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Table of Content

    25 January 2023, Volume 44 Issue 1
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    Protective effect and mechanism of butorphanol combined with flurbiprofen axetil preconditioning on renal injury induced by limb ischemia-reperfusion in mice through ANG (1-7)
    LI Hai-ying, ZHANG Yu-ping, ZHANG Qing, ZHANG Li-min
    2023, 44(1):  5-9,41.  doi:10.3969/j.issn.1007-3205.2023.01.002
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    Objective  To investigate the protective effect of butorphanol combined with flurbiprofen axetil preconditioning on renal injury induced by limb ischemia-reperfusion in mice through angiotensin (1-7) ［ANG (1-7)］ and its effect on TNF superfamily member 14 ligand (LIGHT)/TNF superfamily member 14 (HVEM) in the inflammatory pathway. 
    Methods  Forty-five SPF grade BABL/c mice were randomly divided into control group (n=15), model group (n=15), and experimental group (n=15). Except the control group, renal injury model induced by limb ischemia-reperfusion was established. The experimental group was pretreated with butorphanol and flurbiprofen axetil for 12 h before modeling, and the control group and model group were given the same amount of normal saline. HE staining was used to confirm the pathological level and pathological score of kidney tissues of mice in each group. Biochemical analysis was used to determine the levels of serum creatinine (Scr) and urea nitrogen (BUN), and the levels of ANG (1-7) expression in peripheral blood and kidney tissues. The mRNA and protein expression levels of LIGHT and HVEM in kidney tissues were detected by qPCR and Western blot. 
    Results  Compared with the control group, the renal tissue injury, pathological score, and the expression of Scr and BUN decreased, the expression level of ANG (1-7) decreased, and LIGHT and HVEM increased in the model group (P＜0.01). Compared with the model group, the renal tissue injury, pathological score, and the expression of Scr and BUN decreased, the expression level of ANG (1-7) increased, and LIGHT and HVEM decreased (P＜0.01). 
    Conclusion  Butorphanol combined with flurbiprofen axetil preconditioning has a protective effect on renal injury induced by limb ischemia-reperfusion in mice, and its mechanism may be related to the intervention of ANG (1-7) on the expression of LIGHT/HVEM signal pathway proteins. 

    Correlation between left ventricular compliance assessed by diastolic wall strain and new atrial high-rate episodes
    LIANG Xiao-yun, ZHENG Ming-qi, JI Li-shuang, WANG Le, WEI Mei, LIU Gang
    2023, 44(1):  10-15,56.  doi:10.3969/j.issn.1007-3205.2023.01.003
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    Objective  To explore the association of left ventricular compliance assessed by diastolic wall strain (DWS) with new atrial high-rate episodes (AHREs) after the implantation of cardiac implantable electronic devices(CIEDs). 
    Methods  The medical records of 201 patients with CIEDs implanted in the First Hospital of Hebei Medical University were collected retrospectively. The patients were followed up for more than 2 years. They were divided into AHREs group and non-AHREs group according to occurrence of AHREs. The preoperative DWS and general data of the two groups were compared, and the independent risk factors of AHREs after operation were analyzed by multivariate COX stepwise regression analysis. 
    Results  Of all patients, 26 had AHREs within 12 months after implantation, and a total of 64 patients had AHREs within 2 years after implantation. During the follow-up period, the AHREs group and the non-AHREs group were compared, and there were significant differences in left atrial anteroposterior diameter, left atrial transverse diameter and DWS (P＜0.05). Multivariate COX stepwise regression analysis showed that the increase of left atrial transverse diameter and the decrease of DWS were independent risk factors for AHREs in patients after CIEDS (P＜0.05). ROC curve showed that the optimal critical value of DWS was 0.35, the sensitivity was 81%, and the specificity was 82%. Compared with the group with DWS ≥ 0.35, the group with DWS<0.35 had an increased risk of AHREs (P＜0.05).
    Conclusion  As an echocardiographic marker reflecting left ventricular diastolic function, reduced DWS values increase the risk of new AHREs after CIEDS implantation. 

    Association analysis of SLC16A11, SLC16A13 gene polymorphism and hepatitis B-related liver cancer
    WANG Ying-ying, ZHANG Xian-pei, LIU Zhen-yang, YAN Li-na, GAO Xia
    2023, 44(1):  16-19,67.  doi:10.3969/j.issn.1007-3205.2023.01.004
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    Objective  To investigate the association between SLC16A11 and SLC16A13 genes and hepatitis B-related liver cancer.  
    Methods  In total, 1 039 inpatients and physical examinees were selected from the First Hospital of Hebei Medical University, the Second Hospital of Hebei Medical University, the Fourth Hospital of Hebei Medical University and the Fifth Hospital of Shijiazhuang City, Hebei Province. Among them, 421 patients with hepatitis B-related liver cancer were selected as case group, and 370 healthy people and 248 with natural clearance of HBV as the control group. The association between SLC16A11, SLC16A13 gene polymorphisms and hepatitis B-related liver cancer was analyzed and the odds ratio was calculated by using statistical analysis methods such as χ2 test and binary logistic regression analysis. 
    Results  The population with natural clearance of HBV served as controls. When compared with AA genotype, the AG genotype of the SLC16A13 rs4796576 gene could significantly increase the risk of cancer (OR=1.544, 95%CI：1.073-2.224). Compared with the C allele, the dominant model carrying the G allele of the SLC16A13 rs4796576 gene also significantly increased the risk of cancer (OR=1.530, 95%CI：1.079-2.170). 
    Conclusion  Compared with the population with naturally clearance of HBV, the SLC16A13 rs4796576 gene polymorphisms is related to hepatitis B-related liver cancer.

