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Monthly Established in March 1976

Supervisor: The Education Department of Anhui Province

Sponsor: Bengbu Medical College

ISSN1000-2200

CN34-1067/R

Editor: Editorial Board of Journal of Bengbu Medical College

Chief Editor:GAO Huai-quan

Editorial Director:YAO Ren-bin

Publication: Editorial Department of Journal of Bengbu Medical College

Postal code: 26-37

Price: Domestic ¥15.00,Overseas $10.00

Articles in press have been peer-reviewed and accepted, which are not yet assigned to volumes /issues, but are citable by Digital Object Identifier (DOI).
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Coptisine promots hepatocyte autophagy and cholesterol efflux to improve lipid accumulation in fatty liver
SHEN Min-yan, HU Xi, ZHU Jing, ZHANG Guang-ya, MAO Zi-ming, CHEN Feng-ling
2021, 46(4): 421-424, 430.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.001
[Abstract](33) [FullText HTML](16) [PDF 1376KB](2)
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ObjectiveTo construct a model of fatty liver cell of HepG2 cells treated with oleic acid and palmitic acid, and observe the effects of coptisine(COP) on the accumulation of lipid droplets in fatty liver cells and its mechanism of action.MethodsThe fatty liver cell model of HepG2 cells was constructed by induction of 100 μmol/L oleic acid and 50 μmol/L palmitic acid.The CCK8 was used to detect the effects of COP at different concentrations on cell proliferation.The cells were divided into the control group, the fatty liver cell model group(FFA group), COP+HepG2 group and COP+FFA group.The RT-PCR and Western blotting were used to detect the mRNA and protein levels of autophagy genes LC3Ⅰ/Ⅱ, ATG5 and cholesterol outflow-mediated factor ABCA1 in four groups.The changes of lipid droplets in contral, FFA and COP+FFA groups were observed using oil red O staining.ResultsThe results of oil red O staining showed that compared with contral group, the lipid droplets in HepG2 cells treated with palmitic acid and oleic acid increased significantly in FFA group, and the lipid droplets decreased significantly in COP+FFA group.The results of CCK8 showed that the activity of HepG2 cells was not affected by 0-25 μmol/L COP(P>0.05).The results of Western blotting and RT-PCR showed that compared with the control group, the levels of autophagy and cholesterol outflow-mediated factor ABCA1 in the FFA group significantly reduced, while the expression levels of autophagy genes LC3Ⅰ/Ⅱ, ATG5 and ABCA1 in the COP+HepG2 group significantly increased(P < 0.05 to P < 0.01).Compared with the FFA group, the lipid accumulation in COP+FFA group significantly reduced, and the difference of which between FFA group and COP+FFA group was statistically significnat(P < 0.05 to P < 0.01).The autophagy and cholesterol efflux disorders were also improved in the COP+FFA group.ConclusionsCOP can promote the autophagy and cholesterol efflux of HepG2 cells, and alleviate the accumulation of lipids in fatty liver cells induced by oleic acid and palmitic acid.
Expression and clinical significance of immune checkpoint molecules HHLA2 and PD-L1 in hepatocellular carcinoma
YANG Jing-wen, TANG Xiao-tong, GUO Hui, ZHU Yue, ZHANG Tian-tian, LIU Yang, WU Qiong, WANG Rui
2021, 46(4): 425-430.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.002
[Abstract](28) [FullText HTML](19) [PDF 2452KB](1)
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ObjectiveTo explore the expression levels of immune checkpoint molecules human endogenous retrovirus-H long terminal repeat-associating protein 2(HHLA2) and programmed death ligand-1(PD-L1) in hepatocellular carcinoma(HCC) tissues, and analyze the correlation between HHLA2 and PD-L1 expression, and relationship between HHLA2 and PD-L1 expression, and clinicalpathological characteristics and prognosis.MethodsThe expression levels of HHLA2 and PD-L1 in 90 human HCC tissues and corresponding adjacent tissues were detected using immunohistochemical staining.The correlation between the expression of HHLA2 and PD-L1 in HCC tissues was assessed.The relationship between the expression levels of HHLA2 and PD-L1, and clinical stage, serum α-fetoprotein(AFP) level, pathological grade, chronic hepatitis B virus infection, vascular invasion and over survival time(OS) were analyzed.ResultsThe positive rates of HHLA2 in HCC tissues and adjacent tissues were 54.4% and 36.7%, respectively, and the difference of which was not statistically significant(P>0.05).The positive rates of PD-L1 in HCC tissues and adjacent tissues were 57.7% and 48.9%, respectively, and the difference of which was not statistically significant(P>0.05).The HHLA2 expression in HCC tissues was positively correlated with PD-L1 expression(r=0.280, P < 0.05).The expression of HHLA2 in HCC tissues was not related to the age, sex, pathological grade, serum AFP level and vascular invasion, but related to the clinical stage and chronic hepatitis B virus infection(P < 0.05).The expression of PD-L1 in patients with HCC was not associated with the age, sex, serum AFP level, vascular invasion and chronic hepatitis B virus infection, but associated with the clinical stage and pathological grade(P < 0.05).There was no statistical significance in OS between positive and negative HHLA2 and PD-L1 expression HCC patients(P>0.05).ConclusionsThe expression levels of immune checkpoint molecules HHLA2 and PD-L1 in HCC tissues are on an upward trend, the expression of the two is positively correlated, and the expressions of HHLA2 and PD-L1 are not related to the prognosis of HCC patients.HHLA2, as a new immune checkpoint molecule, may be a potential therapeutic target for advanced liver cancer in the future, which still needs to be further studied.
Study on the correlation between serum levels of mitochondrial fusion protein-2, acetaldehyde dehydrogenase 2 and chronic heart failure
ZHANG Bing, ZHANG Wei, HU Xiang-wen, LI Mao-yuan, TANG Yang, LU Yuan-yuan, KANG Pin-fang, ZHANG Ning-ru
2021, 46(4): 431-435.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.003
[Abstract](31) [FullText HTML](17) [PDF 1046KB](0)
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ObjectiveTo investigate the correlation between the levels of mitochondrial fusion protein-2(Mfn2), acetaldehyde dehydrogenase 2(ALDH2) and chronic heart failure(CHF).MethodsOne hundred and eighty CHF patients and 40 healthy people(control group) were investigated.According to the NYHA heart function classification standard, the CHF patients were divided into the class Ⅱ in 46 cases, class Ⅲ in 63 cases and class Ⅳ in 71 cases.After admission, the results of NT-proBNP and cardiac color Doppler ultrasound were improved, the serum levels of Mfn2 and ALDH2 were detected, and the correlation between Mfn2, ALDH2 and CHF was analyzed.ResultsCompared with the control group, the serum levels of Mfn2, ALDH2 and LVEF decreased, the serum levels of NT-proBNP and LVEDD increased in the CHF group, and the differences of which were statistically significant(P < 0.01).Among the class Ⅱ, Ⅲ and Ⅳ heart function groups, the serum levels of Mfn2 and ALDH2 decreased with the decreasing of heart function, the serum levels of NT-proBNP and LVEDD increased with the increasing of heart function, and the differences of which were statistically significant(P < 0.01).According to the LVEF classification, the serum levels of Mfn2 and ALDH2 in patients with LVEF ≤ 40% were lower than those in patents with LVEF>40%, and the levels of NT-proBNP and LVED in patients with LVEF ≤ 40% were higher than those in patents with LVEF>40%(P < 0.05 to P < 0.01).The results of Pearson correlation analysis showed that the level of Mfn2 was negatively correlated with LVEDD(P < 0.01), and positively correlated with LVEF(P < 0.01), while the level of ALDH2 was positively correlated with LVEF(P < 0.01).The area under ROC curve of Mfn2, ALDH2 and both combination in the diagnosis of CHF were 0.803, 0.831 and 0.891(P < 0.05).ConclusionsWith the decreasing of cardiac function in CHF patients, the serum levels of Mfn2 and ALDH2 decrease.The Serum levels of Mfn2, ALDH2 are related to the CHF, which may play an important role in clinical assessment and diagnosis.
