Loading...

Table of Content

    25 September 2021, Volume 42 Issue 9
    Previous Issue    Next Issue
    Effect of different freezing conditions on the freezing preservation of muscle tissue specimens
    SUN Hong-xing, DOU Yong-qing, HAN Mei
    2021, 42(9):  998-1002.  doi:10.3969/j.issn.1007-3205.2021.09.002
    Asbtract ( 639 )   PDF (3616KB) ( 119 )  
    Related Articles | Metrics
    Objective To select the optimal freezing method for different muscular tissues by comparing the effect of different muscular tissue sections under three freezing conditions. 
    Methods The tissues used in this experiment included skeletal muscle(gastrocnemius), myocardium, and vascular smooth muscle(thoracic aorta). The three freezing conditions were liquid nitrogen immersion, floating on liquid nitrogen, and direct -80 ℃ methods.After sampling, freezing, sectioning and hematoxylin-eosin(HE) staining, the tissue structure morphology was observed under a microscope. 
    Results The optimal freezing condition for the skeletal muscle, myocardium and vascular smooth muscle was liquid nitrogen immersion, floating on liquid nitrogen, and liquid nitrogen immersion or floating on liquid nitrogen, respectively. 
    Conclusion There are differences in the optimal freezing conditions for different muscular tissues.

    MiR-18B-5p regulates BTG3 and downstream signaling pathways to promote the development of hepatocellular carcinoma
    JIAO Wen-peng, HOU Lin, CUI Mei-juan, JIAO Wen-jing, ZHANG Jin-yan
    2021, 42(9):  1003-1007,1015.  doi:10.3969/j.issn.1007-3205.2021.09.003
    Asbtract ( 510 )   PDF (1515KB) ( 121 )  
    Related Articles | Metrics
    Objective To explore the role and the mechanism of miR-18B-5p in hepatocellular carcinoma(HCC). 
    Methods The expression levels of miR-18B-5p were measured in serum of patients with HCC, and its clinical relevance was analyzed. The miR-18B-5p level was down-regulated and the role of miR-18B-5p in the proliferation, migration and invasion in HCC cell lines was examined. In addition, its mechanism was detected by qRT-PCR and luciferase reporters. 
    Results The survival rate of patients in low miR-18B-5p expression group was higher than that in high miR-18B-5p expression group(P＜0.05). Multivariate analysis showed that the expression level of miR-18B-5p(RR: 2.064, 95%CI: 1.522-2.800) and age(RR: 1.762, 95%CI: 1.347-2.305) were the influencing factors of survival. The level of miR-18B-5p expressed by HepG2 cells was higher than that in BEL-7402 group, MHCC97 group and Hep3B group(P＜0.05). The expression of Si-miR-18B-5p and cell proliferation of Si-miR-18B-5p cell line were lower than those of HepG2 cell line(P＜0.05). In Si-miR-18B-5p cell line, miR-18B-5p was down-regulated, and the ability of cell migration and invasion was lower than that of HepG2 cell line(P＜0.05). The mRNA expression of BTG3 in Si-miR-18B-5p cell line was higher than that of HepG2 cell line(P＜0.05). The relative fluorescein activity of BTG3 WT was lower than that of BTG3 Mut(P＜0.05). 
    Conclusion MiR-18B-5p may be a new therapeutic target and prognostic biomarker for HCC.

    Study on the mechanism of geniposide inhibiting oxidative stress and apoptosis of Parkinson′s disease model through AMPK/mTOR pathway
    ZHU Ning, MA Xiao-shan, CHEN Chun-li, LI Guo-xian, YANG Xiu-juan, XIE Dong
    2021, 42(9):  1008-1015.  doi:10.3969/j.issn.1007-3205.2021.09.004
    Asbtract ( 721 )   PDF (1452KB) ( 179 )  
    Related Articles | Metrics
    Objective To investigate the effect of geniposide(GP) on the apoptosis and oxidative stress injury of the Parkinson′s disease model obtained by 1-methyl-4-phenyl 1,2,3,6-tetrahydropyridine(MPP+) induced human neuroblastoma SH-SY5Y cells through Adenosine 5′-monophosphate(AMP)-activated protein kinase/mammalian target of rapamycin(AMPK/mTOR) pathway. 
    Methods The SH-SY5Y cells were selected as the research subject, and according to different treatment methods, they were divided into Control group(normal culture), MPP+ group(supplemented with 1 mmol/L MPP+ on the basis of the Control group), GP group(supplemented with 100 μmol/L GP on the basis of the Control group), and MPP++GP group(supplemented with 100 μmol/L GP on the basis of the MPP+ group). Malondialdehyde(MDA), lactate dehydrogenase(LDH) and superoxide dismutase(SOD) kits, flow cytometry and Western blot were used to detect the changes in oxidative stress injury of cells, cell apoptosis and related proteins expression levels of AMPK, mTOR and LC3 in each group. The changes in the related expression levels of the above proteins in MPP+ group and MPP++GP group were detected by Western blot after treatment with AMPK activator or mTOR inhibitor. 
    Results Compared with the Control group, the cell apoptosis, LDH activity, MDA content, AMPK phosphorylation level, LC3-Ⅱ/LC3-Ⅰ ratio were increased, while SOD activity and mTOR phosphorylation level were reduced in the MPP+ group(P＜0.01). Compared with the MPP+ group, the cell apoptosis, LDH activity, MDA content, AMPK phosphorylation level, and LC3-Ⅱ/LC3-Ⅰ ratio were reduced, while SOD activity and mTOR phosphorylation level were increased in the MPP++GP group(P＜0.01). After AMPK activator or mTOR inhibitor was added, the AMPK phosphorylation level and LC3-Ⅱ/LC3-Ⅰ ratio were increased, while mTOR phosphorylation level was reduced in the MPP+ group and MPP++GP group. 
    Conclusion GP can inhibit MPP+ induced apoptosis of SH-SY5Y cells, oxidative stress injury and autophagy partly by AMPK/mTOR pathway.

