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Table of Content

    25 December 2017, Volume 38 Issue 12
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    Correlative analysis between changes of secreted frizzledrelated protein 5 and Nterminal Btype natriuretic peptide in patients with chronic heart failure#br#
    JIN Xin, GUO Bingyan, LI Yongjun*
    2017, 37(12):  1365-1368,1372.  doi:10.3969/j.issn.10073205.2017.12.001
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    ［Abstract］ Objective〖HTSS〗〓To explore the correlation of serum levels of secreted frizzledrelated protein 5(sFRP5) and Nterminal Btype natriuretic peptide(NTProBNP) with chronic heart failure(CHF).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and three CHF patients with New York Heart Association(NYHA) grade Ⅱ-Ⅳ and 44 healthy controls treated were summarized. The sFRP5, NTProBNP, fasting blood glucose，total cholesterol, triacylglycerol, low density lipoprotein cholesterol were detected，the height, weight, body mass index, blood pressure were taken and left ventricular ejection fraction(LVEF) and left ventricular enddiastolic dimension(LVEDD) were measured by echocardiography.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The levels of sFRP5 and NTproBNP were significantly increased compared with the control group, the levels of sFRP5, NTproBNP and LVEDD were gradually increased whereas the LVEF was decreased with NYHA classification(P<0.05). sFRP5 and NTproBNP levels were positively correlated with NYHA grade and LVEDD respectively, and negatively correlated with LVEF(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓sFRP5 and NTproBNP are associated with the severity of cardiac function, and the combined application of them could be effective indexes for evaluating early diagnosis of chronic heart failure.
    Relationship between serum cystatin C and Ddimer and carotid plaque stability in patients with cerebral infarction
    QU Mingwei, WU Huijun, ZHANG Fubo， RUI Hanchen， YAO Yufang， ZHANG Lihua
    2017, 37(12):  1369-1372.  doi:10.3969/j.issn.10073205.2017.12.002
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    ［Abstract］ Objective〖HTSS〗〓To investigate the relationship between serum cystatin C and Ddimer levels and carotid plaque stability in patients with acute cerebral infarction.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 82 patients with acute cerebral infarction were enrolled in our hospital. Sixtyfive healthy controls were collected from our hospital. The levels of serum cystatin C and Ddimer were measured. The levels of carotid intimamedia thickness(IMT) and atherosclerotic plaque were measured by color Doppler ultrasonography.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The levels of serum cystatin C and Ddimer in cerebral infarction group were significantly higher than those in control group(P＜005). The levels of cystatin C in IMT group and intimal thickening group were lower than those in plaque group, There was significant difference between the IMT group and the normal group(P＜005). The level of cystatin C in stable plaque group was lower than that in unstable plaque group, the difference was statistically significant(P＜005). There was no significant difference in Ddimer level between the two groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Serum cystatin C levels are closely related to the development of cerebral infarction and the stability of carotid plaques, while Ddimer level is elevated in early stage of cerebral infarction, but with unclear relationship to plaque stability.
    Effects of fasudil hydrochloride combined with extract of Ginkgo Biloba on treatment of acute cerebral infarction and serum Level of NSE#br#
    YIN Nan1， CHEN Hua2, YANG Yanyan3, KONG Lingxiong4
    2017, 37(12):  1373-1375,1380.  doi:10.3969/j.issn.10073205.2017.12.003
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    ［Abstract］ Objective〖HTSS〗〓To study the clinical effect of fasudil hydrochloride combined with extract of Ginkgo Biloba on treatment of acute cerebral infarction and serum level of neuron specific enolase（NSE）.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Ninetytwo patients with acute cerebral infarction were randomly divided into combined group and control group, 46 cases in each group. Based on conventional symptomatic treatment, the control group used fasudil hydrochloride treatment. On the basis of the control group, the combined group was treated with extract of Ginkgo Biloba. Both groups were treated for 14 consecutive days. The clinical effects and total effective rates, the Clinical Neurological Deficit Scales(CNDSs) and serum levels of NSE of two groups before and after treatment were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After 14 days treatment, the clinical effect and total effective rate of the combined group were better than those of the control group, with differences between two groups(P＜0.05).The CNDSs and serum levels of NSE of two groups were significantly decreased after treatment, the CNDSs and serum levels of NSE of the combined group were much lower than those in the control group after treatment, presenting statistical significance(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Fasudil hydrochloride combined with extract of Ginkgo Biloba have good efficacy in treatment of acute cerebral infarction, and can significantly lower the level of NSE. It promotes the recovery of neural function and thus is worthy of clinical application.
