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    25 November 2022, Volume 43 Issue 11
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    Study on the mechanism of protective effect of mannitou on cerebral ischemia-reperfusion in rats
    LUO Zhi-zhong, FENG Kai, LUO Ya-qi
    2022, 43(11):  1244-1249.  doi:10.3969/j.issn.1007-3205.2022.11.002
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    Objective To observe the effects of mannitou on nerve injury, inflammation, oxidative stress and neuronal apoptosis in brain tissue of rats with ischemia-reperfusion, and to explore the relationship between its potential mechanism and mitogen-activated protein kinase (MAPK) signaling pathway. 
    Methods The model of cerebral ischemia-reperfusion injury in rats was established by thread occlusion method. Sixty rats were randomly divided into sham operation group, model group, mannitou group and mannitou+metformin group. The nerve defect, brain water content, cerebral stroke rate and pathological injury of hippocampus were detected. Serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), superoxide dismutase (SOD), and malondialdehyde (MDA) were detected by enzyme-linked immunosorbent assay (ELISA). TdT mediated dUTP nick end labeling (TUNEL) was used to detect neuronal apoptosis in brain tissue, and the phosphorylated (p)-p38 mitogen-activated protein kinase (p38), extracellular regulated protein kinase 1/2 (ERK1/2), p38 and ERK1/2 proteins were detected by Western blot (WB). 
    Results Compared with the sham operation group, the model group had increased neurological deficit score, brain water content, cerebral stroke rate and neuron apoptosis rate, aggravated pathological injury of neurons, and increased serum TNF-α, IL-6 and MDA increased, decreased SOD, and increased expression of p-p38 and p-ERK1/2 protein in brain (P＜0.05). After administration of mannitou, the above indexes of rats were significantly and reversely regulated, and this effect of mannitou could be weakened by metformin. 
    Conclusion Mannitou could reduce the brain nerve injury induced by ischemia-reperfusion in rats, and inhibit brain inflammation, oxidative stress and neuronal apoptosis, thus protecting the brain. The mechanism may be related to the inhibition of the activity of MAPK signaling pathway.

    Effect of miR-181d-5p expression on proliferation, apoptosis and invasion of cervical cancer cells
    TONG Ya-kun, ZHAO Dan-dan, AN Guo-jing
    2022, 43(11):  1250-1254,1260.  doi:10.3969/j.issn.1007-3205.2022.11.003
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    Objective To investigate the effects of miR-181d-5p on proliferation, apoptosis and invasion of cervical cancer cells and its effect on sulfation rate-limiting enzyme (PAPSS2)/proteoglycans （VCAN） signal pathway. 
    Methods In terms of cytological experiment, HeLa cells were divided into control group, NC group and miR-181d-5p group. MTT, flow cytometry and Transwell assay were used to detect the proliferation, apoptosis and invasion ability of cells in each group. The protein expression levels of PAPSS2 and VCAN were detected by Western blot. In terms of nude mice tumor bearing experiment, 20 SPF node mice were randomly divided into control group(n=10) and miR-181d-5p group(n=10). They were inoculated with wild type cells and transfected with miR-181d-5p cells respectively. The tumor volume of mice was measured every 3 d for 21 d consecutively, and the tumor mass and volume were measured at the end of experiment. 
    Results Cytological experiment showed that, compared with the control group and NC group, miR-181d-5p group had a significantly lower cell proliferation ability, a significant increase in the proportion of cell apoptosis, a significant reduction in cell invasion ability, and a significant down-regulation of the expression levels of PAPSS2 and VCAN(P＜0.05). There was no significant difference between NC group and control group(P＞0.05). The nude mice tumor bearing experiment showed that the tumor growth of miR-181d-5p group was significantly inhibited, and the tumor quality was significantly lower than that of the control group(P＜0.05). 
    Conclusion miR-181d-5p can inhibit the proliferation and invasion ability of human cervical cancer cells and promote apoptosis. Its mechanism may related to the inhibition of PAPSS2/VCAN signal pathway. 

    The effect of SPHK1 gene on malignant behavior of epithelial ovarian cancer cells and its related mechanism
    ZHAO Huan, PANG Yi-cun, ZHAO Jun, XING Hui-min, MA Xiao-lin, HUO Cui-min
    2022, 43(11):  1255-1260.  doi:10.3969/j.issn.1007-3205.2022.11.004
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    Objective To explore the effect of sphingosine kinase 1（SPHK1） on the biological behavior changes of ovarian cancer cells and its related mechanisms. Provide new evidence for the early diagnosis, prognosis, drug resistance treatment, and targeted therapy of epithelial ovarian cancer. 
    Methods After transfecting SKOV3 cells with small interfering RNA (siRNA) to interfere with the expression of SPHK1 gene, we detected the effect of the changes of SPHK1 expression on cell proliferation, cell cloning and sensitivity to cisplatin, and also on the expression of stem cell markers NANOG, and the drug resistance-related gene MDR1. 
    Results Decreased expression of SPHK1 gene caused a decrease in the proliferation of ovarian cancer cells, a decrease in clonogenicity, and an increase in sensitivity to cisplatin. The decreased expression of SPHK1 affected the expression of NANOG and MDR1 in ovarian cancer cells. 
    Conclusion SPHK1 may influence the proportion of tumor stem cells through the NANOG, thereby affecting the malignant behavior of epithelial ovarian cancer. 

