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    25 September 2023, Volume 44 Issue 9
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    QTRT1 expression is associated with prognosis and tumor immunity in kidney renal clear cell carcinoma
    WANG Tian-yun, KUI Xiang, ZHAO Chun-mei, WANG Yan
    2023, 44(9):  998-1005.  doi:10.3969/j.issn.10073205.2023.09.002
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    Objective  To investigate the relationship between the expression of Queuine tRNAribosyl transferase 1  (QTRT1) and the prognosis and tumor immunity in kidney renal clear cell carcinoma (KIRC) by means of bioinformatics analysis. 
    Methods  The research was carried out through multiple software and online tools such as R software, TCGA database, GEO database, HPA database, STRING database, GENEMAIN database, GSEA software, TIMER2.0 database, Sanger box 3.0 online platform, and GEPIA2 platform, supplemented by qRT-PCR for cell experiment verification. 
    Results  By conducting rank sum tests on 535 patients with cancer and 72 normal tissues in TCGA, it was found that the expression of QTRT1 in KIRC tissue was significantly higher than that in normal tissue (P＜0.05). The mRNA expression intensity of QTRT1 in 780-O and Caki2 of KIRC cells was significantly stronger than that in normal renal tubular epithelial cell HK2 (P＜0.05). The mRNA expression of QTRT1 showed statistical significance in different groups of T stage and clinical stage (P＜0.05). Age, grade, M stage, and QTRT1 expression were all significantly correlated with OS of KIRC. Age, grade M-stage and QTRT1 expression could serve as independent prognostic factors for OS in KIRC (P＜0.05). A total of 19 genes with the most significant interaction with QTRT1 were displayed. Simultaneously, a PPI network was constructed using the STRING platform, and 10 proteins interacting with QTRT1 were displayed. The relationship between QTRT1 and Tumor Mutation Burden (TMB) was obtained using Sangerbox, and there was a positive correlation between QTRT1 and TMB in KIRC (P＜0.05). 
    Conclusion  QTRT1 is significantly upregulated in KIRC, and its upregulation is a poor prognostic signal in KIRC patients. QTRT1 is closely related to multiple immune factors such as immune cell infiltration, and immune checkpoints in KIRC, and is a potential target for immunotherapy. 

    Expression levels and clinical application value of TNF-α, M-CSF and miR-181a in serum of elderly AD patients
    FU Dan, LIANG Hong-bo, SUN Dong-peng, LI Bin
    2023, 44(9):  1006-1010,1026.  doi:10.3969/j.issn.1007-3205.2023.09.003
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    Objective  To observe the expression of tumor necrosis factor-α (TNF-α), macrophage colony stimulating factor (M-CSF) and microRNA (miR)-181a in serum of patients with Alzheimer′s disease (AD) and their diagnostic value. 
    Methods  A total of 140 AD patients diagnosed and treated in our hospital were selected as the research subjects (AD group), and they were divided into the mild group (n=52),the moderate group (n=49), and the severe group (n=39) according to the clinical dementia scale, and 50 healthy people who underwent physical examination during the same period were used as the control group. The relative expression of serum miR-181a was detected by real-time fluorescence quantitative PCR (RT-qPCR), and the levels of serum TNF-α and M-CSF were detected by enzyme-linked immunosorbent assay (ELISA). The correlation of serum TNF-α, M-CSF and miR-181a was analyzed by Pearson correlation. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum TNF-α, M-CSF and miR-181a expression in AD. 
    Results  The expression levels of serum TNF-α, M-CSF and miR-181a in AD group were significantly higher than those in control group (t=49.291, 30.485, 28.313, all P＜0.05). There were statistically significant differences in the expressions of serum TNF-α, M-CSF and miR-181a among the mild, moderate and severe groups (all P＜0.05). Serum TNF-α in AD patients was significantly and positively correlated with the expressions of M-CSF and miR-181a (r=0.524, 0.610, both P＜0.05), and M-CSF was significantly and positively correlated with the expression of miR-181a (r=0.498, P＜0.05). Serum TNF-α＞27.18 ng/L, serum M-CSF＞635.81 ng/L and serum miR-181a＞1.83 were the risk factors of AD. The areas under the ROC curve (AUC) of serum TNF-α, M-CSF,miR-181a and joint testing were 0.741 (95%CI: 0.684-0.789), 0.693 (95%CI: 0.630-0.757), 0.727 (95%CI: 0.682-0.774) respectively, and 0.862 (95%CI: 0.818-0.899), and the AUC of combined detection in diagnosing AD was greater than that of TNF-α, M-CSF and miR-181a alone in diagnosis (Z=3.357, 5.894, 4.911, all P＜0.05). 
    Conclusion  The expression of serum TNF-α, M-CSF and miR-181a in AD patients is increased, and the increased levels of the three are independent risk factors for AD, and the combined detection of the three has high value in the diagnosis of AD. 

