Table of Content

25 June 2023, Volume 44 Issue 6

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The mechanism of GV-971 improving cognitive impairment and reducing neuroinflammation in Alzheimer′s disease

WANG Ling-ling, YANG Juan, WANG Tao, LI Jin-shi, SUI Hai-jing, ZHAO Xiao-hui

2023, 44(6):  629-634,639.  doi:10.3969/j.issn.1007-3205.2023.06.002

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Objective To investigate the mechanism of the effect of oral administration of sodium oligomannate capsules (GV-971) on cognition and neuroinflammation in Alzheimer′s disease (AD) mice. 
Methods Female APP/PS1 mice with Alzheimer′s disease were purchased and treated with oral GV-971. The cognitive function of mice was tested by Morris water maze test and Y-maze test. Amyloid β-protein (Aβ) deposition was detected by thioflavin S staining, and the levels of inflammatory cytokines interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and IL-10 in the brains of each group of mice were measured by enzyme-linked immunosorbent assay (ELISA) kits. Quantitative real time polymerase chain reaction (qRT-PCR) and Western blot were used to detect the expression levels of BACE1 mRNA and protein in the brain tissue of mice, respectively. 
Results The escape latency of the healthy group and the control group showed a decreasing trend over time, with the healthy group showing a more significant trend than the control group. The escape latency of the treatment group showed a trend of initially shortening, then prolonging, and then shortening over time. There was a significant difference in the interaction between groups, time points, and time points between groups (P＜0.05). The percentage of time spent in the target quadrant in the treatment group was less than that in the healthy group and the control group (P＜0.05). The accuracy of Y-maze passage in the treatment group was lower than that in the healthy group and control group (P＜0.05). Compared with the healthy group, the percentage and area of Aβ plaques in cerebral cortex and hippocampus the control group were increased (P＜0.05), which, however, were decreased in the treatment group, as compared with the control group, (P＜0.05). The ELISA results showed that compared with the healthy group, inflammatory cytokines IL-1β and TNF-α levels in brain tissue of mice in the control group mice were increased, while the IL-10 levels were decreased (P＜0.05). Compared with the control group, IL-1β and TNF-α levels in the treatment group were decreased, while the IL-10 levels were increased (P＜0.05). Compared with the healthy group, the mRNA and protein levels of BACE1 in the brain tissue of mice in the control group were increased (P＜0.05). Compared with the control group, the mRNA and protein expression of BACE1 in the brain of mice in the treatment group was decreased (P＜0.05). 
Conclusion GV-971 decreased the expression of BACE1 in the brain tissue, improved cognitive impairment and reduced neuroinflammation in AD mice. 


The effect of early sarcopenia screening on the prognosis and rehabilitation of stroke patients

LI Yan-li, MU Bin, YANG Wen-jie

2023, 44(6):  635-639.  doi:10.3969/j.issn.1007-3205.2023.06.003

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Objective To explore the effect of early sarcopenia screening on the prognosis and rehabilitation of patients with ischemic stroke. 
Methods A total of 200 patients with ischemic stroke admitted to Hebei Petro China Central Hospital were selected and divided into stroke with sarcopenia group (n=100) and stroke group (n=100) according to presence of accompanied sarcopenia. Skeletal muscle mass/height, calf circumference,body mass index (BMI) and prognostic outcome at 6 months after stroke were compared between two groups. The patients were divided into good prognosis group (n=128) and poor prognosis group (n=72) according to the rehabilitation effect. The influencing factors of the rehabilitation effect of patients were analyzed by Logistic data model. 
Results The skeletal muscle mass/height, calf circumference and BMI of the stroke with myopenia group were lower than those of the stroke group (P＜0.05), and the poor prognosis rate of the stroke with myopenia group was higher than that of the stroke group (P＜0.05). The National Institute of Health Stroke Scale （NIHSS） score, Glasgow Coma Scale （GCS） score, mean arterial pressure variability, hypertension, diabetes, and atrial fibrillation at admission of the good prognosis group were compared with those of the poor prognosis group (P＜0.05), Multivariate Logistic analysis showed that the higher the NIHSS score at admission, the lower the GCS score at admission, the greater the variability of mean arterial pressure, and the presence of atrial fibrillation and sarcopenia were independent risk factors for poor prognosis in ischemic stroke patients (P＜0.05). 
Conclusion Sarcopenia in patients with ischemic stroke is unfavorable for prognosis and recovery of patients. Early screening of ischemic stroke patients with sarcopenia has certain clinical value. 





Effects of transcutaneous electrical facial nerve stimulation combined with botulinum toxin type A on neurophysiology, sleep and recurrence in patients with lateral facioscapulohumeral spasm

