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RSS2023 Vol. 44, No. 12
2023, 44(12): 1-5.
doi: 10.12259/j.issn.2095-610X.S20231231
Abstract:
Objective To study the chemical constituents from the herbs of Dendrobium crepidatum and identify its antitumor bioactive compounds. Methods The constituents were extracted by methyl alcohol and isolated by CC and Sephadex LH-20. Their structures were identified by spectroscopic analysis（1H NMR, 13CNMR and EIMS）. The antitumor activity of the constituents was determined by MTT assay in vitro. Results 9 compouds were obtained and identified as p-hydroxybenzaldehyde（1）, p-methoxyphenol（2）, p-Hydroxybenzyl alcohol（3）, hydroquinone（4）, （24R）-ethylcholest-5-en-3-ol-7-one（5）, sinalexin（6）, bis（2-ethylhexyl） benzene-1, 2-dicarboxylate（7） , pinoresinol（8）, Chaenomin B（9）. The antitumor activity of compounds 5～9 was tested, and it was found that compound 9 had good inhibitory activity against A549 cell line. Conclusion Compounds 2～5, 7～8 were isolated from the herbs for the first time and compounds 6, 9 were isolated from this genus for the first time. IC50 of 9 on A549 cell line is 29.35 μM.
2023, 44(12): 6-12.
doi: 10.12259/j.issn.2095-610X.S20231201
Abstract:
Objective To investigate the effects and mechanisms of median nerve electrical stimulation on synaptic plasticity in ischemic stroke rats. Methods 18 healthy male SD rats were randomly divided into Sham group（n = 6）, ischemic stroke group（MCAO group, n = 6） and median nerve electrical stimulation group（MNES group, n = 6）. The left middle cerebral artery occlusion model of rats was established by thread plug method. Thread plug was not inserted in sham group. The median nerve electrical stimulation group was given median nerve electrical stimulation intervention on the 3rd day after modeling, and intervention on the next day. After intervention for 7 times, behavioral detection, HE staining was used to detect median nerve injury. Nissl staining was used to detect cerebral infarction volume. Western blot was used for detection of the expression level of proteins related to synaptic plasticity, and electron microscopy was performed. Results HE staining showed that median nerve electrical stimulation did not cause damage to the median nerve in stroke rats, and the median nerve membrane was intact without obvious inflammatory cells. Compared with MCAO group, the neural function, motor function and coordination of the injured forelimb in MNES group were significantly improved（P < 0.01）. Compared with MCAO group, cerebral infarction volume in MNES group was significantly reduced（P < 0.05）, the pyknosis of Nissl bodies in ischemic penumbra decreased. Compared with MCAO group, the expression levels of synaptic plastication-related proteins PSD95 and synI in the cortex of MNES group were significantly up-regulated after median nerve electrical stimulation（P < 0.05）, the number of synapses in the ischemic cortex increased significantly（P < 0.01）. Conclusion Median nerve electrical stimulation is a safe and effective therapeutic measure to improve nerve function after stroke, and its mechanism is related to promoting synaptic plasticity.
2023, 44(12): 13-19.
doi: 10.12259/j.issn.2095-610X.S20231202
Abstract:
Objective To study the effects of different types of fluid resuscitation on mesenteric microcirculation and inflammatory factors in rabbits with hemorrhagic shock. Methods The model of hemorrhagic shock rabbits was established by reducing the basic mean arterial pressure by 40% through draining the blood from the common carotid artery. Animals were randomly divided into control group, saline group, lactate Ringer group, acetic acid Ringer group, hydroxyethyl starch group and succinyl gelatin group with 8 animals in each group. Mesenteric microcirculation was monitored with microcirculation monitor. Mean arterial pressure（MAP）, heart rate（HR）, microvascular perfusion ratio（PPV） and microvascular blood flow index（MFI） were recorded before bleeding（T0）, at hemorrhagic shock（T1）, at the beginning of fluid resuscitation（T2）, at the completion of fluid resuscitation（T3）, and at the end of the experiment（T4）. The contents of tumor necrosis factor-α（TNF-α）, interleukin-1（IL-1） and lactic acid（Lac） were measured at T0, T2 and T4. Results Compared with hydroxyethyl starch group, there were statistically significant differences in T3 MAP（P < 0.05）, except for succinyl gelatin group, hydroxyethyl starch group had higher MAP at T4 than other groups, the difference was statistically significant（P < 0.05）. The differences in MAP between experimental control group and other groups were statistically significant at T4 （P < 0.05）. PPV and MFI of hydroxyethyl starch group and succinyl gelatin group were higher than those of normal saline group, lactic acid Ringer group and acetic acid Ringer group at T4（P < 0.05）, and the lactic acid value of hydroxyethyl starch group at T4 was the lowest, compared with lactic acid Ringer group and normal saline group, the difference was statistically significant（P < 0.05）. There were statistical significances between all groups and experimental control group at T4 （P < 0.05）. There were no significant differences in TNF-αand IL-1 in T0, T2 and T4 among all groups（P < 0.05）. Conclusion Hydroxyethyl starch solution and succinyl gelatin solution can improve the microcirculation of rabbits with hemorrhagic shock, but can not improve the level of inflammatory factors.
2023, 44(12): 20-24.
doi: 10.12259/j.issn.2095-610X.S20231203
Abstract:
Objective To explore the regulatory effect of Mertk expression level on NF-κb pathway in rat Schwann cells and its possible mechanism. Methods Rat Schwann cells were cultured in vitro, and the expression of Mertk in Schwann cells exposed to high glucose was detected by Western blot. Co-immunoprecipitation was used to detect the interaction between endogenous Mertk and Ikbkb. Western blot was used to detect the expression levels of Ikbkb, P65 and tumor necrosis factor-α in Schwann cells after Mertk silencing. The protein expressions of Mertk, Ikbkb and P65 after silencing Mertk were detected by immunofluorescence. Results Mertk was expressed in Schwann cells, and the expression level increased with the increase of glucose concentration. Co-immunoprecipitation assay showed that Mertk interacted with Ikbkb in rat Schwann cells. Compared with the control group, the expression level of Mertk was significantly decreased（P < 0.05）, while Ikbkb, P65 and TNF-α were significantly increased（P < 0.05） after knock down expression of Mertk in Schwann cells. Immunofluorescence experiments showed that the fluorescence of Mertk was decreased, and the fluorescence of Ikbkb and P65 was increased in the silenced Schwann cells. Conclusion After the expression of Mertk is decreased, it can mediate the regulation of NF-κb pathway in Schwann cells through interaction with Ikbkb, and up-regulate the expression of P65 and inflammatory factor TNF-α.