    Comparison of the intra-day blood glucose variation indexes of inpatients with type 2 diabetes mellitus between different treatment regimens after insulin pump treatment
    LIU Qing-qing, FU Yong-qi, RONG Yi-hua, ZHENG Kun-jie, SUN Dian-jing
    2023, 44(1):  20-24,80.  doi:10.3969/j.issn.1007-3205.2023.01.005
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    Objective  To study the intra-day blood glucose variation of inpatients with type 2 diabetes mellitus (T2DM) between different regimens after insulin pump treatment. 
    Methods  A total of 165 patients with T2DM were selected and given hypodermic insulin pump for hypoglycemic treatment. The pump was withdrawn after the blood glucose reached the standard. The patients were randomly divided into the detemir (Det)+aspart (Asp) group (control group) and the Asp30 group (experimental group). Blood glucose variation indexes including minimum blood glucose before removing the subcutaneous pump (bminGlu), standard deviation of blood glucose before removing the subcutaneous pump (bSDBG), postprandial glucose excursion before removing the subcutaneous pump (bPPGE), largest amplitude of glycemic excursions before removing the subcutaneous pump (bLAGE) and total insulin before removing the subcutaneous pump (bTins) on the day of pump with drawal were compared between two groups. The blood glucose variation indexes on the 4th day after insulin injection were compared between two groups, including minimum blood glucose after removing the subcutaneous pump (aminGlu), standard deviation of blood glucose after removing the subcutaneous pump (aSDBG), postprandial glucose excursion after removing the subcutaneous pump (aPPGE）, largest amplitude of glycemic excursions after removing the subcutaneous pump (aLAGE) and total insulin after removing the subcutaneous pump (aTins). 
    Results  There was no significant difference in bminGlu, bSDBG, bPPGE, bLAGE, bTins, aminGlu, aSDBG, aPPGE, aLAGE and aTins (P＞0.05). 
    Conclusion  For hospitalized patients with T2DM, both Asp30 injection twice a day and Asp+Det injection at meals could control blood glucose and reduce blood glucose fluctuation after insulin pump treatment. 

    Clinical study of the effect of intestinal microecological modulators on intestinal microbiome and immune microenvironment in patients with rheumatoid arthritis
    WANG Chan, WANG Jun-hua, ZUO Wei, XU Ming-jun, ZHANG Gang
    2023, 44(1):  25-29,61.  doi:10.3969/j.issn.1007-3205.2023.01.006
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    Objective  To explore the effects of intestinal microecological modulators on the intestinal microbiome and immune microenvironment of patients with rheumatoid arthritis (RA). 
    Methods  A total of 90 RA patients who were treated in our hospital were divided into 2 groups: control group (treated with oral methotrexate tablets, n=45) and observation group (treated with intestinal microecological modulators, n=45). The diversity of the intestinal microbiome was analyzed. The levels of immunoglobulin G (IgG), immunoglobulin A (IgA) and immunoglobulin M (IgM) were detected by enzyme-linked immunosorbent assay (ELISA). The classification of diseases and disabilities in two groups was calculated before and after treatment. Disease activity score 28-erythrocyte sedimentation rate (DAS28-ESR) and disease activity score 28 (DAS28) were used to assess overall health status. 
    Results  After treatment, the evenness and richness of microbiome in two groups were increased compared with those before treatment, which were higher in the observation group than in the control group, IgA, IgM and IgG in two groups were increased compared with those before treatment, which were higher in the observation group than in the control group. The proportion of grade Ⅰ and Ⅱ patients in both groups was higher than that before treatment, and the proportion of grade Ⅲ and Ⅳ patients was lower than that before treatment (P＜0.05). After treatment, the significant efficiency and total effective rate in the observation group were higher than those in the control group, while the inefficiency in the observation group was lower than that in the control group; the disease activity score in the observation group was higher than that in the control group (P＜0.05). 
    Conclusion  Intestinal microecological modulators can effectively control the occurrence and development of disease activities in RA patients by regulating the intestinal microbiome and immune microenvironment, which is a safe and effective treatment method.

    Predictive value of Frailty score for the adverse reactions of ixazomib citrate in the treatment of multiple myeloma
    CHEN Ling, ZENG Rong, TAN Jiu-mei, DENG Lan
    2023, 44(1):  30-34.  doi:10.3969/j.issn.1007-3205.2023.01.007
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    Objective  To investigate the predictive value of Frailty score for adverse reactions of ixazomib citrate in the treatment of multiple myeloma(MM). 
    Methods  A total of 72 patients with MM were selected and treated with ixazomib citrate combined with thalidomide and dexamethasone (TD) regimen. The therapeutic effect and adverse reactions were observed. According to the degree of adverse reactions of patients, they were divided into grade Ⅰ-Ⅱ group and grade Ⅲ-Ⅳ group.The Frailty score was compared between two groups. Cox regression model was used to analyze the influencing factors of chemotherapy-related grade Ⅲ-Ⅳ adverse reactions. Receiver operating characteristic (ROC) curve model was used to analyze the predictive value of Frailty score for chemotherapy-related grade Ⅲ-Ⅳ adverse reactions. 
    Results  All 72 MM patients were treated with ixazomib citrate, with a total effective rate of 80.55%; adverse reactions occurred in 70 cases, and fatigue accounted for the highest proportion, with an incidence rate of 72.22%, followed by lymphocyte reduction of 25.00% and anemia of 18.06%, and no adverse reactions occurred in 2 cases. The Frailty score of grade Ⅲ-Ⅳ group was higher than that of grade Ⅰ-Ⅱ group(P＜0.05). The 70 patients with adverse reactions were followed up for 12 months, and their average survival time was (22.30±2.28) months. Cox regression analysis showed that Frailty score ≥ 2 was the influencing factor of grade Ⅲ-Ⅳ adverse reactions in MM patients.ROC curve analysis showed that the Frailty score predicted chemotherapy-related grade Ⅲ-Ⅳ adverse reactions with an AUC value of 0.925(95%CI: 0.816-1.000, P＜0.001), a sensitivity of 88.90% and a specificity of 100.00%. 
