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Table of Content

    25 September 2020, Volume 41 Issue 9
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    The efficacy of low-dose argatroban in the treatment of acute ischemic stroke under TOAST classification#br#
    QU Zheng1， WANG Rui1， ZHANG Ming-rui2， YANG Bin1， SHI Qiu-yan1*
    2020, 41(9):  999-1002.  doi:10.3969/j.issn.1007-3205.2020.09.002
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    Objective  To observe the efficacy and safety of low-dose argatroban in the treatment of patients with acute ischemic stroke under different etiology.
      Methods  A retrospective analysis of 124 patients with acute ischemic stroke within 48 hours of onset was divided into LAA group according to the Trial of Org 10172 in Acute Stroke Treatment(TOAST) classification of patients with argatroban. In the CE group and the SAO group, 20 mg of argatroban injection was given daily for 7 days after admission, and conventional treatments such as 100 mg of aspirin were combined. The short-term clinical effects were compared before treatment and 7 d, 14 d after treatment with the National Institutes of Health Stroke Scale(NHISS) and Barthel Index(BI) rating scale. The bleeding of digestive tract, skin and mucosa, intracranial and other adverse events during hospitalization were observed.
      Results  After treatment, the NHISS scores of the three groups showed a downward trend, and Bi index showed an upward trend. The change range of CE group was the largest, and there were significant differences among groups, time points and interaction between groups(P＜0.05). The total effective rate of CE group was higher than that of LAA group and Sao group(P＜0.05). There was no significant difference in the incidence of adverse events among three groups(P＞0.05).
      Conclusion  The early combined use of low-dose argatroban in patients with acute ischemic stroke under TOAST etiology can benefit without increasing the risk of bleeding, with CE being the best.
    The correlation between RDW of type 2 diabetes mellitus or non-diabeticpatients and severity of acute coronary syndrom
    WU Ting-ting1， CAO Qiu-mei1， TANG Jun-nan2*
    2020, 41(9):  1003-1006.  doi:10.3969/j.issn.1007-3205.2020.09.003
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    Objective  To investigate the correlation between the severity of acute coronary syndrome(ACS) and red blood cell distribution width(RDW) of type 2 diabetes mellitus(DM) and non-diabetic patients.
      Methods  The 497 ACS patients were selected and divided into the 2-DM group(group 1) and the non-diabetic group(group 2), performed coronary angiography(CAG) separately. According to SYNTAX score, group 1 and group 2 were divided into three groups: low group, middle group and high group(group 1：A1, B1, C1； group 2：A2, B2, C2), measuring the RDW width of each group, and conducting comparison and correlation analysis. Glycated hemoglobin(GHb) levels between groups A1, B1 and C1 were measured, and intra-group comparison and correlation analysis were performed.
      Results  The RDW level of A1, B1, C1 in group 1 and A2, B2 and C2 in group 2 was progressively increased with statistically significant difference(P＜0.05), and the RDW level was positively correlated with SYNTAX score(r=0.675, P＜0.01). The RDW level of all 497 patients was positively correlated with SYNTAX score(r=0.686， P=0.041). There was no statistically significant difference in the correlation coefficient between RDW level and SYNTAX score（Z=-1.960， P=0.373）between groups 1 and 2.
      Conclusion  The width of the red blood cells was not affected by the blood glucose level. Whatever type 2 diabetes mellitus and non-diabetic patients, RDW can be used as the evaluation index of the severity of ACS coronary blood vessels.
    The value of different contrast dosage in CT coronary angiography for coronary artery and coronary venous sinus
    WANG Ze-jing1， WANG Xun2， XIAO Kang1
    2020, 41(9):  1007-1010,1046.  doi:10.3969/j.issn.1007-3205.2020.09.004
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    Objective  To analyze the influence of contrast medium dosage on the enhancement of coronary artery and coronary venous sinus in patients with coronary heart disease of different severity during CT coronary angiography, and to explore the diagnostic value of CT coronary angiography for coronary heart disease and the application of contrast medium in enhanced scanning.
      Methods  Ninety-eight patients detected by Philips 256-slice spiral CT coronary angiography were divided into group A(ejection fraction≥50%, n=58) and group B(ejection fraction<50%, n=40) according to the echocardiography reports. Each group was further divided into four groups by random number table method, 29 cases in group A1, 29 cases in group A2, 20 cases in group B1 and 20 cases in group B2. At the time of scanning, the dosage of contrast agent in group A1 and B1(according to body weight) was 0.7 mL/kg; the dosage of contrast agent in group A2 and B2(according to body weight) was 0.8 mL/kg; the maximum CT values of ascending aorta, proximal left anterior descending branch, distal right coronary artery, main left coronary artery and coronary sinus were measured after injection of contrast agent in four groups, and the dosage and injection rate of contrast agent in four groups were also counted. Scanning time, delay time and image quality of four groups were scored, and the values of the above indexes in each group were compared.
      Results  ①The overall difference of the 4 groups with the maximum CT value of the proximal anterior descending branch and the distal right coronary artery was statistically significant(P＜0.001). Pairwise comparison showed that there was no significant difference between the A1 group and the A2 group, while there were statistically significant differences in other groups. ②The overall difference of the 4 groups with the maximum CT value of coronary venous sinus was statistically significant(P＜0.001). Pairwise comparison showed that there were statistically significant differences among all groups. ③The overall difference of image quality scores in 4 groups was statistically significant(P＜0.001). Pairwise comparison showed that there was no significant difference between A1 group and A2 group, while there were statistically significant differences in the other groups.
