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RSS2023 Vol. 44, No. 1
2023, 44(1): 1-6.
doi: 10.12259/j.issn.2095-610X.S20230107
Abstract:
Objective To investigate the effect of down-regulation of Pin1 expression on lipid synthesis, proliferation and apoptosis of cervical cancer SiHa cells. Methods Western Blot was used to detect the expression of Pin1 in Hela, SiHa and H8 cells; Lentiviral transfection technology constructed Pin1 low-expression stable transduction cell line, which was divided into the control group （shPin1-NON）, knockdown group1 （shPin1-1） and knockdown group2 （shPin1-2） according to different treatments; GEPIA2 was used to analyze the expression of key enzymes of lipid metabolism （ACC1, FASN） in cervical cancer and non-tumor tissues and the expression of ACC1 and FASN in cervical cancer and non-tumor tissues; Western Blot and qRT-PCR were used to detect the ACC1, FASN protein and mRNA expression; Western Blot was used to detect the Caspase-8, BCL-2, C-myc protein expression; CCK-8 was used to detect the cell proliferation; Clone formation assay was used to detect the cell colony formation ability and flow cytometry was used to detect the cell apoptosis. Results Pin1 was highly expressed in cervical cancer cells, and the highest expression was in SiHa cells; Pin1 low expression lentivirus effectively down-regulated the Pin1 expression level; ACC1 and FASN mRNA expressions in cervical cancer were higher than those in non-tumor tissues; The protein and mRNA expressions of ACC1 and FASN in shPin1-1 group and shPin1-2 group were lower than those in the shPin1-NON group; the shPin1-1 and shPin1-2 groups were up-regulated compared with the shPin1-NON group, while the expression of BCL-2 and C-myc was up-regulated. The expression was inhibited; The proliferation ability of shPin1-1 group and shPin1-2 group was lower than that of shPin1-NON group; The colony formation ability of shPin1-1 group and shPin1-2 group was lower than that of shPin1-NON group. Compared with the shPin1-NON group, the total apoptotic rate of cells in the shPin1-1 and shPin1-2 groups was significantly increased. （P < 0.05）. Conclusion Low expression of Pin1 can effectively down-regulate fatty acid synthase in cervical cancer SiHa cells, inhibit cell proliferation, and induce cell apoptosis, which provides a new idea for targeted therapy of cervical cancer.
2023, 44(1): 7-11.
doi: 10.12259/j.issn.2095-610X.S20230121
Abstract:
Objective To study the mutation types of OprD gene in Pseudomonas aeruginosa resistant to carbapenems but sensitive to cephalosporins （Car-R/Ceph-S）. Methods Ten strains of Pseudomonas aeruginosa which were resistant to carbapenems but sensitive to cephalosporins were isolated and cultured in the First Affiliated Hospital of Kunming Medical University from January 2021 to March 2021. Polymerase chain reaction （PCR） was used to detect the carrying status of OprD gene in Pseudomonas aeruginosa, and the mutation type of OprD gene was analyzed by sequencing. Results All the 10 strains showed obvious OprD bands and the sequencing analysis showed that there were 2 frameshift mutations, 8 amino acid substitutions, 2 early termination codons and 4 large fragment deletions. Conclusion The mutation types of OprD gene in carbapenem-resistant but cephalosporin-sensitive （Car-R/Ceph-S） strains of Pseudomonas aeruginosa are diversified with the highest frequency of point mutations, deletion of large segments and early termination of codons. These mutations lead to changes in the structure of OprD, resulting in the occurrence of drug resistance.
2023, 44(1): 12-18.
doi: 10.12259/j.issn.2095-610X.S20230104
Abstract:
Objective To explore the identification method of Papaver with the use of DNA barcoding technology and find reliable DNA barcoding sequence for intraspecific and interspecific identification of Papaver. Methods Five different species of Papaver rhoeas and Eschscholtzia californica Cham were used as intraspecific and interspecific plants for the identification of Papaver. The extracted DNA was amplified using primers matK, rbcL, trnH-psbA from chloroplast genomes and ITS2, ITS4, ITS5 from ribosomal genomes, and then bidirectional sequencing and splicing were performed using MEGA X. Sequences were analyzed and aligned, intraspecific and interspecific genetic distances were calculated, and N-J phylogenetic trees were constructed using the software. Results The sequencing results, which were entered into Genbank for comparative analysis, showed that a single DNA barcode sequence was not effective in distinguishing between Papaver somniferum and Papaver rhoeas. At the same time, a phylogenetic tree was successfully constructed using matK+rbcL+trnH-psbA combined barcode through Genbank download data, and the sequencing results of Papaver samples in this study were verified by this method. The combination of matK+rbcL+trnH-psbA barcode successfully constructed the N-J tree, which could effectively distinguish between Papaver somniferum and Papaver rhoeas in this study. Conclusion matK+rbcL+ trnH-psbA can be used as a combined DNA barcode for the identification of Papaver.
2023, 44(1): 19-24.
doi: 10.12259/j.issn.2095-610X.S20230106
Abstract:
Objective To investigate the relationship between KRAS, NRAS and BRAF gene mutations and liver metastasis in colorectal cancer. Methods A total of 246 colorectal cancer tissue specimens were collected from the Affiliated Hospital of North Sichuan Medical College from January 2019 to October 2021. KRAS, BRAF and PIK3CA mutations analysis were performed with ARMS method and fluorescence PCR technology. Clinical data were collected and the relationship between KRAS, NRAS and BRAF gene mutations and liver metastasis were analyzed. Results The mutation rates of KRAS, NRAS and BRAF were 45.93% （113/246）, 6.10% （15/246） and 4.87% （12/246） in 246 colorectal cancer cases, respectively. NRAS gene mutation was associated with synchronous colorectal liver metastasis. The frequency of liver metastasis was higher in the NRAS mutation group at the time of colorectal cancer diagnosis （P = 0.005）, but there was no significant difference in the frequency of liver metastasis within 1a between the NRAS mutant group and the wild group as the disease progresses （P = 0.155）. Multivariate Logistic regression analysis showed that NRAS mutation was an independent risk factor for synchronous colorectal cancer liver metastasis （OR = 9.974, P = 0.008）. KRAS and BRAF mutations had no significant correlation with liver metastasis （P > 0.05）. Conclusion Colorectal cancer patients with NRAS gene mutation are prone to liver metastasis in the early stage. NRAS gene mutation detection not only plays an important role in targeted therapy, but also in the early evaluation of liver metastasis.
