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Table of Content

    02 January 2024, Volume 44 Issue 12
    Previous Issue   
    Comparison of biological characteristics between menstrual blood mesenchymal stem cells and human umbilical cord mesenchymal stem cells
    SUN Cong, XUE Guo-yu, ZHOU Gui-yuan, LI Jing-ze, CHEN Wei, SHAO Su-xia
    2023, 44(12):  1370-1378.  doi:10.3969/j.issn.1007-3205.2023.12.002
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    Objective To compare the biological characteristics of menstrual blood mesenchymal stem cells (MenSCs) with human umbilical cord mesenchymal stem cells (hUCMSCs). 
    Methods Mesenchymal stem cells (MSCs) were isolated from menstrual blood and umbilical cord. The surface markers and cell proliferation of two kinds of stem cells were compared by flow cytometry, immunocytochemistry and CCK8 assay. Experimental groups were divided into control group, MenSCs-CM group, and hUCMSCs-CM group. The effects of two kinds of stem cells on the proliferation, migration and angiogenesis on human umbilical vein endothelial cells (HUVECs) were detected by CCK8 assay, scratch assay and angiogenesis assay. 
    Results Both kinds of stem cells adhered to the wall and were fusiform. There was high expression of CD90, CD44, CD73, CD105, low expression of CD14, CD45, CD34, and no expression of HLA-DR. Both MenSCs and hUCMSCs expressed SOX2 and VEGFA, but MenSCs had highly expressed OCT4. The results showed that proliferation, migration and angiogenesis of HUVECs in both the MenSCs-CM group and hUCMSCs-CM group were higher than those in the control group (P＜0.05). The MenSCs-CM group was superior to the hUCMSCs-CM group with respect to proliferation and angiogenesis of HUVECs (P＜0.05). 
    Conclusion Both kinds of cells have the properties of mesenchymal stem cells, but MenSCs also have the properties of embryonic stem cells. Both MenSCs and hUCMSCs can promote the proliferation, migration and angiogenesis of HUVECs, but the effect of MenSCs is better than hUCMSCs. 

    Effect of silver ion on IL-6, TNF-α, and TGF-β expretion in periodontal tissues of rats with experimental periodontitis
    DU Ning, LIU Xin, LI Kai, TIAN A-lin, ZHANG Xiao-xiao, LIU Xue-cong
    2023, 44(12):  1379-1385.  doi:10.3969/j.issn.1007-3205.2023.12.003
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    Objective To observe the expression of interleukin-6 （IL-6）, tumor necrosis factor-α （TNF-α） and transforming growth factor-β （TGF-β） in periodontal tissues of rats with experimental periodontitis and to explore the therapeutic effect of silver ion on periodontitis after establishment of the animal model of experimental periodontitis by ligating the periodontium of rats, and administration of active silver ion antibacterial solution to perriodontium.  
    Methods A total of 70 purebred, healthy, 6-month-old male SD rats were selected, and 10 rats were randomly selected for periodontitis model identification by ligating the tooth neck of maxillary bilateral first molars. After successful periodontal ligation and establishment of periodontitis models in 60 rats, they were randomly divided into three groups, namely, physiological saline group 1 (n=20), iodoglycerin group 2 (n=20), silver ion group 3 (n=20) with physiological saline, iodoglycerin, and active silver ion antibacterial solution injected in periodontal pockets of rats, respectively. At 4 weeks after treatment, 10 rats from each group were randomly selected and sacrificed, and maxillary bone specimens were taken for sectioning and staining for observation and analysis. The remaining 10 rats in each group were treated with periodontal ligature removal, and the same administration method was used. Physiological saline group 2, iodoglycerin group 2, silver ion group 2 were given physiological saline, iodoglycerin, and active silver ion antibacterial solution, respectively. At 4 weeks after treatment, all rats were sacrificed, and maxillary bone specimens were taken for sectioning and staining for observation and analysis. 
    Results Observation of the joint sections of the tooth body and periodontal tissue of the rat maxillary first molar was performed under histological light microscopy. At 4 weeks after ligation, an increase in epithelial nail processes was observed, and inflammatory cell infiltration was observed in the connective tissue. Combined with epithelial proliferation towards the root, periodontal pockets were formed, with disordered arrangement of periodontal fibers and resorption of alveolar bone. An animal model of experimental periodontitis in rats was successfully established. At 4 and 8 weeks after ligation and administration, the OD values of IL-6 and TNF-α in iodoglycerin group 1 and 2 and silver ion group 1 and 2 were lower than those in physiological saline group 1 and 2, and the OD value of TGF-β was higher than that inphysiological saline group 1 and 2, with a statistically significant difference (P＜0.05). The OD value of IL-6 in silver ion group 1 and 2 was lower than that in iodoglycerin group 1 and 2, while the OD value of TGF-β was higher than that in iodoglycerin group 1 and 2, and the difference was statistically significant (P＜0.05). The OD value of TNF-α in iodoglycerin group 1 and 2 and silver ion group 1 and 2 was not statistically significant (P＞0.05). 
    Conclusion Experimental rat model of periodontitis has been successfully established by wire ligation of tooth neck of maxillary bilateral first molars. The active silver ion antibacterial solution can inhibit the expression of IL-6 and TNF-α, and promote the expression of TGF-β in the periodontal tissue of periodontitis rats. By exploring the correlation between three factors and periodontal inflammation, we can provide a new basis for the research of the pathogenesis of periodontitis. 

