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Table of Content

    25 February 2019, Volume 40 Issue 2
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    Study on changes of electroencephalogram interphase discharge and the clinical efficacy of levetiracetam in generalized seizures
    DU Yakun, FENG Zonghuai, WANG Lihui, ZAHNG Jing， ZHANG Xiaoqing, ZHENG Huacheng*
    2019, 40(2):  133-136,140.  doi:10.3969/j.issn.10073205.2019.02.003
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    ［Abstract］〓Objective〖HTSS〗〓To compare the effects of  the sodium valproate(VPA) and levetiracetam(LEV) monotherapy on the changes of electroencephalogram(EEG) interphase discharge quantity and the clinical effect in generalized seizures.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 140 cases of various generalized epilepsy children were selected andrandomly and were divided into control group and observation group, 70 cases in each group. Control group was treated with sodium valproate. The observation group was treated with levetiracetam. The changes of EEG epileptiform discharge, seizure control and safety before and after treatment were compared between the two groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After treatment, the change of EEG in the observation group was better than that in the control group, and the proportion of interictal epileptiform activity(IEA) disappearing or decreasing by more than 50% was higher than that in the control group（P＜005).The clinical efficacy of the observation group was better than that of the control group, and the difference was statistically significant（P＜005), while the total effective rate of the two groups was not statistically significant（P＞005).There was no statistically significant difference in the incidence of adverse reactions between the two groups（P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓LEV is effective in the treatment of all types of children with generalized epileptic seizures. It has significant effect in improving IEA, low incidence of adverse reactions and good safety.
    Relationship between intracranial pressure and the changes of serum NSE and S100B protein in patients with massive cerebral infarction#br#
    QU Zheng, SHI Qiuyan*, WANG Cuilan, SUN Yuan, FAN Yaxia
    2019, 40(2):  137-140.  doi:10.3969/j.issn.10073205.2019.02.004
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    ［Abstract］ Objective〖HTSS〗〓To analyze the relationship between the changes of intracranial pressure in patients with massive acute cerebral infarction and the changes of serum neuron specific enolase neuronspecific enolase（NSE） and S100B protein.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Thirty patients with large area cerebral infarction who met the criteria were selected, and noninvasive intracranial pressure monitor was used to monitor intracranial pressure. Dynamic monitoring of intracranial pressure was performed on patients who met the criteria within 24 h after admission, 3 days after onset, 5 days after onset, and 7 days after onset. The application of enzyme linked immunosorbent assay in monitoring the protein level of S100B protein and serum NSE, and compared with 30 healthy people(control group), the serum level of NSE and S100B protein subtype and the intracranial pressure were made for the content correlation analysis.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The intracranial pressure, specific enolase and serum S100B protein in the case group were significantly higher than those in the control group within 24 h after onset. The difference was statistically significant(P＜005). In the case group,after the onset of 3 d, 5 d, 7 d of the intracranial pressure, the specific enolase and serum S100B protein were higher than the admission of 24 h, and began to decline on the 7 days after admission, but still higher than admission for 24 h.The difference was statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The changes of intracranial pressure in patients with massive cerebral infarction accompanied by changes in serum NSE and S100B protein levels can reflect the changes of intracranial pressure indirectly by measuring the changes of serum NSE and S100B protein levels，expecting to become a certain reference value for clinical evaluation of the severity and prognosis of the disease.
    Effect analysis of early interventional treatment for cerebral aneurysms
    GUO Yong1， YANG Qin2*，ZHANG Bo3， LI Weifeng2， LIU Yilong4
    2019, 40(2):  141-143.  doi:10.3969/j.issn.10073205.2019.02.005
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    ［Abstract］〓Objective〖HTSS〗〓To study the clinical effect of early interventional therapy for cerebral aneurysms.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixtyeight patients with cerebral aneurysm were selected. The standard for the group was to receive interventional embolization within 3 days，and the 68 patients were divided into early group（32 cases） and late group（36 cases）. The incidence of postoperative cerebral vasospasm, modified Rankin Scale(mRS) score, incidence of cerebral infarction within 30 days after operation, the length of stay and hospital costs were compared between the two groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The incidence of cerebral vasospasm in the early group , mRS score and cerebral infarction 30 days after surgery in the early group were significantly lower than that in the late group. The length of hospitalization was shorter than that in the late group, and the  hospitalization cost was lower than that in the late group，the difference was statistically significant(P＜005) .