    Effect of ZEB1 on invasion and metastasis of esophageal cancer cells and its mechanism
    LI Jun-feng, XU Jun, LI Xiao-lei, LI Han-bing
    2021, 42(9):  1016-1021.  doi:10.3969/j.issn.1007-3205.2021.09.005
    Asbtract ( 509 )   PDF (493KB) ( 94 )  
    Related Articles | Metrics
    Objective The effects of zinc finger E-box-binding protein 1(ZEB1) on cell proliferation, invasion and metastasis of esophageal squamous cell carcinoma(ESCC) and its mechanism. 
    Methods Human ESCC cell line EC9706 was selected, and the ZEB1 shRNA was used to transfect EC9706 cells to knock out ZEB1 expression. The cell viability was determined by CCK8 assay. The ability of cell invasion and migration was detected by scratch test. The expression of ZEB1 shRNA after transfection was detected by Real-Time Quantitative PCR(RT-qPCR). Western blot(WB) was used to determine the protein expressions of extracellular regulated protein kinase(ERK) 1/2, p-ERK1/2, E-cadherin and N-cadherin. 
    Results As compared with the control group, down-regulated ZEB1 expression inhibited the cell viability of EC9706 cells as well as invasion and metastasis ability of ESCC（P＜0.05）. Decreased ZEB1 expression reduced the ERK1/2 activation, increased the expression of E-cadherin, and inhibited the expression of N-cadherin（P＜0.05）. 
    Conclusion The inhibition effects of down-regulated expression of ZEB1 on the proliferation, invasion and metastasis of ESCC cells might be related to the inhibition of ERK1/2 activation and regulation of E-cadherin and N-cadherin. 

    Changes of serum ApoA1/B, Hcy and lipoprotein a in patients with T2DM complicated with microvascular complications and their predictive value
    WANG Zhi-min
    2021, 42(9):  1022-1026，1036.  doi:10.3969/j.issn.1007-3205.2021.09.006
    Asbtract ( 499 )   PDF (626KB) ( 86 )  
    Related Articles | Metrics
    Objective To explore the changes and combined predictive value of serum apolipoprotein A1/apolipoprotein B(ApoA1/B), homocysteine(Hcy), and lipoprotein(a)［Lp(a)］ in type 2 diabetes mellitus(T2DM) patients with microvascular complications(MVC). 
    Methods A total of 134 T2DM patients were selected. According to presence of combined MVC, they were divided into MVC group(n=56) and non-MVC group(n=78). The clinical data, serum ApoA1/B, Hcy, and Lp(a) levels were compared between two groups, and the correlation between serum ApoA1/B, Hcy, and Lp(a) and laboratory indicators was analyzed by Pearson correlation analysis. Logistic regression was used to analyze the influencing factors of T2DM with MVC, and receiver operating characteristic(ROC) curve was used to evaluate the single and combined predictive value of serum ApoA1/B, Hcy, and Lp(a) on T2DM with MVC. 
    Results Serum ApoA1/B in MVC group was lower than that in non-MVC group, and Hcy and Lp(a) were higher than those in non-MVC group(P＜0.05). Serum ApoA1/B was negatively correlated with glycosylated hemoglobin(HbAlc), fasting blood-glucose(FBG), 2 h postprandial plasma glucose(2 hPG), serum totalcholesterol(TC), and triglyceride(TG), and Hcy and Lp(a) were positively correlated with FBG, 2 h PG, HbA1c, TC, and TG(P＜0.05). Course of disease, body mass index, combined hypertension, serum ApoA1/B, Hcy, and Lp(a) were influencing factors of T2DM with MVC(P＜0.05). The AUC of combined serum ApoA1/B, Hcy, and Lp(a) in predicting T2DM with MVC was 0.878, the sensitivity was 73.21%, and the specificity was 88.46%, which was better than the individual prediction of each index(P＜0.05). 
    Conclusion The expression level of serum ApoA1/B in T2DM patients with MVC is significantly reduced, and the expression levels of Hcy and Lp(a) are significantly increased. Detecting changes in their level can help predict the occurrence of MVC in patients with T2DM in clinical practice, and provide an effective reference for patient condition assessment, prevention and treatment. 

