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Table of Content

    25 May 2019, Volume 40 Issue 5
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    Analysis of clinical features and assessment of diagnostic methods of tuberculous meningitis with pulmonary tuberculosis
     
    CHEN Yanqiang1, ZHAO Qing2, LI Wei1, MENG Yizhe1, LI Jing1, LI Junxia1*
    2019, 40(5):  504-507.  doi:10.3969/j.issn.10073205.2019.05.003
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    ［Abstract］ Objective〖HTSS〗〓To analyze the clinical characteristics of tuberculous meningitis associated with tuberculosis and the advantages and disadvantages of improved acidfast staining of cerebrospinal fluid(CSF), tuberculosis bacterium antibody(TBAb), tuberculin skin test(TST) and interferongamma release assays(IGRAs) in the diagnosis of tuberculous meningitis.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixtysix cases of tuberculous meningitis were collected as tuberculous meningitis group(group A), 60 cases of other central nervous system diseases without tuberculosis as nontuberculous meningitis group(group B). Twentyeight cases of tuberculous meningitis with miliary tuberculosis were divided into tuberculous meningitis with miliary tuberculosis group(group C) and 38 cases without miliary pulmonary conjunctiva into tuberculosis group(group D). The sensitivity, specificity, positive predictive value and negative predictive value of CSF improved acidfast staining, TBAb, TST and IGRAs in group A and group B were calculated, and the positive rates of CSF improved acidfast staining, TBAb, TST and IGRAs in group C and group D were compared. The clinical effects of group C and group D were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The positive rate of modified acidfast staining, tuberculosis antibody detection, TST strong positive rate and IGRAs positive rate of CSF in group A were higher than those in group B(P＜005). There was no significant difference in the positive rate of CSF improved acidfast staining, tuberculosis antibody and TST between group C and group D(P＞005). The positive rate of IGRAs in group C was significantly higher than that in group D(P＜005). The sensitivity was IGRAs>TBAb>CSF improved acidfast staining>TST. Specificity was CSF improved acidfast staining>TST>IGRAs>TBAb. Positive predictive value was CSF improved acidfast staining>IGRAs>TST>TBAb. Negative predictive value was IGRAs>TBAb>CSF improved acidfast staining >TST. There was no significant difference in the improvement rate between group C and group D(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The age of onset of tuberculous meningitis with miliary tuberculosis is younger. IGRAs may be the preferred test for suspected tuberculous meningitis with miliary tuberculosis with negative etiological examination.
    Study on the difference of heart rate variability in patients with different types of acute coronary syndrome
    LIU Wei1， XING Xinjie2， ZHANG Chenfeng1， SONG Da3， ZHANG Ming4， HAN Gang5
    2019, 40(5):  508-511.  doi:10.3969/j.issn.10073205.2019.05.004
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the heart rate variability of acute myocardial infarction and unstable angina in acute coronary syndrome, and to clarify the autonomic nerve change rule, so as to provide reference value and new treatment strategy for further observation and treatment and guidance of prognosis.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Patients with acute coronary syndrome were divided into acute myocardial infarction group(group A, 32 cases) and unstable angina pectoris group(group B, 47 cases) according to clinical classification.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Standard deviations of normaltonormal RR intervals（SDNN）, standard deviation of the average normaltonormal intervals（SDANN） and root mean square of successive differece（RMSSD） of group A were significantly lower than that of group B, with statistically significant difference(P＜005), while proportion of number of pairs of adjacent normaltonormal intervals by more than 50 ms（pNN50） of 2 groups showed no statistically significant difference(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓In acute coronary syndrome, the autonomic nervous function of the acute myocardial infarction group is more seriously impaired than that of the unstable angina group. The autonomic nervous function of the patients should be actively improved according to the changes in heart rate variability, so as to reduce the incidence of coronary heart disease complications and improve the prognosis of patients with coronary heart disease.
    Expression of IGF1 mRNA in bone tissues of type 2 diabetic osteoporosis rats
    ZHANG Lili1, WANG Lihui1, HU Shuguo1, LI Yukun2*
    2019, 40(5):  512-515.  doi:10.3969/j.issn.10073205.2019.05.005
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    ［Abstract］ Objective〖HTSS〗〓To determine the relationship between insulinlike growth factor1（IGF1） mRNA levels of bone tissues and the pathogenesis of type 2 diabetic osteoporosis.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓After fed with high fat diet for 8 weeks, rats was injected with streptozotocin intraperitoneally and had ovariectomy to establish type 2 diabetic osteoporosis rat mode. The body weight, fasting plasma glucose, insulin and bone mineral density were analyzed in type 2 diabetic osteoporosis rats. Realtime PCR was used to measure the expression of IGF1 in bone tissue of type 2 diabetic osteoporosis rats.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Twelve weeks after ovariectomy, body weight of normal ovariectomy(NOVX) group was slightly higher than that of normal control（NC） group. Body weight of diabetic control（DC） group and diabetic ovariectomy（DOVX） group was lower than that of NC group and NOVX group. And body weight of DOVX group was higher than that of DC group(P＜005). The level of fasting blood glucose of NOVX group was lower than that of NC group. The levels of fasting blood glucose of DC group and DOVX group were higher than those of NC group and NOVX group. And the level of fasting blood glucose of DOVX group was higher than that of DC group(P＜005). The levels of fasting insulin were increased gradually and insulin sensitivity was decreased gradually in all groups(P＜005). Bone mineral density of NOVX group was lower than that of NC group. Bone mineral density of DC group was lower than that of NC group and was higher than that of NOVX group(P＜005). The relative levels of IGF mRNA were decreased gradually among groups(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The level of IGF1 mRNA in rat bone tissue decreased with the decrease of bone mineral density.
