Table of Content

25 August 2017, Volume 38 Issue 8

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Genomics studies the role of the Csu cluster in the biofilm formation#br#

LI Haitao, ZHANG Lutao, LI Shuai, WANG Boli, QI Tianjie, LI Honglin

2017, 37(8):  869-872.  doi:10.3969/j.issn.10073205.2017.08.001

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［Abstract］ Objective〖HTSS〗〓To study the role of Csu cluster in the biofilm formation of the multidrug resistant Acinetobacter baumannii by genomics.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The bacteria were selected from the clinical laboratory of our hospital. The rapidly growth period and biofilm stage were obtained. The mRNA of the two different stages were extracted and sequenced. Compared the gene sequence with the public database, we found the differences in gene expression.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓There were significant differences in the expression of genes between the two strains in the rapid growth phase and biofilm stage of the same strain. In the biofilm state, the expression of 106 genes was upregulated in the cells with rapid growth phase, in which the expression of CsuA/B/C/D gene cluster was significantly increased, and the expression of 92 genes was down regulated.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The Csu cluster played an important role in biofilm formation and maintenance. In the formation of biofilm, the initial adhesion of the cells required significant expression of the Csu A/B/C/D. The Csu cluster mediated the biosynthesis of pili and the secretion of extracellular matrix, which were necessary for the early stages of the biofilm formation.


Expression change of GPX1 in lung of renal ischemia reperfusion injury rats

YU Guoxia1, HUO Hongchang1, WANG Suling2, WANG Qie3*

2017, 37(8):  873-877.  doi:10.3969/j.issn.10073205.2017.08.002

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［Abstract］ Objective〖HTSS〗〓To observe the expression change of glutathione peroxidase1(GPX1) in lung of renal ischemia reperfusion injury(RIRI) model and to explore the role of GPX1 in protecting lung against peroxide damage by scavenging peroxide.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The left renal artery of Wistar rats was clipped with nondamage vascular clamp after removing the right kidney to create RIRI model. After 24 hours of renal blood perfusion, the blood, kidney and lung were collected. The serum blood urea nitrogen(BUN) and serum creatinine(SCr) were detected with picric acid method and enzyme coupling rate method, respectively. The morphological changes of kidney was observed with HE staining , the malondialdehyde（MDA）and hydrogen peroxide(H2O2 ) content in lung tissue were determined by thiobarbituric acid colorimetric method and molybdate colorimetric method, respectively. The GPX1 mRNA and protein expression were evaluated by RTPCR and Western blotting, respectively. The correlation between MDA content, H2O2 content and GPX1 expression level was analyzed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with the control group, the morphological structure of lung tissue of RIRI model was significantly damaged, the BUN and SCr level, the MDA and H2O2 content in lung tissue of RIRI were significantly increased, mRNA and protein level of GPX1 were also significantly enhanced. There were positive correlation between MDA and GPX1 mRNA, between MDA and GPX1 pretein, between H2O2 and GPX1 mRNA, between H2O2 and GPX1 pretein.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The RIRI can make lung tissue to be in oxidative stress and be subjected to peroxidative damage. GPX1 may protect lung against peroxide damage by scavenging superoxide.


Detection of STK11 gene mutation in Chinese PeutzJeghers syndrome patients and high frequency mutation analysis

JIANG Yuliang1,2, LI Weicong3, ZHAO Ziye4, LI Bairong1, MAO Xuyan5, NING Shoubin1*