    Expression of miR-130b-3p in renal cell carcinoma and the mechanism of PI3K/AKT pathway involvement
    TAN Chao, CHEN Hai-bin, LI Ke-ji, ZHAO Jian-jun
    2023, 44(12):  1386-1392.  doi:10.3969/j.issn.1007-3205.2023.12.004
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    Objective To explore the effect and mechanism of miR-130b-3p regulating PI3K/AKT pathway on the biological behavior of renal cancer cells. 
    Methods A total of 78 renal cancer patients were clinically selected. The protein levels of miR-130b-3p and PTEN in tumor tissues and adjacent tissues were detected, and the relationship between miR-130b-3p and pathological features of renal cancer was analyzed. The correlation between miR-130b-3p and PTEN protein in renal cancer tissue was explored by correlation analysis. 786-O cells were divided into negative control (NC) group, miR-130b-3p, PTEN and miR-130b-3p+PTEN groups. NC, miR-130b-3p mimic and/or pcDNA 3.1 PTEN were transfected to overexpress miR-130b-3p and/or PTEN, respectively. The cell viability, apoptosis rate, invasion ability and PI3K/AKT pathway level in each group were detected respectively. 
    Results The level of miR-130b-3p in renal cancer tissues was significantly higher than that in adjacent tissues (P＜0.05). The expression level of miR-130b-3p was independent of gender, age and tumor diameter. High level of miR-130b-3p was associated with high clinical stage and lymphatic metastasis (P＜0.05), with miR-130b-3p targeted binding to PTEN (P＜0.05). Compared with the NC group, the PTEN protein and apoptosis rate of the miR-130b-3p group were significantly decreased, and the proliferation activity, invasion ability and PI3K/AKT pathway were significantly increased (P＜0.05). In the PTEN group, the PTEN protein and apoptosis rate were significantly increased, while the proliferation activity, invasion ability and PI3K/AKT pathway were significantly inhibited (P＜0.05). The PTEN protein and apoptosis rate of the miR-130b-3p+PTEN group were significantly higher than those of the miR-130b-3p group and significantly lower than those of the PTEN group, while the proliferation activity, invasion ability and PI3K/AKT pathway were significantly lower than those of the miR-130b-3p group, and significantly higher than those of the PTEN group (P＜0.05). 
    Conclusion miR-130b-3p is upregulated in renal cancer tissues, and high levels of miR-130b-3p are associated with high clinical stage and metastasis in renal cancer patients. miR-130b-3p can regulate PI3K/AKT pathway, inhibit the expression of PTEN protein, promote the invasion of renal cell carcinoma cells and inhibit apoptosis. 

    Screening of hub genes in skin lesions of psoriasis and exploration of potential immune mechanisms
    LEI Ming-jun, LI Wen-xue, ZHAO Jun, BAI Fan
    2023, 44(12):  1393-1399.  doi:10.3969/j.issn.1007-3205.2023.12.005
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    Objective To screen the pathogenic hub genes of psoriasis by machine learning algorithm and to explore the potential mechanism of immune cell subtype recruitment. 
    Methods Transcriptome sequencing data sets of psoriasis lesional samples (LS) (n=44) and non-lesional tissue samples (NLS) (n=44) were downloaded from public database (GSE142582,GSE161683 GSE121212). We screened differentially expressed genes (DEGs) between LS and NLS. The machine learning algorithm was applied to screen the hub genes, and ssGSEA was used to calculate the immune cell infiltration (ICI) level in the samples. The correlation between hub genes expression level and ICI level was analyzed. 
    Results A total of 151 DEGs were screened out in this study. Four hub genes were identified by WGCNA and LASSO regression analysis, which were CCL20, TNFRSF17, ALDH3A1 and EPN3. The four genes had good diagnostic efficacy. CCL20 and TNFRSF17 positively regulated the ICI in LS, while ALDH3A1 and EPN3 negatively regulated ICI in NLS. 
    Conclusion Four genes, including CCL20, ALDH3A1, EPN3 and TNFRSF17, have good diagnostic efficacy in psoriasis lesions. CCL20 and TNFRSF17 are positively correlated with ICI level in LS, which may recruit immune cells. However, ALDH3A1 and EPN3 may negatively regulate immune response and play a protective role in skin. CCL20, ALDH3A1, EPN3 and TNFRSF17 may be the potential biomarkers and therapeutic targets of psoriasis. 

