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Table of Content

    25 July 2020, Volume 41 Issue 7
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    Effect of spironolactone on left ventricular function and serum chemerin in patients with chronic heart failure
    WANG Ya-ling， ZHANG Yang， LIU Tao， GUO An-jun， WANG Mei
    2020, 41(7):  749-753.  doi:10.3969/j.issn.1007-3205.2020.07.002
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    Objective〖HTSS〗To investigate the effect of spironolactone on left ventricular function and serum chemoin in patients with chronic heart failure.
    〖WTHZ〗Methods〖HTSS〗Eighty patients with chronic heart failure were randomly divided into a control group and a research group. The control group received conventional treatment, and the research group received spironolactone treatment based on the control group. Compare the levels of inflammatory factors before and after treatment in the two groups ［hypersensitive C-reactive protein(hs-CRP), interleukin 6(Interleukin-6, IL-6), tumor necrosis factor-α(tumor necrosis factor-α, TNF-α)］, blood lipid levels ［low density lipoprotein cholesterol(LDL-C), total cholesterol(TC), triglyceride(TG)］, cardiac function ［left ventricular end systole Left ventricular end systolic volume(LVESV), left ventricular ejection fraction（LVEF）, left ventricular end diastolic volume(LVEDV)］, 6 min walking distance, serum vascular endothelial growth factor(VEGF), chemerin, Brain natriuretic peptide(BNP) level and stress response.
    〖WTHZ〗Results〖HTSS〗After treatment, the levels of hs-CRP, IL-6, TNF-α, LDL-C, TC, TG, LVESV, LVEDV, VEGF, chemerin, BNP, and MDA were significantly lower than before treatment, and LVEF, AOA, GPx were high Before treatment, the 6-minute walking distance was longer than before treatment. The levels of hs-CRP, IL-6, TNF-α, LDL-C, TC, TG, LVESV, LVEDV, VEGF, chemerin, BNP, and MDA were lower in the study group than in the control group. , LVESV, LVEF, LVEDV, AOA, and GPx were higher than the control group, and the control group with a 6-minute walking distance was significantly different （P＜0.05 or P＜0.01).
    〖WTHZ〗Conclusion〖HTSS〗Spironolactone is effective in the treatment of patients with chronic heart failure. It can reduce inflammatory factors, blood lipid levels and stress responses, improve patients cardiac function, increase 6-minute walking distance, and improve serum VEGF, Chemerin, and BNP levels. It is worthy of clinical promotion.
    Study on the relationship between Lp(a) and left ventricular thrombosis after acute anterior wall myocardial infarction
    WANG Xun1, FU Xiang-hua2, WANG Ze-jing3, XIAO Kang3
    2020, 41(7):  754-757,792.  doi:10.3969/j.issn.1007-3205.2020.07.003
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    Objective〖HTSS〗To observe the relationship between lipoprotein a［Lp(a)］ and left ventricular thrombosis after acute anterior wall myocardial infarction.
    〖WTHZ〗Methods〖HTSS〗The patients who were admitted to our hospital for the first acute anterior wall myocardial infarction and underwent emergency coronary interventional therapy were divided into non-thrombotic group and thrombotic group according to the transthoracic echocardiographic examination. Gender, age, Lp(a), left ventricular diastolic diameter and left ventricular ejection fraction(LVEF) were analyzed and compared between the two groups.
    〖WTHZ〗Results〖HTSS〗A total of 284 patients, aged 38-89 years, with an average age of (71.7±7.4) years, were enrolled, and 19 cases(6.69%) of them developed left ventricular thrombosis. Patients with left ventricular thrombus had higher Lp (a) longer time from attack to reperfusion, higher peak creatine kinase level, lower ejection fraction, lower frequency of TIMI 3 flow post PCI than patients without left ventricular thrombus(all P＜0.01). Multivariable logistic regression models estimated that the Lp(a), peak creatine kinase level, time from attack to reperfusion, impaired LVEF，abnormal TIMI-flow post PCI were positive predictor of left ventricular thrombus.
    〖WTHZ〗Conclusion〖HTSS〗Elevated serum level of Lp(a) (≥300 mg/L) is an independent risk factor for left ventricular thrombosis after acute anterior wall myocardial infarction.
    Assessment of left ventricular function by three-dimensional speckle tracking imaging in patients with apical hypertrophic cardiomyopathy
    ZHOU Jin-ling, WANG Feng, LIU Wei-wei, WANG Yue-heng
    2020, 41(7):  758-763.  doi:10.3969/j.issn.1007-3205.2020.07.004
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    Objective〖HTSS〗To assess the left ventricular systolic function in apical hypertrophic cardiomyopathy（AHCM） with three-dimensional speckle tracking imaging(3D-STI).
