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    25 April 2018, Volume 39 Issue 4
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    Influence of differnce doses of rosuvastatin and folic acid on the expression of atherosclerosis related gene for hyperhomocysteinemia mice#br#
    LIU Aining1， YANG Wengang1, JU Shuhong1, SUN Yiming1, MA Jun2, ZHOU Hui3*
    2018, 38(4):  378-382.  doi:10.3969/j.issn.10073205.2018.04.002
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    ［Abstract］ Objective〖HTSS〗〓To explore the influence of different doses of rosuvastatin and folic acid on the expression of atherosclerosis(AS) related gene for hyperhomocysteinemia(HHcy) mice. 
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fortysix mice were randomly divided into five groups. Control group(n=6) was given with ordinary diet. High methionine group(n=10) was given with 2% methionine+ordinary diet, folic acid group(n=10) was given with 0.8 mg/kg folic acid by gavage and 2% methionine after methionine for 4 weeks. Rosuvastatin group of low dose(n=10), high dose(n=10) was given with 0.8 mg/kg, 1.6 mg/kg rosuvastatin by gavage and 2% methionine after methionine for 4 weeks. All mice were executed by drawingout blood after 12 weeks, the serum Hcy, blood lipid indicators including TG, TC, HDLC, LDLC, hsCRP, TNFα, MMP9, the expression of AS related genes including CXCL1, ICAM1, VCAM1 were detected.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The level of HHcy in high methionine group, folic acid group, low dose group was higher than that of control group, and folic acid group, low dose group and high dose group was lower than high methionine group, high dose group was lower than folic acid group(P＜005). The level of TC in high methionine group, folic acid group, low dose group was higher than that of control group, and folic acid group, low dose group and high dose group was lower than high methionine group, high dose group was lower than folic acid group and low dose group(P＜005). The level of TG in high methionine group was higher than that of control group, and high dose group was lower than high methionine group(P＜005). The level of LDLC in high methionine group, folic acid group, low dose group was higher than that of control group, and folic acid group, low dose group and high dose group was lower than high methionine group, high dose group was lower than folic acid group and high dose group(P＜005). The level of HDLC in high methionine group, folic acid group, low dose group was lower than that of control group, and high dose group was higher than high methionine group, folic acid group and low dose group(P＜005).Compared with control group, high methionine group, folic acid group, low dose group and high dose group had higher levels of serum hsCRP， TNFα, lower level of MMP9(P＜005). The inflammatory indicators in high dose group were significantly lower than those in high methionine group, folic acid group and low dose group(P＜005). The percentages of positive cells of CXCL1, ICAM1, VCAM1, MMP9 in aorta tissue of high methionine group, folic acid group, low dose group and high dose group were significantly lower than those in control group(P＜005). Compared with folic acid group, low dose group, the percentages of positive cells of AS related genes including CXCL1, ICAM1, VCAM1, MMP9 in high dose group were significantly lower than those in high methionine group, folic acid group, low dose group(P＜005). There was no statistically significant difference in the percentages of positive cells of AS related genes between folic acid group and low dose group(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓High methionine diet can induce HHcy in mice, and high dose of rosuvastatin can contribute to reduce the level of serum Hcy, improve blood lipid disorder, and downregulate the expression of AS related genes.