    Clinical research for treatment of diabetic peripheral neuropathy by combination therapy with small doses of anisodamine injection and ligustrazine injection#br#
    LUO Niya1， ZHANG Lihui2*， ZHANG Chengliang1, YUAN Na1, LIU Shuke3, YIN li1
    2019, 40(5):  516-520,524.  doi:10.3969/j.issn.10073205.2019.05.006
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the efficacy and safety of lowdose anisodamine injection combined with tetramethylpyrazine injection in the treatment of patients with diabetic neuropathies.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty patients with diabetic neuropathies were randomly divided into control group and treatment group, 30 cases in each group. The control group was treated with Mecobalamin and Epalrestat. The treatment group was treated with lowdose anisodamine and Tetramethylpyrazine injection in addition to the medicine used in the control group. The treatment lasted 2 weeks. The following data were used to compare the clinical efficacy of the two groups before and after treatment：the level of high sensitive C reaction protein(hsCRP); the score of the Toronto Clinical Scoring System(TCSS); the motor nerve conduction velocity(MNCV) of bilateral median nerve, common peroneal nerve, tibial nerve and the sensory nerve conduction velocity(SNCV) of median nerve, sural nerve.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓After treatment, the hsCRP levels in both groups were significantly lower than those before treatment, and the hsCRP levels in the treatment group were significantly lower than those in the control group(P＜005). In both groups, the MNCV data of median nerve, the common peroneal nerve, the radial nerve and median nerve and the sural nerve were significantly higher than those before treatment, and the MNCV date of common peroneal nerve, tibial nerve and the SNCV data of median nerve, sural nerve were higher than those of control group(P＜005). The clinical efficacy of the treatment group was better than that of the control group, and the total effective rate was higher than that of the control group(P＜005). The TCSS scores of the two groups were significantly lower than those before treatment. The TCSS scores of the treatment group were lower than the control group(P＜005). The TCSS score of the treatment group was better than that of the control group, and the total effective rate was significantly higher than that of the control group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The treatment of diabetic neuropathies with lowdose anisodamine combined with tetramethylpyrazine is relatively safe and costeffective, especially for grassroots patients with primary disease who have practical clinical significance in reducing drug costs and social security expenses.
    The value of tumor markers in the evaluation of invasion depth and treatment decision of gastric cancer #br#
    HE Rongli1， ZHAO Zhiying1， LIU Chao1， ZHAO Jianmei2*
    2019, 40(5):  521-524.  doi:10.3969/j.issn.10073205.2019.05.007
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    ［Abstract］ Objective〖HTSS〗〓To investigate the correlation between serum levels of carcinoembryonic antigen(CEA), carbohydrate antigen 125, carbohydrate antigen 199 and alphafetoprotein(AFP) in patients with gastric cancer and the depth of invasion of gastric cancer, and to evaluate the clinical value of endoscopic submucosal dissection(ESD) in patients with gastric cancer.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The serum levels of carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 199 and AFP in 107 patients with gastric cancer before operation were detected by electrochemiluminescent immunoassay. The value of each index in judging the depth of invasion of gastric cancer was retrospectively analyzed by using the working characteristic curve and the area under the curve.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The levels of serum tumor markers CEA, carbohydrate antigen 125, carbohydrate antigen 199 AFP in group B were significantly higher than those in group A(P＜0.05). The accuracy of combined detection of serum tumor markers CEA, carbohydrate antigen 125 and carbohydrate antigen 199 in predicting the feasibility of ESD treatment in patients with gastric cancer was 75.70%.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Combined detection of serum tumor markers CEA, carbohydrate antigen 125 and carbohydrate antigen 199 has a high sensitivity for predicting the depth of invasion of gastric cancer patients, and has a certain reference value for judging whether ESD treatment is feasible for such patients.