    Clinical significance of annulus fibrosus repair for the recovery of spinal motor function after minimally invasive nucleus pulposectomy
    BA Yi-dong, LI Peng-fei, JIA Nan, JIN Xian-hui, WANG Jing-xing, YANG Hu
    2023, 44(12):  1400-1407.  doi:10.3969/j.issn.1007-3205.2023.12.006
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    Objective To investigate different ways of annulus fibrosus repair after transforaminal endoscopic nucleus pulposectomy in the treatment of lumbar disc herniation and clinical outcomes. 
    Methods In total, 128 patients with lumbar disc herniation were treated with minimally invasive transforaminal endoscopic nucleus pulposectomy via the lateral-posterior approach. All patients underwent transforaminal endoscopic nucleus pulposectomy (using TESSYS technology). Thirty-two patients in the control group were directly withdrawn from the working channel without any routine treatment after simple removal of the nucleus pulposus. The experimental group was divided into three groups according to different repair methods of annulus fibrosus repair before surgery: the radiofrequency group (n=32) was treated with bipolar radiofrequency to ablate and shrink the ruptured fibrous ring; 32 patients in the protein glue group were treated with medical biological protein glue to locally seal the damaged area of the fibrous ring before the end of the surgery. Another 32 patients in the artificial dura mater group were treated with artificial dura mater slices (5 mm×5 mm) placed at the damaged area of the fibrous ring. Visual analog scale (VAS) pain score, Oswestry disability index (ODI), MRI T2 weighted image signal intensity, and nucleus pulposus removal volume (cm3) lumbar curvature index (LCI) and intervertebral space height were compared in the four groups. 
    Results The incisions of all postoperative patients healed in stage I, and there were no early postoperative complications. All patients were followed up for 10-22 months, with an average of 18 months. During the follow-up period, the patient had no typical symptoms of postoperative nucleus pulposus protrusion. Postoperative follow-up did not show any adverse reactions of two absorbable implant materials, biological protein glue and artificial dura mater. During the follow-up period, there were no complications such as intervertebral space infection, cerebrospinal fluid leakage, and epidural hematoma. There was no statistically significant difference in preoperative ODI score, lower back VAS pain score, and lower limb VAS pain score among groups (P＞0.05). At the 2-year follow-up after surgery, all three indicators in each group showed significant improvement compared with those before surgery (P＜0.05). There was no significant difference among four groups (P＞0.05). There was no significant difference in signal intensity of T2 weighted MRI images of intervertebral discs among the groups before surgery (P＞0.05). There was a significant difference between the 2-year follow-up after surgery and before surgery (P＜0.05). There was a significant difference in signal intensity among four groups of intervertebral disc MRI T2 weighted images at 2-year follow-up (P＜0.05). Before surgery, there was no significant difference in LCI and intervertebral space height among four groups (P＞0.05). And the 2-year follow-up after surgery, the LCI and intervertebral space height of the four groups were all lower than those before surgery (P＜0.05), and there was no significant difference in LCI among four groups (P＞0.05). The intervertebral space height of the radiofrequency group, protein glue group, and artificial dura mater group was higher than that of the control group (P＜0.05). The volume of nucleus pulposus removal during surgery in the radiofrequency group, protein glue group, and artificial dura mater group was (4.1 ± 1.8) cm3, (4.2±1.4) cm3, and (4.0 ± 1.6) cm3, respectively, which was greater than the volume of nucleus pulposus removal in the control group ［(3.9±1.9) cm3］, and the difference was significant (P＜0.05). At 3 and 6 months after surgery, the spinal motor function measurements in the frequency group, protein glue group, and artificial dura mater group were better than those in the control group (P＜0.05). 
    Conclusion Application of transforaminal endoscopic nucleus pulposectomy and annulus fibrosus repair in the treatment of lumbar disc herniation have great clinical outcomes. More to the point, longer-term results will need further follow-up observation. 

    Clinical observation of rotator cuff tear treated by knotless double-row suture bridge fixation under arthroscope
    LIU Wei, NING Ren-de, FANG Run, ZHENG Han-lin, TAO Xun-xun, PAN Liang-chun
    2023, 44(12):  1408-1412.  doi:10.3969/j.issn.1007-3205.2023.12.007
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    Objective To investigate the value of knotless double-row suture bridge fixation for rotator cuff tear under arthroscope. 
    Methods A total of 80 patients with rotator cuff tears (all patients with medium and large tears) were selected and divided into two groups according to random number table method, with 40 patients in each group. The control group was treated with traditional arthroscopic suture bridge technique, and the observation group was treated with arthroscopic knotless double-row suture bridge fixation. Pain and shoulder joint function scores and rotator cuff retear probability were analyzed at 1 d before surgery and at 2 weeks after surgery. 
    Results There was no significant difference in visual analogue scale (VAS) score and the university of California at Los Angeles shoulder rating scale (UCLA) score between two groups at 1 d before surgery (P＞0.05). At 2 weeks after surgery, the VAS score of the two groups was lower than that at 1 d before surgery, while the UCLA score was higher than that at 1 d before surgery. The VAS score of the observation group was lower than that of the control group, while the UCLA score was higher than that of the control group (P＜0.05). There was no significant difference in shoulder joint mobility between two groups at 1 d before surgery (P＞0.05). At 2 weeks after surgery, the shoulder joint mobility of the two groups was better than that at 1 d before surgery, which was better in the observation group than in the control group (P＜0.05). The average recovery time and weight bearing time of the affected hand in the observation group were shorter than those in the control group (P＜0.05). Compared with the control group, the observation group had a lower incidence of rotator cuff retearing and joint stiffness (P＜0.05). 
    Conclusion The rotator cuff tear can be repaired with arthroscopic knotless double-row suture bridge fixation, which can significantly improve the shoulder joint function, increase the range of motion, and avoid the occurrence of retear. It has the advantages of simple operation, and has a wider range of adaptation in clinical treatment. 