    Effect of telmisartan combined finasteride on hypertension and benign prostatic hyperplasia and its effects on blood pressure, IPSS, Qmax, total prostate volume and residual urine volume
    LI Ru, HU Weiwei, CHEN Liman, YING Junqi
    2018, 38(4):  383-386,400.  doi:10.3969/j.issn.10073205.2018.04.003
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the clinical efficacy of telmisartan combined with finasteride in treatment of hypertension patients with benign prostatic hyperplasia and on the level of blood pressure, the International Prostate Symptom Score(IPSS), maximum urinary flow rate(Qmax), total prostate volume and residual urine volume.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 108 patients with hypertension and benign prostatic hyperplasia were randomly divided into group A, B and C with 36 cases in each group. Group A was given telmisartan treatment, group B was treated with finasteride, and group C was given telmisartan combined finasteride treatment. After 1 years of followup, the treatment effect of the 3 groups was compared and the blood pressure, IPSS, Qmax, the total volume of the prostate and the residual urine volume were observed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The levels of SBP and DBP in three groups after treatment were significantly lower than those before treatment(P＜005). There was no significant difference in SBP and DBP levels, blood pressure lowering effect and total effective rate between the three groups(P＞005). The volume of prostate in group B and C was smaller than that in group A, and the volume of prostate in group C was significantly less than that in group B(P＜005). There was no significant difference in the effective rates of three groups of prostatic hyperplasia(P＞005). The IPSS and residual urine volume of the three groups after treatment were significantly lower than that before treatment, Qmax was significantly higher than that before treatment. IPSS and residual urine volume in group B and C was significantly lower than the group A, Qmax higher than the group A, IPSS and residual urine volume in group C was significantly lower than that of group B, and Qmax was higher than that of group B(P＜005). There was no significant difference in the incidence of adverse reactions among the three groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Telmisartan combined with finasteride treatment of hypertension associated with benign prostatic hyperplasia are better, which can improve the IPSS, increase Qmax, reduce residual urine output, and less adverse reactions.
    Predictive value of cystatin C on the prognosis in patients with acute ischemic stroke
    LIU Xiao, WANG Lin, REN Hao, XU Qianqian, GAO Yanjun*
    2018, 38(4):  387-390,395.  doi:10.3969/j.issn.10073205.2018.04.004
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    ［Abstract］ Objective〖HTSS〗〓To investigate the predictive value of cystatin C(Cys C) on the prognosis in patients with acute ischemic stroke.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 264 consecutive patients admitted to the department of neurology, were recruited retrospectively. The clinical characteristics regarding the patients were recorded. Neurologic impairment was assessed based on the National Institutes of Health Stroke Scale(NIHSS). The patients were divided into favorable prognosis group(n=150) and poor prognosis group(n=114), according to the modified Rankin Scale(mRS). The differences of the general characteristics were compared between 2 groups. The multivariate logistic regression analysis was used to analyze the factors of poor prognosis of acute ischemic stroke. The serum Cys C levels in patients with different stroke severity were compared. The receiver operating characteristic curve was used to evaluate the predictive value of Cys C.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Age/the history of atrial fibrillation in patients and the history of ischemic stroke in patients with poor outcome were significantly higher than those in patients with favorable outcome. The level of serum Cys C and NIHSS score in the poor prognosis group were higher than those in the favorable prognosis. The degree of neurological impairment were positively correlated with the serum Cys C. The results of multivariate logistic regression analysis showed that increased NIHSS score, the level of Cys C and the history of atrial fibrillation in patients on admission were independent risk factors for poor prognosis. The optimal critical value of the level of Cys C on admission for the poor prognosis were 0.97. The sensitivity was 65.8%, while the specificity was 66.7%, while the acauracy was 66.0%.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The level of serum Cys C at admission has a good predictive value for the prognosis of patients with acute cerebral infarction. High serum Cys C level suggests poor prognosis.
    Relationship between neutrophil lymphocyte ratio and prognosis of small cell lung cancer#br#
    WANG Hongling1，2, LI Lin1, WANG Jianwei1, GUO Xia1, HAN Xiaoqing1, YU Changli1*
    2018, 38(4):  391.  doi:10.3969/j.issn.10073205.2018.04.005
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    ［Abstract］ Objective〖HTSS〗〓To investigate the relationship between neutrophil lymphocyte ratio(NLR) and prognosis of patients with small cell lung cancer at first visit.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical data of 162 patients with small cell lung cancer who were diagnosed and untreated were collected. Using SPSS 22.0 software, we determine the NLR boundary value by using the ROC curve. According to the boundary value, the selected patients were divided into 2 groups, and through the KaplanMeier drawing method of progression free survival(PFS) and overall survival(OS) survival curve, non parametric test was carried out with Log Rank, respectively. The clinical features of high and low NLR group, patients in the NLR group and the influence on the prognosis of small cell lung cancer were observed. COX regression model was applied for multivariate survival analysis. Comprehensive evaluation of influence of NLR on small cell lung cancer prognosis was made. 