    Conclusion  Common adverse reactions during the treatment of MM patients with ixazomib citrate are fatigue, anemia, and thrombocytopenia. During treatment, the Frailty scoring system is used to evaluate adverse reactions, which is helpful for timely detection of those with high risk of adverse reactions and provides guidance for the adjustment of treatment plans.

    The predictive value of miR-19b-3 pevaluated by Logistic regression combined with ROC curvein the treatment of depression
    JIANG Hong-yun, ZHOU Jin-bo, LIU Ran
    2023, 44(1):  35-41.  doi:10.3969/j.issn.1007-3205.2023.01.008
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    Objective  To explore the predictive value of microRNA-19b-3p (miR-19b-3p)evaluated by Logistic regression combined with ROC curve in the treatment of depression. 
    Methods  A total of 112 patients with depression admitted to our hospital were selected as the research subjects (case group), and 60 healthy volunteers who presented to our hospital for physical examination during the same period were selected as the control group. The expression levels of peripheral serum miR-19b-3p in all subjects were detected by real-time quantitative polymerase chain reaction (PCR), and the expression levels of serum miR-19b-3p in the two groups before treatment and changes in the expression levels of serum miR-19b-3p in the case group before and after treatment were compared. According to the therapeutic effect, the case group was subdivided into a good prognosis group and a poor prognosis group, and the serum miR-19b-3p expression levels and other factors were compared between the good prognosis group and the poor prognosis group. Logistic regression analysis was used to identify the risk factors for poor prognosis in patients with depression, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum miR-19b-3p expression levels before and after treatment for poor prognosis in patients with depression. 
    Results  Before treatment, the serum miR-19b-3p level in the case group was higher than that in the control group (P＜0.05), and after treatment, the serum miR-19b-3p level in the case group was lower than that before treatment (P＜0.05). Family history of depression (positive), poor treatment compliance, poor family social support, poor relationship with neighbors, the proportion of major life events, the number of episodes, and serum miR-19b-3p levels before and after treatment were higher in the poor prognosis group than in the good prognosis group (P＜0.05). Logistic regression analysis showed that poor treatment compliance, poor family social support, associated psychotic symptoms, miR-19b-3p (before and after treatment), and major life events were all risk factors for poor prognosis in patients with depression (P＜0.05). ROC curve analysis showed that the area under the ROCcurve (AUC), sensitivity, specificity and the optimal cut-off point of serum mir-19b-3p level before treatment in predicting the poor prognosis of patients with depression were 0.739, 78.56%, 64.28%, and 11.25, respectively. The AUC, sensitivity, specificity, and optimal cut-off point of serum miR-19b-3p levels after treatment in predicting poor prognosis in patients with depression were 0.756, 80.75%, 60.15%, and 7.14, respectively. 
    Conclusion  Serum miR-19b-3p is abnormally highly expressed in patients with depression, which has a certain relationship with the poor prognosis of patients with depression, and can be used to predict the prognosis of patients with depression.
    Study on influencing factors of 30-day prognosis in patients with acute paraquat poisoning
    FAN Dan-dan, YAO Fang-lan, PEI Hong-hong, GAO Ye
    2023, 44(1):  42-45,50.  doi:10.3969/j.issn.1007-3205.2023.01.009
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    Objective  To explore the influencing factors of 30-day prognosis in patients with acute paraquat poisoning(APP) after blood purification. 
    Methods  A total of 79 patients with APP who met the inclusion and exclusion criteria in the First Affiliated Hospital of Xi′an Jiaotong Universityand the Second Affiliated Hospital of Xi′an Jiaotong University were selected. The 30-day prognosis was obtained by telephone interview. They were divided into the death group(n=40) and the survival group(n=39). Age, gender, history of hypertension, history of diabetes, poisoning dose, time from taking poison to seeing a doctor, the ratio of neutrophil to lymphocyte, the ratio of monocyte to lymphocyte, blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, prothrombin time, thrombin time, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) were compared between two groups. Binary logistic regression analysis was used to predict the risk factors of death. The area under the receiver operating characteristic(ROC)curve(AUC) was used to analyze the predictive value of the poisoning dose of the death group. Kaplan-Meier survival curve was used to analyze the relationship between poisoning dose and 30-day prognosis. 
    Results  The poisoning dose and APACHE Ⅱwere independent risk factors for 30-day prognosis(P＜0.05). The AUC of poisoning dose in the death group for predicting 30-day mortality was 0.882(P＜0.001), and the cutoff value was 40 mL(sensitivity of 72.5%, specificity of 87.18%). The AUC of APACHE Ⅱ in the death group for predicting 30-day mortality was 0.722(P＜0.001), and the cutoff value was 4(sensitivity of 85%, specificity of 87.18%). Kaplan-Meier survival curve showed that there was significant difference between poisoning dose＞ 40 mL group and poisoning dose≤40 mL group with respect to 30-day cumulative survival rate(χ2=48.452，Log-rank P＜0.001). 
    Conclusion  The poisoning dose and APACHE Ⅱ can predict the 30-day prognosis of patients with APP. The poisoning dose ≤ 40 mL and APACHE Ⅱ ≤ 4 indicate favorable short-term prognosis. 