2023, 44(1): 25-30.
doi: 10.12259/j.issn.2095-610X.S20230124
Abstract:
Objective To establish a mouse model of necrotizing enterocolitis and detect the key protein molecules in serum of neonatal rats with early NEC, so as to preliminatively determine whether necrotizing enterocolitis is involved in early neonatal necrotizing enterocolitis. Methods The NEC mouse model was established and randomly divided into the experimental group and control group with 12 newborn rats in each group. The neonatal rats in the experimental group were induced into NEC animal models. Blood samples were extracted and the concentrations of IL-18, Gasdermin D and Caspase-1 in serum of all rats were detected by Elisa kit. The concentration of target protein in serum of the two groups was compared, α = 0.05. Results The concentrations of Gasdermin D and Caspase-1 in serum of rats in the two groups were significantly different, with P values of 0.017 and < 0.001, respectively. It could be considered that the concentrations of Gasdermin D and caspase-1 in serum of rats in the experimental group were higher than those in the control group. There was no significant difference in serum IL-18 concentration between the two groups （P = 0.755）. Conclusion Gasdermin D mediated pyroptosis may be involved in the pathogenesis of early NEC.
2023, 44(1): 31-34.
doi: 10.12259/j.issn.2095-610X.S20230120
Abstract:
Objective To investigate the incidence probability and epidemiological characteristics of flat foot in school-age children （7～13 years old） in Kunming, and to provide the evidence for the prevention of flat foot. Methods The incidence of flat foot, age trend, male to female ratio, severity and the incidence of single and double foot of school-age children were analyzed by using the optical foot assessment recording device in the second primary school of Dianchi Resort, the fifth Primary School of Jingkai District, Guolin Primary School and Wenbi Primary School in Kunming. Results The overall incidence of flat foot in 4444 school-age children （7-13 years old） in Kunming was 29.1%. The incidence of flat foot in school-age children of different ages was statistically significant （χ2 = 159.887, P < 0.001）. The prevalence was 36.91% at age 7 and 29% at age 13. The incidence of flat feet was 62.49% in boys and 37.51% in girls. There was a statistically significant difference in the incidence of flat feet between boys and girls （ χ2 = 63.886, P < 0.001）. The prevalence of flat feet in boys of all ages was higher than that in girls.The total incidence of flat foot in school-age children was divided into mild 21.79%, moderate 52.43% and severe 25.78% according to degree. The incidence of flat foot was 89.1% in bipedal type, and there was no statistical significance in the left and right type of flat foot （ P > 0.05）. Conclusion The incidence of flat foot in school-age children aged 7-13 years decreases gradually with the increase of age. The incidence of flat foot in girls is lower than that in boys, and the incidence of flat foot in most children is moderate flat foot. For school-age children, flat feet should be prevented, detected and treated as early as possible.
2023, 44(1): 35-40.
doi: 10.12259/j.issn.2095-610X.S20230128
Abstract:
Objective To create a combined model and explore its value in predicting the rupture risk of acute type A aortic dissection （ATAAD）. Methods The relevant data and the first cTn-I value of the ATAAD patients admitted and treated in a tertiary hospital from September 2018 to December 2020 were collected and analyzed retrospectively. The patients were divided into the dead group according to whether they died after admission （n = 44） and the survival group （n = 109）. The general data and cTn-I value of the two groups were compared, and a binary logistic regression analysis was used to explore the risk factors related to the in-hospital rupture of ATAAD. Results There were significant differences in syncope, WBC > 15×109/L, pericardium, and periaortic hematoma between the two groups （P < 0.05）, but no significant differences in other aspects （P > 0.05）. There was significant difference in cTn-I value between the two groups （P < 0.05）. Syncope, WBC > 15×109/L, pericardium, periaortic hematoma and cTn-I were included in binary logistic regression analysis. The results showed that there were significant differences in the multivariate analysis of pericardium, periaortic hematoma, and cTn-I value. The combined model created by combining the above factors predicted the AUC of ATAAD rupture was 0.859 （P < 0.05）. Conclusion The joint prediction model has the prediction performance.
2023, 44(1): 41-46.
doi: 10.12259/j.issn.2095-610X.S20230112
Abstract:
Objective To investigate the different expression levels of TNF-α, sTNFR-55 and sTNFR-75 in the induced sputum and serum of AECOPD patients and their clinical significance. Methods Forty AECOPD patients were enrolled and hospitalized during January 2019 and December 2020. All subjects received the conventional therapy. The expression levels of TNF-α, sTNFR-55 and sTNFR-75 in the induced sputum and serum before the treatment （group Ⅰ） and after the treatment （group Ⅱ） were compared and their correlation with the severity of the disease was analyzed. Meanwhile, the correlation between three inflammatory mediators in the induced sputum and serum was analyzed. According to the smoking history, they were divided into smoking cessation group （group Ⅲ） and smoking group （group Ⅳ）. The changes of TNF-α, sTNFR-55 and sTNFR-75 levels after quitting smoking were also compared and analyzed. Results （1） After the treatment, the levels of TNF-α in sputum and serum decreased significantly （P < 0.05）, while the levels of sTNFR-55 in sputum increased （t = 3.044, P = 0.004）, and the levels of sTNFR-55 and sTNFR-75 in serum showed no significant difference （P > 0.05）. （2） FEV1, FEV1%pred, FEV1/FVC were negatively correlated with the level of TNF-α in sputum （r was -0.827, -0.865, -0.868, respectively, P < 0.001）, and positively correlated with the level of sTNFR in sputum （rsTNFR-55 was 0.415, 0.330 and 0.305, respectively, P < 0.05; rsTNFR-75 was 0.903, 0.969 and 0.965, respectively, P < 0.001）. （3） APACHEIII score was positively correlated with the level of TNF-α in sputum （r = 0.374, P = 0.001）, and negatively correlated with the level of sTNFR level （r was -0.227, -0.341, respectively, P < 0.05）. （4） There was no correlation between TNF-α/sTNFR levels in the induced sputum and serum （P > 0.05）, and its level in serum had no correlation with lung function index and APACHEII score （P > 0.05）. （5） Compared with the smoking group, the TNF-α level in the induced sputum of the smoking cessation group was lower （Z = -2.626, P = 0.008）, while the sTNFR-55 and sTNFR-75 levels in the induced sputum were higher （t = 2.716, P = 0.01; Z = -2.696, P = 0.006）. Conclusion The levels of TNF-α, sTNFR-55 and sTNFR-75 in the induced sputum can be used to evaluate the efficacy and severity of AECOPD patients. No correlation has been found between systemic and airway inflammation in AECOPD patients, and airway inflammation may still progress after smoking cessation.
