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Table of Content

    25 June 2019, Volume 40 Issue 6
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    Efficacy analysis of combined mechanical thrombolysis with intravenous and intraarterial thrombolysis in patients  with acute intracranial large artery occlusion #br#
    WANG Yu， WU Lijuan, XU Yingdong， LI Guofeng, LI Xiaoqiang, WEI Yuqing*
    2019, 40(6):  629-632,649.  doi:10.3969/j.issn.10073205.2019.06.003
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    〖WTHZ〗［Abstract］〓Objective〖HTSS〗〓To investigate the efficacy and safety of mechanical thrombolysis with intravenous and intraarterial thrombolysis in patinets with acute intracranial large artery occlusion.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical data of 38 patients with acute intracranial large artery occlusion by using the combined mechanical thrombolysis with intravenous and intraarterial thrombolysis were analyzed retrospectively. There were 9 cases in internal carotid artery,18 cases in middle cerebral artery,11 cases in basilar artery .The clinical effects and safety were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓According to the stroke type and vascular condition, mechanical thrombolysis was used in 3 patiens. Arterial thrombolysis was used in 13 patients. Mechanical thrombectomy was used in 23 patients. Balloon dilatation was used in 3 patients. Stenting was used in 5 patients. Occluded large arteries of  33 patients were dredged totally or partialy，the recanalization rate or partial recanalization rate of blocked blood vessel was 86.8%,including 22 cases with total recanalization(57.9%),11 cases with partial recanalization(28.9%). The target blood flow evaluated by modified thrombolysis in cerebral infarction can reached form 2b-3 grade. After operation four cases suffered from cerebralhemorrhage，including 1 case of frontal lobe hemorrhage, 1 case of basal ganglia and temporal lobe hemorrhage,6 cases died． 32 patients were survived from treatment. Over time,the ranks of National Institute of Health Stroke Scale gradually decreased, the ranks of Activity of Daily Living Scale gradually increased, and the difference was statistically significant(P＜0.05). The degree of modified Rankin Scale showed no significant difference between leaving and 6 months after departure from the hospital(P＞0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Mechanical thrombolysis with intravenous and intraarterial thrombolysis in patinets with acute intracranial large artery occlusion is a safe and an effective therapy within 4.5 h intravenous thrombolysis time window．
    Protective effect of Salvia miltiorrhiza extract on tumor with myocardial ischemic injury
    QIN Yan1,2, YANG Gaoshan2, ZHANG Nan2, YANG Haojie2, NIE Ziyuan3， ZHOU Jing2,4*
    2019, 40(6):  633-636,641.  doi:10.3969/j.issn.10073205.2019.06.004
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    ［Abstract］ Objective〖HTSS〗〓To observe the role of Salvia miltiorrhiza extract in tumor with myocardial ischemia model.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Thirty female BALB/Cnu nude mice which were 4-6 week old were subcutaneously inoculated with breast cancer MCF7 cells to prepare transplanted tumors. Eighteen mice with successful transplanted tumors were randomly divided into three groups: tumor model group，tanshinone ⅡA group and salvianolic acid B group. After 7 days of transplantation, each group was injected with isoproterenol 2.5 mg/kg intraperitoneally for 7 days to establish an animal model of tumor with myocardial ischemia. Another 6 rats were set as normal control group. The tumor tissue was removed and weighed, and the heart tissue was subjected to Masson′s Trichrome staining. The expression of CD34 and von Willebrand Factor(vWF) in myocardium and tumor tissues was detected by immunohistochemistry. The effect of tanshinone ⅡA on human umbilical vein endothelial cells(HUVECs) and breast cancer MCF7 were observed by MTT.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The results showed that the area of myocardial collagen fibers in the tumor model group was significantly higher than that in the normal control group. The tumor weight and myocardial collagen fiber area in the tanshinone ⅡA group and salvianolic acid B group was significantly smaller than that in the the tumor model group(P＜005). In the myocardial tissue, the expression levels of CD34 and vWF protein in the tanshinone ⅡA group and the salvianolic acid B group were significantly higher than those in the tumor model group(P＜005) . In the tumor tissue, the expression levels of CD34 and vWF protein in tanshinone ⅡA group and in salvianolic acid B were significantly lower than those in the tumor model group(P＜005). In vitro experiments showed that tanshinone ⅡA can promote the proliferation of HUVECc and inhibit the proliferation of breast cancer cells in a dosedependent manner.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The effect of tanshinone ⅡA on protecting myocardial ischemia and inhibiting the growth of breast cancer cells may be related to angiogenesis.
