of the umbilical cord serum is limited.
2021, 42(9): 108-113.
doi: 10.12259/j.issn.2095-610X.S20210901
Abstract:
Objective To evaluate the clinical application value of whole blood interferon-gamma release assay （IGRA） combined with T lymphocyte subset detection in diagnosis of pulmonary tuberculosis （TB）. Methods A total of 58 consecutive patients diagnosed with pulmonary tuberculosis who were hospitalized in our hospital from September 2015 to February 2016 in our hospital were enrolled, including 41 patients with sputum-coated positive pulmonary tuberculosis or confirmed as the pulmonary tuberculosis by pulmonary fine needle aspiration biopsy, and 17 patients with sputum-coated negative and clinically diagnosed as the pulmonary tuberculosis by effective anti-tuberculosis treatment. 48 healthy volunteers were randomly selected in our hospital as the control group. All subjects underwent blood γ- interferon release assay, and T lymphocyte subsets test. Results The sensitivity of IGRA diagnosis of tuberculosis was 86.2% （50/58）, the specificity was 95.8% （46/48）, the underdiagnosis rate was 13.8% （8/58）, and the misdiagnosis rate was 4.2% （2/48）, and the area under the ROC curve （AUC） was 0.816 （P = 0.001）. CD3+, CD4+ and CD4+/CD8+ were significantly decreased and CD8+ was significantly increased in the TB group at the baseline, and the differences were statistically significant compared with the control group （P < 0.05）. The sensitivity of IGRA combined with T lymphocyte subsets detection for the diagnosis of tuberculosis was 96.6% （56/58）, the specificity was 91.7% （44/48）, the underdiagnosis rate was 3.4% （2/58） and the misdiagnosis rate was 8.3% （4/48）. The AUC of IGRA test combined with T lymphocyte subsets detection was 0.911 （P < 0.001）. Conclusion The IGRA combined with T lymphocyte subsets test has the high sensitivity and specificity in the diagnosis of the pulmonary tuberculosis, and the rate of missed diagnosis is significantly lower than that of single IGRA test, which has the high diagnostic value and is worthy of clinical promotion.
2021, 42(9): 114-118.
doi: 10.12259/j.issn.2095-610X.S20210923
Abstract:
Objective To the echocardiography characteristics and the risk factors of coronary artery dilation among the infants with incomplete kawasaki disease （IKD） in Yunnan Province. Methoded A total of 291 children with Kawasaki disease under 3 years were studied retrospectively, All of them were treated in the Kunming Childrens’ Hospital from April 2017 to April 2019, including 113 children with IKD and 179 children with complete kawasaki disease （CKD）, All the children were examined by echocardiography, and the coronary aortic diameter, Z value and the peak diastolic flow velocity （PDV）, mean diastolic flow velocity （MDV） of the two groups were compared. In a way to whether the patient had the coronary artery dilation, risk factors on the coronary artery dilation by single factor and multi factors were analyzed with the logistic regression. Resulted 1. The IKD group with the coronary artery injury was more serious than that in the CKD group （P < 0.05）, and the younger the child, the more severe with coronary artery; There were no significant differences of PDV and MDV between the two groups with the coronary artery dilation （P > 0.05）. The difference in the Z value of the coronary artery diameter between the two groups was statistically significant （P < 0.05） ; 2. The potential risk factors for atypical KD coronary artery dilation were analyzed with the logistic regression. Multivariate linear regression analysis showed that: duration of fever ≥5 d （OR = 1.408, P = 0.006）, C-reactive protein level ≥0.8 ng/L （OR = 1.396, P = 0.003）, white blood cell count ≥20×109/L （OR = 1.382, P = 0.002）, serum albumin ≥135 g/L （OR = 1.867, P = 0.004） were the independent risk factors for the coronary artery dilation, P < 0.05. Conclusion Incomplete Kawasaki disease has a high incidence in infants and young children, and the clinical manifestations are not obvious, which can easily lead to the delay in the disease. It should be taken attention of clinicians. And the younger the age, the worse the coronary artery damage, and echocardiography has the great significance for the early diagnosis of coronary artery disease, Z value can objectively evaluate the damage of coronary artery and the evaluation of the effect after the treatment.
