Table of Content

25 December 2021, Volume 42 Issue 12

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Investigation into the change of β-amyloid protein, tau protein and miR-related indexes of patients with vascular dementia and their correlation with severity of disease

JIANG Chun-lei, ZHAI Bao-lei, YAN Xing-chen

2021, 42(12):  1372-1375.  doi:10.3969/j.issn.1007-3205.2021.12.002

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Objective  To investigate the change of β-amyloid protein, tau protein and miR-related indexes of patients with vascular dementia and their correlation with severity of vascular dementia. 
Methods  A total of 79 patients with vascular dementia were selected as the observation group, and 79 healthy persons undergoing physical examination during the same period were selected as the control group. Then the serumβ-amyloid protein（Aβ1-40 and Aβ1-42）, tau protein（tau and p-tau） and miR-related indexes（miR-34a, miR-132 and miR-135） of the two groups were detected and compared, and the detection results of observation group with different severity of vascular dementia were compared. Then the correlation between those β-amyloid protein,tau protein, miR-related indexes and severity of vascular dementia was analyzed with Spearman rank correlation analysis. 
Results  The serum Aβ1-42, miR-132 and miR-135 of observation group were significantly lower than those of control group, while the serum Aβ1-40, tau protein and miR-34a were significantly higher than those of control group, suggesing significant differences（P＜0.001）. Those detection results of observation group with different severity of vascular dementia were compared, and there were statistically significant differences（P＜0.001）. The Spearman rank correlation analysis showed the serum Aβ1-42, miR-132 and miR-135 were negatively correlated with severity of vascular dementia, while the serum Aβ1-40, tau protein and miR-34a were positively correlated with severity of vascular dementia（P＜0.05）. 
Conclusion  The β-amyloid protein, tau protein and miR-related indexes of patients with vascular dementia show significantly abnormal state, and they all have close correlation to the severity of disease. Therefore, their detection value in the patients with vascular dementia is higher.





Chinese reports of STK11 mutations in Peutz-Jeghers Syndrome: a qualitative study

JIANG Yu-liang, LI Wei-cong, ZHAO Zi-ye, WU Jing, NING Shou-bing, LIU Hong

2021, 42(12):  1376-1381.  doi:10.3969/j.issn.1007-3205.2021.12.003

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Objective  To perform a qualitative study on pathogenic mutations in STK11 gene in Chinese patients with Peutz-Jeghers syndrome(PJS), to analyze the existing ambiguity and faults, and to explore the potential cause. 
Methods  A comprehensive review of STK11 mutations reported in Chinese PJS patients was conducted, and the mutations were critically checked and compared to the information of accessible databases. 
Results  In total, 181 different mutations were found to be recorded in 55 literature, within which 108 was firstly reported by Chinese scholars. Within the 108 mutations, 27 were misidentified(22 recurrent and 5 novel), which was 25.0% of all the cases reported in these articles. The main reasons for misreporting mutations included incomplete database collection, distorted former information misled by wrong information, insufficient literature review, novel ones reported twice in a short period of time and naming errors due to repeated sequences. 
Conclusion  Error reporting happens due to several various reasons, therefore,it is very important and necessary to clarify the wrong information for the genetic counseling of PJS and related research.





Efficacy of meglumine cyclic adenosine phosphate combined with sodium creatine phosphate in the treatment of patients with acute myocardial infarction and heart failure and its influence on the expression of CPP and sNEP

