Table of Content

25 February 2021, Volume 42 Issue 2

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Effects of PKA-PINK1/Parkin signal pathway on apoptosis and pyroptosis of rat cortical astrocytes exposed to oxygen-glucose deprivation/resuscitation

YU Hong, MA Mei-na, ZHOU Zhen-zhen, GUO Qing-duo, YU Hong-mei

2021, 42(2):  129-133,171.  doi:10.3969/j.issn.1007-3205.2021.02.002

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Objective  To investigate the effects of Protein Kinase A(PKA)-PTEN induced putative kinase 1(PINK1)/E3 ubiquitin ligases(Parkin) signal pathway on apoptosis and pyroptosis of rat cortical astrocytes exposed to oxygen-glucose deprivation/resuscitation(OGD/R). 
Methods  Primary cortical astrocytes were cultured in vitro from SD neonatal ratsand seededon 6 or 96-well plates. They were divided into four groups(n=42): control group(C group), oxygen-glucosede privation group/resuscitation group(OGD/R group), and H89+OGD/R group(HO group), and H89 control group(H) group according random number table method. H89 is a specific inhibitor of PKA. OGD/Rmodel was established by 95% N2-5% CO2 and sugar-free culture-medium for 6 h and subsequently at normal culture-medium containing 5% CO2 for 24 h. At 1 h before OGD/R exposure, the cultures in HO and H group were treated with H89 10 μmol/L. C and H groups were rinsed with PBS and cultured in a normal incubator containing 5% CO2. Subsequently, the apoptosis, pyroptosis and viability of cortical astrocytes were assessed by Annexin V-FITC/(Propidium Iodide) PI, cleaved caspase-1/PI and methyl thiazolyl tetrazolium（MTT) assays, respectively. Intracellular calcium ion concentration and reactive oxygen species（ROS) content were assessed by Fluo-3/AM fluorescence and 2′, 7′-dichlorodihydrofluorescein diacetate(DCFH-DA) assays respectively. The activity of PKA was measured by enzyme-linked immunosorbent assay. The expressions in PINK1 and Parkin were measured by Western blot assay. 
Results  Compared with C group, there were significant increases of astrocytes apoptosis, pyroptosis,intracellular free calcium ion concentration, ROS content, PKA activity, and expressions of PINK1 and Parkin, but decreases of viability in OGD/R and HO group(P＜0.05). Compared with OGD/R group, there were significant decreases of astrocytes apoptosis, pyroptosis, intracellular free calcium ion concentration, ROS content, PKA activity, and expressions of PINK1 and Parkin, but increases of viability in HO group(P＜0.05). There were no significant differences in above indicators between C and H groups(P＞0.05). 
Conclusion  Inhibition of overactive PKA-PINK1/Parkin signal pathway could alleviate ratcortical astrocytes apoptosis and pyroptosis induced by OGD/R exposure.





Studies on protective mechanism of curcumin by inhibiting NF-kappaB signaling pathway via miR-146a in mice with diabetic nephropathy

CHEN Jing, WANG Qian, WANG Kai, LI Wen-jian, LI Yi-ming

2021, 42(2):  134-139.  doi:10.3969/j.issn.1007-3205.2021.02.003

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Objective  To investigate the protective effects of curcumin on rat with diabetic nephropathy(DN) as well as the functional mechanism. 
Methods  The SD rats were randomly divided into control group(N group), DN model group(DN group) and curcumin treatment group(CT group). At 4 weeks after treatment, pathological changes of renal tissues were detected and changes of nephrin protein were detected. The expression of miR-146a, pro-inflammatory factors and fibrogenic factors was detected by real-time quantitative polymerase chain reaction(RT-qPCR). HBZY-1 cells under different culture conditions were collected and the mRNA expression of miR-146a was detected. Using transfection technique, miR-146a minics was transfected into HBZY-1 cells under high-glucose culture conditions. The mRNA expression of miR-146a, Traf6, pro-inflammatory factors and fibrogenic factors as well as the change of nuclear factor kappa-B(NF-kappa B) p65 protein were detected. 
Results  Compared with the control group, blood glucose(BG), blood urea nitrogen(BUN), serum creatinine(SCr) and urine albumin creatine ratio(UACR) were significantly increased in the DN group. After curcumin intervention treatment, the content of BG, BUN, SCr and UACR were decreased, and the difference was statistically significant. Pathological sections of kidney and Western blot results showed that compared with the control group, there was the kidney tissue damage in the DN group, which, however, was alleviated in the CT group. RT-qPCR results showed that compared with the control group, the expression of miR-146a was reduced and the expressions of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), transforming growth factor-β(TGF-β) and collagenⅠwere increased in the DN group. Compared with the DN group, the expression of miR-146a was increased, while the expression of cytokine was decreased in the CT group, suggesting significant difference. After stimulating HBZY-1 cells with curcumin at concentrations of 0, 5 μmol/L, 15 μmol/L and 25 μmol/L for 24 h, the mRNA expression of miRNA-146a was gradually increased. Cells were cultured with culture medium containing 4.5 mmol/L(L-HC group) , 15 mmol/L(M-HC group) and 25 mmol/L(H-HC group) glucose, respectively, and the expression of miRNA-146a was gradually decreased. When miR-146a minics and negative control(NC) were transfected into HBZY-1 cells under high-glucose culture conditions, the mRNA expression of miR-146a in H-HC miR-146a group was significantly higher than that in H-HC miR-NC group, but there was no difference between the HC group and the H-HC miR-NC group. Compared with the H-HC miR-NC group, the target genes Traf6 and proinflammatory factors(TNF-α and IL-1β) and fibrosis factors(TGF-β and collagen Ⅰ) were reduced in the H-HC miR-146a group, and the difference was statistically significant. The expression level of p65 protein in H-HC miR-146a group was significantly lower than that in H-HC miR-NC group and H-HC group. 
Conclusion  Curcumin alleviates kidney damage in rats with DN by promoting the expression of miR-146a and inhibiting the NF-κB signaling pathway.