    A comparative clinical study of doxophylline and theophylline on chronic obstructive pulmonary disease
    LI Qian， LIU Yunqiu*， LAN Xuan， LIU Xiaoyu
    2017, 37(12):  1376-1380.  doi:10.3969/j.issn.10073205.2017.12.004
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    ［Abstract］ Objective〖HTSS〗〓To compare the clinical effect of theophylline and doxophylline on moderate stable chronic obstructive pulmonary disease （COPD）.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 107 patients with COPD in stable period were randomly divided into theophylline group with 56 cases and doxophylline group with 51 cases. Theophylline group was administered theophylline sustained release 400 mg once daily and Doxophylline group was administered doxophylline 400 mg twice a day orally. The forced vital capacity(FVC), forced expiratory volume in 1 second(FEV1) and the ratio of FEV1 and FVC were recorded after 14 days of the drug treatment to observe the pulmonary function. COPD assessment test  was evaluated and adverse reactions were monitored of the two groups after 14 days of therapy.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓FVC, FEV1 and FEV1/FVC were improved after treatment in both groups, and that the improvement was statistically significant as compared to the pretreatment values in each group(P＜005). But the improvements in the theophylline and the doxofylline groups were not significantly different from each other(P＞005). The score of COPD assessment test was decreased significantly after the drug treatment in both groups(P＜005). The rate of adverse reactions was 9.8% during the treatment of doxofylline, which is significantly lower than 25.0% during the treatment of theophylline(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓It is concluded that both theophylline and doxofylline can improve the quality of life and lung function of patients of COPD, and doxofylline has a better clinical effect and safety.
    Investigation of acute gastrointestinal injury in critically ill patients in Hebei
    REN Shan1, FANG Yumeng2, GONG Rui3, WANG Zhigang1, SHEN Limin1, ZHAO Heling1*
    2017, 37(12):  1381-1383,1387.  doi:10.3969/j.issn.10073205.2017.12.005
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    ［Abstract］ Objective〖HTSS〗〓To investigate acute gastrointestinal injury(AGI) in critically ill patients in Hebei, to find out the differences between practice and guideline，to formulate the effective protocol and improvement measures.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Threehundred and twenty critically ill patients were included in 25 intensive care units of tertiary hospital of Hebei province. A database of information was built from questionnaires, which included characteristics of patients, types of diseases, Acute Physiology and Chronic Health Evaluation Ⅱ score，Sequential Organ Failure Assessment score, length of stay, length of ICU stay, mortality in ICU and at 28 days, the severity of AGI and so on.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓A total of 207 critically ill patients who were received enteral nutrition was enrolled in the survey to assess the severity of AGI. It is found that AGI grade Ⅰ accounted for 60.4%. AGI grade Ⅱ accounted for 26.6%. AGI gradeⅢaccounted for 10.6%. AGI gradeⅣaccounted for 2.4%. There was a great distance between clinical nutritional practice and guideline recommendation.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Physician should improve the degree of recognition for acute gastrointestinal injury and enhance study and training for the guideline of acute gastrointestinal injury, combine the guideline with individualized treatment.
    Clinical observation of apatinib combined with chemotherapy for secondline treatment failure in advanced ovarian cancer#br#
    LI Qi1, ZHAO Junfeng2*, SHI Xiaoyu2, ZHAO Lixia2, LIU Dan1
    2017, 37(12):  1384-1387.  doi:10.3969/j.issn.10073205.2017.12.006
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    ［Abstract］〓Objective〖HTSS〗〓To observe the shortterm efficacy and safety of the new targeted drug apatinib combined with chemotherapy in the treatment of patients with ovarian cancer recurrence.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 30 cases of patients with secondline treatment failure in advanced ovarian cancer were randomly divided into 2 groups： the observation group(n=10) and the control group(n=20).The patients with advanced ovarian cancer adopted a apatinib and taxel， anthracyclinesbased combination chemotherapy regimen as observation group. Concurrent other patients who did not receive apatinib were chosen as control group. The therapeutic efficacy and sideeffect of the two groups were compare. 