      Conclusion  ①In patients with normal cardiac function, the use of low-dose contrast agents(0.7 mL/kg) did not impair the quality of coronary artery imaging. For patients with reduced cardiac function, low-dose contrast agents can reduce the quality of coronary artery imaging. ②Reducing the amount of contrast agent will reduce the CT maximum value of coronary venous sinus（P＜0.05）. With the same dose of contrast agent, the maximum CT value of coronary venous sinus in normal cardiac function group was lower than that in cardiac insufficiency group.
    Application of TIMI myocardial perfusion frame number in MVO evaluation of STEMI patients after PCI
    ZHAO Jia-yu1， LIU Ya-ting2， ZHU Nan1， ZHANG Fang2
    2020, 41(9):  1011-1015,1064.  doi:10.3969/j.issn.1007-3205.2020.09.005
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    Objective  To explore the value of TIMI myocardial perfusion frame count(TMPFC) in the evaluation of microvascular obstruction after primary percutaneous coronary stenting(PCI) in patients with ST-segment elevation myocardial infarction(STEMI) and its relationship with clinical prognosis.
      Methods  A total of 200 STEMI patients with primary PCI were selected and divided into two groups according to TMPFC. Baseline clinical characteristics and angiographic characteristics of the two groups were observed, and the left ventricular ejection fraction(LVEF) and major cardiovascular adverse events(MACE) were followed up 6 months after PCI.
      Results  The incidence of diabetes, blood glucose, peak cardiac troponin I(CTnI) and MACE in the observation group was higher than that in the control group, while the incidence of pre-infarction angina, baseline LVEF and 6-month LVEF was lower than that in the control group(P＜0.05). In the observation group, the onset to first medical contact time(Onset to FMC) was longer than that in the control group; Post-stent dilation, aspiration catheter, intra-coronary platelet Ⅱb/Ⅲa receptor antagonists, multi-vessel disease, TMPFC were higher than those in the control group. The proportion of TIMI level 3, and TMPG level 3 was lower than that of the control group(P＜0.05). Onset-to-FMC and peak CTnI were independent risk factors for myocardial microcirculation obstruction(OR=1.368, 95%CI:1.149-1.627， P＜0.001; OR=1.014, 95%CI:0.951-1.082; P=0.005), and TMPFC were independent risk factors for MACE in STEMI patients after 6 months follow-up(OR=1.040, 95%CI:1.007-1.092, P=0.020).
      Conclusion  TMPFC was independent risk factors for MACE in STEMI patients undergoing PCI, and as a new quantitative evaluation index of microcirculation, TMPFC was superior to the previous imaging index of myocardial microcirculation.
    The relationship between hormone levels and plasma CTRP3, immunoglobulin levels and coronary plaque stability in premenopausal women with CHD#br#
    WANG Shi-jie, LI Shan, WANG Xiao-gang, LI Pu, WEI Qing-min
    2020, 41(9):  1016-1019,1038.  doi:10.3969/j.issn.1007-3205.2020.09.006
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    Objective  To study the relationship between hormone levels and plasma CTRP3, immunoglobulin levels and coronary plaque stability in premenopausal women with coronary atherosclerotic heart disease（CHD）.
      Methods  The subjects of this study were 50 premenopausal women with coronary heart disease, and 25 healthy premenopausal women treated in our hospital during the same period as the control group. The relationship between hormone levels and plasma CTRP3, immunoglobulin levels and coronary plaque stability in premenopausal women with CHD were analyzed.
      Results  The levels of CTRP3, IgA, IgM, IgG， E2, FSH and LH in the observation group were significantly lower than those in the control group, with statistical significance(P＜0.05).The levels of CTRP3, IgA, IgM, IgG, E2, FSH and LH in the observation group were in turn as the control group, stable angina group and acute coronary syndrome group, with the middle thickness of the artery, plaque surface（P＜0.05）. The area and number of plaques were significantly higher than those in the control group（P＜0.05）. From the analysis of the results of two comparisons, the order of plaque stability from high to low was the control group, stable angina pectoris group and acute coronary syndrome group（P＜0.05）. The levels of E2, FSH and LH were positively correlated with the thickness of middle arterial layer, plaque area, plaque number, CTRP3, IgA, IgM and IgG levels, respectively（P＜0.05）.
      Conclusion  Hormone levels in premenopausal women with CHD are correlated with plasma CTRP3, immunoglobulin levels and coronary plaque stability. It is suggested that sex hormone levels should be used as one of the indicators of the severity of CHD in clinical diagnosis and treatment.
    Expression and clinical significance of hsa-mir-23a and hsa-mir-566 in patients with newly diffuse large B cell lymphoma
    TAO Sheng-neng1, ZHANG Xu-han2, ZHANG Rui3, ZHU Xiao-yu2, WANG Xiao-hua1
    2020, 41(9):  1020-1024.  doi:10.3969/j.issn.1007-3205.2020.09.007
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    Objective  To explore the expression levels of hsa-miR-23a and hsa-miR-566 in patients with newly diffuse large B cell lymphoma(DLBCL) and their clinical significance.