    〖WTHZ〗Methods〖HTSS〗Twenty-one AHCM patients (AHCM group) and 21 healthy volunteers(control group) were selected for routine two-dimensional echocardiography and 3D-STI examination. Three-dimensional dynamic images of left ventricle were obtained and stored, and analyzed by 4D AUTO LVQ software. The parameters and curves of longitudinal strain(LS), circumference strain(CS), area strain(AS) and radial strain(RS) were compared between two groups.
    〖WTHZ〗Results〖HTSS〗LVEDV and SV were lower in AHCM group than those in control group(P＜0.05). The values of global LS, CS, AS and RS in AHCM group were all lower than those in the control group(P＜0.01). Compared to the control group, the LS values of anterior wall, lateral wall, posterior wall and posterior interval of the mitral valve level were lower. At papillary muscles level, the LS, AS and RS values of all segment were lower, and the CS values of anterior, anterior wall, lateral wall and  posterior wall interval were lower. All of the strain values of the apex level were lower in AHCM group.The above differences were statistically significant(P＜0.05 or P＜0.01).
    〖WTHZ〗Conclusion〖HTSS〗In patients with AHCM, the global systolic function of left ventricular decreased to different degrees, while the segment systolic function of the left ventricular reduced most obviously at the apex level, and the papillary muscle level is also affected. 3D-STI can reflect the variations of left ventricular global and segmental systolic function in AHCM patients.
    Effect of high-flow nasal cannula oxygen therapy on the efficacy and short-term prognosis of transnasal high flow oxygen inhalation AECOPD patients with type Ⅱ respiratory failure
    CHAI Shu-kun, WANG Zhen, WANG Xiao-lin, SHI Jin-ying, LI Yan-xiao, WANG Zheng
    2020, 41(7):  764-767,828.  doi:10.3969/j.issn.1007-3205.2020.07.005
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    Objective〖HTSS〗To explore the effect of high flow oxygen inhalation through nose on the efficacy and short-term prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD, AECOPD) and type II respiratory failure.
    〖WTHZ〗Methods〖HTSS〗Sixty-six patients with AECOPD combined with type Ⅱ respiratory failure were selected as the research object. The simple random number table method was divided into a research group and a control group, 33 cases in each group.Patients in both groups received basic comprehensive treatment, patients in the control group received noninvasive positive pressure ventilation, and patients in the study group received nasal high-flow oxygen therapy.The changes of blood gas indexes and vital signs indexes before and after treatment were compared between two groups of patients, as well as clinical efficacy and short-term prognosis.
    〖WTHZ〗Results〖HTSS〗After treatment, the pH, arterial partial pressure of oxygen(PaO2 supplement), and oxygenation index(PaO2/FiO2) of the two groups of patients were higher than before treatment, and the patients in the study group were higher than those in the control group. The respiratory rate(RR) and heart rate(HR) of the two groups of patients were lower than before treatment, and the patients in the study group were lower than those in the control group, the difference was statistically significant(P＜0.05). The total effective rate of clinical efficacy in the study group was 96.97%, which was much better than 81.82% in the control group, and the difference was statistically significant(P＜0.05). There was no significant difference in 28 day tracheal intubation rate and 90 day mortality rate between two groups(P＞0.05), while the improvement rate of the study group was 84.85%, which was higher than that of the control group, 63.64%. Statistical significance(P＜0.05).
    〖WTHZ〗Conclusion〖HTSS〗The effect of transnasal high flow oxygen inhalation on AECOPD patients with type Ⅱ respiratory failure is significant, and the short-term prognosis is satisfactory, which is worthy of clinical application.
    Seroepidemiological survey of hepatitis B among rural women in child-bearing age in Dali prefecture
    HE Zuo1， YOU Feng-feng2
    2020, 41(7):  768-772.  doi:10.3969/j.issn.1007-3205.2020.07.006
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    Objective〖HTSS〗To determine seroepidemiological characteristics of hepatitis B virus （HBV） among rural women of child-bearing age in Dali prefecture and to provide the scientific basis for prevention and control of HBV.
    〖WTHZ〗Methods〖HTSS〗A total of 2 063 rural women of child-bearing age from 15 to 49 years old were selected by stratified cluster sampling and random number table. The subjects were investigated by questionnaire survey and samples of blood were collected， and HBV serological markers were tasted by enzyme linked immunosorbent assay.