GAO Li-na, ZHANG Xuan

2023, 44(6):  640-644.  doi:10.3969/j.issn.1007-3205.2023.06.004

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Objective To compare the clinical efficacy of transcutaneous electricalfacial nerve stimulation combined with botulinum toxin type A in patients with hemifacial spasm (HFS). 
Methods A total of 80 patients with HFS were selected and divided into control group (n=40) and observation group (n=40) according to random number table method. The control group was given repeated injection of botulinum toxin type A, and the observation group was given repeated injection of botulinum toxin type A + transcutaneous electrical facial nerve stimulation. The time to onset, time to spasm remission, incidence of adverse reactions and recurrence rates of the two groups were compared, and the degree of spasticity, neurophysiology (complex muscle action potential, blink reflex), and sleep quality ［Pittsburgh sleep quality index (PSQI)］ before and after treatment were compared. 
Results The time to onset was shorter in the observation group than in the control group, while time to spasm remission in the observation group was longer than that in the control group (P＜0.05). After treatment, the improvement of spasticity was better than that before treatment, and better in the observation group than in the control group (P＜0.05). After treatment, the compound muscle action potential of the two groups was higher than that before treatment, and higher in the observation group than in the control group, and the blink reflex R1, R2, and R2′ amplitudes were lower than those before treatment, and lower in the observation group than in the control group (P＜0.05). The PSQI score was lower in both groups than that before treatment, and lower in the observation group than in the control group after treatment (P＜0.05). There was no significant difference in the incidence of adverse reactions and recurrence rates between two groups (P＞0.05). 
Conclusion Transcutaneous electrical facial nerve stimulation combined with botulinum toxin type A is safe and effective in the treatment of HFS patients, and can improve the spastic symptoms, nerve function and sleep quality of patients.





Correlation between the expression level of autophagy marker gene in peripheral blood and combined organ injury of patients with hemorrhagic shock

LIN Xue-rong, WANG Jia, ZHANG Zhi-bin, ZHU Li-juan

2023, 44(6):  645-649.  doi:10.3969/j.issn.1007-3205.2023.06.005

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Objective To study the correlation between the expression level of autophagy marker gene in peripheral blood and combinedorgan injury of patients with hemorrhagic shock. 
Methods In total, 128 hemorrhagic shock patients were selected as the hemorrhagic shock group, and 54 patients with traumatic hemorrhage but without shock were selected as the traumatic hemorrhage control group. In addition,150 healthy volunteers undergoing physical examination were selected as the healthy control group. The protein expression levels of Beclin-1 and autophagy protein 5 (Atg5) in peripheral blood of all subjectswere detected. The expression levels of Beclin-1 and Atg5 proteins between hemorrhagic shock patients with and without acute heart failure, acute liver injury, and acute kidney injury were compared. The correlation of Beclin-1, Atg5 protein with injury severity score, acute physiology and chronic health evaluation Ⅱ (APACHE-Ⅱ) score, sequential organ failure assessment (SOFA)score, N-terminal pro B-type natriuretic peptide (NT-proBNP), total bilirubin (TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (SCr), blood urea nitrogen(BUN), left ventricular ejection fraction (LVEF)were analyzed. 
Results The protein expression levels of the autophagy marker genes Beclin-1 and Atg5 in the peripheral blood of hemorrhagic shock group were higher than those of the traumatic hemorrhage control group and healthy control group (P＜0.05). In the hemorrhagic shock group, the protein expression levels of the autophagy marker genes Beclin-1 and Atg5 in the peripheral blood of patients with heart failure, kidney injury and liver injury after admission were lower than those of patients without heart failure, kidney injury and liver injury (P＜0.05). The protein expression level of the autophagy marker genes Beclin-1 and Atg5 in the peripheral blood of patients with hemorrhagic shock at admission was negatively correlated with injury severity score, APACHE-Ⅱ score, SOFA score, NT-proBNP, TB, ALT, AST, SCr,and BUN, and positively correlated with LVEF. 
Conclusion The increased expression of autophagy marker genes in the peripheral blood of patients with hemorrhagic shock can play a compensatory protective role, which are negatively correlated with the aggravation of the disease and the degree of organ injury. 





Relationship between HOMA-IR level and swallowing dysfunction in elderly patients with mild cognitive function impairment

LI Jiang-hua, WANG Yue, WEN Yan, JIA Xiao-cui, LI Xia, LU Jia-yu

2023, 44(6):  650-653,659.  doi:10.3969/j.issn.1007-3205.2023.06.006

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Objective To explore the relationship between insulin resistance index (HOMA-IR) and swallowing dysfunction in elderly patients with mild cognitive function impairment (CFI). 
Methods A total of 106 elderly patients with mild CFI were selected as the observation group, and 100 elderly physical examinees without CFI were selected as the control group. The fasting blood glucose (FBG), fasting serum insulin (FINS), glycosylated hemoglobin (HbA1c) and HOMA-IR were compared between the observation group and control group. The correlation between blood glucose index and Montreal cognitive assessment (MoCA) score was analyzed. The observation group was divided into two groups according to presence of swallowing dysfunction: swallowing dysfunction group and non-swallowing dysfunction group. The clinical data of the two groups were compared, and the influencing factors of swallowing dysfunction and the value of logistic regression equation in predicting swallowing dysfunction were analyzed. 
Results FBG, FINS, HbA1c and HOMA-IR in the observation group were significantly higher than those in the control group (P＜0.05). FBG, FINS, HbA1c and HOMA-IR were negatively correlated with MoCA scores (r=-0.311, -0.324, -0.308, -0.341, P＜0.05). In the observation group, swallowing dysfunction occurred in 22 patients (20.75%). The proportion of patients with dysphagia aged ≥ 70 years, diabetes, audiovisual impairment, tooth defect ≥ 6, and FINS, HOMA-IR was significantly higher than those of patients without dysphagia (P＜0.05). Logistic regression analysis showed that age, audiovisual impairment, tooth defect and HOMA-IR were the influencing factors of mild CFI with swallowing dysfunction in the elderly (P＜0.05). The area under the receiver operating characteristic (ROC) curve of the Logistic regression equation in predicting swallowing dysfunction was 0.834 (95%CI: 0.733-0.936), the sensitivity was 84.50%, and the specificity was 63.00%. 
Conclusion The level of HOMA-IR increases in the elderly with mild CFI, which is negatively correlated with MOCA score of patients, and is also an influencing factor of swallowing dysfunction in patients. 





