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Table of Content

    25 August 2018, Volume 39 Issue 8
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    Correlation in homocysteine level and the prognosis of acute ischemic stroke in old elderly patients after intravenous thrombolysis#br#
    ZHANG Li， YANG Junsu*, ZHU Hongwen, BA Ruiqiong, SHI Yuan, MA Xiang
    2018, 38(8):  872-876.  doi:10.3969/j.issn.10073205.2018.08.002
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    ［Abstract］ Objective〖HTSS〗〓To investigate the relationship between serum homocysteine(Hcy) level and prognosis of acute ischemic stroke（AIS）in the old elderly patients who received thrombolysis of recombinant tissue plasminogen activator(rtPA).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fortyseven patients were recruited according to the research criteria and were grouped by their serum Hcy levels.The patients were divided into 24 cases in the high level （Hcy≥18.54 μmol/L） group(group A) and 23 cases in the low level（Hcy＜18.54 μmol/L） group(group B).The data including age, sex, cerebrovascular disease risk factors, onset to needle time, blood glucose level, blood lipids levels, uric acid level, fibrinogen level, hemoglobin level, platelets count,stroke subtypes and clinical outcome were analyzed.All patients took CT/MRI examination to detect cerebral hemorrhage in 24 hours after rtPA treatment. Neurological function was evaluated by National Institute of Health Stroke Scale(NIHSS) score and modified Rankin Scale(MRS) score. The clinical outcome was scored according to the MRS and considered as poor when the MRS score was equal or greater than 4 after 90 days of thrombolysis.Risk factors influencing the prognosis of patients with acute ischemic stroke after thrombolysis were assessed and cutoff values of Hcy were calculated if Hcy level can be used as an index to predict the outcome.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The Hcy mean level of all patients was higher than normal, which were associated with diabetes, smoking, alcohol consumption, uric acid level and hemoglobin level.After 1week rtPA treatment, the NIHSS scores of high Hcy level group were significantly higher than those of low level group(P＜0.05), meantime the high Hcy group showed obvious symptomatic intracerebral hemorrhage risk after 24 hours(P＜005). Poor outcome was presented in MRS score results after 3 months in high Hcy level group, compared with low Hcy level group(P＜005). The Hcy level and initial NIHSS score were risk factors for poor prognosis in old elderly patients with AIS receiving thrombolytic treatment of rtPA with apotentially optimal cutoff value of Hcy at 21.35 μmol/L(sensitivity 78.6%, specificity 63.3%).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Elevated Hcy level is a potential independent predicter of poor prognosis in the old elderly patients with AIS after rtPA treatment，while the probable optimal cutoff value is 21.35 μmol/L.
    Study on the protective effect of Resveratrol on H9C2 myocardial cell injury induced by CoCl2
     
    DU Zheng, WANG Wei, LU Jun, SU Haiming*
    2018, 38(8):  877-881,886.  doi:10.3969/j.issn.10073205.2018.08.003
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    ［Abstract］ Objective〖HTSS〗〓To study the protective mechanism of resveratrol(RES) on H9C2 cells injury induced by two cobalt chloride(CoCl2).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓CoCl2 （500 μmol/L） was used to treat H9C2 cardiac muscle cell for 24 h in order to establish H9C2 myocardial cell hypoxia injury model. The experiment was divided into five groups: blank control group(control); model injury group(H9C2 cells were pretreated with 0.1% DMSO culture medium for 24h, and then they were continued to treat by 500μmol/L CoCl2 for 24h); low dose RES group(H9C2 cells were pretreated with 12.5μmol/L RES for 24h, and then they were continued to treat by 500μmol/L CoCl2 for 24h); medium dose RES group(H9C2 cells were pretreated with 25μmol/L RES for 24h, and then they were continued to treat by 500μmol/L CoCl2 for 24h); high dose RES group(H9C2 cells were pretreated with 50μmol/L RES for 24h, and then they were continued to treat by 500μmol/L CoCl2 for 24h). MTT method was used to evaluate the viability of H9C2 myocardial cell. Morphological changes of H9C2 nucleus were observed by Hoeschst 33342 staining. The changes of mitochondrial membrane potential, intracellular reactive oxygen species(ROS) production and cell apoptosis were detected by flow cytometry in H9C2 cells. Western Blot was used to investigate the changes of apoptosis related proteins in H9C2 cells.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓MTT results showed that RES concentration dependently inhibited the decrease of H9C2 cell viability induced by CoCl2. Hoeschst 33342 staining showed that RES concentration dependently inhibited the appearance of H9C2 cells apoptosis induced by CoCl2. Flow cytometry revealed that RES concentration dependently inhibited ROS production, decreased mitochondrial membrane potential, and increased apoptosis in H9C2 cells induced by CoCl2. Western blot showed that RES concentration dependently inhibited the increase of proapoptotic proteins(Bax, cleavedcaspase3, cleavedcaspase9) and decreased expression of apoptotic protein(Bcl2) in H9C2 cells induced by CoCl2.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓RES has the protective effect on H9C2 myocardial cell injury induced by CoCl2, the mechanism may be related with inhibiting the increase of ROS induced by CoCl2 and decreasing the mitochondrial membrane potential, thus hindering the occurrence of mitochondrial apoptosis in H9C2 cells.