Effects of liraglutide combined with ticagrelor on serum Vaspinand Ghrelin in patients with type 2 diabetes mellitus and coronary heart disease

YANG Xi, YU Li-bo, LI Li

2021, 42(2):  140-144.  doi:10.3969/j.issn.1007-3205.2021.02.004

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Objective  To explore the clinical effect of combined use of liraglutide and ticagrelor in the treatment of type 2 diabetes mellitus(T2DM) complicated by coronary heart disease(CHD) and its effect on serum visceral adipose tissue-derived serine protease inhibitor(Vaspin) and growth hormone releasing peptide Ghrelin. 
Methods  A total of 114 patients with T2DM and CHD diagnosed in our hospital were selected and divided into a control group(n=57) and an observation group(n=57) by random number grouping. The control group was given ticagrelor and metformin hydrochloride, and the observation group was given ticagrelor and liraglutide. The clinical efficacy, blood lipids, blood glucose, cardiac function, levels of serum endothelial cell-associated factors Vaspin and Ghrelin before and after treatment and the incidence of adverse reactions were compared between two groups. 
Results  The effective rate of the observation group was significantly higher than that of the control group(P＜0.05). After treatment, the blood glucose levels of the two groups were significantly lower than before treatment(P＜0.05), and there was no significant difference in blood glucose levels between two groups(P＞0.05). After treatment, the levels of left ventricular eject fraction(LVEF), left ventricular end diastolic dimension(LVEDD), and early/late diastolic mitral flow velocity ratio（E/A） in the control group were improved compared to before treatment, and all indicators of heart function in the observation group were improved compared with before treatment. The indicators of heart function in the observation group improved more significantly than those in the control group(P＜0.05). After treatment, the levels of Ghrelin in the two groups were significantly higher than those before treatment, and the levels of Vaspin were significantly lower than those before treatment. The levels of Vaspin and Ghrelin in the observation group were significantly improved compared with the control group(P＜0.05). 
Conclusion  Liraglutide can effectively regulate blood glucose and serum endothelial cell-related factors Vaspin and Ghrelin levels, and improve vascular endothelial function and cardiac function.





Effect and safety of percutaneous prying technique in the treatment of refractory intertrochanteric fracture

WANG Jian-hua, LIN Yan, WU Yong-dong, WANG You-bao

2021, 42(2):  145-149,153.  doi:10.3969/j.issn.1007-3205.2021.02.005

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Objective  To investigate the clinical effect and safety of percutaneous prying technique in the treatment of refractory intertrochanteric fractures. 
Methods  Clinical data of 90 patients with refractory femoral intertrochanteric fracture were retrospectively analyzed. They were divided into control group(n=45)and observation group(n=45) according to different operation methods. The control group received open reduction and extramedullary fixation, and the observation group received percutaneous prying closed reduction and intramedullary fixation. The intraoperative conditions(incision length, duration of operation, intraoperative blood loss), operation recovery(length of hospitalization, weight-bearing time, fracture healing time), femoral neck shaft angle, femoral neck length, visual analogue scale(VAS) score, excellent and good rate according to Harris score and complications were compared between two groups. 
Results  The incision length, duration of operation, intraoperative blood loss, postoperative hospital stay, weight-bearing time and fracture healing time of the observation group were significantly shorter or less than those of the control group(P＜0.05). There were no significant differences in femoral neck shaft angle and femoral neck length between two groups immediately after operation, at 6 months after operation and before and after treatment(P＞0.05). The VAS score of the two groups was significantly lower than that before operation at 7 d after operation(P＜0.05), and there was no significant difference in VAS score between two groups at the same time point before operation and at 7 d after operation(P＞0.05). The excellent and good rate of Harris score in the observation group was significantly higher than that in the control group(P＜0.05), but there was no significant difference in the incidence of complications between two groups(P＞0.05). 
Conclusion  Percutaneous prying closed reduction and intramedullary fixation in the treatment of femoral intertrochanteric fracture is effective and safe in promoting fracture healing, improving long-term pain and hip joint function, which, therefore, can be widely used in primary hospitals.


The application of a new oral form of anticoagulant in senior citizens with cervical expansive open-door laminoplasty

JIANG Li-qiang

2021, 42(2):  150-153.  doi:10.3969/j.issn.1007-3205.2021.02.006

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Objective  To investigate the efficacy and safety of rivaroxaban as prophylactic anticoagulant therapy after cervical expansive open-door laminoplasty in senior citizens. 
Methods  A retrospective study was performed on 87 patients aged ≥60 years who received posterior expansive open-door laminoplasty for cervical spine. The parients were divided into rivaroxaban group(n=47) and control group(n=40)  according to postoperative thrombosis prevention methods. Rivaroxaban group received rivaroxaban as anticoagulation therapy, while the control group did not receive anticoagulation therapy. Duration of operation, intraoperative blood loss, perioperative blood transfusion rate, incision drainage, postoperative hemorrhage, and incidence of venous thromboembolism(VTE) were compared between two groups. 
Results  There were no statistically significant differences in duration of operation, intraoperative blood loss, perioperative blood transfusion rate, postoperative drainage, and incidence of postoperative hemorrhage  between two groups(P＞0.05). The incidence of VTE in the rivaroxaban group was lower than that in the control group, with statistically significant differences(P＜0.05). 
Conclusion  Rivaroxaban significantly reduces the incidence of VTE after cervical expansive open-door laminoplasty in senior citizens, while avoiding the corresponding risk of bleeding. Therefore, rivaroxaban is a safe and reliable preventive anticoagulant after cervical expansive open-door laminoplasty.