2023, 44(1): 47-53.
doi: 10.12259/j.issn.2095-610X.S20230111
Abstract:
Objective To investigate the relationship between dyslipidemia and its clinical features and renal pathological features in patients with IgA nephropathy. Methods 150 patients with lgA nephropathy were divided into dyslipidemia group and normal blood lipid group, according to the blood lipid level. The dyslipidemia group was further divided into hypercholesterolemia group, hypertriglyceridemia group, mixed hyperlipidemia group and low high density lipoproteinemia group according to the types of dyslipidemia. The clinical features and pathological characteristics of each group. Results Compared with normal blood lipid group, BMI, urea, creatinine, uric acid and 24h-UP of abnormal blood lipid group were significantly higher （P < 0.05）, albumin, eGFR in dyslipidemia group were lower （P < 0.05）. Between different types of dyslipidemia, serum uric acid in hypertriglyceridemia group was higher than that in other dyslipidemia groups （P < 0.05）.The serum albumin in mixed hyperlipidemia group was lower than that in other dyslipidemia groups （P < 0.05）, while the 24-hour urine protein content was higher than that in other dyslipidemia groups （P < 0.05）. The proportion of Lee’s pathological grade Ⅲ-Ⅴ in dyslipidemia group was higher than that in normal blood lipid group, and the difference was statistically significant （P < 0.05）.The proportion of T1 and T2 in dyslipidemia group was higher than that in the normal blood lipid group （P < 0.05）. Multivariatelogistic regression analysis showed that BMI was a high-risk factor for dyslipidemia in patients with IgA nephropathy. Conclusions Dyslipidemia can predict the disease and progression of IgAN. The dyslipidemia group has more severe renal clinical features and pathological grading, and is more pronounced in tubular atrophy/interstitial fibrosis.Elevated BMI is a highrisk factor for dyslipidemia in IgAN patients.
2023, 44(1): 54-58.
doi: 10.12259/j.issn.2095-610X.S20230126
Abstract:
Objective To establish an early screening system for childhood acute lymphoblastic leukemia based on the detection of TEL-AML1 fusion gene in neonatal umbilical cord blood and to explore its clinical significance. Methods First, the newborn with high risk factors of childhood acute leukemia was screened through questionnaire survey. Then, the umbilical cord blood of high-risk neonates at birth was collected and the mRNA of umbilical cord blood mononuclear cells was extracted within 12 to 24 hours. The TEL-AML1 fusion gene in umbilical cord blood was detected by RT-PCR, so as to build a screening system and analyze the feasibility, efficiency and practicality of the screening system. Results 231 cases of high-risk population were screened, including 118 males （51.1%） and 113 females （48.9%）. The TEL-AML1 fusion gene was negative by RT-PCR. The average time spent was （12.3±0.6） hours. The average cost was 200RMB and the satisfaction rate and acceptance rate of patient were both 100%. Conclusion The early screening system for childhood acute lymphoblastic leukemia based on the detection of TEL-AML1 fusion gene in neonatal umbilical cord blood is scientific in theory and feasible in clinical practice, which provides a basis for early screening of childhood acute lymphoblastic leukemia in clinical practice.
2023, 44(1): 59-64.
doi: 10.12259/j.issn.2095-610X.S20230118
Abstract:
Objective Intraoperative use of a high-dose remifentanil may induce postoperative hyperalgesia. This paper aims to investigate whether low-dose nalmefene can prevent the postoperative hyperalgesia induced by high-dose remifentanil. Methods Ninety patients undergoing thyroidectomy were randomly assigned into 3 groups with 0.1 ug/kg/min of remifentanil （LR）, 0.3 μg/kg/min of remifentanil （HR）, 0.3 μg/kg/min of remifentanil with 0.1 μg/kg/h nalmefene （HR+LN） in each group. The pain thresholds to mechanical stimuli were measured by using von frey filaments on the peri-incision area 24 h and 48 h after the surgery. Also the pain intensity, additional analgesics consumption and adverse events up to 48 h were measured after the surgery. Results The pain threshold on the peri-incision area was significantly lower in the HR group at 24 h after the surgery than the preoperative baseline （P = 0.002）. Furthermore, it was decreased in the HR group compared with the LR （P = 0.022） and HR+LN （P = 0.03） groups at 24 h after the surgery. The pain threshold on the peri-incision area still significantly decreased in the HR group at 48 h after surgery compared with the preoperative baseline （P = 0.017）. Furthermore, it was also decreased in the HR group compared with the LR （P = 0.016） and HR+LN （P = 0.02） groups at 48 h after the surgery. Postoperative pain intensity presented as NRS scores were significantly higher in the HR group than in the LR at 6 h （ P = 0.01）, 24 h （P = 0.007） and HR+LN at 6 h （ P = 0.038）, 24 h （P = 0.02） groups after the surgery. The number of patients who requested additional analgesics at 6 h after surgery was significantly higher in the HR group than in the other groups （P < 0.05）. Postoperative adverse events were similar between groups. Conclusion Low dose nalmefene can prevent the postoperative hyperalgesia induced by high-dose remifentanil in patients undergoing thyroidectomy.
