Table of Content

05 August 2022, Volume 43 Issue 8

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Study on the protective effect of early enteral nutrition on intestinal mucosal structure and microecology of young rats with biliary atresia

WU Zhou-guang, WANG Bin, ZUO Tao-yan, CHEN Si-qi, FU Jing-ru, ZHANG Wen-jie

2022, 43(8):  872-876.  doi:10.3969/j.issn.1007-3205.2022.08.002

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Objective To investigate the protective effect of early enteral nutrition on intestinal mucosal function and microecology in young rats with biliary atresia(BA). 
Methods In total, 40 successfully established BA rat models were divided into the sham operation group, parenteral nutrition(PN) group, enteral nutrition(EN) group and antibiotic group by random number method, with 10 mice in each group. Another 10 young rats were selected as sham operation group. All groups had free access to water, the sham operation group was fed with common diet by gavage, and the antibiotic group was given common diet combined with ampicillin by gavage; The PN group was treated with total parenteral nutrition, and the EN group was treated with total enteral nutrition. The weight of the rats in each group was weighed before and after modeling. At 10 d after modeling, young rats were sacrificed, and blood was collected to detect total protein(TP) and albumin(ALB) in serum. Small intestinal tissue was stained with hematoxylin-eosin staining, and the mesenteric lymph nodes were cultured for bacteria. Body weight, nutritional status, small intestinal mucosa morphology(thickness, depth, height) and mesenteric lymph node bacterial culture were compared among the groups. 
Results After the success of modeling, the weight of young rats in each group decreased first and then increased. Compared with the sham operation group, the weight of antibiotic group, EN group and PN group increased slowly after weight loss. There were significant differences in the interaction between the four groups, time points and time points between groups(P＜0.05). At 10 d after treatment, compared with the sham operation group, the levels of TP and ALB in the antibiotic group and PN group decreased, and compared with the antibiotic group and PN group, the levels of TP and ALB in the EN group increased(P＜0.05). Compared with the sham operation group, the mucosal thickness, the depth of glandular recess and the height of villi in the antibiotic group and PN group decreased, which, however, increased in the EN group compared with the antibiotic group and PN group(P＜0.05). Mesangial lymph node bacterial culture showed that compared with the sham operation group, the number of Escherichia coli, Enterobacter cloacae, Pseudomonas aeruginosa and Klebsiella pneumoniae in the antibiotic group and PN group increased, and the number of the above bacteria in the EN group decreased compared with the antibiotic group and PN group(P＜0.05). 
Conclusion Early enteral nutrition therapy can increase the body weight of BA young rats, improve nutritional status and intestinal structure, promote intestinal mucosal repair and stabilize microecological balance.





Anagliptin suppresses high glucose-induced fibrosis of myocardial fibroblasts in diabetic cardiomyopathy through miR-497-5p/GPLD1 signaling pathway

CHANG Yang, YANG Jun-jing, ZHAO Yan-rong

2022, 43(8):  877-883.  doi:10.3969/j.issn.1007-3205.2022.08.003

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Objective To investigate the effect of anagliptin on fibrosis of myocardial fibroblasts(MCFs) induced by high glucose and its mechanism of action. 
Methods MCFs were treated with 5.50 and 25.00 mmol/L glucose respectively and divided into low glucose group and high glucose group. Anagliptin(0.05, 0.10, 0.20 μmol/L) was used for the treatment of MCFs induced by high glucose for 6 h, and the optimal concentration screened was 0.10 μmol/L. The mimics-NC group(transfected mimics-NC), miR-497-5p group(transfected miR-497-5p), anti-NC group(transfected anti-NC), anti-miR-497-5p group(transfected anti-miR-497-5p), si-NC group(transfected si-NC), si-glycosylphosphatidylinositol specific phospholipase D1(GPLD1) group(transfected si-GPLD1), anagliptin + mimics-NC group(transfected mimics-NC), anagliptin+miR-497-5p group(transfected miR-497-5p), anagliptin + mir-497-5p + pcDNA group(co-transfected miR-497-5p and pcDNA), anagliptin + miR-497-5p + pcDNA-GPLD1 group(co-transfected miR-497-5p and pcDNA-GPLD1) were transfected into MCFs and treated with 25.00 mmol/L glucose or 0.10 μmol/L anagliptin. Western blotting(WB) assay, and real time fluorescence quantitative polymerase chain reaction(RT-qPCR) were used to detect the protein expression of alpha smooth muscle actin(α-SMΑ), collagen Ⅰ(Col Ⅰ), collagen Ⅲ(Col Ⅲ) and the expression of miR-497-5p and GPLD1 in cells of each group. Double luciferase reporter gene assay was used to detect the fluorescence activity of cells. 
Results Compared with NG group, the protein expression of α-SMA, Col Ⅰ and Col Ⅲ increased significantly, while miR-497-5p decreased significantly in HG group(P＜0.05). Anagliptin(0.10, 0.20 μmol/L) significantly inhibited the increase in α-SMA, Col Ⅰ and Col Ⅲ protein and the decrease in mir-497-5p in high glucose-induced MCFs in a concentration-dependent manner. After overexpression of miR-497-5p, the expression of α-SMA, Col Ⅰ and Col Ⅲ proteins decreased significantly in high glucose-induced MCFs. miR-497-5p inhibited the fluorescence activity of wild-type GPLD1 cells and negatively regulated the protein expression of GPLD1. Knockdown of GPLD1 inhibited high glucose-induced effect of α-SMA, Col Ⅰ and Col Ⅲ protein expression in MCFs, similar to overexpression of miR-497-5p. Overexpression of GPLD1 could significantly weaken the effect of anagliptin and overexpression of miR-497-5p on inhibition of α-SMA, Col Ⅰ and Col Ⅲ expression in high glucose-induced MCFs. 
Conclusion Anagliptin could inhibit the fibrosis of MCFs induced by high glucose, and its mechanism may be related to the regulation of miR-497-5p/GPLD1 signaling pathway. 