2023, 44(12): 25-31.
doi: 10.12259/j.issn.2095-610X.S20231204
Abstract:
Objective To investigate the mechanisms of miRNA-15a and miRNA-16 in the process of reversing cisplatin resistance in ovarian cancer. Methods Human ovarian cancer cisplatin-resistant cell lines CoC1/DDP were transfected with miRNA-15a and miRNA-16 mimics and treated with cisplatin. qRT-PCR was used to detect the expression levels of miRNA-15a and miRNA-16 in normal CoC1/DDP cell group, cisplatin treated group, negative control group, miRNA-15a transfected group, miRNA-16 transfected group and overexpressed Bmi-1 plasmid. Western blot was used to detect the expression level of Bmi-1 in each group, CCK-8 and Annexin V/PI were used to detect cell survival and apoptosis, and γ-H2AX immunofluorescence was used to detect cell apoptosis. Results The CoC1/DDP ovarian cancer cell line shows low expression of miRNA-15a and miRNA-16, and high expression of Bmi-1 protein, which makes it resistant to cisplatin. When the levels of miRNA-15a and miRNA-16 are overexpressed, the Bmi-1 protein decreases（P < 0.05）, leading to a decrease in cell survival rate（P < 0.05）, a significant increase in DNA apoptosis（P < 0.05）, and more severe DNA damage（P < 0.05）. Overexpression of Bmi-1 plasmid can increase cell viability（P < 0.05） and reduce the rate of cell apoptosis（P < 0.05）. Conclusion The Bmi-1 protein may be a target for the regulation of miRNA-15a and miRNA-16, and overexpression of miRNA-15a and miRNA-16 can increase the sensitivity of ovarian cancer cells to cisplatin by reducing the Bmi-1 protein. This provides a new idea for predicting molecular markers of cisplatin resistance in ovarian cancer and overcoming drug resistance targets in ovarian cancer.
2023, 44(12): 32-40.
doi: 10.12259/j.issn.2095-610X.S20231206
Abstract:
Objective To investigate the expression level of miR-218-5p and LAYN in colon cancer and the effects of their regulatory relationship on the progress of colon cancer. Methods RT-qPCR was used to detect the expression of miR-218-5p in colon cancer tissues, adjacent tissues, and cell lines. Western blot was used to detect the expression level of LAYN protein in colon cancer tissues, adjacent tissues, and cell lines. The in situ hybridization（ISH） was used to detect the expression of miR-218-5p in colon cancer and adjacent tissues. Immunohistochemical（IHC） experiment was used to detect the distribution and expression of LAYN protein in colon cancer tissues and adjacent tissues. The dual luciferase experiment was used to detect the binding relationship between miR-218-5p and 3'- rn-translation region（UTR） of LAYN. CCK-8 was used to detect the cell proliferation. Transwell was used to detect the invasion ability of cells. The flow cytometry was used to detect the apoptosis level of cells. Western blot was used to detect the expression level of cleaved Caspase3 in cells. Results The expression of miR-218-5p decreased in colon cancer tissues and colon cancer cell lines, with the lowest expression in HT-29 cells（P < 0.0001）, and the expression of LAYN increased and the highest expression in HT-29 cells（P < 0.05）. The double luciferase reporter gene experiment（P < 0.01） combined with Western blot experiment（P < 0.01） showed that miR-218-5p could bind to the 3'UTR region of LAYN and inhibit its protein expression. In cell experiments, overexpression of miR-218-5p inhibited cell proliferation（P < 0.05）, invasion（P < 0.001）, and increased apoptosis（P < 0.01）, and the expression of cleaved Caspase3 protein（P < 0.01）. Overexpression of LAYN promoted cell proliferation（P < 0.05）, invasion（P < 0.001）, and decreased apoptosis（P < 0.0001） and the expression of cleaved Caspase3 protein（P < 0.01）, while overexpression of miR-218-5p and LAYN partially reversed the above changes. Conclusion The expression level of miR-218-5p is decreased in colon cancer tissues. Cell experiments show that miR-218-5p inhibits cell invasion and proliferation and promotes cell apoptosis through targeted regulation of LAYN.
2023, 44(12): 41-45.
doi: 10.12259/j.issn.2095-610X.S20231207
Abstract:
Objective To explore the effect of Yunnan specialty rice products on blood sugar by measuring the glycemic index of 5 Yunnan special rice foods: rice noodles, rice cakes, rice rolls, sour rice noodles and dry rice noodles. Methods Following the national standard method to determine the carbohydrate content of 5 Yunnan specialty rice products, and the target amount of the test substance was calculated. Food Glycemic Index Determination Method was used to determine the glycemic index of 5 Yunnan specialty rice products and observe their impact on blood sugar. Results The GI value of Yunnan specialty food rice noodle is 63, rice cake is 64, rice roll is 46, sour rice noodles is 38, and dry rice noodles is 33. Conclusion Yunnan specialty foods rice noodle and rice cake belong to medium GI foods, and diabetes patients should reduce consumption; rice roll, sour rice noodles, and dry rice noodles belong to low GI foods and can be a better staple food source for diabetes patients.