2023, 44(1): 65-69.
doi: 10.12259/j.issn.2095-610X.S20230113
Abstract:
Objective To investigate the clinical significance of color Doppler ultrasound in the diagnosis and treatment of cesarean scar pregnancy. Methods A total of 82 CSP patients diagnosed and treated in the Department of Gynecology of Yunnan First People’s Hospital from January 2019 to December 2021 were collected, and their diagnosis and treatment processes were retrospectively analyzed. A retrospective analysis of the clinical value of ultrasound in the diagnosis and treatment of CSP was carried out. The results of statistical analysis of data by SPSS19.0, Chi square test analysis of inter group comparison and paired T test were used for the comparison and analysis before and after the surgery Results There was the statistical significance in selecting individualized treatment plan after the classification diagnosis of CSP by B-ultrasound. The larger the lesion area, the higher the abnormal probability of postoperative B-ultrasonography and the difference was statistically significant （P = 0.002）; The abnormal rate of GSP type II was higher than that of type Ⅰ and type Ⅲ （P = 0.027）; In terms of operation mode, the abnormal rate of hysteroscopic lesion extraction was lower than that of B-ultrasound guided high-risk abortion and laparoscopic lesion extraction, and the difference was statistically significant （P = 0.002）; There was no significant difference between the number of cesarean section, the blood supply of the focus and the results of postoperative ultrasound （andP values were 1.300/0.558, -/0.059, respectively）. At the same time, the individualized treatment should be fully combined with other relevant test indicators of CSP. Conclusion Transabdominal combined vaginal color Doppler ultrasound has a very important clinical value in the clinical diagnosis and treatment of uterine scar pregnancy.
2023, 44(1): 70-75.
doi: 10.12259/j.issn.2095-610X.S20230105
Abstract:
Objective To investigate the correlation of different degrees and sides of internal carotid artery stenosis with cognitive impairment. Methods From June 2017 to August 2018, patients for cerebrovascular examination with CTA or DSA were selected from the neurology department of a certain hospital. They were divided into the stenosis group and the control group according to the examination results. All the enrolled patients were examined with memory assessment scale+modified WCST. The assessment scores were recorded and the difference of scores among the patients in each group was statistically analyzed. Results 65 cases were included in the study, which were divided into stenosis group （34 cases in total） and control group （31 cases in total） according to the examination results.The stenosis group was divided into mild stenosis group （15 cases in total） and moderate severe stenosis group （19 cases in total） according to the degree of stenosis. And the stenosis group was again divided into left stenosis group （24 cases in total） and right stenosis group （ 10 cases in total） according to the side. The memory and executive ability of the stenosis group and the control group were significantly impaired, the difference was statistically significant （P < 0.05）. The degree and side of stenosis had no correlation with memory and executive ability, and the difference was not statistically significant （P > 0.05）. Conclusion Internal carotid artery stenosis significantly affects cognitive function as indicated by memory and executive ability. However, the severity and side of stenosis are not related to cognitive function.
2023, 44(1): 76-79.
doi: 10.12259/j.issn.2095-610X.S20230108
Abstract:
Objective To measure the size of the fifth metatarsal bone marrow cavity, the length of the intramedullary nail and the length of the fifth metatarsal bone in normal adults by X-ray, and to provide a basis for the selection of the diameter and length of the intramedullary nail for the proximal fifth metatarsal fracture. Methods 120 patients, 60 males and 60 females, aged from 19 to 79 years old, who met the inclusion criteria and underwent foot X-ray examination, were selected from Yunnan Traditional Chinese Medicine Hospital. The diameter of the medullary cavity, the length of the anteroposterior position, and the length of the intramedullary nail （the distance from the base of the fifth metatarsal bone to the bending of the metatarsal shaft） were measured. SPSS26.0 statistical software package was used for statistical analysis of measurement results. Two independent samples of t-test were used for comparison between two groups of normal distribution measurement data. Pearson correlation analysis was used for correlation analysis. P < 0.05 indicated that there was a statistically significant difference. Results The average diameter of the medullary cavity in the anteroposterior position was 4.15 mm （2.24 mm～5.64 mm）, the average diameter of the fifth metatarsal cavity in the oblique position was 4.31 mm （3.18 mm～5.81 mm）, the average length of intramedullary nails was 39.74 mm （28.07 mm～53.46 mm）, the average length of the fifth metatarsal was 71.64 mm （59.73 mm～85.44 mm）, and the average ratio of the length of intramedullary nails to the length of the fifth metatarsal was 55.48% （41.12%～68.05%）. The t-test confirmed that there was no significant difference in ages between men and women （P > 0.05）. The diameter of the medullary cavity, the length of the metatarsal bone, and the length of the intramedullary nail in the positive and oblique positions of men and women were statistically significant （P < 0.05）. The ratio of the length of the intramedullary nail to the length of the fifth metatarsal bone was not statistically significant （P > 0.05）. Pearson correlation analysis: There was no correlation between the metatarsal length and the ratio of intramedullary nail length to the fifth metatarsal length in men and women （P > 0.05）. Conclusion By keeping the length of the intramedullary nail less than 55.48% of the length of the fifth metatarsal bone, the excessive length of the intramedullary nail can be avoided. Since the diameter of the medullary cavity in the positive and oblique position of most patients is greater than 4 mm, an intramedullary nail with a diameter greater than 4 mm may be required to provide adequate fixation and reduce complications.
2023, 44(1): 80-84.
doi: 10.12259/j.issn.2095-610X.S20230122
Abstract:
Objective To investigate the clinical significance of c reactive protein and procalcitonin levels in neonatal ABO hemolytic jaundice . Methods A total of 50 ABO hemolytic jaundice neonates admitted to a grade III and class A hospital in Yunnan Province between September 2021and August 2022 were selected as the observation group and 53 newborns with non hemolytic and pathological jaundice were selected as the control group during the same period. Retrospective analysis was used to compare the levels of CRP and PCT, abnormal value detection rate and infection rate between the two groups. Results The levels of CRP [11.0000 （9.1750, 13.0025）], PCT [0.6750 （0.3175, 2.9025）], the detection rate of CRP abnormal value （80%）, the detection rate of PCT abnormal value （66%） and the incidence of infection （34%） in the observation group were higher than those in the control group [1.5000 （0.7000, 7.5000）, PCT level [0.3200 （0.2000, 0.5850）], CRP abnormal value detection rate （41.5%）, PCT abnormal value detection rate （32.1%） and infection incidence rate （11.3%）]. The differences were statistically significant （P < 0.05）. The area under the curve （AUC） of CRP in the diagnosis of neonatal progression was 0.664, the sensitivity was 91.3%, and the specificity was 46.2%. PCT had an AUC of 0.711, a sensitivity of 82.6%, and a specificity of 60.0%. Conclusion CRP and PCT can be significantly elevated in the early stage of neonatal ABO hemolytic jaundice, and its detection can detect the progress of the condition as early as possible, ensure the effectiveness of treatment and nursing measures taken in time in clinical practices, and have the great significance in promoting the early rehabilitation of newborns.