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The median PFS and OS in the high NLR group were 6 months and 10.7 months respectively, while those in the low NLR group were 7.5 months and 14.3 months. In univariate analysis, risk factors for PFS: NLR, tumor stage, radiotherapy,chemotherapy, suggesting that the PFS of the patient with low NLR group , limited period, radiotherapy and chemotherapy was longer. On the contrary, it is short. Risk factors for OS: NLR, age, gender, tumor stage, radiotherapy,chemotherapy, suggesting that the OS of the patient with low NLR group,youger than 60 age,female,limited period, radiotherapy and chemotherapy was longer. On the contrary, it is short. In multivariate analysis, the curative effect of chemotherapy was an independent risk factor of small cell lung cancer PFS. Age, stage, radiotherapy,chemotherapy and NLR were the independent risk factors of prognosis in patients with small cell lung cancer OS.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓NLR is valuable in assessing the prognosis of patients with primary small cell lung cancer.
    Effect of Schisandrin on the erectile function of diabetic ED rats#br#
    HAO Huiyao, ZUO Hongye, ZHANG Shuo, GUO Pengpeng, ZHANG Lihui, HAO Yongmei*
    2018, 38(4):  396-400.  doi:10.3969/j.issn.10073205.2018.04.006
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    ［Abstract］ Objective〖HTSS〗〓To study the effect of Schisandrin on the erectile function of the diabetic rats with erectile dysfunction(ED).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One handred healthy male SD rats were injected with streptozocin to establish the diabetic rat models. Apomorphine inducing penile erection was used to select the diabetic rats with ED. After 8 weeks of treatment with Schisandrin(lowdose group, middledose group and highdose group)，the intracavernous  pressure(ICP)  and  mean  arterial  blood pressure(MAP) were measured. The inferior vena cava blood of rats were collected to measure the level of alanine aminotransferse(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP) and serum creatinine(SCr).
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The baseline ICP among all groups have no obvious difference before the electrical stimulation(P＞005). The MAP among all groups have no obvious difference when the electrical stimulation(P＞005). When the electrical stimulation,compared with normal control group, the ICP and ICP/MAP of rats from diabetes mellitus and diabetesinduced erection dysfunction(DIED) groups were jointly decreased in sequence(P＜005). Compared with the DIED group, the ICP and ICP/MAP of rats from DIED and lowdose Schisandrin group had no significant changes(P＞005), and the ICP and ICP/MAP of rats from middledose Schisandrin group and highdose Schisandrin group were both increased in sequence(P＜005). The increase in the highdose group was most obvious(P＜005).There was no obvious difference among all groups on the levels of ALT, AST, ALP and SCr(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The application of Schisandrin is able to improve the erection function of rats with DIED and its safety is high. It provides theoretical basis for the clinical application of this drug in the future.
    Clinical effect of tirofiban in the treatment of acute ST segment elevation of myocardial infarction on coronary artery bypass surgery#br#
    MI Huaixue1， ZHANG Shen1*， LIU Linli2
    2018, 38(4):  401-404,408.  doi:10.3969/j.issn.10073205.2018.04.007
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    ［Abstract］ Objective〖HTSS〗〓To investigate the clinical effect of tirofiban in the treatment of coronary artery bypass surgery in patients with acute ST elevation myocardial infarction.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓According to the principle of random, one hundred and eighty patients with acute ST segment elevation myocardial infarction were divided into experimental group and control group, The control group was treated with low molecular weight heparin on the basis of conventional treatment. The patients in the experimental group were treated with tirofiban and low molecular weight heparin on the basis of routine treatment. The proBNP, ECG, ST segment drop, postoperative echocardiography, cardiac function changes and major adverse cardiovascular events were compared between 2 groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After the operation, the level of 2 groups of proBNP was increased first and then decreased. The trend of the test group was less than that of the control group. There were statistical differences between 2 groups in the intergroup, time point, intergroup time point and time point(P＜005). The ST segment dropping rate of the electrocardiogram was higher than that of the control group at the moment after the operation, and the drop rate of ST in the experimental group 1 h and 12 h was higher than that of the control group after the operation, and the rate of decrease was higher in the experimental group than in the control group(P＜005). Cardiac function index of 2 groups after first weeks of echocardiography: there was no significant difference in left ventricular ejection fraction, left ventricular end diastolic diameter and left ventricular end systolic diameter(P＞005). The left ventricular ejection fraction, the left ventricular end diastolic diameter and the left ventricular end systolic diameter were significantly better than the control group fourth weeks after the operation(P＜005). The intractable myocardial ischemia and angina pectoris in the experimental group were lower than those in the control group, and the difference was statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Tirofiban can significantly improve the clinical effect of coronary artery bypass surgery for patients with acute ST segment elevation myocardial infarction.