    Effects of simethicone administered at different time on bowel preparation before capsule endoscopy#br#
    JI Chenguang, LIU Gaifang, WU Jing, MENG Xia, ZHAO Liwei, ZHU Xinying
    2019, 40(5):  525-527,532.  doi:10.3969/j.issn.10073205.2019.05.008
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the effects of simethicone administered at different time on bowel preparation before capsule endoscopy.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total 180 patients undergoing capsule endoscopy were randomly divided into three groups and all patients used polyethylene glycol electrolyte solution for bowel preparation. Group A: the patients were administered with 30ml simethicone 2 h before capsule endoscopy; group B: the patients were administered with 30ml simethicone 1 h before capsule endoscopy; group C, the patients were administered with 30 ml simethicone 0.5 h before capsule endoscopy. The small intestinal preparation quality, the time for gastric transit time and small intestinal transit time, the completion rate of capsule endoscopy and the adverse reactions were observed and compared between three groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The small intestinal preparation quality of group C is higher than group A and B(P＜005). There were no significant differences in the time for gastric and small intestinal transit time, the completion rate of capsule endoscopy and the adverse reactions among the three groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Administration of 30 ml simethicone 0.5 h before capsule endoscopy could improve the small intestinal preparation quality and the quality of the small intestinal endoscopic view.
    Effect of Gli on biological behavior of esophageal adenocarcinoma cells by PLK1#br#
    ZHAO Xin1, DU Yuankun2, ZHANG Yaozhong3, ZHANG Lei4, MI Yuan3, WANG Lei3*
    2019, 40(5):  528-532.  doi:10.3969/j.issn.10073205.2019.05.009
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    〗［Abstract］ Objective〖HTSS〗〓To explore the effect Gli expression on growth of esophageal adenocarcinoma cells  through PLK1 and to detect their molecular mechanisms.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓mRNA and protein expression of Gli1， Gli2 and PLK1 were detected after 24 h treatment of DMSO，  GANT61, NShh and GANT61&NShh respective by real time fluorescence quantitative PCR and Western blot assay. Cell cycle and apoptosis were measured by flow cytometry after 72 h treatment of GANT61.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with DMSO group,realtime fiuorescent quantitative PCR and Western blotting showed that GANT61 could downregulate mRNA and protein expression of Gli1, Gli2and PLK1,while NShh could increase mRNA and protein expression of Gli1, Gli2and PLK1 significantly. GANT61&NShh could restore partly mRNA and protein expression of Gli1,Gli2 and PLK1. OE33 cells showed a strong G2/M arrest and apoptosis 72 h after treatment of GANT61(P＜001). Expression of Gli1 mRNA and Gli1 protein, Gli2 mRNA and Gli1 protein ,PLK1 mRNA and Gli1 in GANT61 group were lower than those in DMSO group. Those indexes were higher in Nshh group than in DMSO group and GANT61 group, GANT61+NShh group were lower than DMSO group, but higher than GANT61 group. Proliferation rate of G0/G1 stage, S stage and G2/M stage in GANT61 group were higher than DMSO group, and it was the same trend with 72 h apoptotic rate between GANT61 group and DMSO group.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Glihas crosstalk relationship with PLK1 which may regulate cell cycle and apoptosis. They may play orchestral role in the growth of esophageal  adenocarcinoma.
    Retrospective analysis of the effects of three different treatments on the prognosis of infant epiphysis osteomyelitis#br#
    HE Mingzhe, SUN Yishuo*, ZHANG Fang， CUI Yingtie, ZHEN Lei
    2019, 40(5):  533-537.  doi:10.3969/j.issn.10073205.2019.05.010
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    ［Abstract］ Objective〖HTSS〗〓To analyze the effect of three different treatment methods on the prognosis of epiphyseal osteomyelitis.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Infans with epiphyseal osteomyelitis were selected and divided into three groups according to the treatment methods: group A underwent arthrotomy and drill,and group B underwent arthrotomy. Group C did not undergo surgery treatment group as a control group. At the time of followup, 21 cases remained in each group. The shoulder joint activity(n=8), hip joint activity(n=7) and knee joint activity(n=6) as well as hospitalization and extubation time were compared before and after treatment. 
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Six months after treatment, the range of shoulder joint abduction, flexion and extension in group A and group B, and the range of shoulder joint abduction and extension in group C were increased significantly compared with that before treatment(P＜005). Six months after treatment, the range of shoulder joint abduction, flexion and extension in group A and group B were increased compared with that in group C, and the difference was statistically significant(P＜005). Six months after treatment, the range of shoulder joint abduction, flexion and extension in group A was higher than that in group B(P＜005). The flexion, abduction and adduction of the hip joint in group A and B were significantly higher than those in group C(P＜005), and the flexion and abduction of the hip joint in group A and B were significantly higher than those in group C(P＜005). After 6 months of treatment, the knee joint activity in three groups was significantly higher than that before treatment(P＜005), but after 6 months of treatment, there was no statistical difference in knee joint activity among the three groups. Learning significance(P＞005), the hospitalization time of group A and B was less than that of group C, group A was less than that of group B, and the extubation time of group A was less than that of group B, the difference was statistically significant(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Arthrotomy and drilling is effective in restoring shoulder joint(abduction, flexion and extension), hip joint (flexion, abduction and adduction) and knee joint flexion and extension, and shorter hospitalization and extubation time can reduce the disability rate of the disease and improve the quality of life of infan after operation.