Observation of the therapeutic effect of Edaravone Dexborneol on acute cerebral infarction after intravenous thrombolysis

JIAO Jun-ping, BAO Jun-qiang, WANG Zhi-wei, TIAN Shu-juan

2022, 43(8):  884-889.  doi:10.3969/j.issn.1007-3205.2022.08.004

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Objective To study the protective effect and mechanism of edaravone dexborneol on acute cerebral infarction after intravenous thrombolysis. 
Methods As a prospective observational study, this study included 95 cases undergoing intravenous thrombolysis with alteplase(rtPA). All patients were divided into rtPA group(n=40), and rtPA+edaravone dexborneol group(n=55) according to different treatment regimens. The primary end point events were National Institute of Health Stroke Scale(NIHSS) score at 14 d after onset, the percentage of patients with a modified Rankin Scale Score(mRS)≤1 at 90 d after onset, and the incidence of symptomatic intracranial hemorrhage(sICH) within 36 h after treatment. Secondary indicators included serum of the two groups collected at admission and at 14 d after admission, and the levels of superoxide dismutase(SOD), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and matrix metalloproteinase-9(MMP-9). The number and total proportion of CD4-negative T-lymphocytes(CD4-T)+CD8-negative T-lymphocytes(CD8-T) were analyzed using flow cytometry analysis.The relationship between time of using edaravone dexborneol, NIHSS score at admission, Trial of Org10172 in Acute Stroke Treatment(TOAST)and endpoint events in edaravone dexborneol group was analyzed. 
Results There was no significant difference in improvement rate of NIHSS score between two groups at 14 d(P＞0.05), and the proportion of mRS ≤ 1 at 90 d was 45% and 67% respectively, which was higher in rtPA+Edaravone Dexborneol group(P＜0.05). After treatment, the levels of SOD, IL-6, TNF-α and MMP-9 in both groups were lower than those before treatment, while the levels of SOD, IL-6, TNF-α and MMP-9 in rtPA+edaravone dexborneol group were lower than those in rtPA group(P＜0.05). After treatment, the count and proportion of CD4-T+CD8-T in the serum of the two groups were lower than those before treatment, which were lower in the intravenous thrombolysis+edaravone dexborneol group than in the intravenous thrombolysis group(P＜0.05). Logistic regression analysis showed that the endpoint events were correlated with the NIHSS score at admission and the time to initiate edaravone dexborneol(P＜0.05). 
Conclusion Edaravone dexborneol can ameliorate ischemia-reperfusion injury after intravenous thrombolysis for acute cerebral infarction. The mechanism may be related to scavenge of oxygen free radicals, anti-inflammation, protection of blood-brain barrier and regulation of immunity.





