Loading...

Table of Content

    25 March 2022, Volume 43 Issue 3
    Previous Issue    Next Issue
    Effect of chronic sleep deprivation on the expression of TGF-β1 in condylar cartilage of rats
    ZHAO Chen, LIU Yang, CUI Yu-lan, BAI Yue-hui, LI Ming-yang
    2022, 43(3):  252-257，封三.  doi:10.3969/j.issn.1007-3205.2022.03.002
    Asbtract ( 321 )   PDF (761KB) ( 144 )  
    Related Articles | Metrics

    Objective To study the effect of chronic sleep deprivation(CSD) on the expression of the transforming growth factor β1(TGF-β1) in condylar cartilage of rats.

    Methods A total of 60 male Wistar rats were randomly divided into three groups, the experimental group, the control group and the recovery group. The modified multiple platforms method(MMPM) was used to build the CSD of rats in the experimental and recovery group. Open field test was performed to evaluate the effect of sleep deprivation model of rats. At the end of the 1, 2, 3 and 4 week of sleep deprivation, 5 rats in the experimental group and the control group were sacrificed respectively. The rats in recovery group received 1 week of cage feeding after sleep deprivation to recover the sleep, and then were sacrificed. Subsequently, bilateral temporomandibular joints were obtained. HE staining was used to observe morphological changes in the condyle of temporomandibular joint. And the immunohistochemistry was performed to detect the changes of TGF-β1 in condylar cartilage.

    Results The rat model of CSD was successfully established by the MMPM, and the rat was in a state of stress. HE staining showed no significant  change in the condyle of rats in the control group. In the experimental group, there were some degenerative pathological changes like fissures and fractures in the superficial fibers of the condyle of the rats, unclear cell boundaries, and ingrowth of subchondral bone into the cartilage layer. Compared with the rats in the experimental group, the control group showed increased fissures of the fibrous band on the condylar surface of the rats, more layers of local mast cells, and clearer cell boundaries of each layer. The immunohistochemistry showed that the TGF-β1 was mainly expressed in the cells of the proliferative layer of condylar cartilage and mast cells of the fibrocartilage layer. There were no obvious changes in TGF-β1 expression in the control group at different time points, which, however, was increased in the experimental group with the prolonged CSD, suggesting significant differences between two groups(P＜0.05). In the recovery group, TGF-β1 expression was slightly decreased compared with the experimental group, and there was significant difference(P＜0.05). At 1 week after CSD, no significant difference was found between the recovery group and the control group(P＞0.05). However, at 2, 3, and 4 weeks after CSD, TGF-β1 expression was higher in the recovery group than in the control group, and the difference was statistically significant(P＜0.05).

    Conclusion CSD can cause stress in rats, leading to degenerative changes in condylar cartilage, and increased TGF-β1 expression in condylar cartilage. TGF-β1 expression increases with prolonged sleep deprivation. In addition, sleep recovery can induce the decrease of TGF-β1 expression.

    Microarray identification of genes and microRNA analysis related to idiopathic pulmonary fibrosis

    SONG Peng, ZHANG Meng, JIANG Shu-juan, YANG Dong-liang
    2022, 43(3):  258-264.  doi:10.3969/j.issn.1007-3205.2022.03.003
    Asbtract ( 400 )   PDF (2278KB) ( 171 )  
    Related Articles | Metrics

    Objective To identify genes and miRNAs by microRNA(miRNA)-mRNA interaction network in idiopathic pulmonary fibrosis(IPF).

    Methods The data of patients with IPF that were downloaded from the gene expression omnibus（GEO）database (GSE27430 and GSE135065) were used to select differentially expressed miRNAs and mRNAs. Transcription factor enrichment analysis was used to select miRNAs, and miRDB, miRTarBase and TargetScan were used to filter miRNA-targeting mRNAs. Cytoscape software was used to visualize the network between miRNA and mRNA and calculate the Hub gene. The GO and KEGG pathways were used to analyze mRNA in the regulatory network.

    Results A total of 21 miRNAs and 119 mRNAs were selected, and we reconstructed a miRNA-mRNA network composed of 3 miRNAs and 3 mRNAs. hsa-miR-199a-5p, hsa-miR-299-5p, hsa-miR-338-3p, NTNG1, SCN2A, and TM6SF1 were identified as key regulators.

    Conclusion This study has found several important Hub genes and miRNAs involved in the pathogenesis of IPF. Among them, the hsa-miR-199a-5p/NTNG1 and hsa-miR-299-5p/SCN2A pathways may be involved in the pathogenesis of IPF, which can help identify the cause and provide potential therapeutic targets.

    A comparative study on the levels of inflammatory and immune factors in patients with pulmonary ground-glass nodules of different nature
    LI Jie, WANG Lan
    2022, 43(3):  265-268，301.  doi:10.3969/j.issn.1007-3205.2022.03.004
    Asbtract ( 519 )   PDF (399KB) ( 173 )  
    Related Articles | Metrics

    Objective To compare the levels of inflammatory factors and immune factors in patients with pulmonary ground-glass nodules(GGN) of different nature.

    Methods In total, 108 patients with pulmonary GGN were selected and divided into lung cancer group(Group A), benign diffuse GGN group(Group B) and benign solitary GGN group(Group C) according to the pathological results. Tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6), and interleukin-10(IL-10) levels as well as immune system T lymphocyte subgroup levels(CD3+, CD4+, CD8+ and CD4+/CD8+) and immunoglobulin G(IgG), immunoglobulin A(IgA), immunoglobulin M(IgM) levels were detected in the three groups.