    Effects of pressurized rapid intravenous infusion of Shenfu on hemodynamics in patients with acute inferior myocardial infarction#br#
    ZHANG Dongmei， SUN Dongxiu， SUN Changlei， DU Lili， YAO Kejing， LIU Yao
    2018, 38(8):  882-886.  doi:10.3969/j.issn.10073205.2018.08.004
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    ［Abstract］ Objective〖HTSS〗〓To investigate the effect of rapid intravenous infusion of Shenfu on hemodynamics in patients with acute inferior myocardial infarction.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and twenty  patients with acute inferior wall myocardial infarction who underwent percutaneous coronary intervention were randomly divided into observation group and control group，60 cases in each group. The control group was treated with percutaneous coronary intervention(PCI) Infusion of normal saline, the observation group received treatment of rapid intravenous infusion of Shenfu injection on the basis of the control  group. The hemodynamic parameters, DtoB time, postoperative blood flow classification, adverse reactions, and 30 days of major adverse cardiovascular events were compared between the two groups before and after surgery.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no significant difference in heart rate(HR), left ventricular diastolic pressure(LVEDP), real portfolio project（RPP）, maximal rising and falling rate of ventricular pressure（±dP/dtmax） between two groups before operation(P＞005). Both HR and ±dP/dtmax at 40 minutes were increased, and LVEDP and RPP were decreased after surgery(P＜005). The HR and RPP of the observation group were significantly lower than those of the control group(P＜005). The duration of DtoB in the observation group was significantly shorter than that in the control group(P＜005). There was no significant difference in TIMI blood flow grade between two groups(P＞005). The incidence of adverse events in the observation group and the incidence of MACE in the 30 days after operation were significantly lower than those in the control group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓In the PCI, rapid intravenous infusion of Shenfu injection can effectively improve the patient′s blood flow, and steadily increase the heart rate and blood pressure, reduce the incidence of nausea and vomiting arrhythmia and the main adverse cardiovascular events, with safety , which is worthy of promotion.
    Alteration of serum levels of thrombopoietin and angiogenin in mice exposed to chronic mild stress#br#
    HU Zhiling1, YANG Shuang2*, DU Yuru3, SHI Haishui3
    2018, 38(8):  887-889,893.  doi:10.3969/j.issn.10073205.2018.08.005
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    ［Abstract］ Objective〖HTSS〗〓To investigate the alteration of serum levels of thrombopoietin(TPO) and angiogenin(ANG) in chronic mild stress(CMS)induced depressed mice.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓CMS procedure was provided in the present study. After depressivelike behavioral tests, serum samples of mice were collected and serum levels of interleukin6(IL6), tumor necrosis factorα(TNFα), TPO and ANG of mice were detected by enzymelinked immunosorbent assay （ELISA）. 