Risk factors of stroke-associated pneumonia in elderly patients with first-onset cerebral infarction and its impact on early outcome

LU Qing-li, LIU Zhong-zhong, LIU Pei, WANG Jing, LIN Xue-mei, WU Song-di

2022, 43(8):  890-894，914.  doi:10.3969/j.issn.1007-3205.2022.08.005

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Objective To investigate the risk factors of stroke-associated pneumonia(SAP) and its impact on early outcome in elderly patients with first-onset cerebral infarction(CI). 
Methods According to the Xi′an Stroke Registration Study, the elderly patients with first-onsetCI admitted to four first-class tertiary hospitals in Xi′an City were included. They were divided into non-SAP group and SAP group based to the occurrence of SAP in hospital, and the differences in baseline clinical characteristics of the two groups were compared. Multivariate Logistic regression model was used to analyze the risk factors for SAP and its impact on early outcome events(poor outcome［mRS score: 3-6 points］, stroke recurrence and death) in elderly patients with first-onset CI. 
Results A total of 1 039 patients with first-onset CI were enrolled in the study, with an average age of (71.58±7.62) years, including 577 males(55.7%) and occurrence of SAP in 64 cases(6.2%).Multivariate Logistic regression model showed that age(OR=1.073, 95%CI: 1.025-1.123, P＜0.001), National Institutes of Health Stroke Scale（NIHSS） score on admission(OR=1.114, 95%CI: 1.047-1.186, P＜0.001), dysphagia(OR=3.042, 95%CI: 1.523-6.084, P=0.002)and white blood cell(WBC) count (OR=1.153, 95%CI: 1.023-1.299, P=0.020)were independent risk factors for SAP in elderly patients with first-onset CI. The incidence of SAP was associated with a higher risk of early poor outcome(OR=3.194, 95%CI: 1.516-6.730, P=0.002), stroke recurrence(OR=3.368, 95%CI: 1.271-8.926, P=0.015) and death(OR=2.706, 95%CI: 1.111-6.588, P=0.028). 
Conclusion Age, NIHSS score on admission, dysphagia and WBC count are independent risk factors for SAP in elderly patients with first-onset CI. The occurrence of SAP significantly increases the risk of poor early prognosis in these patients.





Expression levels of serum succinate and its impact on risk of cardiovascular disease in OSAHS patients

HAN Cai-li, DONG Li-ping, QIAO Tong, ZHANG Jin-qiao, ZHANG Ji-hua, SONG Dong-mei

2022, 43(8):  895-899.  doi:10.3969/j.issn.1007-3205.2022.08.006

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Objective To investigate serum succinate levels and its effect on the risk of cardiovascular disease in patients with obstructive sleep apnea hypopnea syndrome(OSAHS). 
Methods Eighty-five patients(including 38 cases in the mild to moderate group and 47 cases in the severe group) with OSAHS were enrolled consecutively, and 25 healthy controls matched for age, gender, smoking and drinking at baseline were selected. Expression levels of serum succinate were compared between patients with OSAHS and healthy controls, and framingham risk score(FRS)was compared among patients with OSAHS. Univariate regression analysis was applied to clarify the effects of each indicator on FRS, and multiple linear stepwise regression was used to clarify the independent effect of succinate on FRS. 
Results Serum succinate levels were significantly higher in patients with OSAHS than in healthy controls, which increased with the severity of disease. Univariate regression analysis revealed that succinate and apnea-hypopnea index were significantly and positively correlated with FRS, while the lowest oxygen saturation and mean oxygen saturation were significantly and negatively correlated with FRS(P＜0.05). The results of multiple linear regression analysis showed that the serum succinate level was an independent influencing factor of FRS in patients with OSAHS. 
Conclusion Serum succinate levels are strongly associated with the risk of cardiovascular disease.





Study on the predictive value of H-FABP, miRNA-21 and GDF15 in acute chest pain

LIU Xun, DAI Ling, FENG Yuan, ZHAO Yi

2022, 43(8):  900-903，925.  doi:10.3969/j.issn.1007-3205.2022.08.007

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Objective To analyze the predictive value of heart-type fatty acid binding protein(H-FABP), microRNA-21(miRNA-21), and growth differentiation factor-15(GDF15) in acute chest pain. 
Methods In total, 600 patients with acute chest pain were selected as the observation group, and 600 healthy people undergoing physical examination during the same period were selected as the control group. The enzyme-linked immunosorbent assay(ELISA) was used to detect the serum H-FABP, miRNA-21, and GDF15 of subjects in the two groups.Receiver operating characteristics curve(ROC) was used for analysis of the predictive value of H-FABP, miRNA-21, and GDF15 in acute chest pain. 
Results The levels of H-FABP, GDF15 and miRNA-21 in the acute chest pain group were higher than those in the control group(P＜0.05). Compared with those of mild patients, the levels of H-FABP, miRNA-21 and GDF15 increased in moderate and severe patients(P＜0.05), and compared with those of moderate patients, the levels of H-FABP, miRNA-21 and GDF15 increased in severe patients(P＜0.05). Modified early warning score(MEWS)≥ 7, HEART score ≥ 5, and the expression levels of H-FABP, miRNA-21, and GDF15 were higher in patients with decreased renal function(P＜0.05). ROC analysis showed that the sensitivity of H-FABP, miRNA-21 and GDF15 in the diagnosis of acute chest pain was lower than that of combinations of the three(0.692, 0.726, 0.785, 0.867, respectively). 
Conclusion H-FABP, miRNA-21, and GDF15 are highly expressed in the serum of patients with acute chest pain. Measuring the changes of H-FABP, miRNA-21, and GDF15 is of significance in predicting the condition of patients with acute chest pain.