2017, 37(8):  878-881,896.  doi:〓〓10.3969/j.issn.10073205.2017.08.003

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［Abstract］  Objective〖HTSS〗〓To analyze serine/threonine kinase 11 (STK11) gene in patients with PeutzJeghers syndrome(PJS), and explore the relationship between different mutations and clinical features.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The sequencing of STK11 gene coding region was analyzed from 54 inpatients with PJS. Their clinical manifestations and mutations were analyzed. The clinical characteristics of different mutations were compared.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓Of the 54 patients with PJS, 33 cases were found to have mutations in the coding region of STK11 gene. Among them, 30 cases were probands (the mutation detection rate was 58.8%, 30/51), the mutation detection rate of familial patient was 55.0%（11/20）, and the mutation detection rate sporadic patient was 55.9%（19/34）. The 5 patients from 3 families had the same point mutation(c.180C>G), which was suspected high frequency mutation. In another family, 2 patients also had the same mutation(c.658C>T). A patient had two mutations; the other 26 patients had a single mutation site. The proportion of patients with c.180C>G in the first onset age and the first surgery age<7 years of age were significantly higher than other mutations, the difference was statistically significant(P＜005). There were no significant differences in gender, family history, tumor history, abdominal symptoms, and surgical history.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓STK11 gene mutation is the main pathogenicity of PJS. A high frequency mutations were found, patients with this mutation had symptoms and undergo surgery earlier than other patients. We should pay more attention in clinical monitoring and treatment.

Effects of different position intervention on cardiac electrophysiology, gastrointestinal function in AMI early patients#br#

XIE Xuemei, ZHANG Juan, MA Xiulan, ZHUANG Yu

2017, 37(8):  882-885,906.  doi:10.3969/j.issn.10073205.2017.08.004

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［Abstract］ Objective〖HTSS〗〓To investigate the effects of different postural intervention on cardiac electrophysiology and gastrointestinal function in patients with acute myocardial infarction(AMI).
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and four patients with acute myocardial infarction who were treated were divided into control group(conventional 30 ° supine position) and study group(ladder semirecumbent position) . The differences of myocardial oxygen consumption, heart rate variability, QT dispersion(QTd) and gastrointestinal reaction were compared between the two groups in the supine position(t0), just to adjust semirecumbent predetermined angle(t1), semirecumbent 1min(t2), semirecumbent 5 min(t3), semirecumbent 10 min(t4).
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The myocardial oxygen consumption in group 2 was significantly increased from t1 to t4, but was decreased more in the study group. The standard diviation of NN intervals(SDNN) and the square root of the mean squared difference of successive of NN intervals from t2 to t4 and the study group were decreased less. The ΔQTd and ΔQTcd of the two groups were decreased gradually from t2 to t4, but the study group had lower ΔQTd and ΔQTcd at t0, so the decrease of the study group was smaller and more stable. There were significant differences in the intergroup, interpoint and intergroup interaction between time points between the two groups(P<0.05). The patients in the study group had less abdominal distension and belching than the control group, and the increase of bowel movements and the number of first defecation in 3 days were more than that in the control group. The first defecation time and defecation were shorter than the control group, the difference was statistically significant(P<0.05). The numbers in study group showed constipation, difficulty in urinating and visual analogue scale(VAS), Hamilton anxiety scale(HAMA) were lower than those of the control group, the difference was statistically significant(P<0.05). 〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The use of ladder semirecumbent helps to reduce early AMI myocardial oxygen consumption, reduce the incidence of gastrointestinal discomfort and other complications, so as to facilitate rehabilitation of patients.


Preventive effect of HD+HP on atherosclerosis and cardiovascular complications in elderly patients with endstage renal disease#br#