    Clinical significance of stress hyperglycemia combined with early blood lactate clearance rate in the prognosis of patients with severe traumatic brain injury
    YU Kai-wen, MENG Ling-wen
    2023, 44(1):  46-50.  doi:10.3969/j.issn.1007-3205.2023.01.010
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    Objective  To explore the clinical significance of stress-induced hyperglycemia (SIH) combined with early lactate clearance rate (LCR) in the prognosis of patients with severe traumatic brain injury (TBI).  
    Methods  Clinical data of 81 severe TBI patients were collected and divided into good prognosis group and poor prognosis group according to the survival within 28 d. The general data, occurrence of SIH and early LCR of the two groups were compared. The influencing factors of poor prognosis of severe TBI patients were analyzed by Logistic regression analysis, and the clinical value of SIH combined with early LCR for prognosis of patients was analyzed according to receiver operating characteristic (ROC) curve. 
    Results  Among 81 severe TBI patients, 36 survived and 45 died within 28 d, with a fatality rate of 55.56%. The Glasgow coma scale (GCS) score, blood oxygen saturation and early LCR in the poor prognosis group were lower than those in the good prognosis group, while the incidence of cerebral hernia, the incidence of SIH and the duration of coma were higher than those in the good prognosis group (P＜0.05). Logistic regression analysis showed that GCS score, cerebral hernia occurrence, SIH, blood oxygen saturation, duration of coma, and early LCR were risk factors for poor prognosis in severe TBI patients (P＜0.05). ROC analysis showed that the area under the ROC curve (AUC) of early LCR in predicting the prognosis of severe TBI patients was 0.764, and that of SIH in predicting the prognosis of severe TBI patients was 0.761. The AUC of the combined detection in prediction was 0.900, which was higher than that of the early LCR or SIH alone. 
    Conclusion  SIH and early LCR are closely related to the prognosis of severe TBI patients, and their combination has certain clinical value in predicting the prognosis of patients. 
    Effect of TAPB combined with RSB in LC surgery under the concept of ERSA
    ZHANG Min, ZHANG Fu-jie, TAN Hui-ling, CUI Tong-yang, WU Zhen-dong, LYU Yin-xiao
    2023, 44(1):  51-56.  doi:10.3969/j.issn.1007-3205.2023.01.011
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    Objective  To investigate the rehabilitation quality and safety of patients after different modes of nerve block under the concept of enhanced recovery (ERAS) in laparoscopic cholecystectomy (LC). 
    Methods  A total of 85 patients who underwent LC in our hospital were selected and treated with LC. According to the postoperative nerve block mode, the patients were divided into T group (n=22), TR group (n=20), P group (n=21) and N group (n=22). T Group was given right lateral costal transverse abdominal muscle plane block (TAPB), TR group was given TAPB combined with right rectus abdominis sheath block (RSB), A group was given patient-controlled intravenous analgesia (PCIA), and N group was not given analgesic intervention. The differences in duration of operation, intraoperative bleeding, Ramsay sedation score (RSS) and visual analogue scale (VAS) score in each group were observed. 
    Results  There was no significant difference in T group, TR group, P group and N group with respect to duration of operation, intraoperative bleeding and length of postoperative hospital stay (P＞0.05). The time of first exhaust and the first time of off-bed activity after operation in TR group were significantly lower than those in T group (P＜0.05), but there was no significant difference compared with P group (P＞0.05). There was no significant difference in RSS among the four groups in terms of interaction between groups, time points, time points between groups (P＞0.05). The VAS pain scores of the four groups were statistically significant in terms of interaction between groups, time points, and time points between groups. With the extension of time, the VAS pain scores of the four groups showed a downward trend (P＜0.05). At 24 h after operation, C reactive protein（CRP）, interleukin 6（IL-6）, cortisol（Cor） and E in the four groups were significantly better than those after operation, suggesting significant differences (P＜0.05). At 24 h after operation, CRP, IL-6, Cor and E in T group, TR group and P group were lower than those in N group, and CRP, IL-6, Cor and E in TR group were lower than those in T group at 24 h after operation, with no significant difference (P＜0.05). There was no significant difference between TR group and P group (P＞0.05). At 24 h after operation, CO and SV in the four groups were better than those after operation, and the difference was statistically significant (P＜0.05). At 24 h after operation, CO in T group, TR group and P group was higher than that in N group, while SV was lower than that in N group; CO in TR group was higher than that in T group, while SV was lower than that in T group, and the difference was statistically significant (P＜0.05); there was no significant difference between TR group and P group (P＞0.05). There was no significant difference in the interaction between groups, time points, and time points between groups with respect to the scores of the Mini-mental State Examination (MMSE) in the four groups (P＞0.05), but there was significant difference between time points. The MMSE score increased with time after surgery (P＜0.05). There was no significant difference among the four groups (P＞0.05). 
    Conclusion  Under the concept of ERAS, the application of TAPB combined with RSB in LC surgery can effectively reduce postoperative pain and inflammatory stress response, with good safety, which is equivalent to the effect of postoperative PCIA. 
    Effect of autologous PRP injection combined with etoricoxib in the treatment of knee osteoarthritis and its effect on cytokines
    YAN Bin, LIU Gang, ZHANG Lin, LIU Qing-bai
    2023, 44(1):  57-61.  doi:10.3969/j.issn.1007-3205.2023.01.012
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    Objective  To study the effect of autologous platelet rich plasma (PRP) injection combined with etoricoxib in the treatment of knee osteoarthritis (KOA) and its impact on cytokines. 
    Methods  Sixty-eight patients with KOA were selected and divided into single group (n=34) and combination group (n=34) according to random number table. The single group was treated with etoricoxib, and the combination group was treated with autologous PRP injection and etoricoxib. At 6 weeks after treatment, the efficacy of the two groups was compared. Before treatment and at 6 weeks after treatment, the two groups were compared in terms of osteoarthritis index ［Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score］, Lyshom Knee Rsting System (Lysholm) score, quality of life ［Index of Severity Forosteo Arthritis (ISOA) score］ and cytokines ［interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP)］, and incidence of adverse reactions during treatment. 