    Expression and correlation of miR-21, Caveolin-1 and Gal-9 in patients with viral meningitis
    WANG Sha, HE Long, CHENG Li-ping, HUO Rui-min, LIAO Zi-wei, NIU Dong-sheng
    2022, 43(11):  1261-1266,1276.  doi:10.3969/j.issn.1007-3205.2022.11.005
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    Objective To investigate the characteristics of the expression level of micro ribonucleic acid-21(miR-21), Caveolin-1 and galectin-9(Gal-9) in cerebrospinal fluid of patients with viral encephalitis(VM), and to analyze the relationship between miR-21, Caveolin-1, Gal-9 and VM recurrence. 
    Methods A total of 132 patients with VM(VM group) and 136 patients without neurological injury confirmed by examination(control group) were selected. VM patients were divided into severe group(n=58) and mild group(n=74) according to their condition. All patients were followed up for 3 months after discharge and divided into recurrence group(n=26) and non-recurrence group(n=106) according to recurrence of VM. The levels of serum miR-21, Caveolin-1, Gal-9 and inflammatory factors were detected before and after treatment, and the relationship between miR-21, Caveolin-1, Gal-9 and VM severity, inflammatory factors and recurrence was analyzed. Receiver operating characteristic(ROC) curve was used to analyze the value of miR-21, Caveolin-1 and Gal-9 in predicting VM recurrence. 
    Results The expression of miR-21 and the levels of Caveolin-1, Gal-9, tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in VM group were higher than those in control group(P＜0.05). The expression of miR-21 and the levels of Caveolin-1, Gal-9, TNF-α and IL-6 in cerebrospinal fluid of VM patients in severe group were higher than those in mild group(P＜0.05).The levels of miR-21, Caveolin-1 and Gal-9 were positively correlated with TNF-α and IL-6(P＜0.05). Before and after treatment, the expression of miR-21 and the levels of Caveolin-1, Gsl-9, TNF-α and IL-6 in cerebrospinal fluid of the recurrence group were higher than those of the non-recurrence group. After treatment, the expression of miR-21 and the levels of Caveolin-1, Gal-9, TNF-α and IL-6 in cerebrospinal fluid of patients in recurrence group and non-recurrence group were lower than those before treatment(P＜0.05). After treatment, high levels of TNF-α, miR-21, Caveolin-1 and Gal-9 were risk factors for VM recurrence(P＜0.05). The area under the ROC curve(AUC) of combined detection of miR-21, Caveolin-1 and Gal-9 in predicting VM recurrence was 0.858, which was higher than that of single index(P＜0.05). 
    Conclusion The expression levels of miR-21, Caveolin-1 and Gal-9 in the cerebrospinal fluid of VM patients are significantly increased, and the high expression of miR-21, Caveolin-1 and Gal-9 is closely related to the severity and recurrence of VM after treatment.

    Expression of HSF1, sMR, and miR-758-3p in patients with HCC and their relationship with clinicopathological characteristics
    ZHAO Guo-jie, YANG Hong-wei, ZHAO Peng-fei
    2022, 43(11):  1267-1271.  doi:10.3969/j.issn.1007-3205.2022.11.006
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    Objective To investigate the expression levels of heat shock transcription factor 1 (HSF1), soluble mannose receptor (sMR), and miR-758-3p in patients with hepatocellular carcinoma (HCC) and their relationship with clinicopathological characteristics. 
    Methods A total of 68 HCC patients who underwent surgical treatment in our hospital were selected as research subjects, and another 42 patients with chronic hepatitis who presented to our hospital during the same period were selected as controls. Clinical data of patients were collected. HSF1 levels were detected by immunohistochemistry, and serum sMR levels were detected by enzyme-linked immunosorbent assay. RT-qPCR was used to detect miR-758-3p levels. The relationship between HSF1, sMR, miR-758-3p and clinicopathological characteristics was analyzed. 
    Results Compared with the control group, the positive rate of HSF1 and the expression of serum sMR in the experimental group were higher, while the level of miR-758-3p was lower (P＜0.05). The expression levels of HSF1, sMR, and miR-758-3p were related to lymph node metastasis, microvascular invasion, pathological stage, and alpha-fetoprotein (AFP) (P＜0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of HSF1, sMR and miR-758-3p in the diagnosis of HCC was 0.947, 0.983 and 0.787, respectively, and the AUC of combined detection of HSF1, sMR and miR-758-3p in the diagnosis of HCC was 1.000, which was higher than that of single indicator. 
    Conclusion The positive expression of HSF1 and the serum sMR increase significantly, while the level of miR-758-3p decreases significantly in patients with HCC.HSF1, sMR and miR-758-3p are closely related to clinicopathological characteristics, including lymph node metastasis, microvascular invasion, pathological stage and AFP. 