    Results The levels of TNF-α, IL-1β, IL-6, and IL-10 in groups A and B were significantly higher than those in group C, while the levels of CD3+, CD4+, CD8+, CD4+/CD8+, IgG, IgA and IgM were lower than those in group C, suggesting significant difference(P＜0.05). There were no significant differences in the levels of TNF-α, IL-1β, IL-6, IL-10, CD3+, CD4+, CD8+, CD4+/CD8+, IgG, IgA and IgM between group A and group B(P＞0.05).

    Conclusion  Patients with malignant pulmonary GGN have higher levels of inflammatory factors and lower levels of immune factors. Detection of inflammatory and immune factor levels in patients with pulmonary GGN may be used as an auxiliary means to identify the nature of the nodules.

    Establishment of a nomogram to predict severe neutropenia induced by first-line chemotherapy in patients with small cell lung cancer
    LI Yao-yuan, ZHENG Hong-gang, CHENG Meng-qi, ZHAO Yu-wei, WANG Li-ya, HUA Bao-jin
    2022, 43(3):  269-274.  doi:10.3969/j.issn.1007-3205.2022.03.005
    Asbtract ( 392 )   PDF (572KB) ( 103 )  
    Related Articles | Metrics

    Objective To establish a Nomogram to predictive the probability of severe neutropenia(grade 3 or 4) caused by first-line chemotherapy in patients with small cell lung cancer(SCLC).

    Methods In total,263 cases who had histologically confirmed SCLC and received first-line chemotherapy were selected and enrolled in the predictive cohort. Three procedures(forward, backward and stepwise selections) were applied by using the likelihood ratio test with smallest Akaike′s information criterion as the stopping rule in the multivariable logistic regression analysis to establish a Nomogram. The assessment of this Nomogram was performed by evaluating its discrimination and calibration abilities, as well as clinical utility.

    Results Age, current smoking, karnofsky performance status, tumor stage, platelet and chemotherapy regimen were extracted into the predictive model to establish the Nomogram. The results of assessment showed this Nomogram model had a good discrimination with area under the receiver operating characteristics(ROC) curve(AUC) of 0.73, and an acceptable calibration curve. In addition, the decision curve analysis showed when the range of threshold probability was approximately between 15% and 90%, using the nomogram to predict severe neutropenia would get more net benefits than the intervention-all scheme and intervention-none scheme. We suggested doctors should set the threshold or preference at 15%-30%.

    Conclusion The established Nomogram can accurately predict the probability of severe neutropenia before each chemotherapy in SCLC and has certain application value in clinical practice.

    Relationship of peripheral blood Chemerin with glucose and lipid metabolism, visceral fat, oxidative stress and inflammatory indexes in diabetic patients with MAFLD disease
    LI Hai-ling, DONG Lu-ling, YANG Xiu-hong, ZHANG Gui-shan
    2022, 43(3):  275-279，294.  doi:10.3969/j.issn.1007-3205.2022.03.006
    Asbtract ( 368 )   PDF (432KB) ( 121 )  
    Related Articles | Metrics

    Objective To explore the relationship of peripheral blood Chemerin with glucose and lipid metabolism, visceral fat, oxidative stress and inflammatory indexes in patients with diabetes mellitus(DM) complicated with metabolic associated fatty liver disease(MAFLD).

    Methods A total of 84 DM patients(DM group), 124 DM patients with MAFLD(DM combined MAFLD group), and 62 healthy physical examinees(healthy control group) were selected. The peripheral blood Chemerin and its correlation with glucose and lipid metabolism, visceral fat, oxidative stress and inflammatory indexes among three groups were compared in the three groups. The predictive value of peripheral blood Chemerin in DM complicated with MAFLD was evaluated.

    Results The levels of glucated haemoglobin A1c(HbA1c), fasting plasma glucose(FPG), 2 h plasma glucose(2 hPG), fasting insulin(FINS), homeostasis model assessment for insulin resistance(HOMA-IR), total cholesterol(TC), triacylglycerol(TG), Chemerin, high-sensitive C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), visceral fat area（VFA） and malonaldehyde(MDA) in DM combined with MAFLD group were higher than those in control group and DM group, while the levels of high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), superoxide dismutase(SOD), and glutathione(CSH) were lower than those in the control group and DM group. The levels of HbA1c, FPG, 2 hPG, FINS, HOMA-IR, TC, TG, Chemerin, hs-CRP, TNF-α, IL-6, VFA and MDA were higher in the DM group than in the control group, while the levels of HDL-C, LDL-C, SOD and CSH were lower than those of the control group, and the differences were statistically significant(P＜0.05). Correlation analysis showed that Chemerin in peripheral blood was significantly positively correlated with TC, TG, Hs-CRP, TNF-α, IL-6, VFA and MDA(r=0.862, 0.784, 0.657, 0.835, 0.827, 0.857, 0.847, P＜0.01), and was significantly negatively correlated with HDL-C, LDL-C, SOD, and CSH(r=-0.300, -0.362, -0.513, -0.630, P＜0.01). Multiple stepwise regression analysis showed that TC, TG, IL-6, VFA and SOD were all influencing factors of Chemerin.