    〖WTHZ〗Results〖HTSS〗Among 2 063 rural women of childbearing age, 45 cases(2.18%) were positive for HBsAg, 734 cases(35.58%) for HBsAb and 243 cases(11.78%) for HBcAb. There were 7 detection patterns of HBV serological markers, mainly susceptible(59.38%). The positive rate of HBcAb in the childbearing age women in mountainous areas was higher than that in non mountainous areas, and the positive rate of HBcAb in the childbearing age women in ethnic minorities was higher than that in the Han nationality, the difference was statistically significant(P＜0.05). With the increase of age, the positive rate of HBsAg and HBcAb in women of childbearing age was higher, the difference was statistically significant(P＜0.05), but there was no significant difference in the positive rate of HBsAb in women of childbearing age(P＞0.05). The positive rates of HBsAg and HBcAb in women of childbearing age with a history of hepatitis B vaccine immunization were lower than those without a history of hepatitis B vaccine immunization, and the positive rates of HBsAb were higher than those without a history of hepatitis B vaccine immunization(P＜0.05).
    〖WTHZ〗Conclusion〖HTSS〗The positive rate of HBsAg among rural women of child-bearing age in Dali prefecture is close to the low level， however，about 60% of the population are still susceptible for HBV. We should strengthen the propaganda of hepatitis B knowledge and promote hepatitis B vaccination among rural women in child-bearing age before pregnancy.
    Compared study on ultrasonic appearances and pathologic features of rabbit liver after utilization of chemotherapeutants and endocriminal medication
    LONG Xiao-xue, LI Peng, LI Wen-fei, WU Shan-shan, LI Jian-hui, SHEN Wen-zeng
    2020, 41(7):  773-779.  doi:10.3969/j.issn.1007-3205.2020.07.007
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    Objective〖HTSS〗To observe and study the ultrasonic appearances and pathologic features of rabbit liver after utilization of chemotherapeutants and endocriminal medicine，with a focus on fatty liver lesion.
    〖WTHZ〗Methods〖HTSS〗Forty female Newzaland rabbits were divided into 4 groups, group A（standard diet+starch）, group B(high-fat diet), group C(epirubicine+cyclophosphamide+tamoxifen+standard diet), group D(epirubicine+cyclophosphamide+tamoxifen+high-fat diet), 10 in each group. Prior to experiment， liver function, blood lipids, conventional ultrasound, shear wave velocity of hepatic parenchyma were executed . After 6-month feeding for group A and group B, and after 6-cycle chemotherapy followed by 3-month tamoxifen for group C and group D , above-mentioned examinations were carried out again. Finally rabbit liver pathology was performed.
    〖WTHZ〗Results〖HTSS〗①Laboratory   Liver function  After the experiment, the values of aspartate aminotransferase（AST） and alanine aminotransferase（ALT） in group B, C ,D were eleveted, the values of AST and ALT in group B, C and D were higher than that of group A, the values of AST and ALT in group C and D were higher than that of group B, the ALT value of group D was higher than that of group C，the above differences were statistically significant(P＜0.05）. Serum lipids  After the experiment, the values of total cholesterol(TC) and triglyceride(TG） in group B,C,D were eleveted, the values of TC and TG in group B, C, D were higher than that of group A, the values of TC and TG in group B, D were higher than that of group C, the TC value of group D was higher than that of group B，the above differences were statistically significant(P＜0.05）. ②Ultrasound  After the experiment, there were no abnormal sonographic appearances in group A. After the experiment,group B showed mild enlargement of the hepatic size, enhanced and dense parenchymal echoes; group C showed normal liver size, but somewhat unsmooth capsule, lightly enhanced and heterogenous panrenchymal echoes; Group D showed obvious and dense echogenicity in liver parenchyma besides group C's characteristics. After the experiment, the shear-wave velocity in group B, C, D were elevated，the values of group B,C,D were higher than that of group A, the above differences were statistically significant(P＜0.05）. ③Pathology  After the experiment，group A showed no abnorrnal pathologic findings. Group B showed moderate to severe steatosis, mild to moderate hydropic swelling. Group C showed mild steatosis, moderate to severe hydropic swelling, focal cholestasis and blood stasis, mild to moderate inflammation cell infiltration， focal fibrosis. Group D developped some regenerative nodules besides group C's main findings.
    〖WTHZ〗Conclusion〖HTSS〗Although the rabbits which only recieved the chemotherapy and tamoxifen showed some steatosis  besides hepatic celullar and parenchymal lesions, they did not show ultrasonographically remarkable fatty liver sonogram, 〖JP2〗however those rabbits which recieved high-fat diet or chemotherapy+tamoxifen+〖JP〗high-fat diet showed obvious fatty-liver sonographic characteristics. The fact demonstrates that high-fat diet plays a key role in forming fatty liver. Acoustic radiation force impulse imaging(ARFI) has some values in evaluating the hepatic lesions after the administration of chemotherapy and endocrine medication or high-fat diet.
