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RSS2022 Vol. 43, No. 4
2022, 43(4): 1-5.
doi: 10.12259/j.issn.2095-610X.S20220401
Abstract:
Objective To investigate the optimum extraction technology of Qingyangshengenin from the medicinal plant Cynanchum otophyllum Schnei. Methods The reflux method is used to extract and HPLC method is used to detect Qingyangshengenin. On the basis of single factor experimental, orthogonal design method is selected to explore the conditions of ethanol volume fraction, solid-liquid ratio and extraction time on the extraction of Qingyangshengenin. Results The optimal extraction conditions were as follows: ethanol volume fraction 70%, solid-liquid ratio 1∶15（g/mL）, extraction time 2 h, and the extraction rate was up to 0.3090%. Conclusion The optimized heating reflux extraction process was effective, stable and environment-friendly, which provided a foundation for further studies on pharmacological activity and structural modification of Qingyangshengenin.
2022, 43(4): 6-11.
doi: 10.12259/j.issn.2095-610X.S20220402
Abstract:
Objective To study the role of T lymphocyte immune deficiency in pulmonary fibrosis induced by paraquat. Methods BALB/C （nu/nu） nude mice and BALB/C （nu/+） mice were selected as experimental animal models. Paraquat was given 20 mg/kg by intragastric administration and paraquat concentration in plasma was determined by GC-MS 1 hour after administration. Lung tissues were obtained for pathological sections on the 7th and 28th day after administration by H&E and MASSON staining. Results There was no significant difference in plasma paraquat concentration of 2 strains of mice after 1 hour of exposure （P > 0.05） . H&E and MASSON staining of pathological sections on day 28th showed that there was statistical difference in the degree of fibrosis between the two strains （P < 0.05）. Conclusion T lymphocyte is involved in the pulmonary fibrosis caused by paraquat, but the loss of T lymphocytes does not completely avoid pulmonary fibrosis induced by paraquat. T lymphocyte immune deficiency is not the decisive factor of pulmonary fibrosis induced by paraquat.
2022, 43(4): 12-18.
doi: 10.12259/j.issn.2095-610X.S20220403
Abstract:
Objective To explore the epidemiological characteristics of traumatic brain injury, to provide a basis for diagnosis and treatment of the disease, and to improve the comprehensive treatment of traumatic brain injury. Methods A retrospective research method was adopted to retrieve a series of case data of patients with traumatic brain injury in the medical record department of the First Affiliated Hospital of Kunming Medical University in Yunnan province, covering 3 552 patients including 2 044 inpatients of the First Affiliated Hospital of Kunming Medical University and 1 508 inpatients transferred from other hospitals. Data on gender, age, occupation, cause of trauma , treatment method and prognosis were collected and analyzed . Results Male patients accounted for 75.08%, while female patients accounted for 24.91%, and the ratio of male patients to female patients was 3.01∶1. TBI of all ages was significantly higher in males than in females, and the difference was statistically significant （P < 0.05）. Majority of them were middle-aged patients （41.66±15.72） years old. Migrant workers are the occupation with the most traumatic brain injury. The top 3 causes of trauma were car accident injury （45.27%）, high fall injury （18.92%） and fall injury （17.57%）. Acute brain injury is the leading cause of death. Conclusion The patients with traumatic brain injury in Yunnan province are mainly middle-aged men engaged in physical activity. The top three causes are car accident injuries, high fall injuries and fall injuries. Reducing the occurrence of TBI and improving the emergency treatment of TBI are the focus of acute and critical diseases.
2022, 43(4): 19-25.
doi: 10.12259/j.issn.2095-610X.S20220405
Abstract:
Objective By measuring the blood level of 25-hydroxyvitamin D [25（OH）D] in healthy population, taking Kunming area as an example, the present vitamin D level and its influencing factors in Yunnan Plateau were analyzed and discussed. Methods Serum samples were collected from cases who underwent health examination in the First Affiliated Hospital of Kunming Medical University. Subjects were grouped by sex, season and age. Serum 25（OH） D level was detected by electrochemical luminescence immunoassay. Results The average 25（OH）D level of 2563 subjects was（62.79±23.33）nmol/mL. The normal, insuffcient and deficient rates of vitamin D were 26.06%, 42.84% and 31.10%, respectively. The results showed that gender, season and age all affected serum 25（OH）D. The vitamin D level in women was significantly lower than that in men （P < 0.05）, and the vitamin D deficiency in women was also significantly higher than that in men. There was statistical significance in 25（OH） D levels in different seasons（P < 0.05）. The vitamin D level in autumn was significantly higher than that in other three seasons （P < 0.05）. The difference of 25（OH）D level among age groups was statistically significant （P < 0.05）. Conclusion Different levels of vitamin D deficiency existed in Yunnan Plateau area, which was related to gender, season and age. 25（OH） D test can provide an important reference for clinical evaluation, diagnosis and treatment of metabolic diseases caused by vitamin D deficiency.
2022, 43(4): 26-31.
doi: 10.12259/j.issn.2095-610X.S20220404
Abstract:
Objective To characterize adults periodontal health of the Wa nationality in Gengma County, Yunnan province, and to collect oral health knowledge and oral health behavior data and analyze related factors which affect the periodontal health status to provide evidence for prevention of local oral disease. Methods A total of 486 people were randomly selected from 10 natural villages in Gengma Dai and Wa Autonomous County, Yunnan province, and their periodontal health status was examined and questionnaires were conducted. EpiData 3.1 and SPSS 19.0 software were used for data entry and statistical analysis. Results The detection rates of gingival bleeding in 35～44, 55～64 and 65～74 years old group were 91.22%, 88.08%, 81.82%, respectively; and the detection rates of superficial periodontal pocket （4～5 mm） were 86.34%, 86.53%, 81.82%, respectively. Detection rate of deep periodontal pocket （≥6 mm） were 13.17%, 30.57%, 45.45%; Periodontal health rate were 12.68%, 14.51%, 18.18%, respectively. Combined with the contents of oral questionnaire survey, 7 statistically significant factors were screened as independent variables through single factor analysis, including age, education background, brushing frequency, self-perception of teeth, conscious toothache, smoking and the concept of tooth bleeding. Multivariate Logisitic regression analysis showed that the worse the self-perception of teeth （OR = 1.500, P = 0.003）, the more frequent the toothache （OR = 1.510, P = 0.017） and smoking （OR = 2.161, P = 0.014）, the more likely Wa adults were to develop periodontitis. Higher education （OR = 0.527, P = 0.000） and more times of brushing teeth （OR = 0.519, P = 0.002） were the protective factors for the occurrence of periodontitis. Conclusion The detection rate of gingival bleeding, superficial periodontal pocket and deep periodontal pocket of Wa adults were higher than the fourth national level, the prevalence of periodontitis was higher, the oral health status was poor, far below the national oral health care target. It is necessary to increase the investment of medical resources in ethnic minority areas and strengthen the propaganda of oral health care for ethnic minorities so as to improve the diagnosis rate of periodontal diseases and the quality of life of the population.