      Methods  Sixty cases of newly DLBCL patients were selected as the observation group, and 60 cases of healthy people as the control group. The expression levels of hsa-mir-23a and hsa-mir-566 in peripheral blood of the two groups were detected and compared. The relationship between the expression level of hsa-mir-23a and hsa-mir-566 and the clinical characteristics and prognosis of DLBCL were analyzed.
      Results  The expression levels of sa-mir-23a-3p and hsa-mir-566 in the observation group were higher than those in the control group, The difference was statistically significant(P＜0.05). The expression levels of hsa-miR-23a-3p and hsa-miR-566 in peripheral blood were related to tumor stage, number of lymph node metastasis, and international prognostic index(IPI) points(all P＜0.05). The mean expression levels of hsa-mir-23a-3p and hsa-mir-566 in peripheral blood of DLBCL patients were 3.35 and 1.69 as critical values. The patients were divided into hsa-mir-23a-3p high expression group(32 cases), hsa-mir-23a-3p low expression group(28 cases), hsa-mir-566 high expression group(29 cases) and hsa-mir-566 low expression group(31 cases). The overall survival rate of hsa-mir-23a-3p high expression group was 40.63%(13/32), which was significantly lower than 67.86%(19/28) of low expression group, The difference was statistically significant(χ2=4.450, P=0.035)； The median survival time of hsa-mir-23a-3p high expression group and hsa-mir-23a-3p low expression group were(26.73 months vs 32.52 months, P＜0.01). The overall survival rate of hsa-mir-566 high expression group was 37.93%(11/29), which was significantly lower than 67.74%(21/31) of low expression group. The difference was statistically significant(χ2=5.350, P=0.021). The median survival time of hsa-mir-566 high expression group and hsa-mir-566 low expression group were(27.45 months vs 32.35 months，P＜0.01).
      Conclusion  The expression of hsa-mir-23a-3p and hsa-mir-566 in the peripheral blood of patients with newly DLBCL is high, which is closely related to the clinical stage, the number of lymph node metastasis, IPI index and prognosis of patients with DLBCL, and is expected to become an important marker in the diagnosis of DLBCL.
    Changes of endothelial progenitor cells in peripheral blood of patients with obstructive sleep apnea hypopnea syndrome
    CHI Wei-wei1, NIU Ying-hao1, DONG Li-ping1, ZHANG Ji-hua2, WU Guang-li1, SONG Dong-mei1*
    2020, 41(9):  1025-1028.  doi:10.3969/j.issn.1007-3205.2020.09.008
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    Objective  To study the changes of endothelial progenitor cells in peripheral blood of patients with obstructive sleep apnea hypopnea syndrome（OSAHS）.
      Methods  A prospectivestudy of 30 obstructive sleep apnea hypopnea syndrome patients were selected in the department of otolaryngology, the first hospital of Hebei Medical University. Thirty healthy subjects were selected as control group. Monocytes were obtained from 10 mL of venous blood by density gradientcentrifugation, Endothelial progenitor cells(EPCs）were cultured and identified byfluorescence microscopy. The number, migration, proliferation and adhesion of EPCs in two groups were evaluated.
      Results  The number of proliferating cells, migratingcellsand adheringrate  in the normal control group were significantlyhigher than those in the OSAHS group(P＜0.05).
      Conclusion  The number of endothelial progenitorcells in OSAHS patients with hard plaque is small, and their proliferation, migration andadhesion ability are impaired.
    Clinical study of correlation between perirenal hematoma after renal biopsy in patients with AKI and preoperative dialysis intervention#br#
    HAN Bi-cui1, ZHANG Fu1, LIN Shao-qiang2
    2020, 41(9):  1029-1032.  doi:10.3969/j.issn.1007-3205.2020.09.009
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    Objective  To investigate the correlation between perirenal hematoma after renal biopsy in patients with AKI and preoperative dialysis intervention.
      Methods  Clinical data of 180 AKI patients with renal biopsy were retrospectively chosen. All patients were divided different groups according to whether or not dialysis intervention before operation and perirenal hematoma after operation. The baseline clinical characteristics and the indexes of postoperative hemorrhage of different groups were compared, and  the correlation between the perirenal hematoma and the preoperative dialysis intervention by logistic regression method were analyzed.
      Results  ①The proportion of AKI  2-3 stage, Cr and BUN levels in dialysis group were significantly higher than non-dialysis group（P＜0.05）. The Hb level of dialysis group was significantly lower than non-dialysis group（P＜0.05）. ②108 cases(60.0%) were confirmed to have perirenal hematoma by renal ultrasound 24 hours after operation. Among them, there were 46 cases in dialysis group and 62 cases in non dialysis group.There was no significant difference in the incidence of postoperative perirenal hematoma between dialysis group and non-dialysis group（P＞0.05）. The level of Hb of dialysis group was significantly lower than non-dialysis group（P＜0.05）. ③There was no significant difference in baseline clinical characteristics between 2 groups（P＜0.05）. ④Pearson method evaluation results showed that there was no correlation between the occurrence of perrenal hematoma after renal biopsy and preoperative hemodialysis(r=0.34, P=0.26); the results of multivariate analysis showed that the diameter of perinephric hematoma after renal biopsy There is no correlation between the risk of ≥5 cm and preoperative hemodialysis treatment(r=0.27, P=0.35).