    Conclusion Chemerin is closely related to IL-6, VFA and SOD, and is involved in the pathophysiological process of DM combined with MAFLD.

    Meta-analysis of the correlation between gene polymorphism of vitamin D receptor and metabolic syndrome
    WEI qin, SHI Wei-wei, YANG Yu-yan, LU Xiao-ying, CAO Ya-jing, CUI Ze
    2022, 43(3):  280-285.  doi:10.3969/j.issn.1007-3205.2022.03.007
    Asbtract ( 498 )   PDF (705KB) ( 213 )  
    Related Articles | Metrics

    Objective To explore the relationship between the gene polymorphism of vitamin D receptor(VDR) and genetic susceptibility to metabolic syndrome(MetS).

    Methods Pubmed, CNKI, Wanfang and Chinese Biomedical Literature Database were searched to obtain the related articles about the relationship between FokI rs2228570 G＞A, BsmI rs1544410 G＞A polymorphism and MetS susceptibility up to March 2021. Stata12.0 statistical software was used for meta-analysis. Combined odds ratio(OR) and its 95% confidence interval(95%CI) were used to evaluate the correlation strength.

    Results A total of 9 articles with 4 239 subjects were included. The results of meta-analysis showed that the FokI rs2228570 polymorphism could significantly increase the genetic susceptibility to MetS; in allele model(f vs. F), dominant model(ff+Ff vs. FF), recessive model(ff vs. Ff+FF) and homozygous model(ff vs. FF), the OR and 95%CI were 1.25(1.07-1.46), 1.25(1.09-1.44), 1.40(1.10-1.77) and 1.51(1.13-1.03), respectively. The BsmI rs1544410 polymorphism could significantly decline the genetic susceptibility to MetS; in allele model(b vs. B) and heterozygous model(Bb vs. BB), the OR and 95%CI were 0.86(0.76-0.98) and 0.77(0.62-0.95), respectively.

    Conclusion VDR gene polymorphism is significantly related to genetic susceptibility to MetS. FokI f allele may be a risk factor for MetS, and BsmI b allele may be a protective factor for MetS.

    The influence of coagulation function indexes on the prognosis of patients with severe traumatic brain injury
    CHI Cheng, WANG Dong-jing
    2022, 43(3):  286-289，306.  doi:10.3969/j.issn.1007-3205.2022.03.008
    Asbtract ( 407 )   PDF (494KB) ( 79 )  
    Related Articles | Metrics

    Objective To explore the role of changes in coagulation function in predicting short-term prognosis in patients with severe traumatic brain injury (sTBI).

    Methods Clinical data of 329 sTBI patients were retrospectively collected and analyzed. According to the prognosis at discharge, the patients were divided into poor prognosis group(n=139) and good prognosis group(n=190). Coagulation function indexes at admission were collected from the two groups, and the influence of coagulation function indexes on patients′ prognosis was evaluated by multivariate Logistic analysis.

    Results  The incidence of coagulation dysfunction in the poor prognosis group was higher than that in the good prognosis group, while the fibrinogen(Fib) was lower than that in the good prognosis group; the proportion of midline shift＞5 mm on admission, double negative pupil response to light, and acute surgery was higher than that in the good prognosis group(P＜0.05). Activated partial thromboplastin time(APTT) and prothrombin time(PT) were longer than those in the good prognosis group(P＜0.05). Multivariate Logistic regression analysis showed that PT＞14.6 s(OR=1.66, 95%CI: 1.23-4.12, P=0.006), and APTT＞39.3 s(OR=1.38, 95%CI: 1.15-2.97, P=0.010) were independent risk factors for poor prognosis in patients with sTBI, and Fib＞2.7 g/L(OR=0.79, 95%CI: 0.32-0.89, P=0.024) was its protective factor. The ROC curve showed that the AUC［0.843(95%CI:0.783-0.902, P＜0.001)］ for PT to predict poor prognosis of sTBI patients was higher than Fib［0.735(95%CI:0.658-0.811, P＜0.001)］ and APTT［ 0.762(95%CI: 0.691-0.833, P＜0.001)］.

    Conclusion sTBI patients with coagulation dysfunction are more common. PT and APTT are prolonged, while Fib is reduced. The short-term mortality risk of patients is increased, and PT has the highest predictive value.

    The impact of bronchial artery embolization on pulmonary function and arterial blood gas in patients with massive hemoptysis due to pulmonary tuberculosis and related factors of postoperative recurrence
    LI Qiang, LU Ping, YAN Tao, LI Xian-ning
    2022, 43(3):  290-294.  doi:10.3969/j.issn.1007-3205.2022.03.09
    Asbtract ( 382 )   PDF (403KB) ( 172 )  
    Related Articles | Metrics

    Objective To explore the effects of bronchial artery embolization(BAE) and conventional medical treatment on pulmonary function and arterial blood gas in patients with massive hemoptysis due to pulmonary tuberculosis, and to analyze related factors for recurrence after BAE.

    Methods We retrospectively analyzed 78 patients with massive hemoptysis due to pulmonary tuberculosis who had failed conventional medical treatment. All patients were given BAE. The recovery of lung function and arterial blood gas indicators as well as the recurrence of massive hemoptysis and related risk factors were observed in all patients.