Effects of dapagliflozin combined with irbesartan on urinary ACR, glomerular filtration rate and CysC levels in patients with diabetic nephropathy

LI Wen-ya, GAO Ying, TANG Ying, DENG Yan-bei

2022, 43(8):  904-908.  doi:10.3969/j.issn.1007-3205.2022.08.008

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Objective To explore the effects of dapagliflozin combined with irbesartan on random urine microalbumin to creatinine ratio(ACR), glomerular filtration rate（eGFR）, and serum cystatin C(Cys C) levels in patients with diabetic nephropathy. 
Methods A total of 72 patients with diabetic nephropathy admitted to our hospital were selected as the research subjects. The patients were divided into a control group(35 cases) and an observation group(37 cases) by random number method. The control group was treated with irbesartan on the basis of conventional treatment, and the observation group was treated with dapagliflozin on the basis of the control group. The differences in urinary ACR, eGFR, CysC and blood lipid indexes of the two groups of patients before and after treatment were analyzed, and the incidence of adverse reactions after treatment in two groups were compared. 
Results The total effective rate of treatment in the observation group was 89.19%(33/37), which was significantly higher than 68.57%(24/35) in the control group. There was a statistical difference between the two(P＜0.05). After 2 months of treatment,  total cholesterol(TC), triglyceride(TG),  low density lipoprotein cholesterol(LDL-C) and other blood lipid indicators in the two groups decreased significantly, and the degree of blood lipid decrease in the observation group was significantly higher than that of the control group, the difference was statistically significant(P＜0.05). The urinary ACR and Cys C levels of the two groups of patients decreased significantly, and the eGFR level increased significantly, and the changes of various indicators in the observation group were significantly higher than those of the control group, the difference was statistically significant(P＜0.05). One case(2.70%) in the observation group had an end-point event, which was significantly less than the 6 cases(17.14%) in the control group. The difference was statistically significant(P＜0.05). 
Conclusion The treatment of DN with dapagliflozin combined with irbesartan can effectively improve the clinical efficacy and glomerular filtration rate of the patient, reduce the patient′s blood lipid level, the ratio of urine microalbumin to urine creatinine and serum cystatin C, and protect the patient renal function, reduce the incidence of adverse events after treatment, and provide favorable conditions for the prognosis of patients.





Analysis of effect of HFHD combined with cisapride on inflammatory factors, renal function indexes and clinical efficacy in patients with chronic CRF

GAO Yan-ling

2022, 43(8):  909-914.  doi:10.3969/j.issn.1007-3205.2022.08.009

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Objective To analyze the effect of high flux hemodialysis(HFHD) combined with cisapride on inflammatory factors, renal function indexes and clinical efficacy in patients with chronic renal failure(CRF). 
Methods A total of 152 patients with CRF who were treated were enrolled, and randomly divided into observation group(n=76) and control group(n=76). The control group was treated with HFHD, and the observation group was treated with cisapride on the basis of the control group. The inflammatory factors, renal function indexes, gastrointestinal hormones, clinical efficacy and treatment safety of the two groups were evaluated and compared. 
Results After treatment, the levels of calcitonin gene-related peptide(CGRP), serum fibroblast growth factor 23(FGF-23) and heat shock protein 47(HSP47) in the observation group were lower than those in the control group(P＜0.05). After treatment, renal function indexes［β2-microglobulin(β2-MG), urea nitrogen(BUN) and serum creatinine(Scr)］ in the observation group were lower than those in the control group(P＜0.05). After treatment, the levels of gastrin(GAS), vasoactive intestinal peptide(VIP) and motilin(MOT) in the observation group were higher than those in the control group(P＜0.05). After treatment, the total effective rate was 92.11%(70/76), which was higher than that ［80.26%(61/76)］ in the control group(P＜0.05). The incidence of adverse reactions in the two groups were 14.47%(11/76) and 10.53%(8/76) respectively(P＞0.05). 
Conclusion HFHD combined with cisapride is effective in the treatment of patients with chronic CRF. It can reduce the level of inflammatory reaction, and improve the level of gastrointestinal hormone and the renal function, with good safety.





