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Table of Content

    25 August 2021, Volume 42 Issue 8
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    Effect of CM-Dil labeling on bone marrow stromal stem cells and its tracking in rat model of vaginal reconstruction
    ZHANG Ning, QIN Xi-jing, ZHU Yu-lin, LI Pei, HUANG Xiang-hua
    2021, 42(8):  872-875,封三.  doi:10.3969/j.issn.1007-3205.2021.08.002
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    Objective  To explore the effect of chloromethyl-benzamidodialkylcarbocyanine(CM-Dil) labeling on bone marrow stromal stem cells(BMSCs) and its tracking in rat model of vaginal reconstruction. 
    Methods  Rat BMSCs were prepared with the whole bone marrow adherent method. BMSCs were labeled with different concentrations of CM-Dil and their labeling efficiency and reproductive activities were observed. The rat model of vaginal reconstruction was established with BMSCs seeded on small intestinal submucosal matrix（SIS）. Its tracking in rat model of vaginal reconstruction was observed. 
    Results  BMSCs could be labeled with different concentrations of CM-Dil and the labeled efficiency was＞98%, but the fluorescence intensity became stronger with the increase of concentration. The growth curves after labeling with the concentration of 2.5 μmol/L and 5 μmol/L were not significantly different from those of the control group, and the growth curves after labeling with 10 μmol/L and 20 μmol/L were slightly lower than those of the control group. After transplantation, BMSCs were mainly distributed in the deep vaginal tissues, and orange BMSCs could be found at 3 months after vaginal reconstruction. 
    Conclusion  CM-Dil did not affect stem cell activity, and 5 μmol/L may be the optimal labeling concentration. Orange BMSCs could be found at 3 months after vaginal reconstruction and could be used in further study.

    Nutritional risk assessment of patients with acute exacerbation of chronic obstructive pulmonary disease and its predictive value on prognosis
    WANG Hui, YANG Miao, REN Hui-min, ZHAO Ting-ting, XUE Qian-long, LI Wen-hui
    2021, 42(8):  876-880.  doi:10.3969/j.issn.1007-3205.2021.08.003
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    Objective  To evaluate the nutritional risk of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and its predictive value on prognosis. 
    Methods  A total of 86 AECOPD patients were selected as AECOPD group, and 60 patients with stable COPD and 60 healthy people were selected as stable COPD group and control group respectively. Nutrition Risk Screening 2002(NRS 2002) was used for nutritional risk assessment, and the patients were divided into non-nutritional risk patients with 0-2 points and nutritional risk patients with 3-7 points.The prognosis was assessed according to the 28-day survival of AECOPD patients. Kaplan Meier curve was used to analyze the difference of prognosis, ROC curve was used to analyze the predictive value of NRS 2002 score on prognosis, and Logistic regression model was used to analyze the influencing factors of prognosis. 
    Results  The NRS 2002 score and the proportion of nutritional risk in AECOPD group were higher than those in stable COPD group and control group(P＜0.05). Kaplan Meier curve analysis showed that the 28-day cumulative survival rate of patients with nutritional risk in AECOPD group was lower than that in patients without nutritional risk(P＜0.05). ROC curve analysis showed that NRS2002 score had predictive value for 28-day survival of AECOPD patients(P＜0.05). Logistic regression analysis showed that age, ALB, multi-drug resistance, APACHE Ⅱ score and nutritional risk were the influencing factors of prognosis of AECOPD patients(P＜0.05). 
    Conclusion  Nutritional risk is related to the severity and 28-day prognosis of AECOPD patients. Targeted reduction of nutritional risk may help improve the prognosis of AECOPD.