Observation of curative effect of non-dissected cavernous body of urethra combined with widening of urethral lumen with lingua lmucosa in repairing bulbar urethral stricture in males

GUO Ping-ying, DING Ya-juan, LIU Jian, YIN Yue-wei, LU Bao-sai, QI Jin-chun

2021, 42(2):  154-157.  doi:10.3969/j.issn.1007-3205.2021.02.007

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Objective  To observe the effect and complications of non-dissected cavernous body of urethra combined with widening of urethral lumen with lingual mucosa in the repair and reconstruction of bulbar urethral stricturein males. 
Methods  A total of 21 male patients with bulbar urethral stricture were enrolled in this study. After the urethra of the bulbar stenosis was isolated, the corpus cavernosum was not cut off and the urethral lumen was opened longitudinally. Among them, 12 cases of urethral stricture were less than 2 cm in length, and a spoon-shaped urethral anastomosis was performed directly. Nine cases of urethral stricture were more than 2 cm in length. Considering the tension of direct urethral anastomosis, lingual mucosa served as a repair material, and the urethra was capped to widen the urethral lumen. The curative effect of all cases and the incidence of related complications such as urinary fistula, urethral stricture and erectile dysfunction were observed. 
Results  All patients underwent surgery successfully. Of them, 18 cases(85.71%) were successful in one operation without any complications. One case had severe infection after lingual mucosa urethroplasty, which resulted in urethral fistula after anti-inflammatory treatment, multiple dressing changes and rinses. Six months later, the urethral fistula was repaired, the healing was good and he urinated smoothly. One case developed a local hematoma of the scrotum. After debridement, compression bandaging and dressing change, he recovered well. One case had a dehiscence of the perineal incision. After dressing changes, anti-inflammatory and infrared treatments, the incision healed well. After the catheter was removed, the urethra became narrow. After the urethra was dilated, urination could be unblocked. No erectile dysfunction occurred in 21 patients. All patients were followed up, and the patients should be able to urinate smoothly, and the urethra dilatation could persist for more than 3 months. 
Conclusion  The clinical application of non-dissected cavernous body of urethra combined with widening of urethral lumen with lingual mucosa in the repair and reconstruction of bulbar urethral stricture has a positive effect and will not increase the incidence of postoperative erectile dysfunction. Therefore, it is worthy of clinical promotion.





Effects of local mild hypothermia combined with RT PA intravenous thrombolysis on #br# oxidative stress, neurological damage and prognosis in patients  with acute large area cerebral infarction

ZHANG Xin-yu, ZHAO Xin, ZHANG Chong-yang, WANG Yao-hui, LIU Yu-peng

2021, 42(2):  158-162.  doi:10.3969/j.issn.1007-3205.2021.02.008

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Objective  To observe the effect of local mild hypothermia combined with recombinant human tissue type plasminogen activator(rt-PA) intravenous thrombolysis on oxidative stress, neurological damage and prognosis in patients with acute massive cerebral infarction. 
Methods  A total of 79 patients with acute large area cerebral infarction were divided into the observation group(41 cases) and the control group(38 cases). The control group was treated with rt-PA intravenous thrombolysis on the basis of symptomatic treatment, and the observation group was treated with mild hypothermia on the basis of the control group. The superoxide dismutase(SOD), malondialdehyde(MDA), heart type fatty acid binding protein(H-FABP), N-terminal pro-B type natriuretic peptide(NT-proBNP) between two groups before and 7 days after treatment were compared. The levels of NT proBNP, neuron specific enolase(NSE), S100β protein, and NIH stroke scale(NIHSS) score and recovery of daily activities［barthel index(BI)］, the incidence of adverse reactions were compared. 
Results  After treatment, SOD in two groups was higher than that before treatment, MDA was lower than that before treatment, SOD in observation group was higher than that in control group and MDA was lower in control group, the difference was statistically significant(P＜0.01). The levels of H-FABP, NT-proBNP, NSE and S100β in the two groups were lower than those before treatment, while the levels of H-FABP, NT-proBNP, NSE and S100β in the observation group were lower than those in the control group(P＜0.01). NIHSS score of two groups was lower than that before treatment, BI was higher than before treatment, NIHSS score of observation group was lower than that of control group, BI was higher than that of control group, the differences were statistically significant(P＜0.01). There was no significant difference in the incidence of adverse reactions between two groups within 7 days(P＞0.05). 
Conclusion  Iocal mild hypothermia combined with rt-PA intravenous thrombolysis can significantly improve the clinical effect of acute large area cerebral infarction, reduce the degree of oxidative stress and brain nerve injury, reduce the level of related nerve injury factors, and improve the prognosis of patients.