2023, 44(12): 46-50.
doi: 10.12259/j.issn.2095-610X.S20231208
Abstract:
Objective To evaluate the efficacy and safety of transurethral resection of Prostate（TURP） combined with endocrine therapy in patients with advanced prostate cancer. Methods A retrospective analysis was conducted on 87 cases of late-stage prostate cancer with dysuria admitted between January 2014 and December 2017. We divided them into 2 groups. TURP group （n = 48） received transurethral resection of prostate, followed by regular endocrine therapy. The control group （n = 39） was only given regular endocrine therapy. Comparative analysis of indicators such as prostate-specific antigen before and after treatment, maximum urinary flow rate, residual urine volume, International Prostate Symptom Score（IPSS）, and 5-year survival rate was performed between the two groups. Results Three months after TURP surgery, the symptoms of urinary difficulty significantly improved, and various indicators showed significant improvement compared to before the surgery. PSA levels also notably decreased compared to before the surgery. After 3 months of treatment, the TURP group showed significant improvements in IPSS, Qmax, RV, and PSA indicators compared to the control group（P < 0.05）. Both groups of patients experienced a gradual decrease in PSA levels after receiving standardized treatment. In the first 12 months of treatment, the PSA levels in the TURP group decreased more significantly compared to the control group, but after 12 months of treatment, the comparison difference was not statistically significant in the PSA levels between the two groups（P = 0.056）. A 5-year follow-up comparison of the two groups of patients revealed that there was no statistically significant difference in survival （P = 0.734）. Conclusion Transurethral resection of Prostate（TURP） combined with regular endocrine therapy can effectively improve the dysuria in prostate cancer patients, improve the quality of life of patients, and will not affect the five-year survival rate. TURP is a safe and effective treatment for advanced prostate cancer.
2023, 44(12): 51-58.
doi: 10.12259/j.issn.2095-610X.S20231209
Abstract:
Objective To explore the co-infection rate, immune function and drug resistance status among tuberculosis patients co-infected with HBV, HCV and HIV in Yunnan. Methods A total of 2271 TB patients in Yunnan province admitted to the Third People's Hospital of Kunming from April 2020 to March 2023 were collected for HBV, HCV, HIV serological tests, lymphocyte tests and drug resistance gene detection, and analysis of TB infection of HBV, HCV, HIV infection, immune function and resistance. Results Among the 2271 TB patients, 499 cases were infected with TB and HBV, the infection rate was 21.97%. 196 cases were infected with HCV, the infection rate was 8.63%. 166 cases were infected with HIV, the infection rate was 7.31%. There were 1410 patients with simple tuberculosis, accounting for 62.09%. The infection rates of tuberculosis combined with HBV, HCV and HIV were statistically significant in different age groups（P < 0.01）. The absolute number expression of CD3+, CD4+ and CD8+T cells was higher in TB patients with HBV and HCV, and the differences between the two were statistically significant（P < 0.05）.The absolute number expression of CD3+ and CD4+T cells was lower in TB patients with HIV, and the absolute number expression of CD8+T cells was increased, and the difference between the two was statistically significant（P < 0.01）. The absolute number of CD3+, CD4+ and CD8+T cells was higher in female patients with tuberculosis and HIV, and the differences were statistically significant（P < 0.05）. In all age groups, the absolute number of CD3+ and CD8+T cells in tuberculosis patients with HIV was the lowest in 46-65 years old group, and the differences were statistically significant（P < 0.05）. Among the 2271 TB patients, 391 were resistant to any first-line drug（single drug resistance）, and the overall drug resistance rate was 17.22%. Among them, 52 cases were combined with HBV drug resistance, the resistance rate was 10.42%. There were 10 cases with HCV drug resistance, the drug resistance rate was 5.10%. 40 cases were combined with HIV drug resistance, the drug resistance rate was 24.10%. Drug resistance in 289 patients with simple tuberculosis was 20.50%. Among them, 33 cases were single drug resistant rifampicin, accounting for 19.88%. Conclusion Tuberculosis has the highest rate of co-infection with HBV, and the immune function of TB patients co-infected with HIV is the worst. The drug resistance rate of TB patients co-infected with HIV is also the highest, with resistance to rifampicin being the most common. TB is a chronic wasting disease, with poorer immune function compared to the general population, making it more susceptible to HBV infection. TB patients who are also infected with HIV tend to have worsened immune function and increased drug resistance.
2023, 44(12): 59-64.
doi: 10.12259/j.issn.2095-610X.S20231210
Abstract:
Objective To analyze the hepatitis B virus infection with extreme reduction of cholinesterase（CHE） not caused by liver synthesis dysfunction, and to explore its clinical significance. Methods The clinical data of 2 rare cases hospitalized in the 3rd people’ s hospital of Kunming in July 2021 and February 2022, including liver function, coagulation function, hepatitis B markers, hepatitis B virus volume, and whole exon sequencing, were collected and analyzed, and literature was reviewed. Results CHE was extremely reduced in 2 patients with HBV infection, liver synthesis function was good, and whole exon sequencing showed the presence of butyrylcholinesterase（BCHE） gene mutation. Conclusion The extremely low CHE in this case is not due to liver function disorder. Exon sequencing detected mutations in the BCHE gene in two patients. Screening for BCHE mutations may be necessary in patients with extremely low cholinesterase levels not due to liver dysfunction.
2023, 44(12): 65-71.
doi: 10.12259/j.issn.2095-610X.S20231211
Abstract:
Objective To investigate the safety and efficacy of endoscopic thyroid surgery through axillary approach in the treatment of unilateral papillary thyroid carcinoma. Methods A total of 135 patients admitted to Yunnan Cancer Hospital from April 2022 to November 2022 were selected. According to the surgical method, 69 patients were in the endoscopic group and 66 patients were in the open surgery group. The clinical data, operation time, intraoperative blood loss, postoperative drainage volume, postoperative hospitalization stay, complications, cosmetic satisfaction, scar evaluation, postoperative swallowing pain and blood calcium, blood phosphorus, PTH levels of the two groups were observed. Results There were no significant differences in general data, pathological features, number of lymph node dissection, and perioperative complications between the two groups（P > 0.05）. The operation time and postoperative drainage volume in the endoscopic group were significantly higher than those in the open surgery group. The intraoperative blood loss, postoperative hospital stay, pain score, serum calcium, serum phosphorus, PTH levels and cosmetic satisfaction in the endoscopic group were significantly better than those in the open group（P < 0.05）. Conclusion Transaxillary approach endoscopic thyroid surgery for the treatment of single-sided papillary thyroid carcinoma is safe, feasible, and provides better protection of the parathyroid glands, postoperative swallowing pain, and cosmetic satisfaction.