    A randomized controlled clinical study of platelet-rich autogenous plasma in promoting the recovery of median nerve function after decompression of carpal tunnel syndrome
    WANG Hui, WANG He, ZHAO Feng, ZHU Chao-hua, HAN Xin-sheng, CHEN Li
    2020, 41(7):  780-783.  doi:10.3969/j.issn.1007-3205.2020.07.008
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    Objective〖HTSS〗To study the effect of autologous platelet-rich plasma(PRP) on the recovery of median nerve function after decompression for carpal tunnel syndrome.
    〖WTHZ〗Methods〖HTSS〗Forty patients with carpal tunnel syndrome were selected. According to the random number table method, they were randomly divided into control group and PRP injection group with 20 cases. The control group received carpal tunnel decompression. PRP injection group received peripheral injection of PRP after carpal tunnel decompression.The recovery of sensation, muscle strength and EMG of the two groups were compared.
    〖WTHZ〗Results〖HTSS〗Thirty-one patients were followed up, with 4 patients lost to follow-up in the control group and 5 patients lost to follow-up in the PRP injection group. Patients in both groups were followed up for more than 12 months. VAS score, muscle strength grading, median nerve SNCV and MNCV showed statistically significant differences between  two groups at 1, 3, 6 and 12 months after surgery(P＜0.01).
    〖WTHZ〗Conclusion〖HTSS〗PRP can promote the recovery of median nerve function after carpal tunnel decompression.
    Effect of holmium laser resection of bladder tumors combined with gemcitabine bladder perfusion therapy on patients with superficial bladder cancer and its affection on levels of serum CXCL5 and value of urinary NMP 22#br#
    DOU Zhen-jing， QIAO Yu-hua*， GUO Rong， YANG Li-hui, CUI Jian, HAO Qiang
    2020, 41(7):  784-787,823.  doi:10.3969/j.issn.1007-3205.2020.07.009
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    Objective〖HTSS〗To analyze the effects of holmium laser resection of bladder tumors(HOLBT) combined with gemcitabine bladder perfusion therapy on patients with superficial bladder cancer and its affection on levels of serum CXCL5 and value of urinary NMP 22.
    〖WTHZ〗Methods〖HTSS〗A total of 104 patients with csuperficial bladder cancer treated were selected as research objects, and divided into control group and observation group(52 cases in each group). Control group was given HOLBT, and observation group was treated with gemcitabine bladder perfusion therapy on the basis of control group. The postoperative recurrence, average recurrence time, average survival time and serum levels of growth factor, level of CXCL5 and NMP22 were compared between two groups.
    〖WTHZ〗Results〖HTSS〗The postoperative recurrence within 1 year and 3 years and the average recurrence time and average survival time in control group after treatment were significantly higher than those in observation group, the difference was statistically significant(P＜0.05 or P＜0.01). The serum VEGF, aFGF, bFGF, CXCL5 and urinary NMP22 levels in observation group were significantly lower than those in control group. After treatment, the levels of VEGF, α FGF, β FGF, CXCL5 and NMP22 in the two groups were lower than those before treatment（P＜0.01）.
    〖WTHZ〗Conclusion〖HTSS〗The HOLBT combined with gemcitabine bladder perfusion therapy on patients with superficial bladder cancer, can effectively reduce postoperative recurrence, prolong the mean survival time of patients, and can significantly reduce the level of CXCL5 and NMP22.
    Impact of double-lobe resection combined with uterine artery occlusion on the level of SDC-1, HPA and VEGF in patients with adenomyosis
    SHU Zhi-ming, MI Gui-lan, WU Jian-fa, LIU Zhou
    2020, 41(7):  788-792.  doi:10.3969/j.issn.1007-3205.2020.07.010
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    Objective〖HTSS〗To observe the efficacy of laparoscopic double-lobe resection combined with uterine artery occlusion in the treatment of adenomyosis and their impact on the levels of syndecan-1(SDC-1), heparanase(HPA) and vascular endothelial growth factor(VEGF).
    〖WTHZ〗Methods〖HTSS〗A total of 60 patients with adenomyosis in our hospital were selected and divided into observation group and control group according to different surgical methods. The control group was treated with double valve resection, while the observation group was conducted uterine artery occlusion on the basis of the control group. Clinical curative effect, total effective rate, operation time, intraoperative blood loss, postoperative intraperitoneal drainage volume, postoperative intraperitoneal drainage time, changes in Hb, hospital stays, total pregnancy rate at 10 months after surgery, changes in menstrual period, uterine volume, CA125,SDC-1, HPA and VEGF levels were observed before and after surgery in two groups.