Expression and interaction of peripheral blood miR-92b-5p and miR-148b-3p in the progression of type 2 diabetes to diabetic nephropathy

XING Yu-wei, SUN Ze-nan, CHAI Xue-jiao, WEI Geng

2023, 44(6):  654-659.  doi:10.3969/j.issn.1007-3205.2023.06.007

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Objective To investigate the changes in serum microRNA (miR)-92b-5p and miR-148b-3p levels and their role in the progression of type 2 diabetes mellitus (T2DM) to diabetic nephropathy (DN). 
Methods A prospective study was conducted on 400 T2DM patients in our hospital, with 200 non-DN patients as the T2DM group and 200 DN patients as the DN group. The clinical data, serum miR-92b-5p and miR-148b-3p levels of the two groups were compared, and the serum miR-92b-5p and miR-148b-3p levels of patients with different stages in the DN group were compared. The correlation between serum miR-92b-5p and miR-148b-3p levels and clinical stages in the DN group, the interaction between serum miR-92b-5p and miR-148b-3p in the progression of T2DM to DN, and the value of serum miR-92b-5p and miR-148b-3p levels in predicting DN were analyzed. 
Results In the DN group, serum creatinine (SCr) and serum miR-148b-3p levels were higher than those in the T2DM group, and the estimated glomerular filtration rate (eGFR) and serum miR-92b-5p levels were lower than those in the T2DM group (P＜0.05). Serum miR-148b-3p levels in the DN group were higher, and serum miR-92b-5p levels were lower than those in the early stage (P＜0.05). Serum miR-92b-5p levels in the DN group were negatively correlated with clinical stage and serum miR-148b-3p levels were positively correlated with clinical stage (P＜0.05). The positive interaction between low expression of miR-92b-5p and high expression of miR-148b-3p in the progression of T2DM to DN was a submultiplicative model (P＜0.05). The area under the curve (AUC) of miR-92b-5p and miR-148b-3p in predicting T2DM progression to DN was 0.840 and 0.812, respectively, and the combined prediction of the two had the largest AUC (0.911). 
Conclusion Serum miR-92b-5p levels are significantly lower and miR-148b-3p levels are significantly higher in DN patients, which are closely related to the clinical stage of DN. Low expression of miR-92b-5p and high expression of miR-148b-3p contribut to the progression of T2DM to DN. 





Clinical value of thyroid function testing and monitoring blood pressure coefficient of variation in predicting pregnancy outcomes in patients with hypothyroidism during pregnancy

FAN Cheng-fang, MA Jun

2023, 44(6):  660-665,680.  doi:10.3969/j.issn.1007-3205.2023.06.008

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Objective To investigate the clinical value of thyroid function testing and monitoring blood pressure coefficient of variation in predicting pregnancy outcomes in patients with hypothyroidism during pregnancy. 
Methods A total of 138 patients with hypothyroidism during pregnancy were selected as the observation group, including 47 cases of clinical hypothyroidism as the observation group one, and 91 cases of subclinical hypothyroidism as the observation group two. Forty-eight patients with normal thyroid function undergoing pregnancy tests were selected as the control group. The general data, thyroid function ［thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4)］, and blood pressure ［diastolic blood pressure (DBP), systolic blood pressure (SBP), DBP coefficient of variation (DCV), SBP coefficient of variation (SCV), DBP standard deviation (DSD), SBP standard deviation (SSD)］ were compared among three groups. The correlation between thyroid function, blood pressure and blood pressure variability in patients with hypothyroidism during pregnancy was analyzed. Logistic regression analysis was used to analyze the influencing factors of adverse pregnancy outcomes in hypothyroidism during pregnancy, and receiver operating characteristic (ROC) was used to analyze the predictive value of thyroid function, blood pressure and blood pressure variability for adverse pregnancy outcomes. 
Results The proportion of gestational hypertension and TSH, FT3, FT4, 24 h-DBP, 24 h-SBP, 24 h-DCV, 24 h-SCV, 24 h-DSD and 24 h-SSD among the three groups were significantly different (P<0.05); Thyroid function in patients with hypothyroidism during pregnancy was related to blood pressure and blood pressure variability (P＜0.05). Logistic regression analysis showed that increased TSH, 24 h-DBP, 24 h-SBP, 24 h-DCV, 24 h-SCV, 24 h-DSD, 24 h-SSD, and decreased FT3 and FT4 were independent risk factors for adverse pregnancy outcomes in patients with hypothyroidism during pregnancy (P＜0.05). The ROC curve showed that the area under the ROC curve (AUC) of TSH, FT3, FT4, 24 h-DBP, 24 h-SBP, 24 h-DCV, 24 h-SCV, 24 h-DSD, and 24 h-SSD in combination for predicting the adverse pregnancy outcome of patients with hypothyroidism during pregnancy was 0.962, which was higher than prediction of each index alone. 
Conclusion The blood pressure and blood pressure coefficient of variation are higher in patients with hypothyroidism during pregnancy. Thyroid function testing combined with blood pressure coefficient of variation can more effectively predict pregnancy outcome, and provide a reference for timely intervention and treatment. 