Expression of UQCRC1 in colorectal cancer tissue and its correlation with serum CEA
LOU Shi-han, WANG Qiang-wu, ZHENG Hai-lun
2021, 46(4): 436-439.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.004
[Abstract](30) [FullText HTML](19) [PDF 1186KB](1)
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ObjectiveTo investigate the expression levels of ubiquinol cytochrome c reductase core protein 1(UQCRC1) in colorectal cancer tissues, and its correlation with serum carcinoembryonic antigen(CEA) level.MethodsThe expression levels of UQCRC1 in 52 cases of colorectal cancer tissue and 37 cases of paracancer tissue were detected using the immunochemistry SP method, and the relationship between the expression levels of UQCRC1, and clinicological characteristics of colorectal cancer and serum level of CEA were analyzed.ResultsThe down-regulation rates of UQCRC1 in cancer tissue and normal tissue adjacent to cancer were 30.8% and 10.8%, respectively, and the difference of which was statistically significant(χ2=4.94, P < 0.05).The UQCRC1 expression was related to lymph node metastasis of colorectal cancer, and the negative expression rate in patients with lymph node metastasis(45.5%) was higher than that in patients without lymph node metastasis(20.0%)(P < 0.05).The UQCRC1 expression in cancer tissue was negatively correlated with the preoperative serum CEA level(r=-0.300, P < 0.05).ConclusionsThe down-regulation of UQCRC1 expression in colorectal cancer may play an important role in tumorigenesis and development, and UQCRC1 combined with serum CEA can provide the theoretical basis in the assessment of colorectal cancer.
Expression and significance of SCN4B/β4 in nasopharyngeal carcinoma tissue
TAO Lu, WEI Zhuo-li, WU Shi-wu, CHENG Ze-nong, JIANG Hao, XIANG Ping
2021, 46(4): 440-443.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.005
[Abstract](37) [FullText HTML](19) [PDF 1740KB](0)
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ObjectiveTo explore the expression level of voltage-gated sodium channel β4 subunit(SCN4B/β4) in nasopharyngeal carcinoma tissue, and analyze its clinical significance.MethodsThe expression levels of SCN4B/β4 in 90 nasopharyngeal biopsy specimens from nasopharyngeal carcinoma patients and 20 archived paraffin-embedded normal nasopharyngeal mucosal tissues(mainly chronic inflammation of nasopharyngeal mucosa) were detected using the ElivisionTM Plus immunohistochemical method.The relationship between the positive expression of SCN4B/β4 and clinicopathological features in patients with nasopharyngeal carcinoma were analyzed.ResultsThe expression rate of SCN4B/β4 protein in nasopharyngeal carcinoma tissue was lower than that in normal nasopharyngeal mucosa(χ2=19.31, P < 0.01).The differences of the expression levels of SCN4B/β4 protein in different T stage, N stage, M stage and clinical stage were statistically significant(P < 0.05 to P < 0.01), the expression rates of SCN4B/β4 protein in stageT1-T2, M0, Ⅰ-Ⅱwere higher than that in stage T3-T4, M1 and Ⅲ-Ⅳ, and the expression rate of SCN4B/β4 protein decreased with the increasing of N stage.The survival rate of patients with high SCN4B/β4 expression was 85.2%, the survival rate of patients with low SCN4B/β4 expression was 60.3%, and the 5-year overall survival rate in patients with high expression of SCN4B/β4 was higher than that in patients with low SCN4B/β4 expression(χ2=5.35, P < 0.05).ConclusionsThe expression level of SCN4B/β4 protein in nasopharyngeal carcinoma is negatively correlated with the lymph node and distant metastasis.The survival rate in patients with high SCN4B/β4 expression is higher.
Correlation between urine ACR and serum cystatin C, β2-microglobulin in type 2 diabetes mellitus patients
YAO Gui-feng, TANG Bu-yang, HUANG Ying-zhi
2021, 46(4): 444-447.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.006
[Abstract](28) [FullText HTML](17) [PDF 979KB](1)
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ObjectiveTo investigate the correlation between urine albumin-creatinine ratio(ACR), and serum cystatin C(Cys-C) and serum β2-microglobulin(β2-MG) in patients with type 2 diabetes mellitus.MethodsA total of 530 patients with type 2 diabetes mellitus were divided into the normal albuminuria group(NA group, 361 cases with ACR < 30 mg/g), microalbuminuria group(MA group, 118 cases with 30 mg/g ≤ ACR < 300 mg/g) and large albuminuria group(LA group, 51 cases with ACR ≥ 300 mg/g) according to the ACR level.The body mass index(BMI), blood urea nitrogen(BUN), serum creatinine(Scr), Cys-C, β2-MG, fasting plasma glucose(FPG) and glycosylated hemoglobin(HbA1c) were compared among three groups, and the correlation between Cys-C, β2-MG and urine ACR was analyzed.ResultsThe differences of the gender, BMI and FPG among the NA, MA and LA groups were not statistically significant(P>0.05).The level of HbA1c in MA group was higher than that in NA group(P < 0.01).The levels of BUN and Scr in LA group were higher than those in NA group and MA group(P < 0.01).The levels of Cys-c and β2-MG in NA group, MA group and LA group gradually increased(P < 0.05 to P < 0.01).The results of Pearson correlation analysis showed that the serum levels of Cys-C and β2-MG were positively correlated with urine ACR(r=0.402 and r=0.624, P < 0.01).ConclusionsWith the aggravation of renal function damage, the serum levels Cys-C and β2-MG in type 2 diabetes mellitus patients gradually increase, which has good correlation with urine ACR, so it is of great significance in the early diagnosis, treatment and condition monitoring of diabetic ridney disease.
Effect of limited resuscitation with sodium bicarbonate Ringer's solution on the internal environment of traumatic hemorrhagic shock
ZHAO De-jun, ZHANG Fu-long, XU Zhi-peng, SONG Qi, JIANG Hai, LI Lei, QIU Zhao-lei, JI Zhong, WANG Zhen-jie
2021, 46(4): 447-450.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.007
[Abstract](30) [FullText HTML](15) [PDF 984KB](2)
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ObjectiveTo compare the effects of limited resuscitation with sodium lactate Ringer's solution and sodium bicarbonate Ringer's solution on peripheral blood cytokines, arterial blood lactate, platelet count and coagulation function in patients with traumatic hemorrhagic shock, to provide reference for screening relatively ideal resuscitation fluid.MethodsIn a prospective controlled study, 48 inpatients with traumatic hemorrhagic shock were selected and divided into observation group and control group using random number table method (24 cases in each group).Sodium bicarbonate Ringer's solution was used for resuscitation in the observation group, sodium lactate Ringer's solution was used in the control group, and limited fluid resuscitation strategy was used in both groups.The levels of interleukin (IL)-4, IL-6, IL-10, tumor necrosis factor (TNF)-α in peripheral blood and arterial blood lactate value, peripheral platelet count, plasma prothrombin time and fibrinogen level were measured before resuscitation and 1 hour after resuscitation.ResultsOne hour after resuscitation, except TNF-α, the other factors in observation group were significantly higher than those before resuscitation (P < 0.01), while only IL-6 and IL-10 in control group were significantly higher than those before resuscitation (P < 0.01);the levels of IL-4 and IL-10 in peripheral blood in observation group were higher than those in control group, while the levels of IL-6 and TNF-α in observation group were lower than those in control group (P < 0.05);the level of arterial blood lactate in observation group was significantly lower than that in control group (P < 0.01), but there was no significant difference in platelet count, plasma prothrombin time and fibrinogen level(P>0.05).ConclusionsEarly resuscitation with sodium bicarbonate Ringer's solution in patients with traumatic hemorrhagic shock can better inhibit the expression of inflammatory factors in peripheral blood and reduce the blood lactate value, which is better than sodium lactate Ringer's solution for resuscitation.