    Study on detection of complement component 3a receptor 1 (C3AR1) in evaluating the efficacy of high-dose atorvastatin combined with dual antiplatelet therapy in the treatment of acute cerebral infarction
    KANG Li-juan, LI Pan, GENG Li-ying, MENG Qi
    2023, 44(9):  1011-1016.  doi:10.3969/j.issn.1007-3205.2023.09.004
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    Objective  To observe the value of complement component 3a receptor (C3AR1) in evaluating the efficacy and prognosis of high-dose atorvastatin combined with dual antiplatelet therapy (DAPT) in the treatment of acute cerebral infarction (ACI). 
    Methods  In total, 60 patients with ACI treated in the hospital were selected as the observation group, and 60 healthy people undergoing physical examination in the hospital during the same period were selected as the control group. The observation group was randomly divided into routine-dose group and high-dose group, with 30 cases in each group. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the difference of serum C3AR1 gene expression between the two groups before treatment and at 1, 2 and 4 weeks after treatment. The number of carotid plaques (or soft plaques) and carotid intima-media thickness (IMT) of patients were measured. In the meantime, National Institute of Health Stroke Scale (NIHSS) score, score of Activity of Daily Living Scale (ADL), modified Rankin Scale score (mRS), hypersensitive C-reactive protein (hs-CRP) and blood lipids ［total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)］ were evaluated. The correlation between C3AR1 and the above indexes was analyzed by Pearson method. 
    Results  The relative expression of C3AR1 mRNA in the observation group was higher than that in the control group (P＜0.05). The number of carotid plaques (or soft plaques), IMT, NIHSS score, ADL score, mRS score, hs-CRP level, TC, TG, HDL-C and LDL-C levels and the relative expression of C3AR1 mRNA in both groups were decreased with the prolongation of treatment time, and the decrease was smaller in the high-dose group than in the routine-dose group; there was no significant difference in IMT, TC, TG and LDL-C between time-points and interaction between groups (P＞0.05), and there were significant differences in other indicators between groups, time points and time points between groups (P＜0.05). Results Bivariate Pearson correlation analysis showed that, the relative expression of C3AR1 mRNA before treatment was not correlated with the number of carotid plaques (or soft plaques), IMT, NIHSS score, ADL score, mRS score, hs-CRP level, TC, TG, HDL-C and LDL-C level in patients with ACI (P＞0.05). At 1, 2 and 4 weeks after treatment, the relative expression of C3AR1 mRNA was positively correlated with the number of carotid plaques (or soft plaques), IMT, NIHSS score, ADL score, mRS score, hs-CRP level, TC, TG, HDL-C and LDL-C level in patients with ACI (P＜0.05). 
    Conclusion  The detection of C3AR1 can be used to evaluate the efficacy and prognosis of high-dose atorvastatin combined with dual antiplatelet therapy in the treatment of ACI. 

    Comparison of effects of zopiclone and clonazepam in the treatment of schizophrenia and sleep disorders
    WU Jiang, GONG Shi-hu, SUN Jie
    2023, 44(9):  1017-1021.  doi:10.3969/j.issn.1007-3205.2023.09.005
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    Objective  To compare the clinical effects of zopiclone and clonazepam in the treatment of schizophrenia and sleep disorders. 
    Methods  In total, 94 patients with schizophrenia complicated by sleep disorders were selected as the research subjects, and they were all given conventional treatment. The patients were divided into zopiclone group and clonazepam group by the random number table method. Zopiclone group and clonazepam group were treated with zopiclone and clonazepam respectively. The therapeutic efficacy, sleep electroencephalogram parameters and nerve electrophysiological indicators were compared between two groups, and positive and negative symptom scale (PANSS) and repeatable battery for the assessment of neuropsychological status (RBANS) were used to evaluate the severity of schizophrenia symptoms and cognitive function before and after treatment. The occurrence of drug-related adverse reactions during treatment were statistically analyzed. 
    Results  There was no significant difference in the total effective rate between two groups (P＞0.05) as well as in scores of items of PANSS between two groups after treatment (P＞0.05). After treatment, the amplitudes of P300 and N2-P3 in zopiclone group were greater than those in clonazepam group, and the duration of S3 phase of sleep electroencephalogram was longer than that in clonazepam group (P＜0.05). The RBANS scores of attention and delayed memory in zopiclone group after treatment were higher than those in clonazepam group (P＜0.05). The incidence rates of somnolence and myotonia were higher in clonazepam group than in zopiclone group (P＜0.05). 
    Conclusion  In the treatment of schizophrenia and sleep disorders, zopiclone, as compared with clonazepam, can more effectively prolong the S3 phase of sleep electroencephalogram, improve the electrophysiological status of brain nerve, enhance the cognitive function, and reduce the incidence rates of adverse reactions, but both drugs have similar effects on mental status of patients. 

    Impact of chest pain center construction on cardiac function and short-term prognosis in patients with acute ST-segment elevation myocardial infarction after reperfusion therapy
    XU Jin-lin, XIAO Bing, HAN Cong-hua, ZHU Dong-mei, YIN Zhang, AI Yu
    2023, 44(9):  1022-1026.  doi:10.3969/j.issn.1007-3205.2023.09.006
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    Objective  To observe and analyze the effect and short-term prognosis of chest pain center (CPC) construction on reperfusion therapy for patients with acute ST-segment elevation myocardial infarction (STEMI). 
    Methods  A total of 284 patients who were treated with percutaneous coronary intervention (PCI) due to acute chest pain and diagnosed as STEMI before and after CPC construction were selected as the research subjects. According to the time of CPC construction, they were divided into the control group (before CPC construction, n=136) and the observation group (after CPC construction, n=148). The general data, differences in major time points, differences in cardiac function indicators after treatment, and the incidence of cardiac dysfunction during postoperative hospitalization between the two groups were analyzed. 
    Results  The observation group had shorter symptom onset to first medical contact (S2FMC), first medical contact to first electrocardiogram (FMC2ECG), door to balloon dilation (D2B), and first medical contact to balloon dilation (FMC2B) as compared with the control group (P＜0.05). The left ventricular ejection fraction (LVEF) after operation in the observation group was higher than that in the control group, while the brain natriuretic peptide (BNP) was lower than that in the control group (P＜0.05). 
    Conclusion  CPC construction can effectively shorten the time from onset to reperfusion in STEMI patients, reduce the time of myocardial ischemia, have a significant effect on the recovery of postoperative cardiac function, reduce the occurrence of short-term postoperative cardiac function-related adverse events, and decrease mortality in STEMI patients, showing a relatively higher clinical application value.