    Results Among the 78 patients, 16 were cured, and the treatment was markedly effective in 30 patients, effective in 20 patients, and ineffective in 12 patients, with a total effective rate of 86.62%. The FVC, FEV, FEV/FVC and PaO2 of patients after conventional medical treatment were higher than those before treatment, while PaCO2 was lower than that before treatment; the FVC, FEV, FEV/FVC and PaO2 after BAE treatment were significantly higher than those before treatment and after conventional treatment, while PaCO2 was lower than that before treatment and after conventional treatment, with significant difference(P＜0.05). Of 78 patients, 26(33.33%) patients had a postoperative recurrence rate. Recurrence group had a higher rate of poor compliance, intense cough, cavitary tuberculosis, infection, poor postoperative activity, postoperative tension anxiety, GS embolization material and bronchiectasis than non-recurrence group(P＜0.05). Logistic regression showed that good treatment compliance, poor postoperative activity, and embolization material were risk factors for recurrence after massibve hemoptysis due to pulmonary tuberculosis(P＜0.05).

    Conclusion BAE can improve the clinical efficacy in the treatment of massive hemoptysis due to pulmonary tuberculosis, accelerate the recovery of pulmonary function, and reduce hemoptysis. Poor treatment compliance, poor postoperative activities, embolization materials are risk factors for the recurrence of massive hemoptysis due to pulmonary tuberculosis after surgery, which should warrant attention.


    The characteristics of pathogenic bacteria in colorectal tumor patients with infection after laparoscopic surgery and their impact on the expression of Th1/Th2, MCP-1 and sTREM-1

    DING Hai-xia
    2022, 43(3):  295-301.  doi:10.3969/j.issn.1007-3205.2022.03.010
    Asbtract ( 355 )   PDF (847KB) ( 166 )  
    Related Articles | Metrics

    Objective To explore the characteristics of pathogenic bacteria in colorectal tumor patients with infection after laparoscopic surgery and their impact on the expression of T Helper(Th)1/Th2, monocyte chemoattractant protein-1(MCP-1) and soluble Trigge ring receptor expressed on myeloid cell-1(sTREM-1).

    Methods A total of 67 colorectal tumor patients with infection after laparoscopic surgery were selected as the infection group, including 23 with mild infection, 27 with moderate infection, and 17 with severe infection. In addition, 67 patients with colorectal tumors without infection during laparoscopic surgery were selected as the non-infection group. The characteristics of pathogenic bacteria in patients colorectal tumors after laparoscopic surgery were statistically analyzed, and the general data and the levels of Th1/Th2, MCP-1 and sTREM-1 after surgery were compared between two groups. The influencing factors of infection after laparoscopic surgery were analyzed, and the value of Th1/Th2, MCP-1 and sTREM-1 levels in the diagnosis of infection after laparoscopic surgery was evaluated. The correlation between the levels of Th1/Th2, MCP-1, sTREM-1 and the degree of infection was analyzed.

    Results The pathogenic bacteria culture results of 67 patients in the infection group showed that 138 pathogenic bacteria were cultured, including 67.39% of gram-negative bacteria, 23.91% of gram-positive bacteria, and 8.70% of others. The proportion of patients with body mass index(BMI) ≥ 24, Dukes stages C and D, diabetes, and duration of operation＞2 h in the infection group was higher than that in the non-infection group, with significant difference(P＜0.05). Logistic regression analysis showed that BMI, Dukes stages C and D, diabetes, duration of operation, and Th1/Th2, MCP-1, and sTREM-1 levels at 3 and 7 d after surgery were all influencing factors for infection after laparoscopic surgery in patients with colorectal tumors(P＜0.05). The receiver operating characteristic(ROC) curve was drawn, which showed that the area under the ROC curve(AUC) of Th1/Th2, MCP-1, and sTREM-1 levels at 3 d after laparoscopic surgery in infection diagnosis was larger than that at 7 d after laparoscopic surgery. The AUC of combined diagnosis was the largest at 3 d after operation, which was 0.913, showing good diagnostic efficiency. There was a negative correlation between Th1/Th2 and the degree of infection in patients with infection after laparoscopic surgery for colorectal tumors, and the level of MCP-1 and sTREM-1 was positively correlated with the degree of infection(P＜0.05).

    Conclusion The significant decrease of Th1/Th2 and the significant increase of MCP-1 and sTREM-1 levels in patients with infection after laparoscopic surgery for colorectal tumors can be used for diagnosis and evaluation of infection. The pathogenic bacteria are mainly Escherichia coli and Staphylococcus aureus. Therefore, clinical attention and targeted treatment programs are needed in order to improve the clinical efficacy and the prognosis of patients.

    Relationship between bone metabolism and intestinal flora imbalance in elderly patients with postmenopausal osteoporosis based on RANKL/RANK/OPG pathway
    SONG Xin, SUN Ying, ZHANG Qi, GENG Tao
    2022, 43(3):  302-306.  doi:10.3969/j.issn.1007-3205.2022.03.011
    Asbtract ( 389 )   PDF (427KB) ( 110 )  
    Related Articles | Metrics

    Objective To study the relationship between bone metabolism and intestinal flora imbalance in elderly patients with postmenopausal osteoporosis based on RANKL/RANK/OPG pathway.