    Relationship between airway inflammation and PI3K/Akt signaling pathway activation of EOS in patients with bronchial asthma
    LIU Hong-hong, XING Ning-ning, SHI Li-min, LI Ai-jun
    2021, 42(8):  881-885.  doi:10.3969/j.issn.1007-3205.2021.08.004
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    Objective  To explore the relationship between airway inflammation and  phosphatidylinositol kinase 3/Protein Kinase B(PI3K/Akt) signaling pathway of activation eosinnophil(EOS) in patients with bronchial asthma. 
    Methods  A total of 36 patients with bronchial asthma treated in our hospital were selected as observation group, and 36 people undergoing physical examination during the same period were selected as control group. The clinical data of the patients were collected, and the percentage of bronchial wall area to total airway cross-sectional area(WA%), the ratio of bronchial wall thickness to bronchial lumen diameter(T/D) and the distribution of cells in induced sputum were detected. The airway remodeling, inflammatory indicators, and PI3K/Akt signaling pathway-related protein levels in patients with different sputum eosinophil levels were analyzed, and Person correlation was used to analyze the relationship between inflammatory indicators and PI3K/Akt signaling pathway-related proteins. 
    Results  The proportion of eosinophils in the observation group was significantly higher than that in the control group, while the proportion of neutrophils and macrophages in the observation group was significantly lower than that in the control group(P＜0.05). The fractional exhaled nitric oxide(FeNO) volume concentration, serum total IgE, T/D and WA in the high eosinophil group were significantly higher than those in the low eosinophil group(P＜0.05). The PI3K and p-Akt expression level of the patients in the high eosinophil group was significantly higher than that in the low eosinophil group(P＜0.05). Pearson analysis showed that FeNO volume concentration and serum total IgE were positively correlated with PI3K and p-Akt respectively(P＜0.05).  
    Conclusion  The PI3K/Akt signaling pathway of EOS in patients with bronchial asthma is activated and has a positive correlation with airway inflammation(FeNO and serum IgE).

    Effect of systemic immune-inflammation index on prognosis of patients with small cell lung cancer
    TENG Hua, LIU Miao-miao, ZHANG Rong-san, XIE Jian-hua, ZHANG Hong-zhen
    2021, 42(8):  886-890.  doi:10.3969/j.issn.1007-3205.2021.08.005
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    Objective  To investigate the effect of systemic immune-inflammation index(SII) based on neutrophil, platelet and lymphocyte on the clinical prognosis of patients with small cell lung cancer(SCLC). 
    Methods  The case data of 98 patients with SCLC were analyzed retrospectively. According to the results of blood routine before treatment, the SII value was calculated, and the optimal cut-off value of SII was obtained by ROC curve. The effects of SII level and clinicopathological characteristics on progression-free survival(PFS) and the overall survival(OS) were estimated using the Kaplan-Meier curves and Cox proportional hazards regression models. 
    Results  The optimal cut-off value of SII was 571.5. The proportion of the low SII group in the limited stage was higher than that of the high SII group(P＜0.05). The median PFS and OS of the low SII group were longer than that of the high SII group(P＜0.001). Multivariate analyses further revealed SII level as an independent prognostic factor for PFS and OS(P＜0.05). 
    Conclusion  High SII often indicates poor prognosis and plays an important role in prognostic evaluation of SCLC patients. 

    The predictive value of IPCL typing combined with Cyclin D1 and PDGFR in the diagnosis and prognosis of early esophageal cancer
    ZHONG Can-xin, ZHANG Shi-hao
    2021, 42(8):  891-895.  doi:10.3969/j.issn.1007-3205.2021.08.006
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    Objective  To explore the predictive value of intrapapillary capillary loop(IPCL) typing combined with Cyclin D1 and platelet-derived growth factor receptor(PDGFR) in the diagnosis and prognosis of esophageal cancer. 
    Methods  A total of 118 patients with superficial esophageal lesions(118 lesions) examined by NBI-ME were enrolled in this study.The esophageal cancer tissues were classified based on IPCL typing and pathological typing, and Cyclin D1 and PDGFR expression in esophageal cancer tissues were detected. They were followed-up for 5 years after operation, and patient survival was recorded. 
    Results  Based on ICT typing of esophageal cancer with superficial esophageal lesions, type Ⅲ and type Ⅳ were mainly esophagitis and LGIN. Type V1, type V2 and type V3A were mainly early esophageal cancer(EEC), and the sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV)in the diagnosis of EEC were 85.5%(71/83), 80.0%(28/35), 91.0%(71/78), and 83.9%(28/40), respectively. Type V3B and type VN were mainly SM1, SM2, and lower segment esophageal cancer. The sensitivity, specificity, PPV and NPV in the diagnosis of SM2 and lower segment esophageal cancer were 70.0%(7/10), 92.6%(100/108), 46.7%(7/15) and 90.7%(100/103), respectively. The expression of Cyclin D1 and PDGFR in patients with EEC, SM1, SM2 and lower segment esophageal cancer was significantly higher than that in patients with esophagitis and LGIN(P＜0.01). The 5-year survival rate of EEC patients with strong positive expression of Cyclin D1(P=0.036) and PDGFR(P=0.034) was significantly lower than that of patients with positive, weak positive or weak negative expression. IPCL typing, expression of Cyclin D1 and PDGFR in EEC were independent risk factors for the prognosis of EEC. 
    Conclusion  IPCL typing has certain guiding significance for the diagnosis of EEC. Detection of Cyclin D1 and PDGFR expression in esophageal cancer tissues is conductive to the prognosis of EEC. IPCL typing, and expression of Cyclin D1 and PDGFR are the independent risk factors for the prognosis of EEC.