LIU Hanwei1， ZHANG Zhenhui2， TANG Jiwen1， ZOU Lie1， WANG Chunfeng1

2017, 37(8):  886-890.  doi:10.3969/j.issn.10073205.2017.08.005

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［Abstract］  Objective〖HTSS〗〓To investigate the preventive effect of hemodialysis(HD) combined with hemoperfusion(HP) on atherosclerosis and cardiovascular complications in elderly patients with end stage renal disease(ERSD).
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty cases of elderly patients with ESRD treated by maintenance hemodialysis in our hospital were included and randomly divided into 2 groups, with 30 cases in each group, by random number table. The observation group was treated with HD+HP, while the control group was treated with sole HD. Fasting blood samples were collected before and 6 months after treatment, in order to detect and compare the level of apolipoprotein C3(ApoC3), high density lipoprotein(HDL),low density lipoprotein(LDL), triglyceride(TG), total cholesterol(TC), Creactive protein(CRP), hemoglobin(Hb）, albumin(ALB), interleukin6(IL6), interleukin8(IL8), tumor necrosis factorα(TNFα), carotid intimamedia thickness(CIMT)of patients were also detected. The incidence of cardiovascular complications were recorded.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓①6 months after treatment, IL6 and IL8 in the control group were significantly decreased (P＜005). While IL6, IL8, ApoC3, TG and CRP in the observation group were decreased significantly, HDL and ALB in the observation group were increased significantly(P＜005). The decreasing of IL6 and IL8 in the observation group were more obvious than in the control group, the differences were statistically significant(P＜005). ②6 months after treatment, CIMT in the control group was increased significantly(P＜005) compared with before treatment. While CIMT in the observation group did not change obviously. Nonconditional logistic regression analysis showed that APOC3, TG, IL6 and CRP were independent risk factors for CIMT thickening, and HDL was an independent protective factor for CIMT thickening(P＜005).③The incidence rate of myocardial injury and heart failure in the observation group were significantly lower than those in the control group, the differences were statistically significant (P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓HD+HP can inhibit the formation of atherosclerosis in elderly patients with end stage renal disease, which may be related to the inhibition of ApoC3, TG and CRP. This will help to reduce the incidence of various cardiovascular complications.


Clinical research on minimally invasive transfrontal craniopuncture for spontaneous basal ganglia hemorrhage#br#

ZHENG Jun1， ZHAO Bin2， YANG Liang1，WU Jianliang1， ZHANG Gengshen1， FAN Zhenzeng1

2017, 37(8):  891-896.  doi:10.3969/j.issn.10073205.2017.08.006

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［Abstract］ Objective〖HTSS〗〓To evaluate the technique and curative effect of minimally invasive transfrontal craniopuncture for spontaneous basal ganglia hemorrhage.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The microanatomy and technique of minimally invasive transfrontal craniopuncture were elaborated. Sixtyfive patients with basal ganglia hemorrhage were urderwent CTguided  minimally invasive transfrontal craniopuncture. The hematoma was aspirated and the urinary plasminogen activator was injected into the hematoma through a soft catheter to promote the evacuation of hematoma. The evacuation rate of hematoma, the common complications, and the stroke scales were recorded, containing Glasgow Coma Scale(GCS), National Institutes of Health Stroke Scale(NIHSS), and Barthel Index(BI). The shortterm and longterm efficacy was evaluated.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The GCS score at 1 week and 3 months after operation was significantly higher than that before the operation, and the postoperative GCS scores at 3 months were significantly higher than of 1 week. 1 week and 3 months after operation, the NIHSS score was lower than that before operation, and the 3 months after operation were lower than 1 week after operation, the difference was statistically significant(P＜0.05). The evacuation rate of hematoma was 88.1%. There were 24 patients（36.9%） in grade one of BI score, 23 patients（35.4%） in grade two, 9 patients（13.8%） in grade three， 5 patients（7.7%） in grade four，3 patients（4.6%） in grade five. There were 3 patients（4.6%） with rebleeding, 2 patients（3.1%） with intracranial infection, and 1（1.5%） death.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The minimally invasive transfrontal craniopuncture technique could remove the hematoma of small and medium volume basal ganglia effectively, improve neurological outcome, and significantly improve the activities of daily living. It is easy to operate, and is a safe and practical technique in treating cerebral hemorrhage.