The application of LMA-astrach laryngeal mask combined with paravertebral nerve and stellate ganglion block in thoracoscopic surgery with reserved spontaneous breathing
ZHENG Jie, HU Bin, WANG Xin, HE Li, LIU Chang, LIU Qing
2021, 46(4): 451-454, 458.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.008
[Abstract](26) [FullText HTML](15) [PDF 1004KB](0)
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ObjectiveTo evaluate the safety and efficacy of LMA-Fastrach laryngeal mask combined with paravertebral nerve and stellate ganglion block in thoracoscopic surgery.MethodsEighty patients treated with thoracoscopic surgery under general anesthesia were randomly divided into the group T and group M.The group T were treated with conventional double lumen bronchial anesthesia, and the group M were treated with LMA-Fastrach laryngeal mask combined with paravertebral nerve and stellate ganglion block anesthesia.The incidence rates of postoperative pharynx pain, hoarseness and atelectasis in two groups were observed and recorded.The results of arterial blood gas analysis and airway pressure in two groups after intubation(T0), after 10 min of operation(T1), after 30 min of operation(T2) and before 10 min of the end of operation(T3) were analyzed.The total intraoperative anesthetic dose, extubation time and recovery room residence time were recorded in two groups.The VAS score, sleep quality and inflammatory cytokines content after 2 h(T4), 24 h(T5) and 48 h(T6) of surgery were recorded.ResultsThere was no statistical significance in the incidence rates of pharynx pain, hoarseness and atelectasis between two groups(P>0.05).The perioperative usage of remifentanil and sufentanil, endotracheal extubation time and recovery room residence time in group T were higher than those in group M(P < 0.01).The analgesia score and inflammatory factors in group T were higher than those in group M at T4 time point(P < 0.01).The analgesia score, sleep quality score and inflammatory factors in group T were higher than those in group M at T5 time point(P < 0.01).The analgesia score and sleep quality score in group T were higher than those in group M at T6 time point(P < 0.01 and P < 0.05).The airway pressure in group T was significantly higher than that in group M at T1(P < 0.01).The PaO2 and airway pressure in group T were higher than those in group M at T2(P < 0.05 and P < 0.01).The PaO2 in group T at T3 was significantly higher than that in group M (P < 0.01).ConclusionsThe LMA-Fastrach laryngeal mask combined with paravertebral nerve and stellate ganglion block is safe and effective in thoracoscopic surgery.
Application value of non-inflating endoscopic instrument in endoscopic thyroid surgery through the whole areola approach
JIN Gong-sheng, ZHANG Hao, CHEN Yan-song, GUO Wei, ZHANG Xiao-jing, TANG Jing-wei, CHEN Chen
2021, 46(4): 455-458.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.009
[Abstract](30) [FullText HTML](19) [PDF 1503KB](2)
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ObjectiveTo investigate the feasibility and safety of the design of the internal support apparatus in endoscopic thyroid surgery via whole areola approach.MethodsThe clinical data of 20 patients with thyroid tumor were retrospectively analyzed.The patients were treated with non-inflatable areola approach endoscopic thyroidectomy using modified cavity construction instrument, and the relevant clinical indicators were analyzed.ResultsTwenty patients were successfully operated, and not be transfered.The results of postoperative pathology showed that 18 cases were minimal papillary carcinoma of thyroid, and 2 cases were benign thyroid nodules.The unilateral lobotomy was performed in 2 cases, the unilateral glandular leaf + isthmus + central area were cleared in 16 cases, and the bilateral lateral glandular leaves + isthmus + central area were cleared in 2 cases.The operation time was (120.50±40.62) min, the number of central lymph nodes dissected was (6.32±3.00), and the postoperative extubation time was (3.68±2.34) days.One case with recurrent laryngeal nerve palsy after operation was found.The postoperative puncture tunnel bleeding in 1 case was stopped after local pressure dressing.The postoperative hypocalcium convulsions in 1 case was relieved 3 days later.The surgical satisfaction was(8.28±1.42) point.ConclusionsThe internal support free air-filling endoscope in assisting thyroid surgery is feasible, similar to that of CO2 and simple to operate.It can reduce medical cost and anesthesia risk, which is worthy of further exploration.
The application value of DPE combined with PIEB in labor analgesia after epidural perforation
XIE Hai-yan, CHENG Feng, WU Qing-ling, WANG Jing-xian, ZHENG Li-dong
2021, 46(4): 459-463.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.010
[Abstract](23) [FullText HTML](13) [PDF 987KB](0)
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ObjectiveTo investigate the safety and effectiveness of dural puncture epidural(DPE) analgesia combined with programmed epidural intermittent pulse injection(PIEB) in labor analgesia after epidural perforation.MethodsSixty parturient women were randomly divided into group A[treatment with continuous epidural analgesia(CEA) combined with PIEB] and group B(treatment with DPE combined with PIEB).The group A were treated with epidural puncture and catheterization.After successful epidural puncture, the 25G lumbar anesthetic needle was placed in group B, and the epidural tube was placed without injection after cerebrospinal fluid reflux was found.The drug formulation and PIEB settings in group B were the same as the group A.The visual analogue scale(VAS) scores and motor block in two groups before analgesia(T0), after 5 minutes, 10 minutes, 15 minutes, 20 minutes and 1 hour of analgesia(T1, T2, T3, T4 and T5, respectively), full cervical dilation(T6) and during delivery of fetus(T7) were recorded.The controlled epidur alanalgesia(PCEA) frequency, dosage of analgesic drug, analgesic adverse reactions, labor process, delivery results and maternal satisfaction were recorded in two groups.ResultsThe labor analgesian in all parturient women were successfully performed, and the vital signs(including blood pressure, heart rate, pulse oxygen saturation and respiratory rate) and fetal heart rate in two groups were stable during the labor process(P>0.05).The VAS scores in two groups at T1 to T7 time points were significantly lower than at T0(P < 0.05), and the VAS scores in group B at T1 to T4 were significantly lower than those in group A(P < 0.05).There was no statistical significance in Apgar score, labor process and delivery method between two groups(P>0.05).The number of times of pressing analgesic pump and dosage of analgesics in group B were significantly less than those in group A(P < 0.05).The maternal satisfaction in group A was significantly higher than that in group B(P < 0.05).There was no statistical significance in postoperative modified Bromage between two groups(P>0.05), and there was no statistical significance in postoperative complications between two groups(P>0.05).ConclusionsDPE combined with PIEB is a safe and effective method of analgesia, and which can be used for labor analgesia.