    Correlation between IRF1, IRF8 levels and carotid atherosclerosis in patients with type 2 diabetic nephropathy
    JIANG Jiao-jiao, SHAO Yun-xia, DONG Xiong-jun, WANG Zheng-xiang, ZHU Ya-ning
    2021, 42(9):  1027-1031.  doi:10.3969/j.issn.1007-3205.2021.09.007
    Asbtract ( 593 )   PDF (426KB) ( 110 )  
    Related Articles | Metrics
    Objective To observe the correlation between the levels of interferon regulatory factor 1(IRF1), interferon regulatory factor 8(IRF8) and carotid atherosclerosis(CAS) in patients with type 2 diabetic nephropathy(T2DN). 
    Methods A total of 149 eligible patients with T2DN treated were selected as the research subjects, and the baseline data of patients at admission were collected. The levels of serum markers ［C-reactive protein(CRP), fibrinogen(FIB)］, IRF1 and IRF8 were detected, and all patients received 6 months of treatment. All patients underwent color Doppler ultrasound examination at 6 months after treatment, and the patients were evaluated for CAS. According to the evaluation results of CAS, the patients were divided into the CAS group and the non-CAS group. Multivariate regression analysis was used to examine the risk factors of CAS in T2DN patients, and the receiver operating curve(ROC) was drawn to analyze the predictive efficacy of serum markers, IRF1 and IRF8 levels on CAS in patients with T2DN. 
    Results At 6 months after treatment, color Doppler ultrasound examination showed that among 149 cases of patients with T2DN, 68 cases had CAS, and the incidence was 45.64%. After preliminary comparison of baseline data of patients with and without CAS, regression analysis results showed that the up-regulation of CRP, FIB, IRF1 and IRF8 expression at admission was related to the occurrence of CAS in T2DN patients, which might be a risk factor of CAS in T2DN patients(OR＞1, P＜0.05).  Area under curve(AUC) of CRP, FIB, IRF1 and IRF8 levels in predicting CAS in T2DN patients at admission was all >0.80, which had certain predictive value. 
    Conclusion The risk of CAS in patients with T2DN is high. The levels of CRP, FIB, IRF1 and IRF8 are risk factors of CAS in T2DN. The up-regulated expression of each index may indicate a high risk of CAS of patients, of which IRF1 and IRF8 levels can be used as an important auxiliary means to predict CAS in patients with T2DN.

    The ROC curve analysis of the ultrasound characteristics of tibial neuropathy in patients with type 2 diabetes mellitus
    YU Dong, WEN Li, ZHANG Tao, GUO Yan, JIN Cheng, MENG Xian-jun
    2021, 42(9):  1032-1036.  doi:10.3969/j.issn.1007-3205.2021.09.008
    Asbtract ( 572 )   PDF (858KB) ( 286 )  
    Related Articles | Metrics
    Objective To compare the ultrasonic morphological indexes of tibial neuropathy in patients with type 2 diabetes mellitus(T2DM), so as to seek the indexes with high diagnostic value in tibial neuropathy in patients with T2DM. 
    Methods Sixty patients with T2DM who underwent lower extremity vascular ultrasound examination and tibial nerve ultrasound examination were reviewed. The patients were included or excluded based on various factors such as gender, age, course of disease, and so on. Subjects were divided into two groups(DPN group and non-DNP group) with 2 points as the diagnostic cut-off value by the Michigan Neuropathy Screening Instrument(MNSI) table. Two groups of data were compared, including width, thickness, cross-sectional area, mesh-like structure, and presence or absence of Doppler energy signal. 
    Results There were no statistically significant differences in tibial nerve width, presence of clear mesh-like structure and presence of Doppler energy signal between two groups(P＞0.05). There were statistically significant differences in tibial nerve thickness and cross-sectional area between two groups(P＜0.05). The sensitivity and specificity of tibial nerve thickness(AUC=0.826) were 84.21% and 73.81% respectively, and positive and negative predictive values were 69.60% and 82.40% respectively. The sensitivity and specificity of cross-sectional area(AUC=0.921) were 94.74% and 85.71% respectively, and positive and negative predictive values were 81.80% and 94.40% respectively. The difference in ROC AUC between tibial nerve thickness and cross-sectional area was statistically significant(P=0.047). 
    Conclusion The diagnostic value of tibial nerve thickness is medium in all ultrasonic features of tibial neuropathy in patients with T2DM, and when the cut-off value is 3.62 mm, the ideal efficacy can be obtained. The diagnostic value of cross-sectional area is relatively high, and when the cut-off value is 21.0 mm2, the ideal efficacy can be obtained.