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After 6 cycles, clinical curative effect of observation group is better than the control group. There were significant differences in the objective response rate and the disease control rate(P＜005).The most common adverse reactions were handfoot syndrome, hypertension, flatulence and diarrhea, mainly in grade 1-2.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Apatinib combined with chemotherapy is an effective and welltolerated treatment for advanced ovarian cancer, and the adverse reaction were tolerable.
    Investigation and study on the correlation of common psychosomatic diseases and personality traits in some group of cadres#br#
    LU Wenting1， WANG Xueyi1， CUI Lijuan2， FU Yinghui2*, ZHU Derong2, ZHANG Ying2
    2017, 37(12):  1388-1391,1488.  doi:10.3969/j.issn.10073205.2017.12.007
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    〗［Abstract］ Objective〖HTSS〗〓To explore the correlation between psychosomatic and personality traits in some group of cadres.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 2 000 cadres from X Provincial Party School, X Administration College, three Districts and Provincial Straight Government in X city were randomly selected. The questionnaire included a survey of the social demographic data of the respondents and the prevalence of psychosomatic diseases. The personality traits were assessed by Cattell Sixteen Personality Factor Questionnaire(16 PF). All questionnaires were instructed by the team of the research group, which was completed independently by the respondents.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Finally 1 690 valid data were included in the statistical analysis. There were 204(12.07%) respondents with psychosomatic disease and 1 486(87.93%) without psychosomatic disease. There was significant difference between the two groups in warmth sensitivity and abstractedness. Vigilance in the male cadres and privateness in the female cadres was significant difference between the two groups. There were significant differences in emotional stability, aggression, suspicion and fantasy between the two groups of 31 to 40 year old young cadres. There were significant differences in sensitivity and experimental factors between the two groups of 41 to 50 year old middleaged cadres. There were significant differences in emotional stability and tension personality factors between the two groups of 51 to 60 year old middleaged and elderly cadres. After stratification of all interviewees at the administrative level, it was found that there were statistically significant differences between the two groups at the level of grassroots cadres.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Among some cadre groups, common psychosomatic diseases are associated with a number of 16 PF personality traits.

    Comparison of the effects of salmon calcitonin and parathyroid hormone(134) on bone mineral density and bone histomorphometry of vertebra in ovariectomized rats#br#
    LUO Yang1， QI Can1， LUO Pengyuan1, LIANG Shaobo1, TIAN Faming2， ZHANG Liu3
    2017, 37(12):  1392-1396.  doi:10.3969/j.issn.10073205.2017.12.008
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    ［Abstract］ Objective〖HTSS〗〓To compare the effects of salmon calcitonin(CT) and parathyroid hormone(PTH)(134) on bone mineral density and bone histomorphometry of vertebra in ovariectomized rats.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Forty female SpragueDawley rats aged 3 months were randomly divided into four groups(with 10 rats each). All rats but those in the 〖JP2〗Sham group received ovariectomy and treated by vehicle(OVX), salmon calcitonin(OVX+CT) and PTH(134)(OVX+〖JP〗PTH). After animals were sacrificed at 6 months postOVX, the L4-5 spinal segments were harvested. Bone mineral density(BMD) and histomorphometry analysis were performed to evaluate the bone mass and microstructural changes in the lumbar vertebral bodies．Histological analysis with Gemisa staining was used to identify the characteristics of the degenerative discs.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Six months after OVX, the BMD values of L4 vertebral bodies 〖JP2〗in the OVX group were significantly decreased, compared with the Sham group(P＜005)．The BMD values in the OVX+〖JP〗CT group and OVX+PTH group were significantly increased，compared with the OVX group(P＜005), and the BMD values in the OVX+PTH group were significantly increased than that in the OVX+CT group(P＜005). The BV/TV values of L5 vertebral bodies in the OVX group were significantly decreased, compared with the Sham group, the BV/TV values in the OVX+CT group were significantly increased than that in the OVX group, the BV/TV values in the OVX+PTH group were significantly increased, compared with the Sham, OVX and OVX+CT group(P＜005). The Tb.Th values in the OVX group and OVX+CT group were significantly decreased, compared with the Sham group, the Tb.Th values in the OVX+PTH group were significantly increased than that in the Sham group, OVX group and OVX+CT group(P＜005). The values of Tb.Sp in the OVX group were higher than that in the Sham group, OVX+CT group and OVX+PTH group(P＜005). There are no significantly changes of Tb.N values in each groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Both salmon calcitonin and parathyroid hormone(134) can improve the bone mass and suppress the high bone turnover in OVX rats. But the effect of parathyroid hormone(134) to suppress the bone resorption and improve the bone mass is better than that of salmon calcitonin.