    Results  The total effective rate of combination group was higher than that of single group (P＜0.05). At 6 weeks after treatment, WOMAC score, ISOA score, IL-1β, TNF-α, and hs-CRP level were lower than those before treatment, while Lysholm score was higher than that before treatment; WOMAC score, ISOA score, IL-1β,TNF-α, and hs-CRP level were lower in the combination group than in the single group, and the Lysholm score was higher than that of the single group (P＜0.05). There was no significant difference in the incidence of adverse reactions between two groups (P＞0.05). 
    Conclusion  The application of autologous PRP injection combined with etoricoxib in the treatment of KOA has an obvious effect, which can alleviate the inflammatory reaction of bone joints, improve the function of knee joints and quality of life, and regulate the level of cytokines, with high safety. 
    Comparison of clinical application of reduction and plate fixation via the sinus tarsi approach and L-shaped incision reduction and internal fixation in the treatment of calcaneal fractures
    ZHAGN Qing-lin, RONG Cun-min, CHEN Lei, ZHANG Guang-hui, LI Wei, ZHANG Lei
    2023, 44(1):  62-67.  doi:10.3969/j.issn.1007-3205.2023.01.013
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    Objective  To investigate the clinical effect of reduction and plate fixation via the sinus tarsi approach and L-shaped incision reduction and internal fixation in the treatment of calcaneal fractures. 
    Methods  The clinical data of 96 patients with calcaneal fractures were selected for a retrospective study. According to different treatment plans, they were divided into tarsi sinus group and L-shaped group, with 48 cases in each group. The tarsal sinus group was treated with reduction and plate fixation via the tarsal sinus approach, and the L-shaped group was treated with L-shaped incision reduction and internal fixation. Surgical condition, postoperative recovery, excellent and good rate of surgery, and the incidence of complications were compared between two groups. Serum traumatic stress-inflammatory indexes［superoxide dismutase (SOD), malonaldehyde (MDA), tumor necrosis factor-α (TNF-α)］, transforming growth factor-β (TGF-β)/bone morphogenetic proteins(BMPs) signaling pathway indicators (TGF-β1, BMP-2, BMP-7) before and after surgery were compared between two groups. 
    Results  The duration of operation, length of hospital stay, and fracture healing time were shorter in the tarsal sinus group than in the L-shaped group, and the intraoperative bleeding, intraoperative fluoroscopy, and postoperative drainage were less than those in the L-shaped group (P＜0.05). With the prolongation of treatment time, the serum SOD level of the two groups showed a trend of decreasing and then increasing, while the MDA and TNF-α levels showed a trend of increasing and then decreasing. The fluctuation of the tarsal sinus group was smaller than that of the L-shaped group, and the differences of interaction between groups, time points and time point between groups were statistically significant (P＜0.05). The serum TGF-β1, BMP-2, and BMP-7 levels in the two groups showed a gradual increase, and the serum TGF-β1, BMP-2, and BMP-7 levels in the tarsal sinus group were higher than those in the L-shaped group (P＜0.05). The difference in the excellent and good rate of surgery between two groups was not statistically significant (P＞0.05). The overall complication rate was lower in the tarsal sinus group than in the L-shaped group (P＜0.05).  
    Conclusion  Compared with L-shaped incision reduction and internal fixation, reduction and plate fixation via the sinus tarsi approach in the treatment of calcaneal fractures can reduce surgical trauma, shorten the duration of operation, reduce stress and inflammation reactions caused by surgical trauma, reduce the incidence of complications, further improve the expression level of TGF-β/BMPs signaling pathway indexes in patients, and promote postoperative recovery, which is of higher application value in clinical practice.
    Expression of lncRNA OVAAL, miR-335 and TRIM 14 in endometrial cancer and its correlation with clinical characteristics
    GUO Li-ning, CHANG Rui, YANG Jie, LI Hui
    2023, 44(1):  68-73,111.  doi:10.3969/j.issn.1007-3205.2023.01.014
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    Objective  To investigate the expression of ovarian adenocarcinoma amplified long non-coding RNA(lncRNA OVAAL), microRNA(miR)-335 and tripartite motif 14(TRIM14) in endometrial carcinoma(EC) and their correlation with clinical characteristics. 
    Methods  A total of 86 EC patients in our hospital were selected as the case group, and 86 patients with endometrial polyps(EP) during the same period were selected as the control group. The expressions of lncRNA OVAAL, miR-335 and TRIM14 in EC cancer tissues, adjacent tissues and endometrial polyps were detected. Their relationship with clinical characteristics of EC and their predictive value for the risk of EC recurrence were analyzed. 
    Results  The expression of lncRNA OVAAL and TRIM14 in cancer tissue was higher than that in adjacent tissue and EP tissue, while the expression of miR-335 was lower than that in adjacent tissue and EP tissue(P＜0.05). The expression of lncRNA OVAAL and TRIM14 in EP tissues was higher than that in adjacent tissue, and the expression of miR-335 was lower than that in adjacent tissue(P＜0.05). The expression of lncRNA OVAAL, miR-335 and TRIM14 in cancer tissue was related to FIGO stage, histological grade, depth of myometrial invasion, lymph node metastasis, vascular invasion, and pathological type(P＜0.05). The expression of lncRNA OVAAL and TRIM14 in cancer tissues of patients with recurrence was higher than that of patients without recurrence, and the expression of miR-335 was lower than that of patients without recurrence(P＜0.05). After adjusting for FIGO stage, histological grade, depth of myometrial invasion, lymph node metastasis, vascular invasion, and extent of lymph node dissection, the expression of lncRNA OVAAL, miR-335 and TRIM14 were the influencing factors of EC recurrence(P＜0.05). The AUC of lncRNA OVAAL, miR-335 and TRIM14 combined to predict EC recurrence was greater than that of single index. 