Study on the expression of galectin-1/ramp in patients with sepsis and the molecular mechanism regulating inflammatory signaling pathway

DU Rui, HAO Li-na, SONG Shao-hua, LI Dong-liang, WANG Lai, ZHAO Zhi-tao

2023, 44(6):  666-670.  doi:10.3969/j.issn.1007-3205.2023.06.009

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Objective To investigate the expression of galactose lectin 1 (Galectin-1)/recombinant receptor activity modifying protein (RAMP) in patients with sepsis and the molecular mechanism of regulating inflammatory signaling pathway. 
Methods A total of 80 outpatients and inpatients with sepsis treated in the First Hospital of Hebei Medical University were selected, and 80 healthy volunteers were collected as controls. The expression levels of serum anti-inflammatory molecules Galectin-1 and RAMP in the two groups were detected by ELISA. In terms of cytological experiment, CRISPR-Cas9 technique was used to knock out the galectin-1 gene of monocytes. Monocytes TCP-1 were divided into three groups: control group, NC group (transfected with NC plasmid) and experimental group (transfected with crispr-cas9 plasmid). The expression levels of inflammatory factors interleukin 6 (IL-6), interleukin 8 (IL-8) and interleukin 10 (IL-10) were detected. The expression levels of inflammatory pathway molecules ID3 and RAMP mRNA were detected by qPCR, and the expression levels of ID3 and RAMP proteins were detected by Western blot. 
Results Compared with the control group, the expression levels of serum Galectin-1 and RAMP in sepsis group were higher (P＜0.01). In terms of cytological test, compared with the control group, the secretion of inflammatory factors in the knockout group was increased (P＜0.01). QPCR results showed that compared with the control group, the expression levels of ID3 and RAMP mRNA were increased in the knockout group (P＜0.01), and Western blot results showed that compared with the control group, the expression levels of ID3 and RAMP protein were increased in the knockout group (P＜0.01). 
Conclusion Galectin-1 may affect the secretion and metabolism of inflammatory factors in monocytes by inhibiting the inflammatory signal ID3/RAMP pathway, and participate in the occurrence and development of sepsis.





Analysis on the occurrence of postoperative cognitive dysfunction and its influencing factors with severe craniocerebral injury

HE Peng, LIANG Chao, WEI Jin-gang, LIN Xiao-min, LIU Ming-yan

2023, 44(6):  671-674.  doi:10.3969/j.issn.1007-3205.2023.06.010

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Objective To study and analyze the occurrence of postoperative cognitive dysfunction (POCD) and its influencing factors in patients with severe craniocerebral injury (SCCI). 
Methods A total of 150 patients with SCCI treated in Marine Corps Hospital were selected as the research subjects， and POCD rate of all the patients was analyzed. POCD rates of patients with different ages， genders， education levels， injury sites， Glasgow Coma Scale (GCS) score at admission， number of injury sites， causes of injury， smoking history, drinking history， complications and underlying diseases were compared， and the influencing factors of POCD of patients with SCCI were analyzed with multivariate Logistic regression analysis. 
Results Among 150 patients with SCI, 111 patients developed POCD， with an incidence rate of 74.00%, there was no significant difference in the rate of POCD in patients with different genders， causes of injury， smoking history and drinking history（P＞0.05）. POCD rates of patients aged ＞50 years years， primary school education， injury site of frontal lobe， GCS score of 3 to 5 points at admission, number of injury sites ≥ 2, complications and underlying diseases were significantly higher than those of other patients（P＜0.05）. Multivariate Logistic regression analysis showed ＞50 years of age， primary school education， injury site of frontal lobe， GCS score of 3 to 5 points at admission, number of injury sites ≥ 2, complications and underlying diseases were the influencing factors of POCD of patients with SCCI（P＜0.05）. 
Conclusion Patients with SCCI have a high rate of POCD， which has various influencing factors. Therefore, they can provide major reference for the intervention of POCD of patients with SCCI. 





Clinical study of modified minimally invasive anteromedial approach with hollow compression screw for medial malleolar fracture

WU Chao-han, QIN Ying-da, WANG Xin-hui, ZHANG Tao

2023, 44(6):  675-680.  doi:10.3969/j.issn.1007-3205.2023.06.011

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Objective To design a modified minimally invasive anteromedial approach (MMIAA) for medial malleolar fractures and to evaluate the clinical outcomes of treating medial malleolar fractures with hollow compression screws via MMIAA. 
Methods Thirty-nine patients who met the inclusion criteria were selected for the treatment of medial malleolar fractures using MMIAA.Patients were followed up and evaluated by visual analogue painscale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score and Ankle Function score (Kofoed scale). 
Results All 39 patients were followed up for 13-20 months, with a mean of (16.3 ± 2.0) months. All patients achieved bony healing with a mean of (3.0±0.79) months. No incision-related complications were recorded. The mean time from injury to surgery was (3.2±1.4) d, the mean duration of operation was (55.9±9.8) min and the mean length of the surgical incision was (3.7±0.5) cm. According to 12-month follow-up, the mean AOFAS score was (95.1±7.4) points,which were excellent in 31 cases （79.5%） and good in 8 cases （20.5%), with an excellent and good rate of 100%. According to the Kofoed ankle function score with a  mean of (94.4±8.6) points, 32 cases were assessed as excellent， 6 cases as good and 1 case as fair, with an excellent and good rate of 97.4%. 
Conclusion The MMIAA allows a direct visual repositioning of the articular surface and cortex in a minimally invasive manner, and minimizes soft tissue damage as well. MMIAA is an ideal option for most of medial malleolar fractures especially for Herscovici type B and type C.