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓CMS exposed mice exerted significantly depressivelike behaviors, reflected by prolonged floating time(P＜005) without significant effect on latency to floating(P＞005) in the forced swimming test, decreased sucrose preference(P＜005) without significant effect on total intake of sucrose(P＞005) in the sucrose preference test. Results from ELISA showed that CMS induced increased serum concentration of IL6, TNFα, TPO and ANG(all P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓CMS exposure could induce significant alteration of serum levels of TPO and ANG, suggesting that the vascular dysfunction and thrombocytopoiesis may be associated with the pathology of CMSinduced depression.
    Effects of resveratrol on MMPs in rats with cerebral arterial tumors#br#
    YANG Qian1, GUO Yong2*, ZHANG Bo3, ZHANG Jie4,LI Weifeng1
    2018, 38(8):  890-893.  doi:10.3969/j.issn.10073205.2018.08.006
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    ［Abstract］ Objective〖HTSS〗〓To study the expression of matrix metalloproteinase(MMPs) in patients with cerebral aneurysm and to explore the effect of resveratrol on its expression.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Selected 70 adult male SD rats from 250 to 300 grams, were randomly divided into three groups: control group, model group and treatment group. Model group and treatment group were established to model rat renal hypertension. The treatment group was treated with resveratrol(50 mg/kg) mixed with feed. The model group is only for ordinary feed. The control group simulated operation, normal feed feeding. 1, 2 and 3 months after surgery, 10 rats were randomly selected from the model group and the treatment group, and the serum MMP2 and 9 expression levels were detected by enzyme linked immunosorbent assay method. The right arterial ring and its main branches were examined under the microscope.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The comparison between the three groups and the above groups showed significant difference, which was of statistical significance(P＜005), while the difference in interaction between groups and between groups and times were of no statistical significance(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Resveratrol can prevent and delay the occurrence and development of cerebral aneurysms by inhibiting the expression of MMP2 and 9.
    Relationship among nonalcoholic fatty liver disease, hyperuricemia and dyslipidaemia in health checkup polulation
    WEI Wenzhi, WEN Xiaohua, LIU Yanru, GAO Mian, TIAN Jingli
    2018, 38(8):  894-897,902.  doi:10.3969/j.issn.10073205.2018.08.007
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    〗［Abstract］ Objective〖HTSS〗〓To investigate the relationship among nonalcoholic fatty liver disease(NAFLD),  hyperuricemioa(HUA), and dyslipidemias in checkup population.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 8 330 healthy people who underwent health checkup were recruited in this study, who had met inclusion and exclusion standard. The demographic characteristics and detection condition of NAFLD were analyzed, indicators between NAFLD group and nonNAFLD group, indicators and detection rate of NAFLD between HUA group and nonHUA group were observed and compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The median age of the 8 330 healthy people was 43 years old and the interquartile distance was 18 years. The total detection rate of NAFLD was 33.6%. Compared with those in nonNAFLD group, in NAFLD group, body mass index(BMI), waisttostature ratio(WSR), blood glucose(GLU), serum total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDLC) and uric acid(UA) level was significantly increased, while values of high density lipoprotein cholesterol(HDLC) level were decreased（P＜001). Whether the gender, in HUA group, BMI, WSR, GLU, TC, TG, LDLC and UA levels were significantly increased, and HDLC level was significantly decreased, and detection rates of NAFLD were significantly higher than NonHUA group(P＜001). Logistic regression analysis and area under the ROC curve showed that HUA level was an independent risk factor for NAFLD. Spearman′s correlation analyses showed a positive correlation between HUA and BMI, WSR, GLU, TC, TG, LDLC and negative correlation between HUA and HDLC. 
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓NAFLD is closely related to dyslipidemias. HUA is an independent risk factor for NAFLD.