    Conclusion  The abnormal expression of lncRNA OVAAL, miR-335 and TRIM14 in cancer tissue is related to FIGO stage, histological grade, depth of myometrial invasion, lymph node metastasis, vascular invasion, and pathological type in EC patients, which can be used as important indicators for predicting postoperative recurrence.
    Correlation of DWI and IVIM parameters with tumor marker levels in children with gliomas
    HUANG Xiao-ming, LI Jun-liang, LIU Zhen-yin, KUANG Xiao-hua, LUO Qi
    2023, 44(1):  74-80.  doi:10.3969/j.issn.1007-3205.2023.01.015
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    Objective  To investigate the correlation of diffusion-weighted imaging (DWI), and intravoxel incoherent motion diffusion-weighted imaging (IVIM) parameters with tumor marker levels in children with glioma and their diagnostic value. 
    Methods  A total of 89 children with suspected glioma diagnosed in our hospital were selected. With pathological examination as the gold standard, 62 children with definitive diagnosis of glioma were selected as the observation group, and the remaining 27 children were selected as the control group. All subjects were examined by DWI and IVIM, and the levels of carbohydrate antigen 125 (CA125), epidermal growth factor (EGF) and carcinoembryonic antigen (CEA) were detected by enzyme-linked immunosorption assay (ELISA). The levels of apparent dispersion coefficient (ADC), relative cerebral blood volume (rCBV), true water molecular dispersion coefficient (D), perfusion related dispersion coefficient (D*), CA125, EGF and CEA levels were compared in children with different conditions. The correlation between each indicator and the disease type was compared. The correlation between DWI, IVIM parameters and tumor markers in children with glioma was compared. The diagnostic value of DWI and IVIM parameters in glioma was analyzed. 
    Results  Compared with the control group, the ADC value and D parameters of the observation group were higher, while the rCBV and D* parameters were lower (P＜0.05). Compared with children with low-grade glioma, children with high-grade glioma had higher ADC values, D parameters and serum CA125, EGF and CEA levels, but lower rCBV and D* parameters (P＜0.05). The levels of rCBV and D* were negatively correlated with the type of disease (r=-0.395, P＜0.001; r=-0.405, P＜0.001), while ADC value, D, CA125, EGF, CEA levels were positively correlated with disease type (r=0.432, P＜0.001; r=0.441, P＜0.001; r=0.432, P＜0.001; r=0.409, P＜0.001; r=0.431, P＜0.001); ADC value (r=0.409, P＜0.001; r=0.415, P＜0.001; r=0.423, P＜0.001); D parameter was positively correlated with the levels of tumor markers CA125, EGF and CEA (r=0.417, P＜0.001; r=0.43, P＜0.001; r=0.409, P＜0.001); RCBV was negatively correlated with the levels of tumor markers CA125, EGF and CEA (r= -0.402, P＜0.001; r=-0.413, P＜0.001; r=-0.387, P＜0.001); D* level was negatively correlated with the levels of tumor markers CA125, EGF and CEA(r=-0.411, P＜0.001; r=-0.406, P＜0.001; r=-0.399, P＜0.001). Compared with ADC value, rCBV, D and D *, the combined detection of the four indicators was more effective in the diagnosis of glioma (P<0.05). 
    Conclusion  DWI and IVIM parameters have certain correlation with tumor markers in children with glioma, and have certain diagnostic value for the disease types of children with glioma.

    Application value of non-invasive hemodynamic monitoring in children with fulminant myocarditis
    KANG Lei, GUO Fang, BAI Xin-feng, CHENG Cai-yun, CAO Li-jing, XU Mei-xian
    2023, 44(1):  81-85,90.  doi:10.3969/j.issn.1007-3205.2023.01.016
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    Objective  To investigate the application value of non-invasive cardiac system (NICaS) in children with fulminant myocarditis (FM). 
    Methods  A total of 39 children with FM were included as the experimental group, and 47 children with pneumonia hospitalized during the same period as the control group. The cardiac index (CI), △CI, Granov Goor index (GGI) and left ventricular ejection fraction (LVEF) of both groups were monitored by NICaS and transthoracic echocardiography (TTE), and the difference in NICaS and TTE and their correlation in experimental group were compared. The experimental group was randomly divided into group A1 (n=21), in which treatment protocols were formulated by NICaS and group A2 (n=18) in which treatment protocols were formulated by TTE. The prognosis of the two groups was compared. 
    Results  The CI measured by TTE and NICaS in the experimental group was smaller than that in the control group, and the CI measured by NICaS was smaller than that by TTE in the experimental group, suggesting significant difference (P＜0.05). Pearson correlation analysis showed a significantly positive correlation between the CI measured by NICaS and that by TTE in the experimental group and the control group (r=0.853, 0.751, P＜0.001). Bland-Altman analysis showed good consistency (P=0.079) between the △CI measured by TTE and NICaS (P=0.079), and GGI measured by NICaS was significantly correlated with LVEF by TTE (r=0.727, P＜0.001). Group A1 required less infusion volume, shorter time to achieve negative fluid balance, and had a smaller mortality than group A2, all of which were statistically significant. 
    Conclusion  NICaS has good consistency with TTE in terms of CI in children with FM, which can provide simple, non-invasive, reliable and continuous hemodynamic measurements for children with FM, thereby improving the prognosis. 