    〖WTHZ〗Results〖HTSS〗The clinical curative effect of the observation group was better than that of the control group, and the total effective rate was higher than that of the control group. There was a statistically significant difference (P＜0.01 or P＜0.05). In the observation group, the operation time, intraoperative bleeding volume, postoperative abdominal drainage volume, postoperative abdominal drainage time, changes of Hb before and after operation and hospitalization time were significantly shorter or less than those in the control group(P＜0.01), while the cumulative pregnancy in the 10 months after operation was higher than that in the control group(P＜0.05). After treatment, the menstrual period, uterine volume and CA125 level of the two groups were significantly shortened, less or decreased compared with those before treatment, with statistical significance(P＜0.01); The menstrual period, uterine volume and CA125 level of the observation group were significantly shortened, less or decreased compared with the control group, with statistical significance(P＜0.01). After treatment, the levels of SDC-1, HPA and VEGF in the two groups were significantly lower than those before treatment(P＜0.05); The levels of SDC-1, HPA and VEGF in the observation group were significantly lower than those in the control group(P＜0.01).
    〖WTHZ〗Conclusion〖HTSS〗Laparoscopic double-lobe resection combined with uterine artery occlusion is effective in the treatment of adenomyosis, which can significantly relieve dysmenorrhea and 〖JP2〗reduce the volume of uterus. The mechanism may be related to the reduction of the levels of SDC-1,〖JP〗 HPA and VEGF.
    Quantitative study of normal ovarian tissue by real-time shear wave elastography
    HAN Hong, HAO Zhi-hua, SHEN Cai-li, WANG Ya-kun, WANG Jin-hua
    2020, 41(7):  793-796.  doi:10.3969/j.issn.1007-3205.2020.07.011
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    Objective〖HTSS〗To investigate the factors influencing ovarian elasticity, obtain the reference range of young′s modulus of normal ovary, and evaluate and predict the feasibility of real-ltime shear wave elastography(SWE) in the ovarian reserve function.
    〖WTHZ〗Methods〖HTSS〗The elasticity of the ovarian tissue of 671 subjects examined by conventional transvaginal ultrasonography was measured with SWE ultrasonography, and the young′s modulus value of normal ovarian tissue was obtained.
    〖WTHZ〗Results〖HTSS〗The value of young′s modulus of ovary in perimenopausal and menopausal period was greater than that in reproductive period(P＜0.01). There was no significant difference in the young′s modulus between the reproductive age group and the secretion gyoup(P＞0.05). There was no statistically significant difference in the young′s modulus between different age gyoups during childbearing period(P＞0.05).The minimum、maximum and average young′s modulus of the ovary at the childbearing stage were (12.8±4.08) kPa， (16.9±4.86) kPa and (14.63±4.31) kPa.
    〖WTHZ〗Conclusion〖HTSS〗The physiological stage affects the young′s modulus of the normal ovarian tissue, while the menstrual cycle has no effect on the young′s modulus of the ovary, The hardness of the normal ovarian tissue gradually hardens with the youth of age.
    Effect of daytime operation and inpatient operation mode on intraoperative blood loss, hemoglobin, serum sodium and prognosis in patients with hysteromyoma resection
    LIU Yang, CHEN Liang
    2020, 41(7):  797-800.  doi:10.3969/j.issn.1007-3205.2020.07.012
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    Objective〖HTSS〗To explore the effect of day surgery and traditional hospital operation mode applied to hysteroscopic hysteromyoma resection on patients' intraoperative, postoperative and prognosis.
    〖WTHZ〗Methods〖HTSS〗A total of 106 patients with submucosal uterine fibroids who met the standard of day surgery in our hospital were selected. 53 cases were performed during day surgery(observation group) and traditional hospitalization surgery(control group), and the intraoperative blood loss， postoperative hemoglobin And serum sodium content, postoperative complications, postoperative fibroids residual, and menstrual flow improvement were compared between the two groups.
    〖WTHZ〗Results〖HTSS〗There was no statistically significant difference in the amount of intraoperative blood loss, postoperative hemoglobin and serum sodium content between the two groups of patients(P＞0.05); The difference in postoperative complication rate, fibroids residual and menstrual volume improvement rate between two groups of patients There was no statistical significance(P＞0.05).
    〖WTHZ〗Conclusion〖HTSS〗Day surgery does not increase the risk of hysteroscopic hysteromyoma resection, and it has obvious advantages over traditional inpatient surgical models and is worthy of vigorous promotion.
    Expression of thioredoxin-2 in anterior capsule of lens and its relationship with apoptosis and oxidative stress in elderly cataract patients
    WU Chao, YANG Xu
    2020, 41(7):  801-804,833.  doi:10.3969/j.issn.1007-3205.2020.07.013
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    Objective〖HTSS〗To investigate the expression of thioredoxin-2(Trx-2) in anterior capsule of lens and its relationship with apoptosis and oxidative stress in elderly cataract patients.