Effects of recombinant human acidic fibroblast growth factor combined with fusidic acid cream on wound healing, inflammatory level and pain mediators in patients with deep second degree burn

WANG Xu-wen, LI Liang, SU Wei-hai, QI Jie, SHENG Meng-jun

2023, 44(6):  681-685,691.  doi:10.3969/j.issn.1007-3205.2023.06.012

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Objective To observe the effect of recombinant human acidic fibroblast growth factor (rhaFGF) combined with fusidic acid cream on wound healing, inflammatory level and pain mediators in patients with deep second degree burn. 
Methods A total of 120 patients with deep second degree burn treated in hospital were selected as the research subjects and divided into observation group (n=40), control group one (n=40) and control group two (n=40) according to random number table method. Control group one was treated with escharectomy combined with rhaFGF, control group two was treated with escharectomy combined with fusidic acid cream, and the observation group was treated with escharectomy combined with rhaFGF and fusidic acid cream. Patients in the three groups were treated continuously until wound healing. The levels of interleukin-2 (IL-2), interferon-γ (IFN-γ), interleukin-10 (IL-10), interleukin-6 (IL-6), 5-hydroxytryptamine (5-HT) , prostaglandin E2 (PGE2) and neuropeptide Y (NPY) were measured before and after treatment in the three groups. The granulation growth of the three groups was evaluated on the 5th, 10th, 15th and 20th day of treatment, and the wound healing time of the two groups was recorded. The wound healing rate on the 10th day, on the 15th day, and on the 20th day, and the average time of wound healing were recorded. After wound healing, the degree of scar hyperplasia in the three groups was evaluated by Vancouver Scar Scale (VSS), and the adverse reactions in the three groups were recorded. 
Results The levels of IFN-γ and IL-6 in observation group were lower than those in control group one and control group two (P＜0.05), the levels of IL-2 and IL-10 in observation group were higher than those in control group one and control group two (P＜0.05), and the levels of PGE2, 5-HT and NPY in observation group were lower than those in control group one and control group two (P＜0.05). There were significant differences of interaction between time points, groups and time points between groups with respect to granulation growth scores (P＜0.05), and the difference of interaction between groups, time points and time points between groups were statistically significant with respect to wound healing rates (P＜0.05). The mean wound healing time and scar hyperplasia score of observation group were lower than those of control group one and control group two (P＜0.05), and there were no obvious adverse reactions in the three groups. 
Conclusion rhaFGF combined with fusidic acid cream in the treatment of deep second degree burn patients can improve the levels of IL-2 and IL-10, reduce the levels of IFN-γ, IL-6, PGE22, 5-HT and NPY, inhibit inflammation, reduce pain mediators, promote granulation and healing, and reduce scar hyperplasia, with high safety. 





Molecular mechanism of down-regulated lncRNA-ATB inhibiting the occurrence and development of osteosarcoma

QIU Ming-xian

2023, 44(6):  686-691.  doi:10.3969/j.issn.1007-3205.2023.06.013

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Objective To investigate the regulation of lncRNA-ATB on the proliferation, aggregation, migration and apoptosis of S-phase cell cycle of osteosarcoma Saos-2 cells, and to explore its effect on the growth and cell proliferation of subcutaneous osteosarcoma. 
Methods Real-time quantity polymerase chain reaction (qRT-PCR) was used to detect the expression of lncRNA-ATB in osteosarcoma tissues, HOS, Saos-2 and U2OS cell lines and human osteoblast cell line NHOst. CCK8, flow cytometry, TUNEL and Transwell were used to detect the regulation of biological function of lncRNA-ATB in SAOS-2 cells. Ki67 was used to detect cell proliferation. The nude mouse xenograft model of osteosarcoma was constructed by using SAOS-2 cells, and the weight of subcutaneous tumor in nude mouse model was detected. 
Results In 28 patient tissues, the expression level of lncRNA-ATB in osteosarcoma tissue was higher than that in normal adjacent tissue (P＜0.05). Compared with the NHOst group, lncRNA-ATB was elevated in HOS, Saos-2, and U2OS, with the highest expression in Saos-2 (P＜0.05). The OD value of Saos-2 cells in the ATB group was higher than that in the NC group, and the S phase of the Saos-2 cycle in the ATB group was longer than that in the NC group (P＜0.05). The OD value of Saos-2 cells in the siATB group was lower than that in the siNC group, and the S phase of the Saos-2 cycle in the siATB group was shorter than that in the siNC group (P＜0.05). In the ATB group, the apoptosis rate of Saos-2 cells was inhibited, while in the siATB group, the apoptosis rate of Saos-2 cells was inceased. The number of cell perforations in the ATB group was higher than that in the NC group, which was lower in the siATB group than in the siNC group (P＜0.05). The weight of subcutaneous tumors was greater in the ATB group than in the NC group (P＜0.05), but smaller in the siATB group than in the siNC group (P＜0.05). The percentage of positive staining cells in the nucleus of osteosarcoma was higher in the ATB group than in the NC group, but lower in the siATB group than in the siNC group (P＜0.05). 
Conclusion LncRNA-ATB may promote the occurrence, development and malignant biological function of osteosarcoma, while RNA interference technology can inhibit the pathological process of osteosarcoma. 