HUANG Ling-fang, ZHOU Song, LIU Li-jie, DI Ning-ning, GAO Yan-zhou

2021, 42(12):  1382-1386.  doi:10.3969/j.issn.1007-3205.2021.12.004

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Objective  To study the efficacy of meglumine cyclic adenosine phosphate combined with sodium creatine phosphate in the treatment of patients with acute myocardial infarction(AMI) and heart failure and its influence on the expression of copeptin(CPP) and neprilysin(sNEP). 
Methods  A total of 134 patients with AMI and heart failure in our hospital were divided into control group(n=67) and observation group(n=67) according to the random number table method. They all received conventional treatment. The control group was treated with meglumine cyclic adenosine monophosphate, and the observation group was treated with meglumine cyclic adenosine monophosphate combined with sodium creatine phosphate. The curative effects, cardiac function, coronary hemodynamics, and changes in serum CPP and NEP of the two groups were compared, and the main adverse cardiovascular events during one-month follow-up were recorded. 
Results  The effective rate of the observation group was higher than that of the control group(P＜0.05). After treatment, the indexes of coronary hemodynamics in the two groups increased, and the systolic peak velocity, diastolic peak velocity and time velocity integral in the observation group were higher than those in the control group(P＜0.05). After treatment, left  ventricular end diastolic volume and left ventricular end systolic volume decreased, while left ventricular ejection fraction increased significantly; the levels of indexes in the observation group were better than those in the control group(P＜0.05). After treatment, the serum CPP and NEP decreased, which were lower in the observation group than in the control group(P＜0.05). The main adverse cardiovascular events were angina pectoris, myocardial infarction and recurrent heart failure within one-month follow-up, and the incidence of major adverse cardiovascular events in the observation group was lower than that in the control group(P＜0.05). 
Conclusion  Meglumine adenosine cyclophosphate combined with creatine phosphate sodium in the treatment of AMI with heart failure has a significant curative effect. It can reduce the serum levels of CPP and NEP, improve coronary hemodynamic status and cardiac function, and reduce the risk of major adverse cardiovascular events, with good safety.





Value of adhesion factors and renal resistance index in the prediction of early renal function recovery of patients with sepsis-associated acute kidney injury

LI Yan, HUANG Qing-sheng, FANG Ming-xing, ZHANG Li-xia, GUO Jian-ying, WANG Zhi-yong

2021, 42(12):  1387-1391,1396.  doi:10.3969/j.issn.1007-3205.2021.12.005

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Objective  To explore the predictive value of adhesion factors and renal resistance index(RRI) for early renal function recovery of patients with sepsis-associated acute kidney injury(AKI). 

Methods  Patients with sepsis-associated AKI treated in the Third Hospital of Hebei Medical University were enrolled as research subjects. General information of patients was collected. The patient's RRI was detected by bedside ultrasound, and plasma E-selectin, L-selectin and P-selectin as well as the levels of endothelial cell adhesion molecule-1(ICAM-1) and vascular cell adhesion molecule-1(VCAM-1) were measured by enzyme-linked immunosorbent assay(ELISA). They were followed up for 1 month. With renal function recovery at 30 d after enrollment as the standard, the subjects were divided into the renal function recovery group and the non-renal function recovery group. Logistic regression analysis method and receiver operating characteristic(ROC) curve were used to analyze the predictive value of RRI, adhesion factor, RRI combined with adhesion factor in the recovery of renal function in patients with sepsis-associated AKI. 
Results  A total of sepsis-associated AKI 78 patients, including 54 males and 24 females with a mean age of(70.8±23.3) years, were enrolled in this study. The expression of VCAM-1 in patients with sepsis-associated AKI was lower in the early renal function recovery group than in the non-renal function recovery group(P=0.0355). The APACHEⅡ score and white blood cell count of the early renal function recovery group were significantly lower than those of the non-renal function recovery group(P＜0.05). According to ROC analysis, the sensitivity and specificity of VCAM-1 combined with RRI in predicting early renal function recovery were 90.9％ and 32.1% respectively, with AUC=0.68． 
Conclusion  Combination of RRI and VCAM-1 has a high predictive value for early renal function recovery of patients with sepsis-associated AKI. The threshold of RRI is 0.71, and the threshold of VCAM-1 is 1 233 ng/L, which can be used as a predictor of early renal function recovery in patients with sepsis-associated AKI. 





Correlation study between circulating CD4+ T cell subsets and diabetic kidney disease in patients with type 2 diabetes mellitus