    〖WTHZ〗Methods〖HTSS〗Forty cases 40 eyes of elderly cataract patients underwent phacoemulsification cataract extraction were chosen as study group, 20 cases 20 eyes elderly patients treated with transparent lens extraction(non-cataract) due to trauma were chosen as control group. The positive expression of Trx-2 in anterior capsule of lens was determined by immunohistochemistry. Protein expression of apoptosis related molecules［P53 gene(P53), B-cell lymphoma-2(Bcl-2), Apoptosis signal-regulating kinase 1(ASK1)］, contents of oxidative stress indexes［superoxide dismutase(SOD), catalase(CAT) activity and glutathione(GSH), malondialdehyde(MDA)］ levels were compared between study group , control group, Trx-2(+) and Trx-2(-) specimens in study group.
    〖WTHZ〗Results〖HTSS〗Positive rate of Trx-2 expression in study group was significantly lower than that in control group(P＜0.05). Protein expressions of P53 and ASK1 in anterior capsular membrane of study group were higher than those in control group, while protein expressions of bcl-2 was lower than that in control group. Supernatant levels of SOD, CAT and GSH were lower than those in control group, and level of MDA was higher than that in control group(P＜0.01). In study group, the protein expression levels of P53 and ASK1 in Trx-2(+)specimens were lower than those of Trx-2(-), protein expression level of bcl-2 was higher than that of Trx-2(-). levels of SOD, CAT and GSH in Trx-2(+) were higher than those in Trx-2(-), level of MDA was lower than that in Trx-2(-)(P＜0.05 or P＜0.01).
    〖WTHZ〗Conclusion〖HTSS〗Expression of Trx-2 in anterior lens capsule of elderly cataract patients decreases, and its anti-apoptosis、 anti-oxidative stress are weakened, which may be one of the important molecular mechanisms leading to the occurrence and development of the disease.
    Analysis of dentofacial width of class Ⅱ1 malocclusion with different vertical skeletal types of adolescents
    LIU Ye1, SHEN Yue2, ZHANG Shi-long1, KANG Wen-jing1, LU Hai-yan1*
    2020, 41(7):  805-809.  doi:10.3969/j.issn.1007-3205.2020.07.014
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    Objective〖HTSS〗To investigate the correlation between different vertical facial patterns and maxillofacial bone width of angle class Ⅱ1 malocclusion.
    〖WTHZ〗Methods〖HTSS〗Twenty average-angel patients with class Ⅰ malocclusion (the controlled group) and 120 patients with class Ⅱ1 malocclusion (the test group) were collected. Patients with class Ⅱ1 were divided into two groups according to the cause of malocclusion. The first test group was maxilla overgrown group, and the second test group was mandible dysplasia group. There were 60 patients in each group. Each group was divided into average-angle group, high-angle group and low-angle group with 20 cases in each group. Inter-zygomatics width(Zyg-Zyg′), inter-condyles width(Cdl-Cdl′), inter-nasal cavities width(Nc-Nc′), inter-maxillary points width(Mx-Mx′), upper inter-molars width(UM-UM′), lower inter-molars width(LM-LM′) and inter-gonions width(Go-Go′)were measured respectively in the posteroanterior cephalograms.
    〖WTHZ〗Results〖HTSS〗The first and second test groups with average-angel were smaller than the control group in UM-UM′(P＜0.05). The first and second test groups with high-angel were smaller than the control group in UM-UM′ and Mx-Mx′ (P＜0.05). The first test groups with high-angle group was smaller than the low-angle group in UM-UM′ (P＜0.05), UM-UM′ of the first test group was negatively correlated with FH-MP(r=-0.425， P＜0.05). The second test groups with high-angle group was smaller than the low-angle group and average-angel group in UM-UM′(P＜0.05), UM-UM′ of the second test group was negatively correlated with FH-MP (r=-0.533，P＜0.05).
    〖WTHZ〗Conclusion〖HTSS〗As the mandibular plane angle decrease from large to small, the maxilla posterior arch width in patients with class Ⅱ1 malocclusion gradually increase.
    Effects of taraxasterol on inflammatory factor levels and morphology of thymus in acne model of mice through TGF-β/Smad pathway
    LIU Hong-jun, SUN Xue-mei, SUN Ming-qiang, JIN Chun-lin
    2020, 41(7):  810-814.  doi:10.3969/j.issn.1007-3205.2020.07.015
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    Objective〖HTSS〗To investigate the effect of taraxasterol on the level of inflammatory factors and morphology of thymus in acne model mice through transforming growth factor-β(TGF-β)/Smad pathway.
