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Table of Content

    25 March 2019, Volume 40 Issue 3
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    In vitro culture and identification of neural stem cells in ICR mice#br#
    SUN Mengjun1， GUO Jianmei2， ZHOU Gengsu3， DONG Zefei4， ZHENG Chungui3， CAO Cuili5*
    2019, 40(3):  258-262.  doi:10.3969/j.issn.10073205.2019.03.003
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    ［Abstract］〓Objective〖HTSS〗〓To establish a simple method for isolation and culture of mouse neural stem cells(NSCs) from ICR mice in vitro.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The brain tissues of ICR mice were isolated and cultured in serumfree medium. The morphology of cultured cells was observed with an inverted microscope. The specific markers, nestin, glial fibrillary acidic protein(GFAP) and neuronal specific enolase(NSE) were detected by immunocytochemical staining to identify cells. The growth curve of the cells was plotted by CCK8 assay.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The cells isolated from the embryonic brain tissue of ICR mice were amplified in the form of neurospheres in serumfree medium, and could be passaged continuously after digestion. The growth curve showed that the cell doubling time was 2 d. The percentage of nestin positive cells was(72.0±5.5)% in neurospheres. After induced differentiation, two types of cells were observed: one has long and thick projection interlaced into a net, and is GFAP positive; the other is polygonal, with a number of slender projections, and is NSE positive.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The NSCs cultured by this method has high purity, proliferate rapidly, and have the potential of multidifferentiation. Our method is worth popularizing and applying.
    Analysis of three cell lysates on total protein extraction in Western blot#br#
    PANG Yaxiang1, NIE Qihao2, LIU Xiaoning3, WANG Shuai3, FENG Qi3, NIU Honglin4*
    2019, 40(3):  263-267.  doi:10.3969/j.issn.10073205.2019.03.004
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    ［Abstract］〓Objective〖HTSS〗〓To find a cell lysate suitable for total protein extract from cultured vascular smooth muscle cells for better application in Western blot analysis.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Three commonly used cell lysates, solution Ⅰ, solution Ⅱ and solution Ⅲ supplement with protease inhibitors were used to extract total protein from cultured vascular smooth muscle cells. Bradford method was used to determine protein content and SDSpolyacrylamide gel electrophoresis(SDSPAGE) was used to isolate protein. And then, Western blot was used to detect the protein expression of PDGFRβ, Akt, GAPDH and SM22α.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no significant difference in protein concentration among the three cell lysates(P＞005). The optical density values obtaining from cell lysate Ⅱ and Ⅲ were higher than that obtained from cell lysate Ⅰ in small molecular weight proteins(<50 000) detection. The optical density values obtaining from cell lysate Ⅱ and Ⅲ were higher than that obtained from cell lysate Ⅰ, and those values obtaining from cell lysate Ⅲ were higher than that obtained from cell lysate Ⅱ in medium molecular weight proteins(50 000-80 000) detection. The optical density values obtaining from cell lysate Ⅲ were higher than that obtained from cell lysate Ⅰ in high molecular weight protein(>80 000) detection. For Western blot, the band optical density of PDGFRβ detected by cell lysate Ⅱ and Ⅲ was significantly higher than that obtained from cell lysate Ⅰ. The band optical density of Akt detected by cell lysate Ⅱ and Ⅲ was significantly higher than that obtained from cell lysate Ⅰ, and the band optical density of Akt detected from cell lysate Ⅲ was significantly higher than that obtained from cell lysate Ⅱ. The band optical density of GAPDH detected from cell lysate Ⅱ was significantly higher than that obtained from cell lysate Ⅰ and Ⅲ, the band optical density of SM22α detected fromcell lysate Ⅱ was significantly higher than that obtained from cell lysate Ⅰ and Ⅲ(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓An optimal cell lysate was selected to detect the different molecular weight protein from cultured vascular smooth muscle cells, which could provide a suitable protocol for the study of protein function based on Western blot assay.