    Effects of magnesium sulfate atomization inhalation as adjuvant therapy on airway resistance, pulmonary function and inflammatory factors in children with severe bronchiolitis
    SI Yong-hua, LIU Li-ying, LIU Bao-huan, GAO Yang, WANG Rong
    2023, 44(1):  86-90.  doi:10.3969/j.issn.1007-3205.2023.01.017
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    Objective  To observe the effect of magnesium sulfate atomization inhalation as adjuvant therapy on airway resistance, pulmonary function and inflammatory factors in children with severe bronchiolitis. 
    Methods  A total of 88 patients with severe bronchiolitis who were treated in the hospital were selected. They were divided into two groups by random number table method: the research group (treated with magnesium sulfate atomization inhalation as an auxiliary therapy to conventional treatment, n=44) and control group (treated with conventional treatment, n=44). Both groups were treated for 7 consecutive days. Before and after treatment, the inflammatory indicators ［tumor necrosis factor-α (TNF-α), soluble vascular cell adhesion molecule-1 (sVCAM-1), Nod-like receptor pyrin domain-3 (NLRP3), eosinophil cationic protein (ECP) levels］, airway resistance indicators ［proximal airway viscous resistance (R20), total airway resistance (Z5), total airway viscous resistance (R5), pulmonary neurogenic substance P level］, and pulmonary function indicators ［effective airway resistance (Reff), forced expiratory volume in 1 second (FEV1), maximum mid-expiratory flow (MMF) and fractional exhaled nitric oxide (FeNO) levels］ in the two groups were detected. The disappearance time of fever, wet rales, wheezing, and cough was recorded in the two groups of children. 
    Results  The levels of TNF-α, sVCAM-1, ECP and NLRP3 in the research group were lower than those in the control group (P＜0.05), and the levels of Z5, R20, R5 and pulmonary neurogenic substance P in the research group were lower than those in the control group (P＜0.05). The levels of MMF and FeNO in the research group were higher than those in the control group (P＜0.05), while the levels of Reff and FeNO in the research group were lower than those in the control group (P＜0.05). The disappearance time of fever, wet rales, wheezing, and cough in the research group was shorter than that in the control group (P＜0.005). 
    Conclusion  Magnesium sulfate atomization inhalation as adjuvant therapy for children with severe bronchiolitis can inhibit the inflammatory response, improve the airway resistance and the pulmonary function, and relieve the clinical symptoms of the children. 

    The relationship between SOCS-3, HMGB1 and Th17/Treg cell imbalance in children with henoch-schonlein purpura nephritis
    MA Zhi-hua, Bulibuli·Bahati, Abulaiti·Abuduhaer
    2023, 44(1):  91-94,99.  doi:10.3969/j.issn.1007-3205.2023.01.018
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    Objective  To study the relationship between suppressor of cytokine signaling-3(SOCS-3), high mobility group protein B1(HMGB1) and Th17/Treg cell imbalance in children with Henoch-Schonlein purpura nephritis(HSPN). 
    Methods  A total of 100 children with HSPN were selected as research subjects, and included into HSPN group. Meanwhile, 100 children with Henoch Schonlein purpura in our hospital during the same period were selected as the control group, On admission, fasting venous blood was taken from the two groups. The results of HMGB1, SOCS3 mRNA, Th17 and Treg were compared between two groups, and Th17/Treg levels were calculated. Receiver operating characteristic(ROC) curve was used to analyze the value of HMGB1, SOCS3 mRNA, Th17, Treg and Th17/Treg in predicting HSPN, and Person coefficient was used to analyze the correlation of HMGB1 and SOCS3 mRNA with Th17, Treg and Th17, Treg. 
    Results  In HSPN group, HMGB1, SOCS3 mRNA, Th17, and Th17/Treg were significantly higher than those in control group, while Treg level was significantly lower than that in control group, with statistical difference(P＜0.05). ROC analysis showed that the area under the ROC curve(AUC) of HMGB1, SOCS3 mRNA, Th17, Treg, and Th17/Treg in predicting HSPN in children was 0.944, 0.924, 0.942, 0.973 and 0.955, respectively. According to correlation analysis, HMGB1 and SOCS3 mRNA were significantly and positively correlated with Th17 and Th17/Treg, and significantly and negatively correlated with Treg(P＜0.05). 
    Conclusion  The expression of SOCS-3 and HMGB1 in children with HSPN is highly correlated with Th17/Treg cell imbalance.

    Study on the relationship between single-nucleotide polymorphisms in mitochondrial D-Loop region and the risk of laryngeal carcinoma
    CHENG Hong-kun, ZHAO Rui-li, LI Lin, XU Yu-ru, HU Guo-bin, LAN Li-li
    2023, 44(1):  95-99.  doi:10.3969/j.issn.1007-3205.2023.01.019
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    Objective  To investigate the relationship between single-nucleotide polymorphisms (SNPs) in the mitochondrial DNA (mtDNA) D-Loop region and the risk of laryngeal carcinoma. 
    Methods  Experimental samples were collected from 71 laryngeal carcinoma patients who underwent surgery in the Department of Otolaryngology Head and Neck Surgery at the Fourth Hospital of Hebei Medical University. Samples were also collected from 159 healthy people who underwent physical examination in Medical Examination Center of our hospital. The target fragment was amplified by polymerase chain reaction (PCR), and the mtDNA D-Loop region was sequenced. The χ2 test was used to analyze the relationship between different SNPs and the risk of laryngeal carcinoma, and the relationship between the SNPs associated with laryngeal carcinoma and the clinical features of these patients was also analyzed. 
    Results  SNPs in the mtDNA D-Loop region were related with the isk of laryngeal carcinoma. The genotypes of 73G, 309C, 315C and 16319G were significantly related with an increased risk in laryngeal carcinoma, whereas the genotypes of 524C, 556A, 16288T, 16291C and 16311T were associated with the lower risk of laryngeal 
    carcinoma. 