2022, 43(4): 32-37.
doi: 10.12259/j.issn.2095-610X.S20220432
Abstract:
Objective To investigate the nutritional status of elderly tuberculosis patients in Yunnan and provide evidence for the prevention of malnutrition of elderly tuberculosis patients and nutritional intervention. Methods A total of 1316 elderly tuberculosis patients aged ≥65 years who were admitted to The Third People’s Hospital of Kunming from June 2019 to June 2021 were selected as the case group, and 520 healthy people who underwent physical examination during the same period were selected as the control group. The nutrition-related indexes of the two groups were compared to analyze the nutritional status of elderly tuberculosis patients. Results Compared with the control group, TB patients’ hemoglobin （Hb） （126.40 + 25.51） g/L, lymphocyte count （LYM） [（1.24 + 0.59） x 109/L], serum total protein （TP） （66.00 + 8.22） g/L, albumin [（36.03） +/-6.04 g/L）, albumin/globulin ratio （A/g） [1.25 +/-0.33）, cholesterol （TC） [（4.48 +/-1.18） mmol/L], triglycerides （TG） （1.19 +/-0.70） mmol/L and high-density lipoprotein （HDL -C） [（1.19 ± 0.40） mmol/L] levels were lower than those in the control group （t =15.640, 26.240, 14.770, 35.900, 35.080, 8.272, 7.986, 7.381; P < 0.05）; The RBC conut [（4.92 ± 0.52）×1012/L] and globulin level [（29.97 ± 6.06） g/L] were higher than those in the control group （t = 13.060, 15.490; P < 0.05）. The prevalence of anemia [10.50% （105/1000）], hypoproteinemia [30.30% （303/1000）] and low high-density lipoprotein [27.00% （270/1000）] in tuberculosis patients were higher than those in control group （χ2 = 28.900, 147.900, 53.490; P < 0.05）. The prevalence of hypercholesterolemia [11.00% （110/1000）] and hypertriglyceridemia [7.20% （72/1000）] were lower than that of the control group （χ2 = 56.640, 179.900; P < 0.05）. The degree of nutrition-related diseases in TB patients are mild and moderate. The level of Alb[（32.24±6.90） g/L] in patients with tuberculosis combined with diabetes was lower than that in patients with tuberculosis alone [（36.03 ± 6.04） g/L] （t = 3.18; P < 0.01）; The levels of Hb[（146±23.23） g/L] and TC[（5.54±0.85） mmol/L] were higher than those of the tuberculosis group [（126.40 ± 25.51） g/L and （4.48 ± 1.18） mmol/L] （t = 3.720, 8.420; P < 0.05）. In tuberculosis patients, Hb, Alb, TC, HDL-C levels were correlated with age （r = -0.489, 0.604, -0.526, -0.479; P < 0.05）, while TG level was not correlated with age （r = 0.070; P = 0.770）. There were no significant differences in the levels of Alb, TC, TG and HDL-C in gender （t = 0.601, 0.942, 0.299, 0.485; P = 0.548, 0.347, 0.765, 0.628）. Conclusion The incidence of malnutrition in elderly tuberculosis patients in Yunnan was higher than healthy people, The degree of malnutrition is age-related, and nutrition-related diseases are mainly mild and moderate, in addition, diabetes can aggravate the degree of malnutrition in elderly tuberculosis patients.
2022, 43(4): 38-43.
doi: 10.12259/j.issn.2095-610X.S20220408
Abstract:
Objectve To evaluate the clinical outcomes of orbitotomy for orbital cavernous hemangiomas through transconjunctival orbitotomy and lateral-medial orbitotomy. Methods A retrospective analysis was performed on 68 cases of orbital cavernous hemangioma admitted to the Second People’s Hospital of Yunnan Province from September 2009 to September 2019. All cases were divided into two groups, patients underwent transconjunctival orbitotomy were assigned in group A （33 cases）and patients underwent lateral-medial orbitotomy were assigned in group B （35 cases）. Average hospital stay, operating time, operation space, bleeding volume, complete tumor removal rate, and postoperative complications were evaluated（P > 0.05）. Results The average hospital stay was （5.03 ± 1.63）d in group A and （8.34 ± 2.13）d in group B, and the difference was statistically significant （t = -4.926, P = 0.000）. The mean operation time was （55.62 ± 5.43）min in group A and （109.21 ± 13.72）min in group B, and the difference was statistically significant （t = -16.428, P = 0.000）. The operation space was measured by water injection method, which was expressed by the volume of water injection. The average value of group A was （5.22 ± 0.21）mL, and that of group B was （16.501 ± 1.22）mL, with statistical significance （t = -48.362, P = 0.000）. Blood loss was （17.22 ± 1.65）mL in group A and （59.29 ± 6.42）mL in group B, and the difference was statistically significant （t = -28.098, P = 0.000）. The complete tumor removal rate was 90.9% （30/33） in group A and 97.14% （34/35）in group B. Postoperative visual acuity: 93.9% （31/33） of patients in group A had improved or unchanged postoperative visual acuity, and 6.06% （2/33） had decreased postoperative visual acuity. In group B, 85.71% （30/35） had improved or unchanged visual acuity, and 14.3% （5/35） had decreased or lost visual acuity. Conclusion Both transconjunctival orbitotomy and lateral-medial orbitotoy have advantages and disadvantages. The key of removing orbital cavernous hemangiomas completely is to select the right operation method. Preoperative imaging data should be used to accurately determine the location and size of the tumor.