    Relationship between LpPLA2、Hcy、hsCRP and the severity of coronary artery lesions in perimenopausal patients with coronary heart disease#br#
    HAN Haili1， LIU Dongsheng2， JIA Zilei3， ZHANG Mingyuan4
    2019, 40(3):  268-271,276.  doi:10.3969/j.issn.10073205.2019.03.005
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    ［Abstract］ Objective〖HTSS〗〓To explore the relationship between the severity of coronary artery lesions and lipoproteinassociated phospholipase A2(LpPLA2), homocysteine(Hcy), hypersensitive Creactive protein(hsCRP) in perimenopausal women with coronary heart disease.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 112 perimenopausal women with coronary heart disease were selected. According to the results of coronary angiography, they were divided intoⅠgroups(0 to 25 points), Ⅱ groups(26 to 50 points), Ⅲ groups(51 to 90 points) and Ⅳ groups(>90 points). LpPLA2, Hcy and hsCRP values were detected in the four groups of patients, and the relationship between the three indicators and the severity of coronary lesions was analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The LpPLA2 and Hcy of Ⅱgroups，Ⅲ groups，Ⅳgroups were higher than Ⅰ groups, and Ⅳ groups were higher than Ⅱgroups，Ⅲ groups. The differences were statistically significant(P＜005).  The hsCRP of Ⅱgroups，Ⅲ groups，Ⅳgroups were higher thanⅠgroups, and Ⅲ groups , Ⅳ groups were higher than Ⅱgroups. The differences were statistically significant(P＜005). In the ROC curve analysis, the area under ROC curve of LpPLA2, Hcy and hsCRP were 0.821, 0.933 and 0.551 respectively.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓LpPLA2 combined with Hcy and hsCRP can be used to evaluate the severity of coronary heart disease in perimenopausal women.
    Analysis of the clinical characteristics for hepatitis B virus related hepatocellular carcinoma and alcohol related hepatocellular carcinoma#br#
    ZHANG Shasha1， LAI Ruixue1, GAO Xueqing1, GUO Zhanjun2, ZHAO Yue1*
    2019, 40(3):  272-276.  doi:10.3969/j.issn.10073205.2019.03.006
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    ［Abstract］〓Objective〖HTSS〗〓To compare the differences in clinical characteristics between hepatitis B virus related hepatocellular carcinoma(HBVHCC) and alcohol related HCC（alcoholHCC）, as well as evaluate whether these clinical characteristics are associated with the subtype of HCC.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 271 cases of HCC patients were divided into two groups as HBVHCC(n=215) and alcoholHCC(n=56). The clinical data including age, gender, alanine aminotransferase（ALT）, aspartate aminotransferase（AST）, γglutamyl transpeptidase（GGT）, total bilirubin（TBIL）, albumin（ALB）, ChildPugh classification, alphafetoprotein（AFP）, subtype of image classification, tumor quantity, and portal vein tumor thrombosis were evaluated in the two different groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no difference of distribution frequency referring to age between HBVHCC and alcoholHCC(P＞005), whereas the distribution frequency for gender was significantly different in these two subtypes with more male patients in alcoholHCC（P＜005）. There was no difference of distribution frequency in terms of TBIL, ChildPugh classification between the two subtypes(P＞005), whereas ALT， AST， GGT, ALB and AFP were significantly different. The level of GGT increased significantly in alcoholHCC subtypes(P＜005). Compared with alcoholHCC, a lower level of ALB(P＜0.05) and increased AFP， ALT， AST were found in HBVHCC(P＜005). Imaging analysis including subtype of image classification, tumor quantity, and portal vein tumor thrombosis were performed in 104 cases of HBVHCC and 29 cases of alcoholHCC, no difference exist in the two groups（P＞005）.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓More Male patients in alcoholHCC subtype demonstrated the influence of lifestyle on disease. The fact that alcohol is the mitochondrial enzyme inducer of hepatocyte to promote the synthesis and release of GGT could explain the increased GGT levels in alcoholHCC. The low ALB in HBVHCC implied that the HBV could severely destroy the synthesis function of liver. Increased ALT and AST level in HBVHCC suggest that liver function was damaged seriously. The obviously increased AFP in HBVHCC implied the different signal transduction pathway initiated by these two types. The two subtypes of HCC are indistinguishable in terms of image classification, tumor quantity, and portal vein tumor thrombosis.
    Effects of intermittent pneumatic compression on transcutaneous oxygen pressure in dorsum of foot in patients with diabetic lower extremity arteriopathy#br#
    YU Lihong, GE Yanhong, LI Caige, QIN Ling, GAO Junxiang, KANG Shuo
    2019, 40(3):  277-280.  doi:10.3969/j.issn.10073205.2019.03.007
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    ［Abstract］ Objective〖HTSS〗〓To investigate the effect of intermittent pneumatic compression(IPC) on transcutaneous oxygen pressure （TcPO2） in dorsum of foot in patients with diabetic lower extremity arterial disease.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eighty  diabetic lower extremity arterial disease patients were randomly divided into experimental group(40 cases)and control group(40 cases) according to random number table. Both groups were given glucoselowering , blood pressure and blood lipid lowering, improving circulation ,nutritional neurologic and other drug therapy, and the experimental group was treated with IPC therapy instrument. The changes of TcPO2 and ankle brachial index(ABI) in dorsum of foot before and 14 days after treatment were evaluated. 