Molecular mechanism of HIF-1α regulating knee osteoarthritis through inflammasome ASC domain

YANG Xue-yu, GUO Wen-fan, ZHENG Xue-jun, LU Ji-gao, YANG Yong, LI Hui-dong

2023, 44(6):  692-696,706.  doi:10.3969/j.issn.1007-3205.2023.06.014

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Objective To explore the intervention effect of down-regulation of HIF-1α on knee osteoarthritis (KOA) model rats and the mechanism of phosphorylation modification of inflammasome ASC pathway and signaling pathway. 
Methods Forty SPF SD rats were randomly divided into control group (n=10), model group (n=10), negative control (NC) group (n=10) and si-HIF-1α group (n=10). The model group, NC group and si-HIF-1α group were used to establish a rat model of KOA. The NC group and the si-HIF-1α group were injected with 5 nmol of NC plasmid and si-HIF-1α plasmid respectively through the tail vein, and the control group and the model group were given the same amount of normal saline.The rat knee joints were analyzed by HE staining and pathological scoring. The levels of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α （TNF-α） in the joint tissues of the rats were detected by enzyme-linked immunosorbent assay (ELISA). The expression levels of HIF-1α and angiotensin I-converting enzyme (ACE) in knee joint tissue of rats, and the protein expression levels of JUN and ASC and the phosphorylation level of signaling pathway in inflammasome of knee joint tissue of rats were detected by Western blot. 
Results Compared with the control group, the knee joint injury and pathological scores in the model group, NC group and si-HIF-1α group were significantly higher than those in the control group, which were lower in the si-HIF-1α group than in the model group and NC group. ELISA results showed that, compared with the control group, IL-1, IL-6, IL-8 and TNF-α in joint tissues of model group, NC group and si-HIF-1α group were significantly increased (P＜0.01), which were significantly lower in the si-HIF-1 group than in the model group and NC group (P＜0.01). qPCR results showed that compared with the control group, JUN and ASC were significantly up-regulated in the model group and NC group, and significantly down-regulated in the si-HIF-1α group (P＜0.01). Western blot results showed that compared with the control group, JUN and ASC in the model group and NC group were significantly increased, while those in the si-HIF-1α group were significantly decreased, and the phosphorylation level of their signaling pathways was significantly decreased (P＜0.01). 
Conclusion Down-regulation of HIF-1α can inhibit the release of inflammatory factors in KOA model rats, reduce tissue damage, and exert bone protective effect. The mechanism may be related to the regulation of phosphorylation modification of the ASC domain of the inflammasome. 





Expression of nFeNO, OPN and sIgE in AR patients and their value in auxiliary diagnosis of asthma

LI Jun, YE Fang, HAN Fu-guang, LI Bo

2023, 44(6):  697-701.  doi:10.3969/j.issn.1007-3205.2023.06.015

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Objective To investigate the expressions of nasal fractional exhaled nitric oxide (nFeNO), osteopontin (OPN) and specific immunoglobulin E (sIgE) in patients with allergic rhinitis (AR) and their value in auxiliary diagnosis of asthma. 
Methods A total of 228 AR patients in our hospital were selected as the observation group, including 187 patients with pure AR and 41 patients with AR combined with asthma; 45 healthy people undergoing physical examination during the same period were selected as the control group. The levels of nFeNO, OPN, and sIgE between two groups were compared, and the correlation between the levels of nFeNO, OPN, and sIgE in AR patients and total nasal symptom score (TNSS) score was analyzed. Logistic regression analysis was used to analyze the independent influencing factors of AR with asthma, and receiver operating characteristic (ROC) curve analysis was used to analyze the diagnostic value of nFeNO, OPN and sIgE for AR complicated with asthma. 
Results The levels of nFeNO, OPN and sIgE in the observation group were higher than those in the control group (P＜0.05). The levels of nFeNO, OPN and sIgE in AR patients were positively correlated with the TNSS score (P＜0.05). Logistic regression analysis showed that the increased levels of nFeNO, OPN and sIgE were independent risk factors for AR complicated with asthma (P＜0.05). The ROC curve showed that the AUC value of nFeNO, OPN and sIgE in combination to diagnose AR complicated with asthma was 0.829, which was higher than that of single indicator in diagnosis. 
Conclusion The levels of nFeNO, OPN and sIgE in AR patients are positively correlated with the TNSS score, and are of great value in prediction and auxiliary diagnosis of AR complicated with asthma. 