    The expression and clinical significance of STAT3 and Cyclin D1 in cholangiocarcinoma#br#
    WANG Wenbin1, LIU Bing2, WANG Tianyang1, LYU Haitao1, LIU Xueqing1
    2017, 37(12):  1397-1400,1405.  doi:10.3969/j.issn.10073205.2017.12.009
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    ［Abstract］ Objective〖HTSS〗〓To investigate the expression and clinical significance of signal transducer and activator of transcription 3（STAT3 ） and Cyclin D1 in  cholangiocarcinoma tissues.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Immunohistochemical staining was used to detect the expression of STAT3 and Cyclin D1 in 70 cases of cholangiocarcinoma and 15 cases of nontumor bile duct epithelium.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The expression of STAT3 and Cyclin D1 in cholangiocarcinoma(61.4%, 42.9%) was significantly higher than that in nontumor bile duct epithelium(33.3%, 13.3%)(P＜005). STAT3 expression significantly correlated with clinical stage, lymph nodes metastasis and tumor grade. The positive rates of STAT3 was significantly higher in the stage Ⅲ+Ⅳ group , lymph nodes metastasis group and moderately or poorlydifferentiated group than those in stageⅠ+Ⅱ group, no lymph nodes metastasis group and welldifferentiated group(P＜005). Cyclin D1 expression was significantly correlated with lymph nodes metastasis and tumor grade. The positive rates of Cyclin D1 was significantly higher in the lymph nodes metastasis group and moderately or poorlydifferentiated than those in no lymph nodes metastasis group and welldifferentiated. A significant correlation was found between the expressions of STAT3 and Cyclin D1 in cholangiocarcinoma(P＜005). The survival time of negative expression of STAT3 and Cyclin D1 group was longer than that of positive expression of STAT3 and Cyclin D1 group(P＜001).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓STAT3 and Cyclin D1 may be important biomarkers in carcinogenesis and progression of cholangiocarcinoma.
    Clinical application of thoracoscope pulmonary operation with the laryngeal mask anesthesia#br#
    WANG Jiyun1， LI Ting2， LI Wangang1*， TIAN Haoyin1， LIU Tianwei1
    2017, 37(12):  1401-1405.  doi:10.3969/j.issn.10073205.2017.12.010
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    〗［Abstract］  Objective〖HTSS〗〓To investigate the clinical value of non tracheal intubation anesthesia in thoracoscopic pulmonary surgery.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fortyeight cases of lung tumor by thoracoscope surgery were divided into two groups. Thoracoscope pulmonary operation with laryngeal mask anesthesia was performed in 25 cases of laryngeal mask group and thoracoscope pulmonary operation with doublelumenendo tracheal intubation anesthesia was performed in 23 cases of intubation group, then overall effects were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Thoracoscope surgery were successfully completed with all patients, no case was transferred to open chest operation. In laryngeal mask group, the preoperative anesthesia time was shorter, anesthetics dosage was less, postoperative recovery time was shorter, and the incidence of postoperative pharynx complication was lower when compared with the intubation group, and the difference was statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The laryngeal mask airway anesthesia was safe and feasible in pulmonary operation, significant advantage could be observed in the preoperative anesthesia and postoperative recovery time and reducing postoperative throat complication, so it could be wide used in lung operations.
    The immune function and safety effect of irradiated blood in the patients with lung cancer#br#
    ZHAO Zhanwei1， WEI Dongyao1, ZHAO Chong1, LI Yong2*
    2017, 37(12):  1406-1408,1421.  doi:10.3969/j.issn.10073205.2017.12.011
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    ［Abstract］〓Objective〖HTSS〗〓To detect the immune function and safety of irradiated blood in lung cancer patients.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and five patients were divided into irradiated group, conventional group and nontransfusion group. Irradiation group used irradiated blood in the operation, conventional group used regular blood, while the nontransfusion group without transfusion. Then the immune function and transfusion associated graft versus host disease(TAGVHD) in three groups were observed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The T cell subsets(CD4+， CD8+， CD4+/CD8+), NK cell, immunoglobulins(IgM，IgG，IgA) and complement(C3， C4) were all first lowered and then increased, the irradiation group and nontransfusion group returned to normal seven days after surgery. The conventional group did not reach the preoperative level. The CD4+，CD8+， NK cells， immunoglobulin(IgM, IgG, IgA) and complement(C3, C4) betewwn the groups ,time points,groups·time points interaction were statistically significant（P＜005）. CD4+/CD8+ in  time points was significant difference(P＜005), and there was no significant difference in interaction between groups and groups· time points(P＞005). No patients with TAGVHD were found in the irradiated blood group and normal blood group in 1 month.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The irradiated blood had no significant effect on immune function of the lung cancer patients, which was a safe and reasonable and feasible way for blood transfusion.