    Relationship between IRS2 mRNA level in rat bone tissue and osteoporosis in type 2 diabetes mellitus#br#
    ZHANG Lili1, LI Yukun2*
    2019, 40(6):  637-641.  doi:10.3969/j.issn.10073205.2019.06.005
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    ［Abstract］ Objective〖HTSS〗〓To investigate the role of insulin receptor substrate2(IRS2) in the pathogenesis of type 2 diabetic osteoporosis in rats.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixtyfour  female Wistar rats(3months old) were randomly divided into 4 groups: normal control group(NC group), normal ovariectomy group(NOVX group), type 2 diabetes mellitus group(DC group) and diabetes ovariectomy group(DOVX group). Rats in NC and NOVX groups were fed with regular diet, while rats in DC and DOVX groups were fed with high fat diet(45%). After 8 weeks of feeding, DC and DOVX groups received an intraperitoneal injection of streptozotocin. One week later, rats in the NOVX and DOVX groups underwent ovariectomy. After 12 weeks of continuous feeding, the rat model of type 2 diabetic osteoporosis was successfully established. Body weight, fasting blood glucose, fasting insulin and insulin sensitivity index were measured. Bone mineral density and IRS2 mRNA levels were measured at 4, 8 and 12 weeks after ovariectomy.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with NC group and NOVX group, the body weight of DC group and DOVX group was decreased, while the fasting blood glucose and insulin were increased. Compared with NC group and NOVX group, insulin sensitivity index of DC group and DOVX group was decreased. Compared with NC group, the bone mineral density and IRS2 gene levels of NOVX group and DOVX group were gradually decreased at 8 and 12 weeks after ovariectomy.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓IRS2 mRNA level in bone tissue decreases with the decrease of bone density during the development of type 2 diabetic osteoporosis.
    Effects of Liraglutide combined with insulin glargine on the efficacy and islet function of type 2 diabetic patients with obesity#br#
    JIN Kang， ZHANG Lishuang， DONG Lina， QIAO Jingmin， ZHAO Zhigang
    2019, 40(6):  642-645.  doi:10.3969/j.issn.10073205.2019.06.006
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    ［Abstract］ Objective〖HTSS〗〓To evaluate the effect of Liraglutide combined with insulin glargine on curative effect and islet function among type 2 diabetes mellitus population with obesity.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓ixty type 2 diabetes mellitus patients with obesity were randomly divided into trial group and control group with 30 patients in each group.Both groups received diet and exercise education and oral dimethyldiguanide treatment.Control group was given insulin glargine hypodermic injection whereas trial group had both Liraglutide and insulin glargine hypodermic injection for 12 weeks. Body mass index(BMI),fasting bloodglucose(FBG), 2hour postprandial blood glucose(2 hPG), glycated hemoglobin(HbA1c), total cholesterol(TC), triglyceride(TG),insulin resistance index(HomaIR) and side effects were compared before and after treatment.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with that before treatment, both groups showed a significant decrease of BMI, FBG, 2 hPG, HbA1c, TC,T G and HomaIR（P＜005) with a more significant decrease in trial group. After treatment, the above indicators in the observation group were lower than those in the control group, and the difference was statistically significant（P＜005）.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Liraglutide combined with insulin glargine has good therapeutic effect on obesity patients with type 2 diabetes mellitus. It can significantly improve the metabolism of glucose and lipid, reduce weight, and improve the function of islet cells in diabetic patients. It is worthy of clinical promotion.