    Conclusion  SNPs in the mtDNA D-Loopregion can be used as predictors to improve the early diagnosis rate of laryngeal squamous cell carcinoma and guide the clinical treatment of the disease.
    Consistency analysis of TCD combined with TCCD and DSA for cerebral artery stenosis and its value in guiding treatment plan
    ZHANG Shan, ZHU Jun, FANG Kai-feng
    2023, 44(1):  100-105.  doi:10.3969/j.issn.1007-3205.2023.01.020
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    Objective  To investigate the consistency of transcranial Doppler sonography (TCD) combined with transcranial color-coded duplex(TCCD) and digital subtraction angiography (DSA) for cerebral artery stenosis and its value in guiding treatment plan. 
    Methods  In total, 100 patients with ischemic cerebrovascular disease were selected and underwent TCD, TCCD and DSA, and the DSA examination results were used as the “gold standard” to analyze the degree of cerebral artery stenosis, and to observe the ultrasound performance of TCD and TCCD in patients with different degrees of stenosis. The Kappa test was used to analyze the consistency of TCD combined with TCCD in the diagnosis of cerebral artery stenosis and the DSA examination results, and the systolic velocity (Vs), mean velocity (Vm) and pulsatility index (PI) of patients with different degrees of stenosis were compared. Spearman correlation coefficient model was used to analyze the correlation between Vm, PI and the degree of cerebral artery stenosis. All patients were treated medically or surgically, and Vs, Vm, and PI at admission and at 6 months after treatment were compared among patients that were given different treatment methods. 
    Results  In 100 patients with ischemic cerebrovascular disease, there were 42 cases of mild stenosis, 35 cases of moderate stenosis, 20 cases of severe stenosis, and 3 cases of occlusion. The Kappa value of the consistency between TCD combined with TCCD and DSA in the diagnosis of the degree of cerebral artery stenosis in patients with ischemic cerebrovascular disease was 0.924(95%CI:0.790-1.059), and the diagnostic agreement rate was 95.00%. Vs and Vm were higher in patients with severe stenosis than in patients with moderate stenosis and mild stenosis, while PI was lower than that in patients with moderate stenosis and mild stenosis; Vs and Vm were higher in patients with moderate stenosis than in patients with mild stenosis, and PI was lower than in patients with mild stenosis(P＜0.05). Vs and Vm were positively correlated with the degree of cerebral artery stenosis in patients with ischemic cerebrovascular disease, and PI was negatively correlated with the degree of cerebral artery stenosis(P＜0.05). Vs and Vm at admission were higher in surgically treated patients than in drug-treated patients while PI was lower than that in drug-treated patients;Vs and Vm were lower while PI was higher in surgically treated patients, as compared with drug-treated patients at 6 months after treatment; the difference in Vs, Vm and PI at admission and at 6 months after treatment was higher in surgically treated patients than in drug-treated patients(P＜0.05). 
    Conclusion  TCD combined with TCCD in the diagnosis of the degree of cerebral artery stenosis in patients with ischemic cerebrovascular disease is in high agreement with DSA, which can provide a reliable imaging reference for clinical selection of appropriate treatment plans.
    Analgesic effect of erector spinae muscle block at different timings after thoracoscopic lobectomy and its impact on pulmonary function, serum pain factors, NE and PGE2
    SHE Yong-jun, XING Chun-hua, QU Wen-ping
    2023, 44(1):  106-111.  doi:10.3969/j.issn.1007-3205.2023.01.021
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    Objective  To investigate the analgesic effect of erector spinae muscle block at different timings after thoracoscopic lobectomy and its impact on pulmonary function, serum pain factors, norepinephrine (NE) and prostaglandin E2 (PGE2). 
    Methods  In this prospective randomized controlled study, a total of 88 patients undergoing thoracoscopic lobectomy in our hospital were assigned in a 1∶1 ratio to two groups, with 44 cases in each group. Both groups were given patient-controlled intravenous analgesia after surgery. The observation group was given ultrasound-guided unilateral erector spinae plane block before skin incision, and the control group was given ultrasound-guided unilateral erector spinae plane block after surgery. The visual analogue scale (VAS) pain scores at rest and during cough, pain factors ［5-hydroxytryptamine (5-HT), serum substance P (SP), neuropeptide Y(NPY)］, hemodynamics ［heart rate (HR), mean arterial pressure (MAP)］, NE, PGE2, percentage of predicted forced expiratory volume in 1 second (FEV1% pred), FEV1/forced vital capacity (FVC), and complications were compared between two groups. 
    Results  There was no significant difference between VAS scores at rest and during cough immediately after extubation, and at 1 h, 6 h, 24 h, and 48 h after extubation in the two groups (P＞0.05). The comparison of 5-HT, SP, NPY immediately after extubation, at 6 h and 24 h after extubation between the two groups was not statistically significant (P＞0.05).HR and MAP immediately after extubation, at skin incision, and at 24 h after intubation were lower in the observation group than in the control group (P＜0.05); NE and PGE2 immediately after intubation, at skin incision and immediately after extubation in were lower in the observation group than in the control group (P＜0.05).FEV1% pred and FEV1/FVC at 48 h after extubation were higher in the observation group than in the control group (P＜0.05); the complication rate of the observation group (6.82%) was not significantly different from that of the control group (11.36%) (P＞0.05). 
    Conclusion  Thoracoscopic lobectomy before skin incision and erector spinae muscle block after operation can effectively control pain, and the former has advantages in reducing stress response, maintaining hemodynamic stability, and improving early postoperative lung function, with good safety and reliability.