Study on the expression and correlation of AQP4, FASN and EphA2 in meningioma tissue

LI Li-qing, FENG Jing, LIU Dong-xu, LIU Ying

2022, 43(8):  915-919.  doi:10.3969/j.issn.1007-3205.2022.08.010

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Objective To analyze the expression and correlation of aquaporin 4(AQP4), fatty acid synthase(FASN), and epithelial kinase A2(EphA2) in meningioma tissue. 
Methods A total of 43 meningioma patients were selected, their meningioma tissue was surgically removed and enrolled as meningioma group, and 43 meningioma tissues removed by trauma surgery were selected. Relative expression of AQP4 was measured by quantitative real-time polymerase chain reaction(PCR), and relative expression of FASN and EphA2 was detected by immunohistochemistry. The expression and correlation of AQP4, FASN, and EphA2 in meningioma tissues were analyzed. 
Results Compared with normal meningeal tissues, the expressions of AQP4, FASN, and EphA2 in meningioma tissues were increased(P＜0.05). The relative expressions of AQP4, FASN, and EphA2 were correlated with meningioma grade, peritumoral edema, and bone invasion(P＜0.05). Among them, the relative expressions of AQP4, FASN, and EphA2 in patients with grade Ⅱ, grade Ⅲ meningiomas, peritumoral edema, and bone invasion were significantly increased(P＜0.05). Correlation analysis showed that the expression of AQP4 and FASN in meningioma tissues was positively correlated(r=0.506, P＜0.001); The expression of FASN and EphA2 was positively correlated(r=0.528, P＜0.001); The expression of AQP4 and EphA2 was positively correlated(r=0.507, P＜0.001). ROC curve analysis showed that compared with the single diagnosis of AQP4, FASN, and EphA2, the combination of the three had the highest diagnostic value for meningioma(P=0.001). 
Conclusion The relative expression of AQP4, FASN, and EphA2 in meningioma is increased, and is related to the pathological characteristics of the patient. The clinical evaluation of the disease can be made based on the relative expression.





The expression of miR-142-3p, miR-216a and miR-107-5p in AKI patients undergoing blood purification in ICU and their evaluation value for therapeutic effect

DU Fei, ZHENG Li-huan, WANG Zheng, FANG Jian-jian, JIAO Qing-hai

2022, 43(8):  920-925.  doi:10.3969/j.issn.1007-3205.2022.08.011

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Objective To analyze the expression of miR-142-3p, miR-216a and miR-107-5p in patients with acute kidney injury(AKI) undergoing blood purification in ICU and their value of efficacy evaluation. 
Methods A total of 132 AKI patients who received blood purification treatment in ICU of our hospital were selected as the AKI group, and 80 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the healthy group. The expression levels of miR-142-3p, miR-216a and miR-107-5p were detected and analyzed in AKI patients undergoing blood purification in ICU. All patients received blood purification therapy. The expression levels of the above indexes before and after treatment and under different therapeutic effects were compared to analyze the efficacy evaluation value of the three indexes. 
Results Compared with those the healthy group, the expressions of miR-142-3p and miR-107-5p were increased, while the expression of miR-216a was decreased in the AKI group(P＜0.05). Compared with those before treatment, the expressions of miR-142-3p and miR-107-5p were increased, while the expression of miR-216a was decreased in AKI group after treatment(P＜0.05). According to therapeutic effect, they were divided into the effective treatment group(n=110) and the ineffective treatment group(n=22). Compared with the effective treatment group, the expressions of miR-142-3p and miR-107-5p were increased in the ineffective treatment group, while the expression of miR-216a was decreased in the ineffective treatment group(P＜0.05). Compared with surviving patients, miR-142-3p and miR-107-5p were elevated, while miR-216a was decreased in dead patients, and the difference was statistically significant(P＜0.05). ROC curve analysis showed that miR-142-3p, miR-216a and miR-107-5p all had a high value in evaluating the efficacy of blood purification in ICU for AKI patients(P＜0.05). 
Conclusion The high expression of miR-142-3p and miR-107-5p and low expression of miR-216a in AKI patients undergoing blood purification in ICU are closely related to clinical efficacy and can be used to evaluate the efficacy of patients.