The mechanism of macrophage-derived exosomes inhibiting invasion and migration of epithelial ovarian cancer cells after TWEAK stimulation

LI Xia, ZHANG Ke, MIN Nan

2021, 42(2):  163-166.  doi:10.3969/j.issn.1007-3205.2021.02.009

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Objective  To explore the mechanism of macrophage derived exosomes(MDE) inhibiting the invasion and migration of epithelial ovarian cancer(EOC) cells after treatment with tumor necrosis factor-like weak inducer of apoptosis(TWEAK). 
Methods  MDE were collected and explored before and after TWEAK stimulation, and co-cultured with highly metastatic human ovarian cancer cell H08910-PM. The expression of miRNA-7 in MDE, macrophages and co-cultured HO8910-PM cells were detected by real-time PCR. Western blotting was used to detect the expression of epidermal growth factor receptor(EGFR)/threonine kinase(Akt)/extracellular regulated protein kinase(ERK1)/2 signaling pathway in co-cultured HO8910-PM cells. After AntagomiR-7 treatment, the reduced expression of miRNA-7 in macrophages was managed. Exosomes were collected before and after TWEAK treatment to observe the changes of invasion and migration abilities of HO8910-PM cells. 
Results  After TWEAK stimulation, the expression of miRNA-7 in macrophages and their exosomes was increased, and the expression of miRNA-7 in HO8910-PM cells treated by MDE was higher than that in the control group, suggesting significant differences(P<0.05). 
Conclusion  After TWEAK acts on the secretion of macrophages in vivo, miRNA-7 plays an important role in inhibiting EGFR signaling pathway in EOC cells, thereby continuously inhibiting the entire process of invasion.





The relationship between the severity of pneumonia and coagulation function indexes in children

GUO Jing, HAO Ming-ming, LIU Ya-nan, YAN Ping, YIN Zhan-ru

2021, 42(2):  167-171.  doi:10.3969/j.issn.1007-3205.2021.02.010

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Objective  To explore the changes of coagulation function indexes in children with pneumonia of different severity(common pneumonia, critical pneumonia and extremely critical pneumonia), so as to provide a valuable reference for clinical evaluation of the disease. 
Methods  A total of 320 children with common pneumonia, critical pneumonia and extremely critical pneumonia who were admitted to our hospital were enrolled in this study. Among them, there were 182 cases of common pneumonia, 91 cases of critical pneumonia and 47 cases of extremely critical pneumonia. Blood was drawn from all children within 24 h after admission, and the coagulation function, plasma D-dimer(D-D), platelet and other indicators of each group were analyzed and compared. In addition, the correlation of these indicators with pediatric critical illness score(PCIS)was analyzed. 
Results  Prothrombin time(PT), activated partial thromboplastin time(APTT), fibrinogen(FIB), fibrinogen degradation products(FDP) and D-D were higher in critical pheumonia group and extremely critical group than in common pneumonia group(P＜0.05), and FDP and D-D in extremely critical pneumonia group were higher than those in critical pneumonia group(P＜0.05). No significant difference was found in PT, APTT and FIB in extremely critical pneumonia group and critical pneumonia group(P＞0.05). PLT count in critical pneumonia group and extremely critical pneumonia group was lower than that in common pneumonia group, which was lower in extremely critical pneumonia group than in critical pneumonia group(P＜0.05). There was no significant difference in mean platelet volume(MPV) and platelet distribution width(PDW) among three groups(P＞0.05). PLT count, FIB, FDP and D-D were significantly correlated with PCIS. PLT was significantly and positively correlated with the PCIS, while FIB, FDP and D-D were significantly and negatively correlated with the PCIS(P＜0.05). 
Conclusion  There are significant differences in the coagulation function indexes among three types of pneumonia of different severity. Among them, PLT, FIB, FDP, and D-D can effectively judge the severity of children with critical pneumonia, which is of great clinical significance for clinicians to choose a reasonable treatment scheme, and improve the cure rate and the prognosis of children with critical pneumonia. 





Changes of GFAP and S100β in peripheral blood caused by brain injury after neonatal asphyxia and its clinical significance

CHEN Jun, YAN Zheng, LIU Fan

2021, 42(2):  172-176,196.  doi:10.3969/j.issn.1007-3205.2021.02.011

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Objective  To investigate the changes of serum calcium-binding protein S100β, glial fibrillary acidic protein(GFAP) and their correlation with behavioral neurotest neonatal behavioral neurological assessment(NBNA) scores in postnatal asphyxia neonates of different degrees, and to find the basis for early prediction of neonatal brain injury. 
Methods  A total of 38 cases of mild asphyxia, 16 cases of severe asphyxia and 46 cases of normal asphyxia were selected. The samples of the three groups of newborns were collected within 4 hours after birth, and serum GFAP and S100β concentrations were detected by enzyme-linked immunosorbent assay. All asphyxiated newborns underwent cranial imaging examination three to four days after admission and received Neonatal Behavioral Neurological Assessment(NBNA) score three days after birth. 
Results  The S100β level in mild asphyxia group and severe asphyxia group was significantly higher than that in control group, the difference was statistically significant(P＜0.05).There was no statistically significant difference in GFAP level among three groups(P＞0.05). The S100β level in the brain injury group was significantly higher than that in non-brain injury group, the difference was statistically significant(P＜0.05), and there was no statistically significant difference in GFAP level between two groups(P＞0.05). Spearman correlation analysis showed that Neonatal S100β level was negatively correlated with NBNA score(P＜0.05), the GFAP level was not correlated with NBNA score(P＞0.05). Regression analysis showed that S100β was the influencing factor of neonatal brain injury(P＜0.05). The AUC of the ROC curve of S100β for predicting the brain injury after asphyxia was 0.755, with sensitivity of 77.8% and specificity of 77.8%. The AUC of the ROC curve of GFAP for predicting the brain injury after asphyxia was 0.488, with sensitivity of 16.7% and specificity of 97.2%. 
Conclusion  S100β detection within 4 hours of birth is helpful for the diagnosis of neonatal asphyxia and brain injury after asphyxia, and the accuracy of predicting asphyxia brain injury is high. GFAP detection within 4 hours after birth has high specificity, but low sensitivity and accuracy.It has little reference value for the diagnosis of neonatal asphyxia and brain injury after asphyxia. It is not recommended to detect alone within 4 hours after birth. 