2023, 44(1): 85-90.
doi: 10.12259/j.issn.2095-610X.S20230109
Abstract:
Objective To investigate the effect of intestinal segment resection and local tumor removal on the prognosis of patients with intestinal metastatic epithelial ovarian cancer. Methods The clinical data of the patients who were admitted to Yunnan Province Tumor Hospital with advanced epithelial ovarian cancers from June 2017 to June 2021 were reviewed. All of the patients were treated by the same woman tumor expert of the Department of Gynecology and his team and the safety and feasibility of two kinds of operation methods were compared. Results Among 56 patients, 33 （58.9%） underwent the intestinal resection and anastomosis, and 23 （41.1%） underwent the intestinal tumor removal and bowel repair. There was no significant difference in satisfactory tumor reduction rate between the two groups （63.6%, 87.0%, P > 0.05）. In the median follow-up time of 24.5 months （18.75～42.75）, the recurrence rates in the enterectomy group and the tumor excision group were 57.6% and 42.4% respectively, the mortality rates were 78.8% and 82.6%, respectively, and the median relapse-free survival time were 31 months and 19 months, respectively, with no statistical significance （P > 0.05）. Operations in intestinal resection group were carried out with longer time, more difficulties, more blood loss and more blood transfusion. The incidence of postoperative complications was higher, and the difference was statistically significant （P < 0.05）. Conclusion There is no significant difference in the tumor reduction outcome and survival of patients with ovarian cancer tumor cell reduction after the intestinal resection and tumor removal, but the patients may face more complications and poorer quality of life after the intestinal resection. Therefore, during the operation, the depth of tumor invasion of the intestinal wall, the scope of intestinal invasion and the separability of the tumor should be fully assessed, so as to preserve the intestinal tract as much as possible, and to reduce the occurrence of postoperative complications.
2023, 44(1): 91-96.
doi: 10.12259/j.issn.2095-610X.S20230110
Abstract:
Objective To examine the effect of dual-task （DT） training on mobility function in patients with Parkinson’s disease （PD）. Methods 56 patients with PD were randomly divided into DT training group or single-task （ST） training group. Each group of patients received the 60 min/session training, 5 times/week, for over 2 weeks. The motor and cognitive functions of the two groups were compared before and after the training. Results Although there was no significant difference between the two groups in the change time taken to complete the 10 m walking and timed up and go （TUG） test under either DT or ST condition, only the experimental group improved significantly under DT condition （P < 0.05）. For balance function （mini-balance evaluation system test, Mini-BESTest） and balance efficiency （activity-specific balance confidence scale, ABC）, only DT training group showed the significant time effect. Conclusion Walking speed and balance function in patients with PD tend to be improved after DT training. Future research should be conducted to explore the optimized training protocol and improve DT motor function in patients with PD and the ability of transferring the acquired function to new DT scenarios.
2023, 44(1): 97-103.
doi: 10.12259/j.issn.2095-610X.S20230117
Abstract:
Objective To observe the clinical efficacy and safety of first-line nucleos （t）ide analogues antiviral therapy in newly diagnosed chronic hepatitis B patients with low viral load and uncertain stage. Methods A total of 96 diagnosed treatment-naive chronic hepatitis B patients with low viral load in indeterminate stage who attended Kunming Third People’s Hospital from January 2019 to April 2022 were included and divided into the ETV group, TDF group and TAF group according to the drugs used. The differences in clinical efficacy and safety of the three groups were observed at the 12thW, 24thW and 48thW of continuous dosing. Results After 48 weeks of the antiviral treatment, a total of 96.88% （93/96） patients achieved complete virologic response （CVR, defined as HBV DNA < 100 IU/mL） to HBV DNA, with CVR rates in the three groups: 96.97% （32/33） in the ETV group, 96.97% （32/33） in the TDF group 96.97% （32/33）, and 96.67% （29/30） in the TAF group, with no statistically significant difference among the three groups （P = 0.997）. HBsAg levels decreased significantly at 48 weeks of treatment compared to the baseline in all three groups, but there was no statistically significant difference among the three groups （P = 0.348）. eGFR levels were significantly elevated in the TAF group compared to those in the ETV group （P = 0.013） and the TDF group （P = 0.047）, and AFP levels decreased significantly compared to those in the ETV group （P = 0.008） and the TDF group （P = 0.007）. There was no significant difference of ALT recurrence rate for 48 weeks among TAF group （70%）, TDF group （45.45%） and ETV group （60.61%） （P = 0.135）. No serious adverse events occurred during the treatment period. Conclusion The CVR rate of all three groups has reached more than 96% after 48 weeks of the treatment, the ALT normalization rate of the TAF group is better than that of the TDF group, and the decrease in AFP level and improvement in eGFR level of the TAF group are better than those of the ETV and TDF groups. The patients with elevated ALT and low viral load in the indeterminate phase of chronic hepatitis B could benefit from antiviral therapy.
2023, 44(1): 104-108.
doi: 10.12259/j.issn.2095-610X.S20230115
Abstract:
Objective To explore peripheral blood interleukin-6 （ IL-6）, interleukin-10 （ IL-10） hypersensitive C-reactive protein （ hs-CRP） and procalcitonin （ PCT） in children with acute lymphoblastic leukemia （ ALL） co-infection. Methods A total of 141 children with ALL who were admitted to Kunming Children’s Hospital from January 2018 to December 2019 were selected as the research objects. 49 cases were entered into the uninfected group and 92 cases into the infection group （in which 69 cases with the mild infection and 23 cases with the severe infection） according to whether they were co-infected or not. The peripheral blood IL-6, IL-10, hs-CRP and PCT of the two groups were compared, and the diagnostic efficacy of the four infection indicators in ALL children with co-infection was analyzed. Results The four infection indexes in the peripheral blood of the infected group were higher than those in the non-infected group （P < 0.05）. Compared with the mild infection group, the four infection indexes in the severe infection group increased significantly. The area under the ROC curve （AUC） of IL-6, PCT, IL-10, hs-CRP and their combination in the diagnosis of ALL co-infection in peripheral blood were 0.887, 0.781, 0.765, 0.681 and 0.923, respectively. Conclusion IL-6, IL-10, hs-CRP and PCT have the certain diagnostic significance in the diagnosis of ALL co-infection. Among them, IL-6 has the highest diagnostic efficiency. The combination of the four can improve the diagnostic value of ALL co-infection.