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no statistically significant difference between the two groups of patients with TcPO2(P>0. 05)before intervention. After intervention,TcPO2 of the experimental group was higher than the control group, and the difference was statistically significant(P＜005). There was no significant difference between the two groups with ABI before and after intervention(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The treatment of IPC can improve TcPO2 of dorsum of foot in patients with diabetic lower extremity arteriopathy, effectively improve blood supply of lower extremity and microcirculation of foot, and prevent the occurrence of diabetic foot.
    Expression of TGFβ1 and NFκB P65 in kidney of offspring of the mice with hyperthyroidism during pregnancy
    WANG Hong1, WANG Ruiying1*, LIU Zhihong1, LIU Jing1, ZHANG Yanrong2
    2019, 40(3):  281-285,291.  doi:10.3969/j.issn.10073205.2019.03.008
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    ［Abstract］ Objective〖HTSS〗〓To observe the expressions of transforming growth factor 1(TGF1) and nuclear factor kappa B(NFκB) P65 in the renal interstitium of pregnant rats with hyperthyroidism and to investigate the relationship between hyperthyroidism in pregnancy and renal interstitial fibrosis in offspring.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Fiftyfour SD rats aged 60 days were randomly divided into 3 groups, 18 rats in each group which were given continuous gavage with different doses of levothyroxine sodium to make a hyperthyroidism model. After pregnancy, the mother mice continued to be gavage until delivery. The pathological structure and damage of kidney in normal control group, mild hyperthyroidism group and severe hyperthyroidism group were observed. Western blot was also used to determine the expression of TGF1 and NFκB P65.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The serum levels of free triiodothyronine(FT3) and free thyroxine(FT4) in the severe hyperthyroidism newborn mouse group at 21 and 60 days were higher than those in the normal control newborn mouse group and the mild hyperthyroidism newborn mouse group, and the serum levels of thyroid stimulating hormone(TSH) in the severe hyperthyroidism newborn mouse group at 21 and 60 days were lower than those in the normal control newborn mouse group and the mild hyperthyroidism newborn mouse group. FT3 and FT4 were higher on day 60 than on day 21 in each group, and TSH was lower on day 60 than on day 21 in each group, with statistically significant differences(P＜005). TGF 1 and NFκB P65 in renal tubular interstitial cells were higher in the mild hyperthyroidism newborn mouse group and the severe hyperthyroidism newborn mouse group than in the normal control newborn mouse group at 0 d, 21 d and 60 d. The expression levels of TGF 1 and NFκB P65 in the 3 groups were higher at 21 d and 60 d than at 0 d and higher at 60 d than at 21 d, with statistically significant differences(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Maternal hyperthyroidism can cause renal interstitial fibrosis in offspring, which is related to the degree of hyperthyroidism. The early diagnosis and treatment of hyperthyroidism are of great significance for preventing renal interstitial fibrosis in offspring.
    Efficacy and safety of nonvitamin K antagonist oral anticoagulants for venous thromboembolism：a Metaanalysis
    HU Tianyang， JIANG Youfan*
    2019, 40(3):  286-291.  doi:10.3969/j.issn.10073205.2019.03.009
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    ［Abstract］ Objective〖HTSS〗〓To evaluate the efficacy and safety of nonvitamin K antagonist oral anticoagulants in treating venous thromboembolism.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Data of randomized controlled trials and multicenter controlled studies about nonvitamin K antagonist oral anticoagulants versus vitamin K antagonists for treating venous thromboembolism were searched from PubMed, Cochrane Library and EMbase until June 2017, and data were analyzed by RevMan 5.3 software.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓A total of 29 879 patients were included in 7 studies, Metaanalysis showed that: ① Compared with traditional vitamin K antagonists, the new oral nonvitamin K antagonist anticoagulants could significantly reduce major bleeding events （OR=0.61， 95%CI=0.50-0.75，P＜0.01） and fatal bleeding events(OR=0.37, 95%CI=0.17-0.81, P=0.01). ②nonvitamin K antagonist oral anticoagulants could not reduce the incidence of recurrent venous thromboembolism or venous thromboembolismrelated death(OR=0.94, 95%CI=0.81-0.18, P=0.38)or allcause mortality（OR=0.97，95%CI=0.83-1.13，P=0.70）compared with vitamin K antagonists. ③The results of adverse events can not be combined and analyzed，the safety superiority of nonvitamin K antagonist oral anticoagulants needs to be further evaluated.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The efficacy of nonvitamin K antagonist oral anticoagulants in treating venous thromboembolism is no less than that of traditional vitamin K antagonists, and the former could reduce bleeding events significantly though their safety superiority needs to be further evaluated.