    〖WTHZ〗Methods〖HTSS〗C57BL/6 mice were divided into: control group(group A), model group(group B), taraxasterol low-dose group(group C), taraxasterol high-dose group(group D). The ear changes of mice in each group were observed; hematoxylin-eosin staining(HE) staining was used to observe the pathological changes of ear tissue and thymus tissue of mice in each group. Enzyme linked immunosorbent assay(ELISA) was used to detect the expression levels of interleukin-1β(IL-1β) and IL-8 in the serum of mice in each group. Immunohistochemical was used to detect of the expression rate of tumor necrosis factor-α(TNF-α) positive cells in the ear tissues of mice in each group. Western blot was used to detect the expression of transforming growth factor-β1(TGF-β1) and Smad3 protein in the ear tissue of mice in each group.
    〖WTHZ〗Results〖HTSS〗Compared with group B, group C and group D reduced the ear swelling, redness and erythema, dry and rough texture of acne mice, and the ear thickness was significantly reduced(P＜0.05). After taraxasterol treatment by gavage, the inflammation in acne mice was effectively alleviated, and the number of infiltrating inflammatory cells was significantly reduced, and the thickening of the epidermis was also reduced. Compared with group B group, group C and group D increased thymic cortical thickness mice acne and lymphocytes(both P＜0.05); Taraxasterol significantly reduced the level of expression of IL-1β and IL-8 of mouse serum(P＜0.05 or P＜0.01), and the ear tissues of mice TNF-α expression is reduced(P＜0.05). Compared with group B, group C and group D down-regulated the expression of TGF-β1 and Smad3 protein in mouse ear tissues(both P＜0.05).
    〖WTHZ〗Conclusion〖HTSS〗Taraxasterol had a good therapeutic effect on mouse auricular acne model, regulates the expression of inflammatory factors and improves the morphology of mouse thymus, which may be related to TGF-β/Smad pathway.
    Analysis of the influencing factors and characteristics of different degrees of brain white matter injury in premature infants
    ZHANG Hong-tao, LI Yang, KOU Xiao-na, WANG Li-shun
    2020, 41(7):  815-818.  doi:10.3969/j.issn.1007-3205.2020.07.016
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    Objective〖HTSS〗To analyze the influencing factors and the characteristics of different degrees of brain white matter injury in preterm infants.
    〖WTHZ〗Methods〖HTSS〗126 cases of premature infants with brain white matter injury were selected as the observation group, and 88 cases of full-term normal infants were selected as the control group. Logistic regression analysis was used to determine the risk factors of brain white matter injury in preterm infants. Further analyze the clinical data of different degrees of brain white matter injury in the observation group, and explore the clinical characteristics of premature infants with different degrees of brain white matter injury.
    〖WTHZ〗Results〖HTSS〗In the observation group, the fetal age, the proportion of cesarean section, the level of myocardial enzyme, C-reactive protein(CRP), albumin, the incidence of post natal infection and intrauterine distress were significantly higher than those in the control group(P＜0.05 or P＜0.01). Logistic regression analysis showed that low gestational age, high CRP, infection after birth, and intrauterine distress were independent risk factors for the occurrence of brain white matter injury in preterm infants. The incidence of infection, CRP and intrauterine distress increased with the severity of the disease(P＜0.05 or P＜0.01).
    〖WTHZ〗Conclusion〖HTSS〗Postnatal infection, low gestational age, high CRP and intrauterine distress are the risk factors for the occurrence of brain white matter injury in preterm infants. With the aggravation of the disease, the incidence of postnatal infection, high CRP and intrauterine distress gradually increases. The incidence of brain white matter injury in preterm infants can be reduced by doing a good job of perinatal health care.
    Analgesic and sedative effects of different doses of sufentanil in PCIA after maxillofacial fracture internal fixation operation and adverse reactions
    ZHANG Cheng-zhang, LI Zhen-wei
    2020, 41(7):  819-823.  doi:10.3969/j.issn.1007-3205.2020.07.017
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    Objective〖HTSS〗To observe the analgesic and sedative effects of different doses of sufentanil in patient-controlled intravenous analgesia(PCIA) after maxillofacial fracture internal fixation operation and adverse reactions.
    〖WTHZ〗Methods〖HTSS〗Seventy-three patients with maxillofacial fracture  were randomly divided into group A(21 cases，sufentanil 0.02  μg·kg-1·h-1), group B(27 cases，sufentanil 0.04 μg·kg-1·h-1) and group C(25 cases，sufentanil 0.06 μg·kg-1·h-1). The total amount of medication, Visual Analogue Score(VAS), Visual Analogue Fatigue Score(VAFS) and White sedation score were compared at each time point, and the occurrence of adverse effects of postoperative analgesia was counted.