    Meta-analysis and bioinformatics analysis of lncRNA FER1L4 and poor survival of patients with malignant tumors
    ZHANG Shuai, SONG Si-lu, WEI Wei
    2023, 44(12):  1413-1419.  doi:10.3969/j.issn.1007-3205.2023.12.008
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    Objective To verify the relationship between long chain non-coding RNA (lncRNA) fer1 like family member 4 (FER1L4) and the overall survival (OS) of patients with multiple malignant tumors using Meta-analysis and bioinformatics analysis. 
    Methods The related literatures， which were related to relationship between FER1L4 and poor survival of malignant tumor，was retrieved from English and Chinese database including Pubmed,Web of Science, Cochrane Library, Elsevier, ScienceDirect, Chinese national knowledge infrastructure, Wanfang, Vip journal and Chaoxing journal from database inception to May, 2022. Literature screening was carried out according to the inclusion criteria and exclusion criteria, the quality of the included studies was evaluated by the Newcastle-Ottawa scale (NOS), and meta-analysis was carried out by Reviewer Manager 5 software. The gene expression profiling interactive analysis (GEPIA) database was used to search the expression of FER1L4 in patients with various tumors and its relationship with patient survival. 
    Results In total, 519 studies were retrieved and 4 studies were included, including 437 patients with osteosarcoma (OSA), kidney clear cell carcinoma (KIRC),uterine corpus endometrial carcinoma (UCEC) and colon adenocarcinoma (COAD). The abnormal expression of FER1L4 could lead to the decrease of OS in patients with OSA, KIRC, UCEC and COAD ［HR=1.54, 95%CI (1.06,2.23), P=0.02］. FER1L4 was overexpressed in 9 tumors, including bladder urothelial carcinoma (BLCA), cholangiocarcinoma (CHOL), COAD, KIRC, kidney renal papillary cell carcinoma (KIRP), lung adenocarcinoma (LUAD), lung squamous cell carcinoma (LUSC), and rectum adenocarcinoma (READ). The survival rate of patients with KIRC, mesothelioma (MESO), glioblastoma multiforme (GBM), adrenocortical carcinoma (ACC),KIRP and brain lower grade glioma (LGG) with high expression of FER1L4 was lower. 
    Conclusion Different expression levels of FER1L4 have different effects on the survival rate of patients with different tumors, and specific analysis of specific tumor types is required. 

    Evaluation of the effect of modified NRS2002 in nutritional risk screening in patients with acute traumatic fractures
    LI Ran, YANG Zhong-ping, LI Li, WANG Wen-qiang, KANG Rui-xue, HU Ruo-mei
    2023, 44(12):  1420-1426.  doi:10.3969/j.issn.1007-3205.2023.12.009
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    Objective To apply the nutritional risk screening 2002 (NRS2002) and the modified version of NRS2002 (the modified NRS2002) in the nutritional assessment of patients with traumatic fractures, and to evaluate the efficacy of the two screening expressions in order to rationally select screening tools, detect nutritional deficiencies as early as possible and provide nutritional support for patients with traumatic fractures. 
    Methods A total of 271 fracture patients admitted for acute trauma were selected for nutritional risk screening by using NRS2002 and the modified NRS2002. The sensitivity and specificity of the two screening tools were analyzed, the consistency of the two screening tools was judged by calculating Kappa values, and the correlation of physical examination indicators and laboratory indicators with nutritional risk was verified. 
    Results Among the 271 patients, 68 (25.1%) were screened for nutritional risk by NRS2002, and 103 (38.0%) were screened for nutritional risk with the modified NRS2002. In patients with nutritional risk (≥3 points) screened by NRS2002 and the modified NRS2002, their upper arm muscle circumference (AMC), triceps skinfold (TSF), grip strength (GS), total protein (TP), albumin (ALB), prealbumin (pALB), calcium, phosphorus, magnesium, red blood cells (RBCs), and hemoglobin (HGB) were lower than those without nutritional risk, while calf circumference (CC), chloride, white blood cells (WBC), and C-reactive protein (CRP) were higher than those of those without nutritional risk (P＜0.05). There was no difference in the physical examination indexes and laboratory indexes of patients with nutritional risk (≥3 points) screened by the modified NRS2002 and NRS2002. The consistency test of the modified NRS2002 and NRS2002 results was good (Kappa=0.673, P＜0.05), and the area under the receiver operating characteristic (ROC) curve of the modified NRS2002 was 0.894. At one week afterwards, the positive rate of NRS2002 re-screening of patients without nutritional risk (＜ 3 points) was significantly higher than that of the modified NRS2002 (P＜0.05). AMC, TSF, GS, ALB, pALB, and HGB were negatively correlated with NRS2002 and the modified NRS2002 (P＜0.05), while CC was positively correlated with NRS2002 and the modified NRS2002 (P＜0.05). 
    Conclusion The screening results of the modified NRS2002 are generally consistent with those of NRS2002. The sensitivity of the modified NRS2002 is higher in nutritional risk screening, and the positive rate of re-screening after one week is low, indicating that its ability to detect the nutritional risk of patients is superior to that of NRS2002. BMI, AMC, TSF, GS, ALB, pALB, HGB and other factors related to the occurrence of nutritional risk. Therefore, it can be used in combination with the modified NRS2002 to assess the nutritional risk of patients. 