    Clinical study on the relationship between the levels of CC16, PCT, FKN in blood and the frailty of patients with chronic obstructive pulmonary disease
    ZHANG Xin
    2023, 44(9):  1027-1031.  doi:10.3969/j.issn.1007-3205.2023.09.007
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    Objective  To investigate the predictive value of serum Clara cell secretory protein (CC16), procalcitonin (PCT) and fractalkine (FKN) levels in frailty of patients with chronic obstructive pulmonary disease (COPD). 
    Methods  A total of 142 elderly patients with COPD admitted were selected and divided into two groups according to the score of the Frail Screening Scale at admission: a frailty group (n=43, with a score of 3-5), and a non-frailty group (n=99, with a score of less than 3). Another 43 patients were randomly selected as the control group. The differences in pulmonary function, serum CC16, PCT and FKN levels between the two groups were compared. Pearson correlation was used to analyze the correlation between blood indicators and pulmonary function of patients with COPD. Logistic regression analysis was used to analyze the influencing factors of COPD patients' frailty, and the value of positive indicators in predicting the risk of frailty was analyzed by using the receiver operating characteristic (ROC) curve. 
    Results  The levels of serum CC16 in frailty group were significantly lower than those in the control group, while the levels of PCT and FKN were significantly higher than those in the control group (P＜0.05). The levels of forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC in patients with COPD and frailty were significantly lower than those in the control group (P＜0.05). Pearson correlation analysis showed that serum CC16 was positively correlated with pulmonary function indicators (P＜0.05), while serum PCT and FKN levels were negatively correlated with pulmonary function (P＜0.001). Logistic regression analysis showed that the serological indicators CC16, PCT, FKN were all factors affecting the frailty of COPD patients, among which CC16 was a protective factor (P＜0.05). CC16, PCT, and FKN levels were closely associated with frailty of elderly patients with COPD, which could be used as predictive indicators. ROC curve analysis showed that the area under ROC curve (AUC) of PCT was the largest, which was 0.890 (0.824-0.956), followed by FKN ［0.830 (0.742-0.914)］, and CC16 (0.771). All three indicators had the value of predicting the frailty of elderly COPD patients (P＜0.05). 
    Conclusion  The levels of serum CC16, PCT and FKN are closely related to the occurrence of frailty in elderly patients with COPD, and can be used as detection indicators to predict the risk of frailty. 

    Application of tranexamic acid combined with platelet-rich plasma injection under arthroscopy for the treatment of femoroacetabular impingement syndrome
    MA Chen, KOU Wen-guan, KE Lei, LIU Dong-shuai, ZHANG Yue-zhen
    2023, 44(9):  1032-1036.  doi:10.3969/j.issn.1007-3205.2023.09.008
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    Objective  To explore the effect of application of tranexamic acid combined with platelet-rich plasma (PRP) injection under arthroscopy in the treatment of femoroacetabular impingement syndrome (FAIS). 
    Methods  Sixty patients with FAIS who underwent arthroscopic treatment were selected as the research subjects, and then divided into an observation group (n=30) and a control group (n=30) using a random number table method. The control group was treated with PRP, while the observation group was treated with tranexamic acid combined with PRP. Intraoperative blood loss, total blood loss, length of hospital stay, and coagulation function ［prothrombin time (PT), activated partial prothrombin time (APTT)］ before using PRP were compared between two groups. The arthroscopic visual field visibility scale score was used to evaluate the intraoperative visual field of patients, and CT examination was performed to measure angle α and center-edge angle(CEA)of the patients. Visual analog scale (VAS), non-arthritic hip score (NAHS), and Harris hip function score (HHS) were used to assess the severity of pain and hip function of patients, and the clinical efficacy of two groups was compared. 
    Results  The intraoperative blood loss, total blood loss, length of hospital stay,PT and APTT levels in the observation group were significantly lower than those in the control group, and the visual field clarity score was higher than that in the control group (P＜0.05). At 12 months after surgery,angleα and CEA of the two groups were significantly lower than those before surgery (P＜0.05). The VAS scores of the two groups showed a gradually decreasing trend with time, while the NAHS and HHS scores showed a gradually increasing trend. The VAS scores of the observation group were lower than those of the control group, while the NAHS and HHS scores were higher than those of the control group. There was a statistically significant difference in the interaction between groups, time points, and time points between groups (P＜0.05). 
    Conclusion  The application of tranexamic acid combined with PRP injection in perioperative patients with FAIS under arthroscopy can effectively improve the visual field clarity during operation, reduce blood loss, relieve pain and promote the early rehabilitation of hip joint function after operation.