    Effect of ACDF and ACCF on cervical spine range of motion and complications in patients with multilevel cervical spondylosis
    YANG Sai, GONG Chen, ZHOU Sheng-yuan
    2021, 42(8):  896-899.  doi:10.3969/j.issn.1007-3205.2021.08.007
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    Objective  To analyze the effect of anterior cervical discectomy and fusion(ACDF) and anterior cervical corpectomy and fusion(ACCF) in the treatment of patients with multilevel cervical spondylopathy and the influence on cervical spine range of motion(ROM) and postoperative complications. 
    Methods  The clinical data of 60 patients with multilevel cervical spondylopathy who received surgery in our hospital were retrospectively analyzed. According to different operation methods, they were divided into ACDF group(n=28) and ACCF group(n=32). The duration of operation, intraoperative blood loss, duration of hospital stay and postoperative complications of patients in two groups were observed. The visual analogue(VAS) score and the Japan Orthopaedic Association(JOA) score were used to evaluate the pain degree and neurological function of patients in two groups, and the cervical spine curvature and cervical spine ROM of patients in two groups before and after operation were observed and recorded. 
    Results  The intraoperative blood loss in ACCF group was significantly higher than that in ACDF group, and the difference was statistically significant(P＜0.05). The duration of operation in ACDF group was significantly lower than that of ACCF group, and the difference was statistically significant(P＜0.05). There was no significant difference in JOA scores between ACDF and ACCF groups before and at 3 months after operation(P＞0.05), and JOA score of the two groups at 3 months after operation was significantly higher than that before operation, suggesting significant difference(P＜0.05). There were significant differences in cervical spine curvature and ROM between ACDF and ACCF groups before and at 3 months after operation(P＜0.05). Significant difference was found in the cervical spine curvature and ROM before and at 3 months after operation(P＜0.05). No complication occurred in ACDF group, and complication was observed in 6 cases in ACCF group, including 3 cases of hoarseness, 2 cases of incision infection and 1 case of non-fusion; the total incidence was statistically significant(P＜0.05). 
    Conclusion  ACDF and ACCF can significantly improve the ROM of the cervical spine, and both have good effects. However, patients undergoing ACDF have less intraoperative blood loss, shorter duration of operation, and fewer complications. 

    Risk factors of postoperative depression in patients with breast cancer and establishment of clinical predictive model
    WU Xiao, LIU Jia-ni, PENG Xin-yu, LI Xiao-ming, MAO Jing-jing
    2021, 42(8):  900-903,943.  doi:10.3969/j.issn.1007-3205.2021.08.008
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    Objective  To investigate the risk factors of postoperative depression in patients with breast cancer and to establish a predictive model, thereby providing reference for clinical work. 
    Methods   A total of 200 female patients with breast cancer were enrolled in this study. The patients were evaluated by the self-rating depression scale and the family support self-rating scale, and their age, education level, monthly income per capita, type of medical insurance, marital status, tumor stage and mode of operation were recorded. Multivariate Logistic regression analysis was used to determine the risk factors of postoperative depression in patients with breast cancer, and ROC curve was used to evaluate the value of clinical predictive model. 
    Results  Multivariate Logistic regression analysis showed that young age, low monthly income per capita, being unmarried/ divorced/widowed were risk factors for postoperative depression in patients with breast cancer, while good family support and early tumor stage were protective factors. The cutoff value of the clinical predictive model was -0.475, and the area under curve was 0.856(95%CI：0.794-0.919). 
    Conclusion  The clinical predictive model based on age, monthly income per capita, marital status, family support and tumor stage has good predictive value for postoperative depression in patients with breast cancer.