    Effects of different types of high-protein nutritional support on critically ill patients
    LU Peng, YANG Xiu-fen, ZHAO Bin
    2021, 42(9):  1037-1041.  doi:10.3969/j.issn.1007-3205.2021.09.009
    Asbtract ( 473 )   PDF (401KB) ( 101 )  
    Related Articles | Metrics
    Objective To investigate the effects of different types of high-protein nutritional support on nutritional status, immune function and treatment outcome of critically ill patients. 
    Methods A total of 90 critically ill patients treated in our hospital were randomly divided into control group, protein powder group and amino acid group, with 30 cases in each group. The three groups were given equal non-protein calories［25 kcal·kg-1·d-1］. On this basis, the control group was only given enteral nutrition emulsion TPF, the protein powder group was given whey protein powder［1.5-2.0 g·kg-1·d-1］, and amino acid group was given compound amino acid［1.5-2.0 g·kg-1·d-1］. The three groups were intervened for 2 weeks. The treatment conditions (duration of ICU stay, duration of mechanical ventilation), incidence of adverse events, nutrition-related indicators and T lymphocyte subsets were recorded before intervention and at 1 and 2 weeks after intervention.  
    Results The duration of ICU stay and duration of mechanical ventilation were shorter in protein powder group and amino acid group than in control group; nutritional status and immune function at 1 and 2 weeks after intervention were higher in protein powder group and amino acid group than in control group(P＜0.05). There was no significant difference in the incidence of adverse reactions among three groups(P＞0.05). 
    Conclusion High-protein enteral nutrition support can improve the immune function, correct malnutrition,and improve the treatment outcome. 

    Clinical decision support system helps to improve the compliance of bundle therapy for septic shock
    LIU Chun-xia, ZHANG Kun, HAO Gui-zhen, HAN Wei-yan, GE Lan, SHEN Li-min
    2021, 42(9):  1042-1045，1088.  doi:10.3969/j.issn.1007-3205.2021.09.010
    Asbtract ( 595 )   PDF (410KB) ( 411 )  
    Related Articles | Metrics
    Objective To improve the compliance and implementation rate of bundle therapy for septic shock. 
    Methods A total of 144 patients with septic shock were randomly divided into control group and experimental group. The control group completed the established bundle treatment measures within 1 h, 3 h and 6 h after the diagnosis of septic shock according to the guidelines. The experimental group used the septic shock quality control module of intelligent clinical decision support system for severe diseases to establish the bundle treatment path process within 1 h, 3 h and 6 h after the diagnosis of septic shock. The system timely and repeatedly reminded the medical staff in each specific time period until the indicators of septic shock bundle treatment measures were completed. The effects of bundle therapy were compared between two groups, including 1 h, 3 h and 6 h target completion rate, mean arterial pressure（MAP）, central venous pressure（CVP）, central venous oxygen saturation（ScvO2）, 6-hour lactate clearance rate(LCR), urine volume, norepinephrine dose and outcome indicators. 
    Results The target completion rates of 1 h, 3 h and 6 h in the experimental group were higher than those in the control group(P＜0.05). There was no significant difference in MAP, CVP and urine volume between two groups(P＞0.05). ScvO2 and 6 h LCR in the experimental group were lower than those in the control group, while norepinephrine dose was higher than that in the control group(P＜0.05), and the length of ICU stay in the experimental group was shorter than that in the control group(P＜0.05). There was no significant difference in 28-day mortality between two groups(P＞0.05). 
    Conclusion Intelligent clinical decision support system for severe diseases can timely warn and diagnose septic shock through data collection and analysis. Timely and repeated reminders within a specific period of time can promote the effective implementation of various projects of septic shock bundle therapy, significantly improve the therapeutic effect in the treatment of patients with septic shock, and improve the treatment efficiency of septic shock and the quality of medical care. 