2022, 43(4): 44-49.
doi: 10.12259/j.issn.2095-610X.S20220409
Abstract:
Objective To explore the effect of multidisciplinary team （MDT） in the treatment of irreducible anterior displacement of temporomandibular joint disc. Methods 60 patients with irreducible anterior disc displacement of tempor omandibular joint treated in The Affiliated Hospital of Yunnan University from September 2018 to March 2021 were randomly divided into MDT group and non-MDT group. MDT group received MDT diagnosis and treatment model; The non-MDT group received routine treatment. Clinical indicators, psychological status before and after treatment, shart-term clinical efficacy and satisfaction rate of patients in 2 groups were compared. Results The waiting time and average hospital stay in MDT group were lower than those in non-MDT group （P < 0.05）.The total effective rate of MDT was 96.67%, which was higher than 90.00% in non-MDT group. The satisfaction rate of patients in MDT group was 96.66%, which was higher than 86.67% in non-MDT group （P < 0.05）. Conclusion The MDT team diagnosis and treatment model for temporomandibular joint disorders can provide the best treatment appropriate to the condition of patients with irreversible anterior displacement of TMJ, and better guarantee the perioperative safety of patients. At the same time, it can shorten the medical cycle and improve the curative effect.
2022, 43(4): 50-54.
doi: 10.12259/j.issn.2095-610X.S20220410
Abstract:
Objective To explore the changes of immune function in patients with anti-tuberculous drug-induced liver injury （ATB-DILI）, and to explore the clinical value and application significance of serum amylase A （SAA）, matrix metalloproteinase 9 （MMP-9） and matrix metalloproteinase 14 （MMP-14） in anti-tuberculosis drug liver injury. Methods A total of 115 patients with anti-tuberculosis drug-induced liver injury admitted to the Third People’ s Hospital of Kunming from July 2019 to July 2020 were selected. Based on types of liver injury, the patients were divided into 4 subgroups A, B, C and D, and 35 healthy subjects underwent health check during the same period were selected as control group （group E）. The changes and expression levels of immune function, SAA, MMP-9 and MMP-14 in different subgroups were compared, as well as their relationship with ATB-DILI severity grade. Results The CD4+ count of group A patients was lower than that of group E, and the difference was statistically significant （P < 0.05）. The expression levels of SAA and MMP-9 in gronp A were higher than the other three groups, and the difference between the groups was statistically significant （P < 0.05）. The expression of MMP-14 in group C was higher than that of the other three groups, and the difference was statistically significant （P < 0.05）. SAA and MMP-9 were correlated with the severity of anti-tuberculosis drug liver injury （r = 0.687, P < 0.05; r = 0.811, P < 0.05）. Conclusion CD4+ counts were reduced in some patients with ATB-DILI, suggesting that these patients have low immune function, and the impaired immune function may be related to liver injury. SAA, MMP-9 and MMP-14 increased in different degrees in patients with different types of anti-tuberculosis drug liver injury. The severity of liver injury is closely related to the expression of SAA and MMP-9. SAA, MMP-9 and MMP-14 are expected to be the evaluation indicators of the severity of clinical ATB-DILI.
2022, 43(4): 55-61.
doi: 10.12259/j.issn.2095-610X.S20220407
Abstract:
Objective To compare the detection rate of osteoporosis in postmenopausal women with quantitative computed tomography （QCT） and dual energy X-ray absorptiometry （DXA）, and analyze the causes for differences. Methods A total of 148 postmenopausal women were enrolled, with an average age of （63.7±10.4） years old. The lumbar spine bone mineral density was measured by DXA and QCT, respectively. The detection rate of osteoporosis by the two methods was calculated, and the measurement results were analyzed and compared. The plain CT images of patients with inconsistent diagnosis were checked to evaluate whether there were vertebral fracture, degenerative changes of spine and aorta abdominalis calcification. Results In 148 subjects, the detection rate of QCT was 45.9% （68/148）, and the detection rate of DXA was 26.4% （39/148）, the difference was statistically significant （P < 0.05）. The diagnosis of DXA and QCT was consistent in 92 subjects （62.2%）; the diagnosis of DXA and QCT was inconsistent in 56 subjects （37.8%）. 48.2% of the patients （27/56） were diagnosed as osteoporosis by QCT and bone mass reduction by DXA. 33.9% （19/56） of patients were diagnosed as bone mass reduction by QCT and normal bone mass by DXA. Of all patients with inconsistent diagnosis, 2 （2/56） had vertebral compression fractures, and 56 （56/56） had lumbar degeneration （osteophytes, endplate sclerosis, ligament ossification or facet joint osteoarthritis）, 9 （9/56） had abdominal aortic calcification. Conclusion The inconsistent detection rates of osteoporosis between QCT and DXA may be caused by the presence of spinal degeneration, abdominal aortic calcification and other sclerotic lesions, which will increase the BMD value of DXA, resulting in the higher detection rate of QCT than DXA. Compared with DXA, QCT is a more sensitive method for the diagnosis of osteoporosis in postmenopausal women.