2021, 42(9): 119-126.
doi: 10.12259/j.issn.2095-610X.S20210908
Abstract:
Objective To investigate the efficacy and safety of capecitabine combined with bevacizumab or single agent of capecitabine as the maintenance therapy following the induction of XELOX regimen combined with bevacizumab in the first-line treatment of advanced colorectal cancer. Methods A total of 100 patients with the advanced colorectal cancer were treated with XELOX regimen （oxaliplatin plus capecitabine） combined with bevacizumab as first-line induction therapy for 6 cycles, whose efficacy were evaluated as the complete response, partial response or stable disease. These patients were divided in a 1∶1 ratio into the capecitabine combined with bevacizumab group （n = 50） and the single agent of capecitabine group （n = 50） for the maintenance therapy until the first disease progression or intolerable adverse events. The primary end point was progression-free survival from the initiation of maintenance therapy to the disease progression （PFS1）. Secondary endpoints were progression-free survival from the initiation of induction therapy to the disease progression （PFS2）, overall survival （OS） and adverse events. Results One-hundred patients were treated with capecitabine plus bevacizumab （n = 50） or single agent of capecitabine （n = 50） as the maintenance therapy. The median PFS1, median PFS2, and median OS of combination group were significantly longer than those of the monotherapy group, which were 9.0 （95% confidence interval （CI） 8.52-9.47） versus 7.2 （6.16-8.24, P < 0.0001） months, 13.5 （12.55-14.45） versus 12.3 （11.21-13.38, P < 0.0001） months and 27.0 （25.31-28.69） versus 26.2 （24.09-28.31, P = 0.011） months, respectively. Subgroup analysis showed that PFS1 of the combination group was significantly prolonged in the simultaneous metastasis and RAS/BRAF mutant subgroups. OS of the combination group was significantly prolonged in the male and liver metastatic subgroups. Similar treatment-related adverse events were observed in both groups. The most common toxicities both were neutropenia, mucositis, hand-foot syndrome and diarrhea. The incidence of hypertension （20% versus 4%） and proteinuria （14% versus 2%） were higher in the combination group than that in the monotherapy group. Conclusion Both capecitabine combined with the bevacizumab and the single agent of capecitabine can be considered as the appropriate options following the induction of XELOX regimen combined with bevacizumab as the first line treatment for advanced colorectal cancer with good efficacy and acceptable toxicities. Capecitabine combined with bevacizumab as maintenance therapy has a better survival benefit than single agent of capecitabine.
2021, 42(9): 134-137.
doi: 10.12259/j.issn.2095-610X.S20210921
Abstract:
Objective To compare the feasibility of the bronchial artery intervention through the radial artery and femoral artery in patients with lung squamous cell carcinoma. Methods 58 patients with lung squamous cell carcinoma were treated with the bronchial artery intervention via left radial artery approach （47 patients with BAI, 5 patients with BAE, 6 patients with BACE） and 64 patients with bronchial artery intervention via femoral artery approach （51 patients with BAI, 10 patients with BAE and 3 patients with BACE）. Results Transbronchial artery interventional therapy was successfully performed in both approaches, and there were no obvious postoperative complications. The operation time of the left radial artery approach was less than that of the femoral artery approach. Conclusion The bronchial artery interventional therapy via radial artery is safe, rapid and feasible, which provides the more alternative interventional pathways for lung tumor intervention.