The study of the clinical features and pregnancy outcome of placental chorioangioma diagnosed by ultrasound

XIANG Wei, SUN Cong-xin, CHEN Gui-hong, GUAN Jing, WANG Li-xian

2023, 44(6):  702-706.  doi:10.3969/j.issn.1007-3205.2023.06.016

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Objective To investigate the clinical features and pregnancy outcomes of placental chorioangioma diagnosed by ultrasound. 
Methods A total of 23 pregnant women with placental chorioangioma diagnosed by ultrasound were selected as the case group. Among them, the women with the largest diameter of the tumor ≥4 cm were defined as the giant group, and the women with the largest diameter of the tumor ＜4 cm were defined as the general group. Another 60 normal pregnant women were selected as the control group. The differences in clinical features and pregnancy outcomes were analyzed. 
Results Compared with the control group, the case group had a lower spontaneous vaginal delivery rate and a higher assisted vaginal delivery rate (P＜0.05). The ultrasonic manifestations of placental chorioangioma included single or multiple medium to low echo masses that could be seen in the placental parenchymal area and at the edge of the placenta, which were often close to the insertion of the umbilical cord, with blood flow signals that could be seen in some areas. Compared with the general group, the detection rate during mid pregnancy in the giant group was as high as 100%, with high complications (P＜0.05). Compared with the general group and control group, the giant group had a lower spontaneous vaginal delivery rate, higher assisted vaginal delivery rate, higher preterm birth rate, lower birth weight, lower Apgar score, and a significant increase in NICU admission rate and hospital stay (P＜0.05). 
Conclusion Prenatal ultrasound diagnosis of giant placental chorioangioma was of great significance in predicting adverse pregnancy outcomes. 





Comparison of safety between propofol fentanyl and midazolam fentanyl for gastrointestinal endoscopy in advanced liver diseases

LIU Ting-ting, XIE Dong-ming, DENG You-ming

2023, 44(6):  707-712.  doi:10.3969/j.issn.1007-3205.2023.06.017

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Objective To compare the safety of propofol fentanyl and midazolam fentanyl for gastrointestinal endoscopy in patients with advanced liver disease. 
Methods A total of 86 patients with advanced liver disease who underwent gastrointestinal endoscopy due to cirrhosis were recruited. All patients underwent upper gastrointestinal endoscopy examination. Patients were divided into propofol fentanyl group (n=43) and midazolam fentanyl group (n=43), according to the anesthesia medications. The propofol fentanyl group received intravenous propofol 2 mg/kg and fentanyl 0.5 μg/kg, while the midazolam fentanyl group received intravenous midazolam 3 mg and fentanyl 0.5 μg/kg. Changes in hemodynamic parameters ［oxygen saturation (SpO2), heart rate (HR), mean arterial pressure (MAP)］ before induction (T0), at 5 min after sedation (T1), 10 min after sedation (T2), 15 min after sedation (T3), 30 min after sedation (T4), and at 5 min before surgery (T5). The Ramsay sedation scores at T0 to T5 were compared. The bispectral index (BIS) values, and postoperative electroencephalogram (EEG) θ wave and δ wave band frequency before surgery, before anesthesia induction, before tracheal intubation and after surgery were compared. The occurrence of adverse reactions during surgery among the subjects was compared. 
Results The SpO2 levels in the two groups showed a gradual upward trend, while the HR levels showed a gradual downward trend. The increase in SpO2 levels in the propofol fentanyl group was greater than that in the midazolam fentanyl group, while the decrease in HR level was greater than that in the midazolam fentanyl group. There were statistically significant difference in the interaction between groups, time points, and time points between groups (P＜0.05). The Ramsay sedation scores and EEG δ wave band showed a trend of initial increasing and then decreasing in the two groups, while BIS and EEG θ wave band showed a trend of initial decreasing and then increasing. The Ramsay sedation score, BIS, and fluctuation amplitude of EEG θ wave band, EEG δ wave band were greater in the propofol fentanyl group than in the midazolam fentanyl group, and there were statistically significant difference in the interaction between groups, time points, and time points between groups (P＜0.05). The incidence of hypotension in the propofol fentanyl group was higher than that in the midazolam fentanyl group (P＜0.05). 
Conclusion Propofol or midazolam in combination with fentanyl is effective in sedating patients with advanced liver disease undergoing upper gastrointestinal endoscopy. Compared with midazolam, propofol can better exert effects of deep sedation, which is reflected in a decrease in BIS and an increase in EEG δ wave band frequency. However, it increases the risk of hypotension. 





Effect of patient-controlled intravenous analgesia with dexmedetomidine combined with sufentanil on short-term anxiety and depression in patients after cesarean section