CHENG Liang, XU Yong

2021, 42(12):  1392-1396.  doi:10.3969/j.issn.1007-3205.2021.12.006

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Objective  To investigate the changes and significance of circulating CD4+T cell subsets in patients with type 2 diabetes mellitus (T2DM) and diabetic kidney disease(DKD). 
Methods  We recruited 113 patients with newly diagnosed T2DM and 30 healthy volunteers, and compared the differences of the CD4+ T cell subsets, including Th1, Th2 and Tregs, in the peripheral blood of subjects from the three groups. Spearman's rank correlation analysis was conducted to explore the correlation between estimated glomerular filtration rate(eGFR) and CD4+ T cell subsets. Multiple linear regression analysis was used to explore the influencing factors of eGFR changes. 
Results  There were significant differences in the proportion of peripheral blood Th1, Th1/Th2 ratio and the proportion of Tregs among three groups. The Th1 ratio and Th1/Th2 ratio in patients with T2DM and DKD were higher than those of control group, while the proportion of Tregs was lower than that of control group. Moreover, the proportion of Th1 and Th1/Th2 ratio in patients with DKD were higher than those of T2DM group, and the proportion of Tregs was lower than that of T2DM group. There was a negative correlation between the Th1/Th2 ratio and eGFR, and a positive correlation between the proportion of Tregs and eGFR. Multiple linear regression analysis revealed that systolic blood pressure, Tregs, Th1/Th2 ratio and total cholesterol were risk factor for eGFR in patients with T2DM. 
Conclusion  Imbalance in CD4+T cell homeostasis is present in patients with DKD, which is closely related to the decrease of eGFR level. 





Investigation into the relationship between renal blood flow indexes, inflammatory chemokines and insulin resistance of patients with hypertensive renal injury

YANG Zhen, TANG Ke-fei, CHEN Xiao-zhu, LIU Shu-jun, DU Yan-hua

2021, 42(12):  1397-1400,1410.  doi:10.3969/j.issn.1007-3205.2021.12.007

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Objective  To investigate the relationship between renal blood flow indexes, inflammatory chemokines and insulin resistance of patients with hypertensive renal injury. 
Methods  A total of 80 patients with hypertensive renal injury were chosen as the observation group, and in the meantime, 80 patients with hypertension and without renal injury  were chosen as the control group. The renal blood flow indexes and inflammatory chemokines(serum CCL-2， CXCL-10 and IL-8) of two groups were detected and compared， and the renal blood flow indexes and inflammatory chemokines of observation group with different insulin resistance index were compared. The relationship between renal blood flow indexes，inflammatory chemokines and insulin resistance was analyzed with Spearman rank correlation analysis. 
Results  Peak velocity of the systolic wave(Vs) and end diastolic peak flow velocity(Vd)of the segmental renal artery and interlobar renal artery were significantly lower in the observation group than in the control group, while resistance index(RI)，pulsatility index(PI)and inflammatory chemokines of the segmental renal artery and interlobar renal artery were significantly higher than those of control group; the renal blood flow indexes and inflammatory chemokines of observation group with different insulin resistance indexes were compared，and there were statistically significant differences(P＜0.05). The Spearman rank correlation analysis showed that Vs and Vd of the segmental renal artery and interlobar renal artery were negatively correlated with insulin resistance， while the segmental renal artery and interlobar renal artery RI， PI and inflammatory chemokines were positively correlated with  insulin resistance（P＜0.05）. 
Conclusion  The renal blood flow indexes and inflammatory chemokines of patients with hypertensive renal injury are significantly abnormal， which are all closely associated with insulin resistance. Thus, detection and regulation of those indexes should warrant attention.





Clinical observation of liraglutide in the treatment of overweight and obese type 2 diabetes mellitus with nephropathy