    Effects of different surgical methods on hip joint range of motion, immune inflammatory response and coagulation-fibrinolysis system in patients with displaced femoral neck fracture
    HU Yi-ping, LIU Xiao-hui, CAI Fu-jin, TANG Ke, JIANG Jia-yao
    2021, 42(9):  1046-1051.  doi:10.3969/j.issn.1007-3205.2021.09.011
    Asbtract ( 427 )   PDF (435KB) ( 316 )  
    Related Articles | Metrics
    Objective To investigate the effects of different surgical methods on hip joint range of motion(ROM), immune inflammatory response and coagulation-fibrinolysis system in patients with displaced femoral neck fractures. 
    Methods A total of 92 patients with displaced femoral neck fractures in our hospital were prospectively selected as the research subjects and were divided intototal hip arthroplasty(THA)group(n=48) and hemiarthroplasty(HA)group(n=44). The perioperative indicators, postoperative complication rate, surgical efficacy, total cost, functional recovery scale(FRS) score and cost-effectiveness ratio(CER), hip joint ROM score before and after surgery, immune inflammatory indexes ［interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), interleukin -1β(IL-1β)］, coagulation-fibrinolytic system indicators ［kaolin partial thromboplastin time(KPTT), prothrombin time(PT), plasminogen activator inhibitor(PAI), D-dimer(D-D)］ before and after surgery were statistically compared between two groups. 
    Results The duration of operation, intraoperative blood loss and length of hospital stay in THA group were longer or more than those in HA group(P＜0.05). The scores of hip joint ROM were increased, and the scores were higher in THA group than in HA group. There was significant difference in the interaction between groups, time points and time points between groups(P＜0.05). The excellent and good rate of THA group was higher than that of HA group, while the incidence of postoperative complications was lower than that of HA group(P＜0.05). The levels of IL-6, TNF-α, IL-1β, KPTT, PT, PAI and D-D increased initially and then decreased in both groups, which were higher in THA group than in HA group; there were significant differences in the interaction between groups, time points and time points between groups(P＜0.05). The total cost and CER within 2 years in THA group were higher than those in HA group(P＜0.05). There was no significant difference in FRS score between two groups(P＞0.05). 
    Conclusion Compared with HA, the application of THA in the treatment of patients with displaced femoral neck fractures has greater surgical trauma and higher overall costs, but the hip function is improved more significantly. If the patient′s age, life expectancy, physical condition and economic conditions are appropriate, THA is recommended. 

    Anteromedial cortical support for intertrochanteric femurfractures affects the functional prognosis of elderly patients
    HAN Xiao-hui, ZHANG Xi, REN Xin-xin, GUO Jia-liang, HAN Yong-tai
    2021, 42(9):  1052-1056.  doi:10.3969/j.issn.1007-3205.2021.09.012
    Asbtract ( 493 )   PDF (815KB) ( 60 )  
    Related Articles | Metrics
    Objective To compare the effect of positive or negative anterior cortical support for intertrochanteric femur fractures on postoperative rehabilitation of patients. 
    Methods A total of 140 patients with intertrochanteric femur fractures were enrolled. All of them were divided into positive group and negative support group. The patient′s recovery and training plan after operation were observed, and the patient′s bleeding volume, weight-bearing time, Harris scores, and visual analogue scale/score(VAS)were recorded. 
    Results The postoperative functional rehabilitation and weight-bearing time of stable fracture group were not influenced by the type of support， but there was a significant difference in duration of operation(P＜0.05). Significant difference was found in weight-bearing time, Harris scores andVAS scores in positive and negative support of unstable fracture group(P＜0.05). 
    Conclusion For stable fracture, positive support or partial negative support all can achieve satisfactory postoperative rehabilitation. For unstable fracture, positive support or neutral support is mandatory, otherwise it will lead to serious postoperative complications. Postoperative CT examination should be used routinely to guide the surgeon to develop a more individualized treatment plan.
    The value of FSH/LH in assessing poor ovarian response in normal AMH population
    WANG Zi-wei, FAN Yan-li, XIN Xin, XU Xin, ZHAO Pan, HAO Gui-min
    2021, 42(9):  1057-1062.  doi:10.3969/j.issn.1007-3205.2021.09.013
    Asbtract ( 532 )   PDF (469KB) ( 91 )  
    Related Articles | Metrics
    Objective To study whether the increase of follicle-stimulating hormone/luteinizing hormone(FSH/LH) in the population with normal anti-müllerian hormone(AMH) is related to the occurrence of poor ovarian response(POR), in order to determine the diagnostic threshold. 
    Methods A total of 4 363 cycles of patients undergoing in vitro fertilization-embryo transfer(IVF-ET) at the reproductive center of our hospital were analyzed. The relationship between FSH/LH and POR in the population with 1.1＜AMH＜6 μg/L was analyzed through the method of smooth curve fitting, to find the threshold or saturation point, based on which the population was grouped. The population characteristics, cycle information, and cycle outcome of the two groups were compared, and an increase in FSH/LH, and changes in POR and cycle outcome were analyzed. 
    Results In the population with normal AMH, smooth cure fitting found that with the increase of FSH/LH level, the incidence of POR was increased, and the optimal saturation point was 3.3 by threshold and saturation analysis. By comparing FSH/LH＞3.3 group with FSH/LH＜3.3 group, age, body mass index(BMI), FSH, the starting dose of gonadotropins(Gn) and the total dose of Gn were significantly increased, whereas AMH, AFC, basal LH, E2, the total number of eggs obtained, the rate of transferable embryos, the E2 and P levels on the trigger day were all decreased(P＜0.05). 
    Conclusion In the process of controlled ovarian hyperstimulation(COH), AMH is a reliable indicator to predict ovarian responsiveness. In the population with normal AMH, the incidence of POR increases with the increase of FSH/LH. FSH/LH:3.3 is a saturation value, but the accuracy of predicting the occurrence of POR is only 23%. In the population with elevated FSH/LH, both the increase of FSH and the decrease of LH are related to the occurrence of POR. The increase of FSH/LH reduces the final number of eggs obtained and the rate of transferable embryos, but does not affect the rate of high-quality embryos and the final pregnancy rate.  