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The effect of early interventional therapy in patients with cerebral aneurysm rupture and hemorrhage is significant, the incidence of complications is low, the length of hospital stay and the cost of hospital stay are reduced, which is worthy of promotion and application.
    The clinical observation of postprandial hypotension in patients with obesity or overweight and coronary heart disease#br#
    ZHANG Yanan1, PANG YAxiang2, CHEN Tianlei3, GU Guoqiang1, XIE Ruiqing1, CUI Wei1*
    2019, 40(2):  144-148.  doi:10.3969/j.issn.10073205.2019.02.006
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    ［Abstract］ Objective〖HTSS〗〓To investigate the incidence rate, clinical features, risk factors and adverse events during hospitalization and midterm prognosis for postprandial hypotension(PPH) in obesity or overweight patients with coronary heart disease(CHD).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 152 obesity or overweight patients with CHD were selected as the subjects. The blood pressure of patients were monitored by 24 hour ambulatory blood pressure monitor. Subjects were classified into PPH group(n=37) and nonPPH group(NPPH, n=115) according according to PPH diagnostic criteriae. The clinical characteristics of the two groups were compared and the risk factors of PPH, the incidence rate of adverse events and the prognosis of allcause death, cardiovascular and cerebrovascular adverse events were studied.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Among 152 obese or overweight patients with CHD, 37 cases had PPH, the incidence was 24.3%. The proportion of combined with hypertension and taking calcium antagonists in PPH group was higher than that of NPPH group. The incidence rate of PPH at breakfast and dinner was higher than that at lunch. Logistic regression analysis showed that high systolic blood pressure level and oral diuretics were positively correlated with the occurrence of PPH. There was no significant difference in the incidence rate of cardiovascular and cerebrovascular events between the two groups during hospitalization. The 26month followup showed that the incidence of allcause mortality in PPH group was higher than that in NPPH group.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The incidence rate of PPH in obese or overweight patients with CHD was 24.3%. PPH might be likely to occur after breakfast and dinner. High systolic blood pressure and oral diuretics might increase the incidence rate of PPH, and PPH might increase the midterm allcause mortality.
    Analysis of risk factors about reduced atorvastatin compliance in patients with cerebral infarction secondary prevention#br#
    CHEN Mei1, GUO Mingsheng2*, LIU Juan2, WU Hua3, MA Puhong4
    2019, 40(2):  149-152.  doi:10.3969/j.issn.10073205.2019.02.007
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the risk factors about reduced atorvastatin compliance in patients with cerebral infarction secondary prevention.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 546 patients with acute cerebral infarction were followed up for 3 months. All patients were divided into two groups according to the decrease of atorvastatin compliance or not. The following factors were compared between the two groups, including sex, age, neurological function, the number of patients with different daily doses of atorvastatin and incidence of following subjective causes, included economic problems, substitution of traditional Chinese medicine, abnormal guidance, forgetting and misunderstandings, adverse reactions and lack of confidence. Risk factors of reduced compliance of atorvastatin in patients with secondary prevention of cerebral infarction were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓At the end of the investigation, 21 patients lost their visits and 525 patients completed the study, among which 281 patients (53.5%) had decrease of atorvastatin compliance. There was no significant difference on sex, age, neurological function and the number of patients with different daily doses of atorvastatin between two groups(P＞005). The incidence of economic problems, substitution of traditional Chinese medicine, abnormal guidance, forgetting and misunderstandings, adverse reactions and lack of confidence in the decrease of atorvastatin compliance group were significantly higher than those in the not decrease of atorvastatin compliance group(P＜005). Economic problems, substitution of traditional Chinese medicine, abnormal guidance, forgetting and misunderstandings, adverse reactions and lack of confidence were the risk factors about reduced atorvastatin compliance by multivariate Logistic regression analysis. 
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Taking effective measures against the above subjective causes may reduce or even eliminate the decrease of atorvastatin compliance during the secondary prevention of cerebral infarction.