    Effect of pulse therapy combined with SET on cervical biomechanics and cervical muscle fatigue in patients with cervical spondylotic radiculopathy
    SHANG Yan-ping, HAN Yue-e, WANG Jian
    2022, 43(11):  1272-1276.  doi:10.3969/j.issn.1007-3205.2022.11.007
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    Objective To investigate the effect of pulse therapy combined with sling exercise therapy(SET) on cervical spondylotic radiculopathy(CSR) and its impact on cervical biomechanics and cervical muscle fatigue. 
    Methods A total of 162 patients with CSR were selected and divided into the control group(n=81) and the observation group(n=81) according to random number table method. The control group was treated with SET for 4 weeks, while the observation group was treated with pulse therapy combined with SET for 4 weeks. Cervical function, pain, cervical biomechanics, cervical muscle fatigue and complications were compared between two groups before and after treatment. 
    Results After treatment, Japanese Orthopedic Association(JOA) score, cervical flexion angle, cervical extension angle, left flexion angle, right flexion angle, left rotation angle, right rotation angle, integrated electromyography(IEMG) value of cervical extensor muscle group, mean power frequency(MPF) and median frequency(MF) in two groups were higher than those before treatment(P＜0.05), while neck disability index(NDI) and visual analogue scale(VAS) score were higher than those before treatment(P＜0.05). The JOA score, cervical flexion angle, cervical extension angle, left flexion angle, right flexion angle, left rotation angle, right rotation angle, IEMG of cervical posterior extensor muscle group, MPF and MF in the observation group were higher than those in the control group(P＜0.05), while the NDI index and VAS score were lower than those in the control group(P＜0.05). There was no significant difference in the incidence of complications between two groups(P＞0.05). 
    Conclusion Pulse therapy combined with SET can effectively improve cervical biomechanics, reduce muscle fatigue and improve cervical function in patients with CSR.

    The relationship between serum miR-210 and the severity and prognosis of neonatal respiratory distress syndrome
    DU Zhi-yun, SHI Yi-nan, XU Hai-juan, LI Shu-xiu
    2022, 43(11):  1277-1281,1310.  doi:10.3969/j.issn.1007-3205.2022.11.008
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    Objective To explore the relationship between serum mircoRNA-210(miR-210) and the severity and prognosis of neonatal respiratory distress syndrome（NRDS）. 
    Methods A total of 104 children with NRDS were selected and divided into survival group and death group according to the prognosis of the children. All newborns were divided into mild group(grade Ⅰ, Ⅱ) and severe group(grade Ⅲ, Ⅳ) according to the results of the first chest radiograph and the severity of the disease. The general data of the children in the death group and the survival group were compared, and the serum miR-210 level and the scores for neonatalacute physiology and perinatal extension Ⅱ(SNAPPE-Ⅱ) of the mild group and the severe group were compared. The receiver operating characteristic(ROC) curve was drawn to analyze the value of serum miR-210 level in predicting the death of children with NRDS. Spearman correlation was used to analyze the correlation between the occurrence of NRDS and serum miR-210. 
    Results According to grouping by prognosis, among the 104 cases, 81 cases(77.88%) had good prognosis, and 23 cases(22.12%) died. The level of miR-210 and SNAPPE-Ⅱ in the survival group were lower than those in the death group(P＜0.05). There was no significant difference in gender, gestational age, birth weight, maternal age, etiology, cesarean section, twin pregnancy, and abnormal amniotic fluid between two groups(P＞0.05). According to the chest X-ray findings, 73 of the 104 children were mild and 31 were severe. The level of miR-210 and SNAPPE-Ⅱin the mild group were lower than those in the severe group(P＜0.05). The occurrence of NRDS was positively correlated with the level of serum miR-210(r=0.638, P＜0.001). Serum miR-210 was positively correlated with SNAPPE-Ⅱ(r=0.513, P＜0.05). When the optimal cut-off value of serum miR-210 was 16.71 ng/L,the area under the ROC curve was 0.763(OR=0.846, 95%CI:0.892-1.064), the sensitivity was 82.61%, and the specificity was 86.42%. 
    Conclusion The increase in serum miR-210 level is closely related to the severity and prognosis of NRDS, and the serum miR-210 level is positively correlated with the severity of NRDS. When the cut-off value of serum miR-210 is 16.71 ng/L, it is of higher value in assessing the prognosis of children with NRDS. 