Effect and mechanism of dexanedetomidine combined with remote ischemic preconditioning on 1ung injury in patients undergoing thoracoscopic thoracic surgery

YAO Da, WAN Yanhui, LUO Weibin, WU Guodong, QIAN Youhui

2017, 37(8):  897-900,917.  doi:10.3969/j.issn.10073205.2017.08.007

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［Abstract］ Objective〖HTSS〗〓To investigate the effect and mechanism of dexmedetomidine combined with remote ischemic preconditioning(RIPC) on the lung injury in patients undergoing thoracoscopic thoracic surgery.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eighty patients,scheduled for thoracoscopic thoracic operation were randomly divided into 4 groups(n=20 each group) using a random number table: RIPC group(group A), dexmedetomidine group(group B), RIPC combined with dexmedetomidine group(group C) and control group(group D) . At 0 min(T0), 30 min(T1), 1h(T2) and 2 h(T3) of onelung ventilation(OLV), blood samples were obtained for blood gas analysis . Oxygenation index(OI), respiratory index(RI) and intrapulmonary shunt fraction(QS/QT) were calculated and plasma concentrations of tumor necrosis faetorα(TNFα), interleukin6(IL6) and malondialdehyde(MDA) were detected.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The RI and QS/QT of the four groups were increased  at T1-T2 and then decreased at T3, and these at T3 all were  higher than at T0. But OI of the four groups  was decreased  at T1-T2 and then increased at T3, and OI at T3 was lower than at T0. The differences  among the four groups, time points,interaction of groups time points were statistically significant(P＜0.05). The levels of  TNFα, IL6 and MDA of the four groups were increased  at T1-T2 and then decreased at T3, and those at T3 all were far higher than at T0. The differences  among the four groups, time points,interaction of groups time points were statistically significant(P＜0.05).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Dexmedetomidine combined with RIPC could attenuate the lung injury during onelung ventilation in patients undergoing thoracoscopic thoracic surgery, and the mechanisms were related with inhibiting inflammatory responses, reducing airway acidification and reducing pulmonary shunt synergistically.


Study on application value of blastocysts derived from poor quality embryos on day 3#br#

CHAI Sanming1, WANG Zhiqiang1, ZHANG Lin1, YANG Jie1, WANG Cheng1,2, NI Yali1*

2017, 37(8):  901-906.  doi:10.3969/j.issn.10073205.2017.08.008

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［Abstract］ Objective〖HTSS〗〓To explore the application value of blastocysts derived from poor quality embryos on day 3(D3) through its blastulation rate and high quality blastocyst formation rate.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Three hundred and seventyfour in vitro fertilizationembryo transplantation were divided into two groups with blastulation or not after further culture of poor quality embryos on D3. Women′s age, insemination methods, estradiol on the day of human chorionic gonadotropin injection and the number of mature oocytes were also analyzed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The blastulation rate of 1 938 D3 poor quality embryos from 374 patients was 49.1%(952/1 938) and the high quality blastocyst formation rate was 30.4%(590/1 938). The blastocyst formation rate of patients low than 35 years old was 50.7%(875/1 727) and the high quality blastocyst formation rate was 31.6%(546/1 727), which was statistically higher than the patients more than 35 years old 36.5%(77/211), 20.8%(44/211). In vitro fertilzation blastulation rate and high quality blastocyst formation rate was significantly higher than intra cytoplasmic sperm injection blastulation rate: 51.2%(694/1 356) vs 43.0%(136/316), high quality blastocyst formation rate:33.0%(447/1 356) vs 25.6%(81/316). Patients who have more mature oocytes and much higher estradiol on the day of human chorionic gonadotropin injection, they would have more blastocyst and high quality blastocyst. The clinical pregnancy rate after transplanted the blastocysts came from D3 poor quality embryos was 42.5%, which was significantly lower than the blastocysts from D3 high quality embryos(57.5%).
〖HTH〗〖WTHZ〗Conclusion〓〖HTSS〗Further culture of D3 poor quality embryos can increase the utilization ratio of patients oocytes and decrease the costs of treatment. But according to the patient′s age, the mode of fertilization, the basal endocrine level, the number of mature eggs and other conditions, the utility value and application effect of non quality embryo continuous culture are not the same.