Expression of osteopontin and cyclooxygenase-2 in cervical cancer tissues, and their correlation with chemotherapy sensitivity
YANG Yong-bo, XIANG Ping
2021, 46(4): 464-467, 474.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.011
[Abstract](27) [FullText HTML](14) [PDF 1080KB](1)
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ObjectiveTo observe the expression levels of osteopontin(OPN) and cyclooxygenase-2(COX-2) in cervical cancer tissues, and analyze their correlation with the chemotherapy sensitivity.MethodsOne hundred and fifty-seven cervical cancer patients treated with neoadjuvant chemotherapy(NACT) were divided into the sensitive chemotherapy group(112 cases) and insensitive chemotherapy group(45 cases) according to the relevant tumor efficacy evaluation criteria.The mRNA and protein levels of OPN and COX-2 in two groups before and after NACT treatment were detected using RT-PCR and Western blotting, respectively.The relationship between the expression levels of OPN and COX-2 mRNA and ultrasonic parameters[blood vascularization index(VI), flow index(FI) and vascularization flow index(VFI)] in cervical cancer before treatment were analyzed.The multiple factors influencing the chemotherapy sensitivity in patients with cervical cancer were analyzed using logistic regression analysis.ResultsBefore treatment, the expression levels of OPN and COX-2 mRNA and protein in insensitive chemotherapy group were significantly higher than those in sensitive chemotherapy group(P < 0.01).After chemotherapy, there were not significant changes in the expression levels of OPN and COX-2 mRNA and protein in insensitive chemotherapy group(P>0.05), and the expression levels of OPN, COX-2 mRNA and protein in the sensitive chemotherapy group significantly reduced(P < 0.01).Before treatment, the expression levels of OPN and COX-2 mRNA in cervical cancer tissues were positively correlated with VI and FI(P < 0.05), and not significantly correlated with VFI(P>0.05).The expression levels of OPN and COX-2 mRNA, VI and FI in cervical cancer tissues before chemotherapy were the independent risk factors for chemotherapy sensitivity(P < 0.05).ConclusionsThe expression levels of OPN, COX-2 mRNA and protein in cervical cancer tissues are high, and both are closely related to the chemotherapy sensitivity.
Application value of chromosomal microarray analysis in children with unexplained neurodevelopmental disabilities
SHAO Chen, YAN Dong-mei, WANG Yan-juan, ZHAO Ya-li, YANG Shu-ting, WANG Zhi-wei, LIU Shuang, TONG Jiao, WANG Lei-lei
2021, 46(4): 468-474.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.012
[Abstract](27) [FullText HTML](14) [PDF 1590KB](0)
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ObjectiveTo explore the clinical application value of chromosomal microarray analysis(CMA) in the genetic diagnosis of neurodevelopmental disabilities(NDDs).MethodsThe peripheral blood samples were collected for genomic DNA extracting and CMA detecting.The results were analyzed using ChASv3.0 software and related informatics databases.ResultsA total of 22 cases(22.00%, 22/100) with chromosome copy number variations(CNVs) were detected, 14 cass(14/100, 14.00%) with pathological and possibly pathogenic variation were found, and 14 microdeletions (including 1q21.1q21.2, 6p22.3, 7q11.23, 7q11.23, 7q31.1, 8p23.3p23.1, 9q34.3, 10q26.13q26.3, 15q11.2q13.2, 15q11.2q13.1, 15q11.2q13.1, Xp22.32p22.31, Xp22.33p11.23 and Xq21.1q28) and 3 microduplications(including 2q36.3q37.3, 9q34.12q34.3 and 8q24.23q24.3) were involved in 17 cases with pathogenic or likely pathogenic CNVs.The unexplained variations with clinical significance in 8 cases(8/100, 8.00%) were found.No obvious chromosomal abnormalities were found in 78 children, and the detection success rate of samples was 100%.ConclusionsThe CNVs are one of the important genetic factors leading to NDDs.CMA can detect the chromosomal abnormalities, and find numerous microdeletions or microduplications which cannot be found traditional karyotype analysis, the sensitivity, specificity and reliability of detection are greatly improved.
Short-term efficacy observation of gemcitabine combined with nedaplatin in the treatment of advanced lung squamous cell carcinoma
CAO Zi-xiao, ZHOU Li-ya, LIU Jia-hui, ZHOU Xiao-yu, LI Dian-ming
2021, 46(4): 475-479.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.013
[Abstract](52) [FullText HTML](41) [PDF 988KB](3)
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ObjectiveTo compare the short-term clinical efficacy and adverse reactions between gemcitabine combined with nedaplatin and cisplatin in the treatment of advanced lung squamous cell carcinoma.MethodsEighty patients with advanced lung squamous cell carcinoma were randomly divided into the observation group and control group(40 cases in each group).The observation group was treated with gemcitabine combined with nedaplatin, and the control group was treated with gemcitabine combined with cisplatin for 2 cycles.The short-term efficacy, adverse reactions and influence on coagulation function were evaluated according to RECIST1.1 evaluation criteria.ResultsThe difference of the short-term efficacy between two groups was statistically significant(P < 0.05).In terms of hematological toxicity, there was no statistical significance in the levels of white blood cell, neutrophils, hemoglobin and platelet and PLT between two groups before and after chemotherapy(P>0.05).In terms of non-hematological toxicity, there was no statistical significance in the gastrointestinal reactions(nausea, vomiting, etc.) and liver function damage between two groups before and after chemotherapy(P>0.05).After chemotherapy, the levels of D-dimer in two groups increased compared with that before chemotherapy, the increasing of which in observation group was more obvious, and the difference of which between two groups was not statistically significant(P>0.05).ConclusionsCompared with gemcitabine combined with cisplatin, the application of gemcitabine combined with nedaplatin in patients with advanced lung squamous cell carcinoma has better short-term efficacy, less adverse reactions and influence on D-dimer.
Value of cervical cytological p16INK4a protein detection combined with cytological test in screening cervical cancer
LIU Zhan-qiu, HE Yu, XU Chi, HU Xiao-wen, WANG Li, LUO Xin-min
2021, 46(4): 479-483.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.014
[Abstract](31) [FullText HTML](19) [PDF 1146KB](1)
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ObjectiveTo explore the value of cervical cytological p16INK4a protein assay combined with cytological assay in screening precancerous lesions of uterine cervix and cervical cancer.MethodsA total of 790 women aged 20 to 70 who volunteered to undergo cervical cancer screening were selected, and the high-risk human papillomavirus(HR-HPV), thinprep cytologic test(TCT) and p16INK4a cytology detection in the subjects were implemented.The colposcopy and biopsy in patients with any positive test result or all negative test results complicated with obvious clinical symptoms with high suspicion of cervical lesions were examined.The detection effects of HPV, TCT and p16 alone, and combined screening for cervical precancerous lesions and cervical cancer were compared.ResultsAmong all screening subjects, the positive rates of p16, TCT diagnosed as ASCUS or higher grade and HR-HPV were 14.6%, 16.3% and 25.6%, respectively.The positive rates of p16, HPV and TCT gradually increased with the increasing of cervical lesions severity(P < 0.05 to P < 0.01).The sensitivities of p16+TCT, HPV+TCT and p16+HPV detection were 92.1%, 94.7% and 97.4%, respectively.The specificities of p16+TCT, HPV+TCT and p16+HPV detection were 85.6%, 77.5% and 78.8%, respectively.The area under the curve of HPV, TCT, p16, HPV+TCT, p16+HPV, and p16+TCT in the diagnosis of cervical lesions were 0.849, 0.822, 0.893, 0.861, 0.881, 0.889, respectively.The differences of the diagnostic value among each index to cervical lesions were statistically significant(P < 0.01).ConclusionsCompared with the results of HPV plus TCT, the p16 plus TCT has similar sensitivity and higher specificity for screening cervical precancerous lesions and cervical cance, and can be used as a new screening method for cervical cancer.