    miR19a3p regulates the proliferation of gastric cancer cells via targeting PTEN#br#
    NIE Hongfeng1， ZHANG Ping2， HE Xuexia1， CAO Qing1， HOU Yanqing1， MENG Lei1
    2019, 40(5):  538-542,546.  doi:10.3969/j.issn.10073205.2019.05.011
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    ［Abstract］〓Objective〖HTSS〗〓To discuss the effect of miR19a3p on the proliferation of human gastric cancer cell via targeting PTEN, which provided new ideas for the prevention and treatment of gastric cancer.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Gastric carcinoma tissue specimens and matched adjacent tissues were obtained from twenty patients who were identified as aggressive gastric adenocarcinoma. Realtime PCR was used to analyze the levels of miR19a3p in gastric carcinoma tissue specimens and matched adjacent tissues. miR19a3p mimic and miR19a3p inhibitor were transfected into MKN28 cells. Realtime PCR was used to analyze the level of miR19a3p. And MTT assay was used to determine the proliferation of MKN28 cell. miR19a3p mimic and miR19a3p inhibitor were transfected into MKN28 cells. Western blot was used to measure the protein level of PTEN. miR19a3p inhibitor and siRNAPTEN were transfected into MKN28 cells. Western blot was used to measure the protein level of PTEN. And MTT assay was used to determine the proliferation of MKN28 cell.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with adjacent tissues, miR19a3p expression was increased in gastric cancer tissues(P＜005). Compared with negative mimic control group, transfection with miR19a3p mimic increased miR19a3p expression(P＜005). Compared with negative inhibitor control group, transfection with miR19a3p inhibitor decreased miR19a3p expression(P＜005). The level of PTEN mRNA did not significantly change in MKN28 cells transfected with miR19a3p mimic(P＞005) or miR19a3p inhibitor(P＞005). The proliferation of MKN28 cells was inhibited in MKN28 cells transfected with miR19a3p inhibitor(P＜005) and was promoted in MKN28 cells transfected with siPTEN(P＜005). Compared with siPTEN group, the proliferation of MKN28 cells was decreased in MKN28 cells cotransfected with siPTEN and miR19a3p inhibitor(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓miR19a3p regulated the proliferation of human gastric cancer cells via targeting PTEN.
    Cartilage perichondrium composite graft in tympanoplasty#br#
    HE Qiang， ZHANG Ying， JIA Zhanwei, ZHANG Yubo
    2019, 40(5):  543-546.  doi:10.3969/j.issn.10073205.2019.05.012
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    ［Abstract］〓Objective〖HTSS〗〓To analyze the duration of dry ear and hearing recovery of patients with unilateral chronic suppurative otitis media with conductive hearing loss treated with perichondrium cartilage during tympanoplasty.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and twentyone cases of patients were recruited with unilateral chronic suppurative otitis media who were performed with open or complete wall tympanoplasty and the auditory ossicular chain was reconstructed in stage Ⅰ or Ⅱ. The perichondrium cartilage was used as the supporting material of tympanum and the temporalis muscle fascia was repaired in the operation.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Seventyone cases of patients were preformed with  reconstruction of ossicular chain at stage Ⅰ，and 11 patients were preformed with  reconstruction of ossicular chain at stage Ⅱ. The rest of patients were underwent the removal of lesions without reconstruction of ossicular chain. After 12 months of surgery, the average air bone gap(ABG) of patients who were conducted with  reconstruction of ossicular chain at stage Ⅰ and stage Ⅱ were obviously lower than that of preoperation, with statistically significant difference(P＜005). Compared with the ABG of preoperation, the ABG of patients who were underwent the removal of lesions without reconstruction of ossicular chain was no significantly difference(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓As a middle ear supporting material, perichondrium cartilage can maintain the volume of tympanoplasty, facilitate the recovery of eustachian tube function, shorten the dry ear time, and contribute to hearing recovery.