2023, 44(12): 72-78.
doi: 10.12259/j.issn.2095-610X.S20231212
Abstract:
Objective To investigate the microstructural changes in white matter of pituitary adenoma patients when the anterior visual pathway is compressed using diffusion tensor imaging（DTI） and discuss the clinical significance of these changes. Methods Clinical and MRI data of 25 patients with pituitary adenomas and 25 matched healthy controls were prospectively included. Tract-based spatial statistics（TBSS） was carried out to investigate difference in white matter integrity between 2 groups, which was measured using fractional anisotropy（FA）. A correlation between visual function evaluation index and regional FA value was examined using correlation analysis. Results The FA values of bilateral optic radiations and inferior fronto-occipital fasciculus were significantly lower in the research group. The FA values of left optic radiation and inferior fronto-occipital fasciculus were positively correlated to mean deviation and visual field index, negatively correlated to patten standard deviation. The FA values of bilateral optic radiations and inferior fronto-occipital fasciculus were negatively correlated with Bulbo-pontine height. Conclusion Patients with pituitary adenoma may experience damage to the bilateral optic radiation and inferior fronto-occipital fasciculus after compression of the anterior visual pathway, which may affect the patient’ s visual function, further indicating that DTI can quantitatively assess the microstructure damage of the visual pathway in patients with pituitary adenoma.
2023, 44(12): 79-86.
doi: 10.12259/j.issn.2095-610X.S20231213
Abstract:
Objective To analyze the sleep status of infants and young children aged 0～35 months, in order to understand the common sleep problems and possible influencing factors of infants and young children. Methods Healthy infants aged 0～35 months who underwent physical examination in the outpatient Department of Child Health Care, Kunming Children's Hospital from June 2022 to May 2023 were selected as the study subjects. The brief infant sleep questionnaire（BISQ） was completed by their parents. Single factor analysis and Logistic regression analysis were used to analyze the sleep status of infants and young children and the factors affecting sleep problems. Results The primary sleeping mode for infants and young children is sleeping with parents（85.6%）. The average daytime sleep duration is（3.51±1.75） hours, nighttime sleep is（8.84±1.41） hours, and total daily sleep is（12.37±2.07） hours. Daytime and total sleep duration decrease gradually with increasing age in each age group（P < 0.05）. 27.7% of infants and young children may experience insufficient sleep duration; the prevalence of sleep problems is 79%, with the highest rate of difficulty falling asleep at 75.3%, followed by night waking（72.2%） and sleep rhythm disturbances（19.7%）; 278 cases（92.7%） involve involuntary falling asleep. Univariate analysis shows that age and sleep initiation method are related to the occurrence of sleep problems in infants and young children（P < 0.05）. Logistic regression analysis suggests that young age and involuntary falling asleep are risk factors for the occurrence of sleep problems. Conclusion The incidence of sleep problems in infants and young children is high, which is related to the young age and involuntary sleep onset. It is recommended to train infants and young children to fall asleep autonomously as early as possible, and strengthen the education of sleep habits in infants and young children to reduce the incidence of sleep problems in infants and young children.
2023, 44(12): 87-94.
doi: 10.12259/j.issn.2095-610X.S20231214
Abstract:
Objective To investigate the characteristics of clinical cellular immunity and its relationship with prognosis in elderly patients with severe infection caused by Omicron variant. Methods The clinical data of 53 patients with Omicron variant infection admitted to the geriatric Intensive Care Unit of the First Affiliated Hospital of Kunming Medical University from December 2022 to February 2023 were retrospectively analyzed. The patients were divided into 22 survival cases and 31 death cases for comparison between the two groups. Logistic analysis is adopted to define the omicron variants of elderly severe infections prognostic factors and construct the ROC curve. Results Multivariate logistic analysis revealed that the independent risk factors were elevated IL-6（P = 0.043） and decreased absolute T lymphocyte count（P = 0.011）.AUC value of ROC of IL-6, absolute T lymphocyte count and IL-6 combined with absolute T lymphocyte count was 0.818, 0.796 and 0.887. Conclusion Elevated IL-6 and decreased absolute T lymphocyte count are independent risk factors for elderly severe patients with Omicron variant infections.
2023, 44(12): 95-99.
doi: 10.12259/j.issn.2095-610X.S20231215
Abstract:
Objective To analyze the clinical characteristics of pediatric Langerhans cell histiocytosis（LCH）, and to analyse the expression characteristics and prognosis of BRAF-V600E mutation in LCH. Methods The clinical data of 31 children with LCH admitted to the Department of Hematology, Kunming Children's Hospital from February 2017 to December 2021 were retrospectively analyzed. Reference to LCH Shanghai children’ s medical center - 2011 revision chemotherapy（SCMC - LCH - 2011）, at the same time BRAF mutation - V600E targeted biopsies was treated by Dabrafenib. The clinical features, BRAF-V600E mutation and treatment response between single system LCH（SS-LCH） and multisystem LCH（MS-LCH） were summarized. The Kaplan-Meier method was used to draw the survival curve, and the Log-Rank test was used to compare the survival rate between groups. The Shanghai Children's Medical Center LCH-2011 revised chemotherapy regimen（SCMC-LCH-2011 regimen） was referenced, and the targeted drug Dabrafenib was added to treat those with the BRAF-V600E mutation. The clinical characteristics, BRAF-V600E mutation status, and treatment response between the single-system LCH（SS-LCH） group and the multisystem LCH（MS-LCH） group were summarized. Survival curves were plotted using the Kaplan-Meier method, and the Log-Rank test was used to compare the survival rates between the two groups. Results This study included a total of 31 cases, with 18 males and 13 females. The median age of onset was 10 months（ranging from 1 to 84 months）. 9 cases were SS-LCH, and 22 cases were MS-LCH, with 5 cases experiencing pituitary involvement/diabetes insipidus. Among the 27 cases that underwent BRAF-V600E mutation testing, 20 were positive（3 cases in the SS-LCH group, with a positivity rate of 37.5%; 17 cases in the MS-LCH group, with a positivity rate of 89.5%）. The difference in the BRAF-V600E mutation positivity rate between the two groups was statistically significant（P = 0.011）. The median follow-up time was 24 months（ranging from 3 to 62 months）. The effective rate after 6 weeks of induction chemotherapy was 88.9% in the SS-LCH group（8/9） and 81.8% in the MS-LCH group（18/22）. The observed progression-free rate at the end of the observation period reached 29.0%（9/31）. All three deaths occurred in the MS-LCH group with involvement of high-risk organs. There was no statistically significant difference in the overall survival rate between the SS-LCH and MS-LCH groups, as well as between the BRAF-V600E mutation positive and negative groups（χ2 = 1.156, 0.437; P = 0.282, 0.508）. Conclusion LCH in children is more common in infants and young children, with a high incidence of BRAF-V600E gene mutation in affected children, and is often seen in MS-LCH. Dabrafenib may help improve the prognosis of children with BRAF-V600E mutation.