    Comparison of the effect of prucalopride and itopride on bowel preparation in patients with chronic constipation
    JI Chenguang, LIU Gaifang, WU Jing, MENG Xia, ZHU Xinying, YANG Liang
    2019, 40(2):  153-155,160.  doi:10.3969/j.issn.10073205.2019.02.008
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    ［Abstract］〓Objective〖HTSS〗〓To compare the effect of prucalopride and itopride combined with polyethylene glycol electrolyte in bowel preparation before colonoscopy.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Totally 160 chronic constipation patients scheduled for colonoscopy were randomly divided into prucalopride and itopride groups, 80 cases in each group. Patients in prucalopride group started taking prucalopride 2 mg per day three days before colonoscopy, and taking the polyethylene glycol electrolyte on the day of colonoscopy；patients in itopride group started taking itopride 50 mg 3 times per day three days before colonoscopy, and taking the polyethylene glycol electrolyte on the day of colonoscopy. The bowel preparation quality, polyp detection rate, time of reaching the ileocecal junction and adverse reactions were compared between the two groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The Boston Bowel Preparation Scale score of the bowel preparation quality and the polyp detection rate of the prucaropride group were higher than that of the itopride group, and the time of reaching the ileocecal group was shorter than that of the itopride group, there was a statistical differences in the two groups(P＜005). There was no significant difference in the incidence rate of adverse reaction between the two groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The effect of prucalopride combined with polyethylene glycol electrolyte for colonscopy preparation is better than itopride combined with polyethylene glycol electrolyte.
    The effects of liraglutide on cognitive function, Urine albumincreatinine ratio and podocalyxin in patients with type 2 diabetic mild cognitive impairment#br#
    LIU Fan, YANG Aige*, DONG Shanshan, KANG Yan, JIA Xinju, ZHOU Huimin
    2019, 40(2):  156-160.  doi:10.3969/j.issn.10073205.2019.02.009
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    ［Abstract］〓Objective〖HTSS〗〓To explore the effects of liraglutide on score of Montreal Cognitive Assessment(MoCA), urine albumincreatinine ratio(ACR) and urinary podocalyxin(PCX) in patients with type 2 diabetic mild cognitive impairment.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓 Eighty patients with type 2 diabetic mild cognitive impairment were collected and randomly divided into control group(n=40) and liraglutide group(n=40). Premixed insulin was administrated in control group for 24 weeks while liraglutide in liraglutide group. The systolic blood pressure(SBP), diastolic blood pressure(DBP), hemoglobin A1c(HbA1c), fasting plasma glucose(FPG), total cholesterol(TC), triglyceride(TG), urine ACR and urine PCX of were measured and compared before the treatment and 24 weeks after the treatment. Patients cognitive function was assessed by MoCA.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There were no significant difference in FBG, HbA1c, SBP, DBP, TG, and TC between two groups before the treatment and 24 weeks after the treatment, while there was no significant change in FBG, HbA1c, SBP, DBP, TG, and TC after the treatment in the two groups(P＞005). Before the treatment, there were no significant difference in the core of MoCA, urine ACR and PCX between two groups(P＞0.05). After the treatment, there were no significant change in the core of MoCA, urine ACR and PCX as compared with that before treatment in control group(P＞0.05), while the core of MoCA in liraglutide group were significantly higher(P＜005) and urine ACR and PCX lower than that before treatment(P＜005). At 24 weeks after the treatment, the core of MoCA in liraglutide group was significant higher （P＜005）and urine ACR and PCX were significant lower than that of control group（P＜005）.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Liraglutide maybe improve cognitive function and reduce urine ACR and PCX in patients with type 2 diabetic mild cognitive impairment.