WANG Xin, LEI Lin, LU Cai-ping, LIU Chen-xi, REN Qiao-hua, WU Tao

2021, 42(12):  1401-1405.  doi:10.3969/j.issn.1007-3205.2021.12.008

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Objective  To observe the clinical efficacy of liraglutide in the treatment of overweight, and obese type 2 dabetes mellitus(T2DM) complicated with nephropathy. 
Methods  Seventy overweight and obese T2DM patients with glycated hemoglobin(HbA1c)(7%≤HbA1c≤11%) were selected and randomly divided into two groups: insulin combined with metformin and/or acarbose group(insulin group) and liraglutide combined with metformin and/or acarbose group(liraglutide group). Before and at 24 weeks after treatment, body weight(WT), waist circumference(WC), HbA1c, insulin resistance index(HOMA-IR), urinary albumin creatinine ratio(UACR), estimation glomerular filtration rate(eGFR), serum and urinary α1 microglobulin(α1-MG), serum and urinary β2 microglobulin(β2-MG), and other indicators were analyzed. 
Results  At the end of the study, 30 patients in the insulin group completed the study and 31 patients in the liraglutide group completed the study. Compared with those before treatment, HbA1c, HOMA-IR, UACR, eGFR, serum α1-MG, urinary α1-MG, blood β2-MG and urinary β2-MG in the insulin group were lower significantly after treatment, which showed significant difference(P＜0.01). After treatment, WT, WC, body mass index, HbA1c, HOMA-IR, UACR, EGFR, serum α1-MG, urinary α1-MG, blood β2-MG, urinary β2-MG decreased significantly in liraglutide group compared with those before treatment, with statistical significance(P＜0.01). After treatment, UACR, eGFR, serum α1-MG, urinary α1-MG and urinary β2-MG decreased more significantly in the liraglutide group than in the insulin group, with statistical significance(P＜0.05). 
Conclusion  In the treatment of overweight and obese T2DM patients with nephropathy, liraglutide can not only reduce blood glucose and weight, but also improve renal function and delay the progression of nephropathy, and this effect is independent of the effect of lowering blood glucose.





Research on risk factors of hyperuricemia in diabetic nephropathy

LI Xiao-dong, LI Xin-yue, HAN Yong-bin, LI Bao-xin

2021, 42(12):  1406-1410.  doi:10.3969/j.issn.1007-3205.2021.12.009

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Objective  To explore the risk factors of hyperuricemia(HU) in diabetic nephropathy(DN) patients. 
Methods  In total, 350 patients with type 2 DM admitted to the First Central Hospital of Baoding City, Hebei Province, were divided into the HU group(observation group, n=150) and the normal serum uric acid group(control group, n=200). The general characteristics and clinical parameters of the two groups were compared, and the variables with statistical differences were statistically analyzed by binary Logistic regression. 
Results  The body mass index(BMI), low density lipoprotein-cholesterol(LDL-C), glycosylated hemoglobin A1c(HbA1c), 24 hour urinary protein(24 hUpro), C-reactive protein(CRP) and serum creatinine(SCr) in the observation group were higher than those in the control group(P＜0.05). The results of regression analysis showed that BMI, CRP, LDL-C and 24hUpro were independent related factors of HU in DN(P＜0.05). 
Conclusion  The independent risk factors of  HU in DN patients are BMI,CRP, LDL-C, and 24hUpro in our study.Therefore, early diagnosis and treatment-related measures should be carried out to extend the survival of patients with DN.





The relationship between sleep duration and self-reported diabetes in the middle-aged and old residents

TANG Li-juan, LI Yu, ZHANG Fan, LIU Yu-huan, ZHAO Jing-jing, CAO Ya-jing

2021, 42(12):  1411-1416,1431.  doi:10.3969/j.issn.1007-3205.2021.12.010

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Objective  To explore the relationship between sleep duration and self-reported diabetes in the middle-aged and old residents in Hebei Province. 
Methods  According to the multi-stage cluster random sampling method, survey subjects were selected from Hebei Province. Questionnaire surveys and physical examinations were conducted. The middle-aged and old residents aged 45 and above were selected and the χ2 test was used to analyze the data. The relationship between the sleep duration and self-reported diabetes was analyzed by multivariate Logistic regression analysis. 
Results  Sleep duration of 6-8 h/d was associated with the risk of diabetes(OR=0.575，95%CI：0.407-0.813). The women,people in rural area and middle-aged and old people aged 45-59 years with moderate sleep duration(6-8 h/d) were at risk of diabetes 0.486, 0.472 and 0.432 times that of those with insufficient sleep duration(＜6 h/d)respectively(95%CI：0.327-0.724, 95%CI：0.304-0.733, 95%CI：0.221-0.844). 
Conclusion  Sleeping duration of 6~8 h/d can reduce the risk of diabetes in middle-aged and old residents in Hebei Province.