    The effect of silencing miR-26b viaPI3K/Akt pathway on proliferation and apoptosis of placental trophoblastic cells in patients with pregnancy-induced hypertension
    ZHANG Jia-hui, MA Hong-yun, QIN Juan
    2021, 42(9):  1063-1067.  doi:10.3969/j.issn.1007-3205.2021.09.014
    Asbtract ( 370 )   PDF (1254KB) ( 31 )  
    Related Articles | Metrics
    Objective To analyze the effects of silencing micro RNA-26b(miR-26b) on proliferationand apoptosis of placental trophoblastic cells and PI3K/Akt pathway in patients with pregnancy-induced hypertension(PIH). 
    Methods Human placental trophoblastic cells were purchased, and induced by 100 μmol/L N-nitro-L-arginine methyl ester to simulate the microenvironment of PIH. The blank group(N-nitro-L-arginine methyl ester induced placental trophoblastic cells), the overexpression group(N-nitro-L-arginine methyl ester induced placental trophoblastic cells which was transfected with miR-26b for overexpressionplasmid transfection), and the silence group(N-nitro-L-arginine methyl ester-induced placental trophoblastic cells that were silenced by miR-26b for plasmid transfection). Cell proliferation, apoptosis and PI3K/Akt pathway protein expression were detected. 
    Results Compared with the blank group, the expression of miR-26b was increased in the overexpression group and decreased in the silencing group(P＜0.05), indicating that miR-26b was successfully transfected. The cell proliferation rate at 24 h, 48 h and 72 h in the overexpression group was gradually decreased, while that of the silence group was gradually increased, and the differences between groups, time points and time points between groups were statistically significant in three groups(P＜0.05).Compared with the blank group, the expression of PI3K, p-PI3K, Akt, p-Akt and Bcl-2 protein was decreased and the expression of Bax protein was increased in the overexpression group(P＜0.05). Compared with the blank group, the expression of PI3K, p-PI3K, Akt, p-Akt and Bcl-2 protein was increased and the expression of Bax protein was decreased in the silencing group(P＜0.05). Compared with the overexpression group, the expression of PI3K, p-PI3K, Akt, p-Akt and Bcl-2 protein was increased and the expression of Bax protein was decreased in the silencing group(P＜0.05). 
    Conclusion Silencing miR-26b can inhibit apoptosis and promote proliferation of placental trophoblastic cells in patients with PIH, and its underlying mechanism may be related to the activation of PI3K/Akt pathway. 

    Stevens-Johnson syndrome and toxic epidermal necrolysis in children: a retrospective study
    GUO Fang, KANG Lei, BAI Xin-feng, WU Xiao-yuan, LI Wen-hui
    2021, 42(9):  1068-1072.  doi:10.3969/j.issn.1007-3205.2021.09.015
    Asbtract ( 453 )   PDF (403KB) ( 74 )  
    Related Articles | Metrics
    Objective To analyze the etiology, clinical characteristics, treatment management, complications, and prognosis of children with stevens-Johnson syndrome(SJS), toxic epidermal necrolysis(TEN) and SJS/TEN. 
    Methods Clinical data of 32 children with SJS, 28 children with SJS/TEN and 25 children with TEN were retrospectively reviewed. 
    Results The most common pathogenic drugs were antibiotics(31.7%), proprietary Chinese medicines（30.6%）， non-steroidal anti-inflammatory drugs(NSAIDs)(17.6%) and anticonvulsants(14.1%). Mycoplasma pneumoniae(21cases, 24.7%) was the most common pathogen.In addition, 32(37.6%) patients experienced at least one complication, and the most common complication was infection in 26 cases(30.6%), including 12(14.1%) children with skin infection and 8(9.4%) children with lower respiratory tract infection. During hospitalization period, 8 patients received immunoglobulin therapy alone, 35 patients received intravenous glucocorticoid therapy alone, and 37 children received both simultaneously. The mortality rate of the intravenous immunoslobulin combined hormone group was the lowest; 8 patients died, and mortality rate was 9.4%. The severity-of-illness score for toxic epidermal necrolysis(SCORTEN) score of the deceased was higher than that of the survivor on the first day of admission(P＜0.05). 
    Conclusion Antibiotics and proprietary Chinese medicines are the most  common pathogenic drugs, and skin infection is the most common complication. The mortality risk will increase when SCORTEN score＞3 points, therefore, systematic therapy of glucocorticoids and early administration of intravenous immunoglobulin may be an effective means to treat SJS and TEN.