      Conclusion  Dialysis intervention before renal puncture is difficult to effectively reduce or avoid the risk of bleeding after renal biopsy.
    Deep venous thrombosis of lower extremities before release from hospital of orthopedics department: analysis of 26 patients
    NING Yan-ting, DING Jun-qin*, LI Chun-liu, QI Xiang-bei, LI Sheng, LI Zhi-yong
    2020, 41(9):  1033-1038.  doi:10.3969/j.issn.1007-3205.2020.09.010
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    Objective  To investigate the significance of color Doppler ultrasound in lower extremity deep vein before release from hospital.
      Methods  A retrospective analysis was conducted on 26 patients with deep vein thrombosis(DVT) after orthopaedic surgery in Xiangjiang district of the Third Hospital of Hebei Medical University. By analyzing their gender, age, disease diagnosis in department of orthopedics, complications of underlying diseases, types of thrombosis, location and complications of pulmonary embolism, the proportion of different diseases and the distribution of thrombus types were compared.
      Results  In 26 patients with lower limb DVT, three cases of central thrombosis was accounting for 11.54% of the 26 patients(3 cases of superficial femoral vein thrombosis), while 22 cases of peripheral thrombus were accounting for 84.62% of the 26 patients(3 cases of popliteal vein thrombosis , 3 cases of posterior tibial vein thrombosis, 5 cases of fibula thrombosis, 11 cases of intermuscular venous thrombosis).There were 1 cases of thrombus, accounting for 3.85%. There were no significant differences among the three thrombus types in gender, age, obesity, hypertension, diabetes mellitus, surgical method, blood transfusion history, and fracture type composition ratio(P＞0.05). There were 4 cases of multiple fractures( accounting for 15.38%), 9 cases of hip joint replacement and hip fracture(accounting for 34.62%), 6 cases of knee joint surface replacement and knee fracture(accounting for 23.08%),2 cases of ankle joint fracture and foot fracture(accounting for 7.69%), 5 cases of lower limb tubular bone fracture(accounting for 19.23%). During the course of anticoagulation and thrombolytic therapy, all patients had no major bleeding and pulmonary embolism and other related complications.
      Conclusion  Color Doppler ultrasound examination has the advantages of safety,simplicity,convenience,real-time dynamics,repeatabilityand non-invasiveness. It can be used as the preferred method of routine DVT examination. It can detect thrombus in time before discharge and take effective intervention measures to reduce discharge It is worthy of clinical promotion to avoid serious complications such as pulmonary embolism, improve the prognosis of patients and improve the quality of life.
    The accuracy and safety of lumbar pedicle screw placement reference spinous process and lamina rim#br#
    WANG Tie-zhu, ZHOU Ning, YAN Qing-hui, LI Shi-xue, PEI Shi-shen, WANG Qing-he*
    2020, 41(9):  1039-1042,1057.  doi:10.3969/j.issn.1007-3205.2020.09.011
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    Objective  To investigate the accuracy and safety of lumbar pedicle screw placement reference the spine process and the vertebral rim.
      Methods  Eighty-two patients with lumbar spinal stenosis were enrolled and treated with posterior lumbar interbody fusion. According to the pedicle screw placement method, patients were divided into observation group(43 cases) and control group(39 cases). The pedicle screw was placed reference to the spinous process and the vertebral rim in observation group, and it was inserted according to the Magerl method in control group. The operative time, intraoperative blood loss, incision length, intraoperative fluoroscopy times, the accuracy of the nail placement, the relationship between the screw and the pedicle cortex, and the complications were recorded and compared.
      Results  All patients were been operated successfully. The incision length in observation group was significantly longer than that in control group(P＜0.05). There was no significant difference in operative time, intraoperative blood loss, fluoroscopy times, and the accuracy of nail placement between two groups (P＞0.05). The VAS score at one month after surgery was significantly lower than the figure at one week after surgery(P＜0.05). There was no significant difference between two groups at one week and one month after surgery(P＞0.05). The relationship between screw and pedicle cortex in observation group was better than that in control group(P＜0.05). There was no significant difference in the occurrence of complications between two groups(P＞0.05).
      Conclusion  Compared with the Magerl method, the new nailing method can obtain the same accuracy of nail placement, but the relationship between the screw and the pedicle cortex is better. It provided a new solution and choice for the placement of pedicle screws.
    Analysis of the curative effect of free perforator flap of anterolateral femoral artery in repairing foot wound
    LIU Shao-jiang, YANG Wan-gui, LI Lin-tao, ZHONG Feng-lin*, HE Rong-fu
    2020, 41(9):  1043-1046.  doi:10.3969/j.issn.1007-3205.2020.09.012
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    Objective  To explore the effect of free anterolateral femoral artery perforator flap on the repair of foot wound and the function of lower extremity.
      Methods  Sixty patients with open foot injury were selected as the research objects, all of them were accompanied with foot fracture.The patients were treated with free anterolateral femoral artery perforator flap. The flap was cut from 4 cm×3 cm-24 cm×12 cm, and the donor area was grafted or sutured.