    Clinical application of heated humidified high flow nasal cannula ventilation in the treatment of severe pneumonia in infants
    JIA Xi-qun, ZHANG Hua-juan, ZHANG Bi-qi, HONG You-ming
    2022, 43(11):  1282-1285,1290.  doi:10.3969/j.issn.1007-3205.2022.11.009
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    Objective To investigate the clinical effect of heated humidified high flow nasal cannula ventilation(HHFNC) in the treatment of severe pneumonia in infants. 
    Methods A total of 80 children with severe pneumonia admitted to our hospital were selected as the research subjects and randomly divided into mask oxygen inhalation group(control group, n=40) and HHFNC group(experimental group, n=40) by random number table method. The changes in partial pressure oxygen(PaO2), partial pressure of carbon dioxide(PCO2), and PaO2/fraction of inspiration O2(FiO2) of the two groups were compared before treatment and at 2 h, 24 h, and 48 h after treatment. The relief time of dyspnea(nasal flaring and three-concave sign)，the length of hospitalization and the rate of endotracheal intubation were compared.
    Results Before treatment, PaO2, PCO2, PaO2/ FiO2 of the two groups were compared, and the differences was not statistically significant(P＞0.05). After treatment，PaO2 and PaO2/FiO2 in two groups increased gradually，while PCO2 decreased gradually; PaO2 and PaO2/FiO2 in HHFNC group were higher than those in control group，while PCO2 was lower than those in control group; there were significant differences in the interaction among groups，time points and time points between groups(P＜0.05). The relief time of dyspnea and the length of hospitalization were shorter, the rate of endotracheal intubation was lower in HHFNC group than in the control group, and the differences were statistically significant（P＜0.05）. 
    Conclusion HHFNC in the treatment of severe pneumonia in infants can improve the condition, shorten the length of hospitalization, and reduce the rate of tracheal intubation, and the effect is significant.

    Determination of meropenem concentration in human plasma by LC-MS/MS and its application in therapeutic drug monitoring in ICU patients with sepsis
    ZHANG Wei-dong, ZHANG Wei-wei, YAN Yan, ZHOU Jing-fang, CHENG Ye-tong, WANG Na
    2022, 43(11):  1286-1290.  doi:10.3969/j.issn.1007-3205.2022.11.010
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    Objective To develop a method for determination of meropenem concentration in human plasma by liquid chromatograph tandem mass spectrometry (LC-MS/MS), and to apply it to  therapeutic drug monitoring in intensive care unit（ICU） patients with sepsis. 
    Methods The Kinetex-C18 100A column (2.6 μm, 4 mm× 50 mm) was used, and the mobile phase consisted of methanol-1‰ methanoic acid solution (60〖DK〗∶40, v/v), the flow rate of 0.4 mL/min, the column temperature of 40 ℃ and the injection volume of 3 μL. Carbamazepine was used as internal standard, and electron spray ionization (ESI) source was applied and operated in multiple reaction monitoring (MRM) mode. The quantitative analysis transitions were m/z 384→141 (meropenem) and m/z 237→194 (carbamazepine). The method was applied to 197 ICU patients with sepsis for therapeutic drug monitoring. 
    Results The linearity was good for meropenem in human plasma within the range of 0.02-30 mg/L. The calibration curve was y=4.934×10-5x+2.083×10-2 (r=0.999 9). The relative standard deviation (RSD) of intra- and inter-precision was less than 3%, and the extraction recovery was 91.96%-100.97%. The range of plasma concentration of meropenem in 197 sepsis patients was 0-16.33 mg/L. 
    Conclusion The method for determining meropenem concentration is simple, fast, sensitive, specific and accurate, which can be used for the therapeutic drug monitoring in patients with sepsis. 

    Effect of high-intensity ultrasound combined with gabapentin on miR-19a, miR-30b and miR-29c in patients with neuropathic pain
    JI Wei-li, LI Meng, LI Ling-zhi, LIU Tong-tong
    2022, 43(11):  1291-1296,1317.  doi:10.3969/j.issn.1007-3205.2022.11.011
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    Objective To investigate the effect of high-intensity ultrasound combined with gabapentin on microRNA-19a(miR-19a), microRNA-30b(miR-30b), microRNA-29c(miR-29c) in patients with neuropathic pain. 
    Methods A total of 72 patients with neuropathic pain were selected and randomly divided into a control group(n=35) and a combination group(n=37). The control group was treated with gabapentin, and the combination group was treated with high-intensity ultrasound on the basis of the control group. The scores of the National Institute of Health Stroke Scale(NIHSS), modified Barthel index, and the levels of interleukin-6(IL-6), C-reactive protein(CRP), visual analogue scale(VAS) score, neuropathic pain scale(NPS) score, the levels of CD4+, CD8+, CD4+/CD8+, miR-19a, miR-30b and miR-29c, therapeutic effect and occurrence of adverse reactions were compared between two groups. 
    Results After treatment, the NIHSS score, IL-6, CRP, VAS score, NPS score, miR-19a, miR-30b and miR-29c expression levels in the two groups were lower than those before treatment, and the levels of improved Barthel index, CD4+, CD8+, CD4+/CD8+ were higher than those before treatment. After treatment, NIHSS score, IL-6, CRP, VAS score, NPS score, miR-19a, miR-30b, and miR-29c expression levels in the combination group were lower than those in the control group, while the levels of modified Barthel index, CD4+, CD8+ and CD4+/CD8+ were higher than those of the control group(P＜0.05). The total effective rate of clinical treatment in the combination group was higher than that in the control group(P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05). 
    Conclusion High-intensity ultrasound combined with gabapentin in the treatment of patients with neuropathic pain can significantly improve neurological function and immune function, reduce pain and inflammatory response, and regulate the expression of miR-19a, miR-30b and miR-29c, showing a significant therapeutic effect.