    Correlation between serum interleukin-23, vascular endothelial growth factor and clinical prognosis in patients with cervical cancer
    WANG Ying, YAO Man-hong, LIU Yu-feng, AI Zhi-gang
    2023, 44(9):  1037-1042.  doi:10.3969/j.issn.1007-3205.2023.09.009
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    Objective  To investigate the correlation between serum interleukin-23 (IL-23), vascular endothelial growth factor (VEGF) and clinical prognosis in patients with cervical cancer. 
    Methods  A total of 410 patients with cervical cancer treated in the hospital were selected as the research subjects. The baseline data of patients were investigated, and serum IL-23, VEGF and other related indicators were detected. The patients were followed up for 1 year. Recurrence was taken as the criterion of clinical prognosis. The correlation between the levels of serum IL-23 and VEGF and the clinical prognosis was analyzed by COX regression, and the ROC curve and decision-making curve were drawn to analyze the value of serum IL-23 and VEGF levels in predicting the clinical prognosis of patients. 
    Results  At the end of the follow-up of 410 patients with cervical cancer, 62 cases recurred, and the recurrence rate was 15.12%. The levels of serum IL-23, VEGF, carbohydrate antigen (CA) 125 and squamous cell carcinoma antigen (SCC-Ag) in the poor prognosis group were higher than those in the good prognosis group, and the difference was statistically significant (P＜0.05). There was no statistical significant difference between two groups in age, body mass index, pregnancy times, parity, International Federation of Gynecology and Obstetrics (FIGO) stage, pathological type, tumor diameter, hemoglobin (Hb), white blood cell count (WBC), red blood cell count (RBC) and platelet (PLT) levels (P＞0.05). COX regression analysis showed that the levels of serum SCC Ag, CA125, IL-23 and VEGF were related to the clinical prognosis of cervical cancer patients (P＜0.05). The receiver operating characteristic (ROC) curve revealed that the area under the ROC curve (AUC) of serum IL-23 and VEGF level alone and in combination in predicting the clinical prognosis of cervical cancer patients was >0.7, showing certain predictive value, but combined prediction was of the highest value. The results of decision curve analysis showed that in the threshold probability interval of 0.1-0.45, 0.49-0.59 and 0.61-0.77, the net benefit rate of serum IL-23 and VEGF in combination to predict the clinical prognosis of cervical cancer was better than that of serum IL-23 and VEGF alone. 
    Conclusion  The levels of serum IL-23 and VEGF are related with the clinical prognosis of patients with cervical cancer. 

    Effects of biofeedback electrical stimulation and massage of pelvic floor muscles at different time periods on pelvic floor muscle strength and electrophysiology in patients with pelvic floor dysfunction
    WANG Fang-fang, ZHONG Bo, YU Ting-ting, CHENG Yan, WANG Ya-qin, XU Feng-juan
    2023, 44(9):  1043-1046,1052.  doi:10.3969/j.issn.1007-3205.2023.09.010
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    Objective  To explore the effects of biofeedback combined with massage of pelvic floor muscles at different time periods on pelvic floor muscle strength and electrophysiology in patients with pelvic floor dysfunction(PFD). 
    Methods  A total of 232 patients with PFD were selected as the research subjects and divided into group A (receiving treatment within 6 weeks to 3 months after delivery, n=135), group B (receiving treatment within 3 months to 6 months after delivery, n=63), and group C (receiving treatment within 6 months to 1 year after delivery, n=34). After receiving 1 course of combined treatment of biofeedback electrical stimulation and massage of pelvic floor muscles, the change of pelvic floor muscle strength, improvement of symptoms of PFD and electrophysiological status of the three groups were compared. 
    Results  After treatment, type Ⅰand type Ⅱ muscle fiber strength in group A and group B were higher than those before treatment, and the pelvic floor muscle strength in group A and group B was higher than that in group C (P＜0.05). The incidence of stress urinary incontinence in group A and group B was lower than that before treatment, and the incidence of anterior vaginal wall prolapse and uterine prolapse in group A was lower than that before treatment. The incidence of anterior vaginal wall prolapse in group A was lower than that in groups B and C (P＜0.05). Type Ⅰ and type Ⅱmuscle fiber fatigue in group A and group B were lower than those before treatment, vaginal dynamic pressure and normal rate of A3 reflex were higher than those before treatment. Type Ⅰ and type Ⅱmuscle fiber fatigue in group A and group B were lower than those in group C, and the normal rate of A3 reflex was higher than that in group C (P＜0.05). 
    Conclusion  For patients with PFD, biofeedback electrical stimulation and manual massage at 6 weeks to 3 months after delivery produces the best therapeutic effect. The longer the course of the disease, the worse the therapeutic effect; Therefore, further treatment will be needed. 