Clinical analysis and influencing prognosis factors in 77 children with acute disseminated encephalomyelitis
YANG Guang-e, HE Yuan-zhi, JIANG Liang-liang, SONG Cong-lei, YANG Bin
2021, 46(4): 484-488.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.015
[Abstract](24) [FullText HTML](14) [PDF 1307KB](0)
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ObjectiveTo summarize the clinical features and analyze the factors of influencing prognosis in children with acute disseminated encephalomyelitis(ADEM).MethodsThe clinical features of children with ADEM retrospectively analyzed.The children patients were divided into the complete healing group and incomplete healing group.The age, gender, inducements, clinical symptoms, white cell and albumen level in cerebrospinal fluid, electromyogram in extremities and encephalic MRI were compared between two groups, and the factors of influencing prognosis were explored.ResultsA total of 77 patients(44 male and 33 female), aged range from 4 months 14 days to 14 years old, were investigated.Sixty cases with infection history, 7 cases with vaccination history and 14 cases without definite inducement were found.The major clinical symptoms included the motility disorders of extremities, eclampsia, conscious disturbance, headache and dizziness, and the patients often accompanied by non-specific symptoms of fever.The results of encephalic MRI in 76 cases showed that 66 cases were abnormity, and the results of spinal cord MRI in 56 cases showed that 27 cases were abnormity.The lesion in spinal cord was found in the patients with normal encephalic MRI.Forty-one children(including 31 cases of complete healing group and 10 cases of incomplete healing group) were followed up for 6 months to 6 years after illness.The differences of the age, gender, inducements, clinical symptoms, cerebrospinal fluid white blood cell count and protein level, electromyography of limbs and encephalic MRI between two groups were not statistically significant(P>0.05).ConclusionsThe acute or subacute onset, encephalopathy, MRI abnormalities in the cranial or spinal cord are the main diagnosis criteria, and the prognosis in most patients are good.The gender, age of onset, predisposition, main clinical symptoms, general examination of cerebrospinal fluid, electromyography of limbs and head MRI do not affect on the prognosis.
Study on the inflammatory reaction and sleep quality in elderly patients with OSAHS complicated with type 2 diabetes mellitus
LIU Cong-hui, GE Yan-lei, LI Zhen-zhen, XIE Bao-quan, WANG Hong-yang, LI Li-qun, ZHANG Pan-pan, ZHANG Jia-bin, WANG Yuan
2021, 46(4): 488-490.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.016
[Abstract](22) [FullText HTML](8) [PDF 958KB](1)
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ObjectiveTo investigate the characteristics of inflammatory reaction and sleep quality in elderly patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) complicated with type 2 diabetes mellitus, and provide theoretical basis for clinical intervention.MethodsThe serum ievels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in 78 OSAHS complicated with type 2 diabetes mellitus patients diagnosed by polysomnography(PSG) combnined with fasting glucose, and 37 patients with OSAHS were detected using enzyme-linked immunosorbent assay(ELISA).The sleep quality in all cases was evaluted using fatigue severity scale(FSS) and Epworth sleepiness scale(ESS).The serum levels of indicators and scale scores were compared between two groups.ResultsCompared with the simple OSAHS group, the AHI, serum levels of IL-6 and TNF-α and scores of FSS and ESS in OSAHS complicated with type 2 diabetes mellitus group significantly increased(P < 0.01).The serum levels of IL-6 and TNF-α were positively correlated with AHI(P < 0.05), and negatively correlated with SpO2(P < 0.05).ConclusionsCompared with the simple OSAHS patients, the systemic inflammatory response and sleep disorders in elderly patients with OSAHS complicated with type 2 diabetes mellitus are more significant, and the serum levels of IL-6 and TNF-α are associated with the severity of sleep disorders.
Analysis of the risk factors of local tumor progression after liver cancer patients treated with microwave ablation
LIU Yi-xiang, NIU Jian
2021, 46(4): 491-493, 498.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.017
[Abstract](23) [FullText HTML](13) [PDF 980KB](1)
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ObjectiveTo analyze the risk factors of local tumor progression(LTP) after liver cancer patients treated with ultrasound-guided percutaneous microwave ablation(MWA).MethodsA total of 102 lesions in 73 cases of liver cancer treated with MWA were investigated.The clinical data of the patients and postoperative following-up imaging examination data were retrospectively analyzed.ResultsThe total incidence rate of LTP was 15.68%(16/102).The results of univariate analysis showed that the LTP was not related to the age, tumor type, and Child-Pugh classification of liver(P>0.05), and related to the tumor size, clear tumor boundary, tumor adjacence to large blood vessels and tumor blood perfusion degree(P < 0.05 to P < 0.01).The results of further multivariate logistic regression analysis showed that the tumor size >3 cm and tumor adjacence to large blood vessels were the independent risk factors of LTP(P < 0.05).ConclusionsThe tumor size >3 cm and adjacence to large blood vessels are the independent risk factors of LTP after liver cancer patients treated with MWA.The corresponding measures and strategies should be taken to improve the efficacy of MWA in clinic.
Clinical observation of subsection laminectomy spinal decompression combined with internal fixation in the treatment of thoracic ossification of the ligamentum flavum
ZHANG Cun, MIAO Jie, NIE Jia-jia, LI Xiao-dong, LIU Bing-zhi, TIAN Jin-hui
2021, 46(4): 494-498.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.018
[Abstract](23) [FullText HTML](11) [PDF 1959KB](0)
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ObjectiveTo investigate the clinical efficacy and safety of subsection laminectomy spinal decompression combined with internal fixation in the treatment of thoracic ossification of the ligamentum flavum(T-OLF).MethodsThe clinical data of 58 patients with T-OLF were retrospectively analyzed.According to the surgical method, the patients were divided into the group A(25 cases) and group B(21 cases).According to the anatomical characteristics of ligamentum flavum and its adjacent relationship with the vertebral plate, the posterior region of the vertebral plate was divided, and the vertebral plate decompression, segmental resection and spinal cord decompression were performed in group A.The group B was treated with laminae thinning and decompression combined with internal fixation.The operative time, intraoperative blood loss and complications were recorded, and the recovery of neurological function and change of local kyphosis were observed in two groups.ResultsThe differences of the operative time and blood loss between two groups were not statistically significant(P>0.05), and the JOA scores in two groups significantly increased compared with those before surgery(P < 0.05).The neurological improvement rate in group A and group B was(72.2±14.8)% and(73.1±15.2)%, respectively, and the difference of which was not statistically significant(P>0.05).The Cobb angles in two groups were significantly improved compared with preoperative level(P < 0.01), and there was no statistical significance between two groups at different time points(P>0.05).The difference of the incidence rate of cerebrospinal fluid leakage between group A(12.00%) and group B(23.80%) was statistically significant(P < 0.05).ConclusionsThe subsection laminectomy spinal decompression combined with internal fixation can reduce the invasive operation in the spinal canal, the incidence of dural tear is low, the safety is relatively high, and the internal fixation implantation is beneficial to better maintain the stability of thoracic vertebra after operation.
Clinical characteristics of super elderly patients with cholangiopancreatosis treated with therapeutic endoscopic retrograde cholangiopancreatography
GU Lin, ZHENG Hai-lun, ZHAO Rui, YAN Shan-jun
2021, 46(4): 499-503.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.019
[Abstract](23) [FullText HTML](11) [PDF 985KB](1)
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ObjectiveTo investigate the clinical characteristics, safety and clinical value of therapeutic endoscopic retrograde cholangiopancreatography(ERCP) in super elderly patients with cholangiopancreatosis aged 80 years or above.MethodsThe clinical data of 387 patients treated with ERCP diagnosis and treatment were retrospectively analyzed.According to the patients' ages, the patients were divided into the elderly group(≥ 80 years) and non-elderly group(< 80 years), and the clinical characteristics and complications in two groups were analyzed.ResultsThere were 193 patients in the elderly group, and the average age of which was (84.20±3.40) years old.There were 194 patients in the non-elderly group, and the average age of which was (60.10±13.52) years old.The proportion of elderly patients complicated with hypertension, diabetes, coronary atherosclerotic heart disease, cerebrovascular disease, duodenal parapillary diverticulum, malignant obstructive jaundice and stent implantation or replacement in the surgical method in elderly group were higher than those in non-elderly group(P < 0.05 to P < 0.01).Among the super elderly pateints, the primary disease for malignant obstructive jaundice rate, and complicated with hypertension, coronary atherosclerotic heart disease, and duodenal parapillary diverticulum rates in patients with postoperative bleeding were higher tahn those in patients without postoperative bleeding(P < 0.05 to P < 0.01).ConclusionsSuper elderly patients with cholangiopancreatosis have many complications, but ERCP is still safe and effective, and can be used as the first choice for clinical treatment.