2023, 44(12): 100-105.
doi: 10.12259/j.issn.2095-610X.S20231216
Abstract:
Objective To investigate the application value of pre-implantation genetic testing（PGT） in patients with Turner syndrome. Methods The clinical data, embryonic development, PGT results and pregnancy outcome of 18 patients with Turner syndrome who underwent PGT in the reproductive center of 900th Hospital from January 2016 to June 2023 were retrospectively analyzed. Results All 18 patients had spontaneous puberty development, of which 4 patients had primary ovarian insufficiency（POI）. A total of 24 oocyte retrieval cycles were performed in 18 patients, of which 6 patients had no biopsied embryos for 10 cycles. Sixty-one embryos were biopsied and 60 embryos were clearly diagnosed, including 25 with chromosomal abnormalities. Seven patients with mosaic Turner syndrome obtained clinical pregnancies after transplantation, including 4 healthy boys had already been delivered and 3 are in pregnancy. Conclusion There are numerous types of karyotype in Turner syndrome. The clinical phenotypes vary greatly in individuals with Turner syndrome, and prognosis of PGT is significant different. Patients with Turner syndrome who had biopsied embryos can obtain available embryo using PGT, and achieve ideal clinical outcomes.
2023, 44(12): 106-110.
doi: 10.12259/j.issn.2095-610X.S20231217
Abstract:
Objective To evaluate the clinical application of paroxetine in outpatients. Methods A retrospective analysis was used to collect the prescription information of all outpatients who used paroxetine in the hospital from January 1, 2020 to June 30, 2023. The structural characteristics of patients and information on medication dosage, frequency, and cost were analyzed to evaluate the rationality of prescriptions. Results A total of 28, 106 valid prescriptions for paroxetine were included, of which 9257 were male and 18849 were female. The use of paroxetine hydrochloride tablets decreased annually while the use of enteric-coated paroxetine hydrochloride sustained-release tablets increased annually. The annual use of paroxetine hydrochloride tablets decreased, while the annual use of enteric-coated paroxetine hydrochloride sustained-release tablets increased. The average cost of the drug per patient unit dose increased each year. Non-compliant prescriptions included off-label use, improper dosage, excessive treatment duration, and off-label use in children and adolescents. Conclusion The clinical application of paroxetine is not standardized, and there are unreasonable situations such as overuse. It is necessary to further strengthen the medication management of paroxetine in outpatient patients.
2023, 44(12): 111-120.
doi: 10.12259/j.issn.2095-610X.S20231218
Abstract:
Objective To explore the differences in the effectiveness of using different blood indicators individually, in combination, and for dynamic monitoring in the diagnosis, differential diagnosis, and prognosis of bacterial infections. Methods 1843 cases with infectious symptoms or signs from January 2015 to September 2022 at the People’ s Hospital of Yuxi City were selected as the case group, and 2298 uninfected individuals during the same period were selected as the control group. Blood indicators of the two groups were collected. Variables were grouped according to gender, age group, specimen type, etc. SPSS 24.0 and Medcalc 20.0 were used for statistical analysis. Results The individual diagnostic efficacy of various blood indicators for detecting infection ranges from 0.656 to 0.937. When used together, the efficacy ranges from 0.907 to 0.987. The efficacy of distinguishing between G+c and G-b in different specimens is as follows: when PCT is used alone in blood, the AUC is 0.875 for males and 0.769 for females. However, the individual diagnostic efficacy in male mucous secretions, sterile body fluids, and non-adult male sputum is all ≤0.7. Yet, when used together, the efficacy is AUC（0.789, 0.737, 0.86） respectively. The dynamic monitoring of PCT, IL-6, CRP, WBC, and LAC in adult patients at 24 h, 48 h, and 72 h after admission shows statistically significant differences in prognostic efficacy for G+c and G-b（P < 0.05）. Conclusions Blood indicators have a certain diagnostic value for determining whether there is a bacterial infection, and there are gender differences. The combined use of these indicators is more effective. The diagnostic value of using blood indicators alone or in combination for distinguishing between G+c and G-b in different types of specimens varies. The use of PCT alone in blood specimens is the most effective. For adult males, the combined use of body surface mucous secretions and sterile body fluids is most effective, while for underage males, the combined use of sputum is most effective. The combined use for females is not effective. Dynamic monitoring of PCT, CRP, IL-6, LAC, and WBC has a high value for evaluating the prognosis and therapeutic effect of infections. The evaluation of G+c infection is most effective at 24 hours for IL-6, and for G-b infection, it is most effective at 72 hours for PCT.