    Analysis of 25 hydroxyvitamin D status in newly diagnosed Han children with Graves disease in Shijiazhuang city#br#
    PI Yalei1, ZHANG Yanan1, HAN Xiao1, YANG Xiuxian2, GAO Liping3, YAN Xue1*
    2019, 40(5):  547-550.  doi:10.3969/j.issn.10073205.2019.05.013
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the 25 hydroxyvitamin D status in children with Graves disease and the role of vitamin D in the pathogenesis of Graves disease.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Thirtyseven children with Graves disease in Shijiazhuang Han nationality were selected. The patients were divided into summerautumn group(JuneNovember) and winterspring group(December to May of the following year) according to the time of their first visit, and < 10 years old group and ≥10 years old group according to the age. Four milliliters of fasting venous blood were collected to test thyrotropin, total thyroxin, free thyroxine,total triiodothyronine, free triiodothyronine, thyrotropin receptor antibody and thyroglobulin, thyroglobulin antibody, 25 hydroxyvitamin D level; The lengths, widths and thicknesses of the right and left lobes of the thyroid were measured by ultrasound and the volume of thyroid was calculated. The iodine uptake rate of 3, 6 and 24hour were measured by oral 131I method, and the iodine in the midstream urine was measured by electrochemical method.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The level of 25 hydroxyvitamin D in 37 children with Graves disease was（49.95±22.82） nmol/L, 11 cases(29.73%)were deficient, 4 cases(10.81%) were insufficient  and 22 cases(59.46%) were sufficient. The levels of 25 hydroxyvitamin D in the summerautumn group was higher than the winterspring group(P＜005).The 25 hydroxyvitamin D level was no significant difference between <10 years old group and ≥10 years old(P＞005). There were no correlations between serum 25 hydroxyvitamin D level and thyroid volume,total thyroxin, free thyroxine, total triiodothyronine, free triiodothyronine, urine iodine, 131I iodine absorption rate at 3, 6 and 24hour(P＞0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The serum level of 25 hydroxyvitamin D in children with Graves disease was not significantly decreased, and the seasonal changes were still present. The level of serum 25 hydroxyvitamin D does not affect the laboratory and clinical parameters of children with Graves disease.
    Effect of different mechanical ventilation on neonatal  respiratory failure and the levels of CC16 and KL6 in neonates#br#
    YUAN Jing1, LI Shufang1, LI Yafei2, LANG Yuanfa3, WANG Sha4
    2019, 40(5):  551-555.  doi:10.3969/j.issn.10073205.2019.05.014
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    〗［Abstract］ Objective〖HTSS〗〓To explore the clinical efficacy of high frequency oscillatory ventilation and synchronized intermittent mandatory ventilation in the treatment of neonatal respiratory failure, and the influence on the levels of CC16 and KL6 in neonates.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and thirty cases of neonates with respiratory failure were randomly divided into observation group(n=65, 12 cases of premature infants, 53 cases of fullterm infants) and control group(n=65, 12 cases of premature infants, 53 cases of fullterm infants ). The observation group was treated with high frequency oscillatory ventilation, the control group was treated with synchronized intermittent mandatory ventilation, The clinical efficacy of two groups of preterm infants and fullterm infants were compared, and the 0 h, 24 h and 72 h blood gas indexes of two groups were detected, and the changes of serum CC16 and KL6 before and after treatment and the occurrence of adverse reactions were observed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The overall clinical effective rate was 908%(59/65) in the observation group, which was significantly higher than that in the control group(80.0%, 52/65). The effective rate of the two groups of fullterm infants was better than that of premature infants(P＜005). The oral feeding time, ventilator use time and hospitalization time of the observation group were significantly shorter than the control group(P＜005). After mechanical ventilation, the OI, RI and PaCO2 of the two groups showed a gradual decline trend. The PaO2 and PaO2/FiO2 of the two groups showed a gradual increase, but the decrease and increase of the observation group were larger. The two groups were between the groups and the time. There were significant differences in the interaction between the groups and between the groups(P＜005). The serum levels of CC16 and KL6 in the two groups were significantly lower than those before treatment(P＜005). The levels of CC16 and KL6 in the observation group were significantly lower than those in the control group after treatment(P＜005). The incidence of adverse reactions such as pulmonary hemorrhage, ventilatorassociated pneumonia, and lower respiratory tract infection in the observation group were significantly lower than that in the control group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Noninvasive high frequency oscillatory ventilation in the treatment of neonatal  with respiratory failure can significantly improve the blood gas index, reduce inflammation, reduce the level of KL6 and CC16, improve the lung injury and with less adverse reaction.
    Study on the nutrition risk screening and effect factors for malnutrition in hospitalized children with hematological tumor#br#
    ZHANG Huina1, ZHAO Bin2*, MA Dongxue3, LIU Huiling2, ZHAI Yingju1
    2019, 40(5):  556-560.  doi:10.3969/j.issn.10073205.2019.05.015
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the nutritional risk and malnutrition of hospitalized children with blood tumor and analyze its effect factors, providing evidence for the clinical nutritional risk screening program and the reasonable assessment of nutritional status.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Based on the collected data of 350 hospitalized children with blood tumor, Chinese Version Paediatric Yorkhill Malnutrition Score(CVPYMS) was employed to analyze the present situation and effect factors of nutritional risk and malnutrition in hospitalized children with blood tumor.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓69(19.72%) of the 350 hospitalized children's nutritional risk was high, 249(71.14%) was moderateand 32(9.14%) was low. According to the malnutrition classification criteria in Chinese Guidelines for Clinical Application of Paediatric Parenteral Nutrition Support, the malnutritiondetection rate was 5.71%, among which 18(5.14%) were moderately malnourished, and 2(0.57%) were severe malnutrition. Logistic regression analysis indicated that age, chemotherapy period and tumor stage were the independent risk factors affecting themalnutrition risk among hospitalized children with blood tumor.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The incidence of malnutrition among hospitalized children with blood tumor is high; age, chemotherapy period and tumor stage are the critical factors affecting themalnutrition risk among hospitalized children with blood tumor.