Serum Hepcidin levels and their clinical significance in children with acute lymphoblastic leukemia

LIU Na, LIANG YU-Heng, GUO Hong-ming, XUAN Fan, WU Xiao-li

2021, 42(2):  177-180,191.  doi:10.3969/j.issn.1007-3205.2021.02.012

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Objective  To investigate the serum levels of Hepcidin and their clinical significance in children with acute lymphoblastic leukemia(ALL). 
Methods  A total of 30 children with ALL were selected as the study subjects. They were followed up up to February 2020. Serum Hepcidinlevels and erythropoietin(EPO) were detected by enzyme-linked immunosorbent assay(ELISA).The blood analyzer was used to detect the hemoglobin(HGB) level of the subjects, and the Ferritin, Transferrin and C-reactive protein(CRP) levels of the subjects were detected by the special protein immunoanalyzer.The relationship between the Hepcidin level and the prognosis of ALL children was analyzed, as well as the correlation of Hepcidin with EPO, HGB, Ferritin and Transferrin. 
Results  ①All 30 patients with ALL were divided into two groups according to the expression level of Hepcidin. The expression level of Hepcidin was(114.4±48.63) μg/L in the high Hepcidin level group and(21.98±15.94) μg/L in the low Hepcidin level group, with significant difference(P＜0.001). ②The total 5-year EFS of 30 ALL patients was 77.586%. There was no statistically significant difference in survival curves between the high and low Hepcidin level groups(P＞0.05). ③There was a positive correlation between Hepcidin and Ferritin concentration(r=0.466， P=0.010). There was a negative correlation betweenHepcidin level and HGB content(r=-0.407， P=0.026). 
Conclusion  ①Serum Hepcidin level in ALL children is not an independent factor affecting prognosis. ②The expression of Hepcidin in children with ALL is negatively correlated with the hemoglobin content, and positively correlated with the Ferritin concentration. Abnormal iron metabolism may be the cause of anemia in children with ALL.





Related factors influencing recurrence in patients with central serous chorizoretinopathy

SONG Qing-xue, MA He

2021, 42(2):  181-185.  doi:10.3969/j.issn.1007-3205.2021.02.013

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Objective  To explore the related factors affecting recurrence in patients with central serous chorizoretinopathy(CSC).
Methods  A total of 90 patients with CSC admitted to our hospital were selected. All patients were hospitalized for fundus fluorescence angiography(FFA) and visual acuity examination. Patients were followed up for 6 months after treatment for visual function review and fundus angiography review. Patients were divided into a recurrent group(n=30) and a non-recurrent group(n=60) according to their recurrence.Univariate analysis and multivariate Logistic regression analysis were used to analyze the independent risk factors affecting CSC patients recurrence, and Spearman correlation analysis was used to analyze the correlation between risk factors and CSC recurrence. The area under the receiver operating characteristics(ROC) curve(AUC) was used to analyze the evaluation value of risk factors for CSC patients recurrence. 
Results  Univariate analysis showed that there were significant differences between two groups in course of disease, type of leakage, leakage area and distance of leakage points(P＜0.05). The results of multivariate Logistic regression analysis showed that course of disease, type of leakage, leakage area and distance of leakage points were independent risk factors for recurrence in CSC patients(P＜0.05). Spearman correlation analysis showed that the course of disease, type of leakage, leakage area and distance of leakage points were in a linearpositive correlation with CSC recurrence(P＜0.05). The specificity(89.87%), sensitivity(87.91%) and AUC(0.895) of the combined indicators of the course of disease, type of leakage, leakage area and distance of leakage points in CSC patients were significantly higher than those of the single indicator(P＜0.05). 
Conclusion  There are many related factors affecting CSC patients′ recurrence. The course of disease, type of leakage, leakage area and distance of leakage points are independent risk factors affecting CSC patients recurrence.


Comparative analysis of clinical effect and visual quality of SMILE and ICL V4c implantation in the correction of high myopia

LIU Yu, CHEN Hai-ting, NIU Guang-zeng, FAN Yu-xiang

2021, 42(2):  186-191.  doi:10.3969/j.issn.1007-3205.2021.02.014

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Objective  To explore the clinical effects and the variation features of higher-order aberrations(HOAs) of femtosecond laser small incision lenticule extraction（SMILE）and implantable collamer lens （ICL） V4c  after the correction surgery of high myopia. 
Methods  The patients with -6.00 D plus high myopia who underwent myopic surgery were enrolled. In accordance with the surgical methods, they were divided into two groups, SMILE group(30 cases, 58 eyes) and ICL group(30 cases, 59 eyes), and a series of data before and after surgery, including uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), refraction, spherical equivalent(SE), intra-ocular tension and HOAs of corneas, were observed. All patients were followed up for 1 year and analyzed statistically. 
Results  As for security, the BCVA of both groups reached 20/20 plus. None eyes experienced the loss of more than one line at BCVA. As for effectiveness, at one year after the surgery, 53 eyes （91.38%） and 32 eyes （94.91%） reached 20/20 plus at UCVA in two groups respectively, and 58 eyes （100%） and 59 eyes （100%） reached 20/25 plus respectively. In terms of predictability, at one year after the surgery, the proportion of SE at ±1.0 D was 100% in both groups. The residual refractive error in SMILE group was higher than that in ICL group, and the difference between two groups was statistically significant. As for HOAs, total higher-order aberration, spherical aberration and vertical comatic aberration were increased in SMILE group after surgery. As for ICL group, the oblique trefoil was increased whilst horizonal comatic aberration was decreased. Spearman correlation analysis revealed no correlation between the aberration variation value and the preoperative spherical equivalent, cylindrical equivalent, SE, as well as the postoperative residual SE in two groups. 
Conclusion  Both SMILE and ICL have advantages of security and effectiveness for correction surgery of high myopia. ICL possessed stronger predictability for high myopia, and HOAs were not much generated.  