    Ultrasonographic evaluation of subendometrial RI, PI and PSV values in the prediction of endometrial status and ovarian reserve function in infertile patients
    FAN Xiu-mei, YANG Li, ZHAO Gang, HUO Sen-ye, LENG Hui-min
    2023, 44(9):  1047-1052.  doi:10.3969/j.issn.1007-3205.2023.09.011
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    Objective  To investigate the value of ultrasonographic evaluation of subendometrial resistance index (RI), pulsatility index (PI) and peak systolic blood flow velocity (PSV) values in predicting endometrial status and ovarian reserve function (ORF) in infertile patients. 
    Methods  A total of 140 female infertile patients were included as the observation group (83 cases with normal ovarian function and 57 cases with abnormal ovarian function), and 100 healthy women who had given birth during the same period were selected as the control group. Transvaginal Doppler ultrasonography was performed in both groups to measure the values of subendometrial RI, PI and PSV and observe the endometrium simultaneously. Pearson correlation was used to analyze the correlation between RI, PI and PSV values and endometrial conditions, and the predictive efficacy of RI, PI and PSV values on ORF in infertile patients was analyzed by receiver operating characteristic (ROC) curve. 
    Results  The PI and RI values of uterine artery in observation group were higher than those in control group, while the PSV values were lower than those in control group (P＜0.05). The endometrial volume and the number of B-type and C-type endometrium in the observation group were higher than those in the control group, while the endometrial thickness was lower than that in the control group (P＜0.05). Correlation analysis showed that PI and RI values were negatively correlated with endometrial thickness, but positively correlated with endometrial volume and endometrial type. PSV value was positively correlated with endometrial thickness and negatively correlated with endometrial volume and endometrial type (P＜0.05). The RI and PI values of uterine artery in the normal ovarian function group were lower than those in the abnormal ovarian function group, and the PSV values were higher than those in the abnormal ovarian function group (P＜0.05). ROC results showed that the area underthe ROC curve (AUC) of RI, PI and PSV values in predicting ovarian function in infertile patients were 0.648 (0.518-0.777), 0.715 (0.595-0.835) and 0.807 (0.736-0.922), respectively; the sensitivity were 62.51%, 62.48% and 81.21%, respectively, and the specificity was 75.04%, 65.08% and 72.52%, respectively. The AUC of combined diagnosis was 0.905 (0.878-0.984), the sensitivity was 84.43%, and the specificity was 87.56%. The diagnostic efficacy of combined detection for ORF in infertile patients was superior to that of single detection. 
    Conclusion  〖JP2〗There are significant differences in the values of subendometrial RI, PI and PSV values between women with infertility and healthy women. The ultrasonographic evaluation of RI, PI and PSV values can effectively predict the endometrial status and ORF of infertile patients, and the combined detection of the three parameters has a higher predictive value. 

    Value of platelet aggregation rate and platelet adhesion rate in evaluating the condition and prognosis of children with sepsis
    ZHENG Cong-ying, LIN Xiao-fei, LI Jiang-shu, ZHANG Guo-lai
    2023, 44(9):  1053-1057.  doi:10.3969/j.issn.1007-3205.2023.09.012
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    Objective  To explore the value of platelet aggregation rate and platelet adhesion rate in evaluating the condition and prognosis of children with sepsis. 
    Methods  A total of 118 children with sepsis were selected as the research subjects. The basic data and biochemical indicators that might affect the short-term prognosis of all children were collected. All children were followed up for 28 days after admission to evaluate their survival.The risk factors affecting the short-term prognosis of children with sepsis were analyzed. The platelet aggregation rate and platelet adhesion rate of children with different severities of sepsis were analyzed. The value of platelet aggregation rate and platelet adhesion rate in predicting the short-term prognosis of children with sepsis was analyzed. 
    Results  Of 118 children with sepsis, 20 died and 98 survived during the follow-up period. Pediatric logistic organ dysfunction-2 (PELOD-2) scores, oxygenation index, thrombin time (TT), and lactic acid were higher in the death group than in the survival group, while pediatric critical illness score (PCIS), platelet aggregation rate, and platelet adhesion rate were lower than those in survival group (P＜0.05). Multivariate Logistic regression analysis showed that PELOD-2 score, lactic acid score, PCIS score, platelet aggregation rate and platelet adhesion rate were risk factors affecting the prognosis of children with sepsis (P＜0.05). Among the 118 children with sepsis, 69 had no septic shock and 49 had septic shock. The platelet aggregation rate and platelet adhesion rate in septic shock group were higher than those in non-septic shock group (P＜0.05).The results of receiver operating characteristic (ROC) curve showed that the sensitivity of platelet aggregation rate, platelet adhesion rate and their combination to predict the short-term prognosis of children with sepsis were 75.00%, 70.00% and 80.00%, respectively, the specificity was 74.49%, 80.61%, 88.78%, respectively, and the area under the ROC curve was 0.761, 0.768, 0.913, respectively. 
    Conclusion  The combination of platelet aggregation rate and platelet adhesion rate is effective in predicting the short-term prognosis of children with sepsis. 

    Study on the early predictive value of changes in serum markers in children with sepsis secondary to soft tissue infection
    REN Qiang, FENG Yan-hua, LI Jing-yan, ZHEN Lei, ZHANG Fang, TIAN Yi-ren
    2023, 44(9):  1058-1062.  doi:10.3969/j.issn.1007-3205.2023.09.013
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    Objective  To investigate the early predictive value of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT),  interleukin-6 (IL-6) and D-dimer (D-D) in children with sepsis secondary to soft tissue infection. 
    Methods  In total, 138 children with soft tissue infection admitted to the Department of Orthopedics were selected as the soft tissue infection group, and were divided into a common infection group (n=99) and a sepsis group (n=39) based on presence of secondary sepsis. Additionally, 68 normal children during the same period were selected as the control group, and all children were tested for CRP, ESR, PCT, IL-6, and D-D for comparison. 
    Results  The levels of CRP, ESR, PCT, IL-6, and D-D in the soft tissue infection group were higher than those in the normal control group (P＜0.05). The levels of CRP, ESR, PCT, IL-6, and D-D in the common infection group were all lower than those in the sepsis group (P＜0.05). Logistic regression analysis showed that CRP≥35 mg/L, ESR ≥44 mm/1 h, PCT ≥0.08 g/L, IL-6 ≥11 pg/L, and D-D ≥0.72 mg/L were independent risk factors for soft tissue infection-induced sepsis in children. The receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) values of CRP, ESR, PCT, IL-6, and D-D alone and in combination were 0.578, 0.680, 0.784, 0.881, 0.824, and 0.921, respectively. The AUC values of the combined detection of five indicators were greater than those of individual detection. 
    Conclusion  The levels of CRP, ESR, PCT, IL-6 and D-D are significantly increased in children with soft tissue infection, which are independent risk factors of sepsis secondary to soft tissue infection. The combined detection of five indicators has higher value in prediction and diagnosis of secondary sepsis. 