2021, 42(9): 138-143.
doi: 10.12259/j.issn.2095-610X.S20210931
Abstract:
Objective To investigate and compare the application effect of B-ultrasono-guided femoral nerve block （FNB） and the oral analgesia in preoperative analgesia of middle and upper femoral fractures in the elderly. Methods We selected 84 elderly patients with femoral fractures （FF） diagnosed and treated in Kunming Second People’ s Hospital from April 2018 to November 2020. All patients had middle and upper segment fractures. We divided the group by random number table. The control group was treated with oral analgesia and the study group was treated with FNB guided by B-ultrasound. We used visual analogue pain score （VAS） to evaluate the effect indexes of the two groups before and 72 hours after analgesia: the difference of active activity VAS （AVAs） score, passive activity VAS （PVAs） score and tranqillization VAS （RVAS） score; Total compression and effective compression times of patient-controlled intravenous analgesia （PCIA） in the two groups. Data collection period: 72 hours after the beginning of analgesia; Adverse reactions in the two groups. Results Before analgesia, there were no significant differences in AVAS score, PVAS score and RVAS score between 2 groups （P > 0.05）. After 72 hours of the analgesia, AVAS score, PVAS score and RVAS score in the study group were lower than those in the control group, with the statistical significance （P < 0.05）. The total and effective times of pressing PCIA in the study group were lower than those in the control group with statistical significance （P < 0.05）. The adverse reactions in the study group were lower than those in the control group, with the statistical significance （P < 0.05）. Conclusion The application of FNB guided by B-ultrasound in the preoperative analgesia for FF patients can more effectively relieve the pain feeling of patients, with ideal analgesic effect and low adverse reactions.
2021, 42(9): 144-148.
doi: 10.12259/j.issn.2095-610X.S20210902
Abstract:
Hip ankylosis is a kind of stiffness after the loss of hip function caused by a variety of causes. During the evolution of ankylosis, the joint structure is gradually destroyed, and the muscles around the hip are gradually contracted until the ankylosis occurs. When the ankylosis occurs in the non functional position, the joint function will be seriously lost. Patients are suffering from a great deal of psychological disorders. Therefore, it is urgent for patients to take effective and accurate treatment methods to reconstruct the hip joint function and improve the quality of life. This article reviews the etiology and treatment of the hip ankylosis.
Hip ankylosis is a kind of stiffness after the loss of hip function caused by a variety of causes. During the evolution of ankylosis, the joint structure is gradually destroyed, and the muscles around the hip are gradually contracted until the ankylosis occurs. When the ankylosis occurs in the non functional position, the joint function will be seriously lost. Patients are suffering from a great deal of psychological disorders. Therefore, it is urgent for patients to take effective and accurate treatment methods to reconstruct the hip joint function and improve the quality of life. This article reviews the etiology and treatment of the hip ankylosis.
2021, 42(9): 149-155.
doi: 10.12259/j.issn.2095-610X.S20210916
Abstract:
Lipid mediators have an important effect on inflammatory bone diseases such as rheumatoid arthritis, osteoarthritis, periodontitis, etc. Among them, PGE2, which is one of the most important lipid mediators in the process of bone remodeling, plays a significant regulatory role on both osteoblasts and osteoclasts, and participates in the occurrence and development of a variety of inflammatory bone diseases. PGE2 can mobilize cAMP and RANKL to promote osteoclast formation and increase bone resorption. Furthermore, interleukin （IL）-1- and IL-6-stimulated bone resorption involves PGE2 production. In addition to its bone-resorptive effffects, PGE2 promotes the bone formation in vitro by stimulating osteoblastic proliferation and difffferentiation. The multi-faceted nature of PGE2 makes it difficult to discern its role in bone remodeling. This article reviews the role of PGE2 in bone reconstruction in recent years.
Lipid mediators have an important effect on inflammatory bone diseases such as rheumatoid arthritis, osteoarthritis, periodontitis, etc. Among them, PGE2, which is one of the most important lipid mediators in the process of bone remodeling, plays a significant regulatory role on both osteoblasts and osteoclasts, and participates in the occurrence and development of a variety of inflammatory bone diseases. PGE2 can mobilize cAMP and RANKL to promote osteoclast formation and increase bone resorption. Furthermore, interleukin （IL）-1- and IL-6-stimulated bone resorption involves PGE2 production. In addition to its bone-resorptive effffects, PGE2 promotes the bone formation in vitro by stimulating osteoblastic proliferation and difffferentiation. The multi-faceted nature of PGE2 makes it difficult to discern its role in bone remodeling. This article reviews the role of PGE2 in bone reconstruction in recent years.