    Significance of pretreament neutrophiltolymphocyte ratio on prognosis of small cell lung patients
    ZHANG Jie1, ZHANG Xiaolu1, YU Jie1, SHEN Ting1, ZHANG Hongzhen1，2*
    2019, 40(3):  292-295.  doi:10.3969/j.issn.10073205.2019.03.010
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    ［Abstract］ Objective〖HTSS〗〓To evaluate the correlation of pretreament neutrophil/lymphocyte ratio(NLR) with the prognosis of patients with small cell lung cancer.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical data of 75 small cell lung cancer with pathologically diagnose were retrospectively analyzed. Routine peripheral blood test results were used to calculate the NLR. The patients were divided into two groups(high NLR group and low NLR group) with the median value of NLR. The clinical features of high and low NLR group were compared. The differences of overall survival(OS) and progressivefree survival(PFS) were compared in the two groups. The factors affecting PFS and OS in SCLC patients were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The proportion of the high NLR group in extensive stages was higher than that of the low NLR group, and the difference was statistically significant(P＜005). The median PFS of the high NLR group and the low NLR group was 5.73 months vs 8.50 months, respectively, and the difference was statistically significant(P＜005). The median OS in the high NLR group and the low NLR group was 10.57 months and 15.10 months, respectively, with statistically significant differences(P＜005). The Cox regression analysis showed that clinical stage and NLR level were prognostic factors.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓High NLR often indicates poor prognosis, and it is an important prognostic factor and plays an important role in prognostic evaluation of SCLC patients.
    Application of motor nerve conduction velocity in the classification of cubital tunnel syndrome
    ZHANG Hongliang, LI Shentai, LI Ming, SONG Yongzhou, ZHANG Hua, MA Wei
    2019, 40(3):  296-299.  doi:10.3969/j.issn.10073205.2019.03.011
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    ［Abstract］ Objective〖HTSS〗〓To explore the application in the classification of cubital tunnel syndrome by studying the surgical effect of patients with cubital tunnel syndrome(CuTS) when its motor nerve conduction velocity(MNCV) is different.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty patients with cubital tunnel syndrome who underwent ulnar nerve relaxation and subcutaneous anterior transposition were divided into three groups according to MNCV. A group： MNCV is ＞40 m/s. B group： MNCV is 30-40 m/s. C group: MNCV is ＜30 m/s.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The excellent and good results of postoperative comprehensive effect in the three groups were: 90.0%(18/20), 85.0%(17/20), and 45.0%(9/20). The comprehensive effects of group A and group B were better than those of group C, and the difference was statistically significant(P＜005). The recovery of interosseous muscle atrophy, grip strength and clawshaped hand in group A and group B were better than those in group C, and the difference was statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The motor nerve conduction velocity can be classified as cubital tunnel syndrome alone ,and it is worth being popularized in clinics. When MNCV is ＞40 m/s， it is mild and we can choose conservative treatment, but the MNCV should be regularly reviewed, if the MNCV is continue to slow down, surgical treatment should be taken. When the MNCV is 30-40 m/s，it is moderate and we should choose surgery treatment and the effect of surgery is good. When MNCV is ＜30 m/s, we should choose surgical treatment as early as possible but the postoperative effect is poor.
    Clinical research of minimally invasive treatment for transradial styloid perilunatefracturedislocations of the carpus
    MA Xuelin, ZHANG Hongjuan, SHAO Xinzhong, ZHANG Zhemin, LYU Li*
    2019, 40(3):  300-304.  doi:10.3969/j.issn.10073205.2019.03.012
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    ［Abstract］ Objective〖HTSS〗〓To introduce minimally invasive surgery for a special type of wrist injury, transradial styloid perilunate fracturedislocations of the carpus, and evaluate its curative effect.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Six cases of transradial styloid perilunate fracturedislocations were treated under the Carm, Kirschner wire poking reset, and percutaneous Kirschner wire fixation, ligaments were repaired by miniature anchor under the small incision. Short arm plaster fixation after operation and assisted with functional exercises. Xray and computed tomography(CT) evaluation were given during the followup period, and the wrist function was evaluated with Cooney scoring method.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There were no aseptic necrosis of carpus, traumatic arthritis of wrist and carpal instability in all 6 cases.The range of motion of wrist joint was significantly improved compared with that before operation, and the difference was statistically significant(P＜005). The grip strength of affected side/healthy side recovered to 76%-93%, average(85.0±7.8)%. The healing time of radial styloid fracture ranged from 6 to 8 weeks, average(6.7±0.6) weeks.During followup, Cooney score of wrist joint reached good or above in 5 cases, and the patients were satisfied.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓This kind of minimally invasive treatment is a secure, safe and effective method for the treatment of transradial styloid perilunate fracturedislocations. 