    Clinical observation of hyperthermic intraperitoneal chemotherapy with paclitaxel in patients with advanced ovarian cancer#br#
    LI Nan1, SUN Yanan2, YANG Liang3, CHEN Suqin1
    2017, 37(12):  1409-1412.  doi:10.3969/j.issn.10073205.2017.12.012
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    ［Abstract］〓Objective〖HTSS〗〓To evaluate the effect of hyperthermic intraperitoneal chemotherapy with paclitaxel after cytoreductive surgery(CRS) in patients with advanced ovarian cancer.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 46 cases of advanced(stage Ⅲ-Ⅳ) ovarian cancer patients were included in our study, 23 cases in study group and 23 cases in control group randomly. The study group was treated by hyperthermic intraperitoneal chemotherapy with paclitaxel and venous chemotherapy with oxaliplatin and docetaxel regimen after CRS. While the control group was treated by venous chemotherapy with oxaliplatin and docetaxel regimen after CRS only.Clinical treatment results for toxicity and adverse reactions, curative effects, remission rate of tumor, controlled rate of ascites, quality of life, and progressionfree survival(PFS) were compared and analyzed after treatment.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The differences of the total remission rate of tumor and curative effects between two groups were not statistically significant(P＞005). The controlled rate of ascites and KPS score in the study group were all better than patients in the control group(P＜005). The PFS is also beteer than that of the control group(P＜005).The differences in the rate of toxicity and adverse reactions between the study group and the control group were not statistically significant(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Applying the hyperthermic intraperitoneal chemotherapy with paclitaxel to treat advanced ovarian cancer after CRS can improve the controlled rate of ascites, KPS score, PFS and with little toxicity and adverse reactions.
    The expression and significance of aminoterminal propeptide of Ctype natriuretic peptide and bone formation markers for neonates of different gestational age#br#
    PI Yalei, ZHANG Yanan, ZHANG Huifeng, YAN Xue*
    2017, 37(12):  1413-1417.  doi:10.3969/j.issn.10073205.2017.12.013
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the role and significance of aminoterminal proCtype natriuretic peptide(NTproCNP), bone specific alkaline(BAP) and osteocalcin(OC) in boneformation of neonates with different gestational age.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eighty cases of neonates born within 24 hours were selected and were divided into group A(gestational age<32 weeks), group B(32 weeks ≤gestational age<37 weeks), and group C(37 weeks ≤ gestational age<42 weeks) according to gestational age. According to the body length participants were divided into three groups: length less than that of gestational age group(L1 group), length appropriate for gestational age group(L2 group), and length greater than the gestational age group(L3 group). According to body weight percentile, they were divided into three groups: body weight less than that of gestational age group(W1 group), body weight appropriate for gestational age group(W2 group), and body weight greater than gestational age group(W3 group). Birth length and body mass were measured within 1 hour after birth. Serum NTproCNP, BAP and OC were measured within 24 hours after birth.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There were no significant differences in gestational age, birth length, body mass, NTproCNP, BAP and OC between male and female neonates(P＞005). Participants from group B and C had higher  birth length and body weight than A group. Participants from group C had higher birth length and body weight than group B. BAP of group C was lower than that of group A and B(P＜005). There was no significant difference in gender, NTproCNP and OC among 3 groups(P＞005). BAP of group L3 was lower than that of group L1 and L2(P＜005). There was no significant difference in the levels of NTproCNP and OC among 3 groups(P＞005); NTproCNP, BAP and OC level had no significant difference among group W1, W2 and W3(P＞005). Neonatal birth weight and body length were positively correlated with gestational age(P＜005). There were no correlation between NTproCNP and OC and gestational age, birth weight and BAP(P＞005). BAP and gestational age, body weight, and body length were negatively correlated(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓No relationship between serum NTproCNP levels and fetal bone development during the second and third trimester of pregnancy was found. BAP is closely correlated with fetal bone growth and development. With the increase of gestational age, fetal ossification gradually weakened. The mineralization of fetal bone is weak and the bone strength of newborn is samll, which may be beneficial to delivery.