    Analysis of the relationship between the electrophysiological indexes and the classification of diabetic peripheral neuropathy#br#
    QI Yanyan
    2019, 40(2):  161-164,168.  doi:10.3969/j.issn.10073205.2019.02.010
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the correlation between neurophysiological parameters and the classification of diabetic peripheral neuropathy(DPN).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 90 patients with DPN were selected as the observation group, and 90 healthy subjects were used as the control group. The motor nerve conduction velocity, distal latency and amplitude were measured. The sympathetic skin response(SSR), upper limb somatosensory evoked potential(SEP) and lower limb SEP abnormalities were recorded. The DPN grading situation was determined and the correlation between disease grading and neurophysiological indicators was analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The motor nerve conduction velocity and amplitude of the observation group were significantly lower than those of the control group. The abnormal rate of distal latency, SSR, upper limb SEP and lower limb SEP was significantly higher than that of the control group(P＜005). Among the 90 patients with DPN, 45 patients were grade Ⅰ, 20 patients were grade Ⅱ, 15 patients  were grade Ⅲ, and 10 patients  were grade Ⅳ. With the aggravation of DPN, the motor nerve conduction velocity and amplitude were significantly reduced, and the abnormal rates of distal latency, SSR, upper limb SEP and lower limb SEP were significantly increased(P＜005). The grade of DPN were negatively correlated with motor nerve conduction velocity and amplitude, and were positively correlated with distal latency, SSR, upper limb SEP and lower limb SEP(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The application of neurophysiological indicators in patients with DNP can improve the diagnosis rate of DPN, reflect the patient's condition and contribute to the early detection and treatment of DPN.
    Clinical application of laparoscopic cholecystectomy for elder patients with acute suppurative cholecystitis#br#
    LIU Xueqing, QIN Jianzhang, XING Zhongqiang, DUAN Jiayue, FENG Feng, LIU Jianhua*
    2019, 40(2):  165-168.  doi:10.3969/j.issn.10073205.2019.02.011
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    〗［Abstract］ Objective〖HTSS〗〓To evaluate the feasibility and safety of laparoscopic cholecystectomy(LC) for elder patients(age>60 years) with acute suppurative cholecystitis(ASC).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical data of 286 elder patients with acute suppurative cholecystitis were extracted and analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Of 285 patients undergoing total laparoscopic surgery, 267 patients received LC and the other 18 patients had cholecystostomy or subtotal cholecystectomy. Conversion occurred in only 1 patient and all 286 patients survived. The mean operative time, intraoperative blood loss, and hospital stay were(84.68±29.18) min, (83.56±43.10) mL, and(9.25±3.07) days, respectively. No jaundice, abdominal pain, fever or other complications occurred during the postoperative 6 months follow up period.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓LC is safe and feasible for elder patients with ASC and should be performed extensively in clinical practice.
    Clinical efficacy of plasma electroresection and laser vaporization in the treatment of benign prostatic hyperplasia and their influence on IPSS, QOL, Qmax and PVR
    WANG Jing1, SHI Shaoxian1, HE Xueqiang1, LI Haitao1, DUAN Xiaoliang2, SUN Bo3
    2019, 40(2):  169-173.  doi:10.3969/j.issn.10073205.2019.02.012
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the clinical efficacy of plasma electroresection and laser vaporization in the treatment of benign prostatic hyperplasia and their influence on international prostate symptom score(IPSS),quality of life(QOL),maximum urine flow rate(Qmax) and postvoid residual volume(PVR).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 78 patients with benign prostatic hyperplasia who underwent surgical resection were analyzed retrospectively. Among them, 43 patients treated with transurethral plasmakinetic bipolar resection were labeled as electroresection group and 35 patients treated with 1 470 nm semiconductor laser vaporization were labeled as laser groups. The clinical efficacy, intraoperative hemoglobin(HB) falling value, blood sodium falling value, bladder irrigation time, operation time, indwelling catheter time and hospitalization time of the two groups were compared.IPSS, QOL, Qmax and PVR before and after treatment and complications such as intraoperative and postoperative bleeding, secondary bleedingand transurethral resection syndrome were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no statistically significant difference in clinical efficacy and total effective rate between two groups(P＞005). The HB falling value and blood sodium falling value in laser group were significantly lower than those in electroresection group, bladder irrigation time, indwelling catheter time and hospitalization time were significantly shorter than those in electroresection group, and the operation time was significantly longer than that in electroresection group(P＜005). Before treatment, there was no significant difference in IPSS, QOL, Qmax and PVR between two groups(P＞005). After treatment, IPSS, QOL, PVR in the two groups were significantly lower than that before treatment. Qmax was significantly higher than that before treatment, and the difference was statistically significant(P＜005). However, there was no significant difference in IPSS, QOL, Qmax and PVR between two groups(P＞005). There was no significant difference in the incidence of adverse reactions between two groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Both 1 470 nm semiconductor laser vaporization treatment and transurethral plasmakinetic bipolar resection treatment have significant clinical effects in the treatment of benign prostatic hyperplasia, they can effectively improve the patient′s IPSS, QOL, Qmax and PVR, transurethral plasmakinetic bipolar resection treatment is with shorter operation time, 1 470 nm semiconductor laser vaporization treatment is with less bleeding.