    Methods A total of 177 elderly female patients with postmenopausal osteoporosis were selected as the research subjects. The patients were divided into a research group and a control group based on the ratio of bifidobacteria to enterobacteria. Enzyme-linked immunosorbent assay(ELISA) was used to detect the serum inflammatory factors interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), transforming growth factor-β1(TGF-β1) and bone metabolism indexes osteocalcin(OC), bone-specific alkaline phosphatase(BALP), 25-hydroxyvitamin D［25(OH)D］, and tartrate resistant acid phosphatase-5b(TRACP-5b) levels. Western blot method was used to detect relative expression of receptor activator of nuclear factor-κB ligand(RANKL), receptor activator of nuclear factor-κB(RANK), osteoprotegerin(OPG) protein in the synovial fluid of patients.

    Results Serum IL-6,TNF-α, TGF-β1, OC, BALP, and TRACP-5b levels were significantly higher in the research group than in the control group, while serum 25(OH)D levels were significantly lower than those in the control group(P＜0.05). The relative expressions of RANKL and RANK proteins in the synovial fluid were higher in the research group than in the control group, and the relative expression of OPG protein was lower than that of the control group(P＜0.05). Correlation analysis showed that there was a positive correlation between bifidobacteria and 25(OH)D levels(r=0.332， P＜0.05) , and negatively correlated with OC, BALP, and TRACP-5b levels(r=-0.318, -0.408, -0.371, P＜0.05). Enterobacteria were negatively correlated with serum 25(OH)D levels(r=-0.378， P＜0.05), and positively correlated with OC, BALP, and TRACP-5b levels(r=0.356, 0.343, 0.364, P＜0.05).

    Conclusion Intestinal flora imbalance may affect bone metabolism through the RANKL/RANK/OPG pathway, leading to abnormal bone metabolism and increased levels of inflammatory factors in elderly postmenopausal women.

    Analysis of the effect of conductive education in improving gross motor and cognitive function of children with cerebral palsy
    CUI Qing-feng, YANG Li, ZHENG Shi-zhu
    2022, 43(3):  307-310.  doi:10.3969/j.issn.1007-3205.2022.03.012
    Asbtract ( 359 )   PDF (384KB) ( 178 )  
    Related Articles | Metrics

    Objective To explore and analyze the effect of conductive education(CE) in improving gross motor and cognitive functions of children with cerebral palsy(CP).

    Methods A retrospective analysis was performed on the clinical data of 60 children with CP admitted. According to the different treatment methods of the children, they were divided into a research group and a control group. Among them, 29 children in the research group were treated with CE training method based on the traditional rehabilitation training therapy in the control group, while 31 children in the control group received traditional rehabilitation training. Gross Motor Function Measure(GMFM-88), event-related potential P300, and The Wechsler Preschool and Primary Scale of Intelligence(WPPSI) and Gesell Developmental Schedules were used to evaluate and compare the gross motor function and cognitive function of children.

    Results The improvement of GMFM score, P300 indexes (including incubation period and amplitude), WPPSI score and Gesell score of children in research group was much better than that of children in control group, and the difference between groups was statistically significant(P＜0.05).

    Conclusion For improving the gross motor function and cognitive function of children with CP, the use of CE can more effectively promote their recovery.

    Measurement of atlantoaxial pedicle of 3-6-year-old children by 3D printing technology
    TIAN Yi-ren, REN Qiang, ZHOU Xiang, ZHEN Lei, ZHENG Mei-na, ZHANG Fang
    2022, 43(3):  311-315，325.  doi:10.3969/j.issn.1007-3205.2022.03.013
    Asbtract ( 458 )   PDF (1200KB) ( 37 )  
    Related Articles | Metrics

    Objective To measure the atlantoaxial pedicles of 3-6-year-old preschool children by using 3D printing imaging technology, and to provide relevant the oretical basis for the placement of atlantoaxial pedicle screws in preschool children.

    Methods The imaging data of 40 children aged 3-6 years who underwent atlantoaxial CT scans in Hebei Children′s Hospital were collected, and atlantoaxial fractures, deformities, tumors and infectious diseases were excluded. A total of 40 cases of atlantoaxial CT imaging data were collected. The 3D model of atlantoaxis was reconstructed by 3D slicer software, and the data parameters such as pedicle length, width, height, width to height ratio were measured. The measured data were grouped by age, namely, group A(aged 3-＜4 years, n=10), group B(aged 4-＜5 years, n=10), group C(aged 5-＜6 years, n=10), and group D(aged 6-<7 years, n=10), and the male to female ratio was 1〖DK〗∶1. The measured data were statistically analyzed.

    Results There was no statistical difference between the left and right sides of the atlantoaxial spine and between men and women in the same age group(P＞0.05). Atlantoaxial pedicle length, width and height measurement indexes showed an increasing trend with age, and the difference was statistically significant(P＜0.05). The ratio of the width/height of the lateral mass of the atlas in the preschool age was greater than 1.0, indicating that the width of the atlas pedicle was greater than the height, and the ratio did not change significantly with age. The ratio of the width/height of the axis pedicle in the preschool age was less than 1.0, indicating that the width of the axis pedicle was less than the height, but the ratio did not change significantly with age.

    Conclusion The actual and accurate data of the atlantoaxial pedicle of children can be obtained by using the isometric 3D printing model. According to its measurement data, the atlantoaxial pedicle of preschool children can accommodate a pedicle screw with a minimum diameter of 3.5 mm. Therefore, atlantoaxial disease of preschool children can be fixed with a pedicle screw with a minimum diameter of 3.5 mm, but different screw placement methods are also recommended according to the age.