2022, 43(4): 62-69.
doi: 10.12259/j.issn.2095-610X.S20220406
Abstract:
Objective To analyze the consistency between the Framinghan, the advance-risk scale and the “sugar-heart risk assessment”, the “CV risk assessment” model on the risk of cardiovascular death in T2DM patients in the next 10 years. Methods A retrospective study of 527 inpatients who met the diagnostic criteria for type 2 diabetes in the Department of Endocrinology, The Second Affiliated Hospital of Kunming Medical University from January 2018 to December 2020 was conducted. The Framinghan rating scale and the Cardiovascular risk assessment for diabetes mellitus model were used to assess the occurrence risk of cardiovascular disease over the next 10 years. 148 patients with increased diabetes duration, UACR and other indicators were included. ADVANCE Risk score and CV Risk Assessment project were used to evaluate the risk of cardiovascular death of the same patient in the next 10 years. Kappa values were used to evaluate the consistency of the results of the two methods. Results The result of Cardiovascular risk assessment for diabetes mellitus model: 431 patients （81.78%） in the medium-risk group, and 250 patients （47.44%） in the high-risk group using Framinghan rating scale. SPSS analysis showed Kappa value, K = 0.051, P = 0.001; The result of CV Risk assessment”: 98 patients （66.22%） in the very high Risk group, and 76 patients （50%） in the ADVANCE Risk model. SPSS analysis showed Kappa value, K = 0.492, P = 0.000. Conclusion In this study, the “Cardiovascular risk assessment for diabetes mellitus” model and Framinghan rating scale in assessing the occurrence risk of cardiovascular disease in patients with type 2 diabetes in the next 10 years were very inconsistent. The “CV Risk assessment” and ADVANCE Risk model had moderate consistency in assessing the mortality risk of cardiovascular in patients with type 2 diabetes over the next 10 years.
2022, 43(4): 70-74.
doi: 10.12259/j.issn.2095-610X.S20220413
Abstract:
Objective To explore the value of magnetic resonance diffusion-weighted imaging （DWI） and Arterial Spin labeling （ASL） in the diagnosis of acute cerebrovascular diseases. Methods A total of 82 patients with suspected acute cerebrovascular disease admitted to the Medical Imaging Department of the Second Affiliated Hospital of Yunnan University of Traditional Chinese Medicine from July 2019 to August 2020 were selected and imaging was conducted using ASL and DWI. The apparent diffusion coefficient （ADC） values, changes of lesion signal characteristics, sensitivity and specificity of ASL and DWI were analyzed at different time points. Results In all patients, ADC values within 6 h, 6～24 h, 24～48 h and average values of the affected side were lower than those of the unaffected side, and the differences were statistically significant （P < 0.05）. There was no statistical significance in ADC values at 6 h, 6～24 h, 24～48 h in unaffected and affected sides （P > 0.05）. There were no statistically significant differences between unaffected side and affected side in 6 h, 6～24 h, 24～48 h and average ADC values （P > 0.05）. Among all patients, there were 47 patients whose CASL-PWI hypoperfusion area was larger than DWI abnormal signal area, and 32 patients whose CASL-PWI hypoperfusion area was smaller than DWI abnormal signal area, and 6 patients whose two signal changes were equal. The lesion area of DWI and PWI in patients with DWI < PWI was higher than that of DWI = PWI and DWI > PWI, and the difference was statistically significant （P < 0.05）. DWI = PWI patients’ lesion area of DWI and PWI was larger than that of DWI > PWI, and the difference was statistically significant （P < 0.05）. The sensitivity and specificity of combined examination were higher than those of DWI and spin marking alone, and the difference was statistically significant （P < 0.05）. Conclusion In the diagnosis of acute cerebrovascular disease, both diffusion weighted magnetic resonance imaging （DWI） and arterial spin labeling are effective, but it is more valuable if combined.
2022, 43(4): 75-81.
doi: 10.12259/j.issn.2095-610X.S20220414
Abstract:
Objective To investigate the weight status of normal single-born live newborns of different gestational ages, obtain the latest birth weight standards of normal newborns of different gestational ages and birth weight standards of male and female newborns of different gestational ages, and draw birth weight curves of newborns. Methods A retrospective analysis was conducted on the birth weight of newborns delivered in the department of Obstetrics of Yunnan First People’ s Hospital from January 1, 2014 to December 31, 2020 without complications, severe malformation or edema during live birth. The birth weight curve was fitted by the internationally established LMSP method. The curve was drawn and checked by the Generalized Additive Model based on Position, Scale and Shape （GAMLSS） 5.3-4 software package in R4.0.2 software. Result The percentile values of birth weight P3, P10, P25, P50, P75, P90, P97 and corresponding birth weight curves were obtained from 36551 cases of newborns born alive at 26 to 42 weeks of normal gestation. There were 19, 072 males（52.18%） and 17, 479 females （47.82%）, respectively, with an average birth weight of 3 231 g and 3 128 g. The average birth weight of female newborns was 103 g less than that of male newborns, and the difference was statistically significant （P < 0.05）. The overall incidence of < gestational age and > gestational age was 8.98% and 9.29%, respectively. Conclusion It is the first time to collect the weight of single live newborn born at 26-42 weeks of normal gestation in Yunnan First People’ s Hospital in the past 10 years with large sample size and updated data. The birth curve drawn can accurately and objectively evaluate the current intrauterine growth and development status of fetuses and perinatal outcomes in Yunnan First People’ s Hospital. It provides important reference value for perinatal health care in Yunnan First People’ s Hospital and even in Kunming area.
2022, 43(4): 82-88.
doi: 10.12259/j.issn.2095-610X.S20220417
Abstract:
Objective To evaluate the value of serum adipokine in the long-term prognosis of colorectal cancer. Methods 80 patients with colorectal cancer were selected as the study subjects, and 80 healthy subjects were selected as the control group. Serum adipokine levels were compared between the two groups and the patients with different pathological characteristics of colorectal cancer tumors. The 5-year overall survival rate was calculated and the survival curve was drawn. Correlation analysis, multivariate analysis and the prediction efficiency of adipokine on 5-year survival were compared. Results Compared with the control group, the levels of visfatin and leptin in colorectal cancer patients were significantly increased （P < 0.05）, and the levels of adiponectin were significantly decreased （P < 0.05）. There were statistically significant differences in the levels of visfatin, adiponectin and leptin in different stages of tumor differentiation and TNM （P < 0.05）. The results of survival curve showed that the 5-year survival time distribution of patients with different concentrations of visfatin, adiponectin and leptin was significantly different （χ2 = 4.715, 4.530, 7.011, P = 0.030, 0.033, 0.008）. Correlation analysis results show that adiponectin was significantly negatively correlated with tumor differentiation, TNM stage and 5-year overall survival rate （P < 0.05）, leptin was significantly positively correlated with tumor differentiation, TNM stage and 5-year overall survival rate （P < 0.05）, while visfatin was not significantly correlated with tumor differentiation and TNM stage （P > 0.05）. There was significant positive correlation with 5-year overall survival rate （P < 0.05）. Multivariate analysis showed that visfatin and leptin were the risk factors for five-year survival of colorectal cancer patients, while adiponectin was the protective factor. The results of ROC curve showed that the AUC, sensitivity and specificity of the combined prediction of the three indexes were higher than those of the independent prediction. Conclusion Visfatin and leptin are risk factors for 5a survival in colorectal cancer patients, while adiponectin is a protective factor. The combination of these indicators has higher efficacy in predicting 5-year survival.