Impact of submerged and nonsubmerged dental implants on patients of the thin gingival missing one molar

ZHANG Ning， MU Tong， LI Hongmei

2017, 37(8):  907-910.  doi:10.3969/j.issn.10073205.2017.08.009

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〗［Abstract］ Objective〖HTSS〗〓To observe the difference of submerged and nonsubmerged dental implants on patients missing one molar with thin gingival.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Twentyfour patients in our department who had no contraindication of dental implants and missed one molar with less than 1.5 mm gingival were chosed and separated into 2 random groups with the method of numbers and draw. Patients of one group were implanted with nonsubmerged SS implants of OSSTEM and  patients of another group were implanted with submerged TS implants of OSSTEM. At the time of implant surgery, second stage surgery, restoration finish and 1 year later, variance of gingival thickness，Jemt index and crestal bone loss were observed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓All implants of 2 groups were successful with the 100.0%, without  looseness and inflammation and crestalbone lost above 2mm. Gingival thickness of SS group was decreased, but that of the TS group was increased first and then decreased. There was no statistic difference between 2 groups about gingival thickness at the different time（P＞005）.There was no statistic difference between 2 groups about Jemt index of gingival papilla after restoration and 1years later（P＞005）,but there was statistic difference in the TS groups with different time（P＜005）. Volume of crestal bone loss in two groups both were increased as time went by. There was no statistic difference between 2 groups（P＞005）, but there was statistic difference between 2 groups about time and interaction with time and groups(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓There is no influence of two surgical methods on variation of gingival thickness and Jemt index. Volume of crestal bone loss between the SS group and the TS group both increased. We would like to choose correct implants tothe patients missing one molar withcorresponding indication.


Effect of ultraviolet irradiation on bonding strength between the denture base and hard relining

ZHANG Pengfei1, YANG Ting1, XU Yin1, GUO Tao1, XU Yanzhi2*

2017, 37(8):  911-913.  doi:10.3969/j.issn.10073205.2017.08.010

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［Abstract］  Objective〖HTSS〗〓To explore the effect of ultraviolet irradiation on bonding strength between the denture base and hard relining.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fiftyeight dentures were randomly divided into 4 groups with 12 tablets each. Group 1 was the control group. Group 2 was treated with ultraviolet irradiation only. Group 3 was the adhesive primer group. Group 4 was treated with ultraviolet irradiation and adhesive primer. Then test the shear strength of each group.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The shear strength of the Group 2 was significantly higher than Group 1. The shear strength of the Group 4 was significantly higher than the other three groups(P＜005). Group 3 has no significant difference with either Group 1 or Group 2(P＞005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Ultraviolet irradiation can significantly improve the bonding strength between the denture base and hard reline material, which can extend the service life of the denture, improve denture function and reduce the economic burden of patients.


Effect of liver and spleen interventional therapy on liver function and portal vein hemodynamics in patients with liver cancer complicated with hypersplenism#br#

HANG Jingxiang， LI Zhigang*, WU Zhonglin, WU Yongchao, LI Bo

2017, 37(8):  914-917.  doi:10.3969/j.issn.10073205.2017.08.011

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［Abstract］  Objective〖HTSS〗〓To investigate the changes of liver function, blood routine and portal vein hemodynamics before and after embolization of hepatosplenic interventional therapy in patients with hepatocellular carcinoma complicated with hypersplenism.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 58 patients with hepatocellular carcinoma and hypersplenism were performed with dual interventional therapy of hepatic and splenic artery chemoembolization. The levels of leukocyte, platelet, alanine aminotransferase and bilirubin were detected in preoperative, on day 3 and one week after the dual interventional.
We also observed portal vein diameter and the flow peak time of portal vein blood before and after the embolization.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The platelet count and the white blood cell count of the patients observed in one week after the embolization were significantly higher than that in patients before and day 3 after the embolization（P＜0.05）. But the levels of alanine aminotransferase and bilirubin of the patients in one week after the interventional therapy were significantly lower than that in patients day 3 after the interventional therapy（P＜0.05）. The diameter of portal vein and the peak time of contrast medium had no significant difference before and after embolization(P＞005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The treatment of liver cancer complicated with hypersplenism by minimally invasive double interventional embolization not only weakens the function of spleen in destroying the blood cells, but also retains the normal immune function of some spleen, increased blood count. The treatment has the advantages of little damage to the liver function, quick recovery, reducing the infection opportunity of the patient, and ensuring the followup treatment of the patients with liver cancer, and has the safety and effectiveness. Minimally invasive Interventional embolization for hepatocellular carcinoma with hypersplenism, not only weakened the function of spleen destruction of blood cells, but also retained some of the normal immune function of the spleen, increased blood cell count, small damage to liver function, rapid recovery, reduced the chance of infection, guaranteed the followup treatment of liver cancer patients, has safety and effectiveness.