Role of CSE1L in cervical lymph node metastasis of human laryngeal squamous cell carcinoma

ZHANG Ji-hua, LI Hao, ZHANG Yuan-yuan, SU Jing, XUE Hai-tao

2021, 42(12):  1417-1420,1436.  doi:10.3969/j.issn.1007-3205.2021.12.011

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Objective  To detect the protein expressions of chromosome segregation like 1 protein（CSE1L） in human laryngeal squamous cell carcinoma(LSCC), and to explore the relationship between CSE1L and cervical lymph node metastasis of LSCC. 
Methods  A total of 76 specimens of human LSCC confirmed by pathology after surgery were collected, including 39 cases with cervical lymph node metastasis and 37 cases without lymph node metastasis. Another 32 specimens of adjacent normal laryngeal mucosa were collected in the meantime. The protein expression of CSE1L in tissue of LSCC and adjacent normal laryngeal mucosa was detected by immunohistochemistry and Western blot. Relationships of cervical lymph node metastasis and other clinical characteristics with CSE1L protein expression of patients were analyzed. 
Results  Among the 39 patients, the positive expression rate of CSE1L in those with cervical lymph node metastasis was 97%（38/39），including 31 patients with strong positive expression, 6 patients with moderate positive expression，1 patient with weak positive expression and only 1 patient with negative expression. Among the 37 patients who had no cervical lymph node metastasis, the positive expression rate of CSE1L was 38%（14/37），including 2 patients with strong positive expression, 11 patients with moderate positive expression，1 patient with weak positive expression and 23 patients with negative expression.  Among the 32 specimens of normal laryngeal mucosa, negative CSE1L expression was reported.  
Conclusion  CSE1L was significantly positively correlated with cervical lymph node metastasis in human LSCC. CSE1L may be a biological marker for judging cervical lymph node metastasis in human LSCC, thereby providing more reliable theoretical basis for the judgment of clinical cervical lymph node metastasis and the implementation of cervical lymph node dissection. 





Assessment of risk factors associated with sarcopenia under according to Asian Working Group for Sarcopenia 2019 Consensus

CHEN Rui, WANG Jing, ZHANG Ke-ying, SONG Xian-dong, WAN Yi, QIN Xu-jun

2021, 42(12):  1421-1425.  doi:10.3969/j.issn.1007-3205.2021.12.012

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Objective  To explore the impact of Asian Working Group for Sarcopenia(AWGS) 2019 Consensus diagnosis on the early diagnosis of sarcopenia, and to screen the risk factors related to sarcopenia, so as to promote early intervention. 
Methods  From June to September 2019, the convenient sampling method was adopted to select 202 elderly persons from 2 nursing homes in Xi′an as the research subjects. The prevalence of sarcopenia was compared with the old and new consensus on diagnosis. Correlation of different age, body mass index(BMI) with detection rate of sarcopenia was analyzed. Based on AWGS 2019 consensus, the risk factors related to sarcopenia were comprehensively analyzed from the perspectives of basic condition, underlying diseases and nutritional diet, and their relationship with the development and progression of sarcopenia was discussed. 
Results  The prevalence of sarcopenia under the new and old consensus on diagnostic criteria was 30.69% and 22.28% respectively. Meanwhile, the sarcopenia detection rate under the new consensus was significantly higher than that of the old consensus(P=0.042). The results of Logistic multivariate analysis showed that muscle strength, 6-meter walking speed under resting state and movement disorder score were statistically different between non-sarcosis and sarcosis(P＜0.01). Among the groups of pre-sarcopenia, sarcopenia(common type) and severe sarcopenia, significant differences were detected in age, height, weight, muscle mass, 6-meter walking speed under resting state, BMI, and underlying diseases(i.e. hypertension, diabetes and hyperlipemia)(P＜0.05). 
Conclusion  Age and BMI was influencing factors for the detection of sarcopenia. Muscle strength and 6-meter walking speed under resting state are the independent diagnostic factors, and movement disorder is the independent influencing factor.The elderly persons(age≥80) and/or accompanying with hypertension, diabetes and hyperlipidemia are the high-risk population forsarcopenia. 