    Clinical  research on the relationship between AR, ER and TSHR expression in papillary thyroid carcinoma#br#
    ZENG Jianfeng, YU Waishi, ZHOU Zhiping, QIU Chengzhi, HUANG Zhongxin
    2019, 40(3):  305-308,328.  doi:10.3969/j.issn.10073205.2019.03.013
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    ［Abstract］ Objective〖HTSS〗〓To analyze expression and correlation of androgen receptor(androgen receptor, AR) , estrogen receptors(estrogen receptor, ER) and thyroid stimulating hormone receptor(thyroidstimulating hormone receptor, TSHR) in thyroid papillary carcinoma(papillary thyroid carcinoma, PTC) expression and correlation of organization, The roles of the three factors in PTC and prognosis were also discussed.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The expressions of AR, ER and TSHR in 197 cases of PTC, 50 cases of paracancer normal tissues and 50 cases of thyroid benign tumors were detected by immunohistochemistry.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The positive expression of ER and TSHR in PTC tissues and paraPTC tissues were significantly higher than those in benign thyroid neoplasms, and the positive expression of AR was significantly lower than that in benign thyroid neoplasms（P＜005）. The positive rate of ER, TSHR and AR expression in female was higher than that in male. The positive rate of ER expression in patients aged＜45 years was higher than that in patients aged≥45 years. The positive expression rates of ER and TSHR in patients with capsule infiltration were higher than those without. The positive rates of ER and TSHR expression in patients with tumor diameter 4 cm were higher than those with tumor diameter<4 cm. The positive rates of ER and TSHR expression in patients with lymph node metastasis were higher than those without lymph node metastasis. Tumor staging Ⅲ-Ⅳ ER and TSHR expression positive rate was higher than the tumor staging Ⅰ-Ⅱ, the differences were statistically significant(P＜005). There was a positive correlation between ER and TSHR protein expression in PTC tissues(rs=0575, P＜005), and a negative correlation between ER and AR, AR and TSHR protein expression in PTC tissues(rs=-0.160, P＜005, rs=-0.186, P＜005), but the correlation was weak.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Combined detection of ER and TSHR is expected to be an important indicator for the diagnosis of PTC invasion and metastasis. AR may be a protective factor, and high expression of AR in PTC indicates a better prognosis.
    Retrospective analysis of factors relating with fertilization failure in conventional IVFET cycles
    CAO Mingya1, ZHAO Zhiming1*, YAN Xue2, HAO Guimin1, CAO Jinfeng1, CUI Na1
    2019, 40(3):  309-314.  doi:10.3969/j.issn.10073205.2019.03.014
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    ［Abstract］ Objective〖HTSS〗〓To retrospectively analyze the medical records of fertilization disorders in conventional in vitro fertilization（IVF） and to explore the clinical and laboratory factors that are closely related to complete fertilization failure and low fertilization rate.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical and laboratory information of conventional IVF cycles from the Second Hospital of Hebei Medical University was retrospectively analyzed. According to the situation of IVF fertilization they were divided into group A(complete fertilization failure, fertilization rate= 0) 56 cycles, group B(low fertilization rate, fertilization rate< 30%) 91 cycles, group C(fertilization rate≥30%) 1 899 cycles. According to the conventional fertilization rate, the rescue intracytoplasmic sperm injection and half intracytoplasmic sperm injection cycles were divided respectively into group A, B and C. The following contents among the three groups were compared. The female age, duration of infertility, basic follicle stimulating hormorne(FSH), luteinizing hormone(LH), estradiol(E2) levels and proportion of primary and secondary infertility and the proportion of causes of infertility were compared. The days of gonadotropin(Gn), Gn dosage, LH, E2, progesterone(P) levels and per eggs E2 level at human chorionic gonadotropin(HCG) injection day and the number of obtained oocytes were compared. The treatment regimen, the proportion of mature eggs, abnormal eggs and the proportion of 1-4 eggs obtained in the three groups were compared. The semen parameters before and after on the day of oocyte retrievaled were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There were no significant differences in age, basal hormones FSH, LH and E2 levels between groups A, B and C(P＞005). The infertility years, the proportion of primary infertility, male factors and the proportion of unexplained infertility in group A and group B were higher than that in group C, and the differences were statistically significant(P＜005). The proportion of tubal factors in group A and group B was lower than that in group C, and the difference was statistically significant(P＜005). There were no significant differences in the days of Gn, Gn dosage, LH, E2, P level and E2 level per egg at HCG injection day between groups A, B and C(P＞005). The number of oocytes obtained in group A was lower than that in group B and C, and the difference was statistically significant(P＜005). Comparison of treatment protocol among groups A, B and C showed no statistical significance(P＞005). The proportion of oocytes number 1-4 was higher in group A than in group C and B, and the difference was statistically significant(P＜005). The proportions of mature oocytes and abnormal oocytes in the three groups were 46.4%， 60.4%， 89.2% and 16.1%， 8.8%， 0.5%, with statistically significant differences(P＜005). The sperm concentration of group A, B and C on the day of egg collection was lower than that of group C. The sperm motility rate, the proportion of forward motile sperm before treatment and the proportion of Aclass sperm in forward motile sperm in group A were lower than those in group B and C, the differences were statistically significant(P＜005). The proportion of forward motile sperm and the proportion of Aclass sperm in forward motile sperm in group A and B were lower than those in group C after treatment, and the differences were statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓There are many factors affecting fertilization disorder during IVF fertilization. High risk factors may include primary infertility, longer infertility time, unknown causes and male infertility. Immature oocytes and low semen parameters or poor sperm quality may be associated with the fertilization failure.