    Correlation analysis of perioperative blood transfusion with serum HGB, PLT and HCT levels after developmental dislocation of the hip
    WANG Jun, GE Yan-ling, WANG Mo-ran, HAN Chen-xi, LI Xing-chen, WANG Xiao-jie
    2023, 44(12):  1427-1431.  doi:10.3969/j.issn.1007-3205.2023.12.010
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    Objective To study the correlation of perioperative blood transfusion with hemoglobin (HGB), platelet count (PLT) and hematocrit (HCT) after developmental dislocation of the hip (DDH). 
    Methods The clinical data of 84 children undergoing surgery for DDH in our hospital were retrospectively analyzed. Blood transfusion in children during perioperative period was recorded. The children undergoing blood transfusion were set as the blood transfusion group (n=50), and the children without undergoing blood transfusion were set as the non-transfusion group (n=34). The gender, age, body weight, the affected side, Tonnis grade, duration of operation, and differences in HGB, PLT, and HCT were compared between two groups. Receiver operating characteristic (ROC) curve was used to analyze the value of HGB, PLT, and HCT in predicting perioperative blood transfusion for DDH. Ultimately, multivariate Logistic regression was used to analyze the influencing factors of perioperative blood transfusion for DDH. 
    Results There was no significant difference in gender composition ratio, age, body weight, affected side composition ratio, Tonnis grade composition ratio, and duration of operation between two groups (P＞0.05). The levels of HGB, PLT and HCT in the blood transfusion group were significantly lower in the non-transfusion group, and the difference was statistically significant (P＜0.05). ROC analysis confirmed that HGB, PLT HCT and joint testing could be used to predict perioperative blood transfusion for DDH, and the area under the ROC curve (AUC) was 0.714, 0.852， 0.858 and 0.894, respectively (P＜0.05). Multivariate Logistic regression analysis confirmed that HGB, PLT, and HCT were the influencing factors of perioperative blood transfusion for DDH (P＜0.05). 
    Conclusion There is a high incidence of blood transfusion in the perioperative period of DDH. The incidence of blood transfusion is affected by the reduction of HGB, PLT, HCT and other factors, which warrants close attention of clinicians. 

    Association between serum uric acid levels and recurrent stroke within 1 year of acute ischemic stroke
    LIU Xiao-fen, HUANG Yi-wen, NA Yuan-yuan
    2023, 44(12):  1432-1435.  doi:10.3969/j.issn.1007-3205.2023.12.011
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    Objective To analyze the correlation between serum uric acid (SUA) level and acute ischemic stroke (AIS) patients with recurrent stroke within one year. 
    Methods A total of 98 patients with AIS treated in the Department of Neurology were enrolled, and the patients were regularly followed up to record the recurrence of stroke within one year after discharge and the time of no recurrence of stroke. According to the median SUA of the subjects, the patients were divided into high SUA group (n=49) and low SUA group (n=49), and the basic clinical data of patients, laboratory tests and National Institute of Health Stroke Scale(NIHSS) scores on the day of admission were collected. The recurrent stroke of the two groups was compared, the clinical value of SUA in predicting recurrent stroke was evaluated by ROC curve, and the factors affecting recurrent stroke were explored by binary logistic regression analysis. 
    Results The incidence of recurrent stroke in the low SUA group was significantly lower than that in the high SUA group, and the survival time of patients without recurrent stroke in the low SUA group was longer than that in the high SUA group (P＜0.05). According to the ROC curve, SUA had a higher value in predicting recurrent stroke in AIS patients within one year. In terms of the area under ROC curve (AUC), 95% confidence interval (CI) was 0.85 (0.75-0.94), and the optimal diagnostic threshold was 417.89 μmol/L. The sensitivity under this diagnostic threshold was 0.87, and the specificity was 0.92. Age ＞53.06 years old, LDL-C ＞3.17 mmol/L, SUA ＞349.25 μmol/L, and NIHSS score ＞12.43 were independent risk factors for recurrent stroke within one year in AIS patients (P＜0.05). 
    Conclusion SUA may be an independent risk factor for recurrent stroke within one year in patients with AIS, and is a potential laboratory indicator to help clinicians identify poor prognosis in patients with AIS. 