Clinical effect and osmotic effect of non-invasive osmotic resin for repairing early proximal carious lesions of deciduous teeth

LIANG Fei-zhao, CHEN Dong-dong, WANG Jun-lin, ZHOU Yan-ping, LIU You-zhang

2021, 42(2):  192-196.  doi:10.3969/j.issn.1007-3205.2021.02.015

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Objective  To investigate the clinical effect and permeability of non-invasive osmotic resin in repairing the adjacent carious lesions of early deciduous teeth. 
Methods  A total of 160 teeth of 100 patients with early deciduous facial paralysis treated were enrolled. The patients were divided into observation group and control group by random number table method. Eighty pieces were repaired with non-invasive penetrating resin and traditional resin repair solutions. The success rate of repair of the two groups of teeth, the proximal tightness of the affected teeth and the periodontal conditions were compared. Another 26 enamel-changing adjacent enamel-exposed molars were selected,  and the teeth were cut perpendicularly to the surface of the lesion as the infiltration group and the adhesive group, respectively, and infiltrated with an infiltration resin and a binder to compare the penetration depth and percentage of penetration of two groups. 
Results  After 6 months of treatment, the success rate of repair in the observation group(95.00%) was significantly higher than that in the control group(76.25%), and the difference was statistically significant(P＜0.05). The adjacent group of the affected group was in compliance with the proximal contact tightness. The rate was 93.75%, which was significantly higher than that of the control group(45.00%). The difference was statistically significant(P＜0.05). After 6 months of repair, the PD, PLI and BOP of the two groups were higher than those before the repair（P＜0.05), but there was no significant difference between the groups(P＞0.05). The results of osmotic study showed that the pentration depth and precentage of penetration of the different grades of the infiltration group were significantly larger than those of the cement group, and the differences were statistically significant(P＜0.05). The study showed that as the lesion grade increased, the penetration depth increased, but the percentage of penetration gradually decreased(P＜0.05). 
Conclusion  Non-invasive osmosis resin has excellent penetrating performance, and has obvious effect on repairing adjacent carious enamel of early deciduous teeth, which can effectively improve the contact tightness of adjacent surfaces and improve the success rate of repair.





Observation on the effect of implant screws in the buccal cortical region of the maxillary second molars on distal movement of the molars

WU Ze-lin

2021, 42(2):  197-200,213.  doi:10.3969/j.issn.1007-3205.2021.02.016

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Objective  To analyze the effect of implant screws in the buccal cortical region of the maxillary second molars on the distal movement of the molars. 
Methods  Eighty patients who declined tooth extraction and orthodontic treatment in outpatient department of our hospital were divided into the observation group(n=40) and control group(n=40) by random number table method. The observation group was treated with implant screws in the buccal cortical region of the maxillary second molars, and the control group was treated with implant screws between the roots of the maxillary second premolars and the first molars. The effects of distal movement of the molars were evaluated by the changes of lateral x-ray images of the head before and after orthodontics. 
Results  Before orthodonic treatment, there was no statistical significance in u1-x, U1-y, U6-x, U6′-y and U6′-y between the two groups(P>0.05). After treatment, the U6′-y and U6′-y of the control group were significantly reduced compared with those before orthodonic treatment, while the U1-y, U6′-y and U6′-y of the observation group were significantly reduced compared with those before orthodonic treatment, and the MTD was significantly lower than that of the control group(P＜0.05). In addition, the U1-y and U6′-y of the observation group were significantly lower than those of the control group(P＜0.05). The differences of U1-y, U6-x, U6′-y, U6′-y and MTD between the two groups were statistically significant(P＜0.05), while the differences of U1-x were not statistically significant(P＞0.05). Before orthodonic treatment, there was no statistical significance in the comparison of facial angle, nasolabial angle, upper lip protrusion and lower lip protrusion between the two groups(P＞0.05). After orthodonic treatment, the facial angle, nasolabial angle and upper lip protrusion of the two groups were significantly improved(P＜0.05), while the lower lip protrusion was not significantly changed(P＞0.05). However, the improvement of facial angle, nasolabial angle and upper lip protrusion of the observation group was significantly better than that of the control group(P＜0.05). 
Conclusion  Implanting of an implant screw between the maxillary second premolars and the roots of the first molars produced a significant distal oblique movement of the maxillary first molars, while the implanting of an implant screw in the buccal cortical region of the maxillary second molars produced a better distal movement of the molars. 