    Analysis on the prognostic factors of the elder patients with spontaneous intracerebral hemorrhage in lingshui li autonomous county of Hainan island#br#
    FU Xiong1, WANG Peng2, BAO Wenjuan3, WANG Han1, ZHAO Zongmao2,4*
    2018, 38(8):  898-902.  doi:10.3969/j.issn.10073205.2018.08.008
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the influencing factors for the prognosis of spontaneous intracerebral hemorrhage in the elder patients in lingshui li autonomous county of Hainan island.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The medical records of the 40 old spontaneous intracerebral hemorrhage patients(≥70 years old) were reviewed for age, gender, etc. to analyze the risk factors of prognosis in elderly patients with spontaneous intracerebral hemorrhage.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The average survival time of patients aged <80 years was longer than that of patients aged ≥80 years. And the average survival time of patients with the hospitalized Glasgow Coma Scale（GCS） score 15 was longer than that of patients with the hospitalized GCS score <15. The average survival time of patients with the intracranial hematoma <40mL was longer than of patients with the intracranial hematoma ≥40 mL. Multivariate Cox regression analysis found that only the midline shift was an independent prognostic factor influencing survival. With the extension of time, the cumulative survival rate of elder patients with intracerebral hemorrhage without midline shift was significantly higher than those with midline shift.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The old intracerebral hemorrhage patients with midline shift often have worse prognosis. Only midline shift was an independent prognostic factor of patients with intracerebral hemorrhage.
    Human umbilical cord mesenchymal stem cells differentiation into neuronlike cells with Baicalin in vitro
    ZHAO Jiahui1， YAN Dongdong2， MA Dongjin3， NAN Chengrui2， LI Na4，ZHAO Zongmao2*
    2018, 38(8):  903-907.  doi:10.3969/j.issn.10073205.2018.08.009
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    ［Abstract］ Objective〖HTSS〗〓To investigate the effects of Baicalin on the differentiation of human umbilical cord mesenchymal stem cells(hUMSCs) into nerve cells.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The cultured P4 generation was selected as the study subjects and divided into four groups according to the drug administration:25 μg/mL group, 50 μg/mL group, 100 μg/mL group and control group. Cell morphology was observed dynamically, and the expression of neural stem cell marker, Nestin, astrocyte marker, glial fibrillary acid protein(GFAP), and neuronal marker, neuronspecific enolase(NSE) were detected by immunohistochemistry staining daily in each group. 
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The cultured P4 generation was selected as the study subjects and divided into four groups according to the drug administration: 25 μg/mL group, 50 μg/mL group, 100 μg/mL group and control group. Cell morphology was observed dynamically, and the expression of neural stem cell marker, Nestin, astrocyte marker, GFAP, and neuronal marker, NSE were detected by immunohistochemistry staining daily in each group.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Baicalin can induce HUMSCs differentiating into neurolike cells in vitro, and the expression of neural markers Nestin, NSE and GFAP showed an increasing tendency follow the concentration increasing in the range of 25-100 μg/mL of Baicalin.
    Clinical efficacy of combined digital technology and arthroscopy  in the treatment of acromion syndrome
    JIANG Shunwan, CHEN Dayu, MAI Qingchun
    2018, 38(8):  908-911.  doi:10.3969/j.issn.10073205.2018.08.010
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    ［Abstract］ Objective〖HTSS〗〓To investigate the effect of combined application of digital technology and arthroscopy in the treatment of acromion syndrome.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The hospitalized patients diagnosed as shoulderimpact syndrome were selected as the study subjects. The DICOM file of CT examination was used before operation to make threedimensional shape in digital software MIMICS 14.0, and it was necessary to simulate the arthroscopy operation for osteophytes. In addition to surgery, guiding surgery， preoperative and postoperative followup were performed using Visual Analogue Scale(VAS) score, University of California at Los Angeles(UCLA) rotator cuff score, and ConstantMurley Shoulder Joint(CMS) score for pain and functional assessment.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The VAS scores of 3 months after operation, 6 months after operation and 1 year after operation were lower than those before and 1 week after operation. The VAS scores of 6 months after operation and 1 year after operation were lower than 3 cases after operation. The differences were statistically significant(P＜005). The total UCLA score, pain score, functional score, flexion angle score and posterior flexion angle score were higher than those before surgery, and the difference was statistically significant(P＜005). Postoperative pain, daily living activities, active range of activity, and muscle strength were all higher than before surgery, and the difference was statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Acromion impingement syndrome is a common cause of shoulder pain and dysfunction. Arthroscopic osteophyte removal and acromioplasty are effective methods.