    Correlation of blood glucose and inflammatory markers with airflow limitation, treatment and prognosis in COPD and clinical significance
    FAN Su-fang, LYU Hou-qiang
    2023, 44(12):  1436-1441.  doi:10.3969/j.issn.1007-3205.2023.12.012
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    Objective To investigate the correlation of blood glucose and inflammatory markers with airflow limitation, treatment and prognosis and clinical significance in chronic obstructive pulmonary disease (COPD). 
    Methods A total of 102 patients with acute exacerbation of COPD were selected, including 30 cases of airflow limitation grade Ⅱ, 38 cases of grade Ⅲ, and 34 cases of grade Ⅳ. Blood glucose, tumor necrosis factor-α (TNF-α), and interleukin-17 (IL-17) were compared between patients with different airflow limitation classification.Pearson analysis was performed to analyze the correlation of blood glucose, TNF-α and IL-17 with airflow limitation classification,and of blood glucose with TNF-α and IL-17.Blood glucose and inflammatory indicators of patients with different treatment outcomes before treatment, at 1 d after treatment, and at 3 d after treatment were compared. Receiver operating characteristic (ROC) and area under the ROC curve (AUC) analysis were used to analyze the value of blood glucose, TNF-α and IL-17 in predicting treatment outcomes at 1 d after treatment and 3 d after treatment. 
    Results The blood glucose, TNF-α and IL-17 of the patients with airflow limitation grades Ⅱ, Ⅲ and Ⅳ were higher than those of patients with grade Ⅱ (P＜0.05). Blood glucose, TNF-α, and IL-17 were positively correlated with airflow limitation classification (r=0.778, 0.828, 0.731, all P＜0.001), and blood glucose was positively correlated with TNF-α and IL-17 (r=0.830, 0.812, both P＜0.001). With prolongation of treatment time, the blood glucose, TNF-α and IL-17 in the good group were decreased gradually (P＜0.001), while there was no significant difference in blood glucose, TNF-α, IL-17 in the poor group, and the difference of interaction between groups, time points and time points between groups were statistically significant (P＜0.05). At 3 d after treatment, the area under the curve (AUC) of each index in predicting the prognosis was greater than that at 1 d after treatment, and the AUC of blood glucose, TNF-α combined with IL-17 in predicting the prognosis of the treatment was the largest at 3 d after treatment. 
    Conclusion Blood glucose, TNF-α and IL-17 are related to COPD airflow limitation and treatment prognosis. Combined detection is expected to be a reliable solution to predict treatment prognosis, so as to provide reference for clinical treatment and promote the relief of symptoms and conditions of patients. 

    Study on the correlation between total bile acid in gastric juice, Helicobacter pylori infection and gastric cancer
    NIU Xiao-lei, CHANG Li-li, GU Pei, ZHANG Hai-ling, WANG Jun-li, LIU Hong-fen
    2023, 44(12):  1442-1447.  doi:10.3969/j.issn.1007-3205.2023.12.013
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    Objective To investigate the relationship of total bile acid (TBA) in gastric juice and helicobacter pylori (Hp) infection with gastric cancer. 
    Methods Sixty patients diagnosed with gastric cancer under gastroscopy were selected as the research group. Adenocarcinoma was diagnosed by pathological examination. During the same period, 60 people for physical examination and with chronic non-atrophic gastritis (CNG) indicated by gastroscope were selected as the control group. Pathology showed no gland atrophy, dysplasia, or intestinal metaplasia. Gastric juice was extracted from the patients to detect the concentration of TBA, the expression of caudal type homeobox 2 (CDX2), mucin 2 (MUC2) and mucin 5AC (MUC5AC) in the tissue specimens were detected by immunohistochemical staining, and rapid urease test and histological modified Giemsa staining were used to detect Hp. 
    Results The TBA concentration in the research group was higher than that in the control group, and the Hp positive infection rate was higher than that in the control group (P＜0.05). There were 32 patients with CDX2 positive expression in the research group, accounting for 53.33%, 33 patients with MUC2 positive expression, accounting for 55.00%, and 25 patients with MUC5AC positive expression, accounting for 41.67%. There was no positive expression of CDX2 and MUC2 in the control group, while MUC5AC was positive in 52 cases, accounting for 86.67%. The positive expression rates of CDX2 and MUC2 in the research group were higher than those in the control group, while the positive expression rate of MUC5AC was lower than that in the control group (P＜0.05). The positive expression rates of CDX2 and MUC2 in the Hp positive group were higher than those in the Hp negative group, while the positive expression rate of MUC5AC was lower than that in the Hp negative group (P＜0.05). Positive Hp and gastric TBA concentration ≥ 300 μmol/L were risk factors for CDX2 and MUC2 positive expression (P＜0.05), and protective factors for MUC5AC positive expression (P＜0.05). 
    Conclusion TBA concentration in gastric fluid ≥ 300 μmol/L and Hp positivity are risk factors for CDX2 and MUC2 positive expression, and are protective factors for MUC5AC positive expression. TBA in gastric fluid and Hp may affect the occurrence of gastric cancer by affecting the expression of CDX2, MUC2, and MUC5AC. 