The effect of percutaneous transforaminal endoscopy TESSYS on structure parameters of lumbar vertebra and motor function in patients with lumbar disc herniation

WANG Chun-hu, MO Nan-wen, MO Fang-liang

2021, 42(12):  1426-1431.  doi:10.3969/j.issn.1007-3205.2021.12.013

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Objective  To explore the effects of transforaminal endoscopic spine system(TESSYS) technique under percutaneous foraminal endoscopy on structure parameters of the lumbar vertebra and motor function of patients with lumbar disc herniation(LDH). 
Methods  A retrospective analysis was performed on the clinical data of 50 patients with LDH. The patients were divided into control group(n=25) and observation group(n=25) according to different treatment methods. The observation group was treated using percutaneous transforaminal endoscopy TESSYS, and the control group was treated using intervertebral disc endoscope. Perioperative related indexes, structure parameters of lumbar vertebrae, motor function and postoperative complications were compared between two groups. 
Results  The intraoperative blood loss, length of incision, first ambulation and length of hospital stay of the observation group were less or shorter than those of the control group(P＜0.05). There was no significant difference in duration of operation between two groups(P＞0.05). At 6 months after operation, lumbosacral angle of the two groups was smaller than that before operation; L5/S1 zygapophysial joint angle, L2-3 zygapophysial joint angle, L3-4 zygapophysial joint angle, L4-5 zygapophysial joint angle or lumbar curvature were larger than those before treatment; lumbosacral angle was smaller in the observation group than in the control group, while L5/S1 zygapophysial joint angle, L2-3 zygapophysial joint angle, L3-4 zygapophysial joint angle, L4-5 zygapophysial joint angle or lumbar curvature were larger in the observation group than in the control group(P＜0.05). At 1 month after operation, Oswestry disability index(ODI) score was lower than that before operation, while Japanese Orthopaedic Association(JOA) score was higher than that before operation; the ODI score of the observation group was lower than that of the control group and the JOA score was higher than that of the control group at 1 month after operation(P＜0.05). There was no significant difference in the incidence of complications between two groups(P＞0.05). 
Conclusion  Percutaneous foraminal endoscopy TESSYS for treating patients with LDH had characteristics of smaller surgical incision, less intraoperative blood loss and faster postoperative recovery. It can significantly relieve the patient′s symptoms, with high safety.





Clinical observation of oral propranolol in the treatment of infantile hemangioma

GAO Mei-hua, LIU Xue-ying, GAO Yang, LI Pan, WANG Hui-xiao

2021, 42(12):  1432-1436.  doi:10.3969/j.issn.1007-3205.2021.12.014

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Objective  To observe the clinical efficacy of oral propranolol in the treatment of infantile hemangioma. 
Methods  Retrospective analysis was performed on 300 infants with hemangioma diagnosed in the Outpatient Department of our hospital. Among them, 150 in the observation group were treated with propranolol, and 150 patientsin the control group were treated with prednisolone therapy. Two groups of children had regular outpatient follow-up visit, and direct observation, manual measurement, color Doppler ultrasound or MRI and other methods were performed to observe the hemangioma area, color change, texture and adverse reactions. 
Results  The tumor size of observation group was significantly smaller than that of the control group, and the time of spontaneous regression was shortened, suggesting significant difference(P＜0.001). Furthermore, the effective rate of the observation group(94.00%) was significantly higher than that of the control group(82.67%), and the adverse reactions of the observation group were significantly lower than those of the control group(P＜0.01). 
Conclusion  Oral propranolol is effective in the treatment of infantile hemangioma without obvious adverse reactions.





Value of ultrasound measurement of umbilical artery PI, RI, S/D combined with serum HIF-1α, FE3 in the diagnosis of fetal distress and its correlation with the severity of the disease