    Correlation between ICAM3, HIF1 protein expression levels and radiotherapy resistance in cervical cancer in high altitude#br#
    CHEN Hua1, ZHOU Cuoji2*
    2019, 40(3):  315-318,323.  doi:10.3969/j.issn.10073205.2019.03.015
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the relationship between the expression levels of intercellular cell adhesion molecule3(ICAM3), hypoxia inducible factor1(HIF1) and the radiotherapy resistance of cervical cancer in plateau.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 58 patients with cervical squamous cell carcinoma were selected, and radical radiotherapy and concurrent chemotherapy were given after diagnosis. Biopsy of cervical squamous cell carcinoma was obtained before biopsy, and the expression of ICAM3 and HIF1 in tissue samples were detected. The efficacy was evaluated according to the objective efficacy criteria of WHO solid tumors. The patients were divided into radiotherapy resistance group and radiotherapy sensitive group according to the treatment effect. The expressions of ICAM3 and HIF1 expression between radiotherapy resistant group and radiotherapy sensitive group, the expression of ICAM3 and HIF1 in different clinical stages, histological grades and lymph node metastasis were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Among the 58 patients, 39 cases were in radiotherapysensitive group and 19 cases were in radiotherapyresistant group. The difference of distribution of ICAM3 and HIF1 expression in the two groups were statistically significant. The positive expression rate of ICAM3 and HIF1 in radiotherapy sensitive group were lower than those in radiotherapy resistance group(P＜005). The positive rate of ICAM3 and HIF1 in welldifferentiated patients were higher than those in low and moderatedifferentiated patients. The positive rate of ICAM3 and HIF1 in lymph nodepositive patients were higher than those in nodenegative patients(P＜005). There were no significant difference in the expression of ICAM3 and HIF1 between different clinical stages(P＞005). Kendall′s taub correlation analysis showed that the expression of ICAM3 were positively correlated with histological differentiation(b=0.529, P=0.007), lymph node metastasis(b=0.510, P=0.012), the expression of HIF1 were also positively correlated with histological differentiation(b=0.489, P=0.018) and lymph node metastasis(b=0535, P=0003).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The higher the expression level of ICAM3 and HIF1 protein, the higher the probability of radiotherapy resistance in cervical cancer patients in high altitude areas, and the positive expression of ICAM3 and HIF1 protein expression were positively correlated with histological grade and lymph node metastasis, can be used as a predictor of radiotherapy sensitivity.
    Risk factors for postoperative pulmonary complications in patients undergoing laparoscopic pancreaticoduodenectomy
    YANG Xiaorong， GAO Jingui*
    2019, 40(3):  319-323.  doi:10.3969/j.issn.10073205.2019.03.016
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    ［Abstract］〓Objective〖HTSS〗〓To identify the risk factors of postoperative pulmonary complications in patients undergoing laparoscopic pancreaticoduodenectomy（LPD） and further improve perioperative anesthesia management and reduce the incidence of postoperative pulmonary complications（PPCs）.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A retrospective survey was undertaken on 100 patients underwent LPD operation. A total of 19 items of information such as gender, age, BMI, ASA classification, smoking, chronic obstructive pulmonary disease(COPD), hypertension, diabetes, coronary heart disease, liver functional grading, fraction of inspiration O2(FiO2), blood transfusion, intraoperative fluid volume, intraoperative warming, application of ulinastatin during operation, postoperative analgesia, ICU observation, operation time, postoperative hospitalization time were collected， and the risk factors for PPCs were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Postoperative pulmonary complications occurred in 33 of the 100 patients, and the incidence was 33.0%. The rate of smoking, COPD, ICU observation, pure oxygen inhalation in PPCs group was higher than that in NPPCs group, ulinastatin application was lower in PPCs group, age was older and hospitalization time was longer in PPCs group, and the difference was statistically significant(P＜005). The multivariate logistic regression analysis displayed that smoking, COPD, pure oxygen inhalation were the risk factors of postoperative pulmonary complications in patients undergoing LPD.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The preoperative history of smoking and COPD, pure oxygen inhalation in perioperative period were high risk factors of postoperative pulmonary complications in patients undergoing LPD.