    Analysis of risk factors of acute biliary pancreatitis
    DU Jun-wei, JIN Jun-hua
    2023, 44(12):  1448-1452.  doi:10.3969/j.issn.1007-3205.2023.12.014
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    Objective Acute biliary pancreatitis (ABP) is caused by multiple factors. The aim of this study was to retrospectively analyze the characteristics of gallstone and biliary duct in patients with gallstones secondary to extrahepatic bile duct stones, so as to understand the risk factors and pathogenesis of ABP, providing the evidence to guide clinical diagnosis and treatment. 
    Methods Retrospective analysis of medical records of patients with biliary stones admitted to the Department of Hepatobiliary Pancreatic and Splenic Surgery, the Affiliated Hospital of Medical University. Comprehensive analysis and grouping comparison were performed on clinical characteristics, laboratory indicators, and imaging characteristics of patients with and without ABP. 
    Results A total of 28 patients with gallstones secondary to extrahepatic bile duct stones were found to have ABP, including 22 with mild acute pancreatitis (MAP)， 3 with moderately severe acute pancreatitis (MSAP), and 3 with severe acute pancreatitis (SAP). One of 28 patients (3.6%) had a fatal outcome. Binary Logistics regression analysis revealed that  diameter of cystic duct ≥5 mm, diameter of the smallest gallbladder stone ＜5 mm， mixed stone in the gallbladder, and pancreaticobiliary maljunction (PBM) remained highly correlated with ABP (OR value： 3.358, 4.414, 7.965 and 6.055, respectively). 
    Conclusion The thickening of cystic duct, mixing of sediment and blocky small stones in the gallbladder, and pancreaticobiliary maljunction are strongly associated with the onset of ABP, which will provide evidence for the diagnosis, treatment and early warning of ABP in the future. 

    Application value of near-infrared spectrometer in monitoring cerebral oxygen saturation during radical operation of senile colorectal cancer
    WANG Lei, XU Xi-ming, SONG Chun-guang
    2023, 44(12):  1453-1459.  doi:10.3969/j.issn.1007-3205.2023.12.015
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    Objective To investigate the application value of near-infrared spectrometer (NRIS) in monitoring cerebral oxygen saturation during radical operation of senile colorectal cancer (CRC). 
    Methods In total, 120 elderly patients with rectal cancer who underwent elective radical surgery for CRC in our hospital were prospectively included as the research subjects. They were randomly divided into a conventional ventilation group (control group, n=60) and a NRIS monitoring technology combined with mechanical ventilation group (research group, n=60) using a random number table method. The arterial blood gas analysis results, as well as the changes in arterial blood carbon dioxide (CO2) partial pressure (PaCO2) and arterial oxygen saturation (SaO2), before surgery (T0), at 5 min before pneumoperitoneum (T1), 20 min after pneumoperitoneum (T2), 1 h after pneumoperitoneum (T3), 2 h after pneumoperitoneum (T4), and 20 min after pneumoperitoneum (T5) were compared between two groups, and cognitive function of the patients at 1 d before surgery, and at 1 d after surgery (M1), 4 d after surgery (M2), and 7 d after surgery (M3) was evaluated using the Montreal Cognitive Assessment Scale (MoCA). Enzyme-linked immunosorbent assay (ELISA) was used to detect serum cortisol and central nervous system specific protein (S-100β), and the intraoperative changes in rSO2 and postoperative neurological complications in each group were recorded. 
    Results There was no statistically significant difference in interactions between groups, time points, and time points between groups in terms of Hb and Lac levels (P＞0.05). There was no statistically significant difference in interactions between groups and time points in terms of PaCO2, rSO2, and pH (P＞0.05). There was no statistically significant difference in interactions between groups and time points in terms of  PaCO2 and pH (P＞0.05). There was a statistically significant difference in interactions between groups and time points in terms of rSO2 (P＜0.05). The MoCA scores of both groups decreased first and then increased with time, and there was a significant difference in the interaction between time points, and time points between groups  (P＜0.05), while there was no significant difference between groups (P＞0.05). Both groups did not experience severe cerebral hypoxia during surgery. The incidence of mild and moderate cerebral hypoxia during surgery, as well as the incidence of postoperative delirium and POCD in the research group, were lower than those in the control group, and the difference was statistically significant (P＜0.05). Before surgery, no significant difference was found in serum cortisol and S-100β in the two groups (P＞0.05). After surgery, the levels of serum cortisol and S-100β were higher than those before surgery, and S-100β level was higher in the research group than in the control group, showing a significant difference (P＜0.05). There was no statistically significant difference in cortisol levels between two groups (P＞0.05).  
    Conclusion The use of NRIS monitoring technology combined with mechanical ventilation can significantly increase rSO2 in elderly colorectal patients undergoing radical resection for CRC, and effectively reduce the risks of cerebral hypoxia during the operation and postoperative neurological complications, which is conducive to reducing the early cognitive dysfunction after operation. 