Clinical effects of acupuncture in the treatment of moderate and severe persistent allergic rhinitis of spleen deficiency type
MA Xin-gang, GUO Yun-liang, LI Zhi-shuai, XIE Kun
2021, 46(4): 504-508, 511.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.020
[Abstract](21) [FullText HTML](11) [PDF 1009KB](0)
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ObjectiveTo explore the effects of acupuncture combined with loratadine in the treatment of moderate and severe persistent allergic rhinitis(AR) of spleen deficiency type, and effects on the serum levels of platelet activating factor(PAF), transforming growth factor-β(TGF-β) and helper T cell 1(Th1)/helper T cell 2(Th2).MethodsSixty patients with moderate or severe persistent AR of spleen deficiency type were divided into the control group and observation group according to the random number table method(30 cases in each group).Two groups were given health education, and the control group and observation group were treated with desloratadine and desloratadine combined with acupuncture for 4 weeks, respectively.The efficacy was compared between two groups.The changes of traditional Chinese medicine(TCM) syndrome scores, visual analogue scale(VAS) scores and RQLQ scores of rhinoconjunctivitis patients before and after treatment were observed and compared between two groups.The serum levels of PAF, TGF-β, interferon-γ(IFN-γ), interleukin-1(IL-1), IL-4, IL-13 and IL-35 in two groups were detected and compared between before and after treatment.ResultsThe effective rates in the observation group and control group were 93.33% and 70.00%, respectively, and the difference of which was statistically significant between two groups(P < 0.05).After treatment, the each item score and total score of TCM syndrome in two groups were lower than those before treatment(P < 0.01), and the observation group was lower than the control group(P < 0.01).The VAS scores and RQLQ scores in two groups after treatment were lower than those before treatment(P < 0.01), and the observation group was lower than the control group(P < 0.01).After treatment, the serum PAF, IL-4, IL-B, and IL-35 levels of the two group decreased(P < 0.01);and the observation group was lower than the control group(P < 0.01);after treatment, the serum TGF-β, IFN-γ and IL-1 levels in the two groups increased(P < 0.01), and the observation group was higher than the control group(P < 0.01).ConclusionsAcupuncture combined with loratadine in the treatment of moderate and severe persistent AR of spleen deficiency type has significant effects.It can significantly improve the nasal symptoms and quality of life of patients, and the mechanism of which is related to the regulation of PAF and TGF-β levels, and Th1/Th2 balance.
Analysis of the causes of conversion to laparotomy in gynecological laparoscopy surgery
ZHU Yi-chen, WANG Cai-zhi
2021, 46(4): 509-511.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.021
[Abstract](18) [FullText HTML](8) [PDF 935KB](0)
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ObjectiveTo analyze the incidence of conversion to laparotomy in gynecological laparoscopy surgery, and its influencing factors.MethodsThe clinical data of 2 683 patients of gynecological laparoscopy surgery in The First Affiliated Hospital of Bengbu Medical College from 2014 to 2018 were retrospectively analyzed.According to the laparoscopic surgery methods, the patients were divided into the type Ⅰ group(treatment with laparoscopy or appendage surgery), type Ⅱ group(treatment with ovariectomy or ovariectomy), type Ⅲ group(treatment with myomectomy, subtotal or total hysterectomy) and type Ⅳ group(treatment with extensive hysterectomy combined with pelvic lymphadenectomy).The operation methods and reasons of conversion to laparotomy in 22 patients were analyzed.ResultsAmong the 2 683 laparoscopic patients, 22 cases were converted to laparotomy, and the conversion rate was 0.81%.The conversion rates of type Ⅰ, Ⅱ, Ⅲ and Ⅳ groups were 0.36%(6/1 680), 0.97%(3/310), 1.52%(10/660) and 9.09%(3/33), respectively.The conversion rates in type Ⅰ, Ⅱ and Ⅲ groups were lower than that in type Ⅳ group(P < 0.01).The causes of conversion to laparotomy included the severe adhesions[36.36%(8/22)], special lesions[22.73%(5/22)], bleeding[18.18%(4/22)], malignant tumors[13.64%(3/22) and injuries[9.09%(2/22)].ConclusionsThe occurrence of conversion to laparotomy in gynecological laparoscopy surgery is closely related to the difficulty of operation and scope of operation required.The strict preoperative evaluation, selection of surgical indications, use of appropriate surgical methods and improvement of operative skills are the effective methods to prevent gynecological laparoscopy conversion to laparotomy.
Efficacy of CalliSpheres drug-loaded microsphere embolization in the treatment of primary massive liver cancer, and its effects on tumor markers and liver function
CHEN Pin, TIAN Shi-jiang, ZHANG Hong-kun, YUAN De-peng
2021, 46(4): 512-517.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.022
[Abstract](20) [FullText HTML](9) [PDF 1266KB](0)
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ObjectiveTo investigate the effects of CalliSpheres drug-loaded microsphere embolization in the treatment of primary massive liver cancer, and its effects on tumor markers and liver function.MethodsEighty patients with primary massive liver cancer were divided into the control group and observation group according to the random number table method(40 cases in each group).The control group was treated with iodized oil transcatheter arterial chemoembolization, and the observation group was treated with CalliSpheres drug-loaded microsphere transcatheter arterial chemoembolization.The clinical effects, postoperative complications, and serum tumor markers[including carbohydrate antigen 199(CA199), α-fetoprotein(AFP) and E-cadherin(EC)], liver function index[including aspartate aminotransferase(AST), alanine aminotransferase(ALT), total bilirubin(TBIL) and albumin(Alb)] levels between two groups after 1 and 3 months of operation were compared.The 1-year survival rate was compared between two groups.ResultsThe disease remission rate and disease control rate(57.50% and 82.50%) in observation group were higher than those in control group after 3 months of operation(30.00% and 60.00%) (P < 0.05).The serum levels of CA199, AFP and EC in observation group after 1 and 3 months of operation were lower than those in control group(P < 0.01).After 3 months of operation, the serum levels of AST, ALT, TBIL in observation group were lower than those in control group(P < 0.01), and the level of Alb in observation group was higher than that in control group(P < 0.01).The incidence rate of fever and CINV grade in observation group were lower than those in control group(P < 0.05 and P < 0.01).The 1-year survival rate in observation group(73.68%) was higher than that in control group(51.35%)(P < 0.05).ConclusionsThe CalliSpheres drug-loaded microsphere embolization in the treatment of primary massive liver cancer can further improve the therapeutic effects, has less impact on the liver function, and can effectively reduce the incidence rate of adverse reactions and improve the 1-year survival rate of patients.
Expression and significance of p53 and TAZ in triple negative breast cancer
ZHU Jing-wei, MENG Chao, TONG Jing-wei, XU Pei-quan
2021, 46(4): 517-520.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.023
[Abstract](23) [FullText HTML](12) [PDF 1733KB](0)
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ObjectiveTo study the expression and significance of p53 and transcriptional co-activator with PDZ binding motif(TAZ) in triple negative breast cancer(TNBC), and explore their relationship with the clinicopathological characteristics in TNBC patients.MethodsSixty patients with invasive breast cancer diagnosed by pathology were divided into the TNBC group(30 cases) and non-TNBC group(30 cases).The expression levels of p53 and TAZ in cancer tissue were detected using immunohistochemistry.The relationship between the expression levels of p53 and TAZ, and age, tumor size, lymph node metastasis, TNM stage and histological grade of TNBC patients were analyzed.ResultsThe expression level of TAZ in TNBC group was higher than that in non-TNBC group(P < 0.01).The positive expression rates of p53 in patient age ≤ 45 years old and tumor >2 cm were higher, while the positive expression rates of TAZ in tumor >2 cm and histological grade Ⅰ-Ⅱ were higher(P < 0.01 and P < 0.05).In TNBC group, the expression level of p53 was positively correlated with TAZ expression(rs=0.381, P < 0.05).ConclusionsTAZ may be involved in the development of TNBC.