    Value of shear wave elastrography combined with AKT1 in predicting the efficacy and short-term prognosis of neoadjuvant chemotherapy for HER2-positive locally advanced breast cancer patients
    QIN Li-li, CHENG Hong, KUANG Si-jie, WANG Kai-quan
    2022, 43(11):  1297-1301,1327.  doi:10.3969/j.issn.1007-3205.2022.11.012
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    Objective To study the value of shear wave elastrography(SWE) combined with serine/threonine kinase1(AKT1) in predicting the efficacy and short-term prognosis of neoadjuvant chemotherapy(NC) for human epidermal growth factor receptor-2(HER2)-positive locally advanced breast cancer patients. 
    Methods In total, 124 patients with HER2-positive locally advanced breast cancer were selected as research subjects. All patients received NC treatment, and the pathological complete remission(pCR) rate was recorded. The SWE parameters and positive rate of AKT1 of patients with different curative effects were compared, and the related factors affecting the pCR were analyzed. The short-term prognosis of patients with different pathological characteristics was compared. 
    Results Among the 124 patients, 2 were lost to follow-up and 122 were enrolled, including 38 patients who reached the pCR, with the pCR rate of 31.15%. The follow-up time ranged from 4 to 12 months. In addition, 40 cases died and 82 cases survived. The one-year survival rate was 67.21%. Multivariate logistic analysis showed that the degree of differentiation(OR=0.614, 95%CI=0.482-0.782, P＜0.001), elastic modulus(OR=0.431, 95%CI=0.286-0.650, P＜0.001) and AKT1 positive(OR=0.565, 95%CI=0.338-0.944, P=0.029) were independent influencing factors for the curative effect of NC(P＜0.05). The area under ROC curve(AUC) of joint prediction probability of elastic modulus value + AKT1 to evaluate the pCR was higher than that of single index(P＜0.05). The 1-year survival rates of patients with different degree of differentiation, elastic modulus and AKT1 expression level were significantly different(P＜0.05). 
    Conclusion SWE parameters combined with AKT1 can help to judge the NC efficacy and short-term prognosis of HER2-positive locally advanced breast cancer patients. 

    The diagnostic value of vaginal ultrasound for tubal pregnancy and the comparison between methotrexate and laparoscopy
    LI Hong-mei, SHI Shao-feng, XIAO Xian-jing
    2022, 43(11):  1302-1305.  doi:10.3969/j.issn.1007-3205.2022.11.013
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    Objective To investigate the diagnostic value of vaginal ultrasound in tubal pregnancy and to observe the effect of conservative treatment with methotrexate versus laparoscopic treatment. 
    Methods Ninety-four patients with tubal pregnancy admitted to our hospital were retrospectively selected to undergo vaginal ultrasound(vaginal ultrasound group) and abdominal ultrasound(abdominal ultrasound group), and the 94 patients were divided into two subgroups according to the treatment modality, including 45 cases in the methotrexate group and 49 cases in the laparoscopic group. The diagnostic value of vaginal ultrasound for tubal pregnancy was compared, and the efficacy of conservative treatment with methotrexate versus laparoscopic treatment on tubal pregnancy was analyzed. 
    Results The positive rates of ultrasound imaging findings such as intrauterine pseudopregnancy sac, adnexal mass, pregnancy germ, yolk sac, and heart bud pulsation were 37.23%, 94.68%, 42.55%, 47.87% and 12.77% respectively, which were higher than 15.96%, 76.60%, 18.09%, 26.60% and 10.64% by abdominal ultrasound, suggesting significant differences(P＜0.05). The diagnostic accuracy of transvaginal ultrasound was 92.55%, which was higher than that(76.60%) of abdominal ultrasound(P＜0.05). The length of hospitalization and the recovery time of human chorionic gonadotropin(hCG) in the laparoscopic group were significantly shorter than those in the methotrexate group, and the incidence of abdominal pain was higher than that in the methotrexate group, suggesting significant differences(P＜0.05). At 1 year after treatment, the intrauterine pregnancy rate in laparoscopic group was lower than that in methotrexate group, suggesting significant differences(P＜0.05), but there was no significant difference in tubal pregnancy again between two groups(P＞0.05). 
    Conclusion Vaginal ultrasound has a high diagnostic value for tubal pregnancy, while conservative treatment with methotrexate and laparoscopic treatment have certain therapeutic effects on tubal pregnancy, and each has its own advantages. The clinical choice can be made based on treatment needs.