Analysis of influencing factors of joint function rehabilitation after surgery for tibial plateau fracture combined with intercondylar spine fracture

GU Ye, PENG Yu-qin, WANG Qiu-fei, ZHU Feng, XU Yao-zeng

2022, 43(8):  926-930.  doi:10.3969/j.issn.1007-3205.2022.08.012

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Objective To analyze the factors affecting the effect of postoperative joint function rehabilitation in patients with tibial plateau fracture combined with intercondylar spine fracture by Logistic regression analysis, and to establish a risk model prediction to further lay the foundation for postoperative knee joint function rehabilitation. 
Methods A total of 272 patients with tibial plateau fracture combined with intercondylar spine fracture were selected as the research subjects. The Knee Joint Score of the American Hospital of Special Surgery(HSS) was used to evaluate the postoperative knee function rehabilitation effect of the patients, and logistics regression analysis was used to analyze the influencing factors of postoperative joint function rehabilitation effect. A Logistic regression prediction model was established to further evaluate the sensitivity and specificity of this model to predict postoperative joint function rehabilitation effect. 
Results In 272 patients with tibial plateau fracture combined with intercondylar spine fracture, the postoperative knee function recovered well in 79.41%of patients, and the postoperative knee function recovered poorly in 20.59% of patients. The logistic regression analysis showed that age, body mass index(BMI), preoperative American Society of Anesthesiologists(ASA) grade, and duration of operation, osteoporosis, preoperative range of motion(ROM) of the knee joint, and postoperative pain were the influencing factors of postoperative joint function rehabilitation in patients with tibial plateau fracture combined with intercondylar spine fracture(P＜0.05). When Logistic(P) was >3.87, the predictive value was the highest, with a sensitivity of 67.9% and a specificity of 93.5%. 
Conclusion Affected by factors such as age, BMI, preoperative ASA grade, duration of operation, osteoporosis, preoperative ROM of the knee joint, and postoperative pain, patients with tibial plateau fracture combined within tercondylar spine fracture are at risk of poor recovery of knee joint function after surgery. In clinical practice,preventive interventions should be strengthened to improve the rehabilitation effect and prognosis.





The relationship of HPV16 E6, E7 protein levels in cervical cancer tissues with clinical characteristics and prognosis

LU Ling, ZHANG Yuan-yuan, XU Yao, WU Bao-hua, XU Lei, WU Hai-yan

2022, 43(8):  931-934，955.  doi:10.3969/j.issn.1007-3205.2022.08.013

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Objective To explore the relationship of the levels of human papilloma virus E6 protein(HPV16 E6) and human papilloma virus E7 protein(HPV16 E7) in cervical cancer tissues with the clinical characteristics and prognosis of patients. 
Methods The tumor tissue, adjacent tissue, and normal cervical tissue specimens of 87 patients undergoing radical cervical cancer surgery were selected for research. Immunohistochemistry was used to detect the expression of HPV16 E6 and HPV16 E7 proteins in the tissues for analysis by combining the clinicopathological characteristics of the patients. Kaplan-Meier survival curve was used to compare the 3-year survival of the patients, and the COX regression analysis was used to analyze the effect of various factors on the prognosis of the patients. 
Results Immunohistochemical results showed that the positive rates of HPV16 E6 and HPV16 E7 in tumor tissues were higher than those in adjacent tissues and normal tissues(P＜0.05), and the 3-year survival rate of patients with positive expression of HPV16 E6 and HPV16 E7 protein was lower than that of patients with negative expression(P＜0.05). Multivariate analysis showed that HPV16 E6 and HPV16 E7 were independent risk factors for poor prognosis in patients with cervical cancer(P＜0.05). 
Conclusion HPV16 E6 and HPV16 E7 proteins are positively expressed in cervical cancer tissues, which are related to the clinicopathological characteristics and prognosis of patients, and may play a role as new targets for the treatment of cervical cancer.

Analysis of the curative effect of modified complex decongestion therapy on moderate to severe lower limb lymphedema after gynecological pelvic tumor surgery