      Results  In this group, 60 cases of free anterolateral femoral artery perforator flaps survived successfully, with 57 cases of primary wound healing and 3 cases of delayed wound healing. All 60 patients were followed up for 6 to 20 months, with an average of 12 months.There was no hypomyosis in the donor area of the flap, the texture and appearance were satisfactory, the tactile and thermosensory recovery and movement were good, among which 55 flaps were not overstaffed at all, 5 were relatively overstaffed and 5 were severely scarred, and the patient's satisfaction was 95% at the last follow-up. The average healing time was 8.5 months.In the recovery of limb function, 35 cases were excellent, 20 cases were good, 5 cases were medium and 0 cases were poor. The excellent and good rate was 91.67%. 
      Conclusion  The free anterolateral femoral artery perforator flap is thin, and the lateral femoral muscle is not cut. It has little damage to the donor area, and the texture and appearance of the flap are satisfactory. It is helpful for the patients to recover the limb function and meet the requirements of the foot wound repair.
    Diagnostic analysis of MRI in early and atypical spinal tuberculosis#br#
    WANG Li-qiang1, JIN Ying2, LIU Shu-fang1, JIA Jian-lei1
    2020, 41(9):  1047-1049,1069.  doi:10.3969/j.issn.1007-3205.2020.09.013
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    Objective  To analyze the diagnostic value of MRI in early and atypical spinal tuberculosis.
      Methods  The clinical data of 200 patients with spinal tuberculosis diagnosed were analyzed retrospectively. All patients were examined by X-ray, CT and MRI. The diagnostic results of the three methods were compared and analyzed, and the value of MRI in the diagnosis of early and atypical spinal tuberculosis was comprehensively evaluated.
      Results  The coincidence rates of X-ray, CT and MRI in the diagnosis of spinal tuberculosis were 36.5%(127/200), 77.5%(155/200) and 97.0%(194/200),  MRI was higher than CT and X-ray, and CT was higher than X-ray, the difference was statistically significant(χ2=69.062, P=0.001). The sensitivity of CT examination in the diagnosis of dead bone formation(95.69%; 200/209) was much better than that of X-ray(34.93%; 73/209) and MRI(30.63%; 64/209). The sensitivity of MRI in the diagnosis of involved vertebral body, intervertebral disc and spinal canal was 100%(512/512), 100%(354/354) and 95.71%(201/210), respectively, which was better than that of 57.23%(293/512), 46.32%(164/354)、 30.47%(64/210) of X-ray, and 73.24%（375/512）, 74.29%（263/354）and 56.67%(119/210) of CT. The difference was statistically significant(χ2=67.961，P＜0.001).
      Conclusion  MRI is valuable in the diagnosis of early and atypical spinal tuberculosis, it can clearly show the different signs of spinal tuberculosis and has high sensitivity, which is worth popularizing.
    The clinical value of 320 multi-slice CT in measurement of ureteric stone#br#
    ZHAO Jun-lu1， NIE Guan-wei2， ZHAO De-yuan1， WANG Meng1， REN Qing-yun1*
    2020, 41(9):  1050-1052,1083.  doi:10.3969/j.issn.1007-3205.2020.09.014
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    Objective  To determine the clinical value of 320-slice spiral CT in the measurement of ureteral calculi.
      Methods  All patients who underwent unenhanced 320 multi-slice CT scan for the evaluation of ureteral colic were evaluated. Maximal stone diameter was measured respectively in 2 dimension in axial and reformatted coronal sections.
      Results  The average maximum diameter and maximum area of the calculus measured in the coronal reconstruction image group of 100 patients were larger than the cross-sectional image(P＜0.05）. The volume of the stone was 24-3 060 mm3. There was 37% underestimation of maximal stone diameter in axial plane for all stones as compared with measurement on coronal reconstruction.
      Conclusion  Measuring the ureteric stone diameter on axial plane of 320 multi-slice computed tomography(MSCT） scan underestimates size of ureteric stone,coronal reformatted plane be used size estimation. The volume measurement of calculi after volume rendering(VR）  reconstruction is helpful for the clinical selection of follow-up treatment for ureteral calculi.
    Study on the dependency between PON1,HtrA4 and the efficacy of Labe in the treatment of preeclampsia complicated with metabolic syndrome#br#
    DONG Shu-xiao1, LIU Zhi-hu2, LIU Hui-li1, SHI Guo-su1, ZHENG Li-xia1*
    2020, 41(9):  1053-1057.  doi:10.3969/j.issn.1007-3205.2020.09.015
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    Objective  To study the dependency between paraoxonase-1(PON1), HtrA serine peptidase 4(HtrA4) and the efficacy of Labe in the treatment of preeclampsia complicated with metabolic syndrome.
      Methods  A totla of 114 patients of preeclampsia  of gynecology and obstetrics were divided into preeclampsia without metabolic syndrome group(n=42) and preeclampsia with metabolic syndrome group(n=72). Normal pregnant women who were examined in our hospital at the same time were selected as normal pregnancy group(n=50). The clinical data, the levels of serum PON1 and HtrA4 before and after treatment of the three groups were compared. According to the therapeutic effect, the patients of preeclampsia with metabolic syndrome group were divided into three groups: obvious effective, effective and ineffective,the serum levels of PON1 and HtrA4 before and after treatment were compared, and the correlation test was carried out.