    Effects of transcranial direct current electrical stimulation combined with upper limb robots on upper limb motor function and surface electromyogram signal in patients with cerebral infarction during convalescence
    ZHANG Ying1， WANG Jun2
    2019, 40(5):  561-564.  doi:10.3969/j.issn.10073205.2019.05.016
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    ［Abstract］〓Objective〖HTSS〗〓To observe the effects of transcranial direct current stimulation combined with upper limb robots on motor function and surface electromyogram signal of spastic upper limbs in patients with cerebral infarction during convalescence.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 72 patients with cerebral infarction in convalescent stage were randomly divided into control group and treatment group, 36 cases in each group. The control group was treated with routine rehabilitation exercise therapy, while the treatment group was treated with transcranial direct current stimulation combined with upper limb robot on the basis of the control group. The clinical efficacy, FuglMeyer motor Assessment(FMA), Modified Ashworth Scale(MAS), biceps brachii synergistic contraction rate and triceps brachii synergistic contraction rate were evaluated before and after treatment.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The clinical efficacy of the treatment group was better than that of the control group, and the total effective rate of the treatment group was significantly higher than that of the control group(P＜005). After treatment, the FMA scores of the two groups were significantly higher than those before treatment. The MAS scores, biceps brachii synergistic contraction rate and triceps brachii synergistic contraction rate were significantly lower than those before treatment. The FMA scores of the treatment group were significantly higher than those of the control group, while the MAS scores, biceps brachii synergistic contraction rate and triceps brachii synergistic contraction rate were significantly lower than those of the control group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Transcranial direct current stimulation combined with upper limb robots can effectively improve the motor function of spastic upper limbs in patients with cerebral infarction in convalescence, reduce muscle tension and promote the rehabilitation of patients, which is worthy of clinical promotion.
    Comparison of radiation doses between two modes in lumber interverbral disc CT scan#br#
    LI Xiaona1, WANG Yuhui2, ZHANG Yinghua1,WANG Xiaoying1, SUN Chen3, PENG Zhigang1*
    2019, 40(5):  565-569.  doi:10.3969/j.issn.10073205.2019.05.017
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    〗［Abstract］ Objective〖HTSS〗〓To investigate the effects of the sequential lumbar intervertebral disc scanning mode and the continuous lumbar interverbral disc reconstruction mode on computed tomography(CT) radiation dose and image quality of lumbar intervertebral disc.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and twentyeight patients with clinically suspected lumbar  disc herniation were randomly divided into two groups. One group(group A) used conventional sequential lumbar intervertebral disc scanning mode; another group(group B) used the scan mode with the automatic expose control system that the normal intervertebral disc was reconstructed by continuous lumbar scanning, in which the original data were reconstructed by multiplane reconstruction after scanning. The reconstructed axial images were corresponding to the part of the conventional disc position. Then the radiation doses of the two mode scans were recorded and the image quality of the corresponding axial images was analyzed through the doubleblind method by two qualified diagnostic doctors.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The scan time and radiation dose of group B in lumbar disc reconstruction mode was less than those of group A in sequential lumbar disc scan mode(P＜005). The signaltonoise ratio of abdominal aorta in group B was lower than that in group A(P＜005). However, two diagnostic doctors had consistent subjective rating for image quality. Two groups can better display lumber diseases, especially the lumbar vertebral reconstruction model(group B) is more convenient for stereoscopic observation.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓For the CT examination of lumbar intervertebral disc, the continuous lumbar interverbral disc reconstruction mode combined with automatic expose control technique can reduce the radiation dose.