2023, 44(12): 121-126.
doi: 10.12259/j.issn.2095-610X.S20231219
Abstract:
Objective To study the association between mean platelet volume（MPV）, platelet distribution width（PDW） and procalcitonin（PCT） and cardiac function in patients with pulmonary hypertension（PH） and their diagnostic value on heart failure. Methods 103 patients with PH（PH group） in the 3rd People's Hospital of Chengdu from October 2021 to October 2022 and 103 healthy subjects with physical examination（control group）were selected as study subjects. Fasting peripheral venous blood was collected on the 1st day of admission and MPV, PDW and PCT were detected. The left ventricular ejection fraction（LVEF） was measured and the cardiac function was evaluated by New York Heart Association（NYHA） grading criteria. The patients with PH were divided into failure group and non-failure group according to the diagnosis results of heart failure. The relations of MPV, PDW and PCT with cardiac function in patients with PH and the diagnostic value on heart failure were analyzed. Results The levels of MPV, PDW, and PCT were all higher in the experimental group compared to the control group, while the LVEF was lower, and these differences were statistically significant（P < 0.05）; as the NYHA classification increased, the levels of MPV, PDW, and PCT showed an increasing trend, while LVEF showed a decreasing trend, and the differences between the groups were statistically significant（P < 0.05）; in the heart failure group n = 65, the levels of MPV, PDW, and PCT were higher compared to the non-heart failure group n = 38, while LVEF was lower, and these differences were statistically significant（P < 0.05）. The levels of MPV, PDW, and PCT werr significantly positively correlated with NYHA functional classification and LVEF（P < 0.05）. The levels of MPV, PDW, and PCT had good reference value for the diagnosis of heart failure in PH patients, with AUC values of 0.816, 0.897, and 0.825 respectively, and the combined diagnostic AUC is 0.952, which wass statistically different from the application of the three indicators alone（P < 0.05）. Conclusion RDW, PDW and PCT are closely related to cardiac function in patients with PH, and can provide reference information for diagnosis and treatment of heart failure in patients with PH.
2023, 44(12): 127-132.
doi: 10.12259/j.issn.2095-610X.S20231220
Abstract:
Objective To compare the clinical efficacy of invisible appliance and fixed appliance in the treatment of skeletal class I malocclusion. Methods A prospective cohort study with a minimum sample size of no less than 19 subjects in each group was used, and 46 adult patients with bone type I were eventually enrolled. According to the type of appliance, they were divided into the invisible appliance group（group A） with 25 patients and the fixed appliance group（group B） with 21 patients . Data were analyzed before orthodontic treatment（T0） after（T1） between invisible and traditional fixed orthodontics. Results The static occlusion index and PAR score were improved after treatment, and the differences were statistically significant（P< 0.01）. The occlusal dynamic parameters including OT, OFAT, OFPT, AOF and DT were significantly improved after treatment（P< 0.01）. There were significant differences in AOF, forward and lateral DT between the two groups（P< 0.01）, the invisible group was better than the fixed group. Conclusion Both the dynamic and static occlusal changes can be greatly improved with invisible and fixed appliance in the treatment of patients with class I malocclusion. Invisible appliance is better than fixed appliance in balancing occlusion, eliminating and reducing occlusal interference.
2023, 44(12): 133-138.
doi: 10.12259/j.issn.2095-610X.S20231221
Abstract:
Objective To explore the correlation between 4D-CTA imaging and the risk factors for the rupture of anterior communicating aneurysms. Methods A total of 100 patients with anterior communicating aneurysms in the Department of Radiology of Yan’ an Hospital of Kunming City from June 2020 to March 2023 were selected as the study objects. The patients were divided into ruptured group and unruptured group based on whether the aneurysm had ruptured（with 50 cases in each group）. The unruptured group（50 cases） received conservative treatment and follow-up observation for 1-12 months. The measurements included the aneurysm neck width（Wn）, aneurysm height（H）, average diameter of the carrying artery（DA）, aneurysm length（L）, aneurysm neck ratio（AR）, the ratio of aneurysm height to carrying artery diameter（SR）, aneurysm volume to aneurysm base area（VOR）, and the search for the pulsation point of the aneurysm, analyzing the correlation between these measurements and aneurysm rupture. Results Wn, AR, L and SR in ruptured group 1 were higher than those in non-ruptured group 1（P < 0.05）. Wn, AR, L and SR in fracture group 2 were higher than those in non-fracture group 2（P < 0.05）. The CT values of internal carotid artery and middle cerebral artery, and the CT values and noise of brain parenchyma in 4D-CTA were higher than those in 3D-CTA（P < 0.05）. Conclusion The use of 4D-CTA imaging for quantitative analysis of anterior communicating aneurysms can not only predict the risk of rupture, but also provide better image quality compared to 3D imaging while reducing radiation dosage. 4D-CTA imaging has a positive impact on the diagnosis and treatment of clinical aneurysms.
2023, 44(12): 139-143.
doi: 10.12259/j.issn.2095-610X.S20231222
Abstract:
Objective To analyze the clinical features of children with EV71 positive hand, foot, and mouth disease（HFMD） and EV71 vaccination, and to explore the relationship between the occurrence of severe disease and the preventive effect of EV71 vaccine. Methods From January 1, 2020 to December 31, 2022, the clinical data of 131 children with HFMD diagnosed with EV71 infection in Kunming Children's Hospital were retrospectively analyzed. The stool samples of patients with clinically confirmed HFMD were selected for enterovirus nucleic acid detection. The clinical data and EV71 vaccination status of children with universal enterovirus positive and EV71 positive HFMD were analyzed. Results Among the 131 positive cases detected, there were 116 mild cases and 15 severe cases. Among the 80 children who received phone consultations about their EV71 vaccine status, 17 were vaccinated, and 63 were not vaccinated. The vaccinated children were all mild cases, while among the unvaccinated children, 6 were severe cases. From 2020 to 2022, the period from April to September each year is the peak period for detecting EV71-positive hand, foot, and mouth disease（χ2 = 125.705, P = 0.000）. The positive detection rate for children under 1 year old and over 5 years old was higher than that for children aged 1 to 5 years（χ2 = 8.765, P = 0.033）, and there was no significant difference in the positive detection rate between boys and girls（χ2 = 1.221, P = 0.269）. Conclusion EV71 vaccine is of great significance in reducing the occurrence of severe cases. Combined with the current low vaccination rate in Kunming, Yunnan Province, it is suggested that relevant institutions should continue to increase the publicity of EV71 vaccination.