2021, 42(9): 156-161.
doi: 10.12259/j.issn.2095-610X.S20210929
Abstract:
Ischemic stroke （IS） is one of the main causes of long-term and severe disability due to its high incidence rate, mortality rate, disability rate, and recurrence rate. At present, there is only the only approved recombinant tissue-type plasminogen activator for the treatment of is in the clinic. However, due to its narrow time window and many relative contraindications, the clinical medication is greatly limited. Therefore, the development of new and efficient is neuroprotective drugs has important clinical significance. In recent years, peptide molecular have attracted extensive attention due to their low toxicity, high targeting, and specificity. The prevention and treatment effect of exogenous peptide molecular on IS has also been reported. In this paper, we reviewed the preventive and therapeutic effects and mechanisms of various peptide molecule on IS and provided new molecular biological templates and research ideas for the development of new and efficient neuroprotective drugs for IS.
Ischemic stroke （IS） is one of the main causes of long-term and severe disability due to its high incidence rate, mortality rate, disability rate, and recurrence rate. At present, there is only the only approved recombinant tissue-type plasminogen activator for the treatment of is in the clinic. However, due to its narrow time window and many relative contraindications, the clinical medication is greatly limited. Therefore, the development of new and efficient is neuroprotective drugs has important clinical significance. In recent years, peptide molecular have attracted extensive attention due to their low toxicity, high targeting, and specificity. The prevention and treatment effect of exogenous peptide molecular on IS has also been reported. In this paper, we reviewed the preventive and therapeutic effects and mechanisms of various peptide molecule on IS and provided new molecular biological templates and research ideas for the development of new and efficient neuroprotective drugs for IS.
2021, 42(9): 162-166.
doi: 10.12259/j.issn.2095-610X.S20210911
Abstract:
Objective To explore the application effect of the lung cancer MDT combined with CBL+PBL model teaching. Methods Physicians who received standardized training of thoracic surgery resident physicians from May 2020 to May 2021 were randomly divided into the control group and the experimental group, with 24 people in each group. The control group adopted the traditional teaching mode LBL teaching method, and the experimental group adopted MDT combined with PBL + CBL teaching mode. Results Compared with the experimental group, the control group had the statistically significant differences in theoretical scores, case analysis and clinical skill manipulation scores [（80.039±5.744） points vs （84.001±6.474） points, P < 0.05; （77.708±5.599） points vs. （82.250±6.081） points, P < 0.05; （76.041±5.568） points vs （84.208±6.199） points, P < 0.05]. The results of the questionnaire survey showed that the experimental group had a statistically significant difference in the teaching satisfaction compared with the control group （P < 0.05）; the differences in the improvement of self-study ability, learning interest, comprehension ability, practical ability, thinking ability, etc. were also significant. There was a statistical significance （P < 0.05）. Conclusion In the teaching of lung cancer, MDT combined with PBL+CBL model has achieved good results in the actual teaching activities.
2021, 42(9): 167-172.
doi: 10.12259/j.issn.2095-610X.S20210920
Abstract:
Objective To investigate the awareness and influencing factors of cancer pain nursing knowledge among the oncology nurses of hospitals at all levels in Yunnan Province so as to explore and analyze the current status of cancer pain nursing. Methods A convenient sampling method was used to select 673 nurses from 34 third-level hospitals and 6 second-level hospitals in Yunnan Province, and a self-designed questionnaire about cancer pain nursing knowledge and current status was distributed. Results The awareness rate of cancer pain nursing knowledge among the oncology nurses was not high, only 48.67%; the first degree and professional title were the influencing factors of cancer pain nursing knowledge （P < 0.05）. In the survey of the current status of cancer pain care, 68.79% of oncology nurses believed that they did well, generally 26.34%. Conclusion Currently, the awareness rate of cancer pain knowledge and cancer pain nursing among the oncology nurses of all levels of hospitals in Yunnan Province is not optimistic. Managers should pay attention to cancer pain management. They can rely on multiple platforms to strengthen the training and change the concept of nurses. They can also promote the establishment of standardized cancer pain wards to improve the quality of cancer pain care.