    The clinical effect of HRCT combined with tumor markers detection in diagnose of solitary pulmonary nodule
    ZHOU Xiumei1， LI Kuncheng2*
    2019, 40(5):  570-574.  doi:10.3969/j.issn.10073205.2019.05.018
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    ［Abstract］ Objective〖HTSS〗〓To study the effect of highresolution CT(HRCT) combined with serum tumor markers detection in diagnose of solitary pulmonary nodule(SPN).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and twentysix cases of malignant SPN patients were selected as observation groups, 98 cases of benign SPN patients from the same time were selected as control group. Serum lung cancer markers were combined into four groups:carcino embryonic antigen(CEA), squamous cell carcinoma(SCC), neuronspecific enolase(NSE), cytokeratin19fragment 211(CYFRA211) detection and HRCT detection. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of HRCT, serum tumor markers and their combined detection were evaluated according to the gold standard of pathological results.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓SPN pathological results showed that 59 cases of adenocarcinoma, 42 cases of squamous cell carcinoma, 16 cases of bronchioloalveolar carcinoma and 9 cases of small cell carcinoma. On HRCT signs, the detection rates of typical nodules with deep lobulation, pleural depression, short and fine spikes, vacuole sign, bronchial vascular cluster sign and spinous process in malignant group were higher than those in benign group, while the detection rates of adjacent pleural thickening and satellite oven in benign group were higher than those in malignant group(P＜005). The levels of serum CEA, SCC, NSE and CYFRA211 in malignant group were higher than those in benign group(P＜005). The sensitivity of combined examination was the highest among the three methods, but the specificity was the lowest, the accuracy of tumor markers was the lowest, HRCT and combined examination were similar; the positive predictive value of HRCT was the highest, and the negative predictive value was lowest with the detection of tumor markers.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Joint examination has the highest sensitivity and the lowest specificity. We should pay attention to the identification of false positive rate, comprehensive evaluation of various indicators, HRCT examination indicators are relatively constant, and have higher diagnostic value in clinic. Detection of tumor markers combined with HRCT examination will greatly improve the diagnostic value, which is worthy of clinical promotion.
    Quantitative evaluation of lumber vertebra osteoporosis with MRI T2* mapping#br#
    ZHANG Xiaofei, WU Huizhao, HAN Shuman, CAO Lei, WEN Jinxu, WU Wenjuan*
    2019, 40(5):  575-578,591.  doi:10.3969/j.issn.10073205.2019.05.019
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    〗［Abstract］ Objective〖HTSS〗〓To explore the clinical value of MRI T2* values for quantitative evaluation of the lumbar vertebrae osteoporosis.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The patients who underwent the routine lumbar MRI scan, T2* mapping scan and quantitative computer tomography(QCT) were collected. Bone mineral density(BMD) of the QCT were obtained, and T2* values of L2-L4 were measured by two independent observers. According to the BMD values, the vertebral bodies were divided into the normal group, the osteopenia group and the osteoporosis group. The correlations of T2* values and BMD were analyzed with Spearman correlation tests. The diagnostic efficiency of T2* values was evaluated by receiver operating characteristic curve(ROC curve).
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The correlations of the T2* values and BMD values in all three groups were negative(rs=-0.47, -0.52, -0.57, P＜0.05 respectively). The areas under ROC curve of T2* value for diagnosis of the lumber vertebral osteopenia and osteoporosis were 0.76 and 0.79, respectively. The diagnosis sensitivity was 82.2% and the specificity was 59.3% for diagnosis of osteopenia at the threshold of 12.48, 87.1% and 56.2% for the diagnosis of osteoporosis at the threshold of 17.13.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The MRI T2* mapping sequence could be a reliable diagnostic indicator for quantitative evaluation of the lumbar vertebrae osteoporosis．
    Clinical value of ultrasonography in monitoring umbilical artery and venous catheter blood flow spectrum parameters in fetuses with tricuspid regurgitation#br#
    LUO Bing1, WANG Yicheng1*, YANG He1, YANG Ruimin1, JIAO Guiqing2, ZHANG Liwei1
    2019, 40(5):  579-582.  doi:10.3969/j.issn.10073205.2019.05.020
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    ［Abstract］ Objective〖HTSS〗〓To investigate the changes and clinical value of blood flow spectrum parameters of umbilical artery(UA) and ductus venous(DV) in fetuses with tricuspid regurgitation at different degrees.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Two hundreds and fiftythree fetuses(20-41+6week without structural defects) were divided into 3 groups: 68 cases with mild tricuspid regurgitation(mild group), 20 cases with moderate tricuspid regurgitation(moderate group) and 165 normal fetuses(control group). The blood flow spectrum of UA and DV in each group was obtained. The parameters of UA: peak systolic velocity(S), end diastolic velocity(D), S/D ratio, resistance index(RI) and pulsatility index(PI) were measured. Then the parameters of DV peak ventricular systolic velocity(S), peak atrial systolic velocity(A), S/A ratio, RI and PI were measured. Finally, conduct comparative analysis among the three groups was used.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no significant difference in S/D, RI, PI of UA and S/A, RI and PI of DV between mild reflux group and control group(P＞005). The parameters of UA blood flow spectrum S/D, RI, PI and DV in moderate reflux group were higher than those in control group and mild reflux group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓UA and DV blood flow spectrum can be used to evaluate the condition of fetus and placenta when tricuspid regurgitation happens. Therefore, it can provide substantial support for intervening measures.