    The effect of PRF membrane covering the surface of Bio-oss bone graft material on the soft tissue augmentation of dental implants in aesthetic area of anterior teeth and its aesthetic effect
    DUAN Li-li, XUE Yi, GUO Kang, LIU Qi, BIAN Yu-xin, LI Hui
    2023, 44(9):  1063-1067.  doi:10.3969/j.issn.1007-3205.2023.09.014
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    Objective  To investigate the effect of platelet-rich fibrin (PRF) membrane covering the surface of Bio-oss bone graft material on the soft tissue augmentation of dental implants in the aesthetic area of anterior teeth and its aesthetic effect. 
    Methods  A total of 80 patients receiving implantation (single tooth) in the aesthetic area of anterior teeth were selected and divided into the control group (n=40) and the research group (n=40) by random number table method. In the control group, the surface of Bio-oss bone graft material was covered with Bio-gide biofilm, and in the research group the surface of Bio-oss bone material was covered with PRF film. Wound healing time in the implantation area, excellent and good rate of implantation, soft tissue increment (increase in width of attached gingiva, increment in thickness of attached gingiva) after implantation, occlusal force, chewing efficiency, inflammatory factors of gingival crevicular fluid ［high sensitivity C-reactive protein (hs-CRP), matrix metalloproteinase-2 (MMP-2), interleukin-6 (IL-6)］ levels, anterior teeth esthetics ［pink ethetic scot (PES), white esthetic score (WES)］ were compared between two groups. 
    Results  The wound healing time in the implantation area in the research group was shorter than that of the control group, and the excellent and good rate of implantation was higher than that of the control group (P＜0.05). At 3 months and 6 months after implantation, the increment of gingival width and gingival thickness of the research group was greater than that of the control group, and the difference was statistically significant (P＜0.05). The increment of gingival width and gingival thickness of the research group at 6 months after implantation was greater than that of the control group at 3 months after implantation, and the difference was statistically significant (P＜0.05). At 6 months after implantation, the occlusal force and masticatory efficiency of the two groups were higher than those immediately after implantation, which were higher in the research group than in the control group, and the difference was statistically significant (P＜0.05). At 3 weeks after implantation, hs-CRP, MMP-2, and IL-6 levels in the gingival sulcus fluid of the two groups were lower than those immediately after implantation, which were lower in the research group than in the control group, and the difference was statistically significant (P＜0.05). At 6 months after implantation,the PES and WES scores of the two groups were higher than those immediately after implantation, which were higher in the research group than in the control group, and the difference was statistically significant (P＜0.05). 
    Conclusion  PRF membrane covering the surface of Bio-oss bone graft material can more effectively improve the soft tissue increment of dental implant in the esthetic area of anterior teeth, effectively promote the wound healing of the implantation area, improve the excellent and good rate of implantation, and improve the oral function and aesthetic effect of patients. 

    Effect of monitoring the depth of anesthesia by bispectral index during open heart surgery under cardiopulmonary bypass
    HUANG Hong-mei, LI Xi-song, QIN Si-ping, LI Hui-wei
    2023, 44(9):  1068-1073.  doi:10.3969/j.issn.1007-3205.2023.09.015
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    Objective  To observe the effect of monitoring the depth of anesthesia by bispectral index (BIS) during open heart surgery under cardiopulmonary bypass. 
    Methods  We selected 40 patients who underwent openheart surgery under cardiopulmonary bypass in People′s Hospital of Baise City, and divided them into two groups randomly, with 20 patients in each group. During anesthesia induction, 0.05 mg/kg of midazolam, 10 μg/kg of fentanyl, 0.3 mg/kg of cis-atracurium and 0.3 mg/kg of etomidate were given intravenously in both groups, and booster drugs were given to increase blood pressure if blood pressure dropped during induction period. The BIS values were observed and recorded at different time points, including immediately after intubation (T0), immediately after sternotomy (T1), at 10 min after the initiation of cardiopulmonary bypass (T2), at the time of the lowest nasal temperature (T3), the time of rewarming to 36 degrees (T4), the time of stopping cardiopulmonary bypass (T5). 0.5 μg·kg-1·h-1 dexmedetomidine was continuously pumped into both groups during the maintenance period of anesthesia, and 10 μg/kg of fentanyl was supplemented before skin cutting and sternotomy. In the observation group B, the dosage of propofol was adjusted by the change of BIS value, and the BIS value was maintained in the range of 40-60 during the operation. In the control group, BIS monitoring was also used but the chief anesthesiologist was blinded to the BIS values. The intraoperative dosage was adjusted by the anesthesiologist according to the traditional standard of blood pressure and heart rate. The intraoperative BIS values of the control group were collected from the monitoring records after the operation. The blood pressure of the two groups was kept within 20% of the preoperative basic value through the pump injection of vasoactive drugs. In this study, all of the key variables were recorded in detail, including the total dosage of propofol, vasoactive drugs and fentanyl; duration of anesthesia, duration of operation, the blocking time of ascending aorta, the time before establishing cardiopulmonary bypass, the time of postoperative extubation and the time totransfer out of cardiosurgery intensive care unit (CSICU) after surgery, the intraoperative memory of the patients within 3 days after the operations, and the date of postoperative discharge. 
    Results  There was no statistically significant difference in the total amount of fentanyl used during surgery between two groups (P＞0.05). The total amount of propofol used during surgery in the observation group was smaller than that in the control group, and the amount of vasoactive drugs used during surgery was smaller than that in the control group (P＜0.05). The BIS values of the observation group were higher than those in the control group at all time points. The BIS values of both groups first decreased， and then increased with time, and then stabilized between groups, and the differences of interaction between groups,time points, and time points between groups were statistically significant (P＜0.05). The observation group had shorter time to tracheal extubation and length of hospitalization than the control group (P＜0.05). There was no statistically significant difference in the time to transfer out of CSICU after surgery (P＞0.05). 
    Conclusion  The application of BIS in monitoring the depth of anesthesia during open heart surgery under cardiopulmonary bypass is of great value. It can reduce the use of narcotic and maintain hemodynamic stability through individualized medication under the guidance of BIS monitoring on the premise of ensuring the smooth operation. 