    Clinical evaluation of locking plate in the treatment of Diepunch fracture of the distal radius
    ZHANG Jiangtao1，2， ZHANG Xiong1， ZHOU Yanqing1， ZHANG Bing1*
    2019, 40(2):  174-177.  doi:10.3969/j.issn.10073205.2019.02.013
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    〗［Abstract］〓Objective〖HTSS〗〓To investigate the preliminary results of locking plate in the treatment of Diepunch fracture of the distal radius.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Twentyeight patients were enrolled in this study . Surgical duration, intraoperative blood loss, incision length, postoperative hospital stay and the other index were recorded. Visual analogue scale（VAS） score, Disabilites of the Arm, Shoulder,and Hand（DASH） score, Sarmiento Colles score were performed to evaluate clinical results of these patients.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The mean time of surgical duration, intraoperative blood loss, incision length, postoperative hospital stay and DASH score of the 28 Diepunch fracture patients who were treated by locking plate therapy were(64.35±12.16) min， (51.68±891) mL， (8.28±1.36) cm， (6.87±1.47) d， respectively. During a 3month followup, VAS score(0.68±0.72) and DASH score(5.86±7.38) showed excellent wrist function in 22 cases, good wrist function in 4 cases, fair wrist function in 1 case and poor wrist function in 1 case, with an excellent and good rate of 92.86 %.There was no significant difference in scores of functional status among dorsal type, palmar type and longitudinal split type（P＞0.05）.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Locking plate can ensure the biomechanical stability required for Diepunch fractures, and the good function of the wrist can restore after postoperative functional exercise.
    Therapeutic effect of drug coated balloon in the treatment of lower extremity arteriosclerosis obliterans#br#
    ZHANG Jun， LIN Ruimin， LIU Jun， CHEN Zhan， ZHANG Zaixing， OU Yunsong
    2019, 40(2):  178-180,197.  doi:10.3969/j.issn.10073205.2019.02.014
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    ［Abstract］ Objective〖HTSS〗〓To evaluate the safety and efficacy of drug coated balloon(DCB) in the treatment of arteriosclerosis obliterans of lower extremities.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 94 cases of lower extremity arteriosclerosis obliterans were randomly divided into 2 groups, 46 cases in the control group treated with conventional balloon dilatation plus stenting, 48 cases in the treatment group expanded by Medtronic Inc DCB balloon, and stent plasty was given when necessary. The patients were followed up for 6 months and 12 months after the operation to compare the late vascular lumen loss in the 2 groups. The late lumen loss, restenosis rate, revascularization rate and incidence of malignant events were compared between the 2 groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After 6 months of followup, the loss of advanced vascular lumen in the treatment group was less than that of the control group. The difference was statistically significant(P＜005), and there was no significant difference in the restenosis rate, revascularization rate and the incidence of malignant events between the 2 groups(P＞005). After 12 months of followup, the loss of advanced vascular lumen in the treatment group was less than that of the control group. The restenosis rate of the treatment group was less than that of the control group, the difference was statistically significant(P＜005), but the revascularization rate and the incidence of malignant events in the 2 groups were not statistically significant(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓DCB balloon has a good longterm effect in the treatment of arteriosclerotic occlusive disease of the lower extremities. It can obviously reduce the loss of vascular lumen and restenosis rate at 12 months after operation.