2023, 44(12): 144-149.
doi: 10.12259/j.issn.2095-610X.S20231223
Abstract:
Objective To analyze the epidemiological characteristics of an outbreak of carbapenem resistant Klebsiella pneumoniae（CRKP） hospital infection in the neonatal intensive care unit（NICU） , and to explore possible causes of the outbreak. Methods Case analysis, epidemiological studies and environmental detection methods were used to investigate the detection of CRKP in the NICU of a hospital from March 11, 2022 to May 3, 2022, and the causes and corresponding prevention and control measures were analyzed. Results This CRKP outbreak in the NICU occurred in two phases. The first phase was from March 11, 2022, to March 30, 2022, during which 3 people contracted CRKP hospital infections. The second phase was from April 13, 2022, to May 3, 2022, during which 4 people contracted CRKP hospital infections. The source of the hospital infection outbreak was patient No.1. All 13 CRKP cases showed sensitivity only to amikacin and tigecycline, with intermediate sensitivity to levofloxacin, and high resistance to other antibiotics. All 13 CRKP cases carried resistant genes for metalloenzymes. After the outbreak, the ward environment was sampled three times, with 35 samples taken in total, and 14 of them tested positive for CRKP. After strict environmental cleaning, disinfection, and multiple control measures, no new hospital infection cases similar to this outbreak were detected after May 13, 2022. Conclusion The outbreak of NICU hospital infections may be due to the contamination of the ward environment, medical equipment, and inadequate hand hygiene of medical staff, leading to its spread. Therefore, strict cleaning and disinfection of the environmental surfaces, strengthening hand hygiene of medical staff, and implementing multiple measures can effectively control hospital infections of CRKP.
2023, 44(12): 150-158.
doi: 10.12259/j.issn.2095-610X.S20231224
Abstract:
Objective To explore the clinical efficacy and safety of betaquiline fumarate tablets in the treatment of multi drug resistant pulmonary tuberculosis. Methods Patients with multidrug-resistant tuberculosis（MDR-TB） admitted to the Third People's Hospital of Kunming from March 2019 to September 2022 were selected as the research objects. They were divided into two groups by random number table method. The observation group (n = 93) received anti tuberculosis treatment with a regimen containing bedaquiline fumarate tablets, while the control group (n = 90) received anti tuberculosis treatment with a regimen without bedaquiline fumarate tablets. The lesion absorption rate, sputum negative conversion rate, cavity reduction rate, treatment efficiency, and adverse drug reactions during treatment were collected at the end of 24 weeks. Results At the end of the 24th week of treatment, the differences between the observation group and the control group in the rates of lesion absorption rate（85.7%, 63.3%）, negative conversion of sputum smears（89.7%, 71.4%）, negative conversion of sputum cultures（82.1%, 68.6%）, cavity shrinkage rate（88. 2%, 69. 4%）, and total treatment efficacy（81.9%, 60.2%） were statistically significant（P<0.05）. The difference in the incidence of adverse drug reactions between the observation group and the control group（69.9% and 83.4%） was statistically significant（P<0.05）, but the difference in the severity of adverse reactions was not statistically significant（P> 0.05）. Conclusion The regimen containing betaquiline fumarate tablets has good efficacy and is safe in the treatment of multidrug-resistant pulmonary tuberculosis.
2023, 44(12): 159-164.
doi: 10.12259/j.issn.2095-610X.S20231225
Abstract:
Objective To explore the effects of paroxetine and sulpiride in the treatment of social phobia in young women and the effects on neurotransmitters and sleep structure. Methods 102 young female patients with social phobia in our hospital from February 2021 to February 2023 were selected and divided into 2 groups with 51 cases in each group by random number table method. The control group was treated with Paxil, and the study group was treated with Paxil + sulpiride for 3 months. Treatment effect, neurotransmitters [5-hydroxytryptamine（5-HT）, dopamine（DA）, gamma-aminobutyric acid（GABA）, myeloperoxidase（MPO）], sleep structure, social anxiety（LASA）, social fear（SPS） and social Results The research group's overall effective rate of treatment is 88.24%, which is higher than the control group's 70.59%（P<0.05）. 1 month and 3 months after treatment, the research group's serum levels of DA and MPO are lower than those of the control group, while the levels of 5-HT and GABA are higher than those of the control group（P<0.05）. 1 month and 3 months after treatment, the research group's sleep transition frequency and the proportion of stage I + stage II are lower than those of the control group, while the proportion of stage III + stage IV and REM stage are higher than those of the control group（P<0.05）. 1 month and 3 months after treatment, the research group's LASA, SPS, and SAFE scores are lower than those of the control group（P<0.05）; The incidence of adverse events in the research group is 13.73% compared to 9.80% in the control group, with no statistically significant difference（P>0.05）. Conclusion Paroxetine and sulpiride combined can improve the sleep structure of young women with social phobia, regulate serum neurotransmitter levels, alleviate social anxiety symptoms, improve social adaptability, and have a certain level of safety.
2023, 44(12): 165-170.
doi: 10.12259/j.issn.2095-610X.S20231226
Abstract:
Objective To analyze the correlation between different types of anemia（small cell anemia and normal cell anemia） before operation and pathological features and prognosis of colorectal cancer patients. Methods The clinical data of 130 patients with colorectal cancer who underwent radical surgery in our hospital from March 2018 to February 2021 were retrospectively analyzed. According to the morphology of red blood cells, the patients were divided into group A（70 cases without anemia）, group B（18 cases with small cell anemia） and group C（42 cases with normal cell anemia）. Pathological features and postoperative 2 a survival rate of the 3 groups were compared. The correlation between preoperative anemia types and pathological features of colorectal cancer was analyzed by Phi coefficient test, and Kaplan-Meier survival curve was drawn to compare the survival rate of the 3 groups. Results There were significant differences in gender, tumor site, tumor diameter and TNM stage distribution among the three groups（P < 0.05）. The Phi coefficient test showed that preoperative anemia type was correlated with gender, tumor site, tumor diameter, and TNM stage（r = 0.238, 0.255, 0.266, 0.331, P = 0.025, 0.015, 0.010, 0.001）. Multivariate Logistic regression analysis showed that tumor diameter ≥5 cm, TNM stage Ⅲ-Ⅳ, distant metastasis, lymph node metastasis, preoperative small cell anemia, preoperative normal cell anemia were the risk factors for the prognosis of colorectal cancer after radical surgery（OR > 1, P < 0.05）. The overall survival rate of 2a in group A was higher than that in group C > that in group B（P < 0.05）. Log-rank test showed that the postoperative survival rate of the three groups was significantly different（P < 0.05）. Conclusion Preoperative anemia types were correlated with tumor site, tumor diameter, TNM stage and postoperative survival time of colorectal cancer patients, among which preoperative small-cell anemia patients had the lowest survival rate.