    〖WTHZ〗Results〖HTSS〗The VAS and VAFS scores of group B and group C were significantly lower than those of group A at 6 h, 12 h, 24 h and 48 h after operation(P＜0.05), but there was no significant difference between group B and group C at all time points after operation(P＞0.05); The White sedation scores of group C at all time points after operation were significantly higher than those of group A and group B(P＜0.05); While there was no significant difference between group A and group B at all time points(P＞0.05). The incidence of dizziness, nausea and vomiting in group A and group B was significantly lower than that in group C(P＜0.05), while there was no significant difference in the incidence of adverse reactions between group A and group B(P＞0.05).
    〖WTHZ〗Conclusion〖HTSS〗Continuous infusion of sufentanil 0.04 μg·kg-1·h-1 is suitable for PCIA after maxillofacial fracture internal fixation operation, which can obtain good analgesic effect and high safety.
    Present situation and intervention of mental health of young doctors in different genders
    WANG Shan-shan, YANG Liu， GUO Qiong-jie， SUN Wei, WANG Guo-yu， SHI Wen-zong
    2020, 41(7):  824-828.  doi:10.3969/j.issn.1007-3205.2020.07.018
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    Objective〖HTSS〗To understand the mental health status of young doctors of different genders in public hospitals, including depression symptoms, subjective well-being and their interrelation.To pay attention to the establishment of mental health files, using the files to guide the intervention of young doctors′ mental health. To provide support for reducing depression and improving subjective well-being of young doctors.
    〖WTHZ〗Methods〖HTSS〗A survey of depression scale and subjective well-being of doctors born after 1990 in a public hospital was conducted by using systematic sampling method. With unified instruction, questionnaire were collected on the spot.
    〖WTHZ〗Results〖HTSS〗The prevalence of depression in young doctors was 51.5%(159), the main symptom was depression. Subjective well-being score was above average, the life satisfaction score of female doctors was significantly higher than that of male doctors.
    〖WTHZ〗Conclusion〖HTSS〗The prevalence of depression in young doctors has a high detection rate, correlation score is moderate, the life satisfaction score of female doctors is significantly higher than that of male doctors. According to the results of the psychological test questionnaire of this study, the mental health files of the employees are summarized, with active follow-up and intervention. We should pay attention to the mental health of young doctors, conduct professional mental health guidance, establish mental health records to ensure the mental health of young doctors.
    Quality of blood transfusion medical records in the Fourth Hospital of Hebei Medical University from 2016 to 2018
    HAN Li-na, SUN Nan, WU Bo, ZHAO Liang, JU Hong-mei, ZHAO Xue-tao
    2020, 41(7):  829-833.  doi:10.3969/j.issn.1007-3205.2020.07.019
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    Objective〖HTSS〗To investigate the problems existing in hospital blood transfusion records, analyze the unreasonable factors, improve the quality of blood transfusion records, and provide guarantees for safe blood transfusion.
    〖WTHZ〗Methods〖HTSS〗According to “Management of blood for clinical use in medical institutions” and “Technical specifications for clinical transfusion”, develop evaluation criteria for clinical blood transfusion records, 1 183 blood transfusion records were randomly selected from clinical departments with blood transfusion, pre-transfusion testing, informed consent, indication assessment, course record, management of transfusion process, adverse reaction report and return of large amount of transfusion were evaluated. 
    〖WTHZ〗Results〖HTSS〗A total of 1 183 medical records were randomly examined, among which 203 were defective, accounting for 17.16%. From 2016 to 2018, unqualified medical records decreased significantly, and the difference was statistically significant(P＜0.05). In 2016, the examination items of blood transfusion defect medical records accounted for a large proportion, and the proportion of defect cases was also relatively high. With the in-depth examination of blood transfusion medical records, the unqualified items in defect medical records decreased year by year, and the proportion of defect cases gradually decreased, with statistically significant difference(P＜0.05). By 2018, the unqualified items mainly focus on the evaluation of indications for blood transfusion(3.96%). Among the sampled medical records, 537 were from non-surgical departments, among which 55 were defective, accounting for 10.24%. There were 646 medical records in surgical departments, including 148 defective medical records, accounting for 22.91%. There were statistically significant differences in the proportion of qualified medical records between surgical departments and non-surgical departments in 2016 and 2017(P＜0.05). 
    〖WTHZ〗Conclusion〖HTSS〗Through the examination of blood transfusion medical records, the medical records of blood transfusion in the hospital were improved, however, there are still some problems, so the training of clinicians should be strengthened to further improve the quality of blood transfusion records.