2023, 44(1): 109-115.
doi: 10.12259/j.issn.2095-610X.S20230116
Abstract:
Objective To investigate the characteristics and significance of nutritional status and immune function in patients with pulmonary tuberculosis. Methods 1041 tuberculosis patients admitted to Kunming Third People’s Hospital from March 2021 to March 2022 were collected as the research group and 854 healthy subjects during the same period were selected as the control group. The levels of related indicators between the two groups were compared, and the characteristics and relationships of the nutritional status and immune function of tuberculosis patients were analysed. Results Compared with the control group, the nutritional and immune-related indicators expressions of Hb, TP, Alb, Glob, A/G, PA, TC, TG, HDL, LDL, CD3+T, CD4+T, CD8+T, CD4+/CD8+ CD19+B, NK and NKT were decreased （all P < 0.05）. The levels of cytokines IL-1β, IL-8, IL-17 were increased, and IL-4, IL-10, IL-12p70, IFN-γ were decreased （P < 0.05）. In the research group, tuberculosis patients with low hemoglobin, low albumin, high cholesterol, high triglyceride, and low high-density lipoprotein were mainly mild and moderate, with a small proportion of severe; Th1 cytokines （IL-1β, IL-2, TNF-a, IFN-γ） were higher than Th2 cytokines （IL-4, IL-5, IL-6, IL-10） （P < 0.05）; The levels of TP, TG and NKT were higher in males than those in females, and the expressions of TC, CD3+T, CD4+T, CD8+T, IL-1β, IL-4, IL-10 and IL-12p70 were lower than those in females （all P < 0.05）; The relevant indicators of each age group analyzed with one-way ANOVA of variance showed that there were statistically significant differences in the expression of Hb, TC, TG, CD3+T, CD4+T, CD8+T, CD4+/CD8+, and IL-1β; The counts of CD3+T, CD4+T, CD8+T in the ≥61 year old group were significantly lower than those in the ≤20 year old group （all P < 0.05）; Nutrition-related indicators were positively correlated with the number of lymphocytes, cytokine levels and immune-related indicators by Spearman correlation analysis （r = 0.461, 0.262, 0.491; P < 0.05）. Conclusion The nutritional status and immune function of tuberculosis patients in Yunnan are lower than those of healthy people, which may be prone to mild and moderate malnutrition, and its immune response is mainly Th1 type. Women’s immune function and responsiveness are stronger than men’s, and elderly patients are often in poor immune function. The nutritional status of patients can affect their immune function and there is a positive correlation between them. Serum protein levels, lymphocyte counts and cytokine levels can be used as the important reference indicators for nutritional status and immune function in tuberculosis patients and play a positive role in the prevention and treatment of tuberculosis.
2023, 44(1): 116-121.
doi: 10.12259/j.issn.2095-610X.S20230114
Abstract:
Objective To investigate the relationship among high-sensitive HBV-DNA load , high-sensitivity HBV-DNA load, HBV genotype distribution, HBV P region drug resistance mutation, HBeAg, HBsAg, ALT and its value of clinical application in patients among the chronic hepatitis B with persistent low-level viremia in Kunming. Methods A total of 707 patients with chronic hepatitis B who received inpatient and outpatient treatment in the Third People’s Hospital of Kunming from January 2021 to December 2021 were selected. The relationship between different HBV-DNA loads and HBeAg, HBsAg and ALT was analyzed. Results Among the 707 chronic hepatitis B patients with persistent low load in the study, 446 cases had high-sensitivity HBV DNA load < 500 IU/ml, accounting for （63.50%）, and there were 576 chronic hepatitis B patients with high-sensitivity HBV DNA < 2000 IU/ml, accounting for （81.90%）; 262 cases （37.05%） were HBeAg positive; genotype C accounted for the highest proportion of 60.53% （428/707）. Among the 196 chronic hepatitis B patients with HBeAg （+） and HBV DNA < 2000 IU/mL, males were dominant, accounting for 69.89%; ALT > 40 U/L accounted for 28.57% and 73.47% of patients had HBV DNA > 20 IU/mL mL. Among the 265 chronic hepatitis B patients with HBV DNA < 20 IU/mL, HBeAg （-） accounted for 80.38% （213 cases）, and HBeAg （+） accounted for 19.62% （52 cases）. Compared with the clinical indicators, the positive rate of HBeAg, the abnormal rate of ALT, the mutation rate of drug resistance sites and other sites were significantly different among different HBV DNA load levels （P < 0.05）. Conclusion For chronic hepatitis B patients with persistent low-level viremia, the use of high sensitivity PCR technology to regularly monitor HBV DNA of hepatitis B virus in combination with quantitative monitoring of clinical indicators such as HBeAg, HBsAg, ALT, etc. can provide the objective reference for the clinical treatment of follow-up patients.
2023, 44(1): 122-127.
doi: 10.12259/j.issn.2095-610X.S20230123
Abstract:
Objective To explore the relationship between the quantitative analysis of real-time ultrasound elastography and the prognosis of percutaneous transbiliary drainage （PTCD） in elderly patients with advanced malignant obstructive jaundice. Methods A retrospective selection of 112 elderly patients with advanced malignant obstructive jaundice who underwent PTCD treatment in Kunming First People’s Hospital between May 2017 and May 2021 were divided into poor prognosis （n = 42） and good prognosis groups （n = 70） according to their prognosis. The clinical data, quantitative real-time ultrasound elastography before PTCD （at admission） and after PTCD （1 week after surgery） between the two groups were compared so as to analyse the correlation between quantitative real-time ultrasound elastography and Child-Pugh score, the relationship between quantitative real-time ultrasound elastography after PTCD and the prognosis of PTCD in elderly patients with advanced malignant obstructive jaundice. The subject work characteristic （ROC） curve was plotted to evaluate the diagnostic value of quantitative real-time ultrasound elastography after PTCD on the prognosis of PTCD in elderly patients with advanced malignant obstructive jaundice. Results The mean strain values were lower and the percentage of blue fields was higher in the poor prognosis group compared to those of the good prognosis group for quantitative indicators of real-time ultrasound elastography after PTCD （P < 0.05）; The mean value of strain and blue field percentage were associated with Child-Pugh score （P < 0.05）; Strain mean value and blue field percentage were independent factors influencing PTCD prognosis in elderly patients with advanced malignant obstructive jaundice （P < 0.05）; The AUC for the combined diagnosis of strain mean value and blue field percentage in elderly patients with advanced malignant obstructive jaundice for PTCD prognosis was 0.862. Conclusion Real-time ultrasound elastography quantitative measurement of mean strain and percentage of blue area in elderly patients with advanced malignant obstructive jaundice are related to the liver function and prognosis. Real-time ultrasound elastography quantification after PTCD can help predict the prognosis of the disease. It is of great significance in clinical work.