    The effect of resuscitation of traumatic hemorrhagic shock with different fluid resuscitation and its effect on immune function and electrolyte level
    TU Pan
    2019, 40(2):  181-184.  doi:10.3969/j.issn.10073205.2019.02.015
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    ［Abstract］〓Objective〖HTSS〗〓To analyze the rescue effect of different fluid resuscitation on traumatic hemorrhagic shock and its influence on immune function and electrolyte level.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and twenty patients with traumatic hemorrhagic shock were randomly divided into limited group(40 cases treated with limited fluid resuscitation), hypertonic saline group(40 cases treated with hypertonic saline resuscitation) and conventional group(40 cases treated with conventional fluid resuscitation). The rescue effect(mortality within 24 h and mortality within 7 d), electrolyte level(concentration of K+, Na+, Cl-, Mg2+), coagulation function(prothrombin time, activation time of partial thromboplastin), complication rate and average infusion volume were compared among the three groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no significant difference in 7day mortality and complication rates between the restricted group and the hypertonic saline group(P＜005). Prothrombin time and activated partial thromboplastin time in the restricted group and the hypertonic saline group were shorter than those in the conventional group, and the infusion volume was less than that in the conventional group(P＜005). There was no significant difference in electrolyte levels between the three groups before and after resuscitation(P＞005). After resuscitation, the levels of K+ and Mg2+ in the three groups were lower than those before resuscitation, and the Na+ levels in the restricted group and the hypertonic saline group were higher than those before resuscitation, with a statistically significant difference(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Limiting group and hyperosmotic salt group can actively improve coagulation function and reduce the incidence of complications compared with the conventional group in the treatment of traumatic hemorrhagic shock.
    The clinical outcomes and preventive measures of penetrating rupture of pregnancy uterus in 22 cases#br#
    WANG Chengshu, YAN Lu, HUANG Xianghua*, JIA Wen
    2019, 40(2):  185-187,192.  doi:10.3969/j.issn.10073205.2019.02.016
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    ［Abstract］ Objective〖HTSS〗〓To investigate the causes and prevention of uterine rupture during pregnancy.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Clinical data of 22 patients with penetrating rupture of pregnancy uterus were analyzed retrospectively.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The incidence of penetrating rupture of pregnancy uterus was 0.086%(22/25707). The causes of uterine rupture included a history of miscarriage, history of uterine surgery(including the history of cesarean section) and its defect healing, unreasonable application of drug induced labor and productive force, which often give rise to fetal distress, fetal death, blood loss, uterine loss and so on.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The risk of uterine rupture should not be ignored among pregnancy women with the history of abortion, multipara, advanced age when more attention is paid to uterine rupture of pregnancy women with the history of cesarean section.
    The correlation between corrected coronary opacification measurement with 256slice spiral CT and coronary artery stenosis, plaque load and clinical prognosis in patients with coronary heart disease#br#
    YAN Liqun, KANG Jianli, WANG Guoshi, WANG Wenyan, MU Xiaodan, DONG Qianbo
    2019, 40(2):  188-192.  doi:10.3969/j.issn.10073205.2019.02.017
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    ［Abstract］ Objective〖HTSS〗〓To study the value of coronary artery corrected contrast medium concentration(CCO) in evaluating coronary stenosis, coronary plaque load and clinical prognosis in patients with coronary heart disease by spiral CT.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Two hundred and five patients with coronary artery disease with stenosis of left anterior descending artery were enrolled in this study. All of them had TIMI score and underwent coronary CT imaging with 256slice spiral CT. The CCO values in the anterior and posterior lumen of coronary artery stenosis and the CCO differences before and after the stenosis were measured by CT imaging workstation. Three acyl glycerol, total bilirubin, gamma glutamyl transferase, total cholesterol, high density lipoprotein cholesterol, uric acid, glycosylated hemoglobin, low density lipoprotein cholesterol, apolipoprotein A, apolipoprotein B, apolipoprotein a, coronary arteriongraphy, homocysteine were detected in all patients. Patients underwent coronary angiography and intravascular ultrasound. Multivariate regression analysis was used to analyze the correlation between CCO difference, coronary arteriongraphy（CAG） coronary stenosis rate, intravenous ultrasound(IVUS) stenosis rate, plaque burden measured by IVUS and TIMI score.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The correlation coefficients between CCO difference, CAGmeasured coronary stenosis rate, IVUS stenosis rate, IVUSmeasured plaque load and TIMI score were 0.646, 0.464, 0.656 and 0.722 respectively. The determination coefficients of CAGmeasured coronary stenosis rate, IVUS stenosis rate, IVUSmeasured plaque load and TIMI score and CCO difference were 0.537 by multivariate linear regression analysis.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓CCO difference has a good correlation with coronary artery stenosis, plaque load and coronary artery intraluminal hemodynamics in patients with coronary heart disease. It may become a new rapid, noninvasive and convenient evaluation index of coronary heart disease.