2022, 43(4): 89-92.
doi: 10.12259/j.issn.2095-610X.S20220412
Abstract:
Objective To evaluate the misdiagnosis rate of endometrial polyps by ultrasound imaging, and to explore simple, cost-effective, and time-saving ultrasound imaging methods to improve the diagnostic compliance rate of endometrial polyps. Methods A total of 484 patients with endometrial polyp ultrasound and pathological diagnosis in the Second People’s Hospital of Yunnan Province from January 2019 to May 2021 were included in the study. The patients were divided into two dimensional ultrasound group, color Doppler （CDFI） group and power Doppler （CDE） group. The pathological results were analyzed in different groups to find the misdiagnosis factors of endometrial polyps by ultrasound images. Results Compared with 2D ultrasound, CDE reduced the misdiagnosis rate [OR （95% CI）: 0.172 （0.048～0.625）] .The misdiagnosis rates of the two-dimensional ultrasound group, CDE group, and CDFI group were 33.3%, 7.9%, and 46.0%, respectively （P < 0.001）. Conclusions Based on two-dimensional ultrasound, the application of CDE can reduce the misdiagnosis rate of endometrial polyps and provide clinicians with valuable information in a short time.
2022, 43(4): 93-98.
doi: 10.12259/j.issn.2095-610X.S20220415
Abstract:
Objective Fragmented red blood cells （FRC） is a new detection parameter provided by the automatic blood cell analyzer, which is closely related to thrombotic microangiopaemia and other diseases. This study is aimed at evaluating the detection performance of automatic hematology analyzer for RBC fragments. Methods The performance of SYSMEX XN series automatic blood cell analyzer was evaluated by carrying contamination rate, precision, linearity, accuracy, sensitivity, specificity and other indicators. All data were analyzed by SPSS 19.0 software. Results The contamination rate of red blood cell fragments detected by SYSMEX XN series automatic hematology analyzer was 0.11%. Intra-batch precision: coefficient of variation （CV） at each experimental concentration were 8.75% （42.15×109/L）, 6.38% （83.42×109/L）, 4.57% （228.74×109/L）, 5.31% （796.89×109/L）. Linear verification: the linear regression equation was Y = 1.0001X + 9.3288, and the correlation coefficient is r = 0.9936., and the correlation coefficient is R =0.9936; Correctness verification: compared with manual microscopy, the was no statistically significant difference(P＞0.05）, the correlation coefficient, sensitivity and specificity were r = 0.82, 92% and 82% respectively. Conclusion SYSMEX XN series automatic blood cell analyzer is quick and easy to operate in detecting red blood cell fragments, with low contamination rate, fair precision and satisfactory linear range. Compared with manual microscopy, it has better correlation, higher specificity and sensitivity. Blood cell analyzer can be used as a rapid screening method for fragments of peripheral blood red blood cells, but the precision of its detection still needs to be further improved, and due to the limitations of the method, positive specimens need to be confirmed under a microscope.
2022, 43(4): 99-102.
doi: 10.12259/j.issn.2095-610X.S20220416
Abstract:
Objective To explore the diagnostic value of glutamic acid decarboxylase antibody （GAD）, islet cell autoantibody （ICA） and C-Peptide （C-P） detection in Type I diabetes mellitus. Methods GAD, ICA and C-P values of 54 T1DM confirmed patients in People’ s Hospital of Chuxiong Yi Autonomous Prefecture from January 2019 to August 2020 were analyzed retrospectively, and compared with 50 normal people who came to our hospital for physical examination during this period. Results GAD and ICA in observation group were significantly higher than those in control group. The C-P of observation group was significantly lower than that of control group, and the difference was statistically significant （P < 0.05）. The AUC of GAD, ICA, C-P and three combined tests for T1DM diagnosis were 0.927, 0.840, 0.956 and 0.993, respectively. The area under ROC curve （AUC） of GAD, ICA and C-P combined detection was the largest, suggesting that the diagnostic efficiency of GAD, ICA and C-P combined detection was higher than that of GAD, ICA and C-P alone. Conclusion The combined detection of GAD, ICA and C-P can improve the sensitivity and specificity of T1DM diagnosis, and play an outstanding role in the early diagnosis, treatment, prevention and early warning evaluation of T1DM.
2022, 43(4): 103-106.