Efficacy and safety of ultra pulse CO2 fractional laser combined with recombinant bovine epidermal growth factor gel in the treatment of facial depressed scar after surgery

ZHANG Su-rui, LIU Wei, CHEN Feng, TAN Xiao-lei, WANG Rui-chao, WANG Lu-ye

2021, 42(2):  201-204.  doi:10.3969/j.issn.1007-3205.2021.02.017

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Objective  To investigate the efficacy and safety of ultra pulse CO2 fractional laser combined with recombinant bovine basic epidermal growth factor gel in the treatment of facial depressed scar after surgery. 
Methods  A total of 100 patients with depressed facial scar after surgery were selected and divided into observation group and control group according to patient number. The control group was treated with ultra pulse CO2 fractional laser once every 2 months, for a total of 5 times as 1 course of treatment, and the observation group was supplemented with recombinant bovine basic epidermal growth factor gel on the basis of the control group. After each laser treatment, recombinant bovine basic fibroblast growth factor gel was applied twice a day for 20 d. After one course of treatment, the curative effect, duration of wound scab formation, erythema duration, duration of wound pain, skin dryness and tension, patient satisfaction and adverse reactions such as infection, edema and new scar were compared between two groups. 
Results  There was no significant difference in the total effective rate between  two groups(P＞0.05). Duration of wound scab formation, erythema and wound pain was shorter in the observation group than in the control group, and the incidence of skin dryness and tension was lower than that of the control group; the patient satisfaction was higher than that of the control group, and the total incidence of adverse reactions during treatment was lower than that of the control group, suggesting significant difference(P＜0.05). 
Conclusion  The combination of ultra pulse CO2 fractional laser and recombinant bovine basic epidermal growth factor gel in the treatment of depressed facial scar after surgery failed to improve the curative effect, which, however, could accelerate wound repair, relieve wound pain and discomfort such as skin dryness and tension, improve patient satisfaction and reduce the incidence of adverse reactions during treatment. 





Clinical application of color Doppler ultrasonography in monitoring angioplasty for arteriovenous fistula in patients with end-stage renal disease

GUO Wei-dong, ZHANG Xiao-ling, LI Wen-hong, CAO Ya-kun, JIAO Lei-hong, WANG Yun-tao

2021, 42(2):  205-208.  doi:10.3969/j.issn.1007-3205.2021.02.018

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Objective  To detect the incidence of complications of the two surgical methods-the end-to-side and end-to-end radial artery-cephalic vein anastomosis in patients with end-stage renal disease(ESRD) by color Doppler ultrasonography(CDUS), and to evaluate the advantages and disadvantages of two surgical methods. 
Methods  We selected 60 patients with ESRD that had been treated successfully by the two surgical methods respectively. CDUS was used to detect the three kinds of complications that were higher in incidence in the two groups: endovascular thrombosis, fistula stenosis and aneurysmal dilation of the involved artery and vein. Two sets of data were analyzed statistically. 
Results  CDUS could accurately monitor the occurrence of postoperative complications of arteriovenous fistula, The incidence of endovascular thrombosis and fistula stenosis in end-to-end anastomosis group was higher than that in end-to-side anastomosis group(P＜0.05), but there was no significant difference in the incidence of aneurysmal dilation in two groups(P＞0.05). 
Conclusion  CDUS can be used to detect the common postoperative complications of the two surgical methods accurately, and it can be used as the preferred choice for its cost-effectiveness and accuracy in clinical practice. Among the two commonly used surgical methods, the end-to-side radial artery-cephalic vein anastomosis has fewer complications and milder symptoms, and is therefore recommended as the first choice on the basis of surgical indications. 


MRI in differential diagnosis and prognostic evaluation of reversible splenial lesion syndrome and ischemic cerebral infarction in adults

ZHAO Yong-qiang, WANG Fan, WANG Cheng-jian, LI Zheng-ping, ZHANG Yu-han, ZHANG Yu

2021, 42(2):  209-213.  doi:10.3969/j.issn.1007-3205.2021.02.019

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Objective  To explore the difference in MRI manifestations between reversible splenial lesion syndrome(RESLES) and cerebral infarction in adults, and to analyze the prognostic value of MRI. 
Methods  We selected 21 patients with RESLES and 39 patients with infarction as the research subjects. The location, morphology and imaging characteristics of the lesions in the MRI imaging of the two groups were recorded, and the differences in MRI imaging data of the two groups were analyzed. 
Results  The lesions of 21 RESLES patients were concentrated on the midline of the corpus callosum, symmetrically distributed around the midline position, and all were isolated and circular-like signal images, including 10 cases of circular signals, 8 cases of elliptical signals and 3 cases of fusiform signal. MRI plain scan revealed slightly low signal on T1-weighted imaging(T1WI), slightly higher signal on T2-weighted imaging(T2WI), slightly higher signal on MRI fluid attenuated inversion recovery(FLAIR) sequence, significant high signal on diffusion weighted image(DWI); low signal intensity on apparent diffusion coefficient(ADC) map, with an average value of(0.407 2±0.099 5)×10-3 mm2/s; average maximum cross-sectional area of the lesion was(95.86±7.05) mm2. MRI reexamination interval was 8-30 d. After treatment, imaging examinations of all patients showed the lesions were practically eliminated. Among them, there were 37 patients with cerebral infarction combined with other brain lesions, 36 cases of splenial lesions were single lesions, 3 cases of splenial lesions with multiple lesions, and the lesions were mostly slices, strips or in irregular shapes. Imaging examination showed high signal on DWI, the average ADC was(0.431 6±0.010 4)×10-3 mm2/s, and the average maximum cross-sectional area of the lesion was(100.06±21.84) mm2. There was no statistical difference in ADC values between the two groups(P＞0.05). 
Conclusion  The MRI imaging features of patients with RESLES and corpus callosum infarction showed that the relationship between the lesion and the midline of the corpus callosum and the shape of the lesion could be used as an effective means to differentiate the two diseases, and that the presence or absence of other lesions in the brain could be used for auxiliary identification. In this study, there was no significant difference in the ADC value in patients of the two groups. Further analysis is needed to confirm whether it is valuable for differential diagnosis of the disease. 