MRI study of morphology changes in the corpus callosum in children with periventricular leukomalacia

HE Li, LIU Zhai, REN Qingyun*, LEI Licun

2017, 37(8):  918-920,928.  doi:10.3969/j.issn.10073205.2017.08.012

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［Abstract］  Objective〖HTSS〗〓To evaluate the changes in the corpus callosum of periventricular leukomalacia (PVL).
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Forty cases of PVL（age 1-4 years old）and 40 cases of ageand sexmatched healthy children underwent conventional magnetic resonance imaging(MRI). The width of the corpus callosum genu and body, isthmus and splenium, the length of corpus callosum, area of corpus callosum， the effective area of the cranial cavity were measured.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The width of corpus callosum genu, body, isthmus, splenium, length, the area of corpus callosum, effective area of cranial cavity and normalized area of corpus callosum were lower than controls(P＜005).The width of corpus callosum genu, body, isthmus and splenium, the effective area of the cranial cavity,the area and normalized area of corpus callosum of moderate PVL group were less than mild(P＜0.05). There was no significant difference in the length of the corpus callosum between the mild and moderate PVL groups(P＞0.05).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The corpus callosum appears to shrinks in varying degrees in children with PVL. The extent of the thinning of the corpus callosum in children with moderate PVL was larger than that of the mild PVL. Therefore, midsagittal of MRI can be used to measure the morphological changes of the corpus callosum in children with PVL, and can provide quantitative diagnosis for degree of PVL in children.


Reunderstanding of fallopian tube patency degree in hysterosalpingography#br#

ZHENG Guo1， JIN Zhao1， FENG Li2， QI Jingyi1, CUI Yuemei2, BAI Fenglou2

2017, 37(8):  921-924.  doi:10.3969/j.issn.10073205.2017.08.013

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［Abstract］ Objective〖HTSS〗〓To refine the classification of the patency degree of fallopian tube on hysterosalpingography and to explore the types of the patency degree, because that the patency degree of fallopian tube is the important influence factor in infertility.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓We analyzed 93 cases of infertility patients, drew up the hierarchical quantification standard of patency degree in fallopian tube (hereinafter referred to as test standard) and studied the consistency of different doctors or former and later diagnosis results of the doctor to evaluate the classification standard. In addition, we also observed the retention sign of contractmedium in fallopian tube on delayed photography after 15 minutes(hereinafter referred to as delayed period). Compared with filing period of fallopian tube and uterus(hereinafter referred to as filling period), the author explored the types of patency degree in fallopian tube.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The patency of fallopian tube was diagnosed according to the morphology of fallopian tube and the subjective indexes such as the contrast agent flow rate observed by the operator(hereinafter referred to as the original standard). The diagnosis is poorly consistent, whether between the doctor or the doctor themselves. The patency of fallopian tube was measured by standard test, and the Kappa value was 1.000 among different doctors. There were no significant differences in the patency of fallopian tubes between the two groups during the prolonged period.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The patency degree in fallopian tube can be divided into four grades: patency, patency but not free, tiny patency and occlusion. The patency degree in fallopian tube can be divided into two types, mechanical patency degree and functional patency degree. The internal relation between form and function is the key point for further study.