    Efficacy of compound flumethasone ointment in the treatment of chronic generalized eczema and its effect on the level of serum inflammatory factors
    XUE Qiao, FAN Wen-ge, CHEN Cheng
    2022, 43(3):  316-319.  doi:10.3969/j.issn.1007-3205.2022.03.014
    Asbtract ( 654 )   PDF (372KB) ( 344 )  
    Related Articles | Metrics

    Objective To explore the efficacy of compound flumethasone ointment in the treatment of chronic generalized eczema and its effect on the level of serum inflammatory factors.

    Methods A total of 104 patients with chronic generalized eczema admitted to the First People′s Hospital of Changshu City Affiliated to Suzhou University were selected as the research subjects. They were divided into control group(n=52) and research group(n=52) by random number table method. The control group was treated with hydrocortisone butyrate ointment, and the research group was treated with compound flumethasone ointment. The clinical efficacy, and the level of serum inflammatory factors before and after treatment were compared between two groups. The safety of drugs in the two groups and the recurrence at 1 month after drug withdrawal were calculated.

    Results The total effective rate was higher in research group than in control group(P＜0.05). There was no significant difference in the levels of serum interleukin-4(IL-4) and interleukin-10(IL-10) between two groups before treatment(P＞0.05). The levels of IL-4 and IL-10 after treatment in two groups were lower than those before treatment(P＜0.05), while the levels of IL-4 and IL-10 in the research group after treatment were lower than those in the control group(P＜0.05). There was no significant difference in the total incidence of adverse drug reactions between two groups(P＞0.05). The recurrence rate of the research group(13.46%) was lower than that(30.77%) of control group(P＜0.05).

    Conclusion The compound flumethasone ointment has a definite effect in the treatment of chronic generalized eczema, which can effectively reduce the serum inflammatory factor level in patients with chronic generalized eczema, reduce the risk of recurrence, and has good safety.

    Correlation of 3.0T cardiac magnetic resonance technique with myocardial injury and left ventricular structure and its impact on prognosis in children with viral myocarditis
    LI Meng-yuan
    2022, 43(3):  320-325.  doi:10.3969/j.issn.1007-3205.2022.03.015
    Asbtract ( 393 )   PDF (1378KB) ( 193 )  
    Related Articles | Metrics

    Objective To explore the correlation of T2 ratio and LGE range measured by 3.0T cardiac magnetic resonance(CMR) with myocardial injury and left ventricular structure in children with viral myocarditis(VMC) and their impact on prognosis.

    Methods A total of 93 children with VMC were selected as the research subjects, and all underwent 3.0T CMR examination. According to the 6-month prognosis, they were divided into good prognosis group(n=68) and poor prognosis group(n=25). The general information, serum cardiac troponin T(cTnT), creatine kinase isoenzyme(CK-MB), left ventricular structure［inter ventricular septum thickness(IVST), end diastolic volume(EDV), end systolic volume(ESV)］, CMR examination parameters ［T2 ratio, late gadolinium enhancement(LGE) range］ were compared between two groups. The correlation between T2 ratio, LGE range and serum cTnT, CK-MB, left ventricular structure indicators, and factors affecting the prognosis of children with VMC were analyzed, and the prognostic value of T2 ratio and LGE range alone and in combination were evaluated.

    Results The proportion of fulminant myocarditis, hypotension, tachyarrhythmia, and use of epinephrine, as well as serum cTnT, CK-MB levels, IVST, EDV, and ESV, T2 ratio and LGE range on admission in the poor prognosis group were greater than those in the good prognosis group(P＜0.05). Correlation analysis results showed that T2 ratio(r=0.780, 0.770, 0.528, 0.494, 0.605), and LGE range(r=0.674, 0.880, 0.636, 0.575, 0.676) were positively correlated with serum cTnT, CK-MB, IVST, EDV, and ESV(P＜0.05). Logistic regression analysis showed that fulminant myocarditis, hypotension, tachyarrhythmia, use of epinephrine, T2 ratio and LGE range were important factors influencing the prognosis of children with VMC(P＜0.05). AUC value of combined detection of T2 ratio and LGE range in prediction was higher than that of single prediction(P＜0.05).

    Conclusion The 3.0T CMR technique can evaluate the left ventricular function of children with VMC by measuring the T2 ratio and LGE range, and is closely related to myocardial injury and left ventricular structure, thus providing a reasonable basis for clinical evaluation and prognosis prediction.

    Expression of MCM7 in papillary thyroid carcinoma and its relationship with survivin and P27 protein
    ZHANG Xin, XIAO Ni
    2022, 43(3):  326-330.  doi:10.3969/j.issn.1007-3205.2022.03.016
    Asbtract ( 387 )   PDF (1444KB) ( 99 )  
    Related Articles | Metrics

    Objective To analyze the expression of microchromosome maintenance protein 7(MCM7), survivin and P27 protein in papillary thyroid carcinoma tissues and the correlation of MCM7 with survivin and P27 protein.

    Methods Surgically resected tissues of 60 cases of thyroid papillary adenocarcinoma, 40 cases of thyroid adenoma, and 40 cases of nodular goiter that were pathologically confirmed, and thyroid tissue from 20 bodies with normal thyroid gland obtained by biopsy in our hospital were selected. Immunohistochemistry was used to detect the expression of MCM7, survivin, and P27 protein. The relationship between the expression of MCM7, survivin, and P27 protein in papillary thyroid carcinoma tissues and the clinical data of patients, and the correlation between MCM7, survivin, and P27 protein were analyzed.