    Expression and correlation analysis of Atg5 and Atg7 in childhood acute leukemia#br#
    WU Xiaoli, GAO Xing, LIU Na, ZHAO Xiaoqing, MA Futian, ZHANG Baoxi*
    2017, 37(12):  1418-1421.  doi:10.3969/j.issn.10073205.2017.12.014
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    ［Abstract］  Objective〖HTSS〗〓To explore the relationship of the expression level of Atg5 protein and Atg7 protein with the occurrence and development of leukemia.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fifty children who were newly diagonesd with acute leukemia(AL) were collected as experiment group, including 30 cases of acute lymphoblastic leukemia(ALL) and 20 cases of acute myelogenous leukemia(AML). Twenty cases of nonmalignant hematological disease children were selected as control group. Immunohistochemical staining was used to test the expression level of Atg5 protein and Atg7 protein in bone marrow cells.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The positive rate of Atg5 protein expression in ALL and AML group was higher than that in control group, and the positive rate of Atg7 protein expression in AML group was higher than that in control group, the difference was statistically significant（P＜005）. Spearman rank correlation analysis showed that there was no correlation between the expression of Atg5 and Atg7 protein(r=0.333, P＞001).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Atg5 protein is upregulated in AL and may be involved in the development of AL. The elevated expression of Atg7 protein in AML may be related to the occurrence and development of AML.
    MRI appearances and grades of lissencephaly#br#
    HE Li1, MENG Yanjun2, SUN Mengyue1, REN Qingyun1, LIU Zhai1*
    2017, 37(12):  1422-1425,1429.  doi:10.3969/j.issn.10073205.2017.12.015
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    ［Abstract］〓Objective〖HTSS〗〓To analyze the clinical features and MRI characteristics of lissencephaly for its early diagnosis，treatment and prognosis judgment in clinical practice.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical symptoms and signs and the findings in magnetic resonance imaging(MRI)of 20 cases of lissencephaly were investigated retrospectively. Its severity in MRI finding was graded.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The spectrum of lissencephaly ranges from absent(agyria) or decreased(pachygyria) convolutions to less severe malformation known as subcortical band heterotopia. Of twenty patients, The clinical features were mainly manifested as mental retardation(twenty patients)，and motor retardation(twenty patients)，and epilepsy(six patients)． In terms of MRI features, agyria displayed cerebral surface smooth, hourglass of cerebral contour , increased cortical gray and relatively small amount of white matter, while pachygyria displayed broad ，flat gyri with thickened cortex，and reduced white matter，smooth border between the gray and white matter. subcortical band heterotopias displayed the characteristic isointensity of the heterotopic band with the cortex in all imaging sequences between the normal white matter and cortex gray. According to the Dobyns′ graded, 1 case in grade 1, 2 cases in grade 2, 1 case in grade 3, 12 cases in grade 4, 3 cases in grade 5, 1 case in grade 6. Severity of clinical finding correlates well with the degree of lissencephaly.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Lissencephaly is a brain malformation caused by neuronal migration abnormality. The characteristics of MRI along with clinical findings could provide important evidence for early diagnosis，timely treatment and prognosis judgment of lissencephaly.
    Clinical analysis of transcranial colorcoded Dopplex sonography in basilar artery stent
    WANG Yanjun1, CHEN Meihong2*, YANG Ying1, MA Teng1, LI Jing1
    2017, 37(12):  1426-1429.  doi:10.3969/j.issn.10073205.2017.12.016
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    ［Abstract］ Objective〖HTSS〗〓To evaluate the hemodynamic changes and the incidence of restenosis after stenting in patients with basilar artery stenosis by transcranial colorcoded Dopplex sonography(TCCS).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Retrospective analysis of TCCS and digital subtraction angiography confirmed 96 cases of severe symptomatic basilar artery stenosis in the department of neurology and department of neurosurgery. Systolic peak flow velocity(PSV), vascular pulsatility index(PI), mean flow velocity(MFV) and end diastolic flow velocity(EDV) of the basilar artery stenosis segment, the vertebral artery, the intracranial segment, and the posterior cerebral artery(measured at higher side) within 1 months and after 3, 6, 12 month were checked and recorded before and after operation. The hemodynamic parameters were compared before and after operation, and the incidence of restenosis was analyzed. 