      Results  Before the treatment, patients′ serum PON1 level in preeclampsia with metabolic syndrome group was lower than that of preeclampsia without metabolic syndrome and normal pregnancy group, serum HtrA4 level higher than that of preeclampsia without metabolic syndrome group and normal pregnancy group（P＜0.05）. Patients′ serum PON1 level in preeclampsia without metabolic syndrome group was lower than the normal pregnancy group, serum HtrA4 level higher than that of normal pregnancy group(P＜0.05). After treatment, patients′ serum PON1 level in preeclampsia with the metabolic syndrome group and preeclampsia without metabolic syndrome group was higher than the level before the treatment, serum HtrA4 level was lower than the level before treatment(P＜0.05). The patients′ serum PON1 level in the preeclampsia with metabolic syndrome group was lower than that of preeclampsia without metabolic syndrome group, serum HtrA4 level was higher than that of preeclampsia without metabolic syndrome group(P＜0.05). After treatment, in the group of preeclampsia with metabolic syndrome, there were 28 cases with obvious effective curative effect, and 36 cases with effective curative effect and 8 cases with ineffective curative effect. After treatment,serum PON1 level in the obvious effective group, effective group and ineffective group was higher than that before treatment, serum HtrA4 level was lower than that before treatment, PON1 level in the effective group was higher than that in the effective group and ineffective group. Serum PON1 level in the effective group was higher than that in the ineffective group, and serum HtrA4 level was lower than that in the ineffective group(P＜0.05).PON1 level was positively correlated with clinical curative efficacy, while HtrA4 level was negatively correlated with clinical efficacy(P＜0.05).
      Conclusion  Serum PON1 and HtrA4 are both involved in the occurrence of preeclampsia complicated with metabolic syndrome and are correlated with the clinical efficacy of Labe therapy.They may be the new biological index to evaluate the therapeutic effect of preeclampsia combined with metabolic syndrome.
    Mechanism of HOST2 lncRNA targeting miR-211 in ovarian cancer cell metastasis#br#
    REZIYA·Kuerban, GULIMIRE·Buranjiang, GUZALINUER·Abulizi*
    2020, 41(9):  1058-1064.  doi:10.3969/j.issn.1007-3205.2020.09.016
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    Objective  To investigate the mechanism of HOST2 lncRNA targeting miR-211 in ovarian cancer cell metastasis.
      Methods  Quantitative real-time polymerase chain reaction(qRT-PCR) was used to detect the expression of HOST2 lncRNA and miR-211 in seven kinds of ovarian cancer cells. Dual luciferase reporter gene assay was used to detecte the targeted correlation between of miR-211 and HOST2 lncRNA. The candidate cells were divided into 3 groups: the negative control group, the HOST2 lncRNA overexpression group and both HOST2 lncRNA and miR-211 overexpression group. Cell scratch assay, transwell invasion and migration assays and nude mice xenograft tumor assays were conducted to assess the effects of HOST2 lncRNA and miR-211 on cell metastasis capabilities in vivo and in vitro after transfection. Western Blot was used to detect the expression changes of metastasis-associated proteins in ovarian cancer cells.
      Results  HOST2 lncRNA was highly expressed in seven ovarian cancer cells while miR-211 was significantly down-regulated in these cells. And there was a significant negative correlation between HOST2 lncRNA and miR-211. Dual luciferase reporter assay showed that the luciferase activity of SKOV3 cells was significantly inhibited in the SKOV3 cells after co-transfection of the HOST2-WT with miR-211 mimic. Overexpression of HOST2 lncRNA promoted cell scratch healing, invasion and migration in vitro and metastasis of peritoneal xenografts in vivo. In turn, co-transfection of miR-211 mimic reversed this phenomenon. Western Blot results showed that overexpression of HOST2 lncRNA significantly increased the expression of SOX4, Snail1 and N-cadherin proteins and decreased the expression of E-cadherin protein, whereas co-transfection of miR-211 mimic reversed the expression of the proteins above.
      Conclusion  HOST2 lncRNA may promote the metastasis of ovarian cancer cells in vivo and in vitro by competitively binding to miR-211 as competing endogenous RNAs.
    A study of dry eyes in children with mild allergic conjunctivitis and the treatment
    ZHAO Ru-lian, WANG Yang, PI Lian-hong*
    2020, 41(9):  1065-1069.  doi:10.3969/j.issn.1007-3205.2020.09.017
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    Objective  To investigate the principle of dry eye in children with mild allergic conjunctivitis and the effect of different therapies, and provide guidance for the treatment of allergic conjunctivitis.
      Methods  Retrospective analysis was performed on 101 children (observation group) and 100 healthy children (control group) aged 4-10 years with mild allergic conjunctivitis. Children with allergic conjunctivitis were tested for allergens. The relationship of tear film breakup time(BUT), corneal fluorescein(FL) score, tear meniscus height(TMH)between two groups was analyzed. And the correlation between BUT, FL score, TMH and course of disease was analyzed. The observation group was divided into group A(42 cases of children) and group B(59 cases of children) according to the presence of artificial tears in the treatment plan. BUT, FL score and TMH of group A and B were compared before and after treatment.