    Clinical analysis of limited laminectomy combined with pedicle screw fixation in the treatment of cervical spondylotic myelopathy#br#
    LI Zhiyuan,TIAN Jinhui, LIU Bingzhi, LI Xiaodong, MIAO Jie*, LIU Fajing
    2018, 38(8):  912-915.  doi:10.3969/j.issn.10073205.2018.08.011
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the clinical effects of limited laminectomy combined with pedicle screw fixation in the treatment of multilevel cervical spondylotic myelopathy(MCSM).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Thirtyfive cases of MCSM patients were accepted the procedure of limited laminectomy combined with pedicle screw fixation. The postoperative neurological recovery, cervical curvature index(CCI), axial symptoms and C5 nerve root paralysis were recorded and analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The operative time was(139.9±24.1) min with a blood loss of(285.9±51.3) mL. The width of laminectomy was(16.5±1.1) mm and the distance of spinal cord drift at C5 level was(2.8±0.3) mm. At 3 months and the last followup, the JOA score was significantly higher than that of preoperation(P＜005), and the neurological recovery rate at the final followup was(65.8±13.6)%. The CCI at the final followup was higher than preoperation(P＜005). There were 4 cases of axial symptoms(11.4%) and 2 cases C5 nerve root paralysis(5.7%) occurred.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Limited laminectomy combined with pedicle screw fixation not only can relieve spinal cord compression and promote neurologcial recovery, but also avoid the occurrence of cervical kyphosis and decrease the axial symptoms. Most of all, it can reduce the incidence of C5 nerve root paralysis.
    Selection of surgical methods for Brucellosis in lumbar spine and its clinical efficacy#br#
    LI Zhuo， YAO liming， ZHANG Helong， JIA Chenguang， WANG Lianbo， YAO Xiaowei*
    2018, 38(8):  916-920.  doi:10.3969/j.issn.10073205.2018.08.012
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    ［Abstract］ Objective〖HTSS〗〓To explore the choice of surgical methods for Brucellosis and analyze the therapeutic effects.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eightynine  patients with lacteal Brucellosis divided into two groups. In group A, fortynine  patients were treated with anterior debridement, bone graft fusion and internal fixation.In Group B, forty patients were selected for posterior fixation and anterior debridement and bone graft fusion. The operative time, intraoperative blood loss, hospitalization time, bone fusion time before and after surgery were recorded and compared. Visual Aanalogue Scale(VAS) score, Oswestry Disability Index(ODI) score and the American Spinal injury Assoeiation(ASIA) score were compared between the two groups before operation, one month after operation, and at the last followup. erythrocyte sedimentation rate and Cobb angle, Bridwell grading.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The blood loss in group A was less than that in group B. The operation time and length of hospital stay were shorter than those in group B.The  difference was statistically  significant(P＜005). There was no significant difference in bone fusion time between the two groups(P＞005) .The VAS scores and ODI scores of both groups showed a gradually decreasing trend, and the ASIA scores showed a gradually increasing trend. The differences between the two groups at the time points were statistically significant(P＜005). The interactions among groups, groups and time points were observed. The difference was not statistically significant (P＞005). There was no significant difference in bone graft fusion rate between the two groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓According to the degree of bone destruction of the lumbar spine and the range of abscesses, individualized surgical methods combined with standardized drugs for the treatment of lumbar Brucellosis can achieve satisfactory therapeutic effects.