doi: 10.12259/j.issn.2095-610X.S20220418
Abstract:
Objectives To investigate the infection of H.pylori in 528 children with epigastric pain in Dali Bai Autonomous Prefecture People’s Hospital, to study the correlation between infection and iron deficiency anemia （IDA） and to provide evidence for the diagnosis and treatment of H.pylori infection and IDA in children. Method A total of 528 children aged 3 to 13 who received 13C-UBT due to upper abdominal pain in the outpatient department of Dali Bai Autonomous Prefecture People’ s Hospital from January 2019 to December 2020 were selected, and the gender and ethnicity of the detected children were analyzed by questionnaire. There were 119 H.pylori positive children listed as the observation group, and 409 H.pylori negative children listed as the control group. Hemoglobin （Hb）, mean red blood cell Volume （MCV）, serum iron （SI） , total iron binding capacity （TIBC） and serum ferritin （SF） were tested to determine the occurrence of IDA, and the correlation between H.pylori infection and IDA was analyzed. Results The total infection rate of H.pylori in 528 children was 22.53%, and the positive rates of H.pylori in male and female children were 22.88% and 22.22%, respectively. There was no significant difference in the positive rate of H.pylori in male and female children （χ2 = 0.08, P > 0.05）. The positive rates of H.pylori infection in Han, Bai, Tibetan and other minority children were 17.95%, 20.69%, 64.29% and 26.92%, respectively. The positive rate of H.pylori infection was significantly different （χ2 = 273.659, P < 0.01）. The levels of Hb, MCV, SI and SF in the observation group were significantly lower than those in the control group, and the level of TIBC was significantly higher than that in the control group, with statistical significance （P < 0.05）. Conclusion H.pylori infection rate was not related to gender, and there were obvious ethnic clusters. H.pylori infection is associated with IDA in children and may be a risk factor for IDA. Therefore, routine H pylori monitoring and anti-H.pylori treatment should be included in the clinical treatment of IDA to obtain better clinical outcome.
2022, 43(4): 107-111.
doi: 10.12259/j.issn.2095-610X.S20220422
Abstract:
Objective To investigate effect of body position on ultrasonographic measurement of ligamentum flavum lengthin lumbar intervertebral space in the elderly patients. Methods 40 patients over 65 years of age who underwent spinal anesthesia were selected to examine the L 3/4, L 4/5 and L 5 / S1 intervertebral spaces. Anterioredge length oftheligamentum flavum （ALL） and distance from skin to theligamentum flavum （DSL） of L3/4, L4/5 and L5/S1 intervertebral spaces were measured by ultrasonic parasagittal oblique view in both sitting and left lateral decubitus position, and definition degree of each ultrasonic image were analyzed. Results Compared with the measurement in left lateral position, ALL at L5/S1 level in sitting position was longer, and longer than that at L3/4 in the same position （P < 0.05）; DSL at L5/S1 was lower than that at L3/4 in sitting position （P < 0.05）. Compared with ultrasonic definition of L5/S1, the fine definition rate of the left and right sides of L3/4 and L4/5 in both positions was lower （P < 0.05） . Conclusion The ALL ultrasonic measurement at L5/S1 level in sitting position was longer than that in left lateral decubitus position, and also longer than that at L3/4 and L4/5 in the same position, its depth and image were shallower and clearer than other spaces. It is recommended for elderly patients to use the paramidian puncture approach for lumbar anesthesia. The relatively shallow width of L5/ S1 should be selected under the sitting position, and the left and right sides are equivalent, especially under the guidance of ultrasound.
2022, 43(4): 112-117.
doi: 10.12259/j.issn.2095-610X.S20220430
Abstract:
Objective To explore the effectiveness of gene detection in improving individualized medication’s curative effect in patients with hypertension. Methods 200 inpatients with grade 3 hypertension were randomly divided into two groups. There were 100 patients in the gene testing group. After admission, personalized drug genetic testing was performed for hypertension, and then individualized precise antihypertensive therapy was performed according to the results of gene testing. The other group was the rontine treatment group, a total of 100 patients, according to previous conventional treatment based on experience. The time of blood pressure compliance, side effects of antihypertensive drugs and hospital stay were recorded. Results The blood pressure compliance rate of patients within 4 d in hospital was 41% in gene testing group versus 17% in rontine treatment group, and the incidence of drug side effects was 13% in gene testing group versus 27% in rontine treatment group. Gene testing group was significantly better than rontine treatment group, with statistical significance （P < 0.05）. Average length of hospital stay in gene testing group （5.42±3.24） d vs rontine treatment group （6.26±3.43） d, gene testing group was significantly lower than rontine treatment group, the difference was statistically significant （P < 0.05）. Conclusion Gene detection of individualized medication for hypertension can improve the curative effect of patients with hypertension and shorten the average hospital stay of patients with hypertension.
2022, 43(4): 118-124.
doi: 10.12259/j.issn.2095-610X.S20220411
Abstract:
Objective To evaluate the efficacy of different mathematical models of multi-b-value DWI in predicting lymphatic vascular invasion （LVSI） of endometrial cancer （EC）. Methods The study population comprised 61 women who underwent multi-b-value DWI pelvic MRI between September 2019 and May 2021. The apparent-diffusion-coefficient （ADC）, bi-exponential model parameters （D, D* and f） and stretched-exponential model parameters （DDC and α） were measured and compared to analyze the following prognosis-related risk factors confirmed by pathology: histological grade and LVSI. The receiver operating characteristic （ROC） curve was performed to evaluate the diagnostic performance of these parameters in predicting EC histological grade and LVSI. The EC histological grade and LVSI related DWI model parameters were determined by multiple logistic regression model. The intra-group correlation coefficient （ICC） was used to assess the inter-observer agreement. Results The ADC, D, f, and DDC of the high histological grade group were significantly lower than those of the low histological grade group （P < 0.05, AUC: 0.699-0.882）. Compared with tumors without LVSI, tumors with LVSI had significantly lower ADC, D*, f and DDC values （ P < 0.05, AUC: 0.671-0.759）. The combination of f and DDC showed higher AUC （0.895, 0.797） than a single parameter in distinguishing high histological grade and LVSI tumors. Multivariate logistic regression analysis showed that both f and DDC can be used as independent predictors of histological grade and LVSI. ICC analysis showed that the inter-observer agreement for the D （ICC = 0.973; 95%CI = 0.956-0.985）, D* （ICC = 0.911; 95%CI = 0.851-0.946）, ADC （ICC = 0.968; 95%CI = 0.947-0.980）, f （ICC = 0.957; 95%CI = 0.922-0.974）, DDC （ICC = 0.947; 95%CI = 0.912−0.968） and α value （ICC = 0.931; 95%CI = 0.884-0.958） were very good. Conclusions Multi-b value DWI with different mathematical models is a useful and noninvasive approach for prediction of prognosis-related risk factors in EC with more comprehensive biological information.