    Expression and clinical significance of CRIP1 gene in human ovarian cancer
    LIU Yang, KANG Lin, ZHENG Guo-na, ZHAO Huan-fen
    2021, 42(8):  904-908.  doi:10.3969/j.issn.1007-3205.2021.08.009
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    Objective  To analyze the expression level and clinical significance of cysteine-rich intestinal protein 1(CRIP1) gene in ovarian cancer via bioinformatics methods. 
    Methods  Oncomine database was used to analyze the expression level of CRIP1 gene in different types of tumors and pathological types of ovarian cancers.Kaplan-Meier Plotter tool was employed to analyze the relationship between high and low expression of CRIP1 gene and prognosis of ovarian cancer patients. STRING database and GEPIA database were retrieved to analyze CRIP1- interacting proteins in ovarian cancer. 
    Results  CRIP1 gene was found to be differentially expressed in various types of tumors(P＜0.05), but highly expressed in ovarian cancer tissue. Combined with clinical characteristics, overall survival(OS) and progression-free survival of ovarian cancer patients with the high expression of CRIP1 gene were significantly reduced, and the patients with CRIP1 high expression had a poor OS after chemotherapy with Paclitaxel, Docetaxel or Topotecan. The interaction network diagram of CRIP1 was constructed, and CRIP1 was negatively correlated with STK4 and YAP1, while positively correlated with LGALS3 and ATOX1 in ovarian cancer. Moreover, go clustering analysis showed that CRIP1 was involved in various biological pathways. 
    Conclusion  CRIP1 gene could be a significant target for the diagnosis and treatment, as well as a key indicator for the prognosis in ovarian cancer patients. 

    Analysis of vaginal microecological characteristics and influencing factors in ovarian cancer patients with vaginitis
    ZHANG Wei, GUO Bu-qing, HOU Yu-na, WANG Wei-wei, SHANG An-quan
    2021, 42(8):  909-913.  doi:10.3969/j.issn.1007-3205.2021.08.010
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    Objective  To analyze the vaginal microecological characteristics and influencing factors of patients with ovarian cancer complicated with vaginitis, thereby providing reference for clinical prevention and treatment. 
    Methods  A total of 330 ovarian cancer patients admitted were selected. The infection rate and vaginal microecological characteristics of patients with vaginitis were analyzed. Patients were divided into infection group and non-infection group according to presence or absence of vaginitis. Age, education level, underlying diseases, condom use, sexual frequency, chemotherapy, self-vaginal irrigation and history of vaginitis were compared between the two groups. Multivariate Logistic regression analysis was used to determine the influencing factors of ovarian cancer with vaginitis. 
    Results  Of 330 patients with ovarian cancer,117(35.45%) were complicated with vaginitis. The top three infection types in 117 patients were vaginal candidiasis(VVC) in 35 cases(29.91%). bacterial vaginosis(BV) in 30 cases(25.64%) and microecological disorders in 28 cases(23.93%). Age ≥50 years, underlying diseases, frequency of sexual life ≥2 times/week, chemotherapy, self-vaginal irrigation and history of vaginitis were higher in infection group than in non-infection group, while junior college education or higher and condom use ratio were lower in infection group than in non-infection group, suggesting significant difference(P＜0.05). Logistic regression analysis showed that age ≥50 years, underlying diseases, frequency of sexual life≥2 times/week, chemotherapy, self-vaginal irrigation and history of vaginitis were the risk factors of ovarian cancer complicated with vaginitis(P＜0.05). Junior college education or higher and condom use were the protective factors of ovarian cancer complicated with vaginitis(P＜0.05). 
    Conclusion  Ovarian cancer patients with vaginitis mainly had VVC, followed by BV. Age, underlying diseases, frequency of sexual life and chemotherapy are the risk factors of ovarian cancer complicated with vaginitis. Junior college education and condom use are the protective factors of ovarian cancer complicated with vaginitis. In clinical practice, according to the characteristics of infection and risk factors, we should correct the poor living habits related to risk factors and strengthen the popularization of knowledge on physiological health and disease prevention.