    Results The positive expression of MCM7 and survivin in papillary thyroid carcinoma was significantly higher than that of other tissues, and the expression of P27-positive protein was significantly lower than that in other tissues(P＜0.05). The MCM7 positive expression rate was significantly higher in patients with tumor diameter＞1 cm, TNM stage Ⅲ-Ⅳ, and lymph node metastasis than that in patients with tumor diameter ≤1 cm, TNM stages Ⅰ-Ⅱ, and no lymph node metastasis; the positive expression rate of survivin was significantly higher in patients with TNM stages Ⅲ-Ⅳ and lymph node metastasis than in patients with TNM stages Ⅰ-Ⅱ and no lymph node metastasis(P＜0.05). The expression of MCM7 in papillary thyroid adenocarcinoma tissue was significantly positively correlated with the expression of survivin, and was significantly negatively correlated with the expression of P27 protein(P＜0.05). Receiver operating characteristic(ROC) curve analysis showed that the area under the ROC curve(AUC) of MCM7 in the diagnosis of papillary thyroid adenocarcinoma was 0.942, the sensitivity was 93.3%, and the specificity was 89.0%.

    Conclusion The overexpression of MCM7 in papillary thyroid adenocarcinoma tissue is closely related to survivin and P27 proteins, which may participate in the occurrence and development of cancer tissues and promote metastasis. MCM7 can be used for differential diagnosis of papillary thyroid carcinoma, with high accuracy.

    Safety and efficacy of remimazolam combined with alfentanil in anesthesia in daytime operation
    GU Xue-peng, ZHOU Na, ZHANG Nai-fu, SUN Jia-yue, GAO Dan, DING Li-gang
    2022, 43(3):  331-334.  doi:10.3969/j.issn.1007-3205.2022.03.017
    Asbtract ( 538 )   PDF (377KB) ( 284 )  
    Related Articles | Metrics

    Objective To investigate the safety and efficacy of remimazolam combined with fentanyl in anesthesia in daytime operation.

    Methods A total of 100 patients undergoing anesthesia in daytime operation in Qinhuangdao Military Industry Hospital were selected and randomly divided into control group and research group, with 50 cases in each group. The control group was given propofol combined with fentanyl for anesthesia, and the research group was given remimazolam combined with fentanyl for anesthesia. Propofol or remazolam was added when body movement occurred during the operation until the body movement disappeared. Heart rate(HR), oxygen saturation(SpO2) and mean arterial pressure(MBP) from entering the operating room to leaving the operating room were recorded between two groups. Alertness/sedation score(OAA/S) was used to evaluate the sedation state of the two groups. The proportion of intraoperative body movement, recovery time, residence time in recovery room and incidence of adverse reactions were recorded.

    Results There was no significant difference in HR, MAP, SpO2 and OAA/S scores of the group from the beginning of operation(T1) to the end of operation(T3), as compared with those before operation(T0)(P＞0.05). HR, MAP, SpO2 and OAA/S scores of the control group at T1-T3 were significantly lower than those of T0(P＜0.05). The scores of HR, MAP, SpO2 and OAA/S at T1, T2 and T3 were higher in research group than in the control group(P＜0.05). The body movement ratio, recovery time and residence time in the recovery room were smaller or shorter in the research group than in the control group(P＜0.05). The incidence of adverse reactions such as drowsiness, hypotension and respiratory depression in the research group was significantly lower than that in the control group(P＜0.05).

    Conclusion Compared with propofol, remimazolam combined with fentanyl for anesthesia is more helpful to maintain the stability of vital signs, shorten the postoperative recovery time and reduce the incidence of adverse reactions.

    Comparison of perioperative analgesic effect and safety between single multi-point and continuous thoracic paravertebral nerve block during unilateral thoracotomy
    XU Hai-li, CHEN Hong-ye, TONG Fei, KONG Ming-jian
    2022, 43(3):  335-338，344.  doi:10.3969/j.issn.1007-3205.2022.03.018
    Asbtract ( 382 )   PDF (417KB) ( 54 )  
    Related Articles | Metrics

    Objective To compare the perioperative analgesic effect and safety of single multi-point thoracic paravertebral nerve block and continuous thoracic paravertebral nerve block during unilateral thoracotomy.

    Methods A total of 84 lung cancer patients who underwent unilateral thoracotomy in our hospital were randomly divided into single group(single multi-point thoracic paravertebral nerve block) and continuous group(continuous thoracic paravertebral nerve block), with 42 cases in each group. The dosage of anesthetic during operation, extubation time, length of post-anesthesia care unit(PACU) stay, postoperative pain at different time points, times of analgesia pump pressing, times of rescue analgesic use and occurrence of adverse reactions were compared between two groups.

    Results There was no significant difference in dosage of sufentanil, propofol and sevoflurane, extubation time, length of PACU stay, times of postoperative analgesia pump pressing, times of rescue analgesic use and total incidence of adverse reactions between two groups(P＞0.05). There was a statistically significant difference in the time effect and interaction effect of the visual analogue scale(VAS) score during cough and at resting between two groups(P＜0.001), and there was no statistically significant difference in the effect between groups(P＞0.05). The VAS pain score during coughing in both groups was higher than that at resting(P＜0.05). There was no significant difference in the VAS scores at resting and during cough between the continuous group and the single group at 1 h, 6 h, 12 h, 24 h, and 48 h after surgery(P＞0.05).