    Application analysis of laparoscopic surgery in children with  congenital choledochus dilatation
    JIN Ming-jun, DONG Liang, YANG Hong, DONG Ying, BAO Guo-qiang, CUI Hua-lei
    2021, 42(9):  1073-1077.  doi:10.3969/j.issn.1007-3205.2021.09.016
    Asbtract ( 325 )   PDF (872KB) ( 26 )  
    Related Articles | Metrics
    Objective To explore the effect and safety of laparoscopic surgery on children with congenital choledochus dilatation(CCD). 
    Methods A total of 50 children with CCD who underwent laparoscopic surgery were selected as the research subjects(the observation group), and 50 children with CCD who underwent laparotomy during the same period were selected as the control group. Both groups underwent the resection of bile duct cysts and Roux-Y anastomosis of common hepatic duct-jejunum. The operation-reelated conditions of two groups were compared, and the liver function indexes and inflammation indexes of the two groups were detected before and after operation. 
    Results The duration of operation was longer in the observation group than in the control group, the intraoperative bleeding volume was lower than that of the control group, and the postoperative defecation time, postoperative time of food intake and postoperative hospital stay were shorter than those of the control group(P＜0.05). There were significant differences in the level of total bilirubin(TBIL), alanine aminotransferase(ALT), aspartate transaminase(AST), C-reactive protein(CRP) and interleukin 6(IL-6) in the observation group and the control group from 1 d before operation to 7 d after operation, and the incidence of complications was lower in the observation group than in the control group, suggesting significant difference(χ2=5.316，P＜0.05). There was no significant difference in the average operation and hospitalization expenses between two groups(t=1.518, P＞0.05). 
    Conclusion Compared with the laparotomy, the laparoscopic resection of bile duct cysts combined with Roux-Y anastomosis of common hepatic duct-jejunum can effectively reduce the traumatic stress and inflammatory response, with faster postoperative recovery and fewer complications.

    Study on the relationship between the quantitative parameters of IVIM imaging and the pathological characteristics of prostate cancer and the combined diagnosis
    HUANG Ji-wei, LI Jian-fei, WANG Jia, LIU Guo-kun, LI Jian-li, WANG Yu-fang
    2021, 42(9):  1078-1083.  doi:10.3969/j.issn.1007-3205.2021.09.017
    Asbtract ( 702 )   PDF (619KB) ( 125 )  
    Related Articles | Metrics
    Objective To study the relationship between the quantitative parameters of intravoxel incoherent motion(IVIM) imaging in small visual field and the pathological characteristics of prostate cancer(PC) and the value of combined diagnosis. 
    Methods A total of 62 PC patients were selected as the observation group, and 62 patients with benign prostatic hyperplasia were selected as the control group. The general information and quantitative parameters of IVIM technology imaging ［pseudo diffusion coefficient(D*), perfusion fraction(f), diffusion coefficient(D), apparent diffusion coefficient(ADC)］ were compared between two groups. The receiver operating characteristic curve(ROC) was used to analyze the imaging quantitative parameters of IVIM technology and the value of the combined diagnosis of PC, and the imaging quantitative parameters of IVIM technology in patients with different pathological characteristics were compared. Spearman and Pearson were used for correlation analysis. 
    Results The D and ADC of the observation group were lower than those of the control group(P＜0.05). There was no statistically significant difference in D* and f between two groups(P＞0.05). ROC analysis results showed that the AUC values of D and ADC in the diagnosis of PC were 0.800 and 0.773, respectively, and the AUC value of D combined with ADC in the diagnosis of PC was 0.865(P＜0.05). Logit(p) was used as an independent test variable, and the results showed that the AUC value of combined detection in the diagnosis was greater than that of single parameter detection alone(P＜0.05). No significant difference was found in D and ADC in patients with different 2016 editions of renal cancer WHO urology curriculum/International Society of Urological Pathology(ISUP) grade, D′Amico risk, tumor T stages, and Gleason scores(P＜0.05). There was no significant difference in D and ADC in patients with different tumor size and PSA level D(P＞0.05). D and ADC were negatively correlated with ISUP grade, Gleason score, D′Amico risk, and tumor T stages(P＜0.05). 
    Conclusion Among the quantitative parameters of IVIM technology imaging, D and ADC have high sensitivity and specificity in diagnosing PC, and the parameter values are closely related to pathological characteristics. The combination of the two can not only further improve the diagnostic efficiency, but also provide a reference for clinical evaluation of pathological characteristics, and facilitate the formulation of treatment plans. 