    Blood routine, immunoglobulin, D-D expression and their efficiency of predicting the risk of plastic bronchitis in children with RMPP
    LI Huan-huan, WANG Jun
    2021, 42(8):  914-919,938.  doi:10.3969/j.issn.1007-3205.2021.08.011
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    Objective  To explore blood routine, immunoglobulin, D-Dimer(DD) expression and their efficiency in predicting the risk of plastic bronchitis in children with refractory mycoplasma pneumoniae pneumonia(RMPP). 
    Methods  A total of 125 children with RMPP(RMPP group) and 125 children with Mycoplasma pneumoniae pneumonia(MPP) (MPP group) in our hospital were selected. The blood routine ［white blood cell count(WBC), percentage of neutrophils(N%), percentage of lymphocytes(L%), platelet(PLT), lactate dehydro-genase(LDH), C-reactive protein(CRP), red blood cell distribution width(RDW), pre-albumin(PAB)］,serum immunoglobulin ［immunoglobulin(Ig) A, IgM, IgE, IgG］ and D-D level of children with or without plastic bronchitis were compared between the two groups and in RMPP group. The influencing factors of plastic bronchitis, the correlation between various indicators and the severity of plastic bronchitis ［pediatric risk of mortality Ⅲ(PRISM Ⅲ)］, and the efficiency of predicting plastic bronchitis were explored. 
    Results  WBC, N%, LDH, CRP, IgM, IgE, and D-D in RMPP group were higher than those in MPP group, while L%, PLT, and PAB were lower than those in MPP group(P＜0.05). In the RMPP group, N%, LDH, CRP, IgM, IgE, and DD in children with plastic bronchitis were higher than those in children without plastic bronchitis, while L%, PLT, and PAB were lower than those in children without plastic bronchitis(P＜0.05). Multivariate Logistic regression analysis showed that an increase in IgM, IgE, N%, CRP, and D-D was a risk factor for plastic bronchitis(P＜0.05). Pearson analysis revealed that there was a positive correlation between N%, CRP, IgM, IgE, D-D and PRISMⅢ scorein children with plastic bronchitis(P＜0.05). The receiver operating characteristic(ROC)curve of N%, CRP, IgM, IgE, D-D to predict plastic bronchitis was drawn, and the area under the ROC curve(AUC) of IgM, IgE, N%, CRP, and D-D combined to predict plastic bronchitis was 0.896, which was greater than the AUC predicted by each index alone, with the best sensitivity of 84.21% and specificity of 85.85%. The AUC predicted by N%+CRP for type I plastic bronchitis was 0.867, which was greater than the AUC predicted by each index alone. The optimal sensitivity was 70.00% and the specificity was 88.89%. 
    Conclusion  The expression of blood routine, immunoglobulin, and D-D in children with PMPP is obviously abnormal, and the combined detection of the three has a good effect in predicting the risk of plastic bronchitis. 