      Results  The observation group BUT shorter than the control group. The FL score was higher than the control group(P＜0.01). There was no significant difference in TMH between two groups(P＞0.05). In the observation group, BUT was negatively correlated with course of disease(r=-0.439, P＜0.01), FL score was positively correlated with course of disease(r=0.396, P＜0.01), TMH was not correlated with course of disease(r=0.043, P＞0.05). After treatment, BUT was longer, FL score was lower in group A and B. TMH was higher than before in group A; and in group A,BUT was longer, FL score was lower, TMH was higher than group B, the difference was statistically significant(P＜0.05).
      Conclusion  Allergic conjunctivitis in children can reduce the stability of tear film in both eyes, destroy the integrity of corneal epithelium and cause dry eye symptoms, but it has no significant effect on tear secretion. The longer course of the disease causes the lower stability of tear film which leads the greater damage of corneal epithelium. Anti-allergy combined with artificial tear treatment of allergic conjunctivitis is more effective.
    Study on benign paroxysmal plsitional vertigo and bone mineral density#br#
    LI Yun1, CUI Li-ping1, DONG Wen-rong1, ZHENG Fei2
    2020, 41(9):  1070-1074.  doi:10.3969/j.issn.1007-3205.2020.09.018
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    Objective  To explore the change rules of bone mineral density in patients with benign paroxysmal positional vertigo(BPPV) and the effect of bone mineral density on BPPV.
      Methods  The 105 BPPV patients were selected as the experimental group, and 108 healthy subjects were selected as the control group. Both group are taken ENT specialist examination, nystagmus inspection, position test, and whole body bone density determination(dual energy X-ray absorption method, calculated by T-score). Then we concluded the change rules of the whole body bone mineral density T-value of BPPV patients in different genders and ages, and the effect of bone density on BPPV.
      Results  The T-value of bone mineral density in the experimental group was lower than that in the control group, and the difference was statistically significant(P＜0.05).The bone mineral density T value of the male and female test groups was lower than that of the control group, and the incidence of bone density reduction was higher than that of the control group.The bone mineral density T-value of the two groups of women was lower than that of men, and the incidence of bone density reduction in women was higher than that of men, the difference was statistically significant(P＜0.01).The bone mineral density T-value of the test group between 41 to 50 years old, 51 to 60 years old, 61 to 70 years old, and 71 years or older was lower than that of the control group, and the incidence of bone density reduction was higher than that of the control group. The difference was statistically significant(P＜0.05 or P＜0.01). There was no statistically significant difference in bone mineral density T-value and the incidence of bone mineral density reduction between the test group and the control group younger than or equal to 40 years old(P＞0.05). With the increase of age, the bone density T value of the two groups showed a decreasing trend, and the incidence of bone density decrease showed an increasing trend, and the difference was statistically significant(P＜0.05). Logistic regression analysis showed that bone density reduction was a risk factor for BPPV.
      Conclusion  The T-value of bone mineral density in BPPV patients is significantly lower than that in the normal control group, and showes an increasing trend with age, especially in women. Decreased bone density is a risk factor for BPPV.
    The clinical efficacy study of active silver ion antibacterial liquid in the treatment of children′s oral ulcer#br#
    DU Ning1, ZHANG Zhe2, ZHOU Xiang3, LI Kai1, LIU Xue-cong1*
    2020, 41(9):  1075-1078.  doi:10.3969/j.issn.1007-3205.2020.09.019
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    Objective  To observe the clinical effect of active silver ion antibacterial liquid in the treatment of children's oral ulcer.
      Methods  A total of 92 children with oral ulceration were selected from our department. The children were divided into experimental group and control group according to the principle of random, and 46 cases in each group. The experimental group was given local treatment with active silver ion antibacterial liquid, while the control group was given local treatment with kangfuxin liquid. The treatment effect, the time of relieveing pain, the healing time of the ulceration, the degree of pain after treatment and the degree of response of the children to the drug were observed.
      Results  Compared with the control group, there was no significant difference in the overall effective rate of the experimental group(P＞0.05).  The pain relief time of oral ulcer in the experimental group was shorter than that in the control group, the difference was statistically significant(P＜0.05). There was no significant difference in healing time between two groups(P＞0.05). After treatment, the degree of pain in the experimental group was significantly lower than that in the control group, the difference was statistically significant(P＜0.05). The compliance of children in the experimental group to drug use was significantly better than that in the control group, the difference was statistically significant(P＜0.05).
      Conclusion  The active silver ion antibacterial liquid can promote the improvement of clinical symptoms, accelerate the healing of the ulceration, relieve the local pain of the child, and is more suitable for children, and has remarkable effect and is worthy of popularization and application.
    Expression and distribution of polycystin in ameloblastoma#br#
    HOU Ya-li1， YANG Li2， LIU Bing3， ZHANG Hao2， LI Xiang-jun2*
    2020, 41(9):  1079-1083.  doi:10.3969/j.issn.1007-3205.2020.09.020
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    Objective  To observe the expression and distribution of polycystin-1(PC-1)and polycystin-2(PC-2) in ameloblastom, and compared with the odontogenic keratocysts, so as to provide clues for the study of the pathogenesis and development of ameloblastoma and the search for new treatment methods.
      Methods  The expression and distribution of PC-1 and PC-2 in 30 ameloblastomas and 15 odontogenic keratocysts were detected by immunohistochemistry.