    Predictive effect of ultrasound imaging evaluation on pregnancy outcome after ovulation induction#br#
    ZHANG Zhifeng1， ZHAO Shuangdan2， CAO Mingya2， CUI Xiaoli2， JIA Rui2， ZHAO Zhiming2*
    2019, 40(3):  324-328.  doi:10.3969/j.issn.10073205.2019.03.017
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    ［Abstract］〓Objective〖HTSS〗〓To analyze the predictive effect of ultrasonography on pregnancy outcomes of infertile women by observing the intraovarian follicle reserve imaging characteristics and endometrial receptivity of infertile women receiving controlled ovarian stimulation(COS) via ultrasonography.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Retrospective  analysis the related data of 209 cycles were taken from infertile patients treated with COS. According to the pregnancy outcome, the cycles were divided into the pregnancy group(30 cycles) and the nonpregnant group(30 cycles randomly selected from the nonpregnant patients). The endometrial thickness, endometrial type, endometrial volume, ovarian volume, number of antral follicles and the maximum diameter of follicles before ovulation of both groups were compared. The 60 cycles were divided into group＜8 mm, group 8-14 mm, and group＞14 mm, according to the endometrial thickness; type A, type B, and type C, according to the endometrial type; group＜2 mL group 2-4 mL and group＞4 mL, according to the endometrial volume; group＜3 cm3, group 3-6 cm3, and group＞6 cm3 ,according to the ovarian volume; group＜5, group 6-15 and group ＞15, according to the number of antral follicles. The pregnancy rates of each group were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The endometrial thickness and endometrial volume of the pregnant group were higher than those of the nonpregnant group. In the pregnant group，the endometrial morphology type A was in the majority, while in the nonpregnant group, the endometrial morphology type C was in the majority; the ovarian volume and the number of antral follicles in the pregnant group were significantly higher than those of the nonpregnant group, the differences above were statistically significant(P＜005). There was no significant difference in the maximum follicle diameter on the day of human chorionic gonadotropin injection between the two groups(P＞005). The pregnancy rate of the endometrial thickness 8-14 mm group was significantly higher than that of the group＜8 mm and group＞14 mm; the pregnancy rate of endometrial type A group was significantly higher than that of type B and type C; the pregnancy rate of endometrial volume＞4 mL group was significantly higher than that of group ＜2 mL and group 2-4 mL; the pregnancy rate of ovarian volume 3-6 cm3 group was significantly higher than that of group＜3 cm3 and group ＞6 cm3 , and the pregnancy rate of 5-15 follicles group was significantly higher than that of group＜5 and group＞15, the differences above were statistically significant(P＜005). 
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓For infertility patients receiving COS treatment，the ones with endometrial thickness between 8-14 mm, endometrial volume greater than 4 ml, endometrium type A， ovaria volume between 3-6 cm3 and  the number of antral follicles between 5-15 are more likely to get pregnant.
    Application and clinical value of volume rendering technique in the reconstruction of ossicular chain#br#
    ZHAO Mingjuan, BAO Yunfeng*, HUANG Xiaoying, WANG Kaihong， CHEN Yingmin
    2019, 40(3):  329-331,338.  doi:10.3969/j.issn.10073205.2019.03.018
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    ［Abstract］ Objective〖HTSS〗〓To explore the unique advantages and  clinical application of volume rendering technique(VR) in reconstruction of ossicular chain.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 30 patients with suspected ossicular chain lesions were highresolution volumetric scanned with 64slice spiral CT and reconstructed with VR.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Among the 30 cases, 10 cases had normal ossicular structure and 20 cases had abnormal ossicular structure(12 cases had ossicular chain injury and 8 cases had abnormal ossicular chain development). The bone structure of malleolus, incus and stapes can be clearly displayed on the images of volume rendering technique, but the visibility of anterior and posterior feet of stapes, hammeranvil joint and stapes joint is lower than that of the multiple plannar reformation image.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓VR can visually display the overall anatomical structure of the ossicular chain and the corresponding position relationship between the ossicles by using the whole volume scan data,which is of great significance for the clinical diagnosis of ossicular chain lesions.