YANG Xin-yu, YE Qian, GUO Jiang

2021, 42(12):  1437-1441.  doi:10.3969/j.issn.1007-3205.2021.12.015

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Objective  To investigate the value of ultrasound measurement of umbilical artery PI, RI, S/D combined with serum hypoxia inducible factor 1α(HIF-1α), free estriol(FE3) in the diagnosis of fetal distress(FD) and its correlation with the severity of the disease in children. 
Methods  A total of 100 pregnant women with FD in our hospital were selected as the observation group, and 30 healthy pregnant women without FD were selected as the control group. All patients underwent ultrasound examination and serum HIF-1α and FE3 determinations. The levels of PI, RI, S/D, HIF-1α, and FE3 were compared between two groups. Receiver operating characteristic curve(ROC) and area under ROC(AUC) were used to analyze the diagnostic value of PI, RI, S/D, HIF-1α, and FE3 for FD. Pearson correlation analysis was performed to analyze the correlation of PI, RI and S/D with HIF-1α and FE3. Logistic regression equation was used to analyze the influencing factors of FD children′s condition. 
Results  PI and FE3 in the observation group were lower than those in the control group, and RI, S/D and HIF-1α were higher than those in the control group(P＜0.05). In pregnant women with FD, umbilical artery PI measured by ultrasound was positively correlated with FE3, and negatively correlated with HIF-1α. RI and S/D were negatively correlated with FE3 and positively correlated with HIF-1α(P＜0.05). ROC curve showed that the AUC of combined detection of all indicators was the largest, and the optimal sensitivity and specificity were 91.00% and 83.33% respectively. Logistic regression analysis showed that pregnancy-induced hypertension, gestational diabetes mellitus, umbilical artery PI, RI, S/D and serum HIF-1α and FE3 levels were all factors influencing the severity of FD(P＜0.05). 
Conclusion  The ultrasound measurement of umbilical artery PI, RI, S/D in pregnant women with FD is related to the expression of serum HIF-1α and FE3. The combination detection of these indicators can improve the diagnostic efficiency of FD, and guide clinical treatment and prognosis evaluation.





Effect of single erector spinae plane block plus patient-controlled intravenous analgesia on postoperative patients after thoracoscopic wedge resection of the lung

2021, 42(12):  1442-1447,1454.  doi:10.3969/j.issn.1007-3205.2021.12.016

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Objective  To investigate the regulating effects of single erector spinae plane block(ESPB)+patient controlled intravenous analgesia(PCIA) on the degree of pain and comfort, psychological status, stress hormones, pulmonary surfactant protein A(SP-A), and tumor necrosis factor-α(TNF-α) after thoracoscopic wedge resection of the lung. 
Methods  In total, 82 patients undergoing thoracoscopic wedge resection of the lung were divided into control group(n=41) and observation group(n=41), according to random number table method. The control group underwent PCIA and the observation group underwent ESPB and PCIA. The duration of operation, intraoperative sufentanil dosage, intraoperative bleeding, times of PCIA compression within 24 h after operation, length of hospital stay, mean arterial pressure(MAP), heart rate(HR), visual analog scale(VAS), Kolaba′s General Comfort Questionnaire(GCQ), and state-trait anxiety inventory(STAI), stress hormones［cortisol(Cor), adrenocorticotropic hormone(ACTH), prostaglandin E2(PGE2)］, SP-A, TNF-α and security were compared between two groups. 
Results  The dosage of sufentanil during operation and the number of PCIA compression within 24 h after operation in the observation group were lower or less than those in the control group(P＜0.05). MAP and HR at insertion of the double-lumen tube, at skin incision, and at extubation in  two groups were higher than those before anesthesia induction, and lower in the observation group than in the control group(P＜0.05). The VAS score for pain, S-AI score and T-AI score of the observation group were lower than those of the control group at 2, 3 and 4 d after operation, and the GCQ score was higher than that of the control group(P＜0.05). Cor, ACTH, ACTH, PGE2, SP-A and TNF- α in the observation group were lower than those in the control group at 1, 2, 3 and 4 d after operation(P＜0.05). There was no significant difference in the incidence of adverse reactions between two groups(P＞0.05). 
Conclusion  Single ESPB + PCIA in patients undergoing thoracoscopic wedge resection of the lung has a significant analgesic effect, which can reduce the use of anesthetics, ensure the safety of the medication, and reduce the postoperative stress response of the whole body. In addition, it is of great significance in improving the psychological state and comfort of patients, with good safety. 