    Effect of PKRP on prostate function and serum prostate specific antigen level in patients with BPH#br#
    LIU Longqiang1， BAI Ruyu1， WANG Feng2， LIU An1， HE Haibao1*
    2018, 38(8):  921-924,928.  doi:10.3969/j.issn.10073205.2018.08.013
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    ［Abstract］ Objective〖HTSS〗〓To explore the effect of plasma kinetic resection of prostate(PKRP) on prostate function and serum prostate specific antigen level in patients with benign prostatic hyperplasia(BPH).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 120 patients with BPH were selected and randomly divided into experimental group and control group. The experimental group was performed transurethral plasma kinetic resection of prostate, while the control group was treated with transurethral resection of prostate. The urethral function and sexual function were compared between the two groups before and after treatment: Urethral function included maximum urinary flow rate(Qmax), residual urine volume, maximum bladder volume and bladder pressure at the beginning of voiding; Sexual function included the International Index of Erectile Function5(IIEF5) and the proportion of people with retrograde ejaculation. Serum prostate specific antigen(PSA) levels were compared between the two groups before and after treatment.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After treatment, the Qmax in the experimental group was significantly higher than that in the control group, the residual urine volume and urinary bladder pressure at the beginning of urination were significantly lower than those in the control group(P＜005). After treatment, the IIEF5 score of the experimental group was significantly higher than that of the control group, the number of erectile dysfunction and the number of retrograde ejaculation was significantly lower than that of the control group(P＜005). After treatment, the PSA of two groups was first increased and then decreased. The observation group was lower than the control group. The differences between the two groups were statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓PKRP can effectively improve the postoperative urethral function and sexual function in patients with BPH, and 28 days after operation, the level of PSA in patients returned to normal. It is worthy of clinical application.
    Effect of OSAHS on urogenital system of the male NewZealand rabbit#br#
    ZHANG Tiejun1, LIU Xiaoying2, QIAO Xing3, LIU Chunyan3, KANG Wenjing3, LU Haiyan3*
    2018, 38(8):  925-928.  doi:10.3969/j.issn.10073205.2018.08.014
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    ［Abstract］〓Objective〖HTSS〗〓To set up the animal model of obstructive sleep apneahypopnea syndrome(OSAHS) in male NewZealand rabbit, and to observe the effect of the testis and the spermatozoa in cauda epididymis under OSAHS，so that to provide theoretical bases for the preventation of sterility caused by OSAHS.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Twenty male NewZealand white rabbits were randomly divided into two groups and ten rabbits in each. Two groups were obstructive sleep apneahypopnea syndrome group(group OSAHS) and control group. A total of 2 mL polyacrylamide hydrogel were injected into rabbit soft palate of group OSAHS to set up OSAHS animal models. After sleep for 8 weeks by dorsal position, all the animals were killed and the testis were observed  under the transmission electron microscope and the AX80 universal microscope. The left cauda epididymis was obtained to be observed the number, viability, motility rate and abnormal rate of spermatozoa. The SPSS 13.0 software was used to analyse. 〖HTH〗〖WTHZ〗Results〖HTSS〗〓Transmission electron microscope and the light microscope revealed that the spermatogenic cell, the seminiferous tubule and the spermatogenic epithelium were damaged in the group OSAHS. In OSAHS group animals, the number, viability rate and motility rate of spermatozoa in cauda epididymis were significantly decreased while the rate of teratospermia was increased(P＜0.05). The saturation of blood oxygen and the rate of teratospermia were negatively correlated by the correlation analysis.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The damage of spermatogenic cells and the decrease of the sperm quality were caused by hypoxia which was caused by OSAHS.
    Expression of Wip1 in ovarian serous cystadenocarcinoma tissues and its significance
    FENG Yanping1, GUO Wei1, LIU Jing2, ZHANG Hongzhen2*, CHENG Jianxin3
    2018, 38(8):  929-933,937.  doi:10.3969/j.issn.10073205.2018.08.015
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    ［Abstract］ Objective〖HTSS〗〓To explore expression of wildtype p53induced phosphatase 1(Wip1) in ovarian serous cystadenocarcinoma tissues and its relationship with clinicopathological features.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The positive expression of Wip1 as well as the expression of Wip1 mRNA and  Wip1 protein in ovarian serous cystadenocarcinoma tissues(n=50),ovarian serous cystadenoma tissues(n=20) and normal ovarian tissues(n=10) were detected by immunohistochemistry, realtime fluorescent quantitative reverse transcriptionpolymerase chain reaction(RTPCR) and Westernblot.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓 The expression of Wip1 was significantly higher in ovarian serous cystadenocarcinoma and borderline ovarian serous cystadenoma tissues than in normal ovarian tissues (P＜005). There was no significant difference in positive expression of Wip1  between ovarian serous cystadenocarcinoma tissues and  borderline ovarian serous cystadenoma tissues(P＞0.05). Wip1 mRNA expression in borderline ovarian serous cystadenoma  and ovarian serous cystadenocarcinoma tissues were highly increased, as compared with normal ovarian tissues,and the difference was significant (P＜005). The expressions of Wip1 protein were remarkably higher in ovarian serous cystadenocarcinoma and ovarian serous cystadenocarcinoma tissues than in normal ovarian tissues, and the difference was statistically significant (P＜005). The  positive expression of Wip1 in stage Ⅲ and Ⅳ of ovarian serous cystadenocarcinoma tissues was significantly higher than that in stageⅠandⅡ(P＜005). The positive expression of Wip1 was notably higher in groups with lymph node metastasis, as compared with groups without lymph node metastasis(P＜005). There was no significant difference in the positive expression of Wip1 in carcinomas of different histological grades(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Wip1 is highly expressed in ovarian serous cystadenocarcinoma,which is closely associated with lymph node metastasis, clinical staging and histological grade. It is suggested that Wip1 is involved in the development and progression of ovarian serous cystadenocarcinoma.