    Value of combined application of MRI 3D-TOF and 3D-FIESTA-C sequences in the diagnosis of primary hemifacial spasm
    ZHANG Xue, WANG Ya-li, LIU Xiao-ning, ZHANG Cai-xia, PENG Yu
    2022, 43(11):  1306-1310.  doi:10.3969/j.issn.1007-3205.2022.11.014
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    Objective To explore the value of combined application of magnetic resonance imaging(MRI) 3D-TOF-MRA and 3D-FIESTA-C sequence in the diagnosis of the neurovascular relationship in primary hemifacial spasm(pHFS). 
    Methods The MRI data of 58 patients with pHFS who underwent microvascular decompression were retrospectively analyzed. All patients underwent 3D-TOF-MRA and 3D-FIESTA-C sequence scanning, and multiplanar reconstruction was performed on the brainstem, facial nerve and peripheral blood vessels.The adjacent relationship between facial nerve and blood vessel in patients with hemifacial spasm(HFS) was determined.The contact relationship between nerve root and peripheral blood vessels on symptomatic side and non-symptomatic side, as well as the number of nerve compression and deformation was calculated. The responsible blood vessel and its source were further identified, and compared with the intraoperative anatomical results. 
    Results In all patients with HFS, compared with the postoperative results of microvascular decompression, the combined application of MRI 3D-TOF-MRA and 3D-FIESTA-C sequence showed that the positive rate of neurovascular contact and compression on the symptomatic side was 94.83%(55/58), and the positive rate of neurovascular contact and compression on the non-symptomatic side was 17.24%(10/58); the difference between the two groups was statistically significant(χ2=373.812, P＜0.05). Anterior inferior cerebellar artery compression was the most common, accounting for 63.79%(37/58), followed by compression of posterior inferior cerebellar artery, vertebral artery, basilar artery, vein and the combined compression of vertebral artery + anterior inferior artery.Of them, 58 patients underwent 59 times of microvascular decompression, of which 2 cases were evaluated as no compression of the facial nerve before operation and during operation, and 1 case as no facial nerve compression before operation but posterior inferior cerebellar artery compression during operation. The sensitivity and specificity of combined application of preoperative MRI 3D-TOF-MRA and 3D-FIESTA-C sequence in the diagnosis of  responsible vascular compression of the facial nerve were 98.2% and 100% respectively. 
    Conclusion The combined application of MRI 3D-TOF-MRA and 3D-FIESTA-C sequence in patients with primary facial spasm can accurately determine the adjacent relationship of cranial nerves and blood vessels, and can guide the selection of appropriate treatment plans in clinical practice.

    Quantitative analysis of lumbar bone marrow fat content in patients with type 2 diabetes mellitus and non-diabetic patients
    CUI Feng-zhen, WANG Shi-lei, ZHAO Yue-qin, ZHANG Zhe, CAO Jiang-xin
    2022, 43(11):  1311-1317.  doi:10.3969/j.issn.1007-3205.2022.11.015
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    Objective To compare the bone marrow fat(BMF) content of lumbar spine between type 2 diabetes mellitus(T2DM) patients and non-diabetic patients. 
    Methods We conducted a prospective analysis of 100 patients who underwent lumbar MRI iterative decomposition of water and fat with echo asymmetry and least-squares estimation(IDEAL) sequence. The IDEAL-fat and IDEAL-water signal values of lumbar bone marrow were measured. The BMF fraction(BMFFIDEAL) was calculated. The difference of mean IDEAL-fat signal value, mean IDEAL-water signal value and the BMFFIDEAL value of lumbar bone marrow between T2DM group and non-diabetic group were compared, and their correlation with age, gender, body mass index(BMI) and glycated hemoglobin A 1c(HbAlc) were analyzed. 
    Results There was no significant difference in the mean IDEAL-fat signal value and mean IDEAL-water signal value of lumbar bone marrow between T2DM group and non-diabetic group(P＞0.05). The BMFFIDEAL value of lumbar bone marrow in T2DM group was higher than that in non-diabetic group(P＜0.05). There was no significant difference in the BMFFIDEAL value of lumbar bone marrow between male and female group, and between normal group and overweight group in T2DM group(P＞0.05), as well as in non-diabetic group(P＞0.05). There was no significant difference in the IDEAL-fat value among L1-L5 in both T2DM group and non-diabetic group(P＞0.05). There was significant difference in the IDEAL-water value and BMFFIDEAL value among L1-L5 in both T2DM group and non-diabetic group(P＜0.05). The BMFFIDEAL value of L1 of bone marrow was lower than that of L3 in T2DM group. The IDEAL-water value of L1 was higher than that of L3， and BMFFIDEAL value of L1 was lower than that of L3and L4 in non-diabetic group(P＜0.05). The BMFFIDEAL value of lumbar bone marrow was positively correlated with age in T2DM group and non-diabetic group. The BMFFIDEAL value of lumbar bone marrow was positively correlated with HbAlc value in T2DM group(P＜0.05). 
    Conclusion The BMF content of lumbar spine in T2DM patients was higher than that in non-diabetic patients, which is associated with age and HbAlc, but not related to gender and BMI.