Relationship of heat shock protein 70 and functional imaging parameters with prognosis of early-stage small cell lung cancer

ZHANG Dong-wei, LAN Bing, ZHONG Jia-jiang, YANG Chao-sheng, LIU Qiong-xia

2021, 42(12):  1448-1454.  doi:10.3969/j.issn.1007-3205.2021.12.017

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Objective  To analyze the correlation of heat shock protein 70(Hsp70) and imaging parameters of 18F-fluorodeoxyglucose-positron emission tomography(18FDG-PET) with the prognosis of early-stage limited-disease small cell lung cancer(LD-SCLC). 
Methods  A total of 57 patients with early-stage LD-SCLC and 57 healthy people(NC group) were enrolled to analyze the relationship of Hsp70 and imaging parameters, including metabolic tumor volume(MTV), maximum standardized uptake values(SUVmax), mean standardized uptake values(SUVmean), and integrated standardized uptake values(iSUV), with the prognosis of LD-SCLC. 
Results  The gastrin releasing peptide precursor, neuron-specific enolase, lactate dehydrogenase, Hsp70, MTV, SUVmax, SUVmean and iSUV in patients with early LD-SCLC were higher than those in healthy people(P＜0.05). Hsp70, MTV and iSUV had high sensitivity and specificity in the early diagnosis of LD-SCLC. The lung cancer specific survival(LCSS) rate and disease progression-free survival rate(DFS) in the Hsp70≥3.24 μg/L subgroup were lower than those in the Hsp70 ＜3.24 μg/L subgroup(P＜0.05). The 5-year overall survival(OS) and PFS were higher in MTV ＜64.63 cm3 subgroup than in the MTV≥64.63 cm3 subgroup(P＜0.05). The 5-year overall survival(OS) and LCSS rate were higher in the iSUV ＜316.78 subgroup than in the iSUV≥316.78 group(P＜0.05). Cox model regression analysis showed that clinical stage, gastrin releasing peptide precursor, neuron-specific enolase, Hsp70, MTV and iSUV were independent risk factors for the prognosis of early LD-SCLC. 
Conclusion  MTV, iSUV and Hsp70 are closely related to the prognosis of early LD-SCLC patients undergoing early surgery, radiotherapy and chemotherapy treatment. A larger sample size is recommended in future clinical research.





Application of precise ultrasonic classification in the treatment of cesarean scar pregnancy

LI Ping, PANG Yi-cun, LIANG Jun, LIU Xiu-ping

2021, 42(12):  1455-1459.  doi:10.3969/j.issn.1007-3205.2021.12.018

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Objective  To study the relationship between ultrasound image characteristics of cesarean scar pregnancy(CSP) and clinical diagnosis and treatment plan. 
Methods  A retrospective analysis was performed on 38 patients of CSP receiving treatment in the Third Hospital of Hebei Medical University.Different diagnosis and treatment plans were selected on the basis of ultrasonic classification, and its clinical data, diagnosis and treatment plans, and outcomes were analyzed. 
Results  ①All 38 cases were divided into 3 groups, including 14 cases of typeⅠin group one(5.00-9.10 weeks of gestation, 2 cases ≥8 weeks),12 cases of type Ⅱ(5.60-8.40 weeks of gestation) in group two, and 12 cases of type Ⅲ(7.60-9.00 weeks of gestation) in group 3. ②All the patients underwent surgery successfully based on the ultrasonic classification. At one day after surgery,β-human chorionic gonadotropin(β-HCG) levels fell to less than 50% of that before surgery for all the patients. After three months, the sonography of all patients showed no abnormal echo in the lower segment of anterior uterine wall. ③As for duration of operation and blood loss, the median level of blood loss during the procedure was 17.50(40.00) mL of  typeⅠand 20.00(90.00) mL of typeⅠ(more than 8 weeks) and type Ⅱ. The median level of blood loss during the procedure was 100.00(250.00) mL of type Ⅲ. The average of operation duration was(10.42±1.44) min for typeⅠ, (11.92±3.84) min for typeⅡ， and(96.15±39.43) min for  type Ⅲ,suggesting significant differences between groups(P＜0.05).β-HCG fell to normal levels, and the length of hospital stay and the myometrium thickness after operation were better in the laparoscopic surgery group than in curettage group, suggesting significant difference(P＜0.05). 
Conclusion  Preciseultrasonic classification and positioning inspections provide an important basis for the selection of clinical diagnosis and treatment options, which is conducive to individualized diagnosis and treatment according to the specific conditions of patients. Laparoscopic CSP removal of pregnancy products and uterine scar repair have the advantages of high success rate, small trauma and short hospitalization while preserving the patient′s fertility function. They can be the first choice for the treatment of type Ⅲ and some type Ⅱ cases.