    Relationship between increased signal intensity and clinical symptoms and prognosis in patients with cervical spine cord injury without radiographic abnormality
    WANG Rui, HU Chengdong, LIU Fajing, HUO Xiwei, LI Dongfeng, LI Yanfei
    2018, 38(4):  405-408.  doi:10.3969/j.issn.10073205.2018.04.008
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the relationship of increased signal intensity(ISI) and the clinical symptoms and prognosis in patients with cervical spine cord injury without radiographic abnormality(CSCIWORA).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 106 cases of CSCIWORA patients with ISI were enrolled in the study. Based on the prognosis of ISI at 1 year after operation, they were divided into 3 groups. Group A(20 cases): the ISI was not significantly reduced. Group B(38 cases): the ISI significantly weakened. Group C(48 cases): the ISI disappeared completely. The neurological function recovery based on Japanese Orthopedic Association（JOA） score was evaluated and compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The postoperative JOA scores at all patients had significantly increased when compared with the preoperative level(P＜005), and the JOA scores of group C were higher than those of group A and group B(P＜005).The neurological function improvement rate in group B was higher than that in group A, while group C was higher than that in group A and group B(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓CSCIWORA patients usually accompanied with ISI. Once surgery is given, a better prognosis will get if ISI disappeared and a poor prognosis will obtain if ISI existence.
    Clinical study of osteotomy and distal internal displacement combined with modified French osteotomy for cubitus varus in children#br#
    WU Rentao1， CHEN Longfu1， HUANG Chaotong2， LIU Xiaolei1， LIU Pingsheng3
    2018, 38(4):  409-412.  doi:10.3969/j.issn.10073205.2018.04.009
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the clinical effect of distal osteotomy with French osteotomy in the treatment of cubitus varus deformity.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Retrospective analysis of 70 cases of cubitus varus deformity in children was performed. The cases were set as two groups. The two groups were treated with lateral closing wedge osteotomy treatment, the control group took part in medial cortical bone continuous method, while the study group is the removal of the medial cortical bone blocks, distal to the medial movement, and with Kirschner wire to be fixed. At the fourth, sixth week after osteotomy, the fracture healing of fracture was evaluated by Xray imaging, in order to decide whether to dismantle plaster and remove the internal fixator of the fracture site. Bellemore method was used to evaluate the effect of surgery.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The fixed time of plaster in the study group and the fixation time for the removal of fracture healing were longer than that of the control group(P＜005). After the surgery, postoperative ipsilateral carrying angle(humerus elbowwrist angle,HEWA) and lateral elbow protrusion(lateral process index of elbow index, LCPI) of 2 groups were larger than that before the surgery, joint activity was less than that before surgery(P＜005). For healthy side HEWA of 2 groups, there were not statistically significant in HEWA, LCPI and joint activity before and after the operation(P＞005). The clinical effect of the study group was better than that of the control group, and the good rate was higher than that of the control group(P＜005). There was no significant difference in the incidence of complications in the 2 groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The treatment of cubitus varus deformity in children with distal osteotomy and modified French osteotomy is an ideal treatment for this kind of malformation, and there is no obvious adverse event and can avoid the bad shape that may occur after the operation.