    The effects of sevoflurane anesthesia on the expressions of IL-1, ICAM-1 after operation and lung complications in elderly patients with lung cancer
    WANG Xue-ping, ZHANG Hong-yu, CHEN Hai-ming
    2021, 42(9):  1084-1088.  doi:10.3969/j.issn.1007-3205.2021.09.018
    Asbtract ( 396 )   PDF (426KB) ( 73 )  
    Related Articles | Metrics
    Objective To investigate the effects of sevoflurane anesthesia on the expressions of interleukin-1(IL-1), intercellular cell adhesion molecule-1(ICAM-1) after operation and lung complications in elderly patients with lung cancer. 
    Methods A total of 128 elderly patients with lung cancer were selected and divided into research group(n=64) and control group(n=64) according to the random number table method. The elderly lung cancer patients in both groups received surgery. The control group was given propofol general anesthesia before operation, and the research group was given sevoflurane anesthesia. The mini mental state examination scale(MMES) score, the incidence of postoperative cognitive impairment, the levels of serum inflammatory factors［interleukin-1(IL-1), intercellular cell adhesion molecule-1(ICAM-1), vascular endothelial growth factor(VEGF)］, pain mediators ［substance P(SP), bradykinin(BK), interleukin-6(IL-6)］ and postoperative complications were compared between the two groups. 
    Results The MMSE scores of the two groups both decreased initially and then increased; the fluctuation range of the MMSE scores of the research group was smaller than that of the control group, and the differences in the interaction between groups, time points, and time points between groups were statistically significant(P＜0.05). The incidence of cognitive impairment in the research group at 8 h, 24 h, and 3 d after surgery was significantly lower than that in the control group, and the difference was statistically significant(P＜0.05). After operation, the levels of IL-1, ICAM-1, and VEGF in the two groups were significantly lower than those before operation, and the levels of IL-1, ICAM-1, and VEGF in the research group were significantly lower than those of the control group, with significant difference(P＜0.05). The levels of SP, BK, and IL-6 in the two groups were significantly lower than those before surgery, and the levels of SP, BK, and IL-6 in the research group were significantly lower than those in the control group, suggesting significant difference(P＜0.05). The incidence of complications such as pneumonia, purulent sputum, fever and positive sputum culture in the research group was significantly lower than that in the control group, and the difference was statistically significant(P＜0.05). 
    Conclusion Sevoflurane anesthesia can effectively improve the postoperative cognitive function of elderly patients with lung cancer, and reduce the incidence of cognitive impairment, the levels of serum inflammatory factors, pain mediators and the incidence of lung complications, which is safe and effective.

    Study on the effect of nerve block in ward and postoperative PCIA on pain degree， pain mediators and stress state of elderly orthopedic patients during perioperative period
    ZHANG Ming-min, LUO Fang-yi, PANG Bo
    2021, 42(9):  1089-1093.  doi:10.3969/j.issn.1007-3205.2021.09.019
    Asbtract ( 347 )   PDF (395KB) ( 49 )  
    Related Articles | Metrics
    Objective To study and observe the effect of nerve block in ward and postoperative patient controlled intravenous analgesia（PCIA） on pain degree， pain mediators and stress state of elderly orthopedic patients during perioperative period. 
    Methods A total of 90 elderly orthopedic patients were selected as the research subjects， and they were randomly divided into group A（postoperative PCIA group）， group B（“Cocktail” local injection analgesia and PCIA group） and group C（nerve block in ward and postoperative PCIA group）, with 30 cases in each group. Then the visual analogue scale(VAS) score at 2 h， 4 h， 6 h， 12 h， 24 h and 48 h after operation， serum pain mediators and stress state（stress hormones and oxidative stress）indexes at admission and at 12 h， 48 h after operation of three groups were compared. 
    Results The VAS scores of three groups at 2 h， 4 h， 6 h， 12 h， 24 h and 48 h after operation increased initially and decreased afterwards， and the VAS scores of group C were significantly lower than those of group A and group B，and the scores of group B were significantly lower than those of group A，suggesting significant differences（P＜0.05）. There was no significant difference in the serum pain mediators and stress state indexes of three groups （P＞0.05）. The serum pain mediators and stress hormones of three groups at 12 h and 48 h after operation increased initially and decreased afterwards; the serum pain mediators and stress hormone indexes of group C were all significantly lower than those of group A and group B, and the results of group B were significantly lower than those of group A. The serum pain mediators and stress hormones of three groups at 12 h and 48 h after operation increased initially and decreased afterwards; serum oxidative stress indexes of group C were all significantly higher than those of group A and group B， and the results of group B were significantly higher than those of group A，with significant differences（P＜0.05）.  
    Conclusion The nerve block in ward and postoperative PCIA can effectively control the pain degree of elderly orthopedic patients during perioperative period， and its influence on pain mediators and stress state are relatively better. Therefore, its application value is higher in elderly patients undergoing orthopedic surgery.