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The PSV, EDV and MFV of the basilar artery were significantly lower in the 1 months after stent implantation, and PI showed a marked upward trend(P＜005). The intracranial vertebral artery PSV, MFV, EDV were significantly increased compared with the preoperative parameters(P＜005). Compared with the preoperative and posterior communicating arteries, the PSV, EDV, MFV and PI in the posterior cerebral arteries were significantly increased in all the 54 patients(P＜005). During the followup of 96 patients, there were 28 patients with stent restenosis. The cumulative restenosis rate were 14.6%(14/96), 19.8%(19/96) and 29.2%(28/96) at 3, 6 and 12 months respectively.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓TCCS was used to detect the changes of PSV, EDV and MFV in the posterior circulation, it can objectively evaluate the therapeutic effect of basilar artery stent implantation, and is an important screening method for restenosis after basilar artery stenting.
    Application value of continuous management outofhospital patients with longterm biliary extradrainage tube
    WANG Jiaolan, WU Yongchao, ZHU Baoliang, YIN Fenghua, RONG Xiaocui, WU Zhonglin*
    2017, 37(12):  1430-1433,1438.  doi:10.3969/j.issn.10073205.2017.12.017
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    ［Abstract］ Objective〖HTSS〗〓To study the clinical value of continued outofhospital management in patients with malignant high biliary obstruction(MHBO) after implantation of biliary extradrainage tube(BEDT), providing reasonable suggestions to reduce the incidence of outofhospital complications during BEDT.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓120 patients with MHBO after implantating BEDT, were randomly divided into control group and experimental group. 60 cases in the control group received routine management, visiting the hospital regularly. On the basis of conventional management, another 60 cases in the experimental group received continued outofhospital management to prevent the relative complications of BEDT. The incidence and management of complications of BEDT implatation in the two groups outside the hospital were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Outside hospital, the overall complication rate of BEDT in the control group was significantly higher than that in the experimental group with statistically significance(P＜005), including displacement、prolapsus、obstruction of BEDT and biliary tract infection. The hospital referral of patients in the control group was higher than those in the experimental group（P＜005). Because the patients in the control group did not regularly sluice biliary tract, nor regularly change surgical dressing and drainage pack, and they did not record the color and capacity of drainage. 32 cases(53.3%) of the control group were rehospitalized due to complications of BEDT outside hospital, which included 7 cases in the experimental group(11.7%). The difference was statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓In order to fundamentally solve the brought outside the hospital during BEDT complications, prevention was the most important. Continued outofhospital management could reduce incidence of BEDT complications, improve the use of BEDT time and usage rate, reduce the patient's health service cost, which was worthy of clinical application. The prevention and continued outofhospital management are the keys to fundamentally resolve and reduce the beset produced by complications of BEDT. Also, continued outofhospital management improves the usage of BEDT and reduces the health service cost of patients, worthy of generalized clinical application.
    Effect of THEM4 expression on collagen secretion in human embryo kidney epithelial cells treated with high glucose#br#
    CHEN Ning1, YANG Yonghui1, AN Xiaoying1, ZHU Guiyun1, KANG Lifei1, HAO Jun2*
    2017, 37(12):  1434-1438.  doi:10.3969/j.issn.10073205.2017.12.018
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    ［Abstract］ Objective〖HTSS〗〓To investigate the expression of thioesterase superfamily member 4(THEM4) and the relationship between THEM4 and collagen secretion in human embryo kidney epithelial cells(HKC) treated with high glucose.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓In vitro cultured HKC were respectively treated with high glucose(30 mmol/L) for 0, 6, 12, 24 and 48 h. Then cells were collected for the extractions of RNA and total protein. Subsequently, THEM4 mRNA was detected by the method of Realtime PCR. The THEM4, phosphoAkt(Ser 473), transforming growth factor β1(TGFβ1) and αsmooth muscle actin(αSMA) protein expressions were examined by Western blot. As well, immunofluorescence staining was used to explore the expressions and locations of THEM4. Again, collagenⅠ(ColⅠ) and collagen Ⅲ（Col Ⅲ） were detected using the competitive sandwich ELISA kit.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓①High glucose inhibited THEM4 expression, and induced increased phosphoAkt(Ser 473), TGFβ1, αSMA in HKC. Again, THEM4 was negatively correlated with TGFβ1 and αSMA expression(correlation formula: y=-5.100 9x+1.178, R2=0.971 1; y=-3.803 3x+1.408, R2=0.893 9 respectively); ② High glucose induced secreted ColⅠand secreted Col Ⅲ in HKC.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓High glucose caused increased ColⅠand Col Ⅲ secretions likely by inhibiting THEM4, upregulating phosphoAkt(Ser 473), TGFβ1 and αSMA expressions in HKC.