Clinical diagnosis value of PAS combined with ultrasound for acute appendicitis and mesenteric lymphadenitis in children

XIE Qiong， LI Yibing， JI Hongli

2017, 37(8):  925-928.  doi:10.3969/j.issn.10073205.2017.08.014

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［Abstract］ Objective〖HTSS〗〓To investigate the clinical diagnosis value of pediatric appendicitis score(PAS) combined with ultrasound for acute appendicitis and mesenteric lymphadenitis in children.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 194 cases were selected in our hospital because of abdominal pain. Both of PAS and ultrasound diagnosis were used to diagnose patients, the diagnostic value of three diagnostic methods were evaluated.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The final pathological examination confirmed 87 cases of acute appendicitis and 56 cases of acute mesenteric lymphadenitis. The sensitivity, specificity and accuracy of PAS combined with ultrasonography in the diagnosis of acute appendicitis were 96.55%， 93.46% and 94.85%， respectively, which were higher than the PAS(74.71%, 66.36%, 70.10%) and ultrasound diagnosis(88.51%, 92.52%, 90.72%) . The sensitivity, specificity and accuracy of PAS combined with ultrasonography in the diagnosis of mesenteric lymphadenitis were 98.21%， 97.10% and 97.42%，respectively, which were higher than the PAS(25.00%, 63.92%, 79.71%) and ultrasound diagnosis(92.86%, 94.33%, 94.93%).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓PAS combined with ultrasound in the diagnosis of mesenteric lymphadenitis and acute appendicitis has high sensitivity, specificity and  accuracy.


Clinical study of targeted prostate puncture guided by TRUS and contrastenhanced ultrasound combined with MRI#br#

HAN Zechao， ZHANG Yu， TIAN Yacui， WANG Qingwen*

2017, 37(8):  929-932,944.  doi:10.3969/j.issn.10073205.2017.08.015

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［Abstract］  Objective〖HTSS〗〓To evaluate the clinical value of targeted prostate puncture guided by transrectal ultrasound(TRUS) and contrastenhanced ultrasound combined with MRI.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A retrospective analysis was performed in 187 patients who underwent prostate biopsy and confirmed by surgical pathology. One hundred and two patients had the transrectal ultrasoundguided systematic biopsy, and 85 patients had the targeted biopsy. The prostate cancer detection rate, needle number and Gleason score were compared between the 2 groups.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The positive rate and the coincidence rate of postoperative pathology of the target group were higher than that of the systematic group. The difference was statistically significant(P＜005), There was no significant difference in the detection rate of postoperative pathologic prostate cancer between the two groups(P＞005). Among the 85 cases of target puncture, 286pin in the highrisk group, 158pin in the dangerous group, 105pin in the suspicious group, and 63pin in the complement group. The positive rate of highrisk was higher than the suspicious group and the additional puncturing group, the difference was statistically significant(P＜005). The coincidence rate of high score of the Gleason score in the target group was higher than that in the systematic group, the difference was statistically significant(P＜005). There was no statistically significant difference in Gleason score of postoperative pathologic findings between two groups(P＞005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓TRUS and contrastenhanced ultrasound combined with MRI compartmental localization can significantly improve the positive rate of prostate cancer, reduce the number of puncture needles, and improve the detection rate of high Gleason score of prostate cancer, which have a higher clinical value.


Clinical effect observation of nerve stimulator guided coracoid approach next to the brachial plexus block in upper extremity surgery#br#