    Ipsilateral multisegmental femoral shaft fractures treated by intramedullary nailing with an special reduction device#br#
    WANG Wei, LI Sheng, LIU Jianning, XU Guohui, GUO Jichao, QI Xiangbei*
    2018, 38(4):  413-415,430.  doi:10.3969/j.issn.10073205.2018.04.010
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    ［Abstract］ Objective〖HTSS〗〓To evaluate the curative effect and surgical skills of intramedullary nailing(IMN) in the treatment of ipsilateral multisegmental femoral shaft fractures under the assistance of an reduction device by joystick techniques.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Twentyfour adult patients with ipsilateral multisegmental femoral shaft fractures, including 19 males and 5 females, were enrolled into this study. All the patients were treated with anterograde IMN by percutaneous and joystick techniques under the assistance of the special reduction device(Ttape pin redaction device). The operation time, reduction time, fluoroscopy time, and intraoperative blood loss were recorded. Followup was conducted to assess the healing of the fractures and the functional recovery of the affected limbs.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓All the 24 cases were achieved closed reduction under the assistance of an reduction device by joystick techniques, two patients of them needed kirschner wire for reduction. The average operative time, fracture reduction time, fluoroscopy time and blood loss were(61.4±15.1) min, (11.5±3.5) min, (16.3±5.6) s and(183.8±58.0) mL, respectively. All fractures healed well on an average of(4.5±3.3) months. According to FriedmanWyman classification 24 cases get good result.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The method that treated ipsilateral multisegmental femoral shaft fractures with anterograde IMN under the assistance of the Tpin redaction device by percutaneous techniques is a good choice with the advantages of less soft tissue trauma, less intraoperative blood loss, easy reduction, short operative time, high healing rate of bone fractures, less complications and excellent functional recovery, so it is worthy of popularizing in clinic.
    Expression and clinical significance of serum levels of vegf in breast cancer
    WANG Meiqi1， ZHANG Shiyu1, MAO Chaoli2, LIU Huan2, SONG Zhenchuan2， HU Dawei1*
    2018, 38(4):  416-419,424.  doi:10.3969/j.issn.10073205.2018.04.011
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    ［Abstract］〓Objective〖HTSS〗〓To explore the expression and clinical significance of serum levels of vascular endothelial growth factor (VEGF) in breast cancer.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 146 cases of breast cancer patients were selected as experimental group and 30 cases of benign breast disease as control group. Enzyme linked immunosorbent assay method was used to determine serum VEGF levels, the level of serum VEGF in the two groups was analyzed, and serum VEGF levels in patients with different clinical factors(age, histological grade, TNM staging, human epidermal growth factor receptor2, estrogen receptor, progesterone receptor) in the experimental group were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The expression of serum VEGF in breast cancer patients was significantly higher than that in benign breast disease patients, and the difference was statistically significant(P＜005). The higher the histological grade, the later the TNM stage, the higher the human epidermal growth factor receptor2 positive state, the higher the serum VEGF expression level. Differences are statistically significant(P＜005). There was no significant difference in serum VEGF expression among breast cancer patients with different ages, estrogen receptor and progesterone receptor(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Serum VEGF is highly expressed in breast cancer patients and is related to the progression, metastasis and prognosis of breast cancer. Serum VEGF can provide a theoretical basis for the early diagnosis, targeted therapy and prognosis evaluation of breast cancer.
    Factors affecting the quality of life in children with epilepsy and analysis of the effect of family intervention
    XU Bei1, ZHOU Yang2, JIA Xiaoyu2， WANG Guilan2*
    2018, 38(4):  420-424.  doi:10.3969/j.issn.10073205.2018.04.012
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    ［Abstract］ Objective〖HTSS〗〓To explore the influencing factors of life quality of epileptic children and observation of the effect of family intervention.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 138 children with epilepsy(study group, combined family intervention) and 112 healthy children(control group) were investigated. The quality of life on different gender, age, seizure type, cognitive level of disease, antiepileptic drug adverse reaction, seizure frequency, intelligence, depression, anxiety, educational level, family size, medication compliance, age of onset of epileptic children were analyzed. The effect of family intervention in the study group before and after treatment were compared, and the difference of SF36 score between the study group and the control group were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The children with general seizures, low cognitive level of disease，poor family condition, adverse drug reactions, seizure frequency more than 3 times a week, lower intelligence, depression, anxiety, poor education level and medicine compliance have lower quality of life than the other group. The difference was statistically significant(P＜005). After regular treatment and family intervention, memory/attention, school performance, selfefficacy, health concept and SF36 scores of the study group were significantly increased compared with those before family intervention, the difference was statistically significant(P＜005). Logisitic regression analysis showed that epilepsy of generalized seizures, low cognitive level of disease, poor family income, low intelligence, adverse drug reactions, high attack frequency, anxiety, depression, poor education level and drug compliance were important factors for affecting the quality of life in children with epilepsy.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓In addition to regular treatment, we should also carry out family intervention to effectively improve the quality life of children with epilepsy.