    Evaluate on the risk factors of the antibiotic resistance caused by Acinetobacter baumannii pneumonia in Meropenem, Imipenem and CefperazoneSulbactam
    WANG Liyi, CAO Xuhua2*, SHI Like1, WANG Yue1
    2019, 40(3):  332-338.  doi:10.3969/j.issn.10073205.2019.03.019
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    ［Abstract］ Objective〖HTSS〗〓To evaluate the risk factors of the antibiotic resistance of Imipenem(IPM), Meropenem(MEM) and CefperazoneSulbactam(SCF) among the Acinetobacter baumannii(AB) pneumonia.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 944 specimens from lower respiratory tract with acinetobacter baumannii pneumonia were identified: 931, 712 and 887 were subjected to antimicrobial susceptibility testing in IPM, MPM and SCF, respectively. The difference in the rate of multidrugresistant Acinetobacter baumannii(MDRAB) and the clinical characteristics between the dichotomized resistant group and nonresistant group in the three antimicrobial susceptibility testing were analyzed, respectively. Then we used Logistic regression analysis to evaluate the risk factors.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The MDRAB rates of the resistant group were  higher than the nonresistant group in the three antibacterial agents(P＜005). There were significant differences in sex, the use of invasive operation, urinary tract intubation, trachea cannula, tracheotomy, ventilator, central venous catheter, surgery, internal or surgical department, intensive care unit, times of hospitalization, hospital stays and season between the dichotomized resistant group and nonresistant group in IPM, MEM and SCF(P＜005). Logistic regression analysis suggested that the use of ventilator before delivery could increase the risk of these three antibioticresistance(P＜005). While ABpneumonia patients in men, intensive care unit, the antibioticusedays≥5 d and SpringWinter could be easily resistant to both IPM and MEM(P＜005). And  resistance to IPM may easily happened in surgical department and only one timehospitalization（P＜005）. 
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓he prevention and control measures should be designed according to the highrisk population, the highincidence season and the highoccurrence period of each kind of drugsensitive drug resistance, so as to shorten the time of antibiotic use, attach importance to the daily bacterial detection, improve the early detection rate at admission, and effectively control the occurrence and development of bacterial resistance to antibiotics.
    Clinical observation of pregabalin in the treatment of post herpetic neuralgia
    WANG Ping1, CAO Yiqiu2, LU Jiejie1
    2019, 40(3):  339-341,346.  doi:神经痛,带状疱疹后；普瑞巴林；治疗结果
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    ［Abstract］ Objective〖HTSS〗〓To assess the efficacy and safety of pregabalin in the treatment of post herpetic neuralgia(PHN).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty cases of PHN were randomly divided into two groups, and each group had 30 cases. Group A was treated with pregabalin and group B was treated with amitriptyline for 8 weeks. The pain Visual Analogue Scale(VAS) scores, Daily Sleep Interference Scale(DSIS) scores and SelfRating Anxiety Scale(SAS) scores were compared between two groups before the treatment and 1 week, 2 week, 4 week, 6 week, 8 week after the treatment.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After treatment, VAS score, DSIS score and SAS score in group A and group B all showed A gradually decreasing trend, but the VAS score, DSIS score and SAS score in group A decreased more, and the interaction differences between groups, at different time points and between groups and at different time points were statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Pregabalin could rapidly relieve neuropathic pain in PHN patients without serious adverse effects.
    Analysis of pathogen spectrum and drug resistance in blood samples from the secondary hospitals in Hebei province in 2016—2017#br#
    LI Zhirong1,2, ZHAO Jianhong1,2, LI Jihong1, FAN Shiying1, SUN Qian1, SHI Dongyan1*
    2019, 40(3):  342-346.  doi:10.3969/j.issn.10073205.2019.03.021
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the pathogen distribution of blood samples isolated from secondgrade hospitals in Hebei and their resistance to antibiotics.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Drug resistance data of isolated bacteria of blood sample from secondgrade hospitals during 2016—2017 were analysed by  Whonet 5.6 software according to CLSI 2016.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓A total of 2 909 strains of bacteria were collected by blood culture, of which 1 684 strains were G-strains(57.9%) and 1 225 strains were G+ strains(42.1%). Methicillinresistant S. aureus(MRSA) and coagulasenegative Staphylococcus(MRCNS) accounted for 50.0% and 72.1%, respectively. No staphylococcal strains were found resistant to vancomycin, teicoplanin or linezolid. The resistance rates of E. faecalis and E. faecium to vancomycin were 2.7% and 1.8%, respectively. Both of these two kinds of strain have no resistance to teicoplanin or linezolid. The prevalence of ESBLproducing of E. coli and K. pneumonia were 50.3% and 26.2%, respectively. Resistance rates of E. coli to imipenem and meropenem were 6.1% and 1.0%, respectively. Resistance rates of K. pneumoniae to imipenem and meropenem were 5.7% and 6.2%, respectively. The resistance rates of P. aeruginosa to imipenem and meropenem were both 34.0%. The resistance rates of other antibiotics  for P. aeruginosa were lower than 30.0%. The Resistance rates of A. baumannii strains to imipenem and meropenem were 34.0% and 42.5%.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓It is important to evaluate the pathogenicity of different bacteria for clinical diagnosis and treatment. The pathogens isolated from blood specimens are diverse showing various levels of resistance to common antimicrobial agents. Antibiotics should be prescribed reasonably according to local susceptibility testing data.