    Effect of dualinjection on coracoid approach brachial plexus block guided by nerve stimulator：compared with singleinjection 
    HE Wensheng1, ZU Lingjie2, YANG Xiaochun1*, SUN Haijun1, WU Zhenyu1
    2019, 40(2):  193-197.  doi:10.3969/j.issn.10073205.2019.02.018
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    ［Abstract］〓Objective〖HTSS〗〓To observe the effect of dualinjection on coracoid approach brachial plexus block guided by nerve stimulator for upper extremity surgery.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eighty patients ASA classⅠ-Ⅱscheduled for surgery in elbow,forearm,wrist or hand were randomly divided into two group: dualinjection group(group D) and singleinjection group(group S), 40 patients in each group. All cases were received coracoid approach brachial plexus block guided by nerve stimulator. 40 mL 0.375% ropivacaine was injected after evoking one target muscle movement in group S. While two different muscle movements need to be evoke in group D. Sensory block and motor block was evaluated every 5 minutes after injection of the local anesthetic. The time required to complete the block, success rate and complications were also tanked notes.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The sensory block and motor block onset time in group D was significantly shorter than that in group S(P＜005) . The sensory block onset time for ulnar nerve and radial nerve in group D was significantly shorter than that in group S(P＜005). The motor block onset time for radial nerve in group D were significantly shorter than that in group S(P＜005). The success rate in group D was significantly higher than that in group S(P＜005) . The time required to complete the block in group D was longer than that in group S(P＜005). No significant complications occurred in the two groups.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Dualinjection technique can shorten sensory block and motor block onset time and increase block effect without increasing the complications for coracoid approach brachial plexus block. But it requires longer time to complete the block.
    Role of TLR4MMP2/MMP9 signaling pathway in apoptosis of human umbilical vein endothelial cells induced by oxygenglucose deprivationreoxygenation#br#
    LIU Linlin1, WEI Haiting2, GUO Jifeng2, REN Feng3
    2019, 40(2):  198-202.  doi:10.3969/j.issn.10073205.2019.02.019
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    ［Abstract］ Objective〖HTSS〗〓To explore the effects of Toll like receptor 4(TLR4)matrix metalloprotein2(MMP2)/matrix metalloprotein9(MMP9) signal pathway on apoptosis of human umbilical vein endothelial(HUVEC) induced by oxygenglucose deprivation/resuscitation.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓In vitro, HUVEC12 cells which was exposed to oxygen and glucose(OGD) for 6 h and 〖JP2〗reperfusion for 24 h were divided into 4 groups: control(C) group, OGD/R(O) group, TAK242+〖JP〗OGD/R(TO) group, CCT+OGD/R(MO) group. Before OGD exposure, the cultures in TO and MO groups were treated with TLR4 inhibitor TAK242(10 μmol/mL) or MMP2/MMP9 inhibitor CCT(200 μg/mL), respectively. The effects of apoptosis and viability were assessed by Annexin VFITC/PI and MTT assays. The resistance and permeability were assessed by Transwell assay. The levels of TNFα and IL1β were assessed by ELISA. The expressions of MMP2 and MMP9 were assessed by western blot measurement.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with group C, the apoptosis rate and glucanFITC fluorescence intensity of HUVEC12 cells in group O, TO and MO increased, while the survival rate and resistance decreased, and the expression levels of TNFa, IL1β, MMP2 and MMP9 increased(P＜005). Compared with O group, the apoptosis rate and fluorescence intensity of glucanFITC in TO group decreased, the survival rate and resistance increased, and the expression levels of TNFα, IL1β, MMP2 and MMP9 decreased(P＜005). Compared with group O, the apoptosis rate of HUVEC12 cells and the fluorescence intensity of dextranFITC in MO group were decreased, the survival rate and resistance value were increased, and the expression of TNFα and IL1β in water skin was decreased(P＜005). Compared with TO group, the apoptosis rate of HUVEC12 cells and the fluorescence intensity of dextranFITC in MO group increased, the survival rate and resistance value decreased, and the expression of TNFα, IL1β, MMP2 and MMP9 in the water skin increased(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Apoptosis of HUVEC12 cells induced by oxygenglucose deprivationreoxygenation may be related to activation of TLR4MMP2/MMP9 signaling pathway.