2023, 44(1): 128-134.
doi: 10.12259/j.issn.2095-610X.S20220818
Abstract:
Objective To investigate the value of enhanced CT radiomics model in predicting the short-term efficacy （within 6 months） of TACE combined with sorafenib in hepatocellular carcinoma. Method The clinical, pathological and preoperative CT images of 159 HCC patients treated with TACE combined with solafenib were retrospectively analyzed. Local tumor control rate was assessed according to the modified Response Evalaution Criteria in Solid Tumors （mRECIST） 6 months later. The imaging features of arterial and portal phases were extracted to establish radiomics model. The general preoperative clinical risk factors and basic imaging features were analyzed to establish a preoperative clinical model. Radiomics model were added to the preoperative clinical model to form a combined model. The receiver operating characteristic curves （ROC） of the three models were drawn and calculate the area under the curve （AUC） respectively. Results A total of 11 feature values were selected from 1 708 radiomic features to establish the raduomics model. The AUC of training group and the validation group was 0.945 and 0.918 respectively. Except the maximum diameter line and number of tumors, the differences were statistically significant （P < 0.05）, while the other differences were not statistically significant （P > 0.05）. The AUC of the clinical model training group and the validation group was 0.811 and 0.857 respectively. The AUC of the combined model training group is 0.958, and that of validation group is about 0.95. Conclusion The radiomics model constructed in this study is a powerful independent predictor for predicting the short-term efficacy of TACE combined with sorafenib, which can significantly improve the predictive ability of preoperative clinical model, screen patients with higher risk of progression before TACE combined with sorafenib treatment, and help clinicians to develop personalized treatment and follow-up plan to improve the prognosis of patients.
2023, 44(1): 135-139.
doi: 10.12259/j.issn.2095-610X.S20230103
Abstract:
Metastatic prostate cancer （mPCa） will progress to castrate-resistant state after a period of androgen-deprivation therapy （ADT） alone. Therefore, increasing focus is being placed on the additional survival benefits that could potentially be achieved with local cytoreductive and/or metastasis-directed therapies （MDT）. Local treatment of the primary tumour with the established modalities of radiotherapy and radical prostatectomy has been explored in this context, and the use of novel minimally invasive ablative therapies has been proposed. In addition, evidence of the potential clinical benefits of MDT with ionizing radiation （primarily stereotactic ablative radiotherapy） is accumulating. This aticle summarizes the current evidence base for a cytoreductive strategy in patients with mPCa.
Metastatic prostate cancer （mPCa） will progress to castrate-resistant state after a period of androgen-deprivation therapy （ADT） alone. Therefore, increasing focus is being placed on the additional survival benefits that could potentially be achieved with local cytoreductive and/or metastasis-directed therapies （MDT）. Local treatment of the primary tumour with the established modalities of radiotherapy and radical prostatectomy has been explored in this context, and the use of novel minimally invasive ablative therapies has been proposed. In addition, evidence of the potential clinical benefits of MDT with ionizing radiation （primarily stereotactic ablative radiotherapy） is accumulating. This aticle summarizes the current evidence base for a cytoreductive strategy in patients with mPCa.
2023, 44(1): 140-143.
doi: 10.12259/j.issn.2095-610X.S20230101
Abstract:
Lung cancer is one of the most common tumors, and Yunnan has the highest incidence of lung cancer in China. Many patients are diagnosed with advanced lung cancer and are treated with a combination of chemotherapy, radiotherapy, targeted therapy, immunotherapy, and local therapy （ablation, freezing, 125I, etc.）. As one of the local treatment methods for advanced lung cancer, radioactive 125I seed implantation has its unique advantages, such as small radiation radius, specific irradiation targeting of the lesion, and little damage to surrounding normal tissue, and good clinical effect. Studies have shown that epithelial mesenchymaltransformation （EMT） with lung adenocarcinoma is closely related to the growth, invasion, and metastasis. This article discusses the role of radioactive 125I particles in EMT and clinical treatment of lung adenocarcinoma
Lung cancer is one of the most common tumors, and Yunnan has the highest incidence of lung cancer in China. Many patients are diagnosed with advanced lung cancer and are treated with a combination of chemotherapy, radiotherapy, targeted therapy, immunotherapy, and local therapy （ablation, freezing, 125I, etc.）. As one of the local treatment methods for advanced lung cancer, radioactive 125I seed implantation has its unique advantages, such as small radiation radius, specific irradiation targeting of the lesion, and little damage to surrounding normal tissue, and good clinical effect. Studies have shown that epithelial mesenchymaltransformation （EMT） with lung adenocarcinoma is closely related to the growth, invasion, and metastasis. This article discusses the role of radioactive 125I particles in EMT and clinical treatment of lung adenocarcinoma
2023, 44(1): 144-150.
doi: 10.12259/j.issn.2095-610X.S20230125
Abstract:
Pterygium is a common ocular surface disease in the population and its risk factors are mainly ultraviolet radiation. The pathogenesis mainly includes oxidative stress, phototoxicity, cell proliferation and apoptosis, extracellular matrix remodeling, inflammation and immune regulation. A variety of important proteins involved in the above mechanisms have been identified, but their regulatory signaling pathways in pterygium are still unclear and are currently considered to be the result of a combination of mechanisms, and their relatively complete pathogenesis needs further exploration. This paper aims to review the different pathogenesis of pterygium in order to better understand the occurrence and development of pterygium and seek new therapeutic targets and methods, so as to improve the surgical effect and reduce postoperative recurrence.