HE Wensheng1, ZU Lingjie2, YANG Xiaochun1, SUN Haijun1, WU Zhenyu1

2017, 37(8):  933-936.  doi:10.3969/j.issn.10073205.2017.08.016

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［Abstract］  Objective〖HTSS〗〓To observe the clinical effect of coracoid approach brachial plexus block for upper extremity surgery by using  a nerve stimulator.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eighty patients ASA classⅠ-Ⅱscheduled for surgery in elbow, forearm, wrist or hand were randomly divided into two group: coracoid approach group(group A) and axillary approach group(group B), 40 patients in each group. All cases were carried out coracoid approach or axillary brachial plexus block using a nerve stimulator. 40 mL 0.375% ropivacaine was injected after successful localization. Sensory block and motor block was evaluated every 5 minutes after the end of injection of the local anesthetic. The processing time required to complete the block、success rate and complications were also tanked notes.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no significant difference between the two groups in duration of operation and processing time for block(P＞005).  The onset time of sensory block for median nerve, musculocutaneous nerve and onset time of global sensory block in group A were significantly shorter than that in group B(P＜005). The onset time of sensory block for ulnar nerve, radial nerve and medial antebrachial cutaneous nerve in the two groups had no significant difference(P＞005). The onset time of motor block for median nerveand onset time of global motor block in group A were significantly shorter than that in group B(P＜005). The onset time of motor block for ulnar nerve and radial nerve in the two groups had no significant difference(P＞005). The rate of successful block in group A was significantly higher than that in group B(P＜005), and the rate of tourniquet pain in group A was significantly lower than that in group B(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Coracoid approach brachial plexus block is simple and safe guided by nerve stimulator. It requires shorter onset times and produces more perfect anesthesia effect. It is an favorable approach of brachial plexus block.


Impact of timing of dexamethasone on inflammatory factors and curative effect for patients with nerve root injury caused by epidural anesthesia#br#

OUYANG Guihua， WU Jianping

2017, 37(8):  937-940.  doi:10.3969/j.issn.10073205.2017.08.017

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［Abstract］  Objective〖HTSS〗〓To investigate the impact of timing of dexamethasone on nerve injury after cesarean section and inflammatory factors.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and twenty cases of nerve injury in our hospital undergoing epidural anesthesia for cesarean section in the process of puncturing patients were selected as the research objects. According to whether the application to dexamethasone and application time, the patients were divided into group A(dexamethasone using immediately after nerve injury), group B(dexamethasone using at surgery end time), group C(control group).Each group of tumor necrosis factorα(TNFα), interleukin1β(IL1β), interleukin6(IL6) level after 24 h, 48 h, 72 h and the nerve injury recovering were observed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓There were no significant difference in operation time and intraoperative bleeding volume between the 3 groups(P＞005). The clinical efficacy of nerve root injury in group A and group B was better than that in group C, and the excellent rate was higher than that in group C(P＜005). The serum levels of TNFα, IL1β and IL6 increased gradually in the 3 groups, and the increased extent of group A were minimum, while the increased extent of group C were maximum. The differences of interaction among groups, time points, between groups and time points were statistically significant(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Dexamethasone treating cesarean epidural puncturing nerve root injury is worthy of clinical application, and earlier application of dexamethasone could reduce the level of TNFα， IL1β， IL6, which indicates better clinical efficacy.
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Clinical correlation analysis of autoantibodies and clinical symptom of elderly patients with chronic renal failure#br#

LIU Shuangqing1, LI Juan2, NING Li1, CAO Yang1, WEI Dianjun1*

2017, 37(8):  941-944.  doi:10.3969/j.issn.10073205.2017.08.018

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［Abstract］  Objective〖HTSS〗〓To understand the influence of autoantibodies on the clinical features of elderly patients with chronic renal failure, and to provide reference for clinical diagnosis and treatment.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Ninety elderly patients with chronic renal failure were divided into 2 groups according to the detection results of autoantibodies, including 46 cases of patients with autoantibodies(positive group) and 44 cases without autoantibody(negative group). The clinical data and laboratory results of the 2 groups were compared.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The proportion of local infections and renal osteodystrophy in positive group was lower than that in negative group(P＜005). The proportion of partial organ resection was higher than that of negative group(P＜005). Logistic regression analysis revealed that partial organ resection was a independent risk factor of producing autoantibodies(P＜005). Local infections and renal osteodystrophy were independent protective 〖JP2〗factors of producing autoantibodies(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Autoantibodies have a certain influence〖JP〗 on the clinical symptoms of elderly patients with chronic renal failure, and attention should be paid in clinical treatment.
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