Pattern and influence of CD4+ T cell subsets in children with acute respiratory distress syndrome
JIN Zai-xuan, WU Bin
2021, 46(4): 521-524.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.024
[Abstract](18) [FullText HTML](7) [PDF 973KB](0)
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ObjectiveTo study the changes of CD4+ T cell subsets and its effects on acute respiratory distress syndrome(ARDS) in children with ARDS.MethodsSixty-one children with ARDS were divided into the mild group(25 cases), moderate group(20 cases) and severe group(16 cases).At the same time, 61 healthy children were set as the control group.Flow cytometry was used to detect the total amount of T cells, regulatory T cells(Treg), Th17, proportion of Th1 and Th2 in CD4+ T cells in the peripheral blood of ARDS patients and control group.The major cytokines interferon-γ(IFN-γ), interleucin(IL-4), IL-17A and IL-17F in CD4+ T cell subsets were observed.ResultsCompared with the control group, the total amount of T cells, number of Th1, Th2, and Th17 cells and Treg cells, Th17/Treg ratio, and levels of IL-4, IFN-γ, IL-17A and IL-17F increased in ARDS children(P < 0.05 to P < 0.01).The results of Spearman correlation analysis showed that the levels of IL-4, Foxp3, IFN-γ, IL-17A and IL-17F were negatively correlated with prediatric critical illness scores in children with ARDS(P < 0.01).ConclusionsThe pattern of CD4+ T cell subsets is closely related to the pathogenesis of ARDS.The change of CD4+ T cell subsets promotes the development of ARDS, and forms an interactive inflammatory network.
2021, 46(4): 525-527.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.025
[Abstract](26) [FullText HTML](10) [PDF 935KB](1)
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Development and test of reliability and validity of a questionnaire for occupational exposure to infectious diseases in medical workers
ZHU Jing-rui, CUI Zhuo, ZHANG Xiang-jun, WANG Bai-ru
2021, 46(4): 528-532, 536.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.026
[Abstract](23) [FullText HTML](11) [PDF 990KB](1)
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ObjectiveTo prepare a "Risk Questionnaire of Infectious Occupational Exposure of Medical Workers" for comprehensive assessing the risk of occupational exposure to infectious pathogens among medical workers, and evaluate the reliability and validity of the questionnaire.MethodsThe "Risk Questionnaire of Infectious Occupational Exposure of Medical Workers" was developed and designed using the literature research method and expert consultation method.The medical workers in a grad A tertiary medical institution were investigated, the items were screened by item and factor analysis, and the internal consistency, split-half reliability and structural validity were analyzed using SPSS 20.0 statistical software.ResultsThe "Risk Questionnaire of Infectious Occupational Exposure of Medical Workers" included 6 dimensions and 50 items.The total Cronbach's α coefficient of the questionnaire was 0.972, and the Cronbach's α coefficient of each dimension was between 0.736 and 0.973.The split-helf reliability coefficient of the questionnaire and each dimension were 0.973 and 0.925, respectively, and the correlation coefficient between two was 0.751.The KMO test statistic was 0.965, the χ2 value of Bartlett sphere test was 22 562.451, and the df was 1 176(P < 0.001).The Kaiser normalized orthogonal rotation of questionnaire was implemented using principal component analysis, a total of 6 principal component factors were converged and extracted after 13 iterations, and the contribution rate of which was 68.044%.ConclusionsThe "Risk Questionnaire of Infectious Occupational Exposure of Medical Workers" designed by the research team has good reliability and validity, which can be used as an assessment tool to evaluate the risk of infectious occupational exposure of medical workers.
Analysis of the demand of home-based elderly care services and its influencing factor in urban community elderly in Hefei city
WU Li
2021, 46(4): 533-536.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.027
[Abstract](24) [FullText HTML](11) [PDF 960KB](0)
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ObjectiveTo know the current status and influencing factor of the demand of the home-based elderly care service in urban community elderly in Hefei city.MethodsBy stratified multistage random sampling method, a questionnaire investigation was conducted among the elderly residents aged 60 and above in Hefei communities.ResultsThe top four needs of elderly care service were the appointment service hotline(57.1%), meal assistance service(50.3%), medical care service(43.3%) and emergency rescue(34.6%).The results of logistic regression analysis showed that the age of the elderly was positively correlated with the demand for home-based elderly care service, and the demand for home-based elderly care services of unmarried, divorced or widowed elderly were higher than those of married elderly(P < 0.05).The differences of home-based elderly care service demands of the elderly with different education levels were statistically significant(P < 0.05), the impact of family per capita monthly economic income on home-based elderly care service demands was relatively significant(P < 0.05), and the physical health generally had a significant impact on home-based elderly care service demands of the elderly(P < 0.05).The differences of the needs for home-based elderly care service among the elderly needing spouse care, child care, relatives care and nanny care were statistically significant(P < 0.05).ConclusionsThe elderly are more willing to accept home-based care service, but their cognition needs to be further improved.The community home-based elderly care service should be precisely matched between supply and demand according to the demand of the elderly.
Risk factors analysis and preventive measures of neonatal nosocomial infection
WU Qiong-fang, ZHANG Xiu-ping, GAO Qun, HUANG Juan, LIANG Qi-wei, XU Xin-yue
2021, 46(4): 537-539.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.028
[Abstract](26) [FullText HTML](13) [PDF 943KB](2)
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ObjectiveTo analyze the characteristics and related risk factors of nosocomial infection in the neonatal ward of a hospital, and formulate effective preventive and control measures.MethodsUsing the active monitoring method, the clinical data of 1 858 children hospitalized from January to June 2020 were subjectively monitored, and the monitoring results were statistically analyzed to put forward to corresponding preventive measures of nosocomial infection.ResultsAmong 1 858 neonatal cases, the nosocomial infection in 24 cases(27 times) was found, and the incidence rates of nosocomial infection case and time were 1.29% and 1.45%, respectively.The respiratory tract infection was the main infection(accounting for 44.44%), followed by blood infection(accounting for 37.04%).A total of 19 strains of pathogenic bacteria were detected in 27 times of nosocomial infection, mainly included Acinetobacter baumannii(7 strains, 36.84%), followed by Escherichia coli(4 strains, 21.05%).There was no statistical significance in the incidence rate of nosocomial infection among different gender children(P>0.05).The nosocomial infection rate in neonatal endotracheal intubation group was higher than that in non-endotracheal intubation group(P < 0.01).With the increasing of birth mass, the nosocomial infection rate decreased(P < 0.01).ConclusionsThe low-weight infants and endotracheal intubation are the high risk factors of neonatal nosocomial infection.Therefore, it is necessary to strengthen the management of neonatal ward, strictly operate aseptic technique, grasp the indication of catheterization and take preventive measures for its risk factors to reduce the incidence of nosocomial infection.