Pterygium is a common ocular surface disease in the population and its risk factors are mainly ultraviolet radiation. The pathogenesis mainly includes oxidative stress, phototoxicity, cell proliferation and apoptosis, extracellular matrix remodeling, inflammation and immune regulation. A variety of important proteins involved in the above mechanisms have been identified, but their regulatory signaling pathways in pterygium are still unclear and are currently considered to be the result of a combination of mechanisms, and their relatively complete pathogenesis needs further exploration. This paper aims to review the different pathogenesis of pterygium in order to better understand the occurrence and development of pterygium and seek new therapeutic targets and methods, so as to improve the surgical effect and reduce postoperative recurrence.
2023, 44(1): 151-155.
doi: 10.12259/j.issn.2095-610X.S20230127
Abstract:
Objective To explore the feasibility and effectiveness of the oral digital positioning system combined with the CBL teaching method in the teaching of orthodontic bracket bonding and positioning. Methods 56 students were divided into group A （28 students） and group B （28 students） according to the random number table method. The oral digital positioning system was adopted in group A and the traditional teaching method was adopted in group B, and then the three dimensinal position of the two groups of students adhensive brackets was compared. Results The oral digital positioning system could comprehensively evaluate the effect of orthodontic bracket bonding and positioning. The orthodontic bracket bonding accuracy of the CBL group was better than that ofthe traditional teaching group, and the difference was statistically significant （P < 0.05）. Conclusion The digital bracket positioning system combined with CBL can improve the accuracy of direct bonding and positioning of brackets for clinical interns, and can help doctors achieve accurate positioning of brackets in a short time, which is of great significance for improving the effectiveness of malocclusion treatment, and worth promoting in the further.
2023, 44(1): 156-162.
doi: 10.12259/j.issn.2095-610X.S20230102
Abstract:
Objective To explore the key factors for improving the teaching quality of pediatric pharmacy with the use of Kano model. Method The students who practiced in the pharmacy department of Kunming Children’s Hospital from October 2021 to June 2022 were selected as the survey objects, the questionnaire survey with 7 dimensions and 50 elements was carried out and the results were analyzed by Kano model. Results “Clear internship objectives”, “Pharmaceutical laws and regulations” and 10 other items were essential attributes, accounting for 20%. “Perfect teaching program”, “Detailed rotation arrangements” and 18 other items were expectation attributes, accounting for 36%. “Characteristics of childhood diseases”, “Characteristics of pharmacokinetic and pharmacodynamics for children” and 12 other items were Charm attributes, accounting for 24%. “Teacher’s education background and professional title”, “Pediatric prescription review” and 10 other items were attributes with no difference, accounting for 20%. Conclusion In order to improve the quality of pediatric pharmacy teaching, 10 essential attribute elements, such as “clear internship goal” and “pharmacy related laws and regulations”, must be provided to meet the basic service needs of interns; Priority should be given to 18 elements of expected attributes such as “perfect teaching plan” and “detailed rotation arrangement” to improve the satisfaction of pediatric pharmacy teaching; The 12 elements of charm attribute were constantly improved to highlight the quality characteristics of pediatric pharmacy teaching;Appropriate tracking of 10 undifferentiated attributes, timely reduction and adjustment, to reduce the heavy teaching tasks. Based on the results of this study, the teaching of interns is optimized to lay a foundation for training excellent pediatric pharmacists.
2023, 44(1): 163-167.
doi: 10.12259/j.issn.2095-610X.S20230129
Abstract:
Objective To analyze the effect of red light irradiation combined with lower extremity muscle strength training on lower extremity motor function, Toronto Clinical Scoring System （TCSS） score and superoxide dismutase （SOD） level in patients with diabetic peripheral neuropathy （DPN）. Methods A total of 100 DPN patients admitted to our hospital from January 2020 to January 2022 were selected and divided into two groups according to the random number table method. 50 cases in the observation group received red light irradiation combined with lower limb muscle strength training, and 50 cases in the control group received the lower body strength training only. The clinical efficacy, lower extremity FMA score, TCSS score, SOD level and nerve conduction velocity data of the two groups were statistically analyzed. Results The total clinical effective rate of the observation group was 88.00%, which was significantly higher than that of the control group （66.00%）, and the difference was statistically significant （χ2 = 4.312, P = 0.038, P < 0.001）, the TCSS score was significantly decreased （P < 0.001）, and there were statistically significant differences in the FMA score, TCSS score and SOD level between the two groups after the intervention （P < 0.01）; The motor nerve and sensory nerve conduction velocity in the observation group after the intervention were significantly faster than those in the control group, and the difference was statistically significant （P < 0.05）. Conclusion Red light irradiation combined with lower extremity muscle strength training can effectively improve the neuropathy state of DPN patients, reduce oxidative stress, increase nerve conduction velocity, and then enhance the lower extremity motor function.
2023, 44(1): 168-172.
doi: 10.12259/j.issn.2095-610X.S20230119
Abstract:
Objective To investigate the effect of fasting or feeding on intestinal oxygenation in neonates during the blood transfusion. Methods From June 2021 to July 2022, a total of 59 eligible neonates who received the red blood cell infusion treatment in the newborn department of a third class A children’s special hospital in Yunnan Province were randomly divided into the fasting group and the feeding group, with 21 in the fasting group and 38 in the feeding group according to whether they continued to be fed during the blood transfusion. The near-infrared tissue blood oxygen parameter nondestructive monitor was used to detect its indicators and observe the changes of intestinal tissue oxygen saturation （rSO2） in neonates during the fasting or feeding in the caurse of red blood cell infusion. Results There was no significant difference between the two groups in gender, gestational age （corrected gestational age of premature infants） and age of days （P > 0.05）. The average values of RSO2 in intestinal tract before, during and after the fasting in the fasting group in the caurse of red blood cell infusion （%） were （54.77±6.49）, （55.18±7.64） and （55.94±6.46） respectively; The average values of RSO2 in intestinal tract before, during and after the feeding in the feeding group （%） were （55.35±6.11）, （57.79±6.37） and （58.89±5.55） respectively. There was no significant difference between the two groups before fasting/feeding, during fasting/feeding and after fasting/feeding （P > 0.05）. Conclusion The change range of rSO2 in the intestine of neonates before and after fasting or feeding compared with fasting or feeding in the process of red blood cell transfusion is small, and continuous feeding can be considered in the process of blood transfusion on the basis of the original feeding.