    Analysis of relationship between microvessels and cervical cancer metastasis detected by color Doppler ultrasonography#br#
    LIN Li1, LI Xingming2
    2019, 40(5):  583-586.  doi:10.3969/j.issn.10073205.2019.05.021
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    ［Abstract］ Objective〖HTSS〗〓To investigate the relationship between microvessels and cervical cancer metastasis detected by color Doppler ultrasound.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty  patients with cervical cancer were selected in this study. All patients were diagnosed by color Doppler ultrasound imaging and then treated with surgery. The number of lymph nodes removed after operation was recorded and the pathological examination was performed. The type of cervical cancer, vascular involvement, parametrial infiltration and interstitial infiltration depth were detected and recorded. The relationship between the blood flow richness of cervical cancer lesion and the type of cervical cancer, vascular involvement, parauterine infiltration and interstitial infiltration depth was analyzed. The logistic multiple regression analysis was used to analyze the risk factors of cervical cancer metastasis.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓A total of 29 cases(48.3%) of pelvic lymphatic metastasis were found by operation and postoperative pathological examination. A total of 25 cases(41.7%) of pelvic metastasis were found by color Doppler ultrasonography. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of color Doppler ultrasound were 82.76%, 96.77%, 90.00%, 96.00% and 85.74%, respectively. Compared with those without parametrial infiltration, no vascular involvement, interstitial infiltration depth(<10 mm) and no lymph node metastasis, the blood flow was abundant in patients with parametrial infiltration, vascular involvement, interstitial infiltration depth(≥10 cm) and lymph node metastasis. The logistic regression analysis showed that parametrial infiltration, vascular involvement, interstitial infiltration and lymphatic metastasis were the high risk factors for cervical cancer with abundant blood flow.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The color Doppler ultrasound imaging system has a good consistency with pathological results in lymphatic metastasis of cervical cancer patients, and lymphatic metastasis combined with the detection of blood flow richness has a good diagnostic value for cervical cancer metastasis.
    Study on stability of refrigerated drug Nicorandil compatible with solvents of different carriers
    LIU Jian， LIU Xuerei， ZHANG Yakun
    2019, 40(5):  587-591.  doi:10.3969/j.issn.10073205.2019.05.022
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    ［Abstract］〓Objective〖HTSS〗〓To study the stability of refrigerated drug Nicorandil compatible with solvents of different carriers.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The solutions of nicorandil dissolved with 0.9% sodium chloride injection or 5% glucose Injection were stored at room temperature or low temperature for 8 h. The concentration of nicorandil was determined by ultrahigh performance liquid chromatography， and the chromatographic conditions were as follows： chromatographic column was ACEC18（50 mm×2.1 mm， 2.5 μm） column and the column temperature was 40 ℃， the mobile phase was methanolwater（42〖DK〗∶58） with a flow rate of 0.4 mL/min， the detection wavelength was set at 254 nm. The changes of pH were measured with pH meter. The number of insoluble particles were surveyed by particle analyzer.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The linear ranges of nicorandil was 3.316-18.896 mg/L （r=0.999）. The concentration of  nicorandil and the value of pH were stable after dissolved in different solvents and stored at different temperatures within 8 h. Additionally，  the amount of particles（≥25 μm ） was normal， while amount of particles（≥10 μm） was relatively larger.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓When stored at either room temperature or low temperature，the stability of nicorandil solution after dissolved in different solvents is  desirable within 8 h， while the amount of particles（≥10 μm）  exceed the number of regulation.
    Study on the relationship between oxidized low densitylipoprotein antibody and adult acute lymphoblastic leukemia
    LI Weihao1, JI Xin2， GAO Wei3， ZHANG Mingming3, ZHANG Feifei1, ZHANG Zhiping1
    2019, 40(5):  592-597.  doi:10.3969/j.issn.10073205.2019.05.023
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    ［Abstract］ Objective〖HTSS〗〓To investigate the correlation between oxidized low density lipoprotein(oxLDL) antibody and adult acute lymphoblastic leukemia(ALL).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 57 patients with adult ALL and 50 healthy controls were enrolled. Serum total protein, albumin, cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, IgG, IgA, IgM, oxLDL, oxLDLIgG and oxLDLIgM were measured at the time of diagnosis.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Serum total protein, albumin, cholesterol, LDL and oxLDLIgG were lower and oxLDL, oxLDLIgM were higher in ALL patients compared to controls. Serum oxLDLIgG in ALL patients was positively correlated with total protein, cholesterol and LDL, whereas negatively correlated with oxLDL. Total protein, cholesterol and LDL were negatively correlated with oxLDLIgM. According to binary logistic regression analyis, elevation of oxLDLIgG was shown to be a protective factor and elevation of oxLDLIgM to be a risk factor for the onset of adult ALL.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Dysregulated lipid metabolism and increased lipid peroxide levels could be observed in adult ALL patients and the occurrence of ALL was probably related to the decrease of oxLDLIgG and elevation of oxLDLIgM.