Effect of high frequency repetitive transcranial magnetic stimulation on executive function in patients with methamphetamine dependence
WANG Xia, XU Hua-shan, WANG Li-jin, JIAO Dong-liang, GAO He, CHEN Xiao-dong, MU Lin-lin
2021, 46(4): 540-542, 546.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.029
[Abstract](17) [FullText HTML](7) [PDF 975KB](0)
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ObjectiveTo investigate the effects of high frequency repetitive transcranial magnetic stimulation(rTMS) on the executive function in patients with methamphetamine dependence.MethodsForty male patients with methamphetamine dependence were randomly divided into the observation group and control group(20 cases in each group), and intervened with high frequency rTMS and sham stimulation, respectively.The executive function in two groups before and after intervention were measured by behavior rating inventory of executive function-adult version(BRIEF-A) and stroop color word test(SCWT).ResultsBefore intervention, the differences of the BRIEF-A total score, each factor score, average reaction time and correct reaction of SCWT between two groups were not statistically significant(P>0.05).After intervention, the BRIEF-A total score, each factor score and average reaction time of SCWT in observation group were lower than those in control group and before intervention(P < 0.05 to P < 0.01), and the correct reaction of SCWT in observation group was higher than that in control group and before intervention(P < 0.01).The differences of the BRIEF-A total score, each factor score, average reaction time and correct reaction of SCWT in control group between before and after intervention were not statistically significant(P>0.05).ConclusionsThe high frequency rTMS can significantly improve the executive function in patients with methamphetamine dependence.
Analysis of related factors affecting the readiness of primary caregivers in ICU transferred patients
WU Qing-rui
2021, 46(4): 543-546.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.030
[Abstract](20) [FullText HTML](11) [PDF 972KB](1)
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ObjectiveTo analyze the related factors affecting the readiness of primary caregivers in ICU transferred patients.MethodsPrimary caregivers in ICU transferred patients were selected as the study subjects.According to the score using care preparedness scale (CPS), the primary caregivers of ICU transferred patients were divided into the CPS ≤ 16 group and the CPS>16 group.The basic information of the two groups, including gender, age, education, family income, care experience, the degree of understanding the patient's disease knowledge, the relationship with the patient and the patient's health condition such as the activities of daily living scale living (ADL)score, simplified Fugl-Meyer motor function score, mini-mental state examination (MMSE)score were compared.Multivariate logistic regression was used to analyze the related factors affecting the readiness of primary caregivers in ICU transferred patients.ResultsAmong the 120 caregivers of ICU transferred patients, 55 patients had the CPS scores less than or equal to 16 points(CPS ≤ 16) and 65 patients had the CPS scores greater than 16 points (CPS>16).There was no significant difference in gender, family income, and relationship between patients in the two groups(P>0.05).The age in CPS ≤ 16 group was significantly higher than that in CPS>16 group(P < 0.01).The education level, care experience and the degree of understanding the patients' disease knowledge in CPS ≤ 16 group were significantly lower than those in CPS>16 group (P < 0.05 and P < 0.01).The ADL score, simplified Fugl-Meyer motor function score, and MMSE score of patients with CPS ≤ 16 were significantly lower than those with CPS> 16(P < 0.01).After multivariate logistic regression analysis, the age of the primary caregiver, the education level of the primary caregiver, the understanding of the primary caregiver's knowledge of the patient's disease, the patient's ADL score, the patient's simplified Fugl-Meyer motor function score and the patient's MMSE score were the risk factors of readiness of primary caregivers in ICU transferred patients (P < 0.05 to P < 0.01).There was no correlation between the care experience of primary caregivers and the readiness of primary caregivers of ICU transferredred patients(P>0.05).ConclusionsThe age, education level, the degree of understanding the patient's disease knowledge of the primary caregiver, and the health condition of the patients are the related factors that affect the readiness of primary caregiver of ICU transferredred patients, which can be based on by targeted interventions in clinic.
Correlation between resilience and career status of post-90s nurses in Shaanxi province
WANG Jiao, GAI Hai-yun, FENG Yang
2021, 46(4): 547-552.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.031
[Abstract](20) [FullText HTML](10) [PDF 1006KB](0)
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ObjectiveTo understand the status quo of resilience and career status of post-90s nurses in Shaanxi province, and explore the correlation between them, so as to provide theoretical basis for clinical nursing human resource management.MethodsFrom January to March 2019, 1 159 post-90s nurses from 9 grade A tertiary hospitals in Shaanxi province were investigated using general information questionnaire, resilience evaluation scale of medical staff and career status evaluation scale.SPSS 23.0 was used for single factor analysis, correlation analysis and multiple linear regression analysis.ResultsThe total scores of resilience and career status of post-90s nurses in Shaanxi were (73.22±0.85) points and (86.45±15.01) points, respectively.The results of univariate analysis showed that the differences of the resilience scores among the post-90s nurses with different genders, regions, educational backgrounds, professional titles, working hours and advanced training experience were statistically significant(P < 0.05 to P < 0.01), and the differences of the score of career status among post-90s nurses with different regions, professional titles, working hours and advanced training experience were statistically significant(P < 0.05 to P < 0.01).The results of multiple linear regression analysis showed that the gender, region and advanced training experience were the influencing factors of resilience, and the region, working hours and advanced training experience were the influencing factors of career status(P < 0.05 to P < 0.01).The results of correlation analysis showed that the resilience of post-90s nurses was positively correlated with the total score and each dimension score of career status(P < 0.01).ConclusionsNursing managers should pay more attention to and train the post-90s nurses, improve their management mechanism, pay performance and humanistic care, so as to improve their resilience and promote their career development.
Investigation on the cognition and management of stress-related disorder in nurses of burn department
YAN Xue-qin, LUO Cai-feng, BAI Su-ping, YAN Zhi-xin, XING Wei
2021, 46(4): 552-556.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.032
[Abstract](19) [FullText HTML](16) [PDF 977KB](0)
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ObjectiveTo investigate the cognitive status of nurses on stress-related disorder and management status of stress-related disorder in burn department.MethodsThe cognitive status of stress-related disorders of 129 nurses in burn departments from 8 grade A tertiary hospitals were investigated using a general data questionnaire and self-made questionnaire.ResultsThe scores of subjective cognition and objective cognition of stress-related disorder were (12.38±3.79) and (4.42±1.47), respectively, and the average score rates of those were 49.52% and 55.23%, respectively.The results of multiple linear regression analysis showed that training and educational background were the factor influencing the subjective and objective cognition of nurses on stress-related disorder in burn department, respectively(P < 0.01 and P < 0.05).The 83.70% and 73.64% of nurses in burn department said that there was no assessment tool and nursing routine for stress-related disorder, respectively.ConclusionsThe nurses on stress-related disorder are of low awareness, poor behavior and good attitude.The management and training of stress-related disorder in burn department are lack.The managers should pay attention to the management and training of stress-related disorder to improve the quality of nursing and promote patients' physical and mental recovery.
Study on the correlation between the degree of operative pain, and pain fear and psychological resilience in patients with wounds
ZHAO Da-ye, DUAN Xiao-xia
2021, 46(4): 557-561.   doi: 10.13898/j.cnki.issn.1000-2200.2021.04.033
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Abstract:
ObjectiveTo understand the status quo of operative pain in patients with wounds, analyze the influencing factors of operative pain in wounds, and correlation between the pain degree, and pain fear and psychological resilience.MethodsThe convenient sampling method was used to evaluate the pain degree, pain fear and psychological resilience of patients using the self-designed general information questionnaire, numerical rating scale(NRS), pain fear questionnaire(FPQ) and Connor-Davidson resilience scale(CD-RISC).ResultsThe score of operative wound pain degree of patients was(4.53±1.98) points.The age of patients was positively correlated with pain degree(P < 0.01), the education level, wound duration and time since the last dressing change were negatively correlated with pain degree(P < 0.01).The pain fear was positively correlated with pain degree, and the psychological resilience was negatively correlated with pain degree(P < 0.01).The first change of dressing, pain fear and psyschological resilience were the independent influencing factors of pain degree(P < 0.01).ConclusionsThe pain degree of operative wound of patients is closely related to the pain fear and psychological resilience.Medical staff should pay attention to the mutual influence of pain degree, pain fear and psychological resilience during treating the wound of patients.

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