      Results  Compared with odontogenic keratocyst group, the positive expression rate of PC-1 and PC-2 in ameloblastoma group was significantly higher (P＜0.05). The two proteins were distributed in the cytoplasm and membrane of ameloblast like cells, some stellate reticular like cells, squamous metaplasia and cystic tumor cells in ameloblastoma, as well as in the echinoderm, granular layer and some basal cells lined with odontogenic keratocyst epithelium.There was no difference in the distribution and expression of PC-1 and PC-2 between solid or multicystic and monocystic ameloblastoma and multicystic ameloblastoma(P＜0.05).
      Conclusion  Polycystin may be involved in the epithelial stromal transformation of ameloblastoma, and its high expression may be related to the occurrence and development of ameloblastoma, the cystic transformation and biological behavior of the tumor, but not to the formation of cyst.
    Distribution of pathogenic bacteria and antibiotics application in patients with acute appendicitis during pregnancy
    SUN Yan1, ZHANG Wei1, LI Na1, ZHANG Xiao-cheng2*
    2020, 41(9):  1084-1088.  doi:〓〓10.3969/j.issn.1007-3205.2020.09.021
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    Objective  To investigate the results of bacterial culture of pus as well as antibiotic sensitivity in patients with acute appendicitis during pregnancy and to provide basis for future clinical treatment.
      Methods  We selected 164 cases of pregnant patients with acute appendicitis as research objects. The pathogen culture and drug sensitivity analysis of pus samples were conducted.
      Results  A total of 106 pathogenic bacteria were detected in 102 specimens of 164 samples. Gram-negative bacteria accounted for 93.40%, mainly including Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa, accounting for 66.98%, 9.43% and 7.55% respectively. Drug sensitivity analysis showed that Escherichia coli were sensitive to meropenem, imipenem, cefoxitin, piperacillin/tazobactam, cefoperazone/sulbactam, ticarcillin/clavulanic acid and amoxicillin/clavulanic acid. The sensitivity rate was≥85.00%; while Klebsiella pneumoniae was sensitive to meropenem, imipenem, cefoxitin, piperacillin/tazobactam, amoxicillin/clavulanic acid, cefepime, cefoperazone/sulbactam, ticarcillin/clavulanic acid. The sensitivity rate was≥90.00%, and Pseudomonas aeruginosa was sensitive to meropenem, imipenem, cefoxitin, cefepime, piperacillin/tazobactam, ticarcillin/clavulanic acid, amoxicillin/clavulanic acid, ceftazidime and cefoperazone/sulbactam. The sensitivity rate was≥85.00%. The sensitivity was greater than or equal to 85.00%. The most sensitive antibiotics of the three main pathogenic bacteria were meropenem and imipenem, with an effective rate of 100.00%. Cefoxitin, piperacillin/tazobactam, cefoperazone/sulbactam, ticarcillin/clavulanic acid and amoxicillin/clavulanic acid were more than 85.00% sensitive.
      Conclusion  Gram-negative bacteria are the main infections in patients with acute appendicitis during pregnancy. Meropenem and imipenem can be used as the main antibiotic alternatives. Other effective drugs include cefoxitin, piperacillin and cefoperazone. In clinic, the appropriate antibiotics should be selected according to the characteristics of medication for pregnancy.
    Comparison of efficacies of iodized oil and dextran microspheres in embolism of rabbit hepatic VX2 transplantation tumors#br#
    GU Tie-shu， LI Bo， WU Yong-chao， HAO Xiao-guang， SHI Bo， LI Zhi-gang
    2020, 41(9):  1089-1093.  doi:10.3969/j.issn.1007-3205.2020.09.022
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    Objective  The embolization of rabbit hepatic VX2 transplantation tumors was carried out by iodized oil and dextran microspheres respectively. The curative effect of the two kinds of embolization agents was determined by the comparison of CT perfusion values and the expressions of immunohistochemical CD34 and vascular endothelial growth factor(VEGF).
      Methods  Fifty tumor-bearing rabbits were randomly divided into iodized oil group and dextran microsphere group. CT perfusion scans were carried out in 14 days after liver VX2 tumor planting in the rabbits. Hepatic arterial embolization was performed on the 15th day after the planting of rabbit liver VX2 tumors. CT perfusion scan was carried out in 14 days after embolization to observe the change of CT perfusion values. After these tumor-bearing rabbits were killed, the rabbit liver VX2 tumors were isolated, and then immunohistochemical staining was used to observe the expressions of CD34 and VEGF.
      Results  ①Blood flow, blood volume,hepatic arterial fraction and hepatic arterial perfusion of dextran microsphere group were smaller than those of iodized oil group, and portal vein perfusion of dextran microsphere group was larger than that of iodized oil group. ②Immunohistochemical studies showed that no or only a small amount of CD34 and VEGF staining was found in the normal liver parenchyma around the tumors in the iodized oil group and the dextran microsphere group. The expressions of CD34 and VEGF in tumor area in iodized oil group were greater than those in dextran microsphere group, and the differences of microvascular density(MVD) values between two groups were statistically significant(P＜0.05).
      Conclusion  The embolization effect of dextran microsphere is better than that of iodized oil, so it is an ideal embolization agent.