    Effect of ulinastatin combined with adrenal cortex hormones on intestinal mucosal barrier function, NGAL and TREM-1 levels in children with sepsis
    WANG Gai, WANG Wei-wei, WANG Ya-qing, ZHANG Qian, LI Fang
    2021, 42(8):  920-925.  doi:10.3969/j.issn.1007-3205.2021.08.012
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    Objective  To explore the effects of ulinastatin combined with adrenal cortex hormones on intestinal mucosal barrier function, neutrophil gelatinase-associated lipocalin(NGAL), and soluble myeloid cell triggered receptor-1(TREM-1) level in children with sepsis. 
    Methods  A total of 82 children with sepsis admitted to our hospital were selected as research subjects, and were divided into the ulinastatin group(n=41) and the combination treatment group(n=41) according to the random number table method. The ulinastatin group was treated with ulinastatin, and the combination treatment group was treated with adrenal cortex hormones on the basis of the ulinastatin group. A blood gas analyzer was used to detect the level of lactic acid(LA), and the acute physiology and chronic health(APACHEⅡ) score was used to assess the severity of the disease. Enzyme-linked immunosorbent assay(ELISA) was used to detect heparin-binding protein(HBP), prealbumin(PA), retinol-binding protein(RBP), interleukin-6(IL-6), interleukin-10(IL-10), diamine oxidase(DAO), intestinal fatty acid binding protein(IFABP), D-lactic acid, NGAL and TREM-1 levels. An automatic biochemical analyzer was used to detect creatine kinase isoenzyme(CK-MB) and troponin I(cTnI) level. Immune function indicators were detected by flow cytometry. The LA value and therapeutic effect of the two groups of children were observed, and the LCR was calculated. 
    Results  Compared with the ulinastatin group, the combination treatment group had lower LA, HBP, IL-6, CK-MB, cTnI, CD8+, DAO, IFABP, D-lactic acid, NGAL, TREM-1 levels, and APACHE Ⅱ scores(P＜0.05). Compared with the ulinastatin group, the combination treatment group had higher levels of LCR, PA, RBP, IL-10, CD3+, CD4+, NK and the total effective rate of treatment(P＜0.05). 
    Conclusion  Ulinastatin combined with adrenal cortex hormones can effectively improve the clinical symptoms of children with sepsis, promote the normalization of the intestinal mucosal barrier function, and lower the levels of NGAL and TREM-1. Therefore, it is worthy of clinical popularization and application.

    Study on hypoxia-induced cerebral injury and changes in serum BDNF and HSP70 levels in children with febrile convulsion
    HAO Gai-ling, ZHANG Zhong-fu, XU Li-juan, ZHANG Nan, LI Qing-hua, LI Quan-heng
    2021, 42(8):  926-929.  doi:10.3969/j.issn.1007-3205.2021.08.013
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    Objective  To investigate hypoxia-induced cerebral injury and the changes of brain-derived neurotrophic factor(BDNF) and heat shock protein 70(HSP70) in children with febrile convulsion. 
    Methods  A total of 70 children with febrile convulsion were selected as the research group, and they were divided into simple convulsion group(n=45) and status convulsion(SC) group(n=25) according to the duration of febrile convulsion. In the meantime, 70 healthy children undergoing physical examination in our hospital during the same period were selected as the control group. The serum levels of BDNF，HSP70, pH value, arterial partial pressure of oxygen(PaO2), arterial partial pressure of carbon dioxide(PaCO2), total carbon dioxide(TCO2), and blood gas levels were compared among three groups. 
    Results  The levels of BDNF and HSP70 in SC group were higher than those in control group and simple convulsion group(P＜0.05); there was no significant difference between the control group and simple convulsion group with respect to pH value, PaO2, PaCO2 and TCO2(P＞0.05). pH value and PaO2 of SC group were lower than those of control group(P＜0.05), while PaCO2 and TCO2 of SC group were higher than those of control group and simple convulsion group(P＜0.05). pH value and PaO2 of SC group were lower than those of simple convulsion group(P＜0.05). 
    Conclusion  In the study of hypoxia-induced cerebral injury in children with febrile convulsion, it is found that there is a significant correlation of hypoxia-induced cerebral injury with BDNF and HSP70 levels in children with SC, which should be further studied. 