    Conclusion The perioperative analgesic effect of single multi-point and continuous thoracic paravertebral nerve block during unilateral thoracotomy is similar, and the incidence of adverse reactions of the latter is lower.

    Risk factors of CRE infection in critically ill patients undergoing neurosurgery and the value of NLR, PCT and MCP-1 in differential diagnosis of infection
    ZHANG Lin, LEI Xiao-bao, XIONG Jin-zhi, HUANG Qiang, LI Na
    2022, 43(3):  339-344.  doi:10.3969/j.issn.1007-3205.2022.03.019
    Asbtract ( 454 )   PDF (900KB) ( 161 )  
    Related Articles | Metrics

    Objective To investigate the risk factors of CRE infection and the value of neutrophil-to-lymphocyte ratio(NLR), procalcitonin(PCT), monocyte chemo-attractant protein-1(MCP-1) in the differential diagnosis of infection in critically ill patients undergoing neurosurgery.

    Methods In total, 122 patients with severe infection in Department of Neurosurgery of our hospital were selected as the research subjects, including 61 cases of carbapenem-resistant Enterobacteriaceae(CRE) infections and 61 cases of carbapenem-sensitive Enterobacteriaceae(CSE) infections. The clinical data, NLR, PCT, MCP-1 of the two groups were compared, and the risk factors of CRE infection were analyzed by Logistic regression. Pearson analysis was used to analyze the correlation between NLR, PCT, MCP-1 and acute physiology and chronic health(APACHEⅡ) score, and ROC was used to analyze the differential diagnosis value of NLR, PCT, and MCP-1 in critically ill patients with CRE infection undergoing neurosurgery. KM curve was used to analyze the survival rate of NLR, PCT, MCP-1 high-level group and low-level group.

    Results There was a statistically significant difference between two groups with respect to antibiotic drug application, duration of antibiotic drug use, carbapenem use, APACHEⅡ score, NLR, PCT and MCP-1 levels(P＜0.05). The use of antibiotics ≥ 2 combinations, the duration of antibiotics use ≥ 10 days, the use of carbapenems, the APACHE Ⅱ score≥20, NLR, PCT, and MCP-1 high-level expression were all risk factors for CRE infection in critically ill patients undergoing neurosurgery(P＜0.05). There was a positive correlation between NLR, PCT, MCP-1 and APACHEⅡ score in patients with severe CRE infection undergoing neurosurgery(P＜0.05). AUC value of combined diagnosis of CRE infection was greater than single diagnosis(P＜0.05). The mortality of patients with high levels of NLR, PCT and MCP-1 in CRE infection was higher than that in the low-level group(P＜0.05).

    Conclusion CRE infection in critically ill patients undergoing neurosurgery is affected by multiple factors. Among them, NLR, PCT, and MCP-1 are closely related to the severity of the disease, which is conductive to the differential diagnosis of CRE infection. Therefore, targeted intervention measures can be taken accordingly to prevent the occurrence of CRE infection.

    Distribution characteristics of allergens in 16 490 allergic children in Shijiazhuang area
    ZHANG Xiao-shuang, HUANG Shan-shan, YAN Hong, XU Qian-ru, DU Hong-fei, ZHANG Jia-jia
    2022, 43(3):  345-349.  doi:10.3969/j.issn.1007-3205.2022.03.020
    Asbtract ( 480 )   PDF (543KB) ( 91 )  
    Related Articles | Metrics

    Objective To explore the distribution characteristics of 14 kinds of allergens in children in Shijiazhuang area, and to provide scientific basis for the prevention, diagnosis and treatment of children′s allergic diseases.

    Methods A total of 16 490 children aged 0-14 years who were treated at Hebei Children′s Hospital were selected. The serum allergen-specific IgE was detected by Western blotting, and statistical analysis was performed on the detection results of different genders and ages.

    Results Among the 16 490 children with positive allergen detection rates, the top 3 were milk(46.938%), egg albumen(38.666%), and beef/mutton(23.111%), while wheat(0.503%), cashews/peanuts/soybeans(0.309%), and mango(0.297%) had a low positive rate. The positive rate of mixed mold combination(12.562%) of boys was significantly higher than that of girls(9.350%)(P＜0.01), while the positive rate of egg albumen, cat/dog hair of girls was higher than that of boys. There was no statistically significant difference in the positive rate of cockroach allergy in different age groups(P＞0.05). The positive rate of egg albumen, mixed mold combination, milk, beef/mutton, fish/shrimp/crab decreased significantly with age(P＜0.01), while the positive rate of dwarf ragweed/artemisia, mixed dust mite group, humulus, cat hair/dog hair, tree combination, wheat, cashew/peanut/soybean was significantly increased(P＜0.01). The top three positive rates of inhaled allergens were cat hair/dog hair, mixed mold group and mixed dust mite group, with statistical difference in different seasons(P＜0.01).

    Conclusion Milk, eggs, beef/mutton are the main allergens of allergic diseases in children in Shijiazhuang area, and allergens have different trends at different ages. Therefore, allergen testing is beneficial to the prevention and diagnosis of allergic diseases.