HUANG Lie-mi, REN Guo-xing, WU nian, ZHANG Ding, SUN Rui, ZHANG Lun

2022, 43(8):  935-939，949.  doi:10.3969/j.issn.1007-3205.2022.08.014

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Objective To study the therapeutic effect of modified complex decongestion therapy(CDT) on moderate to severe lower limb lymphedema(LLL) after gynecological pelvic tumor surgery. 
Methods A total of 78 patients with moderate to severe LLL after gynecological pelvic tumor surgery were randomly divided into control group(n=39) and modified group(n=39). The control group was treated with traditional CDT, including manual lymphatic drainage(MLD), multi-layer low-elastic bandage, functional exercise and self-skin care, and the modified group was given the same treatment except MLD that was replaced with a negative pressure lymphatic reflux promotion system. Before treatment and at 4 weeks after treatment, the circumference of the affected limb was measured by measuring tape, and the lower limb volume(LLV) was calculated. The lymphedema-related symptom scale was used to evaluate the symptoms of lymphedema, and the extracellular water ratio was measured by the multi-frequency bioelectrical impedance body composition analyzer. Ultrasound imaging was used to detect thickness of full-thickness skin, subcutaneous tissue thickening, deep fascia thickening, subcutaneous tissue echo score, and subcutaneous tissue morphology score, and Hospital Anxiety and Depression Scale (HADS) score was used to evaluate the patient′s emotion. 
Results Compared with those before treatment, at 4 weeks after treatment, patients in the control group and the modified group had reduced limb circumference, LLV and extracellular water ratio, improved lymphedema symptoms, increased skin thickness, thickened subcutaneous tissue and deep fascia, subcutaneous tissue echo score, decreased subcutaneous tissue morphology score, and decreased anxiety score and depression score, suggesting significant difference(P＜0.05). Compared with the control group after treatment, patients in the modified group had reduced limb circumference, LLV, and extracellular water ratio, improved lymphedema symptoms, thickened deep fascia, decreased subcutaneous tissue echo scores, and decreased anxiety scores and depression scores, and the difference was statistically significant(P＜0.05). 
Conclusion The modified CDT can improve moderate to severe LLL, and relieve anxiety and depression, and the therapeutic effect is better than that of traditional CDT and that in the control group. In addition, it is better than modified CDT in the control group with respect to improving the clinical treatment efficiency, which, therefore, is worthy of clinical application.





The value of changes in serological index levels in early prediction of sepsis secondary to acute osteoarticular infection in children

FENG Yan-hua, REN Qiang, ZHEN Lei, HAO Jian-zong, ZHANG Fang, TIAN Yi-ren

2022, 43(8):  940-944.  doi:10.3969/j.issn.1007-3205.2022.08.015

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Objective To explore the value of serological indexes C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), procalcitonin(PCT) , interleukin-6(IL-6) and D-dimer(D-D) in early prediction of sepsis secondary to acute osteoarticular infection(AOI)in children. 
Methods A total of 149 children with AOI were enrolled as AOI group. According to presence or absence of secondary sepsis, they were divided into general infection group(n=108) and sepsis group(n=41). In addition, 71 healthy children in the same period were selected as control group. CRP, ESR, PCT, IL-6 and D-D were measured in all patients. 
Results The levels of CRP, ESR, PCT, IL-6 and D-D in the AOI group were higher than those in the normal control group(P＜0.05), and the levels of CRP, ESR, PCT, IL-6 and D-D in the general infection group were lower than those in the sepsis group(P＜0.05). Multivariate logistic regression analysis showed that the increase of CRP, ESR, PCT, IL-6 and D-D was an independent risk factor for sepsis secondary to AOI(P＜0.05). The AUC of combined detection of the five indicators was greater than that of the single detection, and the sensitivity and specificity were higher, which were 95.43% and 94.53% respectively. 
Conclusion The levels of CRP, ESR, PCT, IL-6 and D-D were significantly higher in children with AOI. Combined detection of the five indicators have a higher value in prediction and early diagnosis of secondary sepsis.





Efficacy and safety of ultrasound-guided dorsal scapular nerve block in patients with unilateral interscapular pain

ZU Bao-li, SHI Sheng-chi

2022, 43(8):  945-949.  doi:10.3969/j.issn.1007-3205.2022.08.016

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Objective To investigate the efficacy and safety of ultrasound-guided dorsal scapular nerve(DSN) block in the treatment of unilateral interscapular pain. 
Methods A total of 156 patients with unilateral interscapular pain admitted to our hospital were divided into two groups by random number table method, with 78 patients in each group. The control group was treated with neck and shoulder manipulation, and the observation group was treated with DSN block under ultrasound guidance on the basis of the control group. The pain degree, range of motion(ROM) of shoulder joint, upper limb function, and quality of life were compared between two groups. 
Results Visual analog scale(VAS) score in two groups decreased at 4 weeks and 12 weeks after treatment compared with that before treatment(P＜0.05). Passive range of motion(PROM) of shoulder flexion, extension, internal rotation and external rotation, and Fugl-Meyer Assessment-Upper Extremity(FMA-UE) score, and modified barthel index(MBI) score increased compared with those before treatment(P＜0.05). VAS scores in the observation group were lower than those in the control group at 4 weeks and 12 weeks after treatment(P＜0.05), while PROM of shoulder flexion, extension, internal rotation and external rotation, FMA-UE score and MBI score were higher than those in the control group(P＜0.05). There was no statistical difference in the incidence of complications between two groups(P＞0.05). 
Conclusion Ultrasound-guided DSN block can effectively reduce the pain degree of patients with unilateral interscapular pain, improve the neck and shoulder activity function, and improve the quality of life.