    Analysis of the application value of DEI and GFR calculated by renal dynamic imaging in the diagnosis and prognosis prediction of patients with chronic obstructive hydronephrosis
    CHEN Wen, LI Ze-sheng, TANG Qian, LI Gang
    2022, 43(11):  1318-1322,1332.  doi:10.3969/j.issn.1007-3205.2022.11.016
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    Objective To investigate the application value of diuretic excretion index(DEI) and glomerular filtration rate(GFR) calculated by renal dynamic imaging in the diagnosis and prognosis prediction of patients with chronic obstructive hydronephrosis. 
    Methods Eighty-two patients with chronic obstructive hydronephrosis were selected as the research group, and 45 healthy people undergoing physical examination during the same period were selected as the control group. The DEI and GFR of the two groups were compared, the influencing factors of chronic obstructive hydronephrosis were analyzed, and the diagnostic value of DEI and GFR in chronic obstructive hydronephrosis was evaluated. The renal dynamic imaging parameters of patients with different degrees of hydronephrosis were compared, and the correlation between renal dynamic imaging parameters and the degree of hydronephrosis was analyzed. The application value of DEI and GFR in the 1-month prognosis prediction of patients with chronic obstructive hydronephrosis was analyzed. 
    Results The renal dynamic imaging parameters DEI and GFR in the research group were lower than those in the control group(P＜0.05). Both DEI and GFR were influencing factors of chronic obstructive hydronephrosis(P＜0.05). The area under the ROC curve(AUC) of DEI and GFR for the diagnosis of chronic obstructive hydronephrosis was 0.784 and 0.827, respectively, and the AUC of combined detection was the largest(0.910). DEI and GFR were lower in patients with severe chronic obstructive hydronephrosis than in patients with moderate and mild disease, and lower in patients with moderate disease than in patients with mild disease(P＜0.05). DEI and GFR were negatively correlated with the degree of hydronephrosis in patients with chronic obstructive hydronephrosis(r=-7.360, -8.015, P＜0.05). Patients with high DEI and GFR had a lower rate of no renal function at 1 month after surgery, as compared with those with low DEI and GFR(P＜0.05). There was a negative correlation between DEI, GFR and the rate of no renal function in patients with chronic obstructive hydronephrosis(r=-0.614, -0.653, P＜0.05).  
    Conclusion Calculation of DEI and GFR by renal dynamic imaging has certain application value in the diagnosis and prognosis prediction of chronic obstructive hydronephrosis.

    Clinical diagnostic value of expression levels of β2M, CD62P and CD63 in ITP
    XU Feng
    2022, 43(11):  1323-1327.  doi:10.3969/j.issn.1007-3205.2022.11.017
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    Objective To study the clinical diagnostic value of expression levels of β2-microglobulin(β2M), platelet membrane glycoproteins CD62P and CD63 in primary immune thrombocytopenia(ITP). 
    Methods In total, 45 patients with ITP who were treated in our hospital were selected as ITP group, 40 patients with moderate or severe anemia as anemia group and 40 healthy people undergoing physical examination during the same period as the control group. The baseline data of the three groups were compared, and platelet(PLT), the mean platelet volume(MPV), plateletcrit(PCT) and platelet distribution width(PDW) of the three groups were detected. The expression levels of β2M, CD62P and CD63 were detected by enzyme-linked immunosorbent assay and compared. The influencing factors of ITP were analyzed, and the diagnostic value of expression levels of β2M, CD62P and CD63 in ITP was analyzed by ROC curve. 
    Results There were statistical differences among the control group, anemia group and ITP group with respect to vital signs, PLT, MPV, PCT, and PDW(P＜0.05), among which the ITP group had the lowest level of vital signs, PLT, MPV, PCT, and PDW, followed by anemia group and the control group(P＜0.05). The serum expression levels of β2M, CD62P and CD63 was the lowest in control group, followed by anemia group and ITP group(P＜0.05). Logistic regression analysis showed that the elevated levels of serum β2M, CD62P and CD63 were the influencing factors of primary ITP. Receiver operating characteristic(ROC) curve analysis showed that the combined detection had a higher diagnostic value for ITP than the detection of β2M, CD62P and CD63 alone(P＜0.05). 
    Conclusion β2M, CD62P and CD63 are involved in the occurrence and development of ITP. The specificity and sensitivity of combined detection of the three are relatively higher in the early diagnosis of ITP.