2022, 43(4): 125-131.
doi: 10.12259/j.issn.2095-610X.S20220419
Abstract:
Objective To determine trace elements in liver tissue and to explore the relationship between the occurrence of liver injury with unknown causes and trace elements in the body. Methods The liver tissue of patients with liver injury of unknown causes was obtained by liver biopsy. The content of 29 trace elements was determined by inductively coupled plasma mass spectrometry （ICP-MS） and were compared with the normal liver tissue of the control group. Results Compared with the control group, 19 elements including lithium, beryllium, aluminum, calcium, titanium, vanadium, chromium, cobalt, nickel, germanium, strontium, molybdenum, indium, tin, rhenium, platinum, mercury, lead, bismuth were significantly increased （P < 0.01）. Arsenic and selenium increased （P < 0.05）, and cadmium significantly decreased （P < 0.01）. However, there were no significant differences in magnesium, manganese, ferrum, copper, zinc, gallium, selenium and barium （P > 0.05）. Spearman correlation analysis showed ferritin was positively correlated with iron content in liver tissue. Conclusion The increase of trace elements in liver tissue of patients with liver injury of unknown cause indicated that abnormal metabolism of trace elements might be one of the causes of liver injury of unknown causes or play a certain role in the occurrence and development of liver disease. By examination of liver pathology and determination of trace elements in liver tissue, the causes of liver damage in the experimental group were clearly found. Ferritin was positively correlated with iron content in liver tissue.
2022, 43(4): 132-136.
doi: 10.12259/j.issn.2095-610X.S20220420
Abstract:
Objective To analyze the clinical features of active tuberculosis cases with negative T cell spot assay （T-SPOT.TB） in peripheral blood. Methods A total of 83 active tuberculosis patients admitted to the Second Department of Tuberculosis in Kunming Third People’ s Hospital from January to December 2019 who tested negative T-SPOT.TB were selected as the study subjects; another 82 active tuberculosis patients who tested positive T-SPOT.TB were selected as the control. The clinical characteristics of the two groups were compared, and the positive rates of several conventional experimental detection methods were compared. Results There was no difference in age and gender between the T-spot. TB negative group and the T-spot. TB positive group （ Conclusion Old age, complicating extrapulmonary tuberculosis, and low immune function may be the causes of T-SPOt-TB negative in active tuberculosis. XpertMtb/RIF test can be used for rapid early diagnosis of TB.
2022, 43(4): 137-141.
doi: 10.12259/j.issn.2095-610X.S20220421
Abstract:
Objective To analyze the level of serum 25-hydroxyvitamin D（25OHD） in women of early pregnancy in Kunming Maternal and Child Health Hospital, and to explore the correlation between the level and gestational age, so as to provide suggestions for reasonable vitamin D supplement for women planning pregnancy. Methods From January 2018 to December 2020, 4283 pregnant women in Kunming Maternal and Child Health Hospital were selected as the observation subjects. They were divided into 16 to 20 years old group（97 cases）, 21 to 25 years old group（999 cases）, 26 to 30 years old group（1894 cases）, 31 to 35 years old group（930 cases）, 36 to 40 years old group（303 cases）. 41 to 45 years old group（60 cases） 6 groups. The serum 25- hydroxyvitamin D levels of 6 groups of pregnant women were compared. Results The average level of vitamin D in 4283 pregnant women was lower than normal, and the level of 25OHD in 16～20 years old group was the lowest. Conclusion Gestational age is correlated with serum 25OHD level, and the serum 25OHD level in the low gestational age group is relatively low, which requires early screening and intervention for the level of 25OHD in the low gestational age women.
2022, 43(4): 142-145.
doi: 10.12259/j.issn.2095-610X.S20220428
Abstract:
Objective To investigate the effects of subcutaneous injection of quick acting insulin analogues on blood glucose level and MCP-1 in patients with hyperglycemic crisis. Methods A total of 89 patients with hyperglycemia crisis in our hospital from March 2017 to November 2018 were randomly divided into observation group （n = 45, subcutaneous injection of insulin analogue after insulin injection with micropump stopped） and control group （n = 44, insulin analogues were administered subcutaneously 1 hour before the insulin micropump was discontinued）. The mean blood glucose values and blood glucose fluctuation amplitude of patients in the two groups were measured at 0.5 and 1 h before pump withdrawal and 0.5, 1 and 2 h after pump withdrawal. White blood cell index （WBC）, urine ketone body, monocyte chemochemic protein-1 （MCP-1）, insulin resistance index （HOMA-IR）, osmotic pressure and anionic gap were detected in 2 groups > 24 h, and the changes of patients status were analyzed. Results There was no significant difference in blood glucose fluctuation between 2 groups at 0.5 h before pump stop, 0.5, 1 and 2 h after pump stop （P > 0.05）. There were no differences in homA-IR, WBC, MCP-1, urine ketone body, osmotic pressure and anionic gap between 2 groups before and after insulin analogue injection at different time points for 24 h （P > 0.05）. Conclusion For patients with hyperglycemic crisis, the conversion of subcutaneous insulin injection can be carried out simultaneously when the intravenous pump injection of insulin is stopped, and there is no effect on the blood glucose fluctuation, HOMA-IR, MCP-1, urinary ketone body, WBC, osmotic pressure and anion gap indexes 24 hours before and after injection.
2022, 43(4): 146-151.
doi: 10.12259/j.issn.2095-610X.S20220423
Abstract:
Scutellarin, chemically named 4, 5, 6-trihydroxyflavone-7-glucosidic acid, is the main active ingredient of the traditional Chinese medicine Breviscapus. Clinically, it has been used in the treatment of cardiovascular and cerebrovascular diseases because of its extremely wide biological activities. In recent years, cardiovascular and cerebrovascular diseases characterized by high morbidity and mortality have become common and frequently-occurring diseases among middle-aged and elderly people. With the change of people’ s diet, unhealthy life style, the onset of the disease has a trend of younger age. Studies have shown that oxidative stress is an extremely important factor in the occurrence and development of cardiovascular and cerebrovascular diseases. Scutellarin has a better therapeutic effect on the treatment of cardiovascular and cerebrovascular diseases. Therefore, it is not difficult to find that scutellarin has a certain inhibitory effect on oxidative stress. This article reviews the mechanism of scutellarin and oxidative stress, and to explore the clinical application of scutellarin to inhibit oxidative stress, so as to provide a certain evidence for the treatment of clinical diseases in the future.