Comparison of clinical effect of deep muscle relaxation and low intra-abdominal pressure versus deep muscle relaxation and high intra-abdominal pressure in laparoscopic radical gastrectomy

FENG Chen, QIU Xiao-juan, XING Fan, HU Jian, ZHANG Zhuang-yun

2022, 43(8):  950-955.  doi:10.3969/j.issn.1007-3205.2022.08.017

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Objective To compare and analyze the clinical effects of deep muscle relaxation and low intra-abdominal pressure versus deep muscle relaxation and high intra-abdominal pressure in laparoscopic radical gastrectomy. 
Methods A total of 96 patients undergoing laparoscopic radical gastrectomy admitted to our hospital were selected and divided into research group(47 cases, using deep muscle relaxation and low intra-abdominal pressure) and control group(47 cases, using deep muscle relaxation and high intra-abdominal pressure) according to the random number table method. The short-term clinical therapeutic effect, long-term clinical therapeutic effect, serum carcinoembryonic antigen(CEA), leptin(LEP), vascular endothelial growth factor(VEGF) level, degree of intestinal mucosal injury, intestinal function recovery, changes of cerebral oxygen balance index before anesthesia, before pneumoperitoneum and after anesthesia, and at 60 min after pneumoperit on eum establishment were analyzed. 
Results The short-term clinical therapeutic effect and long-term clinical therapeutic effect of the research group were significantly better than those in the control group(P＜0.05). After treatment, serum CEA and VEGF levels in the research group were lower than those in the control group, and serum LEP levels were higher than those in the control group(P＜0.05). The level of postoperative intestinal injury in the research group was lower than that in the control group(P＜0.05). The indicators of intestinal function recovery in the research group were shorter than those in the control group(P＜0.05). After the establishment of pneumoperitoneum, the values of the two groups all showed significant fluctuations. Compared with the research group, arterial partial pressure of carbon dioxide(PaCO2), cerebral blood flow/cerebral oxygen metabolic rate ratio(PjvO2), cerebral arteriovenous oxygen content difference(Ca-jvDO2), internal jugular vein oxygen content(CjVO2), jugular vein oxygen saturation(SjvO2) showed less fluctuations. There were significant difference in interaction between groups, time points and time points between groups(P＜0.05). 
Conclusion Compared with deep muscle relaxation and high intra-abdominal pressure, deep muscle relaxation and low intra-abdominal pressure is more effective in laparoscopic radical gastrectomy. It can effectively improve the patients' serum CEA, LEP, VEGF levels, reduce postoperative intestinal injury of patients, accelerate the intestinal function recovery, and stabilize cerebral oxygen balance of patients. Therefore, it is worthy of clinical application and popularization.





Evaluation of risk factors for symptomatic intracranial arterial arteriosclerotic stenosis by 3D pCASL perfusion imaging and Rapid analysis

YAN Li-qun, YAN Jin, HOU Ya-ping, DONG Qian-bo, MU Xiao-dan, LIU Rong-li

2022, 43(8):  956-961.  doi:10.3969/j.issn.1007-3205.2022.08.018

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Objective To assess differences in cerebral blood flow perfusion and risk factors for clinical symptoms in two groups of patients with M1 segment of unilateral middle cerebral artery(MCA) stenosis with and without clinical symptoms by using three-dimensional pseudo-continuous arterial spin labeling(3D pCASL) imaging with two post-labeling delay(PLD) and Rapid software analysis of magnetic resonance perfusion-weighted imaging(PWI). 
Methods A total of 101 patients with M1 segment of unilateral MCA stenosis who underwent 3D pCASL with two PLD and Rapid soft ware analysis of magnetic resonance perfusion imaging(PWI). Binary logistic regression model was established, the presence or absence of symptoms was used as a binary dependent variable, and the local arterial stenosis rate, early-arriving flow proportion(EAFP),late-arriving retrograde flow proportion(LARFP), hypoperfusion intensity ratio(HIR) of downstream of the stenotic artery, and the patient′s age, gender, smoking history, homocysteine, blood pressure, blood lipids and blood glucose parameters were included in the model for analysis as independent variables. 
Results Univariate comparison of exposure factors in the symptomatic and asymptomatic group showed significant differences in LARFP and HIR between two groups, and logistic regression analysis of risk factors in patients with symptomatic stenosis after adjusting for EAFP, arterial stenosis rate, and other parameters showed that LARFP and HIR, which represented collateral blood flow, were independent risk factors for symptomatic stenosis. 
Conclusion Collateral blood flow indownstream of intracranial arterial stenosis is the determinant of clinical symptoms.