2023, 44(12): 171-176.
doi: 10.12259/j.issn.2095-610X.S20231227
Abstract:
Objective To compare the effects of 4 different shaping angle tubes on the success rate of tracheal intubation and postoperative pharyngeal complications among anesthetic beginners. Methods 160 patients who underwent laparoscopic cholecystectomy under general anesthesia, with ASA classification I to II, no history of difficult airway, were randomly divided into 4 groups according to the catheter shape and tip shaping angle: 35°banana-shaped elbow group（A Group）, 50°banana-shaped bent pipe group（Group B）, 35°straight pipe group（Group C）, 50°straight pipe group（Group D）, with 40 cases in each group. After induction of general anesthesia, tracheal intubation is performed using a video laryngoscope. The Cormack-Lehane grade of laryngoscope exposure, external laryngeal compression, one-time success rate of intubation and intubation time were recorded. SPO2, HR and MAP were recorded before anesthesia induction（T0）, at the end of anesthesia induction drug injection（T1）, immediately after intubation（T2） and 1min after intubation（T3）. The incidence of pharyngeal pain and hoarseness immediately after extubation and 24 hours after operation were followed up. Results There were no statistically significant differences in Cormack-Lehane classification, HR, and MAP among the four groups of patients at each time point（P > 0.05）. The number of cases requiring external laryngeal compression, intubation time, first-time intubation success rate, immediate postoperative sore throat, and immediate postoperative hoarseness rates in Groups B and D were all lower than those in Groups A and C, and the differences were statistically significant（P < 0.05）. Conclusion When using video laryngoscope for tracheal intubation, 50°banana-shaped curved tube and 50°straight tube can shorten the intubation time, reduce postoperative complications, and have no obvious hemodynamic fluctuations.
2023, 44(12): 177-183.
doi: 10.12259/j.issn.2095-610X.S20231228
Abstract:
The meniscus in the knee joint plays an important role in bearing load, shock absorption, joint lubrication, and increasing the stability of the knee joint in various directions. Meniscal injury is a common ailment in knee joint injuries, which can cause severe knee pain and limited knee joint movement, significantly affecting the patient's quality of life. Arthroscopic minimally invasive treatment has become the main approach for treating meniscal injuries, with the consensus being to preserve the meniscus morphology and structure as much as possible. By introducing the structure and function of the meniscus, the mechanism of injury, and focusing on several suture techniques for arthroscopic meniscal injury treatment, analyzing their advantages and disadvantages, it aims to provide some reference for clinical research on arthroscopic suture of the meniscus.
The meniscus in the knee joint plays an important role in bearing load, shock absorption, joint lubrication, and increasing the stability of the knee joint in various directions. Meniscal injury is a common ailment in knee joint injuries, which can cause severe knee pain and limited knee joint movement, significantly affecting the patient's quality of life. Arthroscopic minimally invasive treatment has become the main approach for treating meniscal injuries, with the consensus being to preserve the meniscus morphology and structure as much as possible. By introducing the structure and function of the meniscus, the mechanism of injury, and focusing on several suture techniques for arthroscopic meniscal injury treatment, analyzing their advantages and disadvantages, it aims to provide some reference for clinical research on arthroscopic suture of the meniscus.
2023, 44(12): 184-190.
doi: 10.12259/j.issn.2095-610X.S20231229
Abstract:
Escherichia coli is a highly adaptable opportunistic pathogen bacterium that can form biofilms on the surface of implants and generates persistent cells, leading to life-threatening infections that are difficult to treat with antibiotics alone. Therefore, there is a need for an effective E.coli biofilm inhibitor to combat this public health threat.Indole is a novel quorum-sensing signaling molecule of E. coli discovered in recent years, which is of great significance in regulating bacterial growth and biofilm formation, and is a potential target for future research on new anti-biofilm preparations. This article reviews the research progress on the formation of Escherichia coli biofilms, the microbial metabolism of indole and its regulation of Escherichia coli biofilm formation, in order to provide information for clinical treatment and drug development.
Escherichia coli is a highly adaptable opportunistic pathogen bacterium that can form biofilms on the surface of implants and generates persistent cells, leading to life-threatening infections that are difficult to treat with antibiotics alone. Therefore, there is a need for an effective E.coli biofilm inhibitor to combat this public health threat.Indole is a novel quorum-sensing signaling molecule of E. coli discovered in recent years, which is of great significance in regulating bacterial growth and biofilm formation, and is a potential target for future research on new anti-biofilm preparations. This article reviews the research progress on the formation of Escherichia coli biofilms, the microbial metabolism of indole and its regulation of Escherichia coli biofilm formation, in order to provide information for clinical treatment and drug development.
2023, 44(12): 191-196.
doi: 10.12259/j.issn.2095-610X.S20231230
Abstract:
Objective To explore the impact of research based learning（RBL） teaching method on undergraduate research innovation ability. Methods A total of 212 undergraduate students were involved in this study. Among them, 104 undergraduate students participated in the traditional teaching method, and 108 undergraduate students participated in the RBL teaching method. After they finished the comprehensive experiment in medical immunology, we assessed the scientific innovation ability and the degree of satisfaction of teaching effectiveness. Results The undergraduate research and innovation capabilities of the RBL teaching group are higher than those of the traditional teaching group（P < 0.001）. The undergraduate students in the RBL teaching group have higher abilities in experimental design, experimental operation, report writing, result presentation, questioning and answering, as well as satisfaction with teaching effectiveness, compared to the traditional teaching group（P < 0.01）. Conclusion The RBL teaching method can significantly improve the scientific innovation ability of undergraduate students.