Effect of bronchial blocker on arterial blood gas index, lung collapse and incidence of atelectasis in children undergoing surgery for pulmonary hydatid cyst

Bianbawangdui, Chilie, Basangcangmujue, Gesangluobu, LUO Xing-jing

2021, 42(2):  214-217,221.  doi:10.3969/j.issn.1007-3205.2021.02.020

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Objective  To explore the effect of bronchial blocker(BB) on arterial blood gas index, lung collapse and incidence of atelectasis in children undergoing surgery for pulmonary hydatid cyst(PHC). 
Methods  A total of 63 children undergoing surgery for PHC were selected as the research subjects, and they were divided into the control group(n=30) and the research group(n=33) based on the random number table method. The control group was ventilated with a double-lumen bronchial catheter during surgery, and the research group was ventilated with a BB during surgery. Arterial blood gas indexes［partial pressure of carbon dioxide(PaCO2) and partial pressure of oxygen(PaO2)］, excellent and good rate of lung collapse, length of hospital stay, incidence of atelectasis and chest invasion were compared between two groups. 
Results  PaO2 in the two groups showed a gradual decrease, while PaCO2 showed a gradual increase. The PaO2 was lower while the PaCO2 was higher in the research group than in the control group. There were statistical differences in interaction between groups, time points, and time points between groups(P＜0.05). The excellent and good rate of intraoperative lung collapse at 20 min of single-lung ventilation in the two groups was higher than that of the same group at 10 min of single-lung ventilation, and the excellent and good rate of intraoperative lung collapse at 30 min of single-lung ventilation was higher than that of the same group at 10 and 20 min of single-lung ventilation. The excellent and good rate of lung collapse in the research group was significantly higher than that of the control group at 30 min of one-lung ventilation, and the difference was statistically significant(P＜0.05). There was no significant difference in the postoperative hospital stay, the incidence of atelectasis and chest infiltration between two groups(P＞0.05). 
Conclusion  The BB used in surgery for PHC in children can effectively improve the arterial blood gas function and increase the excellent and good rate of lung collapse during surgery. It is safer and has less impact on the incidence of atelectasis.





Effect of Praecoxib sodium combined with continuous positive airway pressure on pulmonary shunt and oxygenation in patients undergoing radical esophagectomy

XU Huan-hang, WANG Hang

2021, 42(2):  218-221.  doi:10.3969/j.issn.1007-3205.2021.02.021

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Objective  To observe the effect of Praecoxib sodium combined with continuous positive airway pressure(CPAP) on pulmonary shunt and oxygenation in patients with esophageal cancer undergoing radical resection, and to explore the protective effect of Praecoxib sodium on pulmonary function. 
Methods  A total of 60 patients undergoing thoracoscopic and laparoscopic radical esophagectomy for esophageal cancer were randomly assigned to the observation group(n=30) and the control group(n=30). The observation group was given parecoxib sodium and the control group was given saline. Both groups were given CPAP. The duration of operation, duration of one-lung ventilation(OLV) and extubation time were compared between two groups. The PaO2 and PaCO2 were measured before induction of anesthesia(T1), 30 min after OLV(T2) and 30 min after recovery of two-lung ventilation(T3), and the intrapulmonary shunt rate(Qs/Qt) was calculated. 
Results  There was no significant difference in duration of operation, duration of OLV and extubation time between two groups(P＞0.05). The PaO2 decreased initially and increased afterwards in two groups. PCO2 and Qs/Qt showed a trend of initial increasing and then decreasing. The difference of interaction between groups, time points and time points between groups were statistically significant with respect to PaO2 and Qs/Qt. The difference of interaction between groups, and time points between groups were statistically significant in terms of PCO2(P＜0.05). 
Conclusion  For esophageal cancer patients undergoing radical resection, the combination of Parecoxib sodium and CPAP can reduce intrapulmonary shunt, improve PaO2, and help prevent the occurrence of hypoxemia. 


Application of virtual reality situational interactive training in the rehabilitation treatment of patients with Alzheimer′s disease in nursing home

SUN Zhi-cheng, WANG Tong, MA Jin-lin, ZHANG Na, PAN Li-jun, DONG Ya-jun

2021, 42(2):  222-227.  doi:10.3969/j.issn.1007-3205.2021.02.022

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Objective  To investigate the effect of rehabilitation therapy of virtual reality（VR） situational interactive training on patients with Alzheimer′s disease（AD） in nursing home. 
Methods  A total of 56 patients with AD in nursing home were randomly divided into control group(n=28) and observation group(n=28). The control group was treated with routine care service of the nursing home and health education. The observation group was given 6 months of VR situational interactive training on the basis of the control group， 45 min each time and 3 times per week. All patients were assessed with cognitive function［mini-mental state examination（MMSE） and AD assessment scale-cognition（ADAS-cog）］， motor function［timed up and go test（TUGT）， 30-second chair stand test（30 sCST）， 30-second arm curl test（30 sACT） and chair sit-and-reach test（CSRT）］， activity of daily living(ADL)［ADL scale］ and quality of life［quality of life-Alzheimer's disease(QOL-AD)］ before and after intervention. 
Results  After intervention， the MMSE scores and the ADAS-cog scores of the observation group were significantly improved, as compared with those before intervention and better than those of the control group(all P＜0.05). The test results of the TUGT， 30 sCST， 30 sACT and CSRT of the observation group were significantly improved, as compared with those before intervention and better than those of the control group（all P＜0.05）. The ADL scores and the QOL-AD scores of the observation group were significantly improved, as compared with those before intervention and better than those of the control group（all P＜0.05）. However, there were no significant differences in the above evaluate test indicators in the control group, as compared with those before intervention（P＞0.05）. 
Conclusion  VR situational interactive training could effectively improve the cognitive function, motor function and ADL， and could increase the quality of life of AD patients in nursing home. Therefore, it is worthy of promotion and application in nursing home.