    Clinical study of nasal nebulization of budesonide suspension combined with clarithromycin in the treatment of chronic rhinosinusitis and nasal polyps with bronchial asthma
    SHAO Chang-bao, WANG Yuan-qiao, MA Lin-juan, YIN Hao, WANG Jian-xing
    2021, 42(8):  930-934,949.  doi:10.3969/j.issn.1007-3205.2021.08.014
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    Objective  To analyze the effect of nasal nebulization of budesonide suspension combined with clarithromycin on the treatment of chronic rhinosinusitis(CRS), nasal polyps and bronchial asthma. 
    Methods  A total of 128 patients with CRS and bronchial asthma undergoing endoscopic sinus surgery at the Fourth Central Hospital of Baoding City(Hebei Province), and the Department of Otolaryngology, the Second Hospital of Hebei Medical University were selected as the research subjects and divided into clarithromycin group(n=64) and combination group(n=64) according to the lottery method. Two groups of patients were treated with FESS operation, after conventional treatment of bronchial asthma before operation. The clarithromycin group was treated with clarithromycin, while the combination group was treated with nasal aerosol inhalation of budesonide suspension on the basis of clarithromycin group. The improvement time of clinical symptoms, lung function of lower airway, eosinophils(EOS) count, neutrophil/lymphocyte ratio(NLR), platelet/lymphocyte ratio(PLR), asthma control test(ACT) score, soluble interleukin-2 receptor(sIL-2R), interferon- γ（IFN- γ, the levels of soluble CD23(sCD23) and interleukin-4(IL-4) as well as the curative effect were measured. 
    Results  Compared with clarithromycin group, the improvement time of moist rales, wheezing, asthma and cough in combination group was shorter(P＜0.05). Compared with clarithromycin group, FEV1, FVC and PEF in combination group were higher(P＜0.05). Compared with clarithromycin group, EOS count, NLR, PLR, sIL-2R, sCD23, and IL-4 levels were decreased in combination group, while ACT score and IFN-γ levels were increased(P＜0.05). Compared with clarithromycin group, the total response rate of combination group was higher(P=0.023). 
    Conclusion  Patients with CRS, nasal polyps and bronchial asthma were treated with nasal nebulization of budonide suspension combined with clarithromycin, which significantly improved clinical symptoms and lung function, and had a significant effect.

    Contrast-enhanced ultrasonography in the diagnosis of liver cancer and the evaluation of residual cancer after TACE
    XUAN Zhi-dong, QIN Yue, WU Na
    2021, 42(8):  935-938.  doi:10.3969/j.issn.1007-3205.2021.08.015
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    Objective  To explore the diagnostic value of contrast-enhanced ultrasonography (CEUS) in liver cancer and the evaluation value of residual cancer after TACE treatment. 
    Methods  A total of 76 patients with suspected primary liver cancer were selected as study subjects for digital subtraction angiography(DSA) examination and clinical diagnosis. The sensitivity and specificity of routine ultrasound and CEUS in the diagnosis of liver cancer were observed with DSA as the gold standard, and their postoperative residual cancer evaluation was analyzed. 
    Results  In this study, 64 patients with single lesions and 5 patients with no liver cancer lesions were included; 50 cases were positive and 2 cases were negative in routine ultrasound examination, while 61 cases were positive and 5 cases were negative in CEUS. The sensitivity, specificity and diagnostic coincidence rate of CEUS diagnosis were significantly higher than those of routine ultrasound(P＜0.05). There were 58 signs of residual activity after TACE operation, 6 cases of complete inactivated. Among them, 44 liver cancer lesions were positive and 1 case was negative in routine ultrasound examination; 55 liver cancer lesions were positive and 4 cases were negative in CEUS. The sensitivity, specificity and diagnostic coincidence rate  of CEUS were significantly higher than those of routine ultrasound(P＜0.05). 
    Conclusion  CEUS for primary liver cancer can improve the diagnostic coincidence rate of lesions and improve the quality of residual cancer detection after TACE operation, which is therefore worthy of popularization in relevant clinical diagnosis and postoperative evaluation. 