    Evaluation and analysis of the effect of submucosal injection for endoscopic resction of duodenal papilla adenoma#br#
    WANG Wenhai, LI Peng, WANG Yongjun, ZHU Shengtao, JI Ming, ZHANG Shutian*
    2019, 40(6):  646-649.  doi:10.3969/j.issn.10073205.2019.06.007
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    ［Abstract］〓Objective〖HTSS〗〓To evaluate and analyze the effect of submucosal injection for endoscopic resction of duodenal papilla adenoma.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 37 cases with duodenal papilla adenoma underwent endoscopic papillectomy and were analyzed retrospectively. Among them,22 patients who were treated with submucosal injection before resection were allocated as treament group and 15 patients without submucosal injection as control group. The rates of total excision, complete excision and complications were compared between the two groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no significant difference in the rates of total excision, complete excision and complications between the two groups.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Submucosal injection is not necessary before endoscopic papillectomy of duodenal papilla adenoma.
    Effect of miR146 on rheumatoid arthritis synovial fibroblasts through PI3K/Akt signaling pathway
    HUANG Qin, MAO Huihui
    2019, 40(6):  650-653,657.  doi:10.3969/j.issn.10073205.2019.06.008
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    ［Abstract］ Objective〖HTSS〗〓To investigate the effect of microRNA(miR146) on rheumatoid arthritis(RA) fibroblastlike synoviocytes(FLS) through  PI3K/Akt signaling pathway.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓RAFLS cells were divided into the control group, lipopolysaccharide(LPS) group and LPS+miR146 group. After transfection of miR146 in the LPS+miR146 group, the LPS group and the LPS+miR146 group were incubated with LPS for 24 h, respectively. The cell proliferation was determined by methylthiazolyldiphenyltetrazolium. The Flow cytometry was used to detect cell apoptosis. The levels of interleukin1β(IL1β), interleukin6(IL6) and tumor necrosis factorα(TNFα) in supernatants were determined by enzymelinked immunosorbent assay. The realtime quantitative polymerase chain reaction was used to detect the expression of miR146, PI3K and Akt mRNA. Western blotting was used to detect the expression of PI3K, Akt and phosphorylated(p)Akt.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Compared with LPS group, the expression of miR146 in LPS+miR146 group was significantly increased(P＜005), the proliferation of RAFLS cells was significantly decreased(P＜005), and the apoptosis was significantly increased(P＜005). Compared with LPS group, the contents of IL1β, IL6 and TNFα in the supernatant in LPS+miR146 group were significantly decreased(P＜005), the expression of PI3K mRNA and protein in LPS+miR146 group was downregulated(P＜005), and the expression of Akt mRNA and protein in LPS+miR146 group was not significantly changed(P＞005), and the expression of pAkt protein in LPS+miR146 group was significantly decreased(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓miR146 may regulate the proliferation, apoptosis and inflammatory factors of RAFLS cells by interfering with PI3K/Akt signaling pathway.
    Relationship among pentraxin3, hypersensitive Creactive protein and malnutrition in hemodialysis patients of old age#br#
    LIU Jieqiong, WANG Jingfu*
    2019, 40(6):  654-657.  doi:10.3969/j.issn.10073205.2019.06.009
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the relationship among pentraxin3(PTX3), hypersensitive Creactive protein(hsCRP) and malnutrition in patients of old age with maintenance hemodialysis(MHD).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Seventyseven MHD patients treated more than three months,with urea clearance index(Kt/V)＞1.2, were included in this study. Fiftyone old MHD patients who were sixtyfive and above were in one group, while twentysix MHD patients who were less than sixtyfive years old were in the other group. Subjective Global Assessment(SGA), Kt/V, blood urea nitrogen(BUN), serum creatinine(SCr), serum albumin(ALB）, hemoglobin(Hb）, PTX3 and hsCRP were compared in two groups. The bivariate correction analysis of PTX3, SGA, hsCRP and ALB was measured in the two groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓There were higher levels of PTX3 and hsCRP,SGA, while lower levels of SCr, BUN and ALB （P＜005） in old MHD patients. The value of PTX3 was positively relative with hsCRP and SGA, while negatively with ALB(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The incidence rate of malnutrition was higher in old MHD patients. PTX3 could detect the malnutrition.
    Efficacy observation of sevelamer combined with elcatonin on hyperphosphatemia in hemodialysis patients#br#
    CHEN Long， CHENG Jiayou， WANG Shan， ZHOU Dongmei， WANG Jin
    2019, 40(6):  658-661,666.  doi:10.3969/j.issn.10073205.2019.06.010
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the effect of sevelamer combined with elcatonin on the efficacy of hyperphosphatemia in hemodialysis patients.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The 103 patients with hemodialysis hyperphosphatemia  were divided into sevelamer group(34 cases), elcatonin group(34 cases) and combined group(35 cases) according to random number table. The patients in sevelamer group were po administered with sevelamer carbonate tablets, 800 mg/times, 3 times daily. The patients in elcatonin group received intramuscular injection of elcatonin injection, 1 mL/times, once a week. The patients in the combined group were treated with sevelamer carbonate and elcatonin, and the method of administration is the same as the two single drug groups. All three groups were treated for 12 weeks. Observe and compare the clinical efficacy of each group.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The clinical efficacy of the sevelamer group was superior to that of the elcatonin group. The combined clinical efficacy was better than the sevelamer group and the elcatonin group(P＜005). The total effective rate in the sevelamer group was significantly higher than that in the elcatonin group; the total effective rate in the combined group was higher than that of the sevelamer group and elcatonin group, the difference was statistically significant(P＜005). After treatment, serum phosphorus, calciumphosphorus product, intact parathyroid hormone(iPTH), highsensitivity Creactive protein(hsCRP), and fibroblast growth factor 23(FGF23) levels were significantly decreased in each group, the serum calcium levels in the combined group and the elcatonin group were significantly lower than before treatment(P＜00.05). Compared with the elcatonin group, the serum phosphorus, calciumphosphorus product, iPTH, hsCRP, and FGF23 levels decreased more significantly in the sevelamer group(P＜005). The changes of the above indicators in the combined group were significantly higher than those in the sevelamer group and the elcatonin group(P＜005). There was no significant difference in the incidence of adverse reactions between the three groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Both sevelamer and elcatonin are effective in lowering blood phosphorus, but sevelamer is more effective than elcatonin. Sevelamer and elcatonin have the best effect of controlling serum phosphorus, which can effectively improve the quality of life of patients and has certain clinical promotion value.
    Expression and correlation of NFκB and NSE in peripheral blood of children with fevered convulsion
    HAO Gailing, ZHANG Zhongfu*, MA Jianping, CHANG Haixia, LI Qinghua, CUI Yuhui
    2019, 40(6):  662-666.  doi:10.3969/j.issn.10073205.2019.06.011
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    ［Abstract］ Objective〖HTSS〗〓To analyze the changes of nuclear factor kappa B(NFκB), neuronspecific enolase(NSE) and lactic acid levels in peripheral blood and the prognostic value of these indicators in children with fevered convulsion.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 100 cases of children with fevered convulsion were selected as subjects. According to the time and frequency of onset, they were divided into simple group(SFS group) 58 cases and complex group(CFS group) 42 cases, and 50 cases without fevered convulsion in the same period were selected as the control group. The expression levels of transcription factor NFκB and NSE were detected by elisa. All indexes were followed up for 6 months, and the prognosis of the children was predicted by ROC curve analysis.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The levels of serum NFκB, NSE, lactic acid and blood glucose in the SFS group and CFS group were higher than those in the control group(P＜005). The levels of NFκB, NSE, lactic acid and blood glucose were all higher than those of < 2 times. The levels of NFκB, NSE, lactic acid and blood glucose were all higher than those of ＜15 min(P＜005). The frequency and duration of convulsion were positively correlated with NFκB, NSE level, lactic acid and blood glucose. According to the ROC curve analysis, the area under the curve of NSE, NFκB and lactic acid for the prognosis of children with convulsion was 0.819, 0.778 and 0.709, respectively, while the area under the ROC curve of the three combined was 0.838. During the 6month followup, 20 cases(47.6%) of the patients with complicated fevered convulsion relapsed, and 10 cases(23.8%) were converted to epilepsy. The incidence rate was higher than that of 12 cases(20.7%) and 3 cases(5.2%) of the patients with simple fevered convulsion relapsed, and the difference between the two groups was statistically significant(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The levels of NSE, NFκB, lactic acid and blood glucose in peripheral blood of children with feverinduced convulsion were all increased, and increased with the frequency and duration of convulsion. The combined detection of NFκB, NSE and lactic acid was of great significance for the prognosis of children with feverinduced convulsion and was worthy of clinical application.
    Application value of hybrid coronary revascularization in the treatment of coronary heart disease
    LIU Ziteng, WU Ruifeng, YANG Weiqi, ZHANG Xuelian, ZHOU Boliang
    2019, 40(6):  667-670.  doi:10.3969/j.issn.10073205.2019.06.012
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    ［Abstract］ Objective〖HTSS〗〓To evaluate the clinical value of hybrid coronary revaseularization(HCR), coronary artery bypass grafting(CABG) and percutaneous coronary intervention(PCI) in the treatment of coronary heart disease.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A retrospective analysis was made of the clinical data of 88 patients with confirmed coronary artery disease and coronary angiography suggesting double or triple vessel lesions of the coronary artery. According to the operation they were divided into 3 groups: 26 cases of HCR group, 32 cases of CABG group, 30 cases of PCI group. The basic conditions, operation time, drainage volume, mechanical ventilation time, postoperative hospitalization days and infection rate were compared before and after operation. The patients were followed up for 1 to 12 months to observe whether there was myocardial infarction or angina attack, and the patency of coronary artery and bridge vessels after 1 year.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The operation time and postoperative hospitalization time of PCI group were significantly shorter than those of HCR group and CABG group, and the postoperative hospitalization time of HCR group was shorter than that of CABG group(P＜0.05); the mechanical ventilation time of CABG group was significantly longer than that of HCR group, and the drainage volume on the first day after operation was less than that of HCR group, the difference was statistically significant(P＜0.05). There were no significant differences in LVEF value, incision infection rate and bridging vessel stenosis rate among the three groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓HCR has important clinical value in the treatment of coronary heart disease in terms of risk, aesthetics and prognosis.
    Relationship and significance of TPX2 in drug resistance of gastric cancer for platinum chemotherapy drugs
    LIU Kaijun1, LI Maoheng1, WANG Wentao2, WEI Ping3
    2019, 40(6):  671-674,678.  doi:10.3969/j.issn.10073205.2019.06.013
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    ［Abstract］ Objective〖HTSS〗〓To test expressions of targeting protein for Xklp2(TPX2) in gastric cancer and adjacent normal tissues, also chemosensitivity to cisplatin(CDDP), oxaliplatin(LOHP), to investigate drug resistant related proteins, and to explore the effect of TPX2 in drug resistance of platinumbased drugs in gastric cancer.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The fresh tissues and paraffin specimens of 85 cases gastric cancer, 30 cases of adjacent normal tissues were collected. Tissues of cases gastric cancer were divided into chemotherapy group, nonchemotherapy group, and adjacent normal tissues group. Expressions of TPX2 and Pglycoprotein(Pgp), glutathione S transferaseπ(GSTπ), B lymphatic leukaemia 2(Bcl2) were tested with immunohistochemistry. MTT assay was applied to detect chemosensitivity of fresh tissues in each group to CDDP, LOHP.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓MTT assay showed that inhibition rates of CDDP, LOHP to chemotherapy group, nonchemotherapy group were lower than adjacent normal tissues group, and inhibition rates of CDDP, LOHP to chemotherapy group were lower than nonchemotherapy group(P＜005). Inhibition rates of CDDP, LOHP to positive TPX2 group were lower than negative TPX2 group(P＜005). Positive rates of TPX2, Pgp, GSTπ, Bcl2 proteins in chemotherapy group, nonchemotherapy group were higher than that of adjacent normal tissues, and positive rates of these proteins in chemotherapy group were higher than that in nonchemotherapy group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The TPX2 protein might be involved in drug resistance of gastric cancer by regulating some drug resistance related proteins, and expression of TPX2 changed in the process of chemotherapy.
    Analysis of serum inflammatory factors and immune function in the treatment of benign thyroid nodules by endoscopy combined with lowincision operation
    YAO Xinguo， LU Chao， LI Chao
    2019, 40(6):  675-678.  doi:10.3969/j.issn.10073205.2019.06.014
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    ［Abstract］〓Objective〖HTSS〗〓To study the clinical effect of endoscopic combined lowincision operation in patients with benign thyroid nodules.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and twenty patients with benign thyroid nodules were selected and randomly divided into two groups(60 cases each). The control group was treated with open thyroid surgery. The observation group was treated with endoscopic combined low incision operation. The operation condition, immune function index, postoperative complications, postoperative pain score, serum inflammatory factor index were compared between the two groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The incision length of the observation group was shorter than that of the control group, and the intraoperative blood loss was less than that of the control group(P＜005). However, there was no statistical difference in operation time between the two groups(P＞005). After surgery, the CD3+ and CD4+/CD8+ in the two groups were lower than those before surgery, while the CD3+ and CD4+/CD8+ of the observation group were higher than those of the control group(P＜005). The total incidence of postoperative complications was lower in the observation group than in the control group(P＜005). Postoperative pain scores showed a decreasing trend at each time point, and the observation group was lower than the control group. There were significant differences in the interaction between the groups, between the time points, and between groups and time points(P＜005).The levels of Creactive protein, interleukin6 and procalcitonin in the observation group were lower than those in the control group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓In the treatment of benign thyroid nodule, the length of incision is shortened by endoscopy combined with low incision, which can effectively reduce the amount of intraoperative bleeding, reduce postoperative complications, protect the immune function of patients and inhibit inflammatory factors.
    Effect of small incision nucleus fragmentation method combined with rhEGF eye drops on cataract patients and its effect on BUT and SⅠt#br#
    YUAN Yu1， SHAO Linhai2*
    2019, 40(6):  679-682,687.  doi:10.3969/j.issn.10073205.2019.06.015
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the effect of small incision nucleus fragmentation method combined with rhEGF eye drops on cataract patients and the effects of breakup time(BUT) and schlrmer Ⅰ test(SⅠt).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and fifty patients(160 eyes) who underwent small incision nucleus surgery were enrolled in this study. The patients were divided into observation groups according to the random number table method. And the control group, each group of 75 cases(80 eyes). Vision, astigmatism, BUT, SⅠt were compared between  two groups before treatment(T0), 1 week after surgery(T1), 4 weeks after surgery(T2), 8 weeks after surgery(T3), and 12 weeks after surgery(T4). The incidence of adverse reactions was compared between two groups at 4 weeks after operation.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The visual acuity of the two groups was gradually increased, and the visual acuity of the observation group was higher than that of the control group, there was significant difference between groups, time and interaction in groups and time(P＜005). The postoperative astigmatism was decreased gradually in both groups, and the difference between time points was statistically significant(P＜005), there was no significant difference between groups and interaction in groups and time(P＞005). BUT and SⅠt in the two groups were decreased after operation. BUT and SⅠt in the observation group were higher than that in the control group, and there was significant difference between groups, time and interaction in groups and time(P＜005). The incidence of corneal edema, dry eye and total adverse reactions in the observation group were significantly lower than that in the control group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Small incision nucleus combined with rhEGF eye drops for the treatment of nuclear cataract is effective, can significantly shorten the recovery time of postoperative visual acuity, promote the secretion of tears after surgery, and help reduce the incidence of postoperative complications. It is worth popularizing and applying in clinic.
    Comparison of radial and focused extracorporeal shock waves in the treatment of temporomandibular disorders
     
    WANG Pu1, NI Guangxiao2, HAN Xiaoyong2, ZHOU Hongbin2, SUN Weili2, LIAN Yunmin1*
    2019, 40(6):  683-687.  doi:10.3969/j.issn.10073205.2019.06.016
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    ［Abstract］ Objective〖HTSS〗〓To compare the effect of radial and focused extracorporeal shock waves in the treatment of temporomandibular disorders.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Sixty patients, aged from 18 to 60 years, who were diagnosed with temporomandibular joint disorders(TMD) Ⅰ were selected. By random block method, the patients were divided into control group, radial extracorporeal shock wave treatment(REWST) group and focused extracorporeal shock wave treatment(FEWST) group. Control group accepted physiotherapy（ultra shortwave and soft tissue massage）， RESWT group accepted physiotherapy and radial extracorporeal shock wave treatment, FEWST group accepted physiotherapy and focus extracorporeal shock wave treatment. Fricton′s craniomandibular index(CMI) was used to evaluate temporomandibular joint function. All subjects′ pain levels with Visual Analogue Scale(VAS) scores were evaluated. During the treatment, the occurrence of adverse reactions was recorded.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓Dysfunction index(DI), CMI and VAS scores in the FEWST group decreased significantly from pretreatment to 3 months after treatment. There were significant differences in DI, CMI and VAS scores among three groups among groups, time points and interactions between groups(P＜005). PI in the FEWST group decreased significantly from pretreatment to 3 months after treatment. There was significant difference between the three groups at different time points(P＜005), but there was no significant difference in the interaction between groups and between groups and time points(P＞005). There were no significant difference in adverse reaction rates among the three groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓In the treatment of TMDⅠ, RESWT can improve joint function and relieve pain in the early stage and has good safety.
    Comparison of the consistency of different examination methods of velopharyngeal function after cleft palate operation#br#
    FENG Xiaowei, LI Xiangjun*, FENG Ying, ZHANG Xiaoyan, ZHANG Xiao, BAI Jiuping
    2019, 40(6):  688-690,696.  doi:10.3969/j.issn.10073205.2019.06.017
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    ［Abstract］ Objective〖HTSS〗〓To compare the examination consistency of velopharyngeal function using speech assessment, cephalograms and nasopharyngeal fibroscope (NPF) after cleft palate operation.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The velopharyngeal closure of 30 patients with cleft palate after palatoplasty was detected and compared by three methods: speech intelligibility test, lateral cranial Xray and NPF.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The χ2 test was used to compare the results of the three methods.There was no statistically significant difference between cephalograms and speech assessment(P＞005). There was no statistically significant difference between  cephalograms and NPF(P＞005). There was no statistically significant difference between speech assessment and NPF(P＞005). All examination results were moderately consistent.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The results were consistent of velopharyngeal functionalexamination using speech assessment, cephalograms and NPF.
    Comparison of radiation doses between single and double localizer radiographies in lumber disc CT scan
    LI Xiaona1, WANG Yuhui2, ZHANG Xuesong1, WANG Xiaoying1, LIU Ying1, PENG Zhigang1*
    2019, 40(6):  691-696.  doi:10.3969/j.issn.10073205.2019.06.018
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    ［Abstract］〓Objective〖HTSS〗〓To investigate the effects of singlelateral localizer radiography and doubllocalizer radiography images on the radiation dose and image quality of lumbar intervertebral disc computed tomography(CT).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and twelve patients with suspected lumbar intervertebral disc herniation were divided into two groups randomly: 53 cases in singlelocalizer group used a conventional single laterallocalizer radiography scan, 59 cases in doublelocalizer group used lateralorthotopiclocalizer radiography scan. Then these two groups performed routine intervertebral disc sequence scanning by 128 slices spiral CT, respectively. Automatic exposure control(AEC) technology was used. The radiation doses of all scans and the corresponding axial image qualities were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The CT dose of doublelocalizer group of the five variables of L1-2, L2-3, L3-4, L4-5 and L5-S1 were significantly lower than that of singlelocalizer group(P＜005). The results of rank correlation analysis showed that there was a positive correlation between body mass index and scan doses of two groups(P＜005). There was no significant difference in the evaluation of image quality between two groups, except that in L5-S1 of noise and signaltonoise ratio of fat measurement of doublelocalizer group was higher than singlelocalizer group(P＜005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓For the examination of the lumbar intervertebral disc sequence CT scanning, the lateralorthotopic doublelocalizer radiography images with AEC technology can reduce the radiation dose of the subjects.
    Effect of perfusion index and narcotrend index monitor on noxious stimulation and anesthesia in children after sufentanil general anesthesia#br#
    LIU Feng， LI Qingjun*
    2019, 40(6):  697-700,705.  doi:10.3969/j.issn.10073205.2019.06.019
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    ［Abstract］ Objective〖HTSS〗〓To explore the effect of perfusion index and narcotrend index monitor on noxious stimulation and anesthesia in children after sufentanil general anesthesia.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and forty patients undergoing laparoscopic surgery under general anesthesia for laparoscopic sucrose fentanyl treatment were randomly divided into observation group and control group with 70 cases in each group. The depth of anaesthesia was monitored by NTI in observation group and PI in control group to compare the changes in PI/NTI and anesthetic effects.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓BIS, SBP and HR during operation between the two groups had statistically difference(P＜005), but the  difference between the two groups  and groups multiplied by different times were not statistically significant(P＞005).  PI/NTI between groups, different times, and groups multiplied by different times had statistically significant difference(P＜005). The positive ratio judged by PI/NTI in observation group was significantly higher than control group(P＜005). There were no significant difference in adverse reaction rates between the two groups(P＞005).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Monitoring of perfusion index and narcotrend index can better reflect the stimulatory response of sufentanil during general anesthesia in children, but the narcotrend index is more sensitive.
    The value of MRI and cerebral spinal fluid examination in diagnosis of intracranial tuberculosis
    LI Wen1， CHEN Yanqiang2， ZHANG Xueping3， BAI Hongzhong4*
    2019, 40(6):  701-705.  doi:10.3969/j.issn.10073205.2019.06.020
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    ［Abstract］〓Objective〖HTSS〗〓To evaluate the role of MRI and cerebrospinal fluid examination in the diagnosis of intracranial tuberculosis, to explore the difficulties in the diagnosis of intracranial tuberculosis, and to clarify the diagnostic ideas.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical data of 71 patients with intracranial tuberculosis were retrospectively analyzed. The results of MRI and cerebrospinal fluid examination were analyzed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓The results of MRI showed that 32 cases had abnormal brain parenchyma, 28 cases had abnormal brain parenchyma and meninges at the same time; only 4 cases had typical changes of cerebrospinal fluid in tuberculous meningitis, 7 cases had atypical changes of cerebrospinal fluid, and 4 cases had simple increase of intracranial pressure. The results of cerebrospinal fluid examination showed that 12 cases of tuberculosis were detected by modified acidfast staining of cerebrospinal fluid, 31 cases were positive for cerebrospinal fluid tuberculosis culture, 27 cases were intracranial hypertension, 49 cases were increased in cerebrospinal fluid routine cells, 35 cases were increased in cerebrospinal fluid protein, 39 cases were decreased in cerebrospinal fluid sugar, 42 cases were decreased in chloride and 39 cases were increased in adenosine deaminase. There were 71 cases of intracranial tuberculosis, 60 cases(84.5%) were positive by MRI, 54 cases(76.0%) were positive by cerebrospinal fluid examination. There was no significant difference in the positive rate between the two methods(P＞005), and the Kappa value was -0.232, suggesting that the consistency of the two methods was not good and each method had advantages.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Brain magnetic resonance plain scan plus enhanced scan and cerebrospinal fluid examination play an irreplaceable role in the diagnosis of intracranial tuberculosis. Each has its own advantages. When clinical suspected cases of intracranial tuberculosis and cerebrospinal fluid bacteriological examination is negative, the detection rate of intracranial tuberculosis should be improved by plain scan plus enhanced combined with cytological and biochemical examination of cerebrospinal fluid.
    Preliminary evaluation the effect of clinical clerkship by sandwich teaching method#br#
    ZHAO Jie， SUN Lixian， LI Chunhua， SHAN Weichao， WANG Ruijuan， ZHANG Ying*
    2019, 40(6):  706-709.  doi:10.3969/j.issn.10073205.2019.06.021
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    ［Abstract］〓Objective〖HTSS〗〓Applying questionnaires to evaluate the effect of sandwich teaching method in clinical probation teaching.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Totally 239 undergraduates of clinical medicine were selected as the research subjects. Sandwich teaching method was used to teach clinical probation of coronary heart disease and heart failure. Questionnaires were conducted after class to evaluate the teaching effect, compared with other traditional probation methods(mainly bedside teaching).
    〖HTH〗〖WTHZ〗Results〖HTSS〗〓To stimulate learning interest and initiative, to improve selfstudy ability and information acquisition ability, to promote language expression ability and speech ability, to promote communication between teachers and students, to promote the comprehensive use and improvement of basic knowledge, to cultivate the thinking ability of solving clinical problems, to cultivate the ability of integrating theory with practice, and to solve problems independently are all higher than traditional teaching methods, and the differences are statistically significant（P＜005）.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Satisfaction of interns with sandwich teaching method is better than that with traditional bedside teaching method.