    Assessment of IVF oocyte maturation and embryonic development by bone morphogenetic protein9 of granulosa cells
    LIU Can， WANG Hui， LI Yi， ZHANG Ping， JIANG Qian， ZHEN Xiuli*
    2018, 38(4):  425-430.  doi:10.3969/j.issn.10073205.2018.04.013
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    〗［Abstract］〓Objective〖HTSS〗〓To detect the expression level of bone morphogenetic protein9(BMP9) in human ovarian granulosa cells, and to discuss its relationship to the maturation of oocyte and development of embryo.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eightyfive cases were collected from the patients taking in vitro fertilization(IVF) with fallopian tube factor. The expression of BMP9 in granulosa cells were measured by immunocytochemistry, RTPCR and Western blot.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓BMP9 was expressed in the cytoplasm of granulosa cells. There are positive correlation between BMP9 mRNA expression and protein expression in granular cells（r=0.220，P＜005）. The expression of BMP9 mRNA and protein in granulosa cells do not have linear correlation with clinical and laboratory IVF data. According to the mean of relative expression of BMP9 mRNA, the patients were divided into low expression group and high expression group. High quality embryos and egg utilization in high expression group were significantly higher than those in low expression group（P＜005）.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓BMP9 expressed in the cytoplasm of human ovarian granulosa cells. High expression of BMP9 can increase the rate of high quality embryos, and its expression level in a certain extent can reflect the quality of oocytes. BMP9 may act as an autocrine/paracrine factor involved in the regulation of the reproductive system.
    A study on the relationship between acoustic emission and hearing impairment in hearing screening distortion products
    LI Hongxia, SU Zhengyi
    2018, 38(4):  431-433,439.  doi:10.3969/j.issn.10073205.2018.04.014
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    ［Abstract］ Objective〖HTSS〗〓To explore the relationship between the results of distortion product otoacoustic emission(DPOAE) and the hearing results, and to provide correct theoretical support for the health education of the parents.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Drawn from our hearing center in random, 304 cases who were not passed the test of  early screening or compound sieve one ear or two ears were accepted comprehensive hearing examination, namely acoustic immittance, DPOAE, multiple frequency steady state(ASSR), brainstem auditory evoked potential. The hearing results are judged by multi frequency steady state with frequency characteristics.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After DPOAE test, they were divided into the ear group and the nonpassing ear group. The positive curved line of not passed group was letter than the pass group(P＜005). The passed group hearing showed that  normal ears was 210(93.8%), mild damage ears was 10(4.5%), moderate damage ears was 2(2.0%), extremely severe damage ears was 2(2.0%). The not passed group hearing showed that normal ears was 82(21.4%), mild damage ears was 60(15.6%), moderate damage ears was 90(23.4%), severe damage ears was 36(9.4%), extremely severe damage ears was 116(15.6%). The hearing damage of not pass group was severe than the pass group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓DPOAE hearing screening is a standard for diagnosing normal hearing. The patients passed DPOAE indicated their cochlear, outer and middle ear is normal. DPOAE through the ear 93.8% means normal hearing, DPOAE did not pass 78.6% mean different degree of hearing loss. It is requires a comprehensive hearing test and analysis to make a correct diagnosis.