    Analysis of varied trend of HIV infection for blood donors in Shijiazhuang
    WANG Suling1, WANG Qie2*, MA Haimin3
    2019, 40(2):  203-207.  doi:10.3969/j.issn.10073205.2019.02.020
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    ［Abstract］〓Objective〖HTSS〗〓To analyze the varied trend of human immunodeficiency virus(HIV) infection rate among different blood donors from 2011 to 2017, provide data basis for targeted donating blood publicity and establish blood donors recruitment policy.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The blood samples of Hebei Blood Center from 2011 to 2017 were collected, which were reactive by enzymelinked immunosorbent assay(ELISA) of antigen and antibody and HIV positive by immunoblotting confirmatory test; the blood samples which were nonreactive by ELISA detection but HIVRNA reactive by nucleic acid test were also collected. These blood samples showed HIVpositive by retroactive confirmation. The gender, age and occupations distribution characteristics of HIVpositive blood donors were observed. The varied trend of HIV infection rate of different gender, age and occupations voluntary blood donors were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓1 178 295 blood samples were detected from 2011 to 2017, 149 blood samples were HIVpositive by immunoblotting confirmatory test, 2 blood samples were HIVpositive by nucleic acid test and retroactive confirmation. The rate of HIV infection of blood donors showed a increasing trend(P＜005). HIVpositive blood donors were mainly males(96.03%), the rate of HIV infection of male blood donors were increasing gradually(P＜005). The HIVpositive blood donors were mainly 18-25(33.11%) and 26-35(28.48%) years old. The rate of HIV infection of 18-25 years old blood donors showed increasing trend(P＜005), there was no significant change in the HIV infection rate of the 26-35 years old blood donors(P＞005). HIVpositive blood donors were mainly freelance workers(33.11%) and staffs(25.83%). The rate of HIV infection of staffs showed the trend of gradual increase(P＜005), but there was no significant change in the rate of HIV infection of freelance workers(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓There are gender, age and occupations distribution characteristics for the HIV infection rate of blood donors in Shijiazhuang. Moreover, the HIV infection rate of the main blood donors show the trend of gradual increase. Blood banks should strengthen the publicity and education of HIV prevention and control knowledge for blood donors, reduce the HIV infection rate and improve blood safety.
    The preparation and clinical application of Dragon′s blood gel#br#
    SHI Cong1, WANG Dongkai1, ZHANG Rongping2, GENG Zhihui1*
    2019, 40(2):  208-212.  doi:10.3969/j.issn.10073205.2019.02.021
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    〗［Abstract］ Objective〖HTSS〗〓To prepare the Dragon′s blood gels and to investigate its clinical effect of the gels.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Orthogonal test was used. Polyvinyl alcohol, polyvinylpyrrolidone, drug quality and glycerol content were taken as the investigation factors. The appearance uniformity, flexibility, heat resistance, cold resistance and centrifugal test of the coating agent were taken as the indexes to select the best formulation of the coating agent. In the clinical experiment, 60 bedsore patients were randomly divided into 2 groups, the control group(pharmaceutical dressing) and observation group(Dragon′s blood gels). The wound healing, cure rate and discharge time of 2 groups of patients with bedsore after medication were observed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Orthogonal test results showed that the formulation of A1B3C3D3 film coating agent had the highest matrix score. Compared with other prescriptions, this prescription has good skin affinity, fast film formation and easy to peel off. The clinical efficacy and cure rate of the observation group were higher than those of the control group, but the difference was not statistically significant(P＞005), The discharge rate of the observation group was significantly higher than the control group, the discharge time and drug effective time were shorter than the control group(P＜005), which showed significant difference.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The preparation technology of Dragon′s blood gels is simple and the gel has good appearance and stability. Moreover, the Dragon′s blood gels have a good effect on bedsore patients.