2022, 43(4): 152-157.
doi: 10.12259/j.issn.2095-610X.S20220424
Abstract:
The incidence of human cancers attributable to infectious agents has been estimated to be 15%. Hepatitis B virus（HBV） infects hepatocytes causing hepatocellular carcinoma. It can also infect extrahepatic cells and cause chronic inflammation, which is associated with a variety of extrahepatic cancers. Female reproductive organs communicate with the external environment through vagina. Viral nucleic acid can be detected in the vaginal secretions and ovarian tissues of HBV carriers. Epidemiological studies suggested HBV infection may be a risk factor for gynecologic malignancies, and related to poor prognosis of patients. Cervical cancer, endometrial cancer and ovarian cancer are most common gynecologic malignancies. This paper reviews the recent studies on the association between HBV infection and gynecologic malignancies, and analyzes the potential mechanism of HBV infection in the occurrence and development of cancer and prospects the future research direction.
The incidence of human cancers attributable to infectious agents has been estimated to be 15%. Hepatitis B virus（HBV） infects hepatocytes causing hepatocellular carcinoma. It can also infect extrahepatic cells and cause chronic inflammation, which is associated with a variety of extrahepatic cancers. Female reproductive organs communicate with the external environment through vagina. Viral nucleic acid can be detected in the vaginal secretions and ovarian tissues of HBV carriers. Epidemiological studies suggested HBV infection may be a risk factor for gynecologic malignancies, and related to poor prognosis of patients. Cervical cancer, endometrial cancer and ovarian cancer are most common gynecologic malignancies. This paper reviews the recent studies on the association between HBV infection and gynecologic malignancies, and analyzes the potential mechanism of HBV infection in the occurrence and development of cancer and prospects the future research direction.
2022, 43(4): 158-162.
doi: 10.12259/j.issn.2095-610X.S20220427
Abstract:
Objective To study the efficacy of targeted model of nursing care for patients with high altitude pulmonary edema. Method A total of 100 patients with acute high altitude pulmonary edema admitted to the emergency department of Shangri-La People’ s Hospital, Diqing, Yunnan Province from June 2019 to December 2019 were selected as the study subjects. According to the order of admission, they were divided into two groups: control group （50 cases） and study group （50 cases）. The control group received routine nursing intervention measures, the study group received targeted nursing mode. The nursing satisfaction and symptom improvement time of the two groups were compared, and their psychological status was evaluated by SAS and SDS scales. Result The satisfaction rate of patients in the study group was 97%, which was significantly higher than the satisfaction rate of patients in the control group of 74% （P < 0.05）. The SAS score of the study group and the control group was （43.64±2.45） points and （51.02±2.67） points, respectively, with was statistically significant difference （P < 0.05）; SDS scores of the two groups were （43.48±1.82） points and （51.90±1.88） points, respectively, with statistical significance （P < 0.05）. The symptom improvement time of the study group was shorter than that of the control group, and the difference was statistically significant （P < 0.05）. Conclusion The application of the targeted nursing care model in hospitals in high altitude region was able to reduce the negative emotions of patients with pulmonary edema, shorten the improvement time of clinical symptoms, and significantly improve patients’ satisfaction.
2022, 43(4): 163-169.
doi: 10.12259/j.issn.2095-610X.S20220431
Abstract:
Objective To explore the application of integrated nursing care combined with Enhanced Recovery after Surgery （ERAS） in patients undergone interventional embolization for ruptured cerebral aneurysms and its effect on recovery quality and short-term prognosis. Methods A total of 158 patients with ruptured cerebral aneurysms admitted to The Affiliated Hospital of Yunnan University from January 2019 to January 2021 were selected as the research subjects. All the patients were treated with interventional embolization within 1～10 days after admission. The patients were divided into two groups according to the order of admission.The control group （79 patients） was given traditional perioperative nursing care. The observation （79 patients） group was given integrated medical care combined with ERAS intervention. The early recovery （catheter indwelling time, postoperative awake time, length of hospital stay）, functional recovery before intervention and at discharge, including cognitive function （MMSE）, neurological function （NIHSS）, daily living ability （ADL）, average activity time and complications, were observed and compared between the two groups. Results The time of postoperative awakening, indwelling catheter and hospitalization length in the observation group were significantly shorter than those in the control group （P < 0.05）. The scores of MMSE and ADL in the observation group were higher than those in the control group, while the NIHSS score in the observation group was lower than that in the control group, and the average activity time （including active or passive activity） in the observation group was significantly longer than that in the control group （P < 0.05）. The incidence of complications in the observation group was 6.33%, which was significantly lower than 16% in the control group （P < 0.05）. Conclusion The integrated nursing care combined with ERAS intervention effectively improved the prognosis of patients, reduced the physiological and psychological stress state of patients, accelerated the process of postoperative rehabilitation, improved cognitive, neurological and activities of daily life, and reduced the risk of complications, which has a positive effect on short-term postoperative recovery.
2022, 43(4): 170-174.
doi: 10.12259/j.issn.2095-610X.S20220429
Abstract:
Objective To establish nursing quality evaluation index system for Health Management Center. Methods The final determination of nursing quality evaluation index system of health management center is based on structure-process-result quality structure mode, and two rounds of expert consultation are carried out by Delphi method. Results The effective recovery rates of the two rounds of expert correspondence questionnaire were 100. 0% , and the coefficient of expert authority was 0. 90 and 0. 92 respectively. The weight of each index was assigned by analytic hierarchy process （AHP）, and all of them passed the consistency test （CR < 0.1）. The evaluation indexes of nursing quality for Health Management Center included 3 primary indexes, 11 secondary indexes and 41 tertiary indexes. Conclusions The building of nursing quality evaluation system index for Health Management Center is scientific and rigorous, which can provide scientific and objective guidance for nursing management.