LI Ming, SONG Dan-dan, WANG Qian, LEI Yu

2023, 44(6):  713-718.  doi:10.3969/j.issn.1007-3205.2023.06.018

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Objective To observe the effect of patient-controlled intravenous analgesia (PCIA) with dexmedetomidine combined with sufentanil on short-term anxiety and depression in patients after cesarean section. 
Methods A total of 100 patients aged 23-40 years with American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ who underwent elective cesarean section were〖JP2〗 randomly divided into normal saline + sufentanil group (S group, n=50) and dexmedetomidine+sufentanil group (DS group, n=50). The Zung Self-Rating Depression Scale (SDS), State-Trait Anxiety Inventory (STAI), Richmond agitation-sedation scale and visual analog score were applied immediately after entry into the operating room (T0), and at 3 h (T1), 6 h (T2), 12 h (T3), 24 h (T4), 48 h (T5) and 72 h (T6) after operation. The frequency of PCIA compression, the dosage of sufentanil and tramadol consumed, time to postoperative anal exhaust, time of lactation initiation, the incidences of nausea and vomiting,pruritus and bradycardia were observed and recorded in two groups. 
Results The Zung SDS scores gradually decreased at T0-T6 in the two groups, with the DS group showing a more significant decrease compared to the S group (P＜0.05). The S-AI and T-AI scores gradually decreased at T0-T6 in the two groups, with the DS group showing a more significant decrease compared to the S group (P＜0.05). At T2-T4, the RASS score in the DS group was lower than that in the S group, with a statistically significant difference (P＜0.05). The VASR and VASW scores in both groups showed a trend of first increasing and then decreasing, with the S group showing a more significant change compared to the DS group, and both scores were higher than those in the DS group (P＜0.05). The dosage of tramadol consumed for relief analgesia and the frequency of PCA compression in the S group were significantly increased compared to those in the DS group (P＜0.05). The time to postpartum lactation initiation and anal exhaust in the DS group were shortened compared with those in the S group, and the incidence of postoperative nausea and vomiting in the DS group was significantly reduced compared with those in the S group (P＜0.05). There was no statistically significant difference in the occurrence of bradycardia and pruritus between the two groups of postpartum women (P＞0.05). 
Conclusion PCIA with dexmedetomidine combined with sufentanil can effectively alleviate maternal anxiety and depression after cesarean section, enhance postoperative analgesic effect, and promote early lactation after cesarean section. 





Consistency evaluation results of squamous cell carcinoma antigen measured by two automated immunoassay systems

YAN Xi, ZHANG Jin-yan, GUO Xiu-juan

2023, 44(6):  719-723,728.  doi:10.3969/j.issn.1007-3205.2023.06.019

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Objective To evaluate the consistency of squamous cell carcinoma antigen (SCCA) results between Roche cobase 602 and Abbott Architect i2000 SR automated immunoassay system. 
Methods A total of 4 231 clinical serum samples were collected during the parallel detection of methodological changes in the Department of Clinical Laboratory, and the SCCA levels were detected by the above immunoassay systems. The precision was evaluated by referring to CLSIEP15-A2 protocols. The data of 138cases of SCCA results were selected by random sampling, and the correlation, consistency and deviation of SCCA results of the two systems were analyzed by correlation analysis, regression analysis and consistency test. The SCCA results of 4 231 patients were analyzed by Kappa analysis, and the results of Roche system were corrected by linear regression equation. The diagnostic coincidence rate, positive coincidence rate and negative coincidence rate of the two systems before and after correction were calculated, to evaluate the diagnostic consistency of the two systems. 
Results The precision of the two detection systems was 2.35%-3.56% and 0.99%-1.70% respectively, and there was a strong correlation between them (rs=0.939). The Passing Bablok regression equation was as follows: y=0.156±1.034x (intercept=0.156, slope=1.034), the average percentage bias was within the acceptable range (-9.30%), but more than 5% of data points fell outside the 95% control limit. The folding of the mountain map was close to 0 (-0.28 mg/L). The intra-group correlation coefficient was 0.912 (95%CI: 0.880-0.937). After correction, the total coincidence rate, positive coincidence rate and Kappa value of Roche and Abbott SCCA results increased from 92.86%, 54.91%, and 0.660 to 93.83%, 90.98% and 0.778, respectively. 
Conclusion The two SCCA detection systems have good correlation and consistency, but there is a systematic deviation. Therefore, the results can be transformed by regression equation before clinical judgment. 





Detection of serum angiotensin converting enzyme 2 and macrophage migration inhibitory factor in patients with hyperlipidemic pancreatitis and its clinical significance

ZHANG Tao, ZOU Ping, ZHAO Qi

2023, 44(6):  724-728.  doi:10.3969/j.issn.1007-3205.2023.06.020

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Objective To explore the detection and clinical significance of serum angiotensin converting enzyme 2 (ACE2) and macrophage migration inhibitory factor (MIF) in patients with hyperlipidemic pancreatitis. 
Methods The medical records of 86 patients with hyperlipidemic acute pancreatitis (HLAP) admitted to our hospital were retrospectively analyzed. According to the results of the three-month review, they were divided into a good prognosis group and a poor prognosis group. The relevant factors affecting the prognosis of hyperlipidemic pancreatitis were analyzed. The predictive value of serum ACE2 and MIF levels on the prognosis HLAP was evaluated by the area under the receiver operator characteristic (ROC) curve (AUC). 
Results Balthazar′s CT grade D, serum levels of MIF, triacylglycerol (TG) and low density lipoprotein cholesterol (LDL-C) were higher in the poor prognosis group than those in the good prognosis group, while the levels of ACE2 and high density lipoprotein cholesterol (HDL-C) were lower than those in the good prognosis group (P＜0.05). Multivariate Logistic regression analysis showed that the proportion of Balthazar′s CT grade D, the increase of serum MIF, TG, LDL-C expression and the decrease of ACE2, HDL-C expression were risk factors for poor prognosis of HLAP (P＜0.05). ROC analysis showed that the AUC of serum ACE2 and MIF alone and in combination in predicting the prognosis of HLAP was 0.754 (95%CI: 0.681-0.827), 0.759 (95%CI: 0.691-0.828) and 0.827 (95%CI: 0.785-0.867), respectively. 
Conclusion Both the increase of serum MIF expression level and the decrease of serum ACE2 level are related to the prognosis of patients with HLAP, and both of them are effective in predicting the prognosis of HLAP.