    Effect of early stage in gestational diabetes mellitus on expression levels of Nesfatin1, IL6, TNFα and APN
    JIANG Haiying, LI jing, YANG Lili, ZUO Jinling, CAO Shuxin
    2018, 38(8):  934-937.  doi:10.3969/j.issn.10073205.2018.08.016
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    ［Abstract］ Objective〖HTSS〗〓To observe the effects of early stage in gestational diabetes mellitus on expression levels of Nesfatin1 , interleukin6(IL6), tumor necrosis factorα(TNFα) and adiponectin(APN).
     〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Followup method have been used in this trail,all the subjects were chosen from pregnant women who accepted health care in our hospital, a total of 103 cases, which means all the subjects were pregnant for 24 weeks,and at this moment, 75 grams of glucose tolerance screening tests were applied to them, abnormality has been examined .The normal control group was selected from the volunteers who had no abnormalities during the same period, 56 cases were included. The general conditions of the 2 groups(including age, height, weight, pregnancy test time), serum Nesfatin1 and APN, IL6, TNFα inflammatory factors in the early pregnancy were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no significant difference in the age, height, weight, pregnancy examination time and other signs between the experiment group and the control group(P＞0.05). The levels of serum Nesfatin1 and IL6 and TNFα in the experimental group were higher than those in the control group at the early stage of pregnancy, while APN was lower than that in the control group, the differences were statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The detection of inflammatory factors such as serum Nesfatin1 and APN, IL6 and TNFα levels in early pregnancy can play an early role in predicting gestational diabetes mellitus. Early intervention on gestational diabetes mellitus can reduce the incidence of maternal and infant complications.
    Effect and prognosis analysis of VM and VEGF on PLN metastasis in endometrial carcinoma#br#
    LI Meiyan
    2018, 38(8):  938-942.  doi:10.3969/j.issn.10073205.2018.08.017
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    ［Abstract］ Objective〖HTSS〗〓To investigate the relationship between vasculogenic mimicry(VM) and vascular endothelial growth factor(VEGF) expression in endometrial carcinoma(EC) and their relationship with pelvic lymph node (PLN), and to analyze the risk factors of PLN metastasis and prognostic factors in EC patients.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 197 confirmed cases of EC were selected. The correlation between VM and VEGF protein expression and PLN metastasis were analyzed by Spearman method. KaplanMeier method was used for univariate survival analysis. Nonconditional logistic regression analysis was used to analyze the risk factors of PLN metastasis in EC. Regression models were used to analyze EC prognosis.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Univariate analysis of PLN metastasis in patients with EC showed that surgical pathology staging, histological grade, depth of myometrial invasion, histological type and VM positive were the significant factors affecting PLN metastasis. Multivariate Logistic regression analysis showed that surgical pathological staging, histological grade, depth of myometrial invasion, histological type and VM positive were the risk factors influencing PLN metastasis. The positive expression of VEGF was positively correlated with VM positive expression(r=0293, P=0000). The VM positive expression was positively correlated with PLN metastasis(r=0221, P=0.002). The positive expression of VEGF protein had no significant correlation with PLN metastasis(P＞005). The positive expression of VM and VEGF and PLN metastasis were all the significant prognostic factors of EC.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The positive expression of VEGF protein was positively correlated with VM positive, VM positive was positively correlated with PLN metastasis. The three were the risk factors for poor prognosis in EC patients.