    Effect of montelukast sodium combined with mometasone furoate on TGFβ1, IL17 and Th17/Treg in patients with mild to moderate adenoid hypertrophy#br#
    LI Runqiu, HE Jintian, YE Beihua
    2018, 38(4):  434-439.  doi:10.3969/j.issn.10073205.2018.04.015
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    ［Abstract］〓Objective〖HTSS〗〓To analyze the clinical effect of montelukast sodium tablet combined with mometasone furoate in the treatment of mild to moderate adenoidal hypertrophy and influence on serum TGFβ1, IL17 and Th17/Treg.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Ninetyeight cases of mild to moderate adenoidal hypertrophy child patients were divided into 4 groups according to the pathogeny and treating method： control group 1(22 cases), control group 2(27 cases), observation group 1(24 cases), observation group 2(25 cases). The control group was treated with mometasone furoate nasal spray, while observation group was treated with mometasone furoate combined with montelukast tablet. All patients were treated for 2 months. OSA18 scale score was used to evaluate the clinical effect, the ratio of adenoids to nasopharynx(A/N) of 4 groups before and after treatment were compared. The clinical effect, serum transforming growth factorβ(TGFβ1), interleukin 17(IL17) level and T helper 17 cells/regulatory T cells(Th17/Treg) of 4 groups were compared. The adverse effect was observed, too.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After treatment, The OSA18 score and A/N of all groups were decreased significantly（P＜005）, and that of observation group 1 and observation group 2 were significantly lower than control group 1 and control group 2,which showed significant difference（P＜005）. The clinical total effect of four groups showed significant difference（P＜005）. The serum TGFβ1, IL17 level of all group were decreased significantly, and that of observation group 1 and observation group 2 were significantly lower than control group 1 and control group 2, which showed significant difference（P＜005）. After treatment, the Th17 and Th17/Treg ratio of all groups were decreased significantly, the Treg of all groups were increased significantly. The Th17 and Th17/Treg of observation group 1 and observation group 2 were significantly lowerr than control groups, the Treg of observation group 1 and observation group 2 were significantly higher than control groups（P＜005）, which showed significant difference.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Montelukast sodium tablet combined with mometasone furoate can effectively cure mild to moderate adenoidal hypertrophy, decrease the serum TGFβ1 and IL17 level, relief the inflammatory reaction, and downregulate the ratio of Th17/Treg, adjust the immune balance, which is safe and effective for mild to moderate adenoidal hypertrophy caused by chronic inflammation and rhinallergosis, and is worthy of promotion.
    Clinical study of high frequency ultrasound and electromyography in diagnosis of carpal tunnel syndrome of median nerve#br#
    CAO Yakun1, GUO Weidong1, SHI Chaoling1, JIAO Leihong1, ZHAO Gang1, GAO Xia2*
    2018, 38(4):  440-443,449.  doi:10.3969/j.issn.10073205.2018.04.016
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    ［Abstract］ Objective〖HTSS〗〓To diagnose carpal tunnel syndrome by high frequency and electromyography（EMG）, and to study the diagnosis from two aspects of morphology and function.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Thirty patients and 30 healthy volunteers were tested in ultrasound and EMG respectively. The echo changes, left and right diameter, anteroposterior diameter and crosssectional area were observed by high frequency ultrasound. At the same time, distal motor latency and amplitude, middle finger to wrist sensory nerve conduction velocity and electrophysiological index of abductor pollicis brevis muscle were performed by EMG. The correlation analysis between the two methods was made. While the receiver operating characteristic(ROC) curve was used to determine the diagnostic value.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓In the carpal tunnel syndrome group, the median nerve echo was decreased, the internal punctate echo disorder was disappeared, the nerve swelling, the median nerve left and right diameter, anteroposterior diameter and crosssectional area were greater than those in the control group(P＜005). The latency of the median nerve was significantly prolonged, the amplitude was decreased, and the sensory conduction velocity was slowed down and amplitude was decreased(P＜005). The crosssectional area measured by high frequency ultrasound was positively correlated with the distal latency of the median nerve, and negatively correlated with the median sensory conduction velocity(P＜001). The diagnostic value of the crosssectional area obtained by ROC curve was the highest, with the sensitivity of 86.7% and the specificity of 93.3%.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓High frequency ultrasound can clearly display the shape of median nerve in wrist and measure the value of clamp pressure. The diagnosis of median nerve injury at the carpal tunnel can be performed by high frequency ultrasound and EMG.