    Effects of lung recruitment with different oxygen concentrations on patients undergoing surgery for lung cancer and Probit attribution analysis of pulmonary complications
    ZHANG Min, LIANG Zheng, LI Chao-yu
    2023, 44(9):  1074-1079.  doi:10.3969/j.issn.1007-3205.2023.09.016
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    Objective  To study and analyze the effects of lung recruitment with different oxygen concentrations combined with positive end-expiratory pressure(PEEP) on stress response in patients with lung cancer and related factors of postoperative pulmonary complications. 
    Methods  A total of 208 patients with non-small cell lung cancer (NSCLC) who underwent unilateral radical resection of lung cancer in our hospital were selected as the research subjects for retrospective analysis. According to the different oxygen concentrations, they were divided into the observation group ［fraction of inspiration O2 (FiO2) adjusted to 30%, n=124］ and the control group (FiO2 adjusted to 80%, n=84). Clinical indications, complications and influencing factors of complications were observed in two groups. "The number of types of pulmonary complications in a single individual" was applied to distinguish the previous "total number of single complications in a single individual", and "the influential factors of the number of types of pulmonary complications explored by Poisson probability regression analysis"was used to distinguish "the influential factors of complications or prognosis by binary logisitc regression analysis". 
    Results  The dose of remifentanil (1.26±0.32) mg and rocuronium bromide (78.39±10.59) mg, duration of operation (125.92±24.18) min, duration of anesthesia (152.42±31.23) min, and length of hospital stay (5.29±0.72) d in the control group were higher or longer than those in the observation group ［(1.15±0.35) mg, ( 71.38±10.35) mg, (113.35±23.67) min, (132.88±28.67) min, and (4.45±0.72) d］ in the observation group (P＜0.05). The number of cases ［8(6.45%)］ with pleural effusion and the number of types of complications in the observation group ［17 cases (13.71%) of 1 type, 3 cases (2.42%) of 2 types］ were lower than those in the control group ［33 cases (39.29%) of 1 type, 16 cases (19.05%) of 2 types, 1 case (1.19%) of 3 types］, and the difference was statistically significant (P＜0.05). The factors influencing the number of types of pulmonary complications were grouping (different oxygen concentrations), smoking history, drinking history, hypertension, operation site, diabetes, pulmonary function status, American Society of Anesthesiologists(ASA) classification, age, duration of operation, intraoperative blood volume, cortisol, adrenocorticotropichormone(ACTH), dosage of remifentanil, forced expiratory volume in one second (FEV1), maximum ventilatory volume/minute(MVV), and oxygenation index. 
    Conclusion  Lung recruitment with low concentration of oxygen is superior to that with high concentration, which can improve pulmonary function, promote oxygenation, and reduce complications. It should be noted that the occurrence of pulmonary complications is affected by various indicators, such as treatment conditions, basic conditions, anesthesia conditions and stress response, so as to optimize treatment and nursing measures.