    Drug resistance surveillance and clinical value evaluation of 2 253 strains Acinetobacter baumannii#br#
    LI Jihong， SHI Dongyan*， YUAN Yue， LI Zhirong
    2017, 37(12):  1439-1442,1447.  doi:10.3969/j.issn.10073205.2017.12.019
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    ［Abstract］  Objective〖HTSS〗〓To investigate the distribution of Acinetobacter baumannii and its resistance to antimicrobial agents in the second hospital of Hebei Medical University from 2015 to 2016, and to evaluate the clinical value of the infection.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓This surveillance totally collected 2 253 strains of nonrepetitive bacteria, had a bacteria identification and drug sensitivity test determination with Vitek2Compact and had a statistic analysis of data with the software of Whonet 5.6.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓In the two years, 2 253 nonrepeat strains were detected in the whole hospital, and the composition ratio was 14% and 14% in 2015 and 2016 respectively. The detection rate of Acinetobacter baumannii was the third highest in the whole hospital. The detection rate of sputum specimens was 89.5% and 91.6% respectively. The detection rate of blood samples was 2.1% and 2.4%. The detection rate of the sputum specimens and blood samples were 1%, 0.8%, no cases of detection of Acinetobacter baumannii were detected by urine and blood culture. In the two years , Acinetobacter baumannii resistance to polymyxin B, tigecycline, cefoperazone/sulbactam, minocycline were less than 30%, the resistance rate to meraceran  was 83.8%, 76.8%, the resistance rate to imipenem was 67.1%, 64.4%, the majority of antimicrobial agents showed a different degree of decline in drug resistance. From 2015 to 2016, Acinetobacter baumannii in addition to cephalosporins antibiotics and aztreonam blood samples were higher than the rate of sputum drug resistance, other sputum specimens were higher than the resistance rate of blood samples. Among them, the resistance rate of nitrofurantoin, meropenem, imipenem, cefepime, tobramycin and levofloxacin were significantly different, which was statistically significant.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Acinetobacter baumannii infection form is still grim, lower respiratory tract infection also led to the risk of bloodstream infection. Quantitative sputum culture, white blood cell count, procalcitonin, increased Creactive protein were used as a risk factor for bloodstream infection to assess the main inflammatory index.
    Association of tolllike receptor 2 gene polymorphism with susceptibility to tuberculosis in the han nationality in Hebei area#br#
    SUN Hongmei, FENG Jianchun, LI Gang, KONG Xianglong, LIU Xiang, DI Hongqin*
    2017, 37(12):  1443-1447.  doi:10.3969/j.issn.10073205.2017.12.020
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    ［Abstract］ Objective〖HTSS〗〓To explore the association of single nucleotide polymorphisms(SNP) in Tolllike receptor 2(TLR2) gene with the susceptibility to tuberculosis(TB).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Two hundred and five cases of normal people and two hundred and fourteen cases of tuberculosis patients were analyzed by the method of microsequencing technology(SNaPshot) in Hebei area via the genotypic and allelic frequencies of TLR2(rs5743708 and rs3804099). The relationship between TLR genotypes and the susceptibility to tuberculosis was analyzed by logistic regression models.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no significant difference between the age and gender of 214 patients with tuberculosis and 205 cases of normal people(P＞005), and the effects of age and gender factor on the results of the study were not statistically significant(P＞005). The distribution of gene frequency in rs5743708 and rs3804099 conformed to the HardyWeinberg equilibrium law by χ2 test. Compared with control group, there were not significant difference on the rs5743708 genotype(χ2=0.925, P=0.925) and allelic frequencies(χ2=0.921, P=0.921), the genotype of rs3804099 loci(χ2=3.388, P=3.388) and allele(χ2=2.843, P=2.843) of TB group(P＞005). The risk of CT genotype at the rs5743708 site was increased compared with the CC genotype, but there was no statistical significance(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The polymorphism of TLR2(rs5743708 and rs3804099) has no significant correlation with the incidence of tuberculosis in the han nationality of hebei province.