    Dynamic observation of immunoinflammatory factors during the course of carbon dioxide fractional laser combined with compound betamethasone in vitiligo and their correlation with recurrence
    ZHANG Li-na, LYU Chao, WANG Xin, SHEN Juan, MIAO Guo-ying
    2023, 44(12):  1460-1466.  doi:10.3969/j.issn.1007-3205.2023.12.016
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    Objective To observe the dynamic changes of immunoinflammatory factors during the course of carbon dioxide (CO2) fractional laser combined with compound betamethasone in vitiligo and their correlation with recurrence. 
    Methods One hundred patients with vitiligo who were treated with CO2 fractional laser combined with compound betamethasone in our hospital were selected and divided into recurrence group and non-recurrence group according to the recurrence of the disease at 6 months after healing. The levels of interleukin-17 (IL-17), interferon-γ (IFN-γ) and interleukin-10 (IL-10) were compared between two groups before treatment, after treatment for two times and after completion of treatment, and the factors associated with recurrence were analyzed by logistic regression. The receiver operating characteristic (ROC) curve was used to analyze the value of IL-17, IFN-γ and IL-10 in predicting recurrence after treatment for two times and after completion of treatment. The time to recurrence in patients with different IL-17, IFN-γ, and IL-10 levels was compared, and Pearson analysis was used to analyze the relationship between IL-17, IFN-γ, and IL-10 and time to recurrence. 
    Results There were more patients with family history of vitiligo in the recurrence group than in the non-recurrence group, and the severity of disease was greater than in the non-recurrence group (P＜0.05). IL-17 and IFN-γ levels were higher in the recurrence group than in the non-recurrence group after treatment for two times and after completion of treatment, and IL-10 level was lower than that in the non-recurrence group (P＜0.05). Logistic regression analysis showed that family history of vitiligo, severity of disease, and the levels of IL-17 and IFN-γ were all independent risk factors associated with recurrence, and the levels of IL-10 was a protective factor associated with recurrence (P＜0.05). The AUC of IL-17, IFN-γ, and IL-10 for predicting recurrence after completion of treatment was greater than that of IL-17, IFN-γ, and IL-10 after treatment for two times (Z=3.784, 2.591, 6.264, P＜0.05); the AUC of IL-17+IFN-γ+IL-10 for predicting recurrence after completion of treatment was greater than that of IL-17+IFN-γ+IL-10 after completion of treatment (Z=2.260, P＜0.05). Time to recurrence was shorter in patients with high levels of IL-17 and IFN-γ than in those with low levels, and longer in patients with high levels of IL-10 than in those with low levels (P＜0.05). IL-17 and IFN-γ were negatively correlated with time to recurrence after completion of treatment (r=-0.838, -0.773, P＜0.05), and IL-10 was positively correlated with time to recurrence (r=0.814, P＜0.001). 
    Conclusion The dynamic changes of IL-17, IFN-γ and IL-10 levels during the course of CO2 fractional laser combined with compound betamethasone  in vitiligo are related to recurrence after healing, and the combined detection of the three levels after completion of treatment can be used as a scheme to predict recurrence, thus providing important reference information for clinical prevention and control of recurrence. 

    Epidemiological characteristics and drug resistance of Haemophilus influenzae strains isolated from children with bloodstream infection
    ZHANG Wen-chao, ZHAO Meng-chuan, HE Bao-hua, JIA Zhao-yi, LEI Mei, GUO Ying-hui
    2023, 44(12):  1467-1471.  doi:10.3969/j.issn.1007-3205.2023.12.017
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    Objective To investigate the epidemiological characteristics and drug resistance of Haemophilus influenzae (H. influenzae) isolated from children with bloodstream infection, providing scientific basis for precise prevention and control of bloodstream infection. 
    Methods The distribution and drug susceptibility concerning 44 strains of H. influenzae isolated from blood samples of hospitalized children aged from 3 months to 7 years were analyzed retrospectively in Hebei Children′s Hospital. Bacterial identification， drug susceptibility analysis and β-lactamase detection were performed using VITEK MS, K-B method and cefnothiophene disk method, respectively. The results of drug sensitivity were interpreted according to the breakpoints of the Clinical and Laboratory Standards Institute (CLSI) in 2020. 
    Results Of all patients, 50% (22/44) of the children with bloodstream infection from H. influenzae were infants under the age of 1 years, 95.5% (42/44) cases had clear infection foci, among which 72.7% (32/44) had respiratory tract-related diseases such as pneumonia and bronchitis alone or in combination, and 45.5% (20/44) had meningitis alone or in combination. For 59.1% (26/44) strains of H. influenzae isolated from blood produced β-lactamase, there was the highest resistance rate to cotrimoxazole (75%), followed by ampicillin (61.4%), and the drug resistance rates to chloramphenicol and rifampicin was lower (<10%). All these H. influenzae strains were susceptible to ceftazidime, cefepime, aztreonam, imipenem, meropenem and ciprofloxacin. 
    Conclusion Bloodstream infection from H. influenzae in children is more common in infants under the age of one, and pneumonia and meningitis are its common presentations. The third generation cephalosporin can be used as the first choice for empiric therapy.