    Comparison of carbapenem inactivation method and modified carbapenem inactivation method for screening of carbapenemaseproducing Enterobacteriaceae#br#
    MA Yulan1,2, SONG Wenjie1, LIANG Yi3, LI Jihong1, FAN Shiying1, SHI Dongyan1*
    2018, 38(8):  943-948.  doi:10.3969/j.issn.10073205.2018.08.018
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    ［Abstract］ Objective〖HTSS〗〓To evaluate the screening capacity of carbapenem inactivation method (CIM) and modified carbapenem inactivation method (mCIM) for phenotypic carbapenemase activity in Enterobacteriaceae bacteria.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 110 isolates of carbapenemresistant Enterobacteriaceae and 25 isolates of carbapenemsensitive Enterobacteriaceae were selected, and carbapenemase activity were determined by the CIM and mCIM, respectively. Meanwhile，the carbapenemase genes such as KPC2, NDM1, IMP4,VIM1 and OXA48 were detected by PCR. The examination results were analyzed statistically.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Of the 110 carbapenemresistant Enterobacteriaceae strains，99 strains were positive detected by PCR, including 77 strains for KPC2, 15 strains for NDM1, 2 strains for both KPC2 and NDM1, 4 strains for IMP4, and 1 strain for VIM1. The strain carring OXA48 gene was not detected. Twentyfive carbapenemsensitive strains were all negative. For CIM, the sensitivity is 87.9% and the specificity is 94.4%. For mCIM, the sensitivity is 95.0% and the specificity is 91.7%. In order to compare the effects of the diameter of bacteriostasis ring on the experimental results, the CIM negative strains were divided into two groups, carbapenemresistant gene positive group and carbapenemresistant gene negative group. The bacteriostasis diameter of the carbapenemresistant gene positive group was significantly lower than that of the gene negative group, and the difference was statistically significant（P＜001）.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓After the optimization of the experimental procedure and the interpretation criteria of the results, the mCIM not only retained the advantages of low cost, simple operation, high sensitivity and good specificity, but the screening ability of carbapenemases had also been significantly improved. mCIM should be a convenient, costsaving and efficient phenotypic screening method.
    Distribution and drug resistance analysis of 698 strains of bloodstream infection pathogens#br#
    TIAN Ruiqing1， SHI Yankui2， CHEN Aidi1， WANG Weihong1， YANG Shengchun1， MENG Qingcai1
    2018, 38(8):  949-953.  doi:10.3969/j.issn.10073205.2018.08.019
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    ［Abstract］ Objective〖HTSS〗〓To analyze the distribution characteristics and drug resistance of pathogens in patients with bloodstream infection from Baoding NO.1 Hospital, and to provide reference for selecting effective antibiotics to treat infection.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Blood culture results from Baoding NO.1 Hospital on 2014-2016 were analyzed, the isolated pathogens were collected using VITEK2 Compact automatic microbial analysis system for bacteria identification and antimicrobial susecptibility test, and the results were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓A total of 698 strains were isolated from 5 020 blood samples, the positive rate was 13.90%, including 417 strains of gramnegative bacillus, accounted for 59.74%, with Escherichia coli and Klebsiella pneumonia, and 221 strains of grampositive coccus, accounted for 31.66% of coagulase negative staphylococci. Higher blood culture positive rate was followed by digestive medicine, urology and ICU. Escherichia coli and Klebsiella pneumoniae showed relatively low resistants to piperacillin/tazobactam, cefotetan, Amikacin, imipenem and meropenem.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Escherichia coli and Klebsiella pneumoniae of gramnegative bacillus are the main pathogenic bacteria in patients with bloodstream infection from Baoding NO.1 Hospital. Coagulase negative staphylococcus separation rate is higher, clinicians should pay attention to blood culture specimens and bacterial drug resistance monitoring, and to use antibiotics rationally for delaying the generation of drugresistant strains.