    The early diagnostic value of color Doppler craniocerebral ultrasound on neonatal encephalopathy
    LI Juanjuan, HAN Ruoling*, GAO Jiening
    2018, 38(4):  444-449.  doi:10.3969/j.issn.10073205.2018.04.017
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    ［Abstract］〓Objective〖HTSS〗〓To explore the clinical value of color Doppler ultrasound in the early diagnosis of neonatal encephalopathy, and provide the basis for early diagnosis and treatment of neonatal encephalopathy.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 92 neonates with neonatal encephalopathy were selected as case group（the mild and the moderate to severe groups）, and 42 neonates without neonatal encephalopathy during the same period were randomly selected as control group. All these neonates received cranial ultrasound to detect intracranial structure and the brain blood flow.And all the cerebral hemodynamics parameters of middle cerebral artery which include peak systolic velocity（PSV）, end diastolic velocity（EDV） and resistance index（RI） were measured via color Doppler flow.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓According to the results of twodimension(2D) Cranial ultrasonography(cUS), 51 cases of the mild group were abnormal(63.0%). 9 cases of the moderate to severe group were abnormal(81.8%). cUS findings were normal in 42 neonates of control group. The color Doppler flow cUS results showed that PSV and EDV of the mild group were lower than that in control group and that PSV and EDV of the moderate to severe group were lower than that in control group and also the mild group, while RI was higher. There were significant differences between groups(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓cUS, using color Doppler flow on the basis of 2D is of great value in early diagnosing of neonatal encephalopathy in neonates.
    Investigation on detection of cervical cancer and precancerous lesion by different testings  among women in poor rural areas#br#
    YU Suxiang, JIA Xiuzhuo, WANG Bin, MA Yinglan
    2018, 38(4):  450-453.  doi:10.3969/j.issn.10073205.2018.04.018
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    ［Abstract］ Objective〖HTSS〗〓To study the detection plans of cervical cancer by different testings among rural women in Tangxian，Baoding, and to provide treatment reference of cervical cancer for local.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The Thinprep cytologic test, Human papilloma virus(HPV) test, colposcopy and biopsy were performed among 5 587 women in outpatient center of gynecologic department from May 2016 to May 2017. Thinprep liquid based cytology was chosen for cytology, In situ hybridization immunofluorescence system applied for hr HPV test.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓A total of 5 587 outpatient visits to women were screened for opportunistic age in a year, aged 18-65 years， average（38.54±4.43） years. The cervical intraepithelial neoplasia 2(CIN2) or greater lesion diagnosed by cotesting（5.199%） was higher than that of hr HPV test （3.539%）and cytology（1.299%）（P＜005）. Differences are statistically significant. The sensitivity of the cotesting  was higher than that of hr HPV test and cytology(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The CIN2 or greater lesions diagnosed by cotesting was higher than that of cytology and hr HPV test. The cotesting could provide more reference for management of abnormal results of cervical screening and very helpful in prevention and treatment. But the testing method should be combined with the specific situation of each patient, and make the best screening program suitable for them.
    Sensitivity and specificity analysis of serum Apelin, Chemerin and FetuinA in diagnosis of early diabetic nephropathy#br#
    SHI Meihong1， DING Jiawei2
    2018, 38(4):  454-458.  doi:10.3969/j.issn.10073205.2018.04.019
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    ［Abstract］〓Objective〖HTSS〗〓To explore the value of serum Apelin, Chemerin and FetuinA in early diagnosis of diabetic nephropathy(DN).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 132 patients with diabetes mellitus admitted were divided into DN group(UACR≥30 g/mg, 84 cases) and NonDN group(UACR＜30 g/mg, 48 cases) according to the patient′s UACR, and 40 healthy people in our hospital were selected as the control group. Serum Apelin, Chemerin and FetuinA levels were measured, and the sensitivity and specificity analysis of serum Apelin, Chemerin combined with FetuinA in diagnosis of early diabetic nephropathy were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The levels of Apelin, Chemerin and FetuinA in DN group were significantly higher than nonDN group and control group(P＜005).The levels of Apelin and FetuinA in nonDN group were significantly higher than control group(P＜005). The sensitivity and negative predictive value of Apelin to diagnose DN alone were the highest. The specificity, accuracy and positive predictive value of Chemerin to diagnose DN alone were the highest. The sensitivity, accuracy and negative predictive value of Apelin, Chemerin combined with FetuinA to diagnose DN parallelly were the highest, and the specificity and positive predictive value of o diagnose DN seriesly were the highest.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The sensitivity and specificity of Apelin, Chemerin and FetuinA to diagnose DN alone were lower, and the diagnostic efficiency of joint diagnosis was better. In parallelly, the combined detection could help to improve the sensitivity of DN diagnosis, among them, the combined detection could help to improve DN diagnosis specificity, which is important for the early diagnosis of DN.