    The role of HR-MR VWI in evaluating the remodeling of VBD vessel wall and its predictive value for cerebral infarction
    XIAO Yao, KANG Zhi-lei, GENG Zi-hui, WANG Xin-ying, GUAN Tie-gang, LIU Bing
    2023, 44(9):  1080-1086,1092.  doi:10.3969/j.issn.1007-3205.2023.09.017
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    Objective  To investigate the role of high-resolution MR magnetic resonance vessel wall imaging (HR-MR VWI) in evaluating the remodeling of vertebrobasilar dolichoectasia (VBD) and its predictive value for cerebral infarction. 
    Methods  A total of 200 VBD patients were selected and underwent HR-MR VWI examination. The patients were divided into the occurrence group (n=44) and the non-occurrence group (n=156) according to occurrence of cerebral infarction within 6 months. The vessel wall remodeling, vessel wall characteristics, and plaque characteristics were compared between two groups. Pearson analysis was used to analyze the relationship between vessel wall remodeling index and the narrowest luminal stenosis rate and plaque load. The relevant influencing factors of cerebral infarction in VBD patients and the value of HR-MR VWI parameters in predicting the occurrence of cerebral infarction in VBD were analyzed. 
    Results  There was a significant difference between the occurrence group and the non-occurrence group with respect to the vessel wall remodeling (P＜0.05). Vessel area and wall area at the narrowest slice, the narrowest luminal stenosis rate and plaque load were higher than those in the non-occurrence group, and the number of unstable plaque was more than that in the non-occurrence group (P＜0.05). The wall remodeling index was positively correlated with the narrowest luminal stenosis rate and plaque load (P＜0.05). Positive remodeling, vessel area and wall area at the narrowest slice,the narrowest luminal stenosis rate, unstable plaque, and plaque load were independently associated with cerebral infarction in patients with VBD (P＜0.05). The area under ther receiver operating characteristic(ROC) curve (AUC)of the combination of positive remodeling, vessel area and vessel wall area at the narrowest slice, the narrowest luminal stenosis rate, unstable plaque, and plaque load in predicting cerebral infarction was greater than that predicted by a single indicator detection. 
    Conclusion  HR-MR VWI examination has high evaluation value for vessel wall remodeling of VBD, vessel wall characteristics and plaque. The combined detection of each index can be used in clinical prediction of complicated cerebral infarction, and provides a reference for clinical intervention plan.

    Ultrasonographic study on placental blood flow status, fetal middle cerebral artery blood flow and cerebroplacental ratio in predicting late-onset fetal growth restriction
    KONG Ya-rong, GU Ye, LIU Yi-ning, ZHAO Yan
    2023, 44(9):  1087-1092.  doi:10.3969/j.issn.1007-3205.2023.09.018
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    Objective  To study placental blood flow status, fetal middle cerebral artery (MCA) blood flow and cerebroplacental ratio (CPR) in predicting late-onset fetal growth restriction. 
    Methods  A total of 120 women with limited fetal delivery in our hospital were selected as the case group, while 60 women with normal fetal delivery during the same period were selected as the control group. The placental blood flow status, CPR and MCA blood flow parameters were detected by three-dimensional Doppler ultrasound. The clinical baseline data were analyzed by univariate analysis. The influencing factors of fetal growth were determined by Logistic regression analysis. Receiver operating characteristics (ROC) curve was used to analyze various indicators and Logistic regression analysis was used to analyze the diagnostic efficacy. 
    Results  The parameters of placental blood flow state, including blood flow index (FI), vascularization index (VI) and vascularization-blood flow index (VFI), of the pregnant women in the case group were significantly lower than those of control group. Pulsatility index (PI), resistance index (RI) and CPR were significantly lower in the case group than in the control group, while EDV was significantly higher in the case group than in the control group. CPR was positively correlated with FI, VI, VFI, PI and RI (r=0.185, 0.594, 0.854, 0.696, 0.701, P＜0.05), but negatively correlated with EDV (r=-0.452, P＜0.05). Logistic regression analysis showed that FI, VI, VFI, PI, RI, EDV and CPR were the influencing factors of FGR. 
    Conclusion  CPR, placental blood flow status and MCA blood flow parameters are abnormal in pregnant women with FGR. CPR, FI, VI, VFI, PI, RI and EDV parameters alone and Logistic regression analysis can be applied to the prediction and diagnosis of FGR.

    Correlation analysis of methylase DNMT3B, forkhead box protein C1 and ultrasound characteristics of cervical cancer
    CHEN Ran, XIAO Bin, GUAN Xin, QIAO Jin-ying
    2023, 44(9):  1093-1098.  doi:10.3969/j.issn.1007-3205.2023.09.019
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    Objective  To analyze the correlation between DNA methyltransferase 3B (DNMT3B), forkhead box protein C1 (FOXC1) and ultrasonic characteristics of cervical cancer, in order to provide more means for clinical diagnosis of cervical cancer. 
    Methods  A total of 117 patients with cervical cancer admitted to our hospital (research group) and 50 healthy physical examinees (control group) during the same period were selected as the research subjects. The expression of DNMT3B and FOXC1 was detected, and the relationship of DNMT3B and FOXC1 with Adler rade of color Doppler ultrasound parameters and the clinical characteristics of patients was analyzed. The clinical significance of DNMT3B and FOXC1 in cervical cancer was explored. 
    Results  DNMT3B and FOXC1 in the research group were higher than those in the control group, which were positively correlated with Adler grade, carbohydrate antigen 125 (CA125), and carbohydrate antigen 199 (CA199) (P＜0.05). DNMT3B was associated with tumor size, high-risk human papillomavirus (HR-HPV) (-/+), lymph node metastasis and international federation of gynecology and obstetrics (FIGO) stage. FOXC1 was related to tumor differentiation and FIGO stage. 
    Conclusion  DNMT3B and FOXC1 expression in cervical cancer is related to results of  dynamic ultrasound for cervical cancer. DNMT3B and FOXC1 expression levels in cervical cancer patients increase with the increase of Adler grade, and DNMT3B and FOXC1 are positively correlated with CA125 and CA199 expression, suggesting that DNMT3B and FOXC1 expression has certain value in the diagnosis of cervical cancer.