    The analgesic effect of dezocine and flurbiprofen axetil in patients undergoing laparoscopic hysterectomy and its influence on stress indicators
    HAO Nan-nan, ZHANG Jing-bo, WANG Xin, ZHOU Hai
    2021, 42(8):  939.  doi:10.3969/j.issn.1007-3205.2021.08.016
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    Objective  To explore the analgesic effect of combined dezocine and flurbiprofen axetil in patients undergoing total laparoscopic hysterectomy(TLH) and its influence on stress indicators and plasma cytokines. 
    Methods  The clinical data of 60 patients undergoing TLH were retrospectively analyzed. According to the method of anesthesia, they were divided into the control group and the observation group, with 30 cases in each group. The control group was given sufentanil for analgesia, and the observation group was given dezocine combined with flurbiprofen axetil for analgesia. VAS scores and Ramsay scores immediately after surgery, at 12 h after surgery, and at 24 h after surgery were compared between two groups. The stress response ［malondialdehyde(MDA), cortisol(Cor), adrenaline(E), norepin ephrine(NE)］ and plasma cytokines ［tumor necrosis factor-α(TNF-α), interleukin-2(IL-2), interleukin-6(IL-6), interleukin-10(IL-10)］ levels of the two groups were compared before and immediately after establishing the vein passage, at 24 h after the surgery, and at 48 h after the surgery. 
    Results  The VAS scores of the two groups increased initially and then decreased. The VAS scores of the observation group were lower than those of the control group, and the differences between groups and time points were statistically significant(P＜0.05). There was no statistical difference in the interaction between groups and time points(P＞0.05). The Ramsay scores of the two groups showed a gradual decrease. The Ramsay scores of the observation group were higher than those of the control group, and the differences in interaction between groups, time points, and time points between groups were statistically significant(P＜0.05). The levels of MDA, Cor, E, and NE in the two groups increased initially and then decreased. The levels of MDA, Cor, E, and NE in the observation group changed less than those in the control group. The difference in interaction between groups, time points, and time points between groups were statistically significant(P＜0.05). TNF-α, IL-2, IL-6, and IL-10 in the two groups showed a trend of initial increase and then decrease. The levels of TNF-α, IL-2, IL-6, and IL-10 in the observation group changed less than those in the control group, and there were statistically significant differences in the interaction between groups, time points, and time points between groups(P＜0.05). 
    Conclusion  Dezocine combined with flurbiprofen axetil is effective for patients undergoing TLH, which can relieve excessive stress reaction and obtain satisfactory sedation and analgesia.

    Investigation into cognition of HPV and vaccination willingness among college students in Shijiazhuang city
    LI Xin-yi, XV Ya-meng, SONG Yu, SUN Yu-cheng, YANG Zhao-hui, LIU Wen-xuan
    2021, 42(8):  944-949.  doi:10.3969/j.issn.1007-3205.2021.08.017
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    Objective  To study the vaccination willingness and influencing factors of human papillomavirus(HPV) for college students in Shijiazhuang City by using different models to analyze different knowledge scores, and to provide the theoretical basis for the promotion of HPV vaccine for college students in Shijiazhuang City. 
    Methods  Using a random sampling method, a questionnaire on demography, HPV and cervical cancer cognition, sexual behavior, HPV vaccine cognition and vaccination intention was conducted universities in Shijiazhuang City, and a total of 1622 valid questionnaires were retrieved. The Chi-square test was used to analyze the differences in basic information, sexual behavior and infection consciousness of college students with different vaccination intentions. The Mann-Whitney U test was employed to observe the effect of HPV-related knowledge on vaccination intention in those students, and the Logistic regression model was used to analyze the factors affecting vaccination. 
    Results  45.62%(740/1622) of college students expressed their willingness to receive HPV vaccine, while 54.38%(882/1622) expressed their unwillingness. The total scores for HPV-related issues were 6.000（2.000，10.000） and 1.000（-2.000，5.250） for students in the willingness and unwillingness groups respectively, with statistically significant differences(P＜0.001), The total score was divided into HPV score and cervical cancer-related knowledge score as well as HPV vaccine-related knowledge score, and the difference was still statistically significant（P＜0.001). The results of Logistic regression analysis showed that HPV-related knowledge score was statistically associated with vaccination willingness(P＜0.001); the higher the score, the higher the intention to vaccinate. After adjusting living expenses, gender, origin and other factors, OR value was decreased in models 1, 2, and 3; after taking sexual behavior and infection risk consciousness into consideration, OR value was increased in model 4, as compared with model 3. 
    Conclusion  The acceptance rate of HPV vaccination for college students in Shijiazhuang City is lower than that at the national level. Therefore, improving HPV-related knowledge of college students will increase their acceptance rate of vaccines, and the relevant departments still need to strengthen publicity and efforts to enhance the awareness of self-protection of college students.