    Correlation analysis of expression levels of serum PS-PLA1, CCL19, IL-17, IL-23 and disease activity in patients with systemic lupus erythematosus
    DU Ya-tao, CAO Gan, CAI Hui-xin, YANG Song, SUN Yang
    2022, 43(11):  1328-1332.  doi:10.3969/j.issn.1007-3205.2022.11.018
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    Objective To analyze the correlation between expression levels of serum phosphatidylserine-specific phospholipase A1(PS-PLA1), chemokine ligand 19(CCL19), interleukin-17(IL-17), and interleukin-23(IL-23) and disease activity in patients with systemic lupus erythematosus(SLE). 
    Methods Clinical data of 103 patients with SLE were collected retrospectively, and the patients were divided into the mild subgroups(n=31), the moderate subgroups(n=50), and the severe subgroup(n=22) according to the systemic lupus erythematosus disease activity score(SLEDAS). Another 62 people undergoing physical examination population during the same period were selected as the control group. The blood routine index ［white blood cell(WBC) count, lymphocyte percentage(LY%), platelet(PLT), hemoglobin(Hb)］ and immune function-related index ［immunoglobulin G(IgG), immunoglobulin A(IgA), immunoglobulin M(IgM), complement 3(C3), and complement 4(C4) ］ of the two groups were compared between two groups. The levels of serum PS-PLA1, CCL19, IL-17, and IL-23 between the research group and the control group as well as between each subgroup were analyzed, and the correlation of PS-PLA1, CCL19, IL-17, IL-23 and blood routine and immune function-related indexes was analyzed by Pearson correlation analysis method. 
    Results The levels of complete blood WBC, LY%, PLT, Hb, C3, and C4 in the research group were lower than those of the control group, while the levels of serum IgG and IgA and IgM were higher than those of the control group(P＜0.05). The levels of serum PS-PLA1, CCL19, IL-17, and IL-23 in the research group were higher than those in the control group(P＜0.05). The levels of serum PS-PLA1, CCL19, IL-17, and IL-23 were higher in the severe subgroup than in the mild and moderate subgroups, and higher in moderate subgroup than in the mild subgroup(P＜0.05). The results of Pearson correlation analysis showed that PS-PLA1 and IgG expression were positively correlated(P＜0.05), CCL19, IL-17, IL-23 and IgG, IgA, IgM expressions were positively correlated(P＜0.05). and IL-17, IL-23 and C3 expression were negatively correlated(P＜0.05). 
    Conclusion The levels of serum PS-PLA1, CCL19, IL-17 and IL-23 in patients with SLE are elevated, and their levels are closely related to the disease activity and cellular immune dysfunction, and may serve as new targets for the clinical diagnosis and treatment of SLE.

    Effects of dexmedetomidine on regional cerebral oxygen saturation and POCD during cardiopulmonary bypass in patients undergoing heart valve replacement
    ZHAGN Dong-ying, MA Long, WANG Jia-zheng, CHEN Yong-xue
    2022, 43(11):  1333-1337,1342.  doi:10.3969/j.issn.1007-3205.2022.11.019
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    Objective To investigate the effect of dexmedetomidine on regional cerebral oxygen saturation (rSO2) during cardiopulmonary bypass (CPB) and postoperative cognitive dysfunction (POCD) in patients undergoing heart valve replacement. 
    Methods A total of 80 patients undergoing elective heart valve replacement were selected and randomly divided into the control group and the observation group, with 40 cases in each group. In observation group, 0.5 μg/kg dexmedetomidine was injected intravenously before induction of anesthesia, and then maintained at a dose of 0.5 μg·kg-1·h-1 until the end of the operation, and the control group was intravenously infused with normal saline. Both groups of patients received intravenous midazolam, sufentanil, etomidate, and rocuronium bromide for induction of anesthesia, and intravenous infusion of propofol and rocuronium bromide, and intermittent infusion of sufentanil to maintain anesthesia. The rSO2, partial pressure of carbon dioxide (PCO2), hematocrit (HCT), hemoglobin (Hb), mean arterial pressure (MAP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels on the left and right sides at each time period of before operation (T0), before induction (T1), after induction and before the initiation of CPB (T2), from the initiation of CPB to the end of cooling (T3), and from the end of CPB cooling to the initiation of rewarming (T4), from the initiation of CPB rewarming to shutdown (T5), and at 30 min after shutdown (T6) were compared between two groups. The cognitive function of the patients was assessed before and at 7 d after the operation, and the incidence of POCD was recorded. 
    Results There were significant differences in PCO2, HCT, Hb and MAP between two groups at different time points (P＜0.05), but there was no significant difference in inter-group comparison and interaction between groups and time points (P＞0.05). The difference of interaction between groups, time points and time points between groups were statistically significant with respect to left rSO2, right rSO2, serum TNF-α and IL-6 (P＜0.05). The scores of mini-mental state examination (MMSE) in both groups decreased after operation, which were higher in the observation group than in the control group (P＜0.05). The postoperative incidence of POCD in the observation group was 2.50%, which was lower than 17.50% in the control group (χ2=5.000, P=0.025). 
    Conclusion Pre-filling dexmedetomidine during heart valve replacement and maintaining the administration until the end of the operation can effectively increase the patient′s rSO2, the reduce the levels of TNF-α and IL-6 and the levels of inflammatory indicators. Therefore, it can effectively improve the balance of cerebral oxygen supply and demand during CPB, and reduce the incidence of POCD.