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Table of Content

    25 April 2020, Volume 41 Issue 4
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    Effect of deferred stent implantation for STEMI patients with high thrombus burden and diffuse lesion
    DU Chao1, ZHANG Li-hua2, JIANG Ping1*, WANG Li-jun1, QIN Li-qiang1， ZHANG Guo-rui1
    2020, 41(4):  377-381,435.  doi:10.3969/j.issn.1007-3205.2020.04.002
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    ［Abstract］Objective〖HTSS〗To observe the effect of deferred stent implantation in acute ST-segment elevation myocardial infarction(STEMI) patients with high thrombus burden and diffuse lesion.
     〖WTHZ〗Methods〖HTSS〗The 96 STEMI patients were selected for coronary angiography to show severe thrombus load and diffuse lesions of infarct related artery(IRA). After initial intervention, the thrombolysis in myocardial infarction（TIMI）blood flow grade 3 of the infarct related artery(IRA) was restored, but the lesions were diffuse. They were randomly divided into immediate group(n=47) and deferred group(n=46). The immediate group received the follow-up stent implantation, and the deferred group received stent implantation 1 week later. The incidence of no re-flow/slow flow, the average number of stents per capita, the average length of the stents, the average length of stay and the mean hospitalized cost were compared between two groups. Left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVD) and major adverse cardiovascular events(MACE) were compared at 6 months.
     〖WTHZ〗Results〖HTSS〗The incidence of no re-flow/slow flow in deferred group was significantly lower than that in immediate group, the number of stent implantation per capita and the average stent length were lower than those in immediate group, and the proportion of stent free implantation was higher than that in immediate group（P＜0.05）. After 6 months, compared with the admission, LVEF and LVD of the two groups were significantly higher and lower(P＜0.05). At 6 months, compared with the immediate group, the deferred group had higher LVEF and lower LVD(P＜0.05). The average length of stay in the deferred group was longer than that in the immediate group, and the average cost of stay was less(P＜0.05). After 6 months follow-up, there was no significant difference in cardiovascular death and target vessel revascularization(TVR) between two groups(P＞0.05). The cumulative MACE free survival rate in deferred group was significantly higher than that in immediate group(P＜0.05).
     〖WTHZ〗Conclusion〖HTSS〗For STEMI patients with high thrombus burden and diffuse lesion, deferred stent implantation can reduce the incidence of no-reflow/slow flow, reduce the number of stent implantation, improve cardiac function and ventricular remodeling at 6 months, reduce the readmission rate within 6 months, and reduce medical costs.
    Effect of Eptifibatide combined with Prostaglandin E1 on myocardial microcirculation after pPCI in STEMI patients
    WANG Hai-yan1, JIANG Wei-xing2, TIAN Li1, FU Xiang-hua3
    2020, 41(4):  382-386.  doi:10.3969/j.issn.1007-3205.2020.04.003
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    ［Abstract］ Objective〖HTSS〗To investigate the effect of Eptifibatide combined with Prostaglandin E1 on myocardial microcirculation in patients with acute ST-segment elevation myocardial infarction(STEMI) after primary percutaneous coronary intervention(pPCI).
     〖WTHZ〗Methods〖HTSS〗A total of 162 patients with acute STEMI were randomly divided into the control group(n=81) and the observation group(n=81). All patients were given Prostaglandin E1 intravenously 30 minutes before surgery and maintained for 7 days. In the observation group, the intracoronary artery was treated with Eptifibatide, and the postoperative venous duration was 18 hours. Thrombolysis in myocardial infarction(TIMI), corrected TIMI frame count(cTFC), ST-segment resolution(STR) rate of ECG, creatine kinase-MB(CK-MB), cardiac troponin I(cTnI), left ventricular ejection fraction(LVEF), and wall motion score index(WMSI) were measured before and after pPCI. Myocardial contrast echocardiography was performed 48 hours and 1 week after surgery, respectively.
     〖WTHZ〗Results〖HTSS〗There was no statistical difference in basic clinical data, coronary angiography data and interventional data between two groups(P＞0.05). The cTFC frames, CK-MB and cTnI peaks in the observation group after pPCI were significantly lower than those in the control group(P＜0.05). However, the postoperative TIMI grade 3 blood flow, the decrease of electrocardiogram STR after 90min, the local myocardial blood flow 48 hours after the operation and 1 week after the operation, and the cardiac color doppler ultrasound LVEF were significantly increased compared with the control group(P＜0.05).
     〖WTHZ〗Conclusion〖HTSS〗Eptifibatide combined with Prostaglandin E1 can effectively improve the myocardial perfusion of acute STEMI and myocardial function.
    Therapeutic effect of repetitive transcranial magnetic stimulation therapy on common peroneal nerve injury
    LIU Min1, LI Song2*, WANG Hong-lian1
    2020, 41(4):  387-390,453.  doi:10.3969/j.issn.1007-3205.2020.04.004
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    ［Abstract］Objective〖HTSS〗To observe the effect of repetitive transcranial magnetic stimulation on the injury of common peroneal nerve, and to explore the effect on the expression of nerve growth factor(NGF) and basic fibroblast growth factor(bFGF).
     〖WTHZ〗Methods〖HTSS〗Eighty male normal healthy Prague Dawley New Zealand rabbits were randomly divided into treatment group and model group. The treatment group was given repeated transcranial magnetic stimulation. Electromyography and motor conduction velocity were examined before and after treatment. The expression of NGF and bFGF in the injured common peroneal nerve tissue of 80 rabbits was detected by streptavidin-perosidase(SP) method The results were tested and analyzed statistically.
     〖WTHZ〗Results〖HTSS〗After treatment, the number of abnormal indexes of insertion potential and prolonged fibrillation potential in the two groups was significantly less than that before treatment, and the number of abnormal indexes of motor unit potential was significantly more than that before treatment, the difference was statistically significant(P＜0.05). After treatment, the number of abnormal indexes of insertion potential and prolonged fibrillation potential in the treatment group was significantly less than that in the model group, and the number of abnormal indexes of motor unit potential in the treatment group was significantly more than that in the model group(P＜0.05). After treatment, the motor nerve conduction velocity and amplitude of the two groups were higher than before treatment, and the motor nerve conduction velocity and amplitude of the treatment group were higher than the model group, the difference was statistically significant(P＜0.05). The gray values of NGF and bFGF in the injured peroneal nerve tissue of the treatment group were significantly higher than those of the model group(P＜0.05).
     〖WTHZ〗Conclusion〖HTSS〗Repetitive transcranial magnetic stimulation therapy can effectively improve the lower limb motor function in patients with common peroneal nerve palsy. NGF and bFGF can promote the functional recovery after PNI, reconstruct the tissue structure of regenerated nerve, and play an important role in the repair ment of peripheral nerve injury.
    Hypertension management program of combining the general practice department in general grade A tertiary hospital and community health service institutions#br#
    SUN Yan-jie1, WANG Yan1, ZHANG Jin-jia1, QI Ran1, WU Qiong2, WANG Rong-ying1*
    2020, 41(4):  391-395.  doi:10.3969/j.issn.1007-3205.2020.04.005
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    ［Abstract］ Objective〖HTSS〗To evaluate the effects of the hypertension management program of combining the general practice department in general grade A tertiary hospital and community health service institutions.
     〖WTHZ〗Methods〖HTSS〗Randomly assigned 500 patients with hypertension from five randomly assigned community health service institutions in Shijiazhuang city. Those patients were randomly assigned to receive regular hypertension management(n=250) from community health service institutions, including regular blood pressure monitoring, medication guidance, and routine health education and combination managements(n=250). Treatments in both groups were at least 6 months. The primary outcomes were the knowledge of hypertension prevention and treatment, and behaviors of self-management.
     〖WTHZ〗Results〖HTSS〗There were no significant differences between groups in the knowledge of hypertension prevention and treatment, and behaviors of self-management before program intervention(P＞0.05). After 6 months program intervention, all primary outcomes in exposure group were higher than non-exposure group with statistically significant(P＜0.05). The blood pressure of the intervention group reached a stable level earlier than the control group.
     〖WTHZ〗Conclusion〖HTSS〗The general practice department of the general grade tertiary hospital closely cooperates with community health service institutions may improve hypertension patients' cognition of hypertension prevention and treatment, and behaviors of self-management.
    Analysis of the correlation between serum homocysteine level and vasculopathy of type 2 diabetes mellitus
    JIA Xin-ju, DONG Shan-shan, KANG Yan, LIU Li, WANG Li-na*
    2020, 41(4):  396-400.  doi:10.3969/j.issn.1007-3205.2020.04.006
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    ［Abstract］Objective〖HTSS〗To analyze the relationship between serum homocysteine(Hcy) and vascular disease in type 2 diabetes mellitus(T2DM).
     〖WTHZ〗Methods〖HTSS〗Clinical data were collected from 160 participants. Three groups were divided according to type of complication： group I of T2DM with no complications， 51 cases(T2DM group), groupⅡof T2DM with vascular complications(macrovascular disease group), and another 59 normal people without T2DM was randomly as control group. All the detailed information(sex, age, smoking, body mass index(BMI), blood pressure) was recorded in the patient record, and the levels of a series index such as, Hcy, triglyceride(TG), total cholesterol(TC), urea nitrogen(BUN), creatinine(Cr) were measured and compared between the three groups. Then the subjects were divided into the normal Hcy group and the high Hcy group according to the serum Hcy level. The relationship between the serum Hcy level and the incidence of T2DM vascular lesions was analyzed, the influencing factors for the formation of high Hcy and the risk factors related to T2DM vascular lesions were analyzed.
     〖WTHZ〗Results〖HTSS〗The levels of TG,TC, and Hcy in T2DM and macrovascular disease group were significantly higher than in control group(P＜0.01). Hcy in macrovascular disease group were higher than in T2DM group(P＜0.01), and Cr in macrovascular disease group was higher than in T2DM and control group(P＜0.01). With Hcy＞15 μmol/L as the hyperhomocysteinemia(HHcy), the incidence of HHcy in T2DM and macrovascular disease group were significantly higher than in the control group(P＜0.01). The incidence of  high level of fasting plasma glucose（FPG）, glycosylated haemoglobin A1c（GHbA1c）, BUN, TC, TG, Hcy and vascular lesions in HHcy group were significantly higher than in normal Hcy group(P＜0.05). Correlation analysis results showed that Hcy had positive correlation with FPG, GHbA1c, BUN, Cr, TC and TG. Analysis of T2DM related risk factors with Logistic regression analysis showed that TC was an independent risk factor of T2DM with vascular complications.
     〖WTHZ〗Conclusion〖HTSS〗Hcy may be involved in the development of T2DM with vascular complications and is an independent risk factor for vascular disease in T2DM.
    Analysis of the 4-week prevalence rate and influencing factors of Chinese adult residents#br#
    GUO Zhi-wang， QIN Pu, ZHANG Rui, YUAN Yu-qi, WANG Wen-juan, WANG Li-qin*
    2020, 41(4):  401-404.  doi:10.3969/j.issn.1007-3205.2020.04.007
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    ［Abstract］ Objective〖HTSS〗To study the 4-week prevalence rate and its influencing factors of adult residents in 12 provinces(autonomous regions) in 2015 in order to provide reference for rational allocation of health resources and promotion of residents health.
     〖WTHZ〗Methods〖HTSS〗In this study, the adult population of the China Health and Nutrition Survey 2015 open database age ≥18 years old was selected as the study object, and the two-category unconditional logistic regression model was used to analyze the influencing factors of the 4-week prevalence rate.
     〖WTHZ〗Results〖HTSS〗The 4-week prevalence rate of adult residents in China was 15.8%. The results of the two-category logistic regression showed that the factors affecting the 4-week prevalence of adult residents were gender, age, marital status, employment status, education, urban and rural areas, and the situation of medical doctors last year. The prevalence rate of females was higher than that of males. The prevalence rate increased with age, and the prevalence rate decreased with the increase of education. The prevalence rate of urban areas was higher than that of rural areas, and the prevalence rate in western areas was higher. The prevalence of other marital status such as divorce or widowhood was higher than that of unmarried and married people. The unemployment rate or unemployment rate was higher than that of the working population. The prevalence rate of people who have seen medical doctors in the previous year was higher than that of people who have not seen medical doctors. 
     〖WTHZ〗Conclusion〖HTSS〗We should strengthen health services and health education for women, old age, divorced or widowed, low-educated, and unemployed and people in the western region.
    Correlation of procalcitonin level with the severity and prognosis of hip joint tuberculosis
    ZHANG Peng1, ZHANG Di1, LI Xiang-ke2, HAN Yong-tai2, SHEN Yong1
    2020, 41(4):  405-408.  doi:10.3969/j.issn.1007-3205.2020.04.008
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    ［Abstract］ Objective〖HTSS〗To investigate the correlation of procalcitonin(PCT) level with the severity of hip joint tuberculosis and its value in predicting the prognosis.
     〖WTHZ〗Methods〖HTSS〗The clinical data of 166 patients with tuberculosis of hip joint were analyzed retrospectively. According to babhulkar's criteria, the patients were divided into four groups: group A(stage Ⅰ, synovitis stage), 58 cases; group B(stage Ⅱ, early arthritis stage), 51 cases; group C (stage Ⅲ, arthritis stage), 33 cases; group D (stage Ⅳ, late arthritis stage), 24 cases. Patients in groups A and B were treated with oral anti-tuberculosis drugs, and patients in groups C and D were treated with surgery and anti-tuberculosis drugs. The changes of PCT in each group at different time points was observed and compared. The visual analog scale(VAS) was used to evaluate the pain and the Harris score was used to evaluate hip function.
     〖WTHZ〗Results〖HTSS〗With the gradual aggravation of the lesion, the PCT concentration and VAS score gradually increased, and the Harris score gradually decreased, and the difference between the groups was statistically significant（P＜0.05）. From 2 weeks of anti-tuberculosis drug treatment to 1 year after surgical treatment, the PCT concentration, VAS score and Harris score of the 4 groups of patients changed significantly, the difference was statistically significant.
     〖WTHZ〗Conclusion〖HTSS〗In patients with tuberculosis of hip joint, the severity of joint disease is positively related to the level of PCT. Antituberculous drugs can reduce the level of PCT, but after surgery, PCT decreases faster, hip pain relief is better, and hip function recovery is better.
    Predictive value of D-dimer dynamic monitoring for DVT after hip replacement
    NIE Guang-long1, MA Wen-hai2*, LI Yong-wang2, LIU Dian-kui1, ZHANG Qian2
    2020, 41(4):  409-412,430.  doi:10.3969/j.issn.1007-3205.2020.04.009
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    ［Abstract］Objective〖HTSS〗To assess the predictive value of D-dimer dynamic changes in deep vein thrombosis(DVT) after hip replacement.
     〖WTHZ〗Methods〖HTSS〗A total of 94 patients undergoing hip replacement for hip fracture were selected. Plasma D-dimer values were monitored before surgery on the day of surgery and on days 1, 2, 3, 6, 9 and 12 after surgery, all patients underwent color Doppler ultrasonography of the deep veins before and 2 and 5 days after operation. When the D-dimer rised significantly, double-lower deep vein color Doppler examinations were performed immediately. In cases where color Doppler could not be diagnosed, double lower limb angiography was performed. ROC curve was draw to evaluate the predictive value of D-dimer dynamics for DVT.
     〖WTHZ〗Results〖HTSS〗DVT occurred in 20 of 94 patients(21.3%). The level of D-dimer in the two groups increased and then decreased, and reached the peak on the third day after operation. The change range of thrombus group was large, and the interaction among groups, time points and time points was statistically significant(P＜0.05 or P＜0.01). The median time from operation date to diagnosis of DVT was 3 days. On the third day after operation, D-dimer level showed moderate accuracy, and the area under the curve was 0.856(95%CI: 0.740-0.971, P＜0.001). The cut-off value of 0.696 was 6.23 mg/L.
     〖WTHZ〗Conclusion〖HTSS〗Dynamic monitoring of D-dimer level is of great significance for DVT prediction. D-dimer level on day 3 can be used as a predictor of DVT.
    Analysis of associated risk factors for surgical site infectionafter intra-articular fracture of distal radius by surgery#br#
    WANG Hong-qing1， ZHU Yan-bin2， SONG Li-hua1， BAI Qing-bing1， MA Tian-yao1， WANG Dong-yue1
    2020, 41(4):  413-417.  doi:10.3969/j.issn.1007-3205.2020.04.010
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    ［Abstract］Objective〖HTSS〗To investigate the risk factors for surgical site infection(SSI) after distal radius fracture, in order to provide evidence to prevent such type of complication.
     〖WTHZ〗Methods〖HTSS〗Retrospective review of 627 cases of intraarticular fractures of distal radius surgically treated in department of hand surgery and orthopaedic trauma were performed. The perioperative data and biochemical test results were obtained by consulting the electronic medical record system, imaging system and test reports. Patients were divided into two groups according to criteria defined by the Centers for Disease Control(CDC) for infection: the infected group and the non-infected group. Univariate and multivariate logistic regression analyses were used to investigate the risk factors associated with the SSI.
     〖WTHZ〗Results〖HTSS〗During the observational period, 42 cases of SSIs were found, and the incidence was 6.7%. According to the results of univariate analysis, statistical difference was found between two groups(P＜0.05 or P＜0.01) in term of patient age, body mass index, smoking status, diabetes, rheumatic immune disease, AO type, fracture type (closed fractures and Gustilo classification), surgical timing, American Society of Anesthesiologists(ASA), operation time, preoperative hemoglobin and albumin level. Multivariate Logistics regression analysis showed that independent risk factors of postoperative SSI were: smoking, open fracture of Gustilo Ⅱ and Ⅲ type, operation time more than 130 minutes and lower preoperative albumin level(< 35 g/L).
     〖WTHZ〗Conclusion〖HTSS〗Identification of these factors is of great significance in assessing the risk of SSI. We suggest that patients should quit smoking in time, rationally plan the surgical procedure to reduce the operation time, and timely supplement nutrition to reduce the risk of SSI.
    The relationship between primary chronic venous insufficiency of lower extremity and epithelial stromal transformation
    ZHOU Ya-dong， CHEN Xing-sheng， GUAN Yun-biao， XUE Ming
    2020, 41(4):  418-421.  doi:10.3969/j.issn.1007-3205.2020.04.011
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    ［Abstract］Objective〖HTSS〗To investigate the relationships between lower extremity primary chronic venous insufficiency(PCVI) and epithelial mesenchimal transition(EMT).
     〖WTHZ〗Methods〖HTSS〗Sixty-seven patients with PCVI were classified into mild groups(n=28), moderate group(n=21), and severe group(n=18). Sixteen patients without PCVI were allocated to control group. Semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR) and Western blot were used to detect the expression of E-cadherin and Vimentin in the varicose vein specimens.
     〖WTHZ〗Results〖HTSS〗Expressions of E-cadherin mRNA and protein in mild group, moderate group and severe group were lower than those in control group. Between different PCVI groups, the expression of E-cadherin mRNA and protein in moderate group and severe group was lower than mild group(P＜0.01).Similarly, expression of E-cadherin mRNA and protein in severe PCVI group were lower than those in moderate PCVI group. The Vimentin mRNA and protein expression levels in mild, moderate and severe group had no significant difference to control group(P＞0.05).
     〖WTHZ〗Conclusion〖HTSS〗The vascular remodeling of PCVI seems to have no relation with EMT. But the expression level of E-cadherin is decreased with the clinical severity of PCVI, therefore it may be an indicator when assessing severity of PCVI.
    Changes of blood glucose, platelet count, white blood cell count and C-reactive protein in children with neonatal sepsis caused by different pathogens#br#
    FENG Yue-hua, ZHAO Wan-jian, LI Jun-hua, CAO Su-fen
    2020, 41(4):  422-425.  doi:10.3969/j.issn.1007-3205.2020.04.012
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    ［Abstract］ Objective〖HTSS〗To investigate the changes of abnormal blood glucose, platelet count, white blood cell count and C-reactive protein in children with neonatal sepsis with different pathogenic bacteria.
     〖WTHZ〗Methods〖HTSS〗A total of 108 children with neonatal sepsis were selected. According to the type of blood culture pathogens, the children were divided into 46 Gram-positive bacteria groups, 43 Gram-negative bacteria groups and 19 fungal groups. The general data of the three groups were analyzed. The clinical manifestations were compared with changes in blood glucose abnormalities, platelet counts white blood cell counts and C-reactive protein in the three groups.
     〖WTHZ〗Results〖HTSS〗Among 108 cases of neonatal sepsis, 46 Gram-positive bacteria(42.59%) were infected, of which coagulase-negative staphylococci(24.07%) and Enterococcus faecium(9.26%) were the main infections; 43 were Gram-negative bacteria. Cases(39.81%), of which E. coli(21.30%) and Klebsiella pneumoniae(14.81%) were predominant; 19 cases(17.60%) were infected with fungi, of which Candida albicans(9.26%) was the Lord. The gestational age and birth weight of the Gram-positive bacteria group were much better than those of the Gram-negative bacteria group and the fungal group, and the differences in gestational age and birth weight among the three groups of children were statistically significant(P＜0.05). The age was significantly larger than that of the Gram-positive bacteria group and the Gram-negative bacteria group, and the age of onset of the Gram-negative bacteria group was significantly larger than that of the Gram-positive bacteria group(P＜0.05). The proportion of abnormal blood glucose in the Gram-negative bacteria group and the fungal group(34.88%, 31.58%) was significantly higher than that in the Gram-positive bacteria group(13.04%)(P＜0.05); The fungal group had abnormal white blood cell counts and elevated C-reactive protein levels. The proportion of Gram-negative bacteria was significantly lower than that of the Gram-positive bacteria group and the Gram-negative bacteria group, and the proportion of C-reactive protein levels in the Gram-negative bacteria group was significantly higher than that of the Gram-positive bacteria group(P＜0.05). The percentage of platelet count reduction in the group and fungal group was significantly higher than that in the Gram-positive group(P＜0.05).
     〖WTHZ〗Conclusion〖HTSS〗When the abnormal white blood cell counts and C-reactive protein levels in children with neonatal sepsis are significantly higher, the probability of bacterial infection is greater; When the platelet count is significantly lowered, it is more likely to be infected with Gram-negative bacteria and fungi. And the proportion of abnormal blood glucose in Gram-negative bacteria group and fungal group was significantly higher than that in Gram-positive bacteria group.
    Expression and clinical significance of miR-655-3p in head and neck squamous cell carcinoma#br#
    ZHAO Lei, ZHAO Bao-jian, RAN Cheng, CHEN Xiang-hong, TIAN Cong-zhe*
    2020, 41(4):  426-430.  doi:10.3969/j.issn.1007-3205.2020.04.013
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    ［Abstract］ Objective〖HTSS〗To explore the expression level of miR-655-3p in head and neck squamous cell carcinoma and its potential clinical significance.
     〖WTHZ〗Methods〖HTSS〗The expression levels of miR-655-3p in head and neck squamous cell carcinoma and its matched normal tissues were measured by the method of quantitative real-time polymerase chain reaction(qRT-PCR), and the correlation between the expression levels of miR-655-3p and the clinical parameters of head and neck squamous cell carcinoma were analyzed.
     〖WTHZ〗Results〖HTSS〗The relative expression level of miR-655-3p in cancerous tissues of head and neck squamous cell carcinoma was significantly lower than that in matched normal tissues(P＜0.05). Clinical stage(P=0.038), differentiation degree(P=0.036) and lymph node metastasis(P=0.042) were significantly different between miR-655-3p high expression group and low expression group. However, there was no significant difference of constituent ratios in gender, age, smoking and drinking between two groups(P＞0.05).
     〖WTHZ〗Conclusion〖HTSS〗The expression level of miR-655-3p in head and neck squamous cell carcinoma is lower and is related to clinical stages, differentiation degrees and lymph node metastasis, suggesting that miR-655-3p may be used as a tumor suppressor gene, and its expression is inactivated in head and neck squamous cell carcinoma, so as to promote the occurrence and development of head and neck squamous cell carcinoma to some extent.
    Effects of different total RNA extraction methods and different reverse transcription primers on circular RNA polymerase chain reaction#br#
    WANG Jian-xing1, NIE Zi-yuan2, DONG Jin-hui1, JIA Xin-jun3*
    2020, 41(4):  431-435.  doi:10.3969/j.issn.1007-3205.2020.04.014
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    ［Abstract］ Objective〖HTSS〗To investigate the effects of different total RNA extraction methods and different reverse transcription primers on circular RAN amplification Hep2 cell and provide a reliable experimental method for the identification and amplification of circular RNA.
     〖WTHZ〗Methods〖HTSS〗Total RNA was extracted from prostate cancer cell line Hep2 cells by using Trizol method and miRNeasy Mini kit protocol. Total RNA was quantified by NanoDorp 2000. Random primer and oligoDT primer were used to reverse transcription of total RNA. Real-time quantitative polymerase chain reaction(RT-qPCR) was used to detect the expression of cicHIPK3 and circFLNA.
     〖WTHZ〗Results〖HTSS〗The concentration of RNA extracted by Trizol method was higher than that of RNA extracted by miRNeasy Mini Kit （P＜0.01）. The purity of RNA extracted by miReasy Mini Kit was higher than that of RNA extracted by Trizol method. The reverse transcription could not amplify the above two circular RNAs, but the universal primers were used for transcription, and both circular RNAs could be amplified; Real-time quantitative polymerase chain result showed that the relative expression of circHIPK3 and circFLNA was higher in miRNeasy Mini method group than in Trizol method(P＜0.01).
     〖WTHZ〗Conclusion〖HTSS〗The purity of RNA extracted by miRNeasy Mini Kit is higher, which is more conducive to the amplification of circular RNA.
    Relationship between ultrasound-guided cervical lymph node puncture combined with serum TSH and SIL-2R levels in cervical lymph node metastasis and disease severity in patients with thyroid cancer#br#
    WANG Gang1, XIE Li-juan2， ZHANG Ming-ju1
    2020, 41(4):  436-439.  doi:10.3969/j.issn.1007-3205.2020.04.015
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    ［Abstract］Objective〖HTSS〗To explore the relationship between ultrasound-guided cervical lymph node puncture combined with thyrotropin(TSH) and oluble interleukin-2 receptor(SIL-2R) and cervical lymph node metastasis and disease severity in patients with thyroid cancer.
     〖WTHZ〗Methods〖HTSS〗One hundred and twenty patients with thyroid cancer were selected and divided into stage Ⅰ/Ⅱ group and stage Ⅲ/Ⅳ group, non-metastatic group and metastatic group according to the postoperative pathological results. All patients underwent ultrasound-guided cervical lymph node aspiration and their serum TSH and SIL-2R levels were measured.
     〖WTHZ〗Results〖HTSS〗Ultrasound-guided cervical lymph node aspiration detected 106 lymph node metastases with an accuracy rate of 85.00%(102/120). The accuracy of ultrasound-guided cervical lymph node aspiration for stage Ⅱ, Ⅲ, and Ⅳ lymph node metastasis was significantly higher than that for stage thyroid cancer lymph node metastasis(P＜0.01). The levels of serum TSH and SIL-2R in stage Ⅲ/Ⅳ group were significantly higher than those in stage Ⅰ/Ⅱ group(P＜0.01). Serum TSH and SIL-2R levels were positively correlated with pathological stage in patients with thyroid cancer(P＜0.01). Serum TSH and SIL-2R levels in the metastatic group were significantly higher than those in the non-metastatic group(P＜0.01). For cervical lymph node metastasis of thyroid cancer, the accuracy, sensitivity, and negative predictive value of the combined ultrasound puncture, TSH, and SIL-2R parallel tests were significantly higher than those of the single test.
     〖WTHZ〗Conclusion〖HTSS〗Patients with stage Ⅲ/Ⅳ or thyroid cancer with cervical lymph node metastasis have higher serum TSH and SIL-2R levels. Ultrasound-guided cervical lymph node aspiration combined with serum TSH and SIL-2R detection can improve the accuracy and sensitivity of diagnosis.
    Expression and influence of CEACAM 5 and PCNA in mucinous epidermoid carcinoma of the parotid gland with different clinical pathological features on clinical prognosis
    MA Sai1， AN Feng1*， LIU Zhen-li1， ZHANG Xuan1， LIU Bo2， ZHANG Hui1
    2020, 41(4):  440-444.  doi:10.3969/j.issn.1007-3205.2020.04.016
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    ［Abstract］Objective〖HTSS〗To study the expression of carcinoembryonic antigen related cell adhesion molecule 5（EACAM 5） and proliferating cell nuclear antigen（PCAN） in mucoepidermoid carcinoma（MEC） of salivary glands, and to investigate correlation with clinicopathological and prognosis of patients.
     〖WTHZ〗Methods〖HTSS〗The immunohistochemical streptavidin-perosidase（SP）was used to examine the expression of CEACAM 5 and PCNA in 55 MEC of salivary glands with different clinicopathological characteristics, 30 salivary pleomorphic adenoma（SPA）and 30 tumor adjacent normal tissues（control group）. The relationship of CEACAM 5, PCNA and clincal prognosis was analyzed.
     〖WTHZ〗Results〖HTSS〗Compared with SPA and control group, the positive expression of CEACAM 5 and PCNA were higher in MEC tissues（P＜0.01）. In MEC of salivary glands group, the positive level of CEACAM 5 and PCNA in pathological grade Ⅲ. The positive rates of CEACAM 5 and PCNA in MEC of salivary gland in TNM stage Ⅲ+Ⅳ were significantly higher than those in TNM stage Ⅰ+Ⅱ. The positive rates of CEACAM 5 and PCNA in MEC with lymph node metastasis were significantly higher than those without lymph node metastasis(P＜0.01). There were no significant difference among the positive expression of CEACAM 5 and PCNA in gender, age and tumor sites（P＞0.05）. The expression of CEACAM 5 was positive related to the level of PCNA in MEC tissues（P＜0.05）. The overall survival of the negative expression of CEACAM 5 and PCNA was significantly longer than the positive expression of CEACAM 5 and PCNA（P＜0.05）.
     〖WTHZ〗Conclusion〖HTSS〗CEACAM 5 and PCNA are highly expressed in MEC of salivary gland, which can co regulate the proliferation of tumor, affect the biological activity of tumor, and ultimately affect the prognosis of tumor patients.
    Value of doppler ultrasonography in predicting fetal distress with oligohydramnios#br#
    LUO Bing1, WANG Yi-cheng1*, ZHANG Li-wei1, REN Wei-li1, JIAO Gui-qing2, GUO Hua-xian3
    2020, 41(4):  445-448.  doi:10.3969/j.issn.1007-3205.2020.04.017
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    ［Abstract］Objective〖HTSS〗To explore the value of blood flow resistance index and ratio of fetal umbilical artery(UA), middle cerebral artery(MCA) and renal artery(RA) in predicting fetal distress with oligohydramnios.
     〖WTHZ〗Methods〖HTSS〗Two hundred and eighty-three pregnant women with gestational weeks of 37 to 41+6 weeks were selected. According to the amount of amniotic fluid, all the cases were divided into oligohydramnios group(83 cases) and control group(200 cases). Meanwhile, fetuses in oligohydramnios group were divided into distress group(n=19) and non-distress group(n=64) according to fetal distress. Among all the fetus, the blood flow spectrum of UA, MCA and RA were obtained by pulsed Doppler technique, and the arterial resistance index(RI) and pulsation index(PI) were measured to calculate RIUA/MCA, PIUA/MCA, RIRA/MCA and PIRA/MCA. Apgar score was recorded at 1 min after birth.
     〖WTHZ〗Results〖HTSS〗The PI and RI of UA and RA in distress group were significantly higher than those in control group and non-distress group, PI and RI of MCA were significantly lower than those in control group and non-distress group, and the levels of RIUA/MCA, PIUA/MCA, RIRA/MCA and PIRA/MCA in distress group were significantly higher than those in control group and non-distress group(P＜0.01). While there were no significant differences in the above-mentioned indexes between control group and non-distress group(P＞0.05).
     〖WTHZ〗Conclusion〖HTSS〗Monitoring the resistance index and ratio of fetal UA, MCA and RA can predict fetal distress with oligohydramnios and indicate clinical treatment timely.
    Expression and prognostic significance of transcription factor TFCP2 in esophageal squamous cell carcinoma tissues
    GAO Yan-fei1, GONG Zhi-ping1, LI Ling1, XU Xiao-ming1, CAO Yu-fei1, SANG Mei-xiang2*
    2020, 41(4):  449-453.  doi:10.3969/j.issn.1007-3205.2020.04.018
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    ［Abstract］Objective〖HTSS〗To investigate the clinical characteristics and prognostic significance of transcription factor TFCP2 in patients with esophageal squamous cell carcinoma(ESCC).
     〖WTHZ〗Methods〖HTSS〗The expression of transcription factor TFCP2 in 80 ESCC specimens and corresponding normal tissues were detected by immunohistochemistry and its association with clinical characteristics and prognosis were analyzed.
     〖WTHZ〗Results〖HTSS〗The positive rates of TFCP2 in ESCC was higher than that in normal tissues（P＜0.01）.TFCP2 was correlated with clinical stage, lymph node metastatis and distant metastasis in patients with ESCC（P＜0.05 or P＜0.01）. TFCP2 was not correlated with age, gender, family history of UGIC, histological grade and tumor size(P＞0.05). Kaplan-Meier analysis showed that ESCC patients with high TFCP2 expression had worse prognosis than those with low TFCP2 expression. Multivariate Cox proportional hazard regression model showed that the expression of TFCP2, lymph node metastasis and distant metastasis were independently related to the survival rate of ESCC patients.
     〖WTHZ〗Conclusion〖HTSS〗Transcription factor TFCP2 is associated with antigen in ESCC tisuses and can be a biomarker of poor prognosis in patients with ESCC.
    Diagnostic values of MPV, PDW and total bilirubin for early renal function damage in gestational diabetes mellitus
    LI Zong-feng, SHEN Wei-wei*
    2020, 41(4):  454-458.  doi:10.3969/j.issn.1007-3205.2020.04.019
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    ［Abstract］Objective〖HTSS〗To detect mean platelet volume(MPV), platelet distribution width(PDW) and serum total bilirubin(TBIL) in peripheral blood of patients with gestational diabetes mellitus(GDM), and explore its clinical significance.
     〖WTHZ〗Methods〖HTSS〗A total of 154 GDM patients were selected as the study object. According to the estimated glomerular filtration rate(EGFR), 154 GDM patients were divided into 50 cases of normal renal function group, 54 cases of early renal function damage group, 50 cases of renal function damage group, and 50 cases of healthy pregnant women in the same period of pregnancy as the control group. The levels of MPV, PDW and TBIL were detected and analyzed.
     〖WTHZ〗Results〖HTSS〗The MPV, PDW, TBIL and Cystatin C(CysC) values of normal renal function group, early renal function damage group and renal function damage group were higher than those of the control group, the TBIL values of normal renal function group, early renal function damage group and renal function damage group were lower than those of the control group, the crea tinine(CREA) values of early renal function damage group and renal function damage group were higher than those of the control group, and the urea values of renal function damage group were higher than those of the control group, with statistical significance(P＜0.05) The MPV, PDW and CysC values of the early damaged group and the damaged group were higher than those of the normal group, the TBIL values of the early damaged group and the damaged group were lower than those of the normal group, and the urea and crea values of the damaged group were higher than those of the normal group(P＜0.05). The MPV, PDW, CysC, urea and crea values in the renal function damaged group were higher than those in the early renal function damaged group, and the TBIL values in the renal function damaged group were lower than those in the early renal function damaged group(P＜0.05). MPV and PDW were positively correlated with CysC concentration(r=0.478, 0.393, both P＜0.05). There was a negative correlation between TBIL and CysC(r=-0.393, P＜0.05). MPV, PDW and CysC were the risk factors of renal function damage in GDM, TBIL was the protective factor. The sensitivity and specificity of MPV, PDW, TBIL and CysC in the early diagnosis of no obvious renal function injury were higher, among which CysC was the highest and the best.
     〖WTHZ〗Conclusion〖HTSS〗MPV, PDW and TBIL can be used as sensitive and reliable clinical indicators